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Asymmetric catalysis for enantioselective intramolecular hydroamination of alkenes is a critical method in the construction of enantioenriched nitrogen-containing rings, often prevalent in biologically active compounds and natural products. Herein, we demonstrate a facile enantioselective intramolecular hydroamination of alkenes for the synthesis of chiral pyrrolidine, piperidine, and indoline moieties, using a manganese (II) chiral aprotic cyclic urea catalyst. The cyclic ligand hinders the inversion of the N atom of the urea and effectively discriminate between the enantiomers of substrates. High-resolution mass spectrometry, deuterium labeling experiments, and molecular orbital energy analysis clearly reveal the intermediates and mechanism of the transformation. As a key step, oxygen coordination by chiral aprotic urea presents a robust control over the asymmetric intra-HA reaction through the involvement of a convergent assembly of two vital intermediates (Mn-N and C-Mn-Br), providing access to chiral cyclic amine systems in high yields with excellent enantioselectivity.
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We evaluated the effect of sodium-glucose cotransporter 2 (SGLT2) inhibition on prostate cancer by evidence triangulation. Using Mendelian randomization, we found that genetically proxied SGLT2 inhibition reduced the risk of overall (odds ratio = 0.56, 95% confidence interval [CI] = 0.38 to 0.82; 79,148 prostate cancer cases and 61,106 controls), advanced, and early-onset prostate cancer. Using electronic healthcare data (nSGLT2i = 24,155; nDPP4i = 24,155), we found that the use of SGLT2 inhibitors was associated with a 23% reduced risk of prostate cancer (hazard ratio = 0.77, 95% CI = 0.61 to 0.99) in men with diabetes. Using data from two prospective cohorts (n4C = 57,779; nUK_Biobank = 165,430), we found little evidence to support the association of HbA1c with prostate cancer, implying a non-glycemic effect of SGLT2 inhibition on prostate cancer. In summary, this study provides multiple layers of evidence to support the beneficial effect of SGLT2 inhibition on reducing prostate cancer risk. Future trials are warranted to investigate whether SGLT2 inhibitors can be recommended for prostate cancer prevention.
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Análisis de la Aleatorización Mendeliana , Neoplasias de la Próstata , Inhibidores del Cotransportador de Sodio-Glucosa 2 , Humanos , Masculino , Neoplasias de la Próstata/genética , Neoplasias de la Próstata/tratamiento farmacológico , Inhibidores del Cotransportador de Sodio-Glucosa 2/uso terapéutico , Persona de Mediana Edad , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/genética , Estudios de Cohortes , Anciano , Hemoglobina Glucada/metabolismo , Transportador 2 de Sodio-Glucosa/metabolismo , Transportador 2 de Sodio-Glucosa/genética , Registros Electrónicos de SaludRESUMEN
The scavenging process significantly affects the combustion and emission performance of marine low-speed two-stroke dual-fuel engines. Optimizing scavenging air pressure and temperature can enhance the engine's combustion efficiency and emission control performance, thereby achieving more environmentally friendly and efficient operation of dual-fuel engines. This study focuses on marine low-speed two-stroke dual-fuel engines, analyzing the effects of scavenging air pressure (3.0 bar, 3.25 bar, 3.5 bar, and 3.75 bar) and scavenging air temperature (293 K, 303 K, and 313 K) on engine performance and emission products. The results indicate that scavenging air pressure has a greater impact on engine performance than scavenging air temperature. An increase in scavenging air pressure leads to higher thermal efficiency and power. As the scavenging air pressure increases from 3 to 3.75 bar, the indicated thermal efficiency (ITE) increases from 44.02 to 53.26%, and indicated mean effective pressure (IMEP) increases by approximately 0.35 MPa. Increased scavenging air pressure improves nitrogen oxide (NOx) and hydrocarbons (HC) emissions. For every 0.25 bar increase in scavenging air pressure, NOx emissions decrease by 3.53%, HC emissions decrease by 33.35%, while carbon dioxide (CO2) emissions increase by 0.71%. An increase in scavenging air temperature leads to lower ITE and IMEP. As the air temperature changes from 293 to 313 K, the ITE decreases by approximately 1%, and IMEP decreases by about 0.04 MPa. Increased scavenging air temperature improves CO2 emissions. For every 10 K increase in the air temperature, the CO2 emissions decrease by 0.02%, while NOx emissions increase by 4.84%, HC emissions increase by 34.39%. Therefore, controlling scavenging air pressure is more important than scavenging air temperature in the operational management of marine two-stroke engines. Higher power and lower NOx and HC emissions can be achieved by increasing the scavenging air pressure.
