Prediabetes and atrial fibrillation risk stratification,phenotyping,and possible reversal to normoglycemia

Patients admitted with prediabetes and atrial fibrillation are at high risk for major adverse cardiac or cerebrovascular events independent of confounding variables.The shared pathophysiology between these three serious but common diseases and their association with atherosclerotic cardiovascular risk factors establish a vicious circle culminating in high atherogenicity.Because of that,it is of paramount importance to perform risk stratification of patients with prediabetes to define phenotypes that benefit from various interventions.Furthermore,stress hyperglycemia assessment of hospitalized patients and consensus on the definition of prediabetes is vital.The roles lifestyle and metformin play in prediabetes are well established.However,the role of glucagon-like peptide agonists and metabolic surgery is less clear.Prediabetes is considered an intermediate between normoglycemia and diabetes along the blood glucose continuum.One billion people are expected to suffer from prediabetes by the year 2045.Therefore,realworld randomized controlled trials to assess major adverse cardiac or cerebrovascular event risk reduction and reversal/prevention of type 2 diabetes among patients are needed to determine the proper interventions.

Laparoscopic intracorporeal anastomosis vs open anastomosis for ileostomy reversal in Crohn's disease:A single center retrospective study

BACKGROUND There is an increased maturation of laparoscopic intracorporeal anastomosis techniques.However,research on its application for small bowel stoma reversal in patients with Crohn's disease(CD)is limited.Therefore,in this study,we compared the perioperative outcomes between laparoscopic intracorporeal ileostomy reversal(LIIR)and open ileostomy reversal(OIR).AIM To compare the safety,feasibility,bowel function recovery,and short-and longterm LIIR and OIR outcomes in patients with CD.METHODS This study included patients who underwent ileal reversal for CD between January 2021 and January 2023 at our institution.The baseline data,postoperative recovery,and complication indicators were retrospectively analyzed.Logistic regression analysis was conducted to explore factors that significantly influenced the development of enteral nutrition intolerance-related symptoms.RESULTS Notably,15 of the 45 patients in this study underwent OIR,and the remaining 30 received LIIR.Notably,no statistically significant differences were found between the two groups regarding clinical baseline characteristics,operation time,intraoperative hemorrhage,anastomotic site,enterolysis range,first postoperative flatus,postoperative complications,reoperation rate,or incidence of postoperative enteral nutrition intolerance.Compared with the OIR group,the LIIR group had a shorter postoperative hospital stay(P=0.045),lower incidence of enteral nutrition intolerance symptoms(P=0.019),and earlier postoperative total enteral nutrition initiation(P=0.033);however,it incurred higher total hospital costs(P=0.038).Furthermore,multivariate logistic regression analysis revealed that the duration of surgery and anastomotic technique were independent risk factors for postoperative symptoms of enteral nutrition intolerance(P<0.05).CONCLUSION Laparoscopic intracorporeal anastomosis for ileostomy reversal is safe and feasible.Patients who underwent this technique demonstrated improved tolerance to postoperative enteral nutrition and quicker resumption of total enteral nutrition.

Numerical analysis for the free-boundary current reversal equilibrium in the AC plasma current operation in a tokamak

In recent decades, tokamak discharges with zero total toroidal current have been reported in tokamak experiments, and this is one of the key problems in alternating current(AC) operations.An efficient free-boundary equilibrium code is developed to investigate such advanced tokamak discharges with current reversal equilibrium configuration. The calculation results show that the reversal current equilibrium can maintain finite pressure and also has considerable effects on the position of the X-point and the magnetic separatrix shape, and hence also on the position of the strike point on the divertor plates, which is extremely useful for magnetic design, MHD stability analysis, and experimental data analysis etc. for the AC plasma current operation on tokamaks.

Protected simultaneous quantum remote state preparation scheme by weak and reversal measurements in noisy environments

We discuss a quantum remote state preparation protocol by which two parties, Alice and Candy, prepare a single-qubit and a two-qubit state, respectively, at the site of the receiver Bob. The single-qubit state is known to Alice while the two-qubit state which is a non-maximally entangled Bell state is known to Candy. The three parties are connected through a single entangled state which acts as a quantum channel. We first describe the protocol in the ideal case when the entangled channel under use is in a pure state. After that, we consider the effect of amplitude damping(AD) noise on the quantum channel and describe the protocol executed through the noisy channel. The decrement of the fidelity is shown to occur with the increment in the noise parameter. This is shown by numerical computation in specific examples of the states to be created. Finally, we show that it is possible to maintain the label of fidelity to some extent and hence to decrease the effect of noise by the application of weak and reversal measurements. We also present a scheme for the generation of the five-qubit entangled resource which we require as a quantum channel. The generation scheme is run on the IBMQ platform.

