This paper mainly studies the following Monge-Ampère type systems{det^(1/n)(ΔuI-D^(2)u)=p(|x|)f(v),x∈R^(n),det^(1/n)(ΔvI-D^(2)v)=q(|x|)g(u),x∈R^(n).The existence of entire radial solutions is obtained by usin...This paper mainly studies the following Monge-Ampère type systems{det^(1/n)(ΔuI-D^(2)u)=p(|x|)f(v),x∈R^(n),det^(1/n)(ΔvI-D^(2)v)=q(|x|)g(u),x∈R^(n).The existence of entire radial solutions is obtained by using monotone iteration method and Arzelà-Ascoli theorem.These results generalize the classical Keller-Osserman condition to fully nonlinear systems.展开更多
We classify a generalized coupled singular Emden-Fowler type system ＋a（t）vn=0,v＋b（t）um=0 with respect to the standard first-order Lagrangian according to the Noether point symmetries which it admits.First integr...We classify a generalized coupled singular Emden-Fowler type system ＋a（t）vn=0,v＋b（t）um=0 with respect to the standard first-order Lagrangian according to the Noether point symmetries which it admits.First integrals of the various cases which admit Noether point symmetries are then obtained.This system was discussed in the literature from the view-point of existence and uniqueness of positive solutions.展开更多
Effect of residual Doppler averaging on the probe absorption in an alkali vapor medium in the presence of a coherent pump beam is studied analytically for the Ξ type system. A coherent probe field is assumed to conne...Effect of residual Doppler averaging on the probe absorption in an alkali vapor medium in the presence of a coherent pump beam is studied analytically for the Ξ type system. A coherent probe field is assumed to connect the ground level with the intermediate level whereas a coherent control beam is supposed to act between the intermediate energy level and the uppermost level. Optical Bloch equations（OBE） for a three-level Ξ type system and a four-level Ξ type system are derived by using density matrix formalism. These equations are solved by an analytic method to determine the probe response, which not only depends on the wavelength difference between the control（pump） field and the probe field but shows substantially different features depending on whether the wavelength of the control field is greater than that of the probe field or the reverse. The effect of temperature on probe response is also shown. Enhancement in probe absorption and additional features are noticed under a strong probe limit at room temperature. The four-level Ξ type system has two ground levels and this leads to substantial modification in the simulated probe absorption as compared to the three-level system.展开更多
In this paper, a necessary and sufficient condition for teh solution of Lienard typesystem with muliiple singular points to oscillation under the more general assumptionis given.Results of the papers [1-4] are also ex...In this paper, a necessary and sufficient condition for teh solution of Lienard typesystem with muliiple singular points to oscillation under the more general assumptionis given.Results of the papers [1-4] are also extended and improved in this paper.展开更多
In this paper,we are interested in the existence of positive solutions for the Kirchhoff type problems{-（a1 ＋ b1M1（∫？｜▽u｜~pdx））△（pu） = λf（u,v）,in ？,-（a2 ＋ b2M2（∫？｜▽v｜~qdx））△（qv） = λg（u,...In this paper,we are interested in the existence of positive solutions for the Kirchhoff type problems{-（a1 ＋ b1M1（∫？｜▽u｜~pdx））△（pu） = λf（u,v）,in ？,-（a2 ＋ b2M2（∫？｜▽v｜~qdx））△（qv） = λg（u,v）,in ？,u = v = 0,on ？？,where 1 〈 p,q 〈 N,M i：R0~＋→ R~＋（i = 1,2） are continuous and increasing functions.λ is a parameter,f,g ∈ C^1（（0,∞） ×（0,∞）） × C（[0,∞） × [0,∞）） are monotone functions such that fs,ft,gs,gt ≥ 0,and f（0,0） 〈 0,g（0,0） 〈 0（semipositone）.Our proof is based on the sub-and super-solutions techniques.展开更多
Diamond thin films were prepared in a modified quartz bell-jar type microwave chemical vapor deposition (MWPCVD) system. The influences of process parameters on MWPCVD diamond thin films quality such as substrate pre...Diamond thin films were prepared in a modified quartz bell-jar type microwave chemical vapor deposition (MWPCVD) system. The influences of process parameters on MWPCVD diamond thin films quality such as substrate pretreatment, deposition gas ratio, deposition pressure and substrate position were examined and studied. The deposited films were characterized by using Scanning electron microscopy(SEM) and Raman spectroscopy. It was shown that this quartz bell-jar type MWPCVD system is beneficial to the deposition of high quality diamond thin films.展开更多
In this paper Hopf bifurcation control is implemented in order to change the bifurcation from supercritical to subcritical in a differential equations system of Lorenz type. To achieve this purpose: first, a region of...In this paper Hopf bifurcation control is implemented in order to change the bifurcation from supercritical to subcritical in a differential equations system of Lorenz type. To achieve this purpose: first, a region of parameters is identified where the system has a supercritical Hopf bifurcation;second, a class of non-linear feedback control laws is proposed;finally, it is shown that there are control laws which the disturbed system undergoes subcritical Hopf bifurcation.展开更多
DNA molecules are green materials with great potential for high-density and long-term data storage.However,the current data-writing process of DNA data storage via DNA synthesis suffers from high costs and the product...DNA molecules are green materials with great potential for high-density and long-term data storage.However,the current data-writing process of DNA data storage via DNA synthesis suffers from high costs and the production of hazards,limiting its practical applications.Here,we developed a DNA movable-type storage system that can utilize DNA fragments pre-produced by cell factories for data writing.In this system,these pre-generated DNA fragments,referred to herein as“DNA movable types,”are used as basic writing units in a repetitive way.The process of data writing is achieved by the rapid assembly of these DNA movable types,thereby avoiding the costly and environmentally hazardous process of de novo DNA synthesis.With this system,we successfully encoded 24 bytes of digital information in DNA and read it back accurately by means of high-throughput sequencing and decoding,thereby demonstrating the feasibility of this system.Through its repetitive usage and biological assembly of DNA movable-type fragments,this system exhibits excellent potential for writing cost reduction,opening up a novel route toward an economical and sustainable digital data-storage technology.展开更多
The main focus of study is to characterize lower and upper cretaceous carbonate deposits with Low Resistivity Pay, in Persian Gulf. Four oil reservoirs in the Cretaceous including the Zubair, Buwaib, Shuaiba and Khati...The main focus of study is to characterize lower and upper cretaceous carbonate deposits with Low Resistivity Pay, in Persian Gulf. Four oil reservoirs in the Cretaceous including the Zubair, Buwaib, Shuaiba and Khatiyah Formations of Southern fields have been analyzed. Here is a look at that to determine main factors on decreasing resistivity in pay zone. In some intervals resistivity responses reach less than 6 to 1 ohm·m. Significant hydrocarbon accumulations are “hidden” in low resistivity Pay zone, (LRPZ). LRPZ reservoirs have been found in some formations in Persian Gulf. Causes of LRPZ reservoirs on the basis of experimental analysis include clay-coated grains, carbonate with interstitial dispersed clay. On the other side Smectite and Kaolinite of main clays types have high CEC and greater impact on lowering resistivity. Micritization and Pyritization of digenetic process have noticeable impact on LRPZ. It is mentioned that Lønøy method applied to address pore throat sizes which contain Inter crystalline porosity, Chalky Limestone, Mudstone micro porosity. Pore systems are classified at class 2 and 3 Lucia and pore size varies from 0.5 to 4 micron. NMR Core and Log results show different pore size distribution. NMR core and MRIL results explain that decreasing of resistivity in pay zone is related to texture and grain size variation not being existence of moved water. Irreducible water estimate for this reservoir was between 30% and 50%. T2 cut off estimates, for defining irreducible water saturation, 115 ms.展开更多