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Covalent organic frameworks (COFs) are an emerging class of crystalline organic materials that have shown potential to be a new physical platform. In this work, a designed COF named AB-COF, which has novel enantiomorphic Kagome bands, is proposed and a feasible route to synthesize it is given. Via a combination of first-principles calculations and tight-binding analysis, we investigate the electronic structures and the phase interference of the COF. It becomes topologically nontrivial when doping one iodine atom in a unit cell. The Berry curvatures of the valence band (VB) and conduction band (CB) of the iodine-doped AB-COF show opposite values and different distributions. This provides an opportunity to study the new mechanism of circular dichroism from the different Berry curvatures of the VB and CB. Surprisingly, the circular-dichroism dissymmetry factor of AB-COF reaches a theoretical maximum value, and the oscillator strength data are in agreement with this result. When two iodine atoms are doped in a unit cell, the Berry curvatures of the VB and CB also have different values, but with more symmetry and similar distributions. This behavior enhances the circular dichroism with a wider range of dissymmetric absorption, and the circular dichroism dissymmetry factor also reaches its theoretical maximum value.
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BACKGROUND: The accumulation of visceral and ectopic fat comprise a major cause of cardiometabolic diseases. However, novel drug targets for reducing unnecessary visceral and ectopic fat are still limited. Our study aims to provide a comprehensive investigation of the causal effects of the plasma proteome on visceral and ectopic fat using Mendelian randomization (MR) approach. METHODS: We performed two-sample MR analyses based on five large genome-wide association study (GWAS) summary statistics of 2656 plasma proteins, to screen for causal associations of these proteins with traits of visceral and ectopic fat in over 30,000 participants of European ancestry, as well as to assess mediation effects by risk factors of outcomes. The colocalization analysis was conducted to examine whether the identified proteins and outcomes shared casual variants. RESULTS: Genetically predicted levels of 14 circulating proteins were associated with visceral and ectopic fat (P < 4.99 × 10- 5, at a Bonferroni-corrected threshold). Colocalization analysis prioritized ten protein targets that showed effect on outcomes, including FST, SIRT2, DNAJB9, IL6R, CTSA, RGMB, PNLIPRP1, FLT4, PPY and IL6ST. MR analyses revealed seven risk factors for visceral and ectopic fat (P < 0.0024). Furthermore, the associations of CTSA, DNAJB9 and IGFBP1 with primary outcomes were mediated by HDL-C and SHBG. Sensitivity analyses showed little evidence of pleiotropy. CONCLUSIONS: Our study identified candidate proteins showing putative causal effects as potential therapeutic targets for visceral and ectopic fat accumulation and outlined causal pathways for further prevention of downstream cardiometabolic diseases.
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Adiposidad , Enfermedades Cardiovasculares , Humanos , Adiposidad/genética , Proteoma , Estudio de Asociación del Genoma Completo , Análisis de la Aleatorización Mendeliana , Obesidad , Proteínas de la Membrana , Chaperonas Moleculares , Proteínas del Choque Térmico HSP40RESUMEN
INTRODUCTION: Visceral adipose tissue-derived serine protease inhibitor (vaspin) is an adipokine. It has been reported that decreased serum vaspin levels are significantly associated with stroke severity and prognosis. OBJECTIVE: This article aims to explore the theoretical feasibility of vaspin supplementation for cerebral ischemia-reperfusion (I/R) injury. METHODS: The I/R mouse models were constructed by the middle cerebral artery occlusion (MCAO) method, and the effects of vaspin on cerebral infarction, neurological function, angiogenesis and endoplasmic reticulum (ER) stress were explored. To verify the mediation of ER stress in the regulation of vaspin, human brain microvascular endothelial cells (HBMECs) were subjected to ER stress agonist tunicamycin in vitro. The impacts of vaspin and tunicamycin on oxygen glucose deprivation/ recovery (OGD/R)-induced cell viability, apoptosis, and angiogenesis were examined. RESULTS: Vaspin inhibited blood-brain barrier breakdown and infarction occurred in the brain tissue of the I/R mice. Vaspin also enhanced cerebral neovascularization and reduced the apoptosis. Additional tunicamycin increased the apoptosis of HBMECs and inhibited angiogenesis, reversing the protective effect of vaspin on cells. CONCLUSION: Together, this study reveals that vaspin supplementation reduces cerebral infarction and works against neurological dysfunction. It maintains the survival and angiogenesis capacity of HBMECs by inhibiting ER stress.
