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Manipulation of the carrier density of layered transition-metal dichalcogenides (TMDs) is of fundamental significance for a wide range of electronic and optoelectronic applications. Herein, we applied the ionic-liquid-gating (ILG) method to inject the smallest ions, H+, into layered MoS2 to manipulate its carrier concentration. The measurements demonstrate that the injection of H+ realizes a nonvolatile n-type doping and metallic state in multilayer-MoS2 with a concentration of injection electron of â¼1.08 × 1013 cm-2 but has no effect on monolayer-MoS2, which clearly reveals that the H+ is injected into the interlayer of MoS2, not in the crystal lattice. The H+-injected multilayer-MoS2 was then used as the contact electrodes of a monolayer-MoS2 field effect transistor to improve the contact quality, and its performance has been enhanced. Our work deepens the understanding of the ILG technology and extends its application in TMDs.
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AIMS: To assess the associations of diabetes duration and glycaemic control (defined by plasma glycated haemoglobin [HbA1c] level) with the risks of cardiovascular disease (CVD) and all-cause mortality and to determine whether the addition of either or both to the established CVD risk factors can improve predictions. MATERIALS AND METHODS: A total of 435 679 participants from the UK Biobank without CVD at baseline were included. Cox models adjusting for classic risk factors (sociodemographic and anthropometric characteristics, lipid profiles and medication use) were used, and predictive utility was determined by the C-index and net reclassification improvement (NRI). RESULTS: Compared with participants without diabetes, participants with longer diabetes durations and poorer glycaemic control had a higher risk of fatal/nonfatal CVD. Among participants with diabetes, the fully-adjusted hazard ratios (HRs) for diabetes durations of 5 to <10 years, 10 to <15 years and ≥15 years were 1.15 (95% confidence interval [CI] 0.99, 1.34), 1.50 (95% CI 1.26, 1.79) and 2.22 (95% CI 1.90, 2.58; P-trend <0.01), respectively, compared with participants with diabetes durations <5 years. In addition, those with the longest disease duration (≥15 years) and poorer glycaemic control (HbA1c ≥64 mmol/mol [8%]) had the highest risk of fatal/nonfatal CVD (HR 3.12, 95% CI 2.52, 3.86). Among participants with diabetes, the addition of both diabetes duration and glycaemic control levels significantly improved both the C-index (change in C-index +0.0254; 95% CI 0.0111, 0.0398) and the overall NRI for fatal/nonfatal CVD (0.0992; 95% CI 0.0085, 0.1755) beyond the use of the classic risk factors. CONCLUSIONS: Both longer diabetes duration and poorer glycaemic control were associated with elevated risks of CVD and mortality. Clinicians should consider not only glycaemic control but also diabetes duration in CVD risk assessments for participants with diabetes.
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Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Hemoglobinas Glicadas/análise , Controle Glicêmico , Humanos , Fatores de RiscoRESUMO
Heterojunction integrated by two-dimensional/three-dimensional materials has shown great potential applications in optoelectronic devices because of its fast response speed, high specific detectivity and broad spectral response. In this work, the vertical n-Si/p-GaTe heterojunction has been designed and fabricated, which shows a high responsivity up to 5.73 A W-1and a fast response time of 20µs at zero bias benifitting from the high efficiency of light absorption, internal photocurrent gain and strong built-in electrical field. A specific detectivity of 1012Jones and a broad spectral response ranging from 300 to 1100 nm can also be achieved. This work provides an alternative strategy for high-performance self-powered optoelectronic devices.
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Black phosphorus has many potential applications in optoelectronic devices because of its unique properties. Adjusting its performance by doping is an important issue of research. In this paper, we synthesized high-quality Te-doped crystals by the chemical vapor transport method. Tellurium doping with an atomic ratio of 0.1% was confirmed by X-ray photoelectron spectroscopy, X-ray diffraction, and energy dispersive X-ray analysis. The performance of field effect transistors devices shows that the hole mobility of Te-doped black phosphorous (BP) is significantly improved compared with that of undoped-BP. The highest hole mobility at room temperature is 719 cm2 V-1 s-1, and the electron mobility is 63 cm2 V-1 s-1. Te-doped BP field effect transistors show an obvious bipolar behavior.
