Objective. To establish a PCR- SSP method for discriminating as many HLA- A* 02 alleles, which could easily be introduced into a routine laboratory. Methods. In this study we typed HLA- A* 02 polymorphisms by a sequen...Objective. To establish a PCR- SSP method for discriminating as many HLA- A* 02 alleles, which could easily be introduced into a routine laboratory. Methods. In this study we typed HLA- A* 02 polymorphisms by a sequence- specific primer (SSP) method, which involved round 1 and round 2 PCR reactions to detect 17 HLA- A* 02 alleles (they are HLA- A* 0201- 0217 alleles) covering exon 2 and exon 3. Results. We have found that DNA sample concentration and purity were the most important variables in determining the quality of the results. For identifying correct band size, the size marker used was important. We noticed that different PCR machines performed differently. By this method, we detected 20 HLA- A* 02 positive genomic DNA samples and found 4 kinds of HLA- A* 02 alleles. They were HLA- A* 0201, 0203, 0206 and 0210. Conclusion. The HLA- A* 02 PCR- SSP method was proven to be a reliable and easily applicable typing method. Our results suggest that the SSP described here provides an optimal HLA- A* 02 typing technique that may be useful in selecting donor- recipient pairs in bone marrow transplantation between unrelated individuals.展开更多
Nitrogen(N)enrichment has resulted in widespread alteration of grassland ecosystem processes and functions mainly through disturbance in soil enzyme activities.However,we lack a comprehensive understanding of how N de...Nitrogen(N)enrichment has resulted in widespread alteration of grassland ecosystem processes and functions mainly through disturbance in soil enzyme activities.However,we lack a comprehensive understanding of how N deposition affects specific key soil enzymes that mediate plant-soil feedback of grassland.Here,with a meta-analysis on 1446 cases from field observations in China,we show that N deposition differently affects soil enzymes associated with soil biochemical processes.Specifically,N-promoted C,N,and P-acquiring hydrolase activities significantly increased by 8.73%,7.67%,and 8.69%,respectively,related to an increase in microbial-specific enzyme secretion.The increased relative N availability and soil acidification were two potential mechanisms accounting for the changes in soil enzyme activities with N enrichment.The mixed N addition in combination of NH_(4)NO_(3) and urea showed greater stimulation effect on soil enzyme activities.However,the high rate and long-term N addition tended to weaken the positive responses of soil C-,Nand P-acquiring hydrolase activities to N enrichment.Spatially increased mean annual precipitation and temperature primarily promoted the positive effects of N enrichment on N-and P-acquiring hydrolase activities,and the stimulation of C-and N-acquiring hydrolase activities by N enrichment was intensified with the increase in soil depth.Finally,multimodal inference showed that grassland type was the most important regulator of responses of microbial C,N,and P-acquiring hydrolase activities to N enrichment.This meta-analysis provides a comprehensive insight into understanding the key role of N enrichment in shaping soil enzyme activities of grassland ecosystems.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
Celiac disease(CD)is a systemic autoimmune disorder triggered by gluten ingestion ingenetically predisposed individuals.It is characterized by intestinal histological damage and the production of specific autoantibodi...Celiac disease(CD)is a systemic autoimmune disorder triggered by gluten ingestion ingenetically predisposed individuals.It is characterized by intestinal histological damage and the production of specific autoantibodies.The latest European Society for Paediatric Gastroenterology,Hepatology,and Nutrition(ESPGHAN)2020 guidelines have excluded human leukocyte antigen(HLA)genotyping from the no-biopsy diagnostic approach due to its weak positive predictive value,limited availability,and high cost in some countries.However,HLA genetic testing remains valuable in certain clinical contexts.This study provided practical indications for when to request and how to interpret HLA genotyping,emphasizing its continued relevance for CD diagnosis in specific cases.We also proposed a strategy for monitoring the risk of developing type 1 diabetes(T1D)in patients with CD,based on the risk stratification carried by different HLA genotypes.A retrospective analysis of 746 patients with CD and 627 controls was conducted at our hospital starting in2012,when HLA genotyping became mandatory for the diagnosis of CD.We identified key clinical scenarios where HLA testing remains useful.Several high risk HLA-DQ genotypes strongly associated with CD were highlighted,including HLA-DQ2.5/HLA-DQ2.2and HLA-DQ2.5/HLA-DQ2.5.Notably,while the HLA-DQ2.5/HLA-DQ2.2 genotype is linked to CD,it appears to confer protection against T1D.To support clinical practice,we presented a table clarifying commonly used HLA terminology,and another summarized the main clinical situations in which HLAgenotyping should still be considered.These findings underscore the dual role of HLA testing:Not only can it help rule out CD in selected cases,but it also identifies patients with CD at risk for T1D,guiding personalized monitoring strategies.展开更多
The information from sparsely logged wellbores is currently under-utilized in reservoir simulation models and their proxies using deep and machine learning (DL/ML).This is particularly problematic for large heterogene...The information from sparsely logged wellbores is currently under-utilized in reservoir simulation models and their proxies using deep and machine learning (DL/ML).This is particularly problematic for large heterogeneous gas/oil reservoirs being considered for repurposing as gas storage reservoirs for CH_(4),CO_(2) or H_(2) and/or enhanced oil recovery technologies.Lack of well-log data leads to inadequate spatial definition of complex models due to the large uncertainties associated with the extrapolation of petrophysical rock types (PRT) calibrated with limited core data across heterogeneous and/or anisotropic reservoirs.Extracting well-log attributes from the few well logs available in many wells and tying PRT predictions based on them to seismic data has the potential to substantially improve the confidence in PRT 3D-mapping across such reservoirs.That process becomes more efficient when coupled with DL/ML models incorporating feature importance and optimized,dual-objective feature selection techniques.展开更多
