Predictive value of bilirubin and serum γ-glutamyltranspeptidase levels in type-2 diabetes mellitus patients with acute coronary syndrome

BACKGROUND Cardiovascular disease is a major complication of diabetes mellitus(DM).Type-2 DM(T2DM)is associated with an increased risk of cardiovascular events and mortality,while serum biomarkers may facilitate the prediction of these outcomes.Early differential diagnosis of T2DM complicated with acute coronary syndrome(ACS)plays an important role in controlling disease progression and improving safety.AIM To investigate the correlation of serum bilirubin andγ-glutamyltranspeptidase(γ-GGT)with major adverse cardiovascular events(MACEs)in T2DM patients with ACS.METHODS The clinical data of inpatients from January 2022 to December 2022 were analyzed retrospectively.According to different conditions,they were divided into the T2DM complicated with ACS group(T2DM+ACS,n=96),simple T2DM group(T2DM,n=85),and simple ACS group(ACS,n=90).The clinical data and laboratory indices were compared among the three groups,and the correlations of serum total bilirubin(TBIL)levels and serumγ-GGT levels with other indices were discussed.T2DM+ACS patients received a 90-day follow-up after discharge and were divided into event(n=15)and nonevent(n=81)groups according to the occurrence of MACEs;Univariate and multivariate analyses were further used to screen the independent influencing factors of MACEs in patients.RESULTS The T2DM+ACS group showed higherγ-GGT,total cholesterol,low-density lipoprotein cholesterol(LDL-C)and glycosylated hemoglobin(HbA1c)and lower TBIL and high-density lipoprotein cholesterol levels than the T2DM and ACS groups(P<0.05).Based on univariate analysis,the event and nonevent groups were significantly different in age(t=3.3612,P=0.0011),TBIL level(t=3.0742,P=0.0028),γ-GGT level(t=2.6887,P=0.0085),LDL-C level(t=2.0816,P=0.0401),HbA1c level(t=2.7862,P=0.0065)and left ventricular ejection fraction(LEVF)levels(t=3.2047,P=0.0018).Multivariate logistic regression analysis further identified that TBIL level and LEVF level were protective factor for MACEs,and age andγ-GGT level were risk factors(P<0.05).CONCLUSION Serum TBIL levels are decreased andγ-GGT levels are increased in T2DM+ACS patients,and the two indices are significantly negatively correlated.TBIL andγ-GGT are independent influencing factors for MACEs in such patients.

Heterogeneously elevated branched-chain/aromatic amino acids among new-onset type-2 diabetes mellitus patients are potentially skewed diabetes predictors

BACKGROUND The lack of specific predictors for type-2 diabetes mellitus(T2DM)severely impacts early intervention/prevention efforts.Elevated branched-chain amino acids(BCAAs:Isoleucine,leucine,valine)and aromatic amino acids(AAAs:Tyrosine,tryptophan,phenylalanine)show high sensitivity and specificity in predicting diabetes in animals and predict T2DM 10-19 years before T2DM onset in clinical studies.However,improvement is needed to support its clinical utility.AIM To evaluate the effects of body mass index(BMI)and sex on BCAAs/AAAs in new-onset T2DM individuals with varying body weight.METHODS Ninety-seven new-onset T2DM patients(<12 mo)differing in BMI[normal weight(NW),n=33,BMI=22.23±1.60;overweight,n=42,BMI=25.9±1.07;obesity(OB),n=22,BMI=31.23±2.31]from the First People’s Hospital of Yunnan Province,Kunming,China,were studied.One-way and 2-way ANOVAs were conducted to determine the effects of BMI and sex on BCAAs/AAAs.RESULTS Fasting serum AAAs,BCAAs,glutamate,and alanine were greater and high-density lipoprotein(HDL)was lower(P<0.05,each)in OB-T2DM patients than in NW-T2DM patients,especially in male OB-T2DM patients.Arginine,histidine,leucine,methionine,and lysine were greater in male patients than in female patients.Moreover,histidine,alanine,glutamate,lysine,valine,methionine,leucine,isoleucine,tyrosine,phenylalanine,and tryptophan were significantly correlated with abdominal adiposity,body weight and BMI,whereas isoleucine,leucine and phenylalanine were negatively correlated with HDL.CONCLUSION Heterogeneously elevated amino acids,especially BCAAs/AAAs,across new-onset T2DM patients in differing BMI categories revealed a potentially skewed prediction of T2DM development.The higher BCAA/AAA levels in obese T2DM patients would support T2DM prediction in obese individuals,whereas the lower levels of BCAAs/AAAs in NW-T2DM individuals may underestimate T2DM risk in NW individuals.This potentially skewed T2DM prediction should be considered when BCAAs/AAAs are to be used as the T2DM predictor.