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Assembling nanoscale building blocks into an orderly network with a programmable layout and channel designs represents a critical capability to enable a wide range of stretchable electronics. Here, we demonstrate the growth-in-place integration of silicon nanowire (SiNW) springs into highly stretchable, transparent, and quasicontinuous functional networks with a close to unity interconnection among the discrete electrode joints because of a unique double-lane/double-step guiding edge design. The SiNW networks can be reliably transferred to a soft elastomer substrate, conformally attached to highly curved surfaces, or deployed as self-supporting/movable membranes suspended over voids. A high stretchability of >40% is achieved for the SiNW network on an elastomer, which can be employed as a transparent and semiconducting thin-film material endowed with a high carrier mobility of >50 cm2/(V s), Ion/Ioff ratio >104, and a tunable transmission of >80% over a wide spectrum range. Reversibly stretchable and bendable sensors based on the SiNW network have been successfully demonstrated, where the local strain distribution within the spring network can be directly observed and analyzed by finite element simulations. This SiNW network has a unique potential to eventually establish a new generically purposed waferlike platform for constructing soft electronics with Si-based hard performances.
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BACKGROUND The aim of this study was to assess the pharmacokinetics after transdermal administration by a novel skin microdialysis technology in rats. The guinea pig model was established by investigating the pharmacodynamics. MATERIAL AND METHODS Three different agents were given after hair removal, and the samples were extracted by microdialysis and detected by HPLC. Subcutaneous/plasma concentration-time curves of the 3 different agents were analyzed and the pharmacokinetic parameters were calculated. The SS-04B UV light therapy instrument was used in the modeling. Changes in melanin index and histopathology were observed with HE staining. RESULTS The increment and decrement results showed that the concentration had no significant effect on drug recovery both in vivo and in vitro. After the paeonol cubic liquid crystalline nanoparticles gel (PAE-LCNPs) was administered, the maximum peak time (tmax) of paeonol skin concentration appeared at 2.42±0.20 h, the maximum skin concentration Cmax was (926±105) ng/ml, and the area under the curve AUC0-8 was (8056±954) ng/h/ml. The tmax was shortened much more than in the other groups, and the performance of PAE-LCNPs targeting was good. Pharmacodynamic results showed that PAE-LCNPs can reduce melanocytes and reduce the melanin index, proving its utility in the treatment of melanin deposition. CONCLUSIONS The skin microdialysis study indicated PAE-LCNPs have good transdermal permeability and efficacy. Pharmacological experiments based on the study found that the topical pigmentation model of guinea pigs showed a better therapeutic effect.
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Acetofenonas/administração & dosagem , Acetofenonas/farmacocinética , Hidrogéis/administração & dosagem , Hidrogéis/farmacocinética , Administração Cutânea , Animais , Portadores de Fármacos/administração & dosagem , Portadores de Fármacos/química , Cobaias , Cristais Líquidos/química , Masculino , Melaninas/metabolismo , Melanócitos/efeitos dos fármacos , Melanócitos/metabolismo , Nanopartículas/administração & dosagem , Nanopartículas/metabolismo , Pigmentação/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Pele/efeitos dos fármacos , Pele/metabolismo , Absorção Cutânea/efeitos dos fármacosRESUMO
OBJECTIVE: To examine the expression of phospholipase A2 receptor (PLA2R) in renal tissues and the level of anti-PLA2R antibody in serum in patients with idiopathic membranous nephropathy (IMN) and secondary membranous nephropathy (SMN), and to evaluate their diagnostic value in IMN.â© Methods: A total of 73 patients, who were diagnosed between May, 2014 and February, 2015 in the Department of Nephrology of the Second Xiangya Hospital, Central South University, were divided into three groups: an IMN group (n=48), an SMN group (n=17) and a minimal change disease group (n=8) according to the renal biopsy. PLA2R expression in renal tissues and the level of anti-PLA2R antibody in serum were detected by indirect immunofluorescence technique.â© Results: The positive rate and fluorescence intensity for PLA2R in the renal tissues in the IMN group were higher than those in the SMN group (91.7% in the IMN group vs 29.4% in the SMN group, P<0.05), while the positive rate and serum level for anti-PLA2R antibody in the IMN group were higher than those in the SMN group (85.4% in the IMN group vs 29.4% in the SMN group, P<0.05); the expression of PLA2R in renal tissues and the serum level for anti-PLA2R antibody were not detected in the minimal change disease group. The serum level of anti-PLA2R antibody was positively correlated with 24 h urine protein (r=0.432, P<0.01) and negatively correlated with serum albumin (r=-0.307, P<0.05).â© Conclusion: The expression of PLA2R in renal tissues and the serum level of anti-PLA2R antibody might be potential markers for diagnosis of IMN.
