The role of machine learning in advancing diabetic foot: a review.

Background: Diabetic foot complications impose a significant strain on healthcare systems worldwide, acting as a principal cause of morbidity and mortality in individuals with diabetes mellitus. While traditional methods in diagnosing and treating these conditions have faced limitations, the emergence of Machine Learning (ML) technologies heralds a new era, offering the promise of revolutionizing diabetic foot care through enhanced precision and tailored treatment strategies. Objective: This review aims to explore the transformative impact of ML on managing diabetic foot complications, highlighting its potential to advance diagnostic accuracy and therapeutic approaches by leveraging developments in medical imaging, biomarker detection, and clinical biomechanics. Methods: A meticulous literature search was executed across PubMed, Scopus, and Google Scholar databases to identify pertinent articles published up to March 2024. The search strategy was carefully crafted, employing a combination of keywords such as "Machine Learning," "Diabetic Foot," "Diabetic Foot Ulcers," "Diabetic Foot Care," "Artificial Intelligence," and "Predictive Modeling." This review offers an in-depth analysis of the foundational principles and algorithms that constitute ML, placing a special emphasis on their relevance to the medical sciences, particularly within the specialized domain of diabetic foot pathology. Through the incorporation of illustrative case studies and schematic diagrams, the review endeavors to elucidate the intricate computational methodologies involved. Results: ML has proven to be invaluable in deriving critical insights from complex datasets, enhancing both the diagnostic precision and therapeutic planning for diabetic foot management. This review highlights the efficacy of ML in clinical decision-making, underscored by comparative analyses of ML algorithms in prognostic assessments and diagnostic applications within diabetic foot care. Conclusion: The review culminates in a prospective assessment of the trajectory of ML applications in the realm of diabetic foot care. We believe that despite challenges such as computational limitations and ethical considerations, ML remains at the forefront of revolutionizing treatment paradigms for the management of diabetic foot complications that are globally applicable and precision-oriented. This technological evolution heralds unprecedented possibilities for treatment and opportunities for enhancing patient care.

Advances in secondary prevention mechanisms of macrovascular complications in type 2 diabetes mellitus patients: a comprehensive review.

Type 2 diabetes mellitus (T2DM) poses a significant global health burden. This is particularly due to its macrovascular complications, such as coronary artery disease, peripheral vascular disease, and cerebrovascular disease, which have emerged as leading contributors to morbidity and mortality. This review comprehensively explores the pathophysiological mechanisms underlying these complications, protective strategies, and both existing and emerging secondary preventive measures. Furthermore, we delve into the applications of experimental models and methodologies in foundational research while also highlighting current research limitations and future directions. Specifically, we focus on the literature published post-2020 concerning the secondary prevention of macrovascular complications in patients with T2DM by conducting a targeted review of studies supported by robust evidence to offer a holistic perspective.

Single-cell sequencing: A promising approach for uncovering the characteristic of pancreatic islet cells in type 2 diabetes.

Single-cell sequencing is a novel and rapidly advancing high-throughput technique that can be used to investigating genomics, transcriptomics, and epigenetics at a single-cell level. Currently, single-cell sequencing can not only be used to draw the pancreatic islet cells map and uncover the characteristics of cellular heterogeneity in type 2 diabetes, but can also be used to label and purify functional beta cells in pancreatic stem cells, improving stem cells and islet organoids therapies. In addition, this technology helps to analyze islet cell dedifferentiation and can be applied to the treatment of type 2 diabetes. In this review, we summarize the development and process of single-cell sequencing, describe the potential applications of single-cell sequencing in the field of type 2 diabetes, and discuss the prospects and limitations of single-cell sequencing to provide a new direction for exploring the pathogenesis of type 2 diabetes and finding therapeutic targets.

Physically and Chemically Stable Molybdenum-Based Composite Electrodes for p-i-n Perovskite Solar Cells.