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Adipoquinas , Angiogénesis , Isquemia Encefálica , Estrés del Retículo Endoplásmico , Daño por Reperfusión , Serpinas , Animales , Humanos , Masculino , Ratones , Adipoquinas/administración & dosificación , Adipoquinas/metabolismo , Adipoquinas/farmacología , Angiogénesis/efectos de los fármacos , Angiogénesis/metabolismo , Apoptosis/efectos de los fármacos , Isquemia Encefálica/tratamiento farmacológico , Isquemia Encefálica/metabolismo , Modelos Animales de Enfermedad , Estrés del Retículo Endoplásmico/efectos de los fármacos , Células Endoteliales/metabolismo , Células Endoteliales/efectos de los fármacos , Infarto de la Arteria Cerebral Media/metabolismo , Infarto de la Arteria Cerebral Media/prevención & control , Neovascularización Fisiológica/efectos de los fármacos , Daño por Reperfusión/metabolismo , Daño por Reperfusión/prevención & control , Serpinas/metabolismo , Serpinas/farmacologíaRESUMEN
BACKGROUND: Nervus intermedius neuralgia (NIN) is characterized by paroxysmal episodes of sharp, lancinating pain in the deep ear. Unfortunately, only a few studies exist in the literature on this pain syndrome, its pathology and postoperative outcomes. METHOD: We conducted a retrospective review of four cases diagnosed with NIN who underwent a neurosurgical intervention at our center from January 2015 to January 2023. Detailed information on their MRI examinations, intraoperative findings and other clinical presentations were obtained, and the glossopharyngeal and vagus nerves were isolated for immunohistochemistry examination. RESULTS: A total of 4 NIN patients who underwent a microsurgical intervention at our institution were included in this report. The NI was sectioned in all patients and 3 of them underwent a microvascular decompression. Of these 4 patients, 1 had a concomitant trigeminal neuralgia (TN), and 1 a concomitant glossopharyngeal neuralgia (GPN). Three patients underwent treatment for TN and 2 for GPN. Follow-up assessments ranged from 8 to 99 months. Three patients reported complete pain relief immediately after the surgery until last follow-up, while in the remaining patient the preoperative pain gradually resolved over the 3 month period. Immunohistochemistry revealed that a greater amount of CD4+ and CD8+ T cells had infiltrated the glossopharyngeal versus vagus nerve. CONCLUSIONS: NIN is an extremely rare condition showing a high degree of overlap with TN/GPN. An in depth neurosurgical intervention is effective to completely relieve NIN pain, without any serious complications. It appears that T cells may play regulatory role in the pathophysiology of CN neuralgia.
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Enfermedades del Nervio Glosofaríngeo , Cirugía para Descompresión Microvascular , Neuralgia , Neuralgia del Trigémino , Humanos , Nervio Facial , Linfocitos T CD8-positivos , Neuralgia/etiología , Neuralgia/cirugía , Neuralgia del Trigémino/diagnóstico por imagen , Neuralgia del Trigémino/etiología , Neuralgia del Trigémino/cirugía , Enfermedades del Nervio Glosofaríngeo/cirugía , Resultado del TratamientoRESUMEN
BACKGROUND: Hyperlipidemia is a major risk factor for many diseases. Previous studies have shown that diet is closely associated with hyperlipidemia. However, the relationship between cooking methods and hyperlipidemia remains unclear. The objective of this study was to identify the major cooking patterns existing in the Eastern Chinese population and evaluate their association with the prevalence of hyperlipidemia. METHODS: We interviewed 4,710 residents in Eastern China regarding the consumption frequency of each cooking method when they prepare food at home or when eating out and regarding the prevalence of hyperlipidemia. Factor analysis, Chi-square tests, analysis of variance, and binary logistic regression analysis were used to identify the cooking patterns and analyze the characteristics of participants' categories of cooking patterns and the relationship between different cooking patterns and prevalence of hyperlipidemia. RESULTS: Three major cooking patterns were identified: Traditional Chinese, Bland (little or no oil is used to process the food), and High-temperature cooking patterns. After controlling for potential confounders, participants in the highest quartile of the Bland cooking pattern had lower odds of hyperlipidemia than those in the lowest quartile. Nevertheless, no significant associations were observed between the Traditional Chinese and High-temperature cooking patterns and the prevalence of hyperlipidemia. CONCLUSIONS: This study confirms the association between cooking patterns and the prevalence of hyperlipidemia and indicates that the Bland cooking pattern is associated with a reduced prevalence of hyperlipidemia.