BACKGROUND The incidence of type 2 diabetes mellitus(T2DM)in children and adolescents is increasing,yet there is limited information on the available pharmacological interventions to combat T2DM and prevent associated...BACKGROUND The incidence of type 2 diabetes mellitus(T2DM)in children and adolescents is increasing,yet there is limited information on the available pharmacological interventions to combat T2DM and prevent associated comorbidities.AIM To assess the effectiveness of current pharmacological treatments in managing T2DM in children and adolescents.The protocol of the study was registered in PROSPERO(CRD42022382165).METHODS Searches were performed in PubMed,EMBASE,Scopus,and ClinicalTrials.gov for publications between 1990 to September 2024 without language restrictions.Randomized control trials(RCTs)of pharmacotherapy in children and adolescents with T2DM(aged<19 years)were included.The primary outcome was a change in glycated hemoglobin(HbA1c)from baseline to follow-up.Secondary outcomes were changes in body weight,body mass index(BMI),total cholesterol,triglycerides,high density lipoprotein,and low-density lipoprotein from baseline,and incidence of adverse events during study periods.Screening,full-text review,data extraction,and assessments of risk of bias were done by two reviewers.Conflicts on each step were resolved by a third reviewer.Data analysis was performed using Review Manager Version 6.5(RevMan 6.5)and‘R’software via RStudio,‘meta’and‘netmeta’.RESULTS A total of 12 studies having low to moderate risk of bias with 1658 participants,and follow-up duration 12-52 weeks were included.In our network meta-analysis,compared to control(s),the reduction of HbA1c was sig-nificantly larger for dulaglutide[mean difference(MD),95%confidence interval:-1.20,-2.12 to-0.28],followed by dapagliflozin(-0.94,-1.44 to-0.44),liraglutide(-0.91,-1.37 to-0.45),empagliflozin(-0.87,-1.40 to-0.34),exenatide(-0.59,-1.07 to-0.11)and linagliptin(-0.45,-0.87 to-0.02)while other drugs had little or no effect.While liraglutide was associated with a change in body weight[MD-2.41(-4.68,-0.14)kg],no other drug treatment was associated with significant changes in body weight,BMI,and lipids.Apart from level 1 hypoglycemia with liraglutide[risk difference(RD):0.20,0.04-0.37]and minor adverse events with dulaglutide(RD:0.24,0.08-0.40),no other treatment was associated with excess risk of hypoglycemia or minor or major adverse events.CONCLUSION Pharmacotherapy of T2DM with dulaglutide,dapagliflozin,liraglutide,empagliflozin,exenatide,and linagliptin in children is associated with modest reduction of HbA1c.Larger RCTs with longer follow-up durations are needed to guide better therapeutic decision making.展开更多
Toxin–antitoxin(TA)systems,which are prevalent in bacteria and archaea,play diverse roles in bacterial physiology and have been proposed to be significant in stress adaptation.Despite the extensive characterization o...Toxin–antitoxin(TA)systems,which are prevalent in bacteria and archaea,play diverse roles in bacterial physiology and have been proposed to be significant in stress adaptation.Despite the extensive characterization of numerous TA systems in various bacteria,the investigation of these systems within Streptococcus suis is still limited.Here,we systematically analyzed the type Ⅱ TA systems of 95 S.suis genomes available in the GenBank database using TAfinder.A total of 612 putative type Ⅱ TA systems were retrieved and classified into 10 categories by phylogenetic analysis.Notably,an elevated occurrence of these TA systems was observed among the important prevalent serotypes 2,4,5,9,14,Chz,NCL1,and NCL3 strains.The following study identified the activities of TA systems using 2 strategies and confirmed the regulatory effect of HigBA on the type Ⅶ secretion system in S.suis by measuringβ-galactosidase activity and transcriptional changes.Moreover,we unveiled a hitherto uncharacterized,highly prevalent novel TA system,with the composition of antitoxin–toxin–antitoxin(SS-ATA),which regulates the downstream two-component signaling system.Altogether,this study systematically analyzed the type Ⅱ TA systems within S.suis,highlighting the widespread distribution of Hig BA and SS-ATA as important regulatory elements in S.suis.展开更多
BACKGROUND Cotadutide(MEDI0382)is a twincretin that acts as an agonist for both the glucagon-like peptide-1 and glucagon receptors.Several randomized controlled trials(RCTs)have been published evaluating the use of co...BACKGROUND Cotadutide(MEDI0382)is a twincretin that acts as an agonist for both the glucagon-like peptide-1 and glucagon receptors.Several randomized controlled trials(RCTs)have been published evaluating the use of cotadutide in individuals with type 2 diabetes(T2D),showing promising results.However,the efficacy and safety of the drug use have been inadequately explored by systematic reviews and meta-analyses.AIM To assess the clinical efficacy and safety of cotadutide in individuals with T2D having overweight or obesity.METHODS The systematic reviews and meta-analyses have been registered with International Prospective Register of Systematic Reviews(CRD42024511703),and the protocol summary can be accessed online.Several databases and registries,including MEDLINE(via PubMed),Scopus,Web of Science,the Cochrane Central Register of Controlled Trials,and ClinicalTrials.gov,were systematically searched using related terms from their inception to May 15,2025,for RCTs involving individuals with T2D receiving cotadutide in the intervention group.Review Manager web was used to conduct meta-analysis using random-effects models.The co-primary outcomes of interest were the changes in glycated hemoglobin(HbA1c)and the percent changes in body weight from baseline.The results of the outcomes were expressed as mean differences(MDs)or risk ratios(RRs)with 95%confidence intervals(CIs).The analysis of outcomes was stratified according to whether the control group received a placebo,denoted as the placebo control group(PCG),or an active comparator,referred to as the active control group(ACG).RESULTS Nine RCTs(mostly phase 2 RCTs,n=1525)with study durations varying from 28 days to 54 weeks that met all the inclusion criteria were analyzed;five studies had a low overall risk of bias,while the other four had some concerns.Compared to the PCG,greater reductions in HbA1c were achieved with cotadutide 100μg(MD-0.77%,95%CI:-1.06 to-0.47),200μg(MD-0.68%,95%CI:-1.12 to-0.23),300μg(MD-0.67%,95%CI:-0.79 to-0.56),and 600μg(MD-0.69%,95%CI:-0.97 to-0.41).Cotadutide 100μg(MD-1.74%,95%CI:-3.23 to-0.25),200μg(MD-2.56%,95%CI:-3.37 to-1.75),300μg(MD-3.49%,95%CI:-4.14 to-2.84),and 600μg(MD-5.45%,95%CI:-7.17 to-3.73)achieved greater percent reductions in body weight from baseline.However,the certainty of evidence for HbA1c and percent body weight reductions was very low to low.Cotadutide,at all doses,also outperformed PCG in reducing fasting plasma glucose and absolute body weight.The changes in HbA1c,percent body weight,fasting plasma glucose,and absolute body weight were similar between the cotadutide group and the ACG.Compared to PCG,pooled doses of cotadutide increased the risks of treatment-emergent adverse events(AEs),treatment-related AEs,and discontinuation of the study drug due to AEs,but not for serious AEs.More subjects experienced overall gastrointestinal AEs,dyspepsia,nausea,vomiting,constipation,and decreased appetite with cotadutide than with PCG.Compared to the ACG,none of the AEs showed increased risk in the cotadutide group.CONCLUSION Cotadutide demonstrated glycemic control and weight-loss benefits in short-term,small RCTs(mostly phase 2).However,small sample sizes,very low to low certainty of evidence,and the absence of data on long-term cardiovascular and renal outcomes highlight substantial uncertainties,warranting cautious interpretation and further investigation in larger,longer-term trials to establish its safety and efficacy profile.展开更多
BACKGROUND Pyroptosis and ubiquitination have been identified as key processes influencing the pathogenesis of diabetes mellitus(DM).AIM To investigate the genes associated with the ubiquitin-proteasome system(UPS)and...BACKGROUND Pyroptosis and ubiquitination have been identified as key processes influencing the pathogenesis of diabetes mellitus(DM).AIM To investigate the genes associated with the ubiquitin-proteasome system(UPS)and pyroptosis in type 2 DM(T2DM),and elucidate their mechanisms of action in T2DM.METHODS The datasets GSE76894,GSE41762,and GSE86469 were utilized in this study.UPS-related genes(UPSGs)and pyroptosis-related genes(PRGs)were obtained from existing literature.Differential expression analysis was performed to identify differentially expressed genes(DEGs).DEGs were intersected with UPSGs and PRGs to identify differentially expressed UPSGs and PRGs.Ubiquitin-pyroptosisrelated biomarkers were determined using Spearman’s correlation,t-tests,and receiver operating characteristic curve analysis.Pathway enrichment of biomarkers was assessed using Gene Set Enrichment Analysis(GSEA).Single sample GSEA(ssGSEA)and Spearman’s correlation were used to analyze the relationship between biomarkers and immune cells.A competitive endogenous RNA network was constructed.Subsequently,drugs related to the biomarkers were identified and a gene-drug network was established.In dataset GSE86469,single-cell sequencing was utilized to determine cell types.Finally,the expression levels of biomarkers were validated through quantitative PCR(qPCR)and western blot analysis.RESULTS A total of 581 DEGs were identified in GSE76894.Four genes[ATP binding cassette subfamily C member 8(ABCC8),retinol binding protein 4(RBP4),Ras protein-specific guanine nucleotide-releasing factor 1(RASGRF1),and solute carrier family 34 member 2(SLC34A2)]were identified as ubiquitin-pyroptosis-related biomarkers in T2DM,based on consistent expression trends and significant differences in GSE76894 and GSE41762.These biomarkers were enriched in oxidative phosphorylation and mitogen-activated protein kinase signaling pathways,which are relevant to DM.ssGSEA revealed significant differences in the enrichment scores of nine immune cell types between groups.A total of 17 microRNAs(miRNAs)and 36 long non-coding RNAs(lncRNAs)were identified,forming numerous miRNA-lncRNA interactions.Additionally,22 drugs related to the biomarkers,such as gliclazide and tretinoin,were identified.In GSE86469,eight cell types,including alpha and beta cells,were characterized.qPCR and western blot analysis confirmed that the expression trends of RASGRF1 and SLC34A2 were consistent with the findings in GSE76894.CONCLUSION This study identified four ubiquitin-pyroptosis-related biomarkers(ABCC8,RBP4,RASGRF1,and SLC34A2)in T2DM through bioinformatics analysis,providing novel insights into the diagnosis and treatment of T2DM.展开更多