Recent increases in infectious diseases affecting the central nervous system have raised concerns about their role in neuroinflammation and neurodegeneration.Viral pathogens or their products can invade the central ne...Recent increases in infectious diseases affecting the central nervous system have raised concerns about their role in neuroinflammation and neurodegeneration.Viral pathogens or their products can invade the central nervous system and cause damage,leading to meningitis,encephalitis,meningoencephalitis,myelitis,or post-infectious demyelinating diseases.Although neuroinflammation initially has a protective function,chronic inflammation can contribute to the development of neurodegenerative diseases.Mechanisms such as protein aggregation and cellular disturbances are implicated with specific viruses such as herpes simplex virus type 1 and Epstein-Barr virus being associated with Alzheimer's disease and multiple sclerosis,respectively.Extracellular nucleotides,particularly adenosine triphosphate and its metabolites are released from activated,infected,and dying cells,acting as alarmins mediating neuroinflammation and neurodegeneration.When viruses infect central nervous system cells,adenosine triphosphate is released as an alarmin,triggering inflammatory responses.This process is mediated by purinergic receptors,divided into two families:P1,which responds to adenosine,and P2,activated by adenosine triphosphate and other nucleotides.This review highlights how specific viruses,such as human immunodeficiency virus type 1,Theiler's murine encephalomyelitis virus,herpes simplex virus type 1,Epstein-Barr virus,dengue virus,Zika virus,and severe acute respiratory syndrome coronavirus 2,can initiate inflammatory responses through the release of extracellular nucleotides,particularly adenosine triphosphate,which act as critical mediators in the progression of neuroinflammation and neurodegenerative disorders.A better understanding of purinergic signaling pathways in these diseases may suggest new potential therapeutic strategies for targeting neuroinflammation to mitigate the long-term consequences of viral infections in the central nervous system.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
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
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
About 44%of the world’s cocoa is produced in one single country,Côte d’Ivoire.Providing this important raw material,most Ivorian cocoa farmers live in severe poverty,which,despite a multitude of sector interven...About 44%of the world’s cocoa is produced in one single country,Côte d’Ivoire.Providing this important raw material,most Ivorian cocoa farmers live in severe poverty,which,despite a multitude of sector interventions,is still widespread,affecting social and environmental sustainability in cocoa production.In this context,cocoa farmers are still often treated as a homogeneous group of small-scale producers(mainly males),resulting in interventions being conceptualized as one-size-fits-all approaches and failing to deliver support schemes that take farmers’specific conditions appropriately into account.Applying a broader typology approach that combines farm characteristics with farmers’characteristics,this study aims to delineate Ivorian cocoa farmers and their farms into specific types in order to improve advice for targeted sustainability interventions and living income(LI)potentials.Principal component analysis and hierarchical clustering analysis of a household dataset collected in 2022 in five cocoa-growing regions of Côte d’Ivoire were chosen to identify types of male-headed farms.To assure gender sensitive analysis,a female-headed farm type was created artificially.The specific characteristics of the identified types were captured using descriptive analysis.Descriptive statistics and non-parametric tests were then applied to examine the relationships between these farm types and various outcomes.Additionally,a binary logistic model was used to estimate the probability of these links in relation to variables relevant for achieving a LI.Finally,Spearman non-parametric correlation was used to identify eventual differences in the strength of relationships between key variables per farm type.Three different types of male-headed farms are identified:type 1(the most productive and diversified farms with larger size),type 2(middle-sized farms with strong focus on cash crops),and type 3(small-sized farms with a good level of diversification for self-consumption).The artificially created type 4 represents female-headed farms with the smallest size.On average,none of these farm types achieves a LI.However,type 1 shows the smallest LI gap,while type 4 is by far the worst.Our analyses reveal underlying socio-economic factors systematically disadvantaging female-headed cocoa farms,most notably limited access to land and other material assets.The key contribution of this study lies in the empirical identification of the different characteristics of farms in a given farming system,thereby identifying the need for targeted support interventions.Type-specific recommendations are made,showing pathways to provide tailored programs to farmers of different types in order to reduce their LI gaps.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
High reliability applications in dense access scenarios have become one of the main goals of 6G environments.To solve the access collision of dense Machine Type Communication(MTC)devices in cell-free communication sys...High reliability applications in dense access scenarios have become one of the main goals of 6G environments.To solve the access collision of dense Machine Type Communication(MTC)devices in cell-free communication systems,an intelligent cooperative secure access scheme based on multi-agent reinforcement learning and federated learning is proposed,that is,the Preamble Slice Orderly Queue Access(PSOQA)scheme.In this scheme,the preamble arrangement is combined with the access control.The preamble arrangement is realized by preamble slices which is from the virtual preamble pool.The access devices learn to queue orderly by deep reinforcement learning.The orderly queue weakens the random and avoids collision.A preamble slice is assigned to an orderly access queue at each access time.The orderly queue is determined by interaction information among multiple agents.With the federated reinforcement learning framework,the PSOQA scheme is implemented to guarantee the privacy and security of agents.Finally,the access performance of PSOQA is compared with other random contention schemes in different load scenarios.Simulation results show that PSOQA can not only improve the access success rate but also guarantee low-latency tolerant performances.展开更多