Storm Liquefaction Deposits:A Possibility of Time Reversal in Sedimentary Strata of an Estuarial Coastal Area

In the sedimentary strata dating of estuarial coastal areas,it is often found that there is phenomenon of time-reversal in strata.The seabed sediments could be liquefied under storm waves.A laboratory wave flume experiment demonstrated that storm-induced liquefaction deposits are formed by the oscillations of liquefied sediments.In this paper,the particle size distribution and ^(210)Pb_(ex) specific activity of the sediment samples from the liquefaction disturbed zone and adjacent stable zone of the Yellow River Delta were tested.The stratigraphic divisions based on storm liquefaction deposit sequence can effectively explain the vertical changes in particle size and ^(210)Pb_(ex) specific activity.Due to the differentiation of particles during the storm induced liquefaction,coarse and fine particles regrouped,which could explain the phenomenon of time-reversal in dating data.

Honeymoon phase in type 1 diabetes mellitus: A window of opportunity for diabetes reversal?

The knowledge of the pathogenesis of type 1 diabetes mellitus(T1DM)continues to rapidly evolve.The natural course of the disease can be described in four clinical stages based on the autoimmune markers and glycemic status.Not all individuals of T1DM progress in that specific sequence.We hereby present a case of T1DM with a classical third phase(honeymoon phase)and discuss the intri-cacies of this interesting phase along with a possible future promise of“cure”with the use of immunotherapies.We now know that the course of T1DM may not be in only one direction towards further progression;rather the disease may have a waxing and waning course with even reversal of type 1 diabetes concept being discussed.The third phase popularly called the“honeymoon phase”,is of special interest as this phase is complex in its pathogenesis.The honeymoon phase of T1DM seems to provide the best window of opportunity for using targeted therapies using various immunomodulatory agents leading to the possibility of achieving the elusive“diabetes reversal”in T1DM.Identifying this phase is therefore the key,with a lot of varying criteria having been proposed.

Reversal of complete atrioventricular block in dialysis patients following parathyroidectomy:A case report

BACKGROUND Refractory secondary hyperparathyroidism(SHPT)is a common complication observed in patients with end-stage renal disease and can result in ectopic calcification.Metastatic calcification involving the heart valves and the conduction system can easily lead to arrhythmias,including atrioventricular block.This case report describes a maintenance hemodialysis patient with refractory SHPT resulting in a complete atrioventricular block(CAVB),which was eventually reversed to a first-degree atrioventricular block.CASE SUMMARY We present the case of a 31-year-old Asian female who was receiving maintenance hemodialysis because of lupus nephropathy.She developed SHPT,and an electrocardiogram revealed a first-degree atrioventricular block.Then,she underwent parathyroidectomy(PTX)with autotransplantation.Unfortunately,a few years later,she developed SHPT again,and an electrocardiogram revealed a CAVB.A few years after the second PTX surgery,the calcification of the left atrium and left ventricle improved,and her CAVB was reversed.CONCLUSION This case revealed that metastatic cardiac calcification can result in complete atrioventricular blockage.Following parathyroid surgery,calcification of the cardiac conduction system improved,leading to reversal of the atrioventricular block.It is important for dialysis patients to optimize intact parathyroid hormone therapy and pay attention to calcification metastasis.

Predictors of complications after prophylactic ileostomy reversal for rectal cancer:A retrospective study

