The neutrophil-lymphocyte ratio as a risk factor for all-cause and cardiovascular mortality among individuals with diabetes: evidence from the NHANES 2003-2016.

BACKGROUND: Evidence regarding the neutrophil-lymphocyte ratio (NLR) and mortality risk in diabetes patients is scarce. This study investigated the relationship of the NLR with all-cause and cardiovascular mortality risk in diabetes patients. METHODS: Diabetes patients (n = 3251) from seven National Health and Nutrition Examination Survey (NHANES) cycles (2003-2016) were included in this study. The cause of death and mortality status of the participants were obtained from National Death Index records. Restricted cubic spline (RCS) was used to visualize the association of the NLR with mortality risk. The maximally selected rank statistics method (MSRSM) was used to determine the optimal NLR cutoff value corresponding to the most significant association with survival outcomes. Weighted multivariable Cox regression models and subgroup analyses were adopted to assess the association of the NLR with all-cause and cardiovascular mortality. Time-dependent receiver operating characteristic curve (ROC) analysis was conducted to evaluate the accuracy of the NLR in predicting survival outcomes. RESULTS: During a median follow-up of 91 months (interquartile range, 55-131 months), 896 (27.5%) of the 3251 diabetes patients died, including 261 (8.0%) with cardiovascular deaths and 635 (19.5%) with noncardiovascular deaths. The RCS regression analysis showed a positive linear association between the NLR and all-cause and cardiovascular mortality (both p > 0.05 for nonlinearity) in diabetes patients. Participants were divided into higher (> 3.48) and lower (≤ 3.48) NLR groups according to the MSRSM. In the multivariable-adjusted model, compared with participants with a lower NLR, those with a higher NLR had a significantly higher risk of both all-cause (HR 2.03, 95% confidence interval (CI) 1.64-2.51, p < 0.0001) and cardiovascular mortality (HR 2.76, 95% CI 1.84-4.14, p < 0.0001). The association was consistent in subgroup analyses based on age, sex, smoking status, drinking status, and hypertension, with no significant interaction between the aforementioned characteristics and the NLR (p interaction > 0.05). The time-dependent ROC curve showed that the areas under the curve of the 1-, 3-, 5-, and 10-year survival rates were 0.72, 0.66, 0.64, and 0.64 for all-cause mortality and 0.69, 0.71, 0.69 and 0.65, respectively, for cardiovascular mortality. CONCLUSION: An elevated NLR is independently associated with increased all-cause and cardiovascular mortality in diabetes patients.

Design and Modeling of a Novel Tripteron-Inspired Triaxial Parallel Compliant Manipulator with Compact Structure.

Compliant mechanisms are popular to the applications of micro/nanoscale manipulations. This paper proposes a novel triaxial parallel-kinematic compliant manipulator inspired by the Tripteron mechanism. Compared to most conventional triaxial compliant mechanisms, the proposed manipulator has the merits of structure compactness and being free of assembly error due to its unique configuration and the utilize of 3D printing technology. The compliance matrix modeling method is employed to determine the input stiffness of the compliant manipulator, and it is verified by finite-element analysis (FEA). Results show that the deviations between simulation works and the derived analytical models are in an acceptable range. The simulation results also reveal that the compliant manipulator can achieve a 16 µm × 16 µm × 16 µm cubic workspace. In this motion range, the observed maximum stress is much lower than the yield strength of the material. Moreover, the dynamic characteristics of the manipulator are investigated via the simulations as well.

Efficient removal of trifluoroacetic acid from water using surface-modified activated carbon and electro-assisted desorption.