Objective To systematically evaluate the overall characteristics and quality of literature on economic evaluation of drugs for type 2 diabetes,and to provide recommendations for future research and related decision-ma...Objective To systematically evaluate the overall characteristics and quality of literature on economic evaluation of drugs for type 2 diabetes,and to provide recommendations for future research and related decision-making.Methods The economic evaluation literature on drugs for type 2 diabetes based on the Chinese population were searched from CNKI,Wanfang,VIP and PubMed databases.The literature that met the inclusion criteria was selected,and the key research elements were extracted.Meanwhile,the quality of health economics studies(QHES)was used to evaluate the quality of the literature.Results and Conclusion A total of 325 articles(296 in Chinese and 29 in English)were included.Most of the studies were conducted by medical institutions(247 articles,76.0%)and they used cost-effectiveness analysis(295 articles,90.8%).However,most of the included literature did not report study perspective(267 articles,90.2%).The average QHES score of the included literature was 57.29,and the quality of the literature was concentrated in“low quality”(123 articles,37.8%)and“average quality”(138 articles,42.5%).Literature published in English journals,or using modeling methods,or from universities had relatively higher quality.The quality of economic evaluation literature on drugs for type 2 diabetes based on the Chinese population is generally low at present.There are many problems,such as single research institutions and methods,lack of research perspectives,and no sensitivity analysis.展开更多
BACKGROUND Diabetes distress(DD),an emotional problem arising from the challenges of living with diabetes and the relentless burden of daily self-management,is common among patients with type 2 diabetes(T2D).South Asi...BACKGROUND Diabetes distress(DD),an emotional problem arising from the challenges of living with diabetes and the relentless burden of daily self-management,is common among patients with type 2 diabetes(T2D).South Asia has a high T2D burden,and many studies have reported varying prevalence rates of DD in this area.AIM To estimate the pooled prevalence of DD among patients with T2D in South Asia,as it is crucial for developing effective therapeutic strategies.METHODS This systematic review and meta-analysis included cross-sectional studies conducted in South Asian countries involving adults with T2D and reported the prevalence of DD.The studies were identified by searching multiple electronic databases and registries from the inception of each database to January 30,2025,using prespecified search terms.Four authors screened and extracted data independently.Meta-analyses were conducted using RStudio software with a random-effects model.The primary outcome was the pooled prevalence of DD.RESULTS Thirty-seven cross-sectional studies(28 from India,five from Bangladesh,and two each from Pakistan and Sri Lanka)with mostly high methodological quality involving 11500 subjects were included.The pooled prevalence of DD was 44%(95%confidence interval:35-53,I2=97.4%).The prevalence of DD was highest in Pakistan(85%),followed by India and Bangladesh(42%each),and Sri Lanka(25%).Emotional burden was the most prevalent form of DD(60%),followed by treatment regimen-related distress(51%),interpersonal distress(31%),and physician-related distress(17%).Meta-regression analysis revealed no significant associations between the prevalence of DD and publication year,sample size,proportion of females,age,duration of diabetes,insulin usage,glycated hemoglobin levels,or diabetic complications.CONCLUSION South Asians with T2D seem to experience a relatively high burden of DD,and the emotional burden is the most common form of DD in this area.Larger studies utilizing unique tools and involving a broader participant base from the region would provide better epidemiological data for effectively planning high-quality diabetes care in South Asian countries.展开更多
BACKGROUND Type 2 diabetes(T2D)is a major health concern globally and its prevalence is expected to continue to escalate.Lifestyle intervention is an integral part of T2D management.Meal replacements are often used as...BACKGROUND Type 2 diabetes(T2D)is a major health concern globally and its prevalence is expected to continue to escalate.Lifestyle intervention is an integral part of T2D management.Meal replacements are often used as part of lifestyle intervention programs in T2D and weight management programs.There are various trials being carried out to date;however,a thorough review regarding the usage of meal replacement on its types,dosage and associated outcomes and adverse events is still lacking.AIM To provide a comprehensive overview on existing studies regarding meal replacement usage among patients with T2D,and map out glycemic and weightrelated outcomes along with adverse effects incidences.METHODS This scoping review is conducted based on Arksey and O’Malley’s seminal framework for scoping reviews.A systematic search has been done for studies published between January 2020 and January 2024 across six online databases(Cochrane Library,PubMed,Science Direct,Scopus,Web of Science and Ebscohost Discovery)using specific keywords.Two researchers independently assessed the eligibility of the studies and extracted the data.The selected articles and extracted data were reviewed by all researchers.RESULTS The initial search resulted in an initial count of 53922 articles from which 133 articles were included in this review after eligibility screening.Included studies were categorized based on meal replacement type into low calorie/energy,low glycemic index,protein-rich,low-fat,diabetes-specific formulas,and combined lifestyle intervention programs.Fifty-nine studies reported improvements on hemoglobin A1c,and 70 studies reported positive changes in weight or BMI after the meal replacement intervention.The combination of meal replacements with education,counseling or structured lifestyle interventions has proved to be effective.Only 13 studies reported occurrence of adverse events related to the intervention.Most of the reported incidents were of mild occurrences with constipation being the most reported adverse event.CONCLUSION The results suggest that meal replacements,especially when combined with lifestyle intervention programs and counseling,are an effective and safe strategy in glycemic and weight management among patients with T2D.展开更多