BACKGROUND Beinaglutide,a short-acting glucagon-like polypeptide-1 receptor agonist,has shown variable efficacy in weight reduction and metabolic control in randomized controlled trials(RCTs).AIM To summarize the ther...BACKGROUND Beinaglutide,a short-acting glucagon-like polypeptide-1 receptor agonist,has shown variable efficacy in weight reduction and metabolic control in randomized controlled trials(RCTs).AIM To summarize the therapeutic effects of beinaglutide in patients with overweight/obesity with/without type 2 diabetes.METHODS RCTs involving patients receiving beinaglutide in the intervention arm and placebo or active comparator in the control arm were searched through multiple electronic databases.The change from baseline in body weight was the primary outcome;secondary outcomes included changes in body mass index(BMI),waist circumference(WC),blood pressure,glycemic parameters,lipids,and adverse events(AEs).RevMan web was used to conduct meta-analysis using random-effects models.Outcomes were presented as mean differences(MDs),odds ratios(ORs),or risk ratios(RRs)with 95%confidence intervals(95%CIs).RESULTS Six RCTs(n=800)with mostly some concerns about the risk of bias were included.Over 12-24 weeks,beinaglutide 0.1-0.2 mg thrice daily was superior to the control group in reducing total(MD=-3.25 kg,95%CI:-4.52 to-1.98,I^(2)=84%,P<0.00001)and percent(MD=-4.13%,95%CI:-4.87 to-3.39,I^(2)=54%,P<0.00001)body weight reduction.Beinaglutide also outperformed the control group in achieving weight loss by 5%(OR 4.61)and 10%(OR=5.34).The superiority of beinaglutide vs the control group was also found in reducing BMI(MD=-1.22 kg/m^(2),95%CI:-1.67 to-0.77)and WC(MD=-2.47 cm,95%CI:-3.74 to-1.19]).Beinaglutide and the control group had comparable impacts on blood pressure,glycemic parameters,insulin resistance,hepatic transaminases,and lipid profile.Beinaglutide posed higher risks of treatment discontinuation due to AEs(RR=3.15),nausea(RR=4.51),vomiting(RR=8.19),palpitation(RR=3.95),headache(RR=2.87),and dizziness(RR=6.07)than the control.However,the two groups had identical risks of total and serious AEs,diarrhea,fatigue,and hypoglycemia.CONCLUSION Short-term data from RCTs suggested that beinaglutide causes modest benefits in reducing body weight,BMI,and WC,with no significant difference in glycemic and other metabolic endpoints compared to the control arm.Safety data were consistent with those of the other drugs in the glucagon-like polypeptide-1 receptor agonist class.Larger RCTs are warranted to prove the longer-term metabolic benefits of beinaglutide.展开更多
This paper explores the possibility of using machine learning algorithms to predict type 2 diabetes.We selected two commonly used classification models:random forest and logistic regression,modeled patients’clinical ...This paper explores the possibility of using machine learning algorithms to predict type 2 diabetes.We selected two commonly used classification models:random forest and logistic regression,modeled patients’clinical and lifestyle data,and compared their prediction performance.We found that the random forest model achieved the highest accuracy,demonstrated excellent classification results on the test set,and better distinguished between diabetic and non-diabetic patients by the confusion matrix and other evaluation metrics.The support vector machine and logistic regression perform slightly less well but achieve a high level of accuracy.The experimental results validate the effectiveness of the three machine learning algorithms,especially random forest,in the diabetes prediction task and provide useful practical experience for the intelligent prevention and control of chronic diseases.This study promotes the innovation of the diabetes prediction and management model,which is expected to alleviate the pressure on medical resources,reduce the burden of social health care,and improve the prognosis and quality of life of patients.In the future,we can consider expanding the data scale,exploring other machine learning algorithms,and integrating multimodal data to further realize the potential of artificial intelligence(AI)in the field of diabetes.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
This editorial delves into the potential of systemic immune indicators(SIIs)as early predictors of renal damage in children with newly diagnosed type 1 diabetes mellitus.By exploring the recent study published by Cao ...This editorial delves into the potential of systemic immune indicators(SIIs)as early predictors of renal damage in children with newly diagnosed type 1 diabetes mellitus.By exploring the recent study published by Cao et al,this article aims to highlight the importance of early detection and intervention.This study compre-hensively analyzes various SIIs,examining their correlation with renal compli-cations in newly diagnosed type 1 diabetic children.The findings reveal a sig-nificant association between immune system dysregulation and the onset of renal damage,suggesting that certain immune indicators can be early markers for predicting renal complications.This editorial emphasizes the clinical implications and applications of utilizing SIIs for early detection in pediatric diabetes care.It underscores the importance of innovative diagnostic approaches and illustrates real-world applications and outcomes.Additionally,it addresses the challenges and considerations in adopting these indicators and outlines future research directions to enhance diabetes management in children.展开更多