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Autoanticorpos/sangue , Glomerulonefrite Membranosa/classificação , Glomerulonefrite Membranosa/fisiopatologia , Rim/química , Receptores da Fosfolipase A2/química , Autoanticorpos/imunologia , Biomarcadores/sangue , Biomarcadores/química , Glomerulonefrite Membranosa/imunologia , Humanos , Nefrose Lipoide/imunologia , Proteinúria , Receptores da Fosfolipase A2/imunologiaRESUMO
BACKGROUND: The aim of this study was to optimize the preparation method for self-assembled glyceryl monoolein-based cubosomes containing paeonol and to characterize the properties of this transdermal delivery system to improve the drug penetration ability in the skin. MATERIAL AND METHODS: In this study, the cubic liquid crystalline nanoparticles loaded with paeonol were prepared by fragmentation of glyceryl monoolein (GMO)/poloxamer 407 bulk cubic gel by high-pressure homogenization. We evaluated the Zeta potential of these promising skin-targeting drug-delivery systems using the Malvern Zeta sizer examination, and various microscopies and differential scanning calorimetry were also used for property investigation. Stimulating studies were evaluated based on the skin irritation reaction score standard and the skin stimulus intensity evaluation standard for paeonol cubosomes when compared with commercial paeonol ointment. In vitro tests were performed on excised rat skins in an improved Franz diffusion apparatus. The amount of paeonol over time in the in vitro penetration and retention experiments both was determined quantitatively by HPLC. RESULTS: Stimulating studies were compared with the commercial ointment which indicated that the paeonol cubic liquid crystalline nanoparticles could reduce the irritation in the skin stimulating test. Thus, based on the attractive characteristics of the cubic crystal system of paeonol, we will further exploit the cosmetic features in the future studies. CONCLUSIONS: The transdermal delivery system of paeonol with low-irritation based on the self-assembled cubic liquid crystalline nanoparticles prepared in this study might be a promising system of good tropical preparation for skin application.
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Acetofenonas/administração & dosagem , Administração Cutânea , Cristais Líquidos/química , Pele/efeitos dos fármacos , Acetofenonas/química , Animais , Varredura Diferencial de Calorimetria , Cromatografia Líquida de Alta Pressão , Difusão , Portadores de Fármacos/química , Glicerídeos/química , Masculino , Nanopartículas/química , Poloxâmero/química , Coelhos , Ratos , Ratos Sprague-DawleyRESUMO
OBJECTIVE: To observe the inhibitory effect of gefitineb on the proliferation and its inducing effect on the apoptosis of mouse I-10 Leydig testicular cancer cells in vitro. METHODS: We treated I-10 Leydig testicular cancer cells of mice with gefitineb at 0, 1.25, 2.5, 5, 10, 20, and 40 µmol/L. Then we determined the inhibitory effect of gefitineb on the growth of the cells by MTT, detected their early and late apoptosis by Annexin V-FITC/propidium iodide double staining and Hoechst 33258 nuclear staining, respectively, and observed the expressions of apoptosis-related proteins Bcl-2, Bax and caspase 3/9 by Western blot. RESULTS: Compared with the blank control group, gefitineb significantly inhibited the proliferation of the I-10 cells at 10 and 20 µmol/L (P < 0.05). The survival rate of the cells was (32.4 ± 2.8)% (P < 0.01) and their early and late apoptosis rates were (26.7 ± 4.2)% and (59.33 ± 10.2)% in the 40 µmol/L group, significantly different from those in the control (P < 0.05 and P <0.01). In comparison with the blank control group, gefitineb at 10, 20, and 40 µmol/L increased the expression of pro-apoptotic protein Bax by (41.9 ± 7.1), (60.1 ± 9.8), and (69.0 ± 11.3)% (all P < 0.05), decreased that of apoptosis-inhibitory protein Bcl-2 by (50.3 ± 8.9), (63.9 ± 6.9), and (88.7 ± 13.9)% (all P < 0.05), and elevated that of the cleft proteins caspase-3 by (69.0 ± 6.9)% (P < 0.05), (71.5 ± 8.1)% (P < 0.05), and (110.9 ± 14.2)% (P < 0.01) and caspase-9 by (51.8 ± 4.9), (54.7 ± 6.7), and (43.8 ± 11.8)% (all P < 0.05). CONCLUSION: Gefitineb can increase the cytotoxicity of I-10 Leydig testicular cancer cells of mice and induce their apoptosis via the mitochondria-mediated apoptosis signaling pathway.