BACKGROUND Current evidence suggests that commonly used antidiabetic drugs have varying effects on cancer risk.Some antidiabetics offer protective effects against cancer,whereas others may increase risk in specific po...BACKGROUND Current evidence suggests that commonly used antidiabetic drugs have varying effects on cancer risk.Some antidiabetics offer protective effects against cancer,whereas others may increase risk in specific populations.AIM To comprehensively compare the effects of different antidiabetic drugs on the risk of various cancers in patients with type 2 diabetes mellitus(T2DM)through a systematic review and network meta-analysis.METHODS Four databases(PubMed,EMBASE,Cochrane Library,and Web of Science)were searched from their inception until April 11,2025.Published randomized controlled trials that enrolled at least 100 participants and had an intervention duration of at least 1 year were included.The inclusion criteria were studies involving adult patients with T2DM and interventions that compared different classes of antidiabetic drugs with a placebo or another antidiabetic drug.Network meta-analysis was conducted using Stata 17.0 software.Confidence in network meta-analysis was used to assess the quality of evidence regarding the risk of cancer associated with different antidiabetic drugs.RESULTS A total of 13535 articles were identified.After applying the inclusion and exclusion criteria,87 high-quality studies involving 216106 patients and 26 different drugs across seven classes were included in this study.Indirect evidence from network meta-analysis revealed some heterogeneity;however,this did not affect the reliability of the results.The results indicated that antidiabetic drugs did not increase the overall risk of cancer compared with placebo.In contrast,some antidiabetic medications demonstrated a more pronounced advantage in reducing cancer risk,such as dipeptidyl peptidase-4 inhibitors for thyroid and rectal cancers;sodium-glucose co-transporter type 2 inhibitors for lung and bronchial cancers;sulfonylureas for gastric and colon cancers;biguanides for pancreatic cancer;insulin for bladder cancer;glucagon-like peptide-1 receptor agonists for prostate,uterine,hepatocellular,renal,and hematologic cancers;and thiazolidinediones for breast cancer.CONCLUSION Antidiabetic drugs reduce cancer risk in patients with T2DM.However,given the limitations in the number and quality of the included studies,our conclusions should be interpreted with caution.More large-scale,high-quality clinical trials are required to validate our findings towards the optimization of comprehensive cancer management strategies for patients with T2DM.展开更多
BACKGROUND Automated insulin delivery(AID)systems have demonstrated benefits in managing patients with type 2 diabetes(T2D),but data are still limited.Moreover,the efficacy and safety of the AID systems in these patie...BACKGROUND Automated insulin delivery(AID)systems have demonstrated benefits in managing patients with type 2 diabetes(T2D),but data are still limited.Moreover,the efficacy and safety of the AID systems in these patients have been inadequately explored by systematic reviews and meta-analyses.AIM To provide a comprehensive understanding of the optimal use of AID in managing insulin-treated outpatients with T2D.METHODS A systematic search of multiple databases and registries,including MEDLINE,Scopus,Web of Science,Cochrane Library,and ClinicalTrials.gov,was conducted from inception to May 15,2025,to identify studies on AID use for outpatients with T2D.The co-primary outcomes were the change in glycated hemoglobin(HbA1c)and continuous glucose monitoring(CGM)metrics.Statistical analyses were conducted using Review Manager Web software with random-effects models and the inverse variance statistical method.The results were presented as mean differences(MDs)or risk ratios(RRs)with 95%CI.RESULTS A total of 15 studies with 28985 participants were identified,including 6 randomized trials(n=748;3 crossover and 3 parallel-group trials)and 9 single-arm studies.All included randomized trials raised some concerns,and the single-arm studies had serious risks of overall bias.Meta-analysis of randomized trials showed that AID is more effective than the control group in lowering HbA1c(MD:-0.89%,95%CI:-1.32 to-0.46,P<0.0001,I2=82%).Compared to control interventions,AID use was linked to a higher percentage of time in range(MD:19.25%,95%CI:11.43-27.06,P<0.00001,I2=74%)and a lower percentage of time above range>10 mmol/L(MD:-19.48%,95%CI:-27.14 to-11.82,P<0.00001,I2=73%);however,time below range remained similar between the two groups.The mean sensor glucose level was lower in the AID group;however,the coefficient of variation of glucose was the same in both groups.AID use also led to a reduction in insulin dose,but this is not a consistent finding across all study designs.The risks of serious adverse events(AEs)and severe hypoglycemia were similar in both groups;however,AID use raised the risk of device deficiency.Single-arm studies with participants using AID systems also demonstrated reductions in HbA1c(ranging from 0.7%to 2.07%)and improvements in CGM metrics,along with acceptable safety data.CONCLUSION Based on short-term study data,the use of AID systems in outpatients with T2D appears to improve glycemic outcomes and CGM metrics,with no significant AEs.Larger and longer-term randomized controlled trials involving diverse populations,along with a cost-benefit analysis,are needed to guide more informed clinical practice decisions.展开更多
BACKGROUND Data on the use of glucagon-like peptide-1 receptor agonists(GLP-1RAs)in individuals with type 2 diabetes mellitus(T2DM)during Ramadan fasting is limited.No meta-analysis has summarized the safety and effec...BACKGROUND Data on the use of glucagon-like peptide-1 receptor agonists(GLP-1RAs)in individuals with type 2 diabetes mellitus(T2DM)during Ramadan fasting is limited.No meta-analysis has summarized the safety and effectiveness of GLP-1RAs in these situations.AIM To evaluate the safety and efficacy of GLP-1RA in patients with T2DM fasting during Ramadan.METHODS Electronic databases were systematically searched for relevant studies that featured GLP-1RA in the intervention arm and other glucose-lowering medications in the control arm.The primary outcome was adverse events(AEs)during Ramadan for both groups;other outcomes included changes in glycemic and anthropometric measures during the peri-Ramadan period.RESULTS Four studies[three randomized-controlled trials with low risk of bias(RoB)and one prospective observational study with serious RoB]involving 754 subjects were analyzed.GLP-1RA group achieved greater glycated hemoglobin reduction than the non-GLP-1RA group[mean difference(MD):-0.31%,95%CI:-0.61 to-0.01,P=0.04,I2=77%]with a lower risk of documented symptomatic hypoglycemia(risk ratio=0.38,95%CI:0.16 to 0.88,P=0.02).Any AEs,serious AEs,or AEs that led to treatment discontinuation were comparable between the two groups.The GLP-1RA group experienced greater weight loss compared to the non-GLP-1RA group(MD:-2.0 kg,95%CI:-3.37 to-0.63,P=0.004,I2=95%).There were comparable changes in blood pressure and lipid profile between the two groups.GLP-1RA users experienced higher risks of gastrointestinal AEs,nausea,and vomiting;however,the risks of heartburn,abdominal pain,and diarrhea were similar in both groups.CONCLUSION Limited evidence suggests that GLP-1RAs are safe for T2DM management during Ramadan,offering modest benefits in blood sugar control and weight loss.Large multicenter trials are needed to confirm their safety and efficacy in at-risk populations,improving clinical practice decision-making.展开更多
A systematic review and meta-analysis study was conducted to assess the effectiveness of probiotic/prebiotic/synbiotic supplementation on the effects of cardiovascular risk factors in patients with type 2 diabetes mel...A systematic review and meta-analysis study was conducted to assess the effectiveness of probiotic/prebiotic/synbiotic supplementation on the effects of cardiovascular risk factors in patients with type 2 diabetes mellitus(T2DM)based on data from randomized controlled trials(RCTs).We searched electronic databases including PubMed,Cochrane Library,Embase,and Web of Science to identify clinical trials published up to 31 March 2023.Data was pooled using a random-effects model if significant heterogeneity(I2>50%),otherwise use a fixed-effects model.Fifty-six trials that included 3317 patients were enrolled for analysis.Meta-analysis reported that probiotic/prebiotic/synbiotic supplementation significantly reduced systolic blood pressure(SBP)(weighted mean difference(WMD):-3.57 mmHg,95% confidence interval(CI):-5.36,-1.78;P=0.000),diastolic blood pressure(DBP)(WMD:-2.05 mmHg,95%CI:-3.07,-1.04;P=0.000),triglycerides(TG)(WMD:-16.10 mg/dL,95%CI:-20.16,-12.05;P=0.000),total cholesterol(TC)(WMD:-14.00 mg/dL,95%CI:-20.46,-7.55;P=0.000),low-density lipoprotein cholesterol(LDL-C)(WMD:-7.03 mg/dL,95%CI:-9.25,-4.81;P=0.000),fasting plasma glucose(FPG)(WMD:-16.57 mg/dL,95%CI:-20.39,-12.74;P=0.000),hemoglobin A1c(HbA1c)(WMD:-0.44%,95%CI:-0.68,-0.20;P=0.000),insulin(standardized mean difference(SMD):-0.37,95%CI:-0.53,-0.21;P=0.000),homeostatic model assessment of insulin resistance(HOMA-IR)(WMD:-1.05,95%CI:-1.56,-0.54;P=0.000),C-reactive protein(CRP)(SMD:-0.35,95%CI:-0.57,-0.13;P=0.002),tumor necrosis factor-α(TNF-α)(SMD:-1.07,95%CI:-1.57,-0.56;P=0.000),interleukin-6(IL-6)(SMD:-0.37,95%CI:-0.61,-0.13;P=0.003)levels,they also increased the high-density lipoprotein cholesterol(HDL-C)(WMD:3.70 mg/dL,95%CI:1.80,5.60;P=0.000)levels in T2DM patients,as compared to the placebo groups.This meta-analysis supports the use of probiotic/prebiotic/synbiotic supplementation as an adjunctive therapy to improve blood pressure,glycemic control parameters,lipid profile and inflammatory markers in patients with T2DM,which are well-known cardiovascular risk factors.展开更多
文摘This paper mainly studies the following Monge-Ampère type systems{det^(1/n)(ΔuI-D^(2)u)=p(|x|)f(v),x∈R^(n),det^(1/n)(ΔvI-D^(2)v)=q(|x|)g(u),x∈R^(n).The existence of entire radial solutions is obtained by using monotone iteration method and Arzelà-Ascoli theorem.These results generalize the classical Keller-Osserman condition to fully nonlinear systems.