BACKGROUND Previous studies have analyzed the risk factors for complications after ileostomy reversal for rectal cancer(RC),but there were significant differences in the reported risk factors for complications after stoma reversal.No studies have analyzed the risk factors for stoma-related complications and overall postoperative com-plications separately.AIM To analyze the risk factors for overall complications and stoma-related complications after ileostomy reversal for patients with RC.METHODS This was a retrospective study of 439 patients who underwent ileostomy reversal at a clinical center and were followed up between September 2012 and September 2022.Continuous variables are expressed as the mean±SD and were analyzed with independent-sample t tests,while frequency variables are expressed as n(%),and theχ2 test or Fisher’s exact test was used.Univariate and multivariate logistic regression analyses were used to identify predictors of overall complications and stoma-related complications.RESULTS The overall complication rate after ileostomy reversal was 11.4%.Patients with lower preoperative albumin concentration(P<0.01),greater blood loss(P=0.017),and longer operative times(P<0.01)were more likely to experience postoperative complications.The incidence of stoma-related complications was 6.4%.Analysis of the study showed that a higher body mass index(BMI)(P<0.01),preoperative comorbid hypertension(P=0.049),time from primary surgery to ileostomy reversal(P<0.01)and longer operation time(P=0.010)were more likely to result in stomarelated complications postoperatively.Multivariate logistic regression analysis revealed that a lower preoperative albumin level(P<0.01,OR=0.888,95%CI:0.828-0.958)was an independent risk factor for overall complications.Moreover,multivariate analysis revealed that BMI(P<0.01,OR=1.176,95%CI:1.041-1.330)and time from primary surgery to ileostomy reversal(P<0.01,OR=1.140,95%CI:1.038-1.252)were independent risk factors for stoma-related complications after stoma reversal.CONCLUSION The preoperative albumin level was a predictor of overall complications.Preoperative BMI and the time from primary surgery to ileostomy reversal were predictors of stoma-related complications.

Efficacy of cognitive-behavioral therapy combined with habit reversal training on anxiety disorders in children with Tourette’s syndrome

BACKGROUND Cognitive-behavioral therapy(CBT)and habit reversal training(HRT)have shown application potential in addressing tic symptoms and comorbid psychiatric conditions.Despite their theoretical potential,empirical evidence on their combined efficacy remains limited.AIM To evaluate the efficacy of CBT combined with HRT on anxiety disorders in children with Tourette’s syndrome(TS).METHODS Clinical data of children with TS admitted to our hospital from January 2022 to June 2023 were collected,and the patients were grouped into the conventional therapy(control)group and the CBT combined with HRT group.Baseline charac-teristics,anxiety scores,tic severity scores,treatment adherence,and parental satisfaction were assessed.Statistical analysis was performed using t-tests,chi-square tests,and correlation analysis.RESULTS A total of 136 patients,including 65 patients in the control group and 71 patients in the CBT combined with HRT group,were included.The CBT combined with HRT group showed remarkable improvements compared with the control group.Post-intervention assessment revealed a decrease in anxiety scores from 63.52±1.81 to 40.53±1.64(t=2.022,P=0.045),and the Yale Global Tic Severity Scale total score decreased from 22.14±5.67 to 16.28±4.91(t=2.288,P=0.024).Treatment adherence was significantly higher in the CBT combined with HRT group(85.47±7.62%)compared with the control group(82.32±6.54%;t=2.596,P=0.010).Parental satisfaction scores were also higher in the CBT combined with HRT group(8.69±1.77)compared with the control group(7.87±1.92;t=2.592,P=0.011).CONCLUSION This study demonstrates that CBT combined with HRT significantly reduces anxiety symptoms and tic severity in children with TS,with higher treatment adherence and parental satisfaction.These findings support the potential application of this comprehensive therapeutic approach for TS treatment.

Sex Reversal of Black-Chinned Tilapia (Sarotherodon melanotheron) Fry Using 17α-Methyltestosterone

This study was conducted to determine the effective dose of 17α-methyltestosterone(MT)that produces all-male fry of black-chinned tilapia,Sarotherodon melanotheron.Five concentrations:0,30,60,90 and 120 mg 17α-methyltestosterone(17α-MT)per kilogram feed were prepared using the ethanol evaporation method,and administered orally to black-chinned tilapia fry for 28 days in triplicate aquarium glass tanks.After the treatment period,triplicates of 60 fry from each treatment were stocked in hapas and further cultured in freshwater ponds.They were fed with commercial fish feed ad libitum.The sex ratio,growth performance and survival were evaluated after 60 and 180 days.At the end of the 60-day period,the sex ratio of 30 fish from each treatment was determined by using the gonadal squash method.The remaining 30 fish from each treatment were grown further for 180 days and their sex ratio determined using the genital papillae.The results demonstrated that 17α-methyltestosterone was effective in producing phenotypic male in S.melanotheron.However,in both 60-day and 180-day experiments,no treatment gave 100%male population.The 90 mg/kg MT yielded the highest all-male fish of 84.13%,highest survival of 70%and highest final mean body weight of 103.99±7.92 g.