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Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Tumor de Células de Leydig/tratamento farmacológico , Proteínas de Neoplasias/metabolismo , Neoplasias Embrionárias de Células Germinativas/tratamento farmacológico , Quinazolinas/farmacologia , Neoplasias Testiculares/tratamento farmacológico , Animais , Proteínas Reguladoras de Apoptose/metabolismo , Caspase 3/metabolismo , Caspase 9/metabolismo , Sobrevivência Celular , Gefitinibe , Tumor de Células de Leydig/metabolismo , Tumor de Células de Leydig/patologia , Masculino , Camundongos , Neoplasias Embrionárias de Células Germinativas/metabolismo , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Testiculares/metabolismo , Neoplasias Testiculares/patologia , Proteína X Associada a bcl-2/metabolismoRESUMO
Objective: In this study, we explore the core and bridge symptoms of demoralization in female cancer patients in China, and provide a basis for precise psychological intervention among female cancer patients. Methods: This study used a cross-sectional survey. Participants were recruited from three third-class hospitals in Jiangsu Province from June 2022 to June 2023 using the convenience sampling method. The severity of each symptom of demoralization was investigated in female cancer patients using the Demoralization Scale (DS). Network analysis was performed using the R language to identify core and bridge symptoms in the network and further explore some characteristic edge connections in the network. Results: The network structure model of demoralization had strong accuracy and stability. In the network, the symptoms with the highest strength centrality were "Discouragement" (C3, strength=2.19), "No self-worth" (A3, strength=1.21), "Don't want to live" (A5, strength=1.20), "Hopeless" (D4, strength=0.81), and "Vulnerability" (B3, strength=0.74), respectively. The bridge strength analysis identified "Hopeless" (D4, bridge strength=0.92), "Discouragement" (C3, bridge strength=0.85), "No self-worth" (A3, bridge strength=0.75), "Poor spirits" (E2, bridge strength=0.71), and "Vulnerability" (B3, bridge strength=0.69) as the bridge symptoms. The strongest edge connections of all dimensions were "No self-worth" and "Worthless" (A3-E6, edge weighting=0.27), "Poor spirits" and "Loss of emotional control" (E2-D1, edge weighting=0.22), "Discouragement" and "Vulnerability" (C3-B3, edge weighting=0.14), and "Hopeless" and "No meaning of survival" (D4-A4, edge weighting=0.12). Conclusion: "Discouragement (C3)", "No self-worth (A3)", "Hopeless (D4)", and "Vulnerability (B3)" are both core symptoms and bridge symptoms. These symptoms can not only trigger a patient's demoralization but also stimulate more severe symptom clusters through interactions. The early recognition of and intervention regarding these symptoms could be important for the prevention and treatment of demoralization among female cancer patients.
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An appropriate level of arousal induces positive emotions, and a high arousal potential may provoke negative emotions. To explain the effect of arousal on emotional valence, we propose a novel mathematical framework of arousal potential variations in the dual process of human cognition: automatic and controlled. A suitable mathematical formulation to explain the emotions in the dual process is still absent. Our model associates free energy with arousal potential and its variations to explain emotional valence. Decreasing and increasing free energy consequently induce positive and negative emotions, respectively. We formalize a transition from the automatic to the controlled process in the dual process as a change of Bayesian prior. Further, we model emotional valence using free energy increase (FI) when one tries changing one's Bayesian prior and its reduction (FR) when one succeeds in recognizing the same stimuli with a changed prior and define three emotions: "interest," "confusion," and "boredom" using the variations. The results of our mathematical analysis comparing various Gaussian model parameters reveals the following: (1) prediction error (PR) increases FR (representing "interest") when the first prior variance is greater than the second prior variance, (2) PR decreases FR when the first prior variance is less than the second prior variance, and (3) the distance between priors' means always increases FR. We also discuss the association of the outcomes with emotions in the controlled process. The proposed mathematical model provides a general framework for predicting and controlling emotional valence in the dual process that varies with viewpoint and stimuli, as well as for understanding the contradictions in the effects of arousal on the valence.