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Hiperlipidemias , Humanos , Prevalencia , Hiperlipidemias/epidemiología , Dieta , Factores de Riesgo , Verduras , Culinaria , China/epidemiologíaRESUMEN
Nitric oxide (NO) has been suggested as an obligate intermediate in anaerobic ammonium oxidation (anammox), nitrification and denitrification. At the same time, ammonia-oxidizing bacteria (AOB) and denitrifying bacteria (DNB) are always existed in anammox flora, so what is the role of NO produced from AOB and DNB? Could it accelerate nitrogen removal via the anammox pathway with NO as an electron acceptor? To investigate this hypothesis, nitrogen transforming of an anammox biofilter was analyzed, functional gene expression of anammox bacteria (AnAOB), AOB and DNB were compared, and NO source was verified. For anammox biofilter, anammox contributed to 91.3 % nitrogen removal with only 14.4 % of AnAOB being enriched, while DNB was dominant. Meta-omics analysis and batch test results indicated that AOB could provide NO to AnAOB, and DNB also produced NO via up-regulating nirS/K and down-regulating nor. The activation of the anammox pathway of NH4++NOâN2 caused the downregulation of nirS and nxr in Ca. Kuenenia stuttgartiensis. Additionally, changes in nitrogen transforming pathways affected the electron generation and transport, limiting the carbon metabolism of AnAOB. This study provided new insights into improving nitrogen removal of the anammox system.
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Amoníaco , Compuestos de Amonio , Amoníaco/metabolismo , Desnitrificación , Óxido Nítrico/metabolismo , Oxidación Anaeróbica del Amoníaco , Oxidación-Reducción , Anaerobiosis , Reactores Biológicos/microbiología , Bacterias/genética , Bacterias/metabolismo , Nitrógeno/metabolismo , Aguas del Alcantarillado/microbiología , Compuestos de Amonio/metabolismoRESUMEN
Objective: The aim of this study was to compare the differences in incident population, comorbidities, and glucose-lowering drug prescriptions between newly diagnosed patients with early-onset type 2 diabetes mellitus (T2DM) and those with late-onset T2DM to provide real-world evidence for clinical practice. Methods: This study was based on the Shanghai Hospital Link Database (SHLD). Anonymized electronic medical record (EHR) data from 2013 to 2021 were included in this study. Newly diagnosed patients with T2DM were defined as those without related diagnostic records or glucose-lowering medicine prescriptions in the past 3 years. Early-onset T2DM was defined as patients who were aged 18-40 years old at the first visit for T2DM to represent those who were born after the 1980s. And late-onset T2DM was defined as those aged 65-80 years old to represent those who were born in a relatively undeveloped period. Descriptive statistical analyses were performed to describe their incidence number, glucose-lowering drug prescriptions, and comorbidities at the first visit to the hospital between two T2DM groups. Results: There were a total of 35,457 newly diagnosed patients with early-onset T2DM and 149,108 newly diagnosed patients with late-onset T2DM included in this study. Patients with late-onset T2DM constituted the majority and their number increased by 2.5% on average by years, while the number of patients with early-onset T2DM remained stable each year. Compared with late-onset T2DM patients, more early-onset T2DM patients had dyslipidemia at the first visit to hospitals (9.5% vs 7.7%, P < 0.01) despite their significant age differences. Patients with early-onset T2DM were more likely to use metformin (74.8% vs 46.5, P < 0.01), dipeptidyl peptidase-4 inhibitors (DDP-4i) (16.7% vs 11.2%, P < 0.01), thiazolidinediones (TZD) (14.9% vs 8.4%, P < 0.01), sodium glucose cotransporter 2 inhibitors (SGLT2-i) (0.8% vs 0.3%, P < 0.01), and glucagon-like peptide 1 receptor agonists (GLP-1 RA) (3.7% vs 0.5%, P < 0.01) at their first visit to the hospital. Conclusions: Different characteristics were observed between patients with early-onset T2DM and those with late-onset T2DM. Compared with patients with late-onset T2DM, those with early-onset T2DM were more prone to dyslipidemia and had novel organ-protective drugs prescribed.