Trifluoroacetic acid (TFA) is a very persistent, very mobile substance (vPvM) with potential toxicity, and causes increasing environmental concerns worldwide. Conventional wastewater treatment strategies are inefficient for selective TFA removal in the presence of inorganic anions. Here we show that surface defunctionalized activated carbon felt (DeACF) carrying anion exchange sites exhibits an outstanding adsorption efficiency towards TFA thanks to introduced electrostatic attraction and enhanced interactions between hydrophobic carbon surface and CF3 moieties (qmax = 30 mg/g, Kd = (840 ± 80) L/kg at cTFA = 3.4 mg/L in tap water). Flow-cell experiments demonstrated a strongly favored TFA uptake by DeACF from tap water over Cl- and SO42- but a remarkable co-adsorption of the inorganic water contaminant NO3-. Electro-assisted TFA desorption using 10 mM Na2SO4 as electrolyte and oxidized ACF as anode showed high recoveries of ≥ 87% at low cell voltages (< 1.1 V). Despite an initial decrease in TFA adsorption capacity (by 33%) caused by partial surface oxidation of DeACF after the 1st ad-/desorption cycle, the system stability was fully maintained over the next 4 cycles. Such electro-assisted 'trap&release' approach for TFA removal can be exploited for on-site regenerable adsorption units and as a pre-concentration step combined with degradation technologies.

The measurement of cyclic nucleotide phosphodiesterase 4 activities via the quantification of inorganic phosphate with malachite green.

A spectrometric method was investigated to measure the activities of recombinant human cyclic nucleotide phosphodiesterase 4 (PDE4), based on the use of malachite green (MLG) to quantify phosphate released from adenosine-5'-monophosphate (AMP) by the action of calf intestinal alkaline phosphatase (CIAP). Glycerol at 2% stabilized the complex between MLG and phosphomolybdate, whose absorbance at 630nm was proportional to phosphate concentrations with resistance to common substances in PDE4 reaction mixtures except papaverine. CIAP had the Michaelis-Menten constant (K(m)) of (12.0+/-2.1)microM (n=3) for AMP at pH 7.4, and was resistant to EDTA below 0.20mM. By the coupled end-point assay at 30.0UL(-1) CIAP with reaction durations within 30min, the rates to release phosphate in PDE4 reaction mixtures containing 10.0mM MgCl(2) and 0.10mM EDTA linearly responded to the amounts of PDE4 over wide ranges. Meanwhile, K(m) of PDE4 was (8.8+/-0.2)microM (n=2), zinc ion inhibited PDE4 and rolipram had the inhibition constant about 10nM. These results supported that by the coupled end-point assay, this method was promising to screen of PDE inhibitors that had no interference with the MLG assay of phosphate.

An integration strategy to estimate the initial rates of enzyme reactions with much expanded linear ranges using uricases as models.

A new strategy was proposed to estimate the initial rates of reactions catalyzed by Michaelis-Menten enzymes via integrating the classical initial rate method for low activities with an improved integrated method for high activities. Between these two individual methods, this integration strategy required: (a) the consistent linear response slopes, acquired with an optimized preset substrate concentration (PSC) to derive the initial rates from the maximal reaction rates estimated by the improved integrated method; (b) an overlapped region of the initial rates measurable with consistent results, realized with an optimized reaction duration to record reaction curves for analyses by the improved integrated method; (c) a switch cutoff, preset as the instantaneous substrate concentration slightly above that after a given lag time when the enzyme activity was just below the upper limit for the linear response of the classical initial rates. By simulation with uricases at a given initial substrate concentration (S(0)), the optimized PSC was 93% S(0), the optimized reaction duration at S(0) from 0.35-fold to 11.0-fold Michaelis-Menten constant (K(m)) was within 6.0 min and the switch cutoff was available at the given S(0) after 30-s lag time, all of which were combined to produce 300-fold linear ranges. By experimentation with one uricase of K(m) at 6.6 microM and the other uricase of K(m) at 220 microM under optimized conditions, this integration strategy with S(0) at 75 microM produced 100-fold linear ranges. Thus, this integration strategy exhibited much expanded linear ranges and practical efficiency over wide ratios between S(0) and K(m).