Metal halide perovskite solar cells (PSCs) have garnered much attention in recent years. Despite the remarkable advancements in PSCs utilizing traditional metal electrodes, challenges such as stability concerns and elevated costs have necessitated the exploration of innovative electrode designs to facilitate industrial commercialization. Herein, a physically and chemically stable molybdenum (Mo) electrode is developed to fundamentally tackle the instability factors introduced by electrodes. The combined spatially resolved element analyses and theoretical study demonstrate the high diffusion barrier of Mo ions within the device. Structural and morphology characterization also reveals the negligible plastic deformation and halide-metal reaction during aging when Mo is in contact with perovskite (PVSK). The electrode/underlayer junction is further stabilized by a thin seed layer of titanium (Ti) to improve Mo film's uniformity and adhesion. Based on a corresponding p-i-n PSCs (ITO/PTAA/PVSK/C60/SnO2/ITO/Ti/Mo), the champion sample could deliver an efficiency of 22.25%, which is among the highest value for PSCs based on Mo electrodes. Meanwhile, the device shows negligible performance decay after 2000 h operation, and retains 91% of the initial value after 1300 h at 50-60 °C. In summary, the multilayer Mo electrode opens an effective avenue to all-round stable electrode design in high-performance PSCs.

Effects and Mechanistic Role of Mulberry Leaves in Treating Diabetes and its Complications.

Diabetes mellitus (DM) has become a surge burden worldwide owing to its high prevalence and range of associated complications such as coronary artery disease, blindness, stroke, and renal failure. Accordingly, the treatment and management of DM have become a research hotspot. Mulberry leaves (Morus alba L.) have been used in Traditional Chinese Medicine for a long time, with the first record of its use published in Shennong Bencao Jing (Shennong's Classic of Materia Medica). Mulberry leaves (MLs) are considered highly valuable medicinal food homologs that contain polysaccharides, flavonoids, alkaloids, and other bioactive substances. Modern pharmacological studies have shown that MLs have multiple bioactive effects, including hypolipidemic, hypoglycemic, antioxidation, and anti-inflammatory properties, with the ability to protect islet [Formula: see text]-cells, alleviate insulin resistance, and regulate intestinal flora. However, the pharmacological mechanisms of MLs in DM have not been fully elucidated. In this review, we summarize the botanical characterization, traditional use, chemical constituents, pharmacokinetics, and toxicology of MLs, and highlight the mechanisms involved in treating DM and its complications. This review can provide a valuable reference for the further development and utilization of MLs in the prevention and treatment of DM.

The Application of Complementary and Alternative Medicine in Polycystic Ovary Syndrome Infertility.

Polycystic ovary syndrome (PCOS) is a lifelong reproductive endocrine disease, which is the most common cause of anovular infertility. Modern medicine mainly treats infertile patients with PCOS by improving living habits, ovulation induction therapy, and assisted reproductive technology (ART), but the effect is not satisfied. Complementary alternative medicine (CAM) has conspicuous advantages in the treatment of PCOS infertility due to its good clinical efficacy, wide mechanism of action, and no obvious adverse reactions, but its safety and effectiveness in the treatment of PCOS infertility have not been proved. Based on the existing clinical and experimental studies, this paper looks for the therapeutic effect and the mechanism behind it, and explores the safety and effectiveness of its treatment in PCOS infertility, in order to provide reference for future clinical treatment and experimental research.

Protein Isolates from Raw and Cooked Foxtail Millet Attenuate Development of Type 2 Diabetes in Streptozotocin-Induced Diabetic Mice.

SCOPE: Millet protein has received much attention due to its beneficial role in alleviating metabolic disease symptoms. This study aims to investigate the role and molecular mechanism of foxtail millet protein isolates, including protein isolates from raw and cooked foxtail millet in alleviating diabetes, including gut microbiota and intracellular signal pathways. METHODS AND RESULTS: Protein isolates from raw and cooked foxtail millet are orally administered to streptozotocin (STZ)-induced diabetic mice for 5 weeks before hypoglycemic effect evaluation. The results show that foxtail millet protein isolates improve glucose intolerance and insulin resistance in diabetic mice. However, only the protein isolate from cooked foxtail millet reverse the weight loss trend and alleviate lipid disorders in diabetic mice. Besides, 16S rRNA sequencing show that both raw and cooked foxtail millet protein isolates altered diabetes-induced gut dysbiosis. In addition, western blotting analysis indicated that the protein isolate from cooked foxtail millet increases the expression levels of glucagon-like peptide-1 receptor (GLP-1R), phosphoinositide 3-kinase (PI3K), and phosphoinositide-protein kinase B (p-AKT)/AKT while the protein isolate from raw foxtail millet downregulates stearoyl-coenzyme A desaturase 1 (SCD1) level. CONCLUSION: Both raw and cooked foxtail millet protein isolates can exert hypoglycemic effects in diabetic mice through rewiring glucose homeostasis, mitigating diabetes-induced gut dysbiosis, and affecting the GLP-1R/PI3K/AKT pathway.