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The kagome lattice is one of the most intriguing topics to study. It has a frustrated flat band touching a set of Dirac bands and can possess various promising properties, such as ferromagnetism, superconductivity, and a non-trivial topology. Covalent organic frameworks (COFs) are a rare type of inorganic material, however, they can provide a platform for generating certain required lattices. Based on first-principles density functional theory calculations, we show that a newly synthesized two-dimensional COF named COF-SH has novel enantiomorphic kagome bands, which include two sets of flat bands touching the Dirac bands around the Fermi level. The Bloch wave of the flat-valence band at the K-point shows the kagome nature of the phase interference. Under charge doping, the COF-SH exhibits a ferromagnetic ground state. Moreover, when COF-SH is doped with iodine atoms, a sizable gap in the system is opened between the flat bands and the Dirac bands due to the spin-orbit coupling (SOC) effect. Meanwhile, the spin degeneracy is lifted since the organic layer loses electrons due to the oxidizing property of iodine. In addition, our tight-binding analysis with the SOC effect shows that the flat valence band separates from the Dirac bands and holds a nonzero Chern number. Consequently, this I-doped COF can give rise to a quantum anomalous Hall effect.
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The frequent occurrence of antibiotics in reclaimed water is concerning, in the case of managed aquifer recharge (MAR), it inevitably hinders further water purification and accelerates the evolutionary resistance in indigenous bacteria. In this study, we constructed two column reactors and nanoscale zero-valent iron (nZVI) amendment was applied for its effects on water quality variation, microbial community succession, and antibiotic resistance genes (ARGs) dissemination, deciphered the underlying mechanism of resistance risk reduction. Results showed that nZVI was oxidized to iron oxides in the sediment column, and total effluent iron concentration was within permissible limits. nZVI enhanced NO3--N removal by 15.5% through enriching denitrifying bacteria and genes, whereas made no effects on oxacillin (OXA) removal. In addition, nZVI exhibited a pivotal impact on ARGs and plasmids decreasing. Network analysis elucidated that the diversity and richness of ARG host declined with nZVI amendment. Denitrifying bacteria play a key role in suppressing horizontal gene transfer (HGT). The underlying mechanisms of inhibited HGT included the downregulated SOS response, the inhibited Type-â £ secretion system and the weakened driving force. This study afforded vital insights into ARG spread control, providing a reference for future applications of nZVI in MAR.
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Agua Subterránea , Contaminantes Químicos del Agua , Hierro , Bacterias , Antibacterianos , Farmacorresistencia MicrobianaRESUMEN
Phosphors with narrow-band green emissions and high photoluminescent quantum efficiency (PLQY) are significantly required for backlighting displays with wider color gamut. In this work, two centimeter-sized manganese (II) halide single crystals TMG2 MnCl4 and TMG2 MnBr4 (TMG = 1,1,3,3-tetramethylguanidine) are synthesized, exhibiting bright narrow-band green emissions with high PLQYs up to 62% and 90%, respectively. The narrow-band green light emission is located at 520 nm with a full-width at half-maximum (FWHM) of only 57 nm. The photoluminescence mechanisms of two single crystals are elaborated. Two white-light-emitting diodes for backlighting displays (BD-WLEDs) based on them are fabricated, exhibiting the widest color gamut of 122% National Television Standards Committee (NTSC), and a luminous efficacy reached ≈93 lm W-1 with excellent luminescence stability at high temperatures. These properties indicate the potential applications of tetrahedral manganese (II) hybrids in wide-color gamut backlighting displays.
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Spin-orbit coupling (SOC) is the interaction between electron's spin and orbital motion, which could realize a charge-to-spin current conversion and enable an innovative method to switch the magnetization by spin-orbit torque (SOT). Varied techniques have been developed to manipulate and improve the SOT, but the role of the orbit degree of freedom, which should have a crucial bearing on the SOC and SOT, is still confusing. Here, we find that the charge-to-spin current conversion and SOT in W3O8-δ/(La, Sr)MnO3 could be produced or eliminated by ionic liquid gating. Through tuning the preferential occupancy of Mn/W-d electrons from the in-plane (dx2-y2) to out-of-plane (d3z2-r2) orbit, the SOT damping-like field efficiency is nearly doubled due to the enhanced spin Hall effect and interfacial Rashba-Edelstein effect. These findings not only offer intriguing opportunities to control the SOT for high-efficient spintronic devices but also could be a fundamental step toward spin-orbitronics in the future.