Alzheimer’s dementia(AD)and type 2 diabetes(T2D)are interrelated global public health problems,and the current epidemics of both AD and T2D are insulin resistance diseases.Thus,AD and T2D may share common risk factor...Alzheimer’s dementia(AD)and type 2 diabetes(T2D)are interrelated global public health problems,and the current epidemics of both AD and T2D are insulin resistance diseases.Thus,AD and T2D may share common risk factors such as an unhealthy diet,lifestyle,and obesity.Meat products is an important part of the diet of consumers worldwide.This systematic review and meta-analysis aims to assess and estimate the effect of meat products consumption on AD and T2D in humans.Web of Science,MEDLINE,PubMed,Cochrane Library,and Embase were searched from January 2012 to April 2024.29 articles reported 32 cohort studies with 1785769 subjects,with 3546 AD cases and 91092 T2D cases that met the inclusion criteria and were included in our analysis.Consumption of various meat products increased the risk of T2D(hazard ratios(HR)=1.19,95%confidence intervals(CI):1.13−1.26,P=0.000;I2=88.5%),consumption of smoked,grilled/roasted and fried meat products was more likely to induce T2D(HR=1.24,95%CI:1.18−1.30,P=0.000;I2=76.1%),but was borderline significant for the risk of AD(HR=1.11,95%CI:0.98−1.25,P=0.094;I2=58.8%),with consumption of mainly livestock and poultry products increasing the risk(HR=1.21,95%CI:1.03−1.42,P=0.017;I2=66.8%).The association between meat products consumption and AD risk was influenced by meat type and sample size,while the risk of T2D was influenced by meat type,follow-up and sex.A daily intake of 27,123 and 170 g of livestock products increased the risk of T2D by 10%,51%and 70%respectively,whereas the risk of T2D was reduced when the intake of various meat products was less than 23 g/day.展开更多
BACKGROUND Diabetes mellitus(DM)is a global health concern,characterized by insulin resistance andβ-cell dysfunction.Traditional treatments often fail to address underlying mechanisms,necessitating alternative therap...BACKGROUND Diabetes mellitus(DM)is a global health concern,characterized by insulin resistance andβ-cell dysfunction.Traditional treatments often fail to address underlying mechanisms,necessitating alternative therapies.Mesenchymal stem cell(MSC)-based therapies have shown promise due to their regenerative and immunomodulatory properties.However,evidence on their efficacy and safety in type 2 DM remains limited and further evaluation is needed.AIM To evaluate the safety,efficacy and therapeutic potential of MSC-based therapies in type 2 DM.METHODS This systematic review analyzed studies published between 2000 and 2025,focusing on autologous and allogeneic MSC therapies in DM.Studies were identified from various databases,including clinical and preclinical trials.Outcomes related to glycemic control,insulin requirements,β-cell function,and safety were assessed.RESULTS MSC-based therapies significantly improved glycemic control,reduced insulin requirements and enhancedβ-cell function in both clinical and preclinical settings.Safety profiles were favorable,with minimal adverse effects observed,primarily transient and self-limiting.No fatal events were reported.Variability in treatment outcomes and the need for standardized protocols were challenges.CONCLUSION MSC-based therapies offer a promising alternative to conventional DM treatments,significantly improving glycemic control and safety.Further research is needed to refine protocols and confirm long-term efficacy.展开更多
Objective Epidemiological studies have shown that vitamin D status affects glycemic control in individuals with type 2 diabetes mellitus(T2DM).However,findings from intervention studies remain inconsistent.Therefore,a...Objective Epidemiological studies have shown that vitamin D status affects glycemic control in individuals with type 2 diabetes mellitus(T2DM).However,findings from intervention studies remain inconsistent.Therefore,a network meta-analysis was conducted to evaluate the comparative efficacy of various vitamin D supplementation strategies on glucose indicators in adults with T2DM.Methods Eligible studies published before September 12,2024,were retrieved from PubMed,EMBASE,Cochrane Library,and Web of Science.A network meta-analysis of multiple dosage strategies—low(<1,000 IU/day,LDS),medium(1,000–2,000 IU/day,MDS),high(2,000–4,000 IU/day,HDS),and extremely high(≥4,000 IU/day,EHDS)—was performed.Results The network meta-analysis of 40 RCTs indicated that,compared with placebo,vitamin D_(3)supplementation increased 25-hydroxyvitamin D[25-(OH)-D]levels,with pooled mean difference(MD)showing a stepwise increase from LDS to EHDS.Ranking probabilities showed a corresponding rise in 25-(OH)-D levels from LDS(46.7%)to EHDS(91.2%).EHDS reduced fasting blood glucose(FBG)relative to no treatment.LDS significantly decreased hemoglobin A1c(HbA1c),and vitamin D_(2) significantly affected FBG levels.MDS led to a significant change in fasting insulin(FIN)compared to both placebo(MD:-4.76;95%CI-8.91 to-0.61)and no treatment(MD:-7.30;95%CI-14.44 to-0.17).Conclusion The findings suggest that vitamin D supplementation may be a viable approach for improving glycemic control in adults with T2DM,with lower doses potentially offering benefit.The analysis also showed a dose-dependent increase in 25-(OH)-D levels.展开更多
文摘Objective. To establish a PCR- SSP method for discriminating as many HLA- A* 02 alleles, which could easily be introduced into a routine laboratory. Methods. In this study we typed HLA- A* 02 polymorphisms by a sequence- specific primer (SSP) method, which involved round 1 and round 2 PCR reactions to detect 17 HLA- A* 02 alleles (they are HLA- A* 0201- 0217 alleles) covering exon 2 and exon 3. Results. We have found that DNA sample concentration and purity were the most important variables in determining the quality of the results. For identifying correct band size, the size marker used was important. We noticed that different PCR machines performed differently. By this method, we detected 20 HLA- A* 02 positive genomic DNA samples and found 4 kinds of HLA- A* 02 alleles. They were HLA- A* 0201, 0203, 0206 and 0210. Conclusion. The HLA- A* 02 PCR- SSP method was proven to be a reliable and easily applicable typing method. Our results suggest that the SSP described here provides an optimal HLA- A* 02 typing technique that may be useful in selecting donor- recipient pairs in bone marrow transplantation between unrelated individuals.
