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This article presents a study conducted in China that explores the treatment satisfaction of individuals with type 2 diabetes who were treated with dulaglutide, a medication used to lower blood sugar levels. The study found that participants reported high levels of satisfaction with dulaglutide, indicating that it may be a beneficial treatment option for individuals with type 2 diabetes in the Chinese population. Factors such as longer treatment duration, lower HbA1c levels, weight loss, absence of adverse events, and the convenience and ease of use of the medication were associated with higher treatment satisfaction. The study suggests that high treatment satisfaction may lead to improved adherence and better clinical outcomes for individuals with type 2 diabetes. [Extracted from the article]

Alumina (Al2O3) particles, the primary combustion products of solid rockets, can accumulate in the stratosphere, changing the global radiative balance. These Al2O3 particles were usually treated as homogeneous spheres. However, they contain impurities and may form clusters during the combustion process. Models representing Al-containing and C-containing Al2O3 clusters were developed, denoted as Al2O3 shell model (ASM) and Al2O3 core model (ACM), respectively. The superposition T-matrix method (STMM) was applied to examine their optical characteristics. Subsequently, a method to obtain the top-of-atmosphere flux was proposed by integrating the models with the moderate resolution atmospheric transmission code (MODTRAN). With the addition of Al/C, the absorption cross-section enhances by several orders of magnitude at 0.55 μm and increases slightly at 10 μm. The equivalent sphere models will weaken their scattering ability. A 4Tg mass burden of Al2O3 produces radiative forcing of −0.439 Wm−2. However, the addition of Al and C reduces the forcing by up to 15% and 12%, respectively. In summary, the optical characteristics and radiative forcing of Al2O3 clusters are sensitive to Al/C and morphology models. While our findings are impacted by various uncertainties, they contribute valuable insights into the radiative forcing of Al2O3 particles, potential climatic changes by space activities. [ABSTRACT FROM AUTHOR]

Degradation and trap evolution in NiO/β-Ga2O3 heterojunction pn diodes under on-state electrical stress were investigated in this work using deep-level transient spectroscopy measurements and density functional theory (DFT) calculations. The decrease in turn-on voltage and forward current appears to correlate with an increase in the concentration of the compensating acceptor-like traps. From the energy level of EV + 1.3 eV, the corresponding acceptor-like traps can be attributed to the Ga vacancy complex with hydrogen (VGa-H). Interestingly, accompanied by the increase in VGa-H concentration, the self-trapped holes (STH) originally passivated by H may gradually recover. DFT calculations show a monotonous decrease in energy, suggesting the spontaneous diffusion of hydrogen from STH passivated sites to the adjacent VGa, which are generated under stress. This phenomenon leads to the recovery of STH and the generation of VGa-H. This investigation offers new insights into the degradation mechanisms of β-Ga2O3-based devices under electrical stress. [ABSTRACT FROM AUTHOR]

Diabetic peripheral neuropathy (DPN) is a highly prevalent chronic complication in type 2 diabetes (T2D) for which no effective treatment is available. In this multicenter, randomized, double-blind, placebo-controlled phase 3 clinical trial in China, patients with T2D with DPN received acetyllevocarnitine hydrochloride (ALC; 1,500 mg/day; n = 231) or placebo (n = 227) for 24 weeks, during which antidiabetic therapy was maintained. A significantly greater reduction in modified Toronto clinical neuropathy score (mTCNS) as the primary end point occurred in the ALC group (−6.9 ± 5.3 points) compared with the placebo group (−4.7 ± 5.2 points; P < 0.001). Effect sizes (ALC 1.31 and placebo 0.85) represented a 0.65-fold improvement in ALC treatment efficacy. The mTCNS values for pain did not differ significantly between the two groups (P = 0.066), whereas the remaining 10 components of mTCNS showed significant improvement in the ALC group compared with the placebo group (P < 0.05 for all). Overall results of electrophysiological measurements were inconclusive, with significant improvement in individual measurements limited primarily to the ulnar and median nerves. Incidence of treatment-emergent adverse events was 51.2% in the ALC group, among which urinary tract infection (5.9%) and hyperlipidemia (7.9%) were most frequent. Article Highlights: The prevalence of diabetic peripheral neuropathy (DPN) in adults with diabetes is ∼50%, with clinical manifestations of burning, tingling, pain, and progressive numbness. Carnitine insufficiency is associated with increased risk of type 2 diabetes complications, and carnitine therapy reduces fasting plasma glucose and hemoglobin A1c concentrations. Adult patients with DPN were treated with acetyllevocarnitine hydrochloride (ALC) orally while receiving concomitant antidiabetic therapy, which resulted in improved modified Toronto clinical neuropathy scores. Dietary ALC supplementation provides at least some incremental improvement in DPN-related symptoms. [ABSTRACT FROM AUTHOR]