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Cooking methods can change the composition of foods and have important effects on human health. The Chinese people have developed many distinct and unique cooking methods. However, the daily cooking patterns of Chinese people and the characteristics and evolution of trends in cooking patterns commonly used by Chinese consumers remain unclear. The objective of this study was to identify the major cooking patterns and discuss their effects on human health, as well as to identify the cooking pattern consumer clusters and the evolution of trends in Chinese consumer cooking patterns. From March to June 2021, this study interviewed 4,710 residents in Eastern China regarding the consumption frequency of each cooking method when food is prepared at home or when eating out. Exploratory factor analysis, K-Means cluster analysis, Chi-square test, pairwise comparisons of multiple sample rates, and multivariate linear regression were used to identify the cooking patterns and cooking pattern consumer clusters, to assess differences in consumption preferences between consumer clusters, and to examine the relationship between demographic characteristic variables and different cooking patterns. Results revealed three major cooking patterns, namely traditional Chinese (cooking methods with native Chinese characteristics), bland, and high-temperature cooking patterns, as well as seven cooking pattern consumer clusters and their demographic characteristics in the Eastern Chinese population. With increases in age, education level, and income, consumers tended to choose the healthy "Bland" cooking pattern. Further, there was a higher proportion of people aged 36-65 years in the C3 cluster, which is characterized by the "Bland" cooking pattern. However, participants who were male and younger made fewer healthy choices in their cooking patterns. Specifically, a higher proportion of participants aged 21-35 years were found in the C5 cluster, which is characterized by the unhealthy "High-temperature" cooking pattern. Therefore, culinary health education should focus on individuals who are male and young. Specifically, the shift in cooking patterns among people aged 21-35 years should receive special attention.
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Culinaria , Conducta Alimentaria , Humanos , Masculino , Femenino , Escolaridad , ChinaRESUMEN
Patients with type 2 diabetes mellitus (T2DM) are at a heightened risk of living with multiple comorbidities. However, the comprehension of the multimorbidity characteristics of T2DM is still scarce. This study aims to illuminate T2DM's prevalent comorbidities and their interrelationships using network analysis. Using electronic medical records (EMRs) from 496,408 Chinese patients with T2DM, we constructed male and female global multimorbidity networks and age- and sex-specific networks. Employing diverse network metrics, we assessed the structural properties of these networks. Furthermore, we identified hub, root, and burst diseases within these networks while scrutinizing their temporal trends. Our findings uncover interconnected T2DM comorbidities manifesting as emergence in clusters or age-specific outbreaks and core diseases in each sex that necessitate timely detection and intervention. This data-driven methodology offers a comprehensive comprehension of T2DM's multimorbidity, providing hypotheses for clinical considerations in the prevention and therapeutic strategies.
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Introduction: Although the subthalamic nucleus (STN) has proven to be a safe and effective target for deep brain stimulation (DBS) in the treatment of primary dystonia, the rates of individual improvement vary considerably. On the premise of selecting appropriate patients, the location of the stimulation contacts in the dorsolateral sensorimotor area of the STN may be an important factor affecting therapeutic effects, but the optimal location remains unclear. This study aimed to define an optimal location using the medial subthalamic nucleus border as an anatomical reference and to explore the influence of the location of active contacts on outcomes and programming strategies in a series of patients with primary dystonia. Methods: Data from 18 patients who underwent bilateral STN-DBS were retrospectively acquired and analyzed. Patients were assessed preoperatively and postoperatively (1 month, 3 months, 6 months, 1 year, 2 years, and last follow-up after neurostimulator initiation) using the Toronto Western Spasmodic Torticollis Rating Scale (for cervical dystonia) and the Burke-Fahn-Marsden Dystonia Rating Scale (for other types). Optimal parameters and active contact locations were determined during clinical follow-up. The position of the active contacts relative to the medial STN border was determined using postoperative stereotactic MRI. Results: The clinical improvement showed a significant negative correlation with the y-axis position (anterior-posterior; A+, P-). The more posterior the electrode contacts were positioned in the dorsolateral sensorimotor area of the STN, the better the therapeutic effects. Cluster analysis of the improvement rates delineated optimal and sub-optimal groups. The optimal contact coordinates from the optimal group were 2.56 mm lateral, 0.15 mm anterior, and 1.34 mm superior relative to the medial STN border. Conclusion: STN-DBS was effective for primary dystonia, but outcomes were dependent on the active contact location. Bilateral stimulation contacts located behind or adjacent to Bejjani's line were most likely to produce ideal therapeutic effects. These findings may help guide STN-DBS preoperative planning, stimulation programming, and prognosis for optimal therapeutic efficacy in primary dystonia.