Numerical Algorithm for Polarity Reversal Electric Field and Its Application

Aim To analyze the transient speciality of nonlinear, anisotropic, AC+DC coupling electric field, and to compare the withstand voltage strength of different insulation structures. Methods The transient process of polarity reversal is analyzed, considering the anisotropic property of oil immersed press board, a new finite element model based on Galerkin method is presented and verified. The model developed is applied to calculate the electric field distribution in four typical winding end structures of the converter transformer. Results\ The whole ring structure possesses the best insulation characteristics. Conclusion\ By introducing reasonable insulation components, insulation strength with the same surrounding sizes can be improved more than 30%.

Efficient hybrid method for time reversal superresolution imaging

An efficient hybrid time reversal（TR） imaging method based on signal subspace and noise subspace is proposed for electromagnetic superresolution detecting and imaging. First, the locations of targets are estimated by the transmitting-mode decomposition of the TR operator（DORT） method employing the signal subspace. Then, the TR multiple signal classification（TR-MUSIC）method employing the noise subspace is used in the estimated target area to get the superresolution imaging of targets. Two examples with homogeneous and inhomogeneous background mediums are considered, respectively. The results show that the proposed hybrid method has advantages in CPU time and memory cost because of the combination of rough and fine imaging.

The Analysis Method of Time Reversal for Defect Diagnosis of Concealed Structure

In this paper, a new method of time reversal for defect diagnosis of concealed structure has been proposed based on the detecting technique of structure acoustic wave and the theory of time reversal. The time reversal recurrence formula for detecting the acoustic wave speed constitution of concealed structures with bilevel asynchronous test has been established. The wave speed constitution can be reconstructed in 2 D graticule form by means of this method. The result of model test shows the method is valid.

他汀预防心血管疾病的新阶段—从REVERSAL到PROVE-IT

本期JAMA发表了强化降脂逆转动脉粥样硬化(Reversal of Athrosclerosis with Aggressive Lipid Lowerig，REVERSAL)试验的结果，并同时刊出了Sacks的评论——“高强度他汀治疗冠心病”。

Investigation of magnetization reversal and domain structures in perpendicular synthetic antiferromagnets by first-order reversal curves and magneto-optical Kerr effect

Perpendicular synthetic-antiferromagnet(p-SAF) has broad applications in spin-transfer-torque magnetic random access memory and magnetic sensors. In this study, the p-SAF films consisting of (Co/Ni)3]/Ir(tIr)/[(Ni/Co)3are fabricated by magnetron sputtering technology. We study the domain structure and switching field distribution in p-SAF by changing the thickness of the infrared space layer. The strongest exchange coupling field(Hex) is observed when the thickness of Ir layer(tIr) is 0.7 nm and becoming weak according to the Ruderman–Kittel–Kasuya–Yosida-type coupling at 1.05 nm,2.1 nm, 4.55 nm, and 4.9 nm in sequence. Furthermore, the domain switching process between the upper Co/Ni stack and the bottom Co/Ni stack is different because of the antiferromagnet coupling. Compared with ferromagnet coupling films, the antiferromagnet samples possess three irreversible reversal regions in the first-order reversal curve distribution.With tIrincreasing, these irreversible reversal regions become denser and smaller. The results from this study will help us understand the details of the magnetization reversal process in the p-SAF.

A novel power-combination method using a time-reversal pulse-compression technique

The electromagnetic time-reversal(TR)technique has the characteristics of spatiotemporal focusing in a time-reversal cavity(TRC),which can be used for pulse compression,thus forming an electromagnetic pulse with high peak power.A time-reversed pulse-compression method in a single channel has high pulse compression gain.However,single channel pulse compression can only generate limited gain.This paper proposes a novel TR power-combination method in a multichannel TRC to obtain higher peak power based on TR pulse-compression theory.First,the TR power-combination model is given,and the crosstalk properties of the associated channel and the influence of the reversal performance are studied.Then,the power-combination performances for the TR pulse compression,such as combined signal to noise ratio(SNR)and combined compression gain,are analyzed by numerical simulation and experimental methods.The results show that the proposed method has obvious advantages over pulse-compression methods using a single channel cavity,and is more convenient for power combination.