文摘We classify a generalized coupled singular Emden-Fowler type system ＋a（t）vn=0,v＋b（t）um=0 with respect to the standard first-order Lagrangian according to the Noether point symmetries which it admits.First integrals of the various cases which admit Noether point symmetries are then obtained.This system was discussed in the literature from the view-point of existence and uniqueness of positive solutions.
文摘Effect of residual Doppler averaging on the probe absorption in an alkali vapor medium in the presence of a coherent pump beam is studied analytically for the Ξ type system. A coherent probe field is assumed to connect the ground level with the intermediate level whereas a coherent control beam is supposed to act between the intermediate energy level and the uppermost level. Optical Bloch equations（OBE） for a three-level Ξ type system and a four-level Ξ type system are derived by using density matrix formalism. These equations are solved by an analytic method to determine the probe response, which not only depends on the wavelength difference between the control（pump） field and the probe field but shows substantially different features depending on whether the wavelength of the control field is greater than that of the probe field or the reverse. The effect of temperature on probe response is also shown. Enhancement in probe absorption and additional features are noticed under a strong probe limit at room temperature. The four-level Ξ type system has two ground levels and this leads to substantial modification in the simulated probe absorption as compared to the three-level system.
文摘In this paper, a necessary and sufficient condition for teh solution of Lienard typesystem with muliiple singular points to oscillation under the more general assumptionis given.Results of the papers [1-4] are also extended and improved in this paper.
基金Supported by the National Natural Science Foundation of China(Grant Nos.1157109311471164)
文摘In this paper,we are interested in the existence of positive solutions for the Kirchhoff type problems{-（a1 ＋ b1M1（∫？｜▽u｜~pdx））△（pu） = λf（u,v）,in ？,-（a2 ＋ b2M2（∫？｜▽v｜~qdx））△（qv） = λg（u,v）,in ？,u = v = 0,on ？？,where 1 〈 p,q 〈 N,M i：R0~＋→ R~＋（i = 1,2） are continuous and increasing functions.λ is a parameter,f,g ∈ C^1（（0,∞） ×（0,∞）） × C（[0,∞） × [0,∞）） are monotone functions such that fs,ft,gs,gt ≥ 0,and f（0,0） 〈 0,g（0,0） 〈 0（semipositone）.Our proof is based on the sub-and super-solutions techniques.
文摘Diamond thin films were prepared in a modified quartz bell-jar type microwave chemical vapor deposition (MWPCVD) system. The influences of process parameters on MWPCVD diamond thin films quality such as substrate pretreatment, deposition gas ratio, deposition pressure and substrate position were examined and studied. The deposited films were characterized by using Scanning electron microscopy(SEM) and Raman spectroscopy. It was shown that this quartz bell-jar type MWPCVD system is beneficial to the deposition of high quality diamond thin films.
文摘In this paper Hopf bifurcation control is implemented in order to change the bifurcation from supercritical to subcritical in a differential equations system of Lorenz type. To achieve this purpose: first, a region of parameters is identified where the system has a supercritical Hopf bifurcation;second, a class of non-linear feedback control laws is proposed;finally, it is shown that there are control laws which the disturbed system undergoes subcritical Hopf bifurcation.
基金supported by the National Key Research and Development Program of China(2018YFA0900100)the Natural Science Foundation of Tianjin,China(19JCJQJC63300)Tianjin University。
文摘DNA molecules are green materials with great potential for high-density and long-term data storage.However,the current data-writing process of DNA data storage via DNA synthesis suffers from high costs and the production of hazards,limiting its practical applications.Here,we developed a DNA movable-type storage system that can utilize DNA fragments pre-produced by cell factories for data writing.In this system,these pre-generated DNA fragments,referred to herein as“DNA movable types,”are used as basic writing units in a repetitive way.The process of data writing is achieved by the rapid assembly of these DNA movable types,thereby avoiding the costly and environmentally hazardous process of de novo DNA synthesis.With this system,we successfully encoded 24 bytes of digital information in DNA and read it back accurately by means of high-throughput sequencing and decoding,thereby demonstrating the feasibility of this system.Through its repetitive usage and biological assembly of DNA movable-type fragments,this system exhibits excellent potential for writing cost reduction,opening up a novel route toward an economical and sustainable digital data-storage technology.
文摘The main focus of study is to characterize lower and upper cretaceous carbonate deposits with Low Resistivity Pay, in Persian Gulf. Four oil reservoirs in the Cretaceous including the Zubair, Buwaib, Shuaiba and Khatiyah Formations of Southern fields have been analyzed. Here is a look at that to determine main factors on decreasing resistivity in pay zone. In some intervals resistivity responses reach less than 6 to 1 ohm·m. Significant hydrocarbon accumulations are “hidden” in low resistivity Pay zone, (LRPZ). LRPZ reservoirs have been found in some formations in Persian Gulf. Causes of LRPZ reservoirs on the basis of experimental analysis include clay-coated grains, carbonate with interstitial dispersed clay. On the other side Smectite and Kaolinite of main clays types have high CEC and greater impact on lowering resistivity. Micritization and Pyritization of digenetic process have noticeable impact on LRPZ. It is mentioned that Lønøy method applied to address pore throat sizes which contain Inter crystalline porosity, Chalky Limestone, Mudstone micro porosity. Pore systems are classified at class 2 and 3 Lucia and pore size varies from 0.5 to 4 micron. NMR Core and Log results show different pore size distribution. NMR core and MRIL results explain that decreasing of resistivity in pay zone is related to texture and grain size variation not being existence of moved water. Irreducible water estimate for this reservoir was between 30% and 50%. T2 cut off estimates, for defining irreducible water saturation, 115 ms.