基金supported by the Strategic Priority Research Program of the Chinese Academy of Sciences(No.XDA28110300)National Natural Science Foundation of China(No.U23A2004)+3 种基金Natural Science Foundation of Jilin Province,China(No.YDZJ202201ZYTS522)Science and Technology Cooperation Program between Jilin Province and Chinese Academy of Sciences(No.2023SYHZ0053)Innovation Team Program of Northeast Institute of Geography and Agroecology,Chinese Academy of Sciences(No.2023CXTD02)the European Commission under Marie Sk?odowska-Curie(No.101034371)。
文摘Nitrogen(N)enrichment has resulted in widespread alteration of grassland ecosystem processes and functions mainly through disturbance in soil enzyme activities.However,we lack a comprehensive understanding of how N deposition affects specific key soil enzymes that mediate plant-soil feedback of grassland.Here,with a meta-analysis on 1446 cases from field observations in China,we show that N deposition differently affects soil enzymes associated with soil biochemical processes.Specifically,N-promoted C,N,and P-acquiring hydrolase activities significantly increased by 8.73%,7.67%,and 8.69%,respectively,related to an increase in microbial-specific enzyme secretion.The increased relative N availability and soil acidification were two potential mechanisms accounting for the changes in soil enzyme activities with N enrichment.The mixed N addition in combination of NH_(4)NO_(3) and urea showed greater stimulation effect on soil enzyme activities.However,the high rate and long-term N addition tended to weaken the positive responses of soil C-,Nand P-acquiring hydrolase activities to N enrichment.Spatially increased mean annual precipitation and temperature primarily promoted the positive effects of N enrichment on N-and P-acquiring hydrolase activities,and the stimulation of C-and N-acquiring hydrolase activities by N enrichment was intensified with the increase in soil depth.Finally,multimodal inference showed that grassland type was the most important regulator of responses of microbial C,N,and P-acquiring hydrolase activities to N enrichment.This meta-analysis provides a comprehensive insight into understanding the key role of N enrichment in shaping soil enzyme activities of grassland ecosystems.
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.
基金Supported by Fondazione di Sardegna,No.2020.2284.
文摘Celiac disease(CD)is a systemic autoimmune disorder triggered by gluten ingestion ingenetically predisposed individuals.It is characterized by intestinal histological damage and the production of specific autoantibodies.The latest European Society for Paediatric Gastroenterology,Hepatology,and Nutrition(ESPGHAN)2020 guidelines have excluded human leukocyte antigen(HLA)genotyping from the no-biopsy diagnostic approach due to its weak positive predictive value,limited availability,and high cost in some countries.However,HLA genetic testing remains valuable in certain clinical contexts.This study provided practical indications for when to request and how to interpret HLA genotyping,emphasizing its continued relevance for CD diagnosis in specific cases.We also proposed a strategy for monitoring the risk of developing type 1 diabetes(T1D)in patients with CD,based on the risk stratification carried by different HLA genotypes.A retrospective analysis of 746 patients with CD and 627 controls was conducted at our hospital starting in2012,when HLA genotyping became mandatory for the diagnosis of CD.We identified key clinical scenarios where HLA testing remains useful.Several high risk HLA-DQ genotypes strongly associated with CD were highlighted,including HLA-DQ2.5/HLA-DQ2.2and HLA-DQ2.5/HLA-DQ2.5.Notably,while the HLA-DQ2.5/HLA-DQ2.2 genotype is linked to CD,it appears to confer protection against T1D.To support clinical practice,we presented a table clarifying commonly used HLA terminology,and another summarized the main clinical situations in which HLAgenotyping should still be considered.These findings underscore the dual role of HLA testing:Not only can it help rule out CD in selected cases,but it also identifies patients with CD at risk for T1D,guiding personalized monitoring strategies.