Interplay of serum biomarkers bilirubin andγ-glutamyltranspeptidase in predicting cardiovascular complications in type-2 diabetes mellitus

This editorial synthesizes insights from a series of studies examining the interplay between metabolic and oxidative stress biomarkers in cardiovascular disease(CVD),focusing particularly on type-2 diabetes mellitus(T2DM)and acute coronary syndrome(ACS).The central piece of this synthesis is a study that investigates the balance between oxidative stress and antioxidant systems in the body through the analysis of serum bilirubin andγ-glutamyltranspeptidase(γ-GGT)levels in T2DM patients with ACS.This study highlights serum bilirubin as a protective antioxidant factor,while elevatedγ-GGT levels indicate increased oxidative stress and correlate with major adverse cardiovascular events.Complementary to this,other research contributions revealγ-GGT’s role as a risk factor in ACS,its association with cardiovascular mortality in broader populations,and its link to metabolic syndrome,further elucidating the metabolic dysregulation in CVDs.The collective findings from these studies underscore the critical roles ofγ-GGT and serum bilirubin in cardiovascular health,especially in the context of T2DM and ACS.By providing a balanced view of the body’s oxidative and antioxidative mechanisms,these insights suggest potential pathways for targeted interventions and improved prognostic assessments in patients with T2DM and ACS.This synthesis not only corroborates the pivotal role ofγ-GGT in cardiovascular pathology but also introduces the protective potential of antioxidants like bilirubin,illuminating the complex interplay between T2DM and heart disease.These studies collectively underscore the critical roles of serum bilirubin andγ-GGT as biomarkers in cardiovascular health,particularly in T2DM and ACS contexts,offering insights into the body’s oxidative and antioxidative mechanisms.This synthesis of research supports the potential of these biomarkers in guiding therapeutic strategies and improving prognostic assessments for patients with T2DM and some CVD.

一种基于T2FPSO的type-2模糊支持向量机场景分类方法（英文）

为提高机器视觉识别的选择性和鲁棒性,给出了基于T2FPSO优化的T2FSVM场景分类方法。算法中,设计了type-2模糊支持向量机模型以提高其泛化能力并得到正确的场景分类信息;为提高PSO在不确定环境中的优化能力,构建了融合type-2模糊集概念的T2FPSO优化算法,并采用区间type-2模糊逻辑系统推理得到其惯性权值。实验结果表明所提出的场景分类方法可对不确定信息进行有效处理。

25-Hydroxyvitamin D Is Associated with Islet Homeostasis in Type-2 Diabetic Patients with Abdominal Obesity