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Nível de Alerta , Emoções , Humanos , Teorema de Bayes , Cognição , EntropiaRESUMO
This work proposed KidneyRegNet, a novel deep registration pipeline for 3D CT and 2D U/S kidney scans of free breathing, which comprises a feature network, and a 3D-2D CNN-based registration network. The feature network has handcrafted texture feature layers to reduce the semantic gap. The registration network is an encoder-decoder structure with loss of feature-image-motion (FIM), which enables hierarchical regression at decoder layers and avoids multiple network concatenation. It was first pretrained with a retrospective dataset cum training data generation strategy and then adapted to specific patient data under unsupervised one-cycle transfer learning in onsite applications. The experiment was performed on 132 U/S sequences, 39 multiple-phase CT and 210 public single-phase CT images, and 25 pairs of CT and U/S sequences. This resulted in a mean contour distance (MCD) of 0.94 mm between kidneys on CT and U/S images and MCD of 1.15 mm on CT and reference CT images. Datasets with small transformations resulted in MCDs of 0.82 and 1.02 mm, respectively. Large transformations resulted in MCDs of 1.10 and 1.28 mm, respectively. This work addressed difficulties in 3DCT-2DUS kidney registration during free breathing via novel network structures and training strategies.
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Aprendizado Profundo , Humanos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos , Respiração , Rim/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodosRESUMO
Three new species of the predaceous midges of genus Alluaudomyia Kieffer, 1913: A.flavinotum Wu & Li, sp. nov. of the maculipennis group, and A.reflexuralis Wu & Li, sp. nov. and A.limu Wu & Li, sp. nov. of the parva group, are described from the National Park of Hainan Tropical Rainforest, Hainan Island, China. Illustrations and COI barcodes (a fragment of the mitochondrial cytochrome c oxidase subunit 1) of the three new species are also provided. Associations of male and female specimens of two species (A.reflexuralis Wu & Li, sp. nov. and A.limu Wu & Li, sp. nov.) are supported by DNA barcodes. The parva group is reported from China for the first time.
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The microstructure and mechanical properties of 6 wt.% Mn-doped martensitic steel have been investigated through a combination of electron backscatter diffraction (EBSD), transmission electron microscopy (TEM), and small-angle neutron scattering (SANS). The 6 wt.% Mn-doped steel exhibits a yield strength of ~1.83 GPa and an elongation-to-failure of ~7% under peak aging, and the ~853 MPa of precipitation strengthening is much higher than that observed in the 1.5 wt.% and 3 wt.% Mn-doped steels. The steel is composed of α'-martensite and slightly equiaxed α-ferrite together with a high proportion (~62.3%) of low-angle grain boundaries, and 6 wt.% Mn doping and the aging treatment have an effect on the matrix's microstructure. However, 6 wt.% Mn doping can obviously increase the mean size of the Cu/NiAl nanoparticles by enhancing the chemical driving force of the Mn partitioning on the NiAl nanoparticles, which differs from the refining effect on the nanoparticles in 3 wt.% Mn-doped steels. Furthermore, larger Cu/NiAl nanoparticles can significantly improve the yield strength of martensitic steel through precipitation-strengthening mechanisms.
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BACKGROUND: Obesity is associated with adverse health events among diabetic patients, however, the relationship between obesity fluctuation and risk of microvascular complications among this specific population is unclear. We aimed to examine the effect of waist circumference (WC) and body mass index (BMI) variability on the risk of diabetic microvascular outcome. METHODS: Annually recorded anthropometric data in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study was used to examine the association of WC and BMI variability defined as variability independent of mean, with the risk of microvascular outcomes, including neuropathy, nephropathy, and retinopathy. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) (Trial registration: ClinicalTrials.gov., no. NCT00000620). RESULTS: There were 4,031, 5,369, and 2,601 cases of neuropathy, nephropathy, and retinopathy during a follow-up period of 22,524, 23,941, and 23,850 person-years, respectively. Higher levels of WC and BMI variability were associated with an increased risk of neuropathy. Compared with the lowest quartile, the fully-adjusted HR (95% CI) for the highest quartile of WC and BMI variability for neuropathy risk were 1.21 (1.05 to 1.40) and 1.16 (1.00 to 1.33), respectively. Also, higher quartiles of BMI variability but not WC variability were associated with increased risk of nephropathic events. The fully-adjusted HR (95% CI) for the highest quartile compared with the lowest quartile of BMI variability was 1.31 (1.18 to 1.46). However, the results for retinopathic events were all insignificant. CONCLUSION: Among participants with type 2 diabetes mellitus, WC and BMI variability were associated with a higher risk of neuropathic events, whereas BMI variability was associated with an increased risk of nephropathic events.