文摘The information from sparsely logged wellbores is currently under-utilized in reservoir simulation models and their proxies using deep and machine learning (DL/ML).This is particularly problematic for large heterogeneous gas/oil reservoirs being considered for repurposing as gas storage reservoirs for CH_(4),CO_(2) or H_(2) and/or enhanced oil recovery technologies.Lack of well-log data leads to inadequate spatial definition of complex models due to the large uncertainties associated with the extrapolation of petrophysical rock types (PRT) calibrated with limited core data across heterogeneous and/or anisotropic reservoirs.Extracting well-log attributes from the few well logs available in many wells and tying PRT predictions based on them to seismic data has the potential to substantially improve the confidence in PRT 3D-mapping across such reservoirs.That process becomes more efficient when coupled with DL/ML models incorporating feature importance and optimized,dual-objective feature selection techniques.
基金supported by funds from the Conselho Nacional de Desenvolvimento Cientifico e Tecnologico do Brasil(CNPq)(312286/2023-6,307201/2023-6,and Instituto Nacional Saude Cerebral INSC,No.406020/2022-1)Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior(CAPES)Fundacao de Amparo a Pesquisa do Estado do Rio de Janeiro-FAPERJ(E-26/010.002260/2019,E-26/010.001652/2019,E-26/010.101036/2018,E-26/202.774/2018,E-26/210.240/2020,E-26/211.138/2021,26/210.823/2021,E-26/211.325/2021,E-26/210.779/2021,E-26/201.086/2022,E-26/210.312/2022,E-26/203.262/2023,E-26/200.195/2023)(to LEBS)。
文摘Recent increases in infectious diseases affecting the central nervous system have raised concerns about their role in neuroinflammation and neurodegeneration.Viral pathogens or their products can invade the central nervous system and cause damage,leading to meningitis,encephalitis,meningoencephalitis,myelitis,or post-infectious demyelinating diseases.Although neuroinflammation initially has a protective function,chronic inflammation can contribute to the development of neurodegenerative diseases.Mechanisms such as protein aggregation and cellular disturbances are implicated with specific viruses such as herpes simplex virus type 1 and Epstein-Barr virus being associated with Alzheimer's disease and multiple sclerosis,respectively.Extracellular nucleotides,particularly adenosine triphosphate and its metabolites are released from activated,infected,and dying cells,acting as alarmins mediating neuroinflammation and neurodegeneration.When viruses infect central nervous system cells,adenosine triphosphate is released as an alarmin,triggering inflammatory responses.This process is mediated by purinergic receptors,divided into two families:P1,which responds to adenosine,and P2,activated by adenosine triphosphate and other nucleotides.This review highlights how specific viruses,such as human immunodeficiency virus type 1,Theiler's murine encephalomyelitis virus,herpes simplex virus type 1,Epstein-Barr virus,dengue virus,Zika virus,and severe acute respiratory syndrome coronavirus 2,can initiate inflammatory responses through the release of extracellular nucleotides,particularly adenosine triphosphate,which act as critical mediators in the progression of neuroinflammation and neurodegenerative disorders.A better understanding of purinergic signaling pathways in these diseases may suggest new potential therapeutic strategies for targeting neuroinflammation to mitigate the long-term consequences of viral infections in the central nervous system.
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 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.
基金This work was conducted in the frame of the accompanying research on strategies for improving farmer families’incomes and sustainable cocoa production funded by the German Federal Ministry for Economic Cooperation and Development(BMZ).
文摘About 44%of the world’s cocoa is produced in one single country,Côte d’Ivoire.Providing this important raw material,most Ivorian cocoa farmers live in severe poverty,which,despite a multitude of sector interventions,is still widespread,affecting social and environmental sustainability in cocoa production.In this context,cocoa farmers are still often treated as a homogeneous group of small-scale producers(mainly males),resulting in interventions being conceptualized as one-size-fits-all approaches and failing to deliver support schemes that take farmers’specific conditions appropriately into account.Applying a broader typology approach that combines farm characteristics with farmers’characteristics,this study aims to delineate Ivorian cocoa farmers and their farms into specific types in order to improve advice for targeted sustainability interventions and living income(LI)potentials.Principal component analysis and hierarchical clustering analysis of a household dataset collected in 2022 in five cocoa-growing regions of Côte d’Ivoire were chosen to identify types of male-headed farms.To assure gender sensitive analysis,a female-headed farm type was created artificially.The specific characteristics of the identified types were captured using descriptive analysis.Descriptive statistics and non-parametric tests were then applied to examine the relationships between these farm types and various outcomes.Additionally,a binary logistic model was used to estimate the probability of these links in relation to variables relevant for achieving a LI.Finally,Spearman non-parametric correlation was used to identify eventual differences in the strength of relationships between key variables per farm type.Three different types of male-headed farms are identified:type 1(the most productive and diversified farms with larger size),type 2(middle-sized farms with strong focus on cash crops),and type 3(small-sized farms with a good level of diversification for self-consumption).The artificially created type 4 represents female-headed farms with the smallest size.On average,none of these farm types achieves a LI.However,type 1 shows the smallest LI gap,while type 4 is by far the worst.Our analyses reveal underlying socio-economic factors systematically disadvantaging female-headed cocoa farms,most notably limited access to land and other material assets.The key contribution of this study lies in the empirical identification of the different characteristics of farms in a given farming system,thereby identifying the need for targeted support interventions.Type-specific recommendations are made,showing pathways to provide tailored programs to farmers of different types in order to reduce their LI gaps.