Background: There is evidence indicating that atherosclerosis is associated with periodontitis, especially in those with diabetes. The purpose of the present study was to determine whether glycemic control influences such association. Methods: Cross‐sectional data on 214 patients diagnosed with type 2 diabetes mellitus were obtained including results of basic laboratory tests, a periodontal examination, and carotid measurements. The association of periodontal parameters and carotid intima‐media thickness (cIMT) or carotid plaque (CP) was evaluated in subgroups. Results: Mean cIMT was significantly correlated with mean PLI, mean BI or number of PD ≥4 mm in the whole sample and the group with poor glycemic control. In the group with good glycemic control, however, only the number of PD ≥4 mm was associated with mean cIMT. A multiple logistic regression analysis also revealed that each 1 increase in mean PLI, mean BI or number of PD ≥4 mm was correlated with an increased cIMT in the whole sample. Conclusions: In addition to confirming the relationship between periodontitis and atherosclerosis, our study found a stronger association in groups with poor glycemic control compared to those with good glycemic control, suggesting that blood glucose modifies the association between periodontitis and arterial injury. [ABSTRACT FROM AUTHOR]

During reentry, the high temperatures experienced by near-space hypersonic vehicles result in surface ablation, generating ablative particles. These particles become part of a plasma, commonly referred to as a "dusty plasma sheath" in radar remote sensing. The dusty plasma model, integral in radar studies, involves extensive charge and dynamic interactions among dust particles. Previous derivations assumed that the dust particle radius significantly surpassed the Debye radius, leading to the neglect of dust radius effects. This study, however, explores scenarios where the dust particle radius is not markedly smaller than the Debye radius, thereby deducing the charging process of dusty plasma. The derived equations encompass the Debye radius, charging process, surface potential, and charging frequency, particularly considering larger dust particle radii. Comparative analysis of the dusty plasma model, both before and after modification, reveals improvements when dust particles approach or exceed the Debye length. In essence, our study provides essential equations for understanding dusty plasma under realistic conditions, offering potential advancements in predicting electromagnetic properties and behaviors, especially in scenarios where dust particles closely align with or surpass the Debye radius. [ABSTRACT FROM AUTHOR]

This article discusses a case study of a 54-year-old female patient with a history of hypertension who presented with left-sided weakness and slurred speech. The patient was diagnosed with an acute ischemic stroke and received antiplatelet therapy. Further investigations revealed a subclavian artery web, a rare condition that can lead to thrombosis and embolic stroke. The case highlights the importance of multiplanar reconstructions in accurately diagnosing arterial webs. The patient remained stroke-free during a 1.5-year follow-up period. [Extracted from the article]