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Diabetes Mellitus Tipo 2 , Doenças Retinianas , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Fatores de Risco de Doenças Cardíacas , Humanos , Obesidade/complicações , Obesidade/epidemiologia , Doenças Retinianas/complicações , Fatores de Risco , Circunferência da CinturaRESUMO
BACKGROUND: Greater lipid variability may cause adverse health events among diabetic patients. We aimed to examine the effect of lipid variability on the risk of diabetic microvascular outcomes among type 2 diabetes mellitus patients. METHODS: We assessed the association between visit-to-visit variability (measured by variability independent of mean) in high-density lipoprotein (HDL) cholesterol, low-density lipoprotein-cholesterol (LDL), triglyceride, and remnant cholesterol (RC) measurements among participants involved in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study and the risk of incident microvascular outcomes, including nephropathy, neuropathy, and retinopathy. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for potential confounders. RESULTS: There were 2400, 2470, and 2468 cases of nephropathy, neuropathy, and retinopathy during a follow-up period of 22 600, 21 542, and 26 701 person-years, respectively. Higher levels of HDL, triglyceride, and RC variability were associated with an increased risk of incident nephropathy and neuropathy. Compared with the lowest quartile, the fully adjusted HRs (95% CI) for the highest quartile of HDL, triglyceride, and RC variability for nephropathy risk were 1.57 (1.22, 2.01), 1.50 (1.18, 1.92), and 1.40 (1.09, 1.80), respectively; and for neuropathy, the corresponding risks were 1.36 (1.05, 1.75), 1.47 (1.14, 1.91), and 1.35 (1.04, 1.74), respectively. Null association was observed between LDL variability and all microvascular complications. Additionally, all associations of variability in the other lipids with retinopathy risk were null. CONCLUSION: Among individuals with type 2 diabetes mellitus, HDL, triglyceride, and RC variability were associated with increased risks of nephropathy and neuropathy but not retinopathy. TRIAL REGISTRATION: ClinicalTrials.gov., no. NCT00000620.
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Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Doenças Retinianas , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , HDL-Colesterol , Diabetes Mellitus Tipo 2/complicações , Fatores de Risco de Doenças Cardíacas , Humanos , Doenças Retinianas/complicações , Fatores de Risco , TriglicerídeosRESUMO
Background: Lean body mass (LBM) and fat mass (FM) have been shown to have different associations with several chronic diseases but little is known about the sex-specific association of LBM and FM with diabetic nephropathy (DN) risk among participants with diabetes. Methods: Participants from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study was used in a post hoc analysis to examine the association of predicted LBM index (LBMI) and FM index (FMI) with incident DN risk (defined as a composite outcome of three types of predefined DN). Because of sex differences in body composition, analyses were conducted separately using sex-specific quartiles of predicted LBMI and FMI. Results: Of the 9,022 participants with type 2 diabetes (5,575 men and 3,447 women) included in this study, 5,374 individuals developed DN (3,396 in men and 1,978 in women). Higher quartiles of LBMI were associated with a reduced risk of DN while higher quartiles of FMI were associated with an increased higher risk of DN among men but not women. Compared with the lowest quartile, the fully adjusted hazard ratios (HRs) and 95% confidence intervals (CIs)for the highest quartile of predicted LBMI and FMI were respectively 0.83 (95% CI 1.71 - 0.96) and 1.23 (95% CI 1.06-1.43) among men; and 0.92 (95% CI 0.63 - 1.33) and 1.14 (95% CI 0.79 - 1.63) among women. Conclusions: Among participants with diabetes, predicted LBMI was inversely associated with risk of DN while predicted FMI was positively associated with an increased risk of incident DN among men but not women. Trial registration: ClinicalTrials.gov., no. NCT00000620.