Hypoglycemic Effect of Prolamin from Cooked Foxtail Millet (Setaria italic) on Streptozotocin-Induced Diabetic Mice.

Millet proteins have been demonstrated to possess glucose-lowering and lipid metabolic disorder modulation functions against diabetes; however, the molecular mechanisms underlying their anti-diabetic effects remain unclear. The present study aimed to investigate the hypoglycemic effect of prolamin from cooked foxtail millet (PCFM) on type 2 diabetic mice, and explore the gut microbiota and serum metabolic profile changes that are associated with diabetes attenuation by PCFM. Our diabetes model was established using a high-fat diet combined with streptozotocin before PCFM or saline was daily administrated by gavage for 5 weeks. The results showed that PCFM ameliorated glucose metabolism disorders associated with type 2 diabetes. Furthermore, the effects of PCFM administration on gut microbiota and serum metabolome were investigated. 16S rRNA gene sequencing analysis indicated that PCFM alleviated diabetes-related gut microbiota dysbiosis in mice. Additionally, the serum metabolomics analysis revealed that the metabolite levels disturbed by diabetes were partly altered by PCFM. Notably, the decreased D-Glucose level caused by PCFM suggested that its anti-diabetic potential can be associated with the activation of glycolysis and the inhibition of gluconeogenesis, starch and sucrose metabolism and galactose metabolism. In addition, the increased serotonin level caused by PCFM may stimulate insulin secretion by pancreatic ß-cells, which contributed to its hypoglycemic effect. Taken together, our research demonstrated that the modulation of gut microbiota composition and the serum metabolomics profile was associated with the anti-diabetic effect of PCFM.

3D Dielectric Layer Enabled Highly Sensitive Capacitive Pressure Sensors for Wearable Electronics.

Flexible capacitance sensors play a key role in wearable devices, soft robots, and the Internet of things (IoT). To realize these feasible applications, subtle pressure detection under various conditions is required, and it is often limited by low sensitivity. Herein, we demonstrate a capacitive touch sensor with excellent sensing capabilities enabled by a three-dimensional (3D) network dielectric layer, combining a natural viscoelastic property material of thermoplastic polyurethane (TPU) nanofibers wrapped with electrically conductive materials of Ag nanowires (AgNWs). Taking advantage of the large deformation and the increase of effective permittivity under the action of compression force, the device has the characteristics of high sensitivity, fast response time, and low detection limit. The enhanced sensing mechanism of the 3D structures and the conductive filler have been discussed in detail. These superior functions enable us to monitor a variety of subtle pressure changes (pulse, airflow, and Morse code). By detecting the pressure of fingers, a smart piano glove integrated with 10 circuits of finger joints is made, which realizes the real-time performance of the piano and provides the possibility for the application of intelligent wearable electronic products such as virtual reality and human-machine interface in the future.

An Integrated Flexible All-Nanowire Infrared Sensing System with Record Photosensitivity.

Infrared (IR) photodetectors are a key optoelectronic device and have thus attracted considerable research attention in recent years. Photosensitivity is an increasingly important device performance parameter for nanoscale photodetectors and image sensors, as it determines the ultimate imaging quality and contrast. However, photosensitivities of state-of-the-art low-dimensional nanostructure-based IR detectors are considerably low, limiting their practical applications. Herein, a biomimetic IR detection amplification (IRDA) system that boosts photosensitivity by several orders of magnitude by introducting nanowire field effect transistors (FETs), resulting in a peak photosensitivity of 7.6 × 104 under an illumination of 1342 nm, is presented. Consequently, high-contrast imaging of IR light is obtained on the flexible IRDA arrays. The image information can be then trained and recognized by an artificial neural network for higher image-recognition efficiency. This work provides a new perspective for developing high-performance IR imaging systems, and is expected to undoubtedly enlighten future work on artificial intelligence and biorobotic systems.

The Glucose-Lowering Effect of Foxtail Millet in Subjects with Impaired Glucose Tolerance: A Self-Controlled Clinical Trial.