Objective Isletαcells input is essential for insulin secretion fromβcells.The present study aims to investigate the association between 25-hydroxyvitamin D[25(OH)D]and islet function homeostasis in type-2 diabetes(T2D)patients.Methods A total of 4670 T2D patients from seven communities in Shanghai,China were enrolled.The anthropometric indices,biochemical parameters,serum 25(OH)D,and islet function[including C-peptide(C-p)and glucagon]were measured.Results The fasting plasma glucose(FPG),glycated hemoglobin(HbA1c),glucagon,and C-p levels exhibited a significantly decreasing trend in T2D patients as the 25(OH)D levels increased.Next,the population was divided into two groups:abdominal obesity and non-abdominal obesity groups.After adjustment,the 25(OH)D level was found to be associated with HbA1c,glucagon,and homeostasis model assessment ofβ(HOMA-β)in the non-abdominal obesity group.There was a significant relationship between 25(OH)D and HbA1c,glucagon,HOMA-IR,baseline insulin or C-p in the abdominal obesity group.In the abdominal obesity group,the ordinary least squares(OLS)regression and quantile regression revealed that 25(OH)D was obviously associated with glucagon and fasting C-p levels.In the abdominal obesity group,the moderate analysis revealed a significant interaction effect of 25(OH)D and glucagon on C-p(P=0.0124).Furthermore,the conditional indirect effect of 25(OH)D on the glucagon/C-p ratio was significantly lower at 1 standard deviation(SD)below the mean(P=0.0002),and lower at the mean of the course of diabetes(P=0.0007).Conclusion 25(OH)D was found to be negatively correlated to glucagon and C-p in T2D patients with abdominal obesity.The 25(OH)D influenced C-p in part by influencing glucagon.The effect of 25(OH)D on the glucagon/C-p ratio in T2D patients with abdominal obesity,in terms of islet homeostasis,is influenced by the course of diabetes.

Type-2 Neutrosophic Set and Their Applications in Medical Databases Deadlock Resolution

Electronic patient data gives many advantages,but also new difficulties.Deadlocks may delay procedures like acquiring patient information.Distributed deadlock resolution solutions introduce uncertainty due to inaccurate transaction properties.Soft computing-based solutions have been developed to solve this challenge.In a single framework,ambiguous,vague,incomplete,and inconsistent transaction attribute information has received minimal attention.The work presented in this paper employed type-2 neutrosophic logic,an extension of type-1 neutrosophic logic,to handle uncertainty in real-time deadlock-resolving systems.The proposed method is structured to reflect multiple types of knowledge and relations among transactions’features that include validation factor degree,slackness degree,degree of deadline-missed transaction based on the degree of membership of truthiness,degree ofmembership of indeterminacy,and degree ofmembership of falsity.Here,the footprint of uncertainty(FOU)for truth,indeterminacy,and falsity represents the level of uncertainty that exists in the value of a grade of membership.We employed a distributed real-time transaction processing simulator(DRTTPS)to conduct the simulations and conducted experiments using the benchmark Pima Indians diabetes dataset(PIDD).As the results showed,there is an increase in detection rate and a large drop in rollback rate when this new strategy is used.The performance of Type-2 neutrosophicbased resolution is better than the Type-1 neutrosophic-based approach on the execution ratio scale.The improvement rate has reached 10%to 20%,depending on the number of arrived transactions.

Interval Type-2 Fuzzy Model for Intelligent Fire Intensity Detection Algorithm with Decision Making in Low-Power Devices

Local markets in East Africa have been destroyed by raging fires,leading to the loss of life and property in the nearby communities.Electrical circuits,arson,and neglected charcoal stoves are the major causes of these fires.Previous methods,i.e.,satellites,are expensive to maintain and cause unnecessary delays.Also,unit-smoke detectors are highly prone to false alerts.In this paper,an Interval Type-2 TSK fuzzy model for an intelligent lightweight fire intensity detection algorithm with decision-making in low-power devices is proposed using a sparse inference rules approach.A free open–source MATLAB/Simulink fuzzy toolbox integrated into MATLAB 2018a is used to investigate the performance of the Interval Type-2 fuzzy model.Two crisp input parameters,namely:FIT and FIG��are used.Results show that the Interval Type-2 model achieved an accuracy value of FIO�=98.2%,MAE=1.3010,MSE=1.6938 and RMSE=1.3015 using regression analysis.The study shall assist the firefighting personnel in fully understanding and mitigating the current level of fire danger.As a result,the proposed solution can be fully implemented in low-cost,low-power fire detection systems to monitor the state of fire with improved accuracy and reduced false alerts.Through informed decision-making in low-cost fire detection devices,early warning notifications can be provided to aid in the rapid evacuation of people,thereby improving fire safety surveillance,management,and protection for the market community.