文摘BACKGROUND The incidence of type 2 diabetes mellitus(T2DM)in children and adolescents is increasing,yet there is limited information on the available pharmacological interventions to combat T2DM and prevent associated comorbidities.AIM To assess the effectiveness of current pharmacological treatments in managing T2DM in children and adolescents.The protocol of the study was registered in PROSPERO(CRD42022382165).METHODS Searches were performed in PubMed,EMBASE,Scopus,and ClinicalTrials.gov for publications between 1990 to September 2024 without language restrictions.Randomized control trials(RCTs)of pharmacotherapy in children and adolescents with T2DM(aged<19 years)were included.The primary outcome was a change in glycated hemoglobin(HbA1c)from baseline to follow-up.Secondary outcomes were changes in body weight,body mass index(BMI),total cholesterol,triglycerides,high density lipoprotein,and low-density lipoprotein from baseline,and incidence of adverse events during study periods.Screening,full-text review,data extraction,and assessments of risk of bias were done by two reviewers.Conflicts on each step were resolved by a third reviewer.Data analysis was performed using Review Manager Version 6.5(RevMan 6.5)and‘R’software via RStudio,‘meta’and‘netmeta’.RESULTS A total of 12 studies having low to moderate risk of bias with 1658 participants,and follow-up duration 12-52 weeks were included.In our network meta-analysis,compared to control(s),the reduction of HbA1c was sig-nificantly larger for dulaglutide[mean difference(MD),95%confidence interval:-1.20,-2.12 to-0.28],followed by dapagliflozin(-0.94,-1.44 to-0.44),liraglutide(-0.91,-1.37 to-0.45),empagliflozin(-0.87,-1.40 to-0.34),exenatide(-0.59,-1.07 to-0.11)and linagliptin(-0.45,-0.87 to-0.02)while other drugs had little or no effect.While liraglutide was associated with a change in body weight[MD-2.41(-4.68,-0.14)kg],no other drug treatment was associated with significant changes in body weight,BMI,and lipids.Apart from level 1 hypoglycemia with liraglutide[risk difference(RD):0.20,0.04-0.37]and minor adverse events with dulaglutide(RD:0.24,0.08-0.40),no other treatment was associated with excess risk of hypoglycemia or minor or major adverse events.CONCLUSION Pharmacotherapy of T2DM with dulaglutide,dapagliflozin,liraglutide,empagliflozin,exenatide,and linagliptin in children is associated with modest reduction of HbA1c.Larger RCTs with longer follow-up durations are needed to guide better therapeutic decision making.
基金supported by the National Key Research and Development Program of China(2022YFD1800904)the National Natural Science Foundation of China(31972650 and 32102673)+1 种基金the Postgraduate Research&Practice Innovation Program of Jiangsu Province,China(KYCX22_0780)the China Postdoctoral Science Foundation(2020M682297)。
文摘Toxin–antitoxin(TA)systems,which are prevalent in bacteria and archaea,play diverse roles in bacterial physiology and have been proposed to be significant in stress adaptation.Despite the extensive characterization of numerous TA systems in various bacteria,the investigation of these systems within Streptococcus suis is still limited.Here,we systematically analyzed the type Ⅱ TA systems of 95 S.suis genomes available in the GenBank database using TAfinder.A total of 612 putative type Ⅱ TA systems were retrieved and classified into 10 categories by phylogenetic analysis.Notably,an elevated occurrence of these TA systems was observed among the important prevalent serotypes 2,4,5,9,14,Chz,NCL1,and NCL3 strains.The following study identified the activities of TA systems using 2 strategies and confirmed the regulatory effect of HigBA on the type Ⅶ secretion system in S.suis by measuringβ-galactosidase activity and transcriptional changes.Moreover,we unveiled a hitherto uncharacterized,highly prevalent novel TA system,with the composition of antitoxin–toxin–antitoxin(SS-ATA),which regulates the downstream two-component signaling system.Altogether,this study systematically analyzed the type Ⅱ TA systems within S.suis,highlighting the widespread distribution of Hig BA and SS-ATA as important regulatory elements in S.suis.
文摘BACKGROUND Cotadutide(MEDI0382)is a twincretin that acts as an agonist for both the glucagon-like peptide-1 and glucagon receptors.Several randomized controlled trials(RCTs)have been published evaluating the use of cotadutide in individuals with type 2 diabetes(T2D),showing promising results.However,the efficacy and safety of the drug use have been inadequately explored by systematic reviews and meta-analyses.AIM To assess the clinical efficacy and safety of cotadutide in individuals with T2D having overweight or obesity.METHODS The systematic reviews and meta-analyses have been registered with International Prospective Register of Systematic Reviews(CRD42024511703),and the protocol summary can be accessed online.Several databases and registries,including MEDLINE(via PubMed),Scopus,Web of Science,the Cochrane Central Register of Controlled Trials,and ClinicalTrials.gov,were systematically searched using related terms from their inception to May 15,2025,for RCTs involving individuals with T2D receiving cotadutide in the intervention group.Review Manager web was used to conduct meta-analysis using random-effects models.The co-primary outcomes of interest were the changes in glycated hemoglobin(HbA1c)and the percent changes in body weight from baseline.The results of the outcomes were expressed as mean differences(MDs)or risk ratios(RRs)with 95%confidence intervals(CIs).The analysis of outcomes was stratified according to whether the control group received a placebo,denoted as the placebo control group(PCG),or an active comparator,referred to as the active control group(ACG).RESULTS Nine RCTs(mostly phase 2 RCTs,n=1525)with study durations varying from 28 days to 54 weeks that met all the inclusion criteria were analyzed;five studies had a low overall risk of bias,while the other four had some concerns.Compared to the PCG,greater reductions in HbA1c were achieved with cotadutide 100μg(MD-0.77%,95%CI:-1.06 to-0.47),200μg(MD-0.68%,95%CI:-1.12 to-0.23),300μg(MD-0.67%,95%CI:-0.79 to-0.56),and 600μg(MD-0.69%,95%CI:-0.97 to-0.41).Cotadutide 100μg(MD-1.74%,95%CI:-3.23 to-0.25),200μg(MD-2.56%,95%CI:-3.37 to-1.75),300μg(MD-3.49%,95%CI:-4.14 to-2.84),and 600μg(MD-5.45%,95%CI:-7.17 to-3.73)achieved greater percent reductions in body weight from baseline.However,the certainty of evidence for HbA1c and percent body weight reductions was very low to low.Cotadutide,at all doses,also outperformed PCG in reducing fasting plasma glucose and absolute body weight.The changes in HbA1c,percent body weight,fasting plasma glucose,and absolute body weight were similar between the cotadutide group and the ACG.Compared to PCG,pooled doses of cotadutide increased the risks of treatment-emergent adverse events(AEs),treatment-related AEs,and discontinuation of the study drug due to AEs,but not for serious AEs.More subjects experienced overall gastrointestinal AEs,dyspepsia,nausea,vomiting,constipation,and decreased appetite with cotadutide than with PCG.Compared to the ACG,none of the AEs showed increased risk in the cotadutide group.CONCLUSION Cotadutide demonstrated glycemic control and weight-loss benefits in short-term,small RCTs(mostly phase 2).However,small sample sizes,very low to low certainty of evidence,and the absence of data on long-term cardiovascular and renal outcomes highlight substantial uncertainties,warranting cautious interpretation and further investigation in larger,longer-term trials to establish its safety and efficacy profile.
基金Supported by National Natural Science Foundation of China,No.82270863 and No.82470849Major Project of Anhui Provincial University Research Program,No.2023AH040400+1 种基金Joint Fund for Medical Artificial Intelligence,No.MAI2023Q026the Project of Health Commission Scientific Research in Anhui Province,No.AHWJ2024Aa20477.