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BACKGROUND: Cardiovascular disease (CVD) is the major cause of death among persons with diabetes. As the preventative use of statin has been proved to reduce CVD risks, understanding the current status and the trend in statin use is crucial to improve clinical treatment strategies. OBJECTIVE: Our study aimed to answer the question of what were the status and trend of statin use in Shanghai, China. METHODS: Our study estimated statin use and trends from 2015 to 2021 among 702 727 patients with type 2 diabetes mellitus (T2DM) based on electronic health records from the Shanghai Hospital Link Database. Patients were grouped according to the presence of CVDs, tested separately for statin primary and secondary prevention use, and stratified by age and sex. RESULTS: In the study population, 221 127 patients (31.5%) received statin therapy, and among patients with CVD, 157 622 patients (51.62%) received statin therapy for secondary prevention, but only 15% of patients received statins for primary prevention. The trend in the use of statins was still on the rise from 28.3% in 2015. Statin use increased with age (18-39 years, 14.0%; 40-59 years, 26.8%; 60-74 years, 33.35%; and 75 and over, 36.1%), and women (29.7%, n = 93 977) were less likely to receive statin therapy compared to men (32.9%, n = 127 150). CONCLUSION: Despite the rise in statin use in T2DM in recent decades, a large proportion of subjects with T2DM did not receive statin therapy.
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OBJECTIVES: The effect of insulin use on gout risk remains unknown. This study aimed to investigate the association between insulin use and gout risk among patients with type 2 diabetes mellitus (T2DM). METHODS: Based on the Shanghai Link Healthcare Database, patients with newly diagnosed T2DM, with or without insulin exposure, were identified from January 1, 2014 to December 31, 2020, and followed until December 31, 2021. Apart from the original cohort, we also established a 1:2 propensity score-matched cohort. A time-dependent Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for gout incidence associated with insulin exposure. RESULTS: A total of 414,258 patients with T2DM, including 142,505 insulin users and 271,753 insulin non-users, were enrolled in this study. After a median follow-up of 4.08 years (interquartile range, 2.46-5.90 years), the incidence of gout was significantly higher in insulin users than in insulin non-users (319.35 versus 302.20 cases per 100,000 person-years; HR 1.09, 95% CI 1.03-1.16). The results were robust in propensity score-matched cohort, sensitivity analyses, and stratified analysis of aspirin. In other stratified analyses, the association between insulin use and increased gout risk was found only in patients who were female, or aged 40-69 years, or without hypertension, dyslipidemia, ischemic heart disease, chronic lung disease, kidney disease, or not using diuretic. CONCLUSIONS: Insulin use is associated with a significantly increased risk of gout among patients with T2DM. Key Points ⢠The first real-world study to investigate the effect of insulin use on gout risk. ⢠Insulin use is associated with a significantly increased risk of gout among patients with type 2 diabetes mellitus.
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Diabetes Mellitus Tipo 2 , Gota , Humanos , Femenino , Masculino , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/epidemiología , Estudios de Cohortes , Estudios Retrospectivos , China/epidemiología , Gota/complicaciones , Gota/tratamiento farmacológico , Gota/epidemiología , Insulina/efectos adversos , Incidencia , Modelos de Riesgos ProporcionalesRESUMEN
Electrical control of magnetic properties is crucial for low-energy memory and logic spintronic devices. We find that the magnetic properties of ferrimagnetic CoGd can be altered through ionic liquid gating. Gate voltages manipulate the opposite magnetic moments in Co and Gd sublattices and induce a giant magnetic compensation temperature change of more than 200 K in Pt/CoGd/Pt heterostructures. The electrically controlled dominant magnetic sublattice allows voltage-induced magnetization switching. Both experiments and theoretical calculations demonstrate that the significant modulations of compensation temperature are relevant to the reduced Gd moments due to the presence of hydrogen ions at positive voltages as well as the enhanced Co moments and reduced Gd moments due to the injection of oxygen ions at negative voltages. These findings expand the possibilities for all-electric and reversible magnetization control in the field of spintronics.