Using a 3D Interval Type-2 Fuzzy Interpolation System to Improve Modeless Robots Measurement and Calibration Accuracy

This paper is an extended research for a novel technique used in the pose error compensations of the robot and manipulator calibration process based on an IT2FEI （interval type-2 fuzzy error interpolation） method. Robot calibrations can be classified into model-based and modeless methods. A model-based calibration method normally requires that the practitioners understand the kinematics of the robot therefore may pose a challenger for field engineers. An alternative yet effective means for robot calibration is to use a modeless method; however with such a method there is a conflict between the calibration accuracy of the robot and the number of grid points used in the calibration task. In this paper, an interval type-2 fuzzy interpolation system is applied to improve the compensation accuracy of the robot in its 3D workspace. An on-line type-2 fuzzy inference system is implemented to meet the needs of on-line robot trajectory planning and control. The simulated results given in this paper show that not only robot compensation accuracy can be greatly improved, but also the calibration process can be significantly simplified, and it is more suitable for practical applications.

基于Type-2型模糊集的动态生态位模型

复杂生态系统中,由于生物进化的高度非线性,使生物更容易适应环境的变化,生物与环境的交流要求用动态的观点来描述生态位及其相关概念。本文利用T ype-2型模糊集合的“宽带”效应,给出了具有动态特性的生态位模型,并相应的给出宽度和重叠的计算公式。应用于植物的生态位宽度和重叠的计算,与已有公式结果的比较,本文提出的模型可以全面的给出了物种在每个资源状态下的情形,同时反应了物种与环境之间的互动交流。为生物系统的应用研究和理论研究提出统一的数学模型。

生物系统冗余结构的Type-2型数学模型

生态系统本身就是一个自组织的进化系统,生物与环境的交流和相互作用中,生物利用自身的冗余结构和冗余补充,使整个系统的进化始终朝着有利于生物发展的方向进化。本文利用Type-2模糊系统建立了生物群落冗余结构的数学模型,提出了生物群落稳定性的度量方法,研究了生物群落冗余结构与生物进化可靠性和稳定性的关系。

区间Type-2 T-S间接自适应模糊控制

本文在Type-1 T-S间接自适应模糊控制器的基础上,利用Type-2模糊系统理论,提出了区间Type-2 T-S间接自适应模糊控制器的设计方法.由于该系统的规则前件是区间Type-2模糊集合,后件为精确数,使构造的控制方法既具备Type-2模糊集处理诸多不确定性的特点,能够减少由于规则不确定对系统的影响,同时又具有T-S模糊模型后件为各输入变量的线性组合的特点,可以提高系统的建模精度,减少系统的规则数等优点.本文利用Lyapunov合成方法,研究了在所有变量一致有界的意义下,闭环系统的全局稳定性,分析了区间Type-2 T-S间接自适应模糊控制系统的收敛性,并给出了系统参数的自适应律.通过倒立摆跟踪模型进行仿真,验证其有效性和优越性.

基于Type-2 T-S的模糊脉冲控制

利用Type-2模糊系统在描述复杂非线性系统诸多不确定性问题时的有效性,在Type-1模糊脉冲控制的基础上,提出了区间Type-2 T-S模糊脉冲控制方法.该方法利用Type-2模糊隶属函数的"宽带"效应,解决了Type-1模糊脉冲控制中数据噪声和外界扰动问题;利用Lyapunov理论和Lipschitz条件,通过运用比较方法和线性矩阵不等式等综合方法,设计Type-2 T-S模糊脉冲控制器,给出系统的渐进稳定性分析;最后,在倒立摆系统的仿真中,较方便地确定了隶属函数并选取了较少的模糊规则,表明系统的有效性和优异性.