文摘BACKGROUND Pyroptosis and ubiquitination have been identified as key processes influencing the pathogenesis of diabetes mellitus(DM).AIM To investigate the genes associated with the ubiquitin-proteasome system(UPS)and pyroptosis in type 2 DM(T2DM),and elucidate their mechanisms of action in T2DM.METHODS The datasets GSE76894,GSE41762,and GSE86469 were utilized in this study.UPS-related genes(UPSGs)and pyroptosis-related genes(PRGs)were obtained from existing literature.Differential expression analysis was performed to identify differentially expressed genes(DEGs).DEGs were intersected with UPSGs and PRGs to identify differentially expressed UPSGs and PRGs.Ubiquitin-pyroptosisrelated biomarkers were determined using Spearman’s correlation,t-tests,and receiver operating characteristic curve analysis.Pathway enrichment of biomarkers was assessed using Gene Set Enrichment Analysis(GSEA).Single sample GSEA(ssGSEA)and Spearman’s correlation were used to analyze the relationship between biomarkers and immune cells.A competitive endogenous RNA network was constructed.Subsequently,drugs related to the biomarkers were identified and a gene-drug network was established.In dataset GSE86469,single-cell sequencing was utilized to determine cell types.Finally,the expression levels of biomarkers were validated through quantitative PCR(qPCR)and western blot analysis.RESULTS A total of 581 DEGs were identified in GSE76894.Four genes[ATP binding cassette subfamily C member 8(ABCC8),retinol binding protein 4(RBP4),Ras protein-specific guanine nucleotide-releasing factor 1(RASGRF1),and solute carrier family 34 member 2(SLC34A2)]were identified as ubiquitin-pyroptosis-related biomarkers in T2DM,based on consistent expression trends and significant differences in GSE76894 and GSE41762.These biomarkers were enriched in oxidative phosphorylation and mitogen-activated protein kinase signaling pathways,which are relevant to DM.ssGSEA revealed significant differences in the enrichment scores of nine immune cell types between groups.A total of 17 microRNAs(miRNAs)and 36 long non-coding RNAs(lncRNAs)were identified,forming numerous miRNA-lncRNA interactions.Additionally,22 drugs related to the biomarkers,such as gliclazide and tretinoin,were identified.In GSE86469,eight cell types,including alpha and beta cells,were characterized.qPCR and western blot analysis confirmed that the expression trends of RASGRF1 and SLC34A2 were consistent with the findings in GSE76894.CONCLUSION This study identified four ubiquitin-pyroptosis-related biomarkers(ABCC8,RBP4,RASGRF1,and SLC34A2)in T2DM through bioinformatics analysis,providing novel insights into the diagnosis and treatment of T2DM.
文摘Objective To systematically evaluate the overall characteristics and quality of literature on economic evaluation of drugs for type 2 diabetes,and to provide recommendations for future research and related decision-making.Methods The economic evaluation literature on drugs for type 2 diabetes based on the Chinese population were searched from CNKI,Wanfang,VIP and PubMed databases.The literature that met the inclusion criteria was selected,and the key research elements were extracted.Meanwhile,the quality of health economics studies(QHES)was used to evaluate the quality of the literature.Results and Conclusion A total of 325 articles(296 in Chinese and 29 in English)were included.Most of the studies were conducted by medical institutions(247 articles,76.0%)and they used cost-effectiveness analysis(295 articles,90.8%).However,most of the included literature did not report study perspective(267 articles,90.2%).The average QHES score of the included literature was 57.29,and the quality of the literature was concentrated in“low quality”(123 articles,37.8%)and“average quality”(138 articles,42.5%).Literature published in English journals,or using modeling methods,or from universities had relatively higher quality.The quality of economic evaluation literature on drugs for type 2 diabetes based on the Chinese population is generally low at present.There are many problems,such as single research institutions and methods,lack of research perspectives,and no sensitivity analysis.
文摘BACKGROUND Diabetes distress(DD),an emotional problem arising from the challenges of living with diabetes and the relentless burden of daily self-management,is common among patients with type 2 diabetes(T2D).South Asia has a high T2D burden,and many studies have reported varying prevalence rates of DD in this area.AIM To estimate the pooled prevalence of DD among patients with T2D in South Asia,as it is crucial for developing effective therapeutic strategies.METHODS This systematic review and meta-analysis included cross-sectional studies conducted in South Asian countries involving adults with T2D and reported the prevalence of DD.The studies were identified by searching multiple electronic databases and registries from the inception of each database to January 30,2025,using prespecified search terms.Four authors screened and extracted data independently.Meta-analyses were conducted using RStudio software with a random-effects model.The primary outcome was the pooled prevalence of DD.RESULTS Thirty-seven cross-sectional studies(28 from India,five from Bangladesh,and two each from Pakistan and Sri Lanka)with mostly high methodological quality involving 11500 subjects were included.The pooled prevalence of DD was 44%(95%confidence interval:35-53,I2=97.4%).The prevalence of DD was highest in Pakistan(85%),followed by India and Bangladesh(42%each),and Sri Lanka(25%).Emotional burden was the most prevalent form of DD(60%),followed by treatment regimen-related distress(51%),interpersonal distress(31%),and physician-related distress(17%).Meta-regression analysis revealed no significant associations between the prevalence of DD and publication year,sample size,proportion of females,age,duration of diabetes,insulin usage,glycated hemoglobin levels,or diabetic complications.CONCLUSION South Asians with T2D seem to experience a relatively high burden of DD,and the emotional burden is the most common form of DD in this area.Larger studies utilizing unique tools and involving a broader participant base from the region would provide better epidemiological data for effectively planning high-quality diabetes care in South Asian countries.
文摘BACKGROUND Type 2 diabetes(T2D)is a major health concern globally and its prevalence is expected to continue to escalate.Lifestyle intervention is an integral part of T2D management.Meal replacements are often used as part of lifestyle intervention programs in T2D and weight management programs.There are various trials being carried out to date;however,a thorough review regarding the usage of meal replacement on its types,dosage and associated outcomes and adverse events is still lacking.AIM To provide a comprehensive overview on existing studies regarding meal replacement usage among patients with T2D,and map out glycemic and weightrelated outcomes along with adverse effects incidences.METHODS This scoping review is conducted based on Arksey and O’Malley’s seminal framework for scoping reviews.A systematic search has been done for studies published between January 2020 and January 2024 across six online databases(Cochrane Library,PubMed,Science Direct,Scopus,Web of Science and Ebscohost Discovery)using specific keywords.Two researchers independently assessed the eligibility of the studies and extracted the data.The selected articles and extracted data were reviewed by all researchers.RESULTS The initial search resulted in an initial count of 53922 articles from which 133 articles were included in this review after eligibility screening.Included studies were categorized based on meal replacement type into low calorie/energy,low glycemic index,protein-rich,low-fat,diabetes-specific formulas,and combined lifestyle intervention programs.Fifty-nine studies reported improvements on hemoglobin A1c,and 70 studies reported positive changes in weight or BMI after the meal replacement intervention.The combination of meal replacements with education,counseling or structured lifestyle interventions has proved to be effective.Only 13 studies reported occurrence of adverse events related to the intervention.Most of the reported incidents were of mild occurrences with constipation being the most reported adverse event.CONCLUSION The results suggest that meal replacements,especially when combined with lifestyle intervention programs and counseling,are an effective and safe strategy in glycemic and weight management among patients with T2D.
基金Supported by National Natural Science Foundation of China,No.82305205Young Elite Scientists Sponsorship Program by China Association of Chinese Medicine,No.2023-QNRC2-A05+1 种基金Safeguard Project of Guang’anmen Hospital,China Academy of Chinese Medical Sciences,No.GAMHH9324001Special Program for the Training of Outstanding Young Scientific and Technological Talents Under the Basic Scientific Research Operating Expenses of the China Academy of Chinese Medical Sciences,No.ZZ18-YQ-011.
文摘BACKGROUND Current evidence suggests that commonly used antidiabetic drugs have varying effects on cancer risk.Some antidiabetics offer protective effects against cancer,whereas others may increase risk in specific populations.AIM To comprehensively compare the effects of different antidiabetic drugs on the risk of various cancers in patients with type 2 diabetes mellitus(T2DM)through a systematic review and network meta-analysis.METHODS Four databases(PubMed,EMBASE,Cochrane Library,and Web of Science)were searched from their inception until April 11,2025.Published randomized controlled trials that enrolled at least 100 participants and had an intervention duration of at least 1 year were included.The inclusion criteria were studies involving adult patients with T2DM and interventions that compared different classes of antidiabetic drugs with a placebo or another antidiabetic drug.Network meta-analysis was conducted using Stata 17.0 software.Confidence in network meta-analysis was used to assess the quality of evidence regarding the risk of cancer associated with different antidiabetic drugs.RESULTS A total of 13535 articles were identified.After applying the inclusion and exclusion criteria,87 high-quality studies involving 216106 patients and 26 different drugs across seven classes were included in this study.Indirect evidence from network meta-analysis revealed some heterogeneity;however,this did not affect the reliability of the results.The results indicated that antidiabetic drugs did not increase the overall risk of cancer compared with placebo.In contrast,some antidiabetic medications demonstrated a more pronounced advantage in reducing cancer risk,such as dipeptidyl peptidase-4 inhibitors for thyroid and rectal cancers;sodium-glucose co-transporter type 2 inhibitors for lung and bronchial cancers;sulfonylureas for gastric and colon cancers;biguanides for pancreatic cancer;insulin for bladder cancer;glucagon-like peptide-1 receptor agonists for prostate,uterine,hepatocellular,renal,and hematologic cancers;and thiazolidinediones for breast cancer.CONCLUSION Antidiabetic drugs reduce cancer risk in patients with T2DM.However,given the limitations in the number and quality of the included studies,our conclusions should be interpreted with caution.More large-scale,high-quality clinical trials are required to validate our findings towards the optimization of comprehensive cancer management strategies for patients with T2DM.