Impacts of the Autumn Arctic Sea Ice on the Intraseasonal Reversal of the Winter Siberian High

During 1979–2015, the intensity of the Siberian high(SH) in November and December–January(DJ) is frequently shown to have an out-of-phase relationship, which is accompanied by opposite surface air temperature and circulation anomalies.Further analyses indicate that the autumn Arctic sea ice is important for the phase reversal of the SH. There is a significantly positive(negative) correlation between the November(DJ) SH and the September sea ice area(SIA) anomalies. It is suggested that the reduction of autumn SIA induces anomalous upward surface turbulent heat flux(SHF), which can persist into November, especially over the Barents Sea. Consequently, the enhanced eddy energy and wave activity flux are transported to mid and high latitudes. This will then benefit the development of the storm track in northeastern Europe. Conversely, when downward SHF anomalies prevail in DJ, the decreased heat flux and suppressed eddy energy hinder the growth of the storm track during DJ over the Barents Sea and Europe. Through the eddy–mean flow interaction, the strengthened(weakened)storm track activities induce decreased(increased) Ural blockings and accelerated(decelerated) westerlies, which makes the cold air from the Arctic inhibited(transported) over the Siberian area. Therefore, a weaker(stronger) SH in November(DJ) occurs downstream. Moreover, anomalously large snowfall may intensify the SH in DJ rather than in November. The ensemble-mean results from the CMIP5 historical simulations further confirm these connections. The different responses to Arctic sea ice anomalies in early and middle winter set this study apart from earlier ones.

Reversal of multidrug resistance of hepatocellular carcinoma cells by metformin through inhibiting NF-κB gene transcription

AIM: To interfere with the activation of nuclear factor-κB(NF-κB) with metformin and explore its effect in reversing multidrug resistance(MDR) of hepatocellular carcinoma(HCC) cells.METHODS: Expression of P-glycoprotein(P-gp) and NF-κB in human HepG 2 or HepG 2/adriamycin(ADM) cells treated with pC MV-NF-κB-small interference RNA(siR NA) with or without metformin, was analyzed by Western blot or fluorescence quantitative PCR. Cell viability was tested by CCK-8 assay. Cell cycle and apoptosis were measured by flow cytometry and Annexin-V-PE/7-AnnexinV apoptosis detection double staining assay, respectively. RESULTS: P-gp overexpression in HepG 2 and HepG 2/ADM cells was closely related to mdr1 mR NA(3.310 ± 0.154) and NF-κB mR NA(2.580 ± 0.040) expression. NF-κB gene transcription was inhibited by specific siR NA with significant down-regulation of P-gp and enhanced HCC cell chemosensitivity to doxorubicin. After pretreatment with metformin, Hep G2/ADM cells were sensitized to doxorubicin and P-gp was decreased through the NF-κB signaling pathway. The synergistic effect of metformin and NF-κB siR NA were found in HepG 2/ADM cells with regard to proliferation inhibition, cell cycle arrest and inducing cell apoptosis. CONCLUSION: Metformin via silencing NF-κB signaling could effectively reverse MDR of HCC cells by downregulating MDR1/P-gp expression.

Reversal of multidrug resistance in vincristine-resistant human gastric cancer cell line SGC7901/VCR by LY980503

AIM： To investigate the reversal effect of LY980503, a benflumetol derivative, on multidrug resistance in vincristine （VCR） -resistant human gastric carcinoma cell line SGC7901/VCR. METHODS： Cells of a human gastric cancer cell line, SGC7901, and its VCR-resistant variant, SGC7901/VCR, were cultivated with LY980503 and/or doxorubicin （DOX）. The cytotoxicity of drugs in vitro was assayed by M-IF method. Based on the flow cytometric technology, the uptake of DOX was detected in these cells by measuring DOX -associated mean fluorescence intensity （MFI）. RESULTS： SGC7901/VCR cells were 23.5 times more resistant to DOX in comparison with 5GC7901 cells. LY980503 at the concentrations of 2.0 μmol/L -10 μmol/ L had no obvious cytotoxicity to SGC7901 and SGC7901/ VCR cells. After simultaneous treatment with LY980503 at the concentrations of 2.0, 4.0 and 10 μmol/L, the ICso of DOX to SGC7901/VCR cells decreased from 1.6 ± 0.12 μmol/L to 0.55 ± 0.024, 0.25 ± 0.032 and 0.11 ± 0.015 μmol/L, respectively, thus, increasing the DOX sensitivity by 2.9-fold （P 〈 0. 05）, 6.4-fold （P 〈 0. 01） and 14.5-fold （P 〈 0. 01）, respectively. In the uptake study of DOX, simultaneous incubation of SGC7901/VCR cells with LY980503 significantly increased the DOX -associated MFI in SGC7901/VCR cells. No such results were found in parental SGC7901 cells.CONCLUSION： LY980503 at non-cytotoxic concentrations can effectively circumvent resistance of SGC7901/VCR cells to DOX by increasing intracellular DOX accumulation.