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Composição Corporal/fisiologia , Diabetes Mellitus Tipo 2 , Nefropatias Diabéticas , Tecido Adiposo/metabolismo , Tecido Adiposo/patologia , Idoso , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/patologia , Nefropatias Diabéticas/epidemiologia , Nefropatias Diabéticas/etiologia , Nefropatias Diabéticas/metabolismo , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Músculos/metabolismo , Músculos/patologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos RetrospectivosRESUMO
Background: The prevalence of diabetes is on the rise globally coupled with its associated complications, such as diabetic nephropathy (DN). Obesity has been identified as a risk factor for the development of DN but it is still unclear which obesity index is the best predictor of incident DN. Methods: Data from the participants with type 2 diabetes mellitus (T2DM) in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study were used to examine the sex-specific association between waist circumference (WC), waist-to-height ratio (WHtR), and body mass index (BMI) with incident DN risk. Results: Among the 8,887 participants with T2DM (5,489 men and 3,398 women), 5,296 participants (3,345 men and 1,951 women) developed the DN composite outcome during a follow-up period of 24302 person-years. Among men, null associations were observed between all anthropometric measures with incident DN in the multivariate analysis although the 3rd quartile of WHtR showed marginally significant results (P = 0.052). However, among women, both central and general obesity measures were associated with increased risks of incident DN. Compared with participants in the WC <88 cm category, the fully adjusted HR and 95% CI for those in the ≥88 cm of WC was 1.35 (95% CI 1.15-1.57). Compared with the lowest quartile, the fully adjusted HRs and 95% CIs for the 2nd to the 4th quartile of WHtR were 1.09 (95% CI 0.96-1.25), 1.12 (95% CI 0.98-1.28), and 1.14 (95% CI 1.00-1.30) respectively; also, compared with the normal BMI category, the fully adjusted HRs and 95% CIs for class I - class III obese were 1.36 (95% CI 1.10 - 1.67), 1.43 (95% CI 1.16 - 1.78) and 1.32 (95% CI 1.05 - 1.66) respectively. Conclusions: Among participants with T2DM, higher levels of both central and general obesity indexes were associated with DN risk among women but not in men. Women with T2DM should maintain a healthy weight targeted at reducing both central and general obesity to enhance nephroprotection. Trial registration: ClinicalTrials.gov., no. NCT00000620.
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Biomarcadores/sangue , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/epidemiologia , Obesidade/fisiopatologia , Circunferência da Cintura , Razão Cintura-Estatura , Estudos de Casos e Controles , Nefropatias Diabéticas/etiologia , Nefropatias Diabéticas/patologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Fatores de RiscoRESUMO
In this paper, we focus on the issue of rigid medical image registration using deep learning. Under ultrasound, the moving of some organs, e.g., liver and kidney, can be modeled as rigid motion. Therefore, when the ultrasound probe keeps stationary, the registration between frames can be modeled as rigid registration. We propose an unsupervised method with Convolutional Neural Networks. The network estimates from the input image pair the transform parameters first then the moving image is wrapped using the parameters. The loss is calculated between the registered image and the fixed image. Experiments on ultrasound data of kidney and liver verified that the method is capable of achieve higher accuracy compared with traditional methods and is much faster.
Assuntos
Fígado , Redes Neurais de Computação , Fígado/diagnóstico por imagem , UltrassonografiaRESUMO
BACKGROUND: To investigate the influence of diabetes duration and glycemic control, assessed by glycated hemoglobin (HbA1c) levels, on risk of incident dementia. METHODS: The present study is a prospective study of 461 563 participants from the UK Biobank. The age at diabetes diagnosis was determined by self-report. Diabetes duration was calculated as baseline age minus age at diagnosis. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) with 95% confidential intervals (CIs). RESULTS: During a median follow-up of 8.1 years, 2 233 dementia cases were recorded. As compared with normoglycemic individuals, individuals with diabetes had higher risk of all-cause dementia, and the risk increased with increasing duration of diabetes; compared with participants with diabetes duration of <5 years, the multivariable-adjusted HRs (95% CIs) were 1.49 (1.12-1.97), 1.71 (1.21-2.41), and 2.15 (1.60-2.90) for those with diabetes durations ≥5 to < 10, ≥10 to <15, and ≥ 15 years, respectively (p for trend < .001). Among participants with diabetes, those with both longer diabetes duration (diabetes duration ≥ 10 years) and poor glycemic control (HbA1c ≥ 8%) had the highest risk of all-cause dementia (multivariable-adjusted HR = 2.07, 95% CI 1.45, 2.94), compared with patients with shorter duration of diabetes and better glycemic control (diabetes duration < 10 years and HbA1c < 8%). CONCLUSIONS: Diabetes duration appeared to be associated with the risk of incident dementia due to factors beyond glycemic control. Clinicians should consider not only glycemic control but also diabetes duration in dementia risk assessments for patients with diabetes.