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 in part by the National Natural Science Foundation of China under grants 61771255in part by the Provincial and Ministerial Key Laboratory Open Project under grant 20190904in part by the Key Technologies R&D Program of Jiangsu (Prospective and Key Technologies for Industry)under Grants BE2022067,BE2022067-1 and BE2022067-2。
文摘High reliability applications in dense access scenarios have become one of the main goals of 6G environments.To solve the access collision of dense Machine Type Communication(MTC)devices in cell-free communication systems,an intelligent cooperative secure access scheme based on multi-agent reinforcement learning and federated learning is proposed,that is,the Preamble Slice Orderly Queue Access(PSOQA)scheme.In this scheme,the preamble arrangement is combined with the access control.The preamble arrangement is realized by preamble slices which is from the virtual preamble pool.The access devices learn to queue orderly by deep reinforcement learning.The orderly queue weakens the random and avoids collision.A preamble slice is assigned to an orderly access queue at each access time.The orderly queue is determined by interaction information among multiple agents.With the federated reinforcement learning framework,the PSOQA scheme is implemented to guarantee the privacy and security of agents.Finally,the access performance of PSOQA is compared with other random contention schemes in different load scenarios.Simulation results show that PSOQA can not only improve the access success rate but also guarantee low-latency tolerant performances.
文摘BACKGROUND Beinaglutide,a short-acting glucagon-like polypeptide-1 receptor agonist,has shown variable efficacy in weight reduction and metabolic control in randomized controlled trials(RCTs).AIM To summarize the therapeutic effects of beinaglutide in patients with overweight/obesity with/without type 2 diabetes.METHODS RCTs involving patients receiving beinaglutide in the intervention arm and placebo or active comparator in the control arm were searched through multiple electronic databases.The change from baseline in body weight was the primary outcome;secondary outcomes included changes in body mass index(BMI),waist circumference(WC),blood pressure,glycemic parameters,lipids,and adverse events(AEs).RevMan web was used to conduct meta-analysis using random-effects models.Outcomes were presented as mean differences(MDs),odds ratios(ORs),or risk ratios(RRs)with 95%confidence intervals(95%CIs).RESULTS Six RCTs(n=800)with mostly some concerns about the risk of bias were included.Over 12-24 weeks,beinaglutide 0.1-0.2 mg thrice daily was superior to the control group in reducing total(MD=-3.25 kg,95%CI:-4.52 to-1.98,I^(2)=84%,P<0.00001)and percent(MD=-4.13%,95%CI:-4.87 to-3.39,I^(2)=54%,P<0.00001)body weight reduction.Beinaglutide also outperformed the control group in achieving weight loss by 5%(OR 4.61)and 10%(OR=5.34).The superiority of beinaglutide vs the control group was also found in reducing BMI(MD=-1.22 kg/m^(2),95%CI:-1.67 to-0.77)and WC(MD=-2.47 cm,95%CI:-3.74 to-1.19]).Beinaglutide and the control group had comparable impacts on blood pressure,glycemic parameters,insulin resistance,hepatic transaminases,and lipid profile.Beinaglutide posed higher risks of treatment discontinuation due to AEs(RR=3.15),nausea(RR=4.51),vomiting(RR=8.19),palpitation(RR=3.95),headache(RR=2.87),and dizziness(RR=6.07)than the control.However,the two groups had identical risks of total and serious AEs,diarrhea,fatigue,and hypoglycemia.CONCLUSION Short-term data from RCTs suggested that beinaglutide causes modest benefits in reducing body weight,BMI,and WC,with no significant difference in glycemic and other metabolic endpoints compared to the control arm.Safety data were consistent with those of the other drugs in the glucagon-like polypeptide-1 receptor agonist class.Larger RCTs are warranted to prove the longer-term metabolic benefits of beinaglutide.
文摘This paper explores the possibility of using machine learning algorithms to predict type 2 diabetes.We selected two commonly used classification models:random forest and logistic regression,modeled patients’clinical and lifestyle data,and compared their prediction performance.We found that the random forest model achieved the highest accuracy,demonstrated excellent classification results on the test set,and better distinguished between diabetic and non-diabetic patients by the confusion matrix and other evaluation metrics.The support vector machine and logistic regression perform slightly less well but achieve a high level of accuracy.The experimental results validate the effectiveness of the three machine learning algorithms,especially random forest,in the diabetes prediction task and provide useful practical experience for the intelligent prevention and control of chronic diseases.This study promotes the innovation of the diabetes prediction and management model,which is expected to alleviate the pressure on medical resources,reduce the burden of social health care,and improve the prognosis and quality of life of patients.In the future,we can consider expanding the data scale,exploring other machine learning algorithms,and integrating multimodal data to further realize the potential of artificial intelligence(AI)in the field of diabetes.
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.
文摘This editorial delves into the potential of systemic immune indicators(SIIs)as early predictors of renal damage in children with newly diagnosed type 1 diabetes mellitus.By exploring the recent study published by Cao et al,this article aims to highlight the importance of early detection and intervention.This study compre-hensively analyzes various SIIs,examining their correlation with renal compli-cations in newly diagnosed type 1 diabetic children.The findings reveal a sig-nificant association between immune system dysregulation and the onset of renal damage,suggesting that certain immune indicators can be early markers for predicting renal complications.This editorial emphasizes the clinical implications and applications of utilizing SIIs for early detection in pediatric diabetes care.It underscores the importance of innovative diagnostic approaches and illustrates real-world applications and outcomes.Additionally,it addresses the challenges and considerations in adopting these indicators and outlines future research directions to enhance diabetes management in children.