Aim Methods Results Conclusions The 2019 ESC/EASD guidelines categorize cardiovascular disease risk (CVD) in patients with diabetes mellitus (DM). Assessing CVD risk is necessary to identify individuals at very high risk of CVD, enabling tailored and precise intervention for this high‐risk population. This study aims to evaluate the severity of a very high risk for CVD stratification among patients with type 2 DM (T2DM) across different regions in China.We conducted a cross‐sectional screening study from 1 January 2020 to 30 December 2022. Disease duration, body mass index (BMI), targeted organ damage, such as atherosclerotic heart disease, proteinuria, impaired renal function, left ventricular hypertrophy, retinopathy and known CVD risk factors, were collected from diabetic patients by professionally trained physicians. The risk of CV in patients with DM was categorized into two groups: very high risk and others, according to the 2019 ESC/EASD guidelines.In total, 1 870 720 participants from 1669 hospitals in 30 provinces of China, excluding Tibet, Taiwan, Hong Kong and Macao, were enrolled from 2020 to 2022, among whom 67.50% of patients with T2DM were at very high risk for CVD. The proportions of very high‐risk T2DM were higher in Northeast China (75.82%), Central China (73.65%) and Southwest China (72.66%), while the lowest prevalence of very high‐risk T2DM was found in Southern China (60.15%). The multivariate binary logistic regression analyses suggested that the category of very high risk for CVD is associated with age [odds ratio (OR) = 1.04; 95% confidence interval (CI): 1.04‐1.04; p < .0001], BMI (OR = 1.07; 95% CI: 1.07‐1.07; p < .0001), duration of DM (OR = 1.05; 95% CI: 1.05‐1.05; p < .0001), hypertension (OR = 3.75; 95% CI: 3.72‐3.78; p < .0001), dyslipidaemia (OR = 5.22; 95% CI: 5.18‐5.27; p < .0001) and smoking (OR = 2.92; 95% CI: 2.89‐2.95; p < .0001).This study represented the largest observational study of CVD risk assessment in patients with T2DM in China. The CVD risk situation of patients with diabetes in China is critical, and comprehensive control and management of CVD risk factors, such as hypertension, BMI and dyslipidaemia, in patients with DM need to be strengthened in patients with T2DM in China. [ABSTRACT FROM AUTHOR]

Circular RNAs (circRNAs) have important regulation in thoracic aortic aneurysm (TAA). The function and mechanism of circCDYL (circ_0008285) was explored in TAA here. Angiotensin II (Ang II) was used to construct a TAA model. Real-time quantitative polymerase chain reaction (RT-qPCR) was performed for the detection of circCDYL, miR-1270, and a disintegrin and metalloproteinase 10 (ADAM10). Cell viability was examined via cell counting kit-8 (CCK-8) assay and proliferation was analyzed using Ethynyl-2′-deoxyuridine (EdU) assay. Apoptosis rate was assessed via flow cytometry. Western blot was used for protein detection. Oxidative stress was evaluated by commercial kits. CircCDYL was upregulated in TAA tissues and Ang II-induced circCDYL upregulation in vascular smooth muscle cells (VSMCs). Knockdown of circCDYL weakened Ang II-aroused inhibition of viability, proliferation, and promotion of apoptosis, ferroptosis, and oxidative stress in VSMCs. CircCDYL served as a miR-1270 sponge. The mitigated regulation of circCDYL knockdown for Ang II-induced injury was restored after miR-1270 downregulation. CircCDYL positively regulated ADAM10 through interacting with miR-1270. Overexpression of miR-1270 abated Ang II-induced injury by downregulating ADAM10. In conclusion, circCDYL was involved in the Ang II-induced VSMC injury in TAA via the miR-1270/ADAM10 axis. [ABSTRACT FROM AUTHOR]