Foxtail millet has relatively low starch digestibility and moderate glycemic index compared to other grains. Since there are still no clinical researches regarding its long-term effect on blood glucose, this self-controlled study was conducted to investigate the glucose-lowering effect of foxtail millet in free-living subjects with impaired glucose tolerance (IGT). Fifty g/day of foxtail millet was provided to enrolled subjects throughout 12 weeks and the related clinical parameters were investigated at week 0, 6 and 12, respectively. After 12 weeks of foxtail millet intervention, the mean fasting blood glucose of the subjects decreased from 5.7 ± 0.9 mmol/L to 5.3 ± 0.7 mmol/L (p < 0.001) and the mean 2 h-glucose decreased from 10.2 ± 2.6 mmol/L to 9.4 ± 2.3 mmol/L (p = 0.003). The intake of foxtail millet caused a significant increase of serum leptin (p = 0.012), decrease of insulin resistance (p = 0.007), and marginal reduction of inflammation. Furthermore, a sex-dependent difference in glucose-lowering effect of foxtail millet was observed in this study. Foxtail millet could improve the glycemic control in free-living subjects with IGT, suggesting that increasing the consumption of foxtail millet might be beneficial to individuals suffering from type 2 diabetes mellitus.

Ni2 P@Carbon Core-Shell Nanoparticle-Arched 3D Interconnected Graphene Aerogel Architectures as Anodes for High-Performance Sodium-Ion Batteries.

To alleviate large volume change and improve poor electrochemical reaction kinetics of metal phosphide anode for sodium-ion batteries, for the first time, an unique Ni2 P@carbon/graphene aerogel (GA) 3D interconnected porous architecture is synthesized through a solvothermal reaction and in situ phosphorization process, where core-shell Ni2 P@C nanoparticles are homogenously embedded in GA nanosheets. The synergistic effect between components endows Ni2 P@C/GA electrode with high structural stability and electrochemical activity, leading to excellent electrochemical performance, retaining a specific capacity of 124.5 mA h g-1 at a current density of 1 A g-1 over 2000 cycles. The robust 3D GA matrix with abundant open pores and large surface area can provide unblocked channels for electrolyte storage and Na+ transfer and make fully close contact between the electrode and electrolyte. The carbon layers and 3D GA together build a 3D conductive matrix, which not only tolerates the volume expansion as well as prevents the aggregation and pulverization of Ni2 P nanoparticles during Na+ insertion/extraction processes, but also provides a 3D conductive highway for rapid charge transfer processes. The present strategy for phosphides via in situ phosphization route and coupling phosphides with 3D GA can be extended to other novel electrodes for high-performance energy storage devices.

CdS Nanoparticle-Modified α-Fe2O3/TiO2 Nanorod Array Photoanode for Efficient Photoelectrochemical Water Oxidation.

In this work, we demonstrate a facile successive ionic layer adsorption and reaction process accompanied by hydrothermal method to synthesize CdS nanoparticle-modified α-Fe2O3/TiO2 nanorod array for efficient photoelectrochemical (PEC) water oxidation. By integrating CdS/α-Fe2O3/TiO2 ternary system, light absorption ability of the photoanode can be effectively improved with an obviously broadened optical-response to visible light region, greatly facilitates the separation of photogenerated carriers, giving rise to the enhancement of PEC water oxidation performance. Importantly, for the designed abnormal type-II heterostructure between Fe2O3/TiO2, the conduction band position of Fe2O3 is higher than that of TiO2, the photogenerated electrons from Fe2O3 will rapidly recombine with the photogenerated holes from TiO2, thus leads to an efficient separation of photogenerated electrons from Fe2O3/holes from TiO2 at the Fe2O3/TiO2 interface, greatly improving the separation efficiency of photogenerated holes within Fe2O3 and enhances the photogenerated electron injection efficiency in TiO2. Working as the photoanodes of PEC water oxidation, CdS/α-Fe2O3/TiO2 heterostucture electrode exhibits improved photocurrent density of 0.62 mA cm- 2 at 1.23 V vs. reversible hydrogen electrode (RHE) in alkaline electrolyte, with an obviously negatively shifted onset potential of 80 mV. This work provides promising methods to enhance the PEC water oxidation performance of the TiO2-based heterostructure photoanodes.