基金supported by the Agricultural Science and Technology Innovation Program,Institute of Food Science and Technology,Chinese Academy of Agricultural Sciences under Grant CAAS-ASTIP-2023-IFSTGuangdong Provincial Key R&D Programme(2023B0202080003).
文摘Alzheimer’s dementia(AD)and type 2 diabetes(T2D)are interrelated global public health problems,and the current epidemics of both AD and T2D are insulin resistance diseases.Thus,AD and T2D may share common risk factors such as an unhealthy diet,lifestyle,and obesity.Meat products is an important part of the diet of consumers worldwide.This systematic review and meta-analysis aims to assess and estimate the effect of meat products consumption on AD and T2D in humans.Web of Science,MEDLINE,PubMed,Cochrane Library,and Embase were searched from January 2012 to April 2024.29 articles reported 32 cohort studies with 1785769 subjects,with 3546 AD cases and 91092 T2D cases that met the inclusion criteria and were included in our analysis.Consumption of various meat products increased the risk of T2D(hazard ratios(HR)=1.19,95%confidence intervals(CI):1.13−1.26,P=0.000;I2=88.5%),consumption of smoked,grilled/roasted and fried meat products was more likely to induce T2D(HR=1.24,95%CI:1.18−1.30,P=0.000;I2=76.1%),but was borderline significant for the risk of AD(HR=1.11,95%CI:0.98−1.25,P=0.094;I2=58.8%),with consumption of mainly livestock and poultry products increasing the risk(HR=1.21,95%CI:1.03−1.42,P=0.017;I2=66.8%).The association between meat products consumption and AD risk was influenced by meat type and sample size,while the risk of T2D was influenced by meat type,follow-up and sex.A daily intake of 27,123 and 170 g of livestock products increased the risk of T2D by 10%,51%and 70%respectively,whereas the risk of T2D was reduced when the intake of various meat products was less than 23 g/day.
基金Supported by Clinical Variants of Metabolic Syndrome and Hormonal Mechanisms of its Formation in the Residents of Aktobe City,No.8/5-1-04/1-36/1.
文摘BACKGROUND Diabetes mellitus(DM)is a global health concern,characterized by insulin resistance andβ-cell dysfunction.Traditional treatments often fail to address underlying mechanisms,necessitating alternative therapies.Mesenchymal stem cell(MSC)-based therapies have shown promise due to their regenerative and immunomodulatory properties.However,evidence on their efficacy and safety in type 2 DM remains limited and further evaluation is needed.AIM To evaluate the safety,efficacy and therapeutic potential of MSC-based therapies in type 2 DM.METHODS This systematic review analyzed studies published between 2000 and 2025,focusing on autologous and allogeneic MSC therapies in DM.Studies were identified from various databases,including clinical and preclinical trials.Outcomes related to glycemic control,insulin requirements,β-cell function,and safety were assessed.RESULTS MSC-based therapies significantly improved glycemic control,reduced insulin requirements and enhancedβ-cell function in both clinical and preclinical settings.Safety profiles were favorable,with minimal adverse effects observed,primarily transient and self-limiting.No fatal events were reported.Variability in treatment outcomes and the need for standardized protocols were challenges.CONCLUSION MSC-based therapies offer a promising alternative to conventional DM treatments,significantly improving glycemic control and safety.Further research is needed to refine protocols and confirm long-term efficacy.
文摘Objective Epidemiological studies have shown that vitamin D status affects glycemic control in individuals with type 2 diabetes mellitus(T2DM).However,findings from intervention studies remain inconsistent.Therefore,a network meta-analysis was conducted to evaluate the comparative efficacy of various vitamin D supplementation strategies on glucose indicators in adults with T2DM.Methods Eligible studies published before September 12,2024,were retrieved from PubMed,EMBASE,Cochrane Library,and Web of Science.A network meta-analysis of multiple dosage strategies—low(<1,000 IU/day,LDS),medium(1,000–2,000 IU/day,MDS),high(2,000–4,000 IU/day,HDS),and extremely high(≥4,000 IU/day,EHDS)—was performed.Results The network meta-analysis of 40 RCTs indicated that,compared with placebo,vitamin D_(3)supplementation increased 25-hydroxyvitamin D[25-(OH)-D]levels,with pooled mean difference(MD)showing a stepwise increase from LDS to EHDS.Ranking probabilities showed a corresponding rise in 25-(OH)-D levels from LDS(46.7%)to EHDS(91.2%).EHDS reduced fasting blood glucose(FBG)relative to no treatment.LDS significantly decreased hemoglobin A1c(HbA1c),and vitamin D_(2) significantly affected FBG levels.MDS led to a significant change in fasting insulin(FIN)compared to both placebo(MD:-4.76;95%CI-8.91 to-0.61)and no treatment(MD:-7.30;95%CI-14.44 to-0.17).Conclusion The findings suggest that vitamin D supplementation may be a viable approach for improving glycemic control in adults with T2DM,with lower doses potentially offering benefit.The analysis also showed a dose-dependent increase in 25-(OH)-D levels.