文摘BACKGROUND Automated insulin delivery(AID)systems have demonstrated benefits in managing patients with type 2 diabetes(T2D),but data are still limited.Moreover,the efficacy and safety of the AID systems in these patients have been inadequately explored by systematic reviews and meta-analyses.AIM To provide a comprehensive understanding of the optimal use of AID in managing insulin-treated outpatients with T2D.METHODS A systematic search of multiple databases and registries,including MEDLINE,Scopus,Web of Science,Cochrane Library,and ClinicalTrials.gov,was conducted from inception to May 15,2025,to identify studies on AID use for outpatients with T2D.The co-primary outcomes were the change in glycated hemoglobin(HbA1c)and continuous glucose monitoring(CGM)metrics.Statistical analyses were conducted using Review Manager Web software with random-effects models and the inverse variance statistical method.The results were presented as mean differences(MDs)or risk ratios(RRs)with 95%CI.RESULTS A total of 15 studies with 28985 participants were identified,including 6 randomized trials(n=748;3 crossover and 3 parallel-group trials)and 9 single-arm studies.All included randomized trials raised some concerns,and the single-arm studies had serious risks of overall bias.Meta-analysis of randomized trials showed that AID is more effective than the control group in lowering HbA1c(MD:-0.89%,95%CI:-1.32 to-0.46,P<0.0001,I2=82%).Compared to control interventions,AID use was linked to a higher percentage of time in range(MD:19.25%,95%CI:11.43-27.06,P<0.00001,I2=74%)and a lower percentage of time above range>10 mmol/L(MD:-19.48%,95%CI:-27.14 to-11.82,P<0.00001,I2=73%);however,time below range remained similar between the two groups.The mean sensor glucose level was lower in the AID group;however,the coefficient of variation of glucose was the same in both groups.AID use also led to a reduction in insulin dose,but this is not a consistent finding across all study designs.The risks of serious adverse events(AEs)and severe hypoglycemia were similar in both groups;however,AID use raised the risk of device deficiency.Single-arm studies with participants using AID systems also demonstrated reductions in HbA1c(ranging from 0.7%to 2.07%)and improvements in CGM metrics,along with acceptable safety data.CONCLUSION Based on short-term study data,the use of AID systems in outpatients with T2D appears to improve glycemic outcomes and CGM metrics,with no significant AEs.Larger and longer-term randomized controlled trials involving diverse populations,along with a cost-benefit analysis,are needed to guide more informed clinical practice decisions.
基金thankful to Dr.Marina George Kudiyirickal MSc,MJDF-RCS,PhD for providing us the audio core tip of this article.
文摘BACKGROUND Data on the use of glucagon-like peptide-1 receptor agonists(GLP-1RAs)in individuals with type 2 diabetes mellitus(T2DM)during Ramadan fasting is limited.No meta-analysis has summarized the safety and effectiveness of GLP-1RAs in these situations.AIM To evaluate the safety and efficacy of GLP-1RA in patients with T2DM fasting during Ramadan.METHODS Electronic databases were systematically searched for relevant studies that featured GLP-1RA in the intervention arm and other glucose-lowering medications in the control arm.The primary outcome was adverse events(AEs)during Ramadan for both groups;other outcomes included changes in glycemic and anthropometric measures during the peri-Ramadan period.RESULTS Four studies[three randomized-controlled trials with low risk of bias(RoB)and one prospective observational study with serious RoB]involving 754 subjects were analyzed.GLP-1RA group achieved greater glycated hemoglobin reduction than the non-GLP-1RA group[mean difference(MD):-0.31%,95%CI:-0.61 to-0.01,P=0.04,I2=77%]with a lower risk of documented symptomatic hypoglycemia(risk ratio=0.38,95%CI:0.16 to 0.88,P=0.02).Any AEs,serious AEs,or AEs that led to treatment discontinuation were comparable between the two groups.The GLP-1RA group experienced greater weight loss compared to the non-GLP-1RA group(MD:-2.0 kg,95%CI:-3.37 to-0.63,P=0.004,I2=95%).There were comparable changes in blood pressure and lipid profile between the two groups.GLP-1RA users experienced higher risks of gastrointestinal AEs,nausea,and vomiting;however,the risks of heartburn,abdominal pain,and diarrhea were similar in both groups.CONCLUSION Limited evidence suggests that GLP-1RAs are safe for T2DM management during Ramadan,offering modest benefits in blood sugar control and weight loss.Large multicenter trials are needed to confirm their safety and efficacy in at-risk populations,improving clinical practice decision-making.
基金Jiangsu College of Nursing 2023 Special Fund for Research and Development of Medical-Educational Integration。
文摘A systematic review and meta-analysis study was conducted to assess the effectiveness of probiotic/prebiotic/synbiotic supplementation on the effects of cardiovascular risk factors in patients with type 2 diabetes mellitus(T2DM)based on data from randomized controlled trials(RCTs).We searched electronic databases including PubMed,Cochrane Library,Embase,and Web of Science to identify clinical trials published up to 31 March 2023.Data was pooled using a random-effects model if significant heterogeneity(I2>50%),otherwise use a fixed-effects model.Fifty-six trials that included 3317 patients were enrolled for analysis.Meta-analysis reported that probiotic/prebiotic/synbiotic supplementation significantly reduced systolic blood pressure(SBP)(weighted mean difference(WMD):-3.57 mmHg,95% confidence interval(CI):-5.36,-1.78;P=0.000),diastolic blood pressure(DBP)(WMD:-2.05 mmHg,95%CI:-3.07,-1.04;P=0.000),triglycerides(TG)(WMD:-16.10 mg/dL,95%CI:-20.16,-12.05;P=0.000),total cholesterol(TC)(WMD:-14.00 mg/dL,95%CI:-20.46,-7.55;P=0.000),low-density lipoprotein cholesterol(LDL-C)(WMD:-7.03 mg/dL,95%CI:-9.25,-4.81;P=0.000),fasting plasma glucose(FPG)(WMD:-16.57 mg/dL,95%CI:-20.39,-12.74;P=0.000),hemoglobin A1c(HbA1c)(WMD:-0.44%,95%CI:-0.68,-0.20;P=0.000),insulin(standardized mean difference(SMD):-0.37,95%CI:-0.53,-0.21;P=0.000),homeostatic model assessment of insulin resistance(HOMA-IR)(WMD:-1.05,95%CI:-1.56,-0.54;P=0.000),C-reactive protein(CRP)(SMD:-0.35,95%CI:-0.57,-0.13;P=0.002),tumor necrosis factor-α(TNF-α)(SMD:-1.07,95%CI:-1.57,-0.56;P=0.000),interleukin-6(IL-6)(SMD:-0.37,95%CI:-0.61,-0.13;P=0.003)levels,they also increased the high-density lipoprotein cholesterol(HDL-C)(WMD:3.70 mg/dL,95%CI:1.80,5.60;P=0.000)levels in T2DM patients,as compared to the placebo groups.This meta-analysis supports the use of probiotic/prebiotic/synbiotic supplementation as an adjunctive therapy to improve blood pressure,glycemic control parameters,lipid profile and inflammatory markers in patients with T2DM,which are well-known cardiovascular risk factors.