Background: Paroxysmal sympathetic hyperactivity (PSH) has been linked to a worse clinical prognosis in patients with traumatic brain injury. We aimed to identify the risk factors and clinical features associated with basilar artery occlusion (BAO) presenting with PSH as the first clinical presentation., Methods: This study recruited patients with acute BAO who received endovascular therapy (EVT) at two stroke centers in China. PSH Assessment Measure ≥8 was included in the PSH+ group, while those with a score below 8 were classified as the PSH- group. Clinical data and radiological findings were compared between the two groups. A binary logistic regression model was employed to identify independent risk factors for PSH., Results: 101 participants were enrolled, of whom 19 (18.8%) presented with PSH as the initial manifestation of BAO. Worse prognosis (modified Rankin Scale score of 4-6) at day 90 occurred in 14 (73.7%) of the PSH+ patients and 42 (51.2%) of the PSH- patients (P=0.076). The 90-day mortality rate was higher in the PSH+ group with 12 (63.2%) participants, compared with 31 (37.8%) participants in the PSH- group (P=0.044). A significantly increased risk of PSH was found in patients with midbrain involvement (OR 6.53, 95% CI 1.56 to 27.30, P=0.01) and a high baseline National Institutes of Health Stroke Scale (NIHSS) score (OR 1.15, 95% CI 1.01 to 1.31, P=0.037)., Conclusions: Patients with BAO presenting with PSH as the initial clinical manifestation experience a higher risk of 90-day mortality, despite undergoing EVT. Midbrain infarction and baseline NIHSS score may be significant risk factors for PSH following BAO., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Prior research based on observations has furnished evidence that supports a connection between daytime napping and the prevalence of non-alcoholic fatty liver disease (NAFLD). Nevertheless, the question of whether this correlation is indicative of a causal link has not been definitively answered., Methods: We used meta-analysis and Mendelian randomization (MR) to synthesize genetic and observational data. A two-sample MR analysis was conducted, leveraging 105 single-nucleotide polymorphisms (SNPs) known to be associated with daytime napping patterns. Additionally, summary-level data pertaining to NAFLD outcomes were acquired from the comprehensive UK Biobank study. Network meta-analyses were employed to investigate the relationship between excessive daytime napping and NAFLD, while subgroup was also performed., Results: Significant associations were observed between daytime napping and NAFLD. The systematic review/meta-analysis uncovered a heightened risk of NAFLD development among individuals who engaged in daytime naps exceeding 30 minutes, when compared to those who did not nap(odds ratio [OR] = 1.32, 95% confidence interval [CI]: 1.05 to 1.66). Furthermore, MR analysis indicated that a genetic propensity towards longer daytime napping was significantly linked to an increased likelihood of NAFLD (OR = 2.26, 95% CI: 1.38 to 3.73)., Conclusion: Daytime napping has been found to be causally related to a higher risk of NAFLD. Furthermore, across all participants, napping for an average duration over 30 minutes was linked to an elevated likelihood of NAFLD., Competing Interests: The authors affirm that the research was carried out free from any commercial or financial ties that could be interpreted as a potential conflict of interest., (© 2024 Qiao et al.)

Rationale: Pulmonary sarcomatoid carcinoma (PSC), a rare tumor, comprises 0.1% to 0.4% of all malignant lung tumors. Given the rarity of PSC, its clinical course, therapeutic guidelines, and patient outcomes remain largely unknown. Therefore, it is imperative to alert clinicians to this extremely rare and instructive early-onset cancer., Patient Concerns: This report describes a 28-year-old woman with PSC, who was initially misdiagnosed with Whipple's disease. A conclusive diagnosis of PSC was made following careful clinical examination, imaging, and histopathological evaluation of the patient's biopsy sample. Radiological imaging revealed multiple nodules and mass formations in the left upper lobe of the patient's lung, with the largest measuring of 5.4 × 3.2 cm., Diagnosis: Histopathological examination indicated the presence of a malignant neoplasm associated with necrosis suggestive of sarcoma, which was pathologically staged as cT4N1M1., Interventions and Outcomes: A regimen of doxorubicin and ifosfamide was administered therapeutically, resulting in a stable disease state., Lessons: The rarity and tumor origin challenge the diagnosis, which emphasizes the imperative role of histological examination, immunohistochemistry, and flow cytometry in achieving an accurate diagnosis. This report summarizes the existing publications to provide a comprehensive overview of PSC, including its clinical manifestations, radiographic imaging, pathologic features, diagnostic challenges, treatment strategies, and prognosis, and aims to improve the understanding of PSC., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)