基于扩展Type-2模糊集的故障检测方法

随着系统复杂程度的不断提高,对系统故障的诊断也越来越困难。提出一种扩展的Type-2模糊集合,利用扩展隶属函数的"肯定证据,排除假象"的特性,建立基于Type-2的模糊诊断方法,并给出了相应的设计算法。增加了负值的扩展隶属函数,将系统输出的残差清晰地划分为三个状态:正常、异常和故障。增加了一个状态,能够更好地得出清晰的诊断结果,有效地避免误诊和漏诊。针对三水箱系统,仿真结果表明了该方法的有效性。

永磁同步电机自适应高阶滑模Type-2模糊控制

针对永磁同步电机数学模型不确定问题,提出一种自适应高阶滑模Type-2模糊控制方法。采用积分滑模面二阶滑模控制律,保持传统滑模控制的鲁棒性并实现不含不确定高阶输入输出有限时间稳定;不需要预先确定干扰与不确定上边界,利用Lyapunov理论获得自适应调节Type-2模糊规则生成Super-Twisting信号削弱抖振。仿真结果表明永磁同步电机具有良好的跟踪性能,同时验证了该方法的可行和有效性。

Matlab与C混合编程实现Type-2模糊系统

Type-2模糊系统的理论有着广泛的应用,但是Type-2模糊系统结构较Type-1模糊系统复杂,且编程实现难度和计算强度都较大。Matlab平台下,运用M语言调试算法,在实现Type-2模糊系统的基础上,利用C语言的高效性优化算法,改进程序,克服了Matlab计算瓶颈的问题。给出的Matlab+C混合编程实现Type-2模糊系统的程序,编译后可以函数的形式调用,既保留了Matlab平台处理数据的便捷性,又具有很高的执行效率。仿真结果表明该方法的有效性。

Type-2模糊系统在黄金价格预测中的应用

选择了一个模糊时间序列的模型来确定模糊系统初始参数,同时运用了Type-2模糊系统和Type-1模糊系统进行了训练及预测,比较了他们的训练逼近效果,以及预测效果,给出了仿真.

Entropy measures of type-2 intuitionistic fuzzy sets and type-2 triangular intuitionistic trapezodial fuzzy sets

In order to measure the uncertain information of a type- 2 intuitionistic fuzzy set （T21FS）, an entropy measure of T21FS is presented by using the constructive principles. The proposed entropy measure is also proved to satisfy all of the constructive principles. Further, a novel concept of the type-2 triangular in- tuitionistic trapezoidal fuzzy set （T2TITrFS） is developed, and a geometric interpretation of the T2TITrFS is given to comprehend it completely or correctly in a more intuitive way. To deal with a more general uncertain complex system, the constructive principles of an entropy measure of T2TITrFS are therefore proposed on the basis of the axiomatic definition of the type-2 intuitionisic fuzzy entropy measure. This paper elicits a formula of type-2 triangular intuitionistic trapezoidal fuzzy entropy and verifies that it does sa- tisfy the constructive principles. Two examples are given to show the efficiency of the proposed entropy of T2TITrFS in describing the uncertainty of the type-2 intuitionistic fuzzy information and illustrate its application in type-2 triangular intuitionistic trapezodial fuzzy decision making problems.

面向后件集的模糊推理机制:用于区间型type-2模糊逻辑系统

目前,大多数模糊推理都是利用t–范数和t–余范数或其改进形式对连接词进行建模,这些模型不能将模糊规则中前件集与后件集之间的相关性信息引入到模糊推理过程,这会丢失蕴含在规则中的一些信息甚至导致推理结果与实际经验严重不符.为解决此问题,本文首先引入模糊集合面向对象变换的概念,并将其推广,建立了合成type-2模糊集合模型.基于此模型,针对区间型type-2模糊逻辑系统,提出一种面向后件集的模糊推理机制,该机制能将前件集与后件集的相关性信息(包括清晰数和模糊数两种情形)引入到模糊推理过程.仿真结果表明,该方法能捕获到模糊规则中更多的不确定性信息,并为模糊逻辑系统的设计提供更大的自由度.

基于生态系统冗余结构的Type-2模糊控制器设计

本文提出了一类新的基于生态位模型的Type-2模糊控制系统,将含参数的生态位贴近度函数作为模糊规则的后件,从而构成了Type-2 Takagi-Sugeno(T-S)模糊控制模型。主要采用Lyapunov方法设计控制器,利用梯度下降法优化参数,得到参数的自适应律。建立的模糊T-S模型具有生物个体的自适应性,可以确保整个系统的稳定性,通过prey-predator生态模型验证了该类控制器的有效性。

Type-2模糊逻辑系统研究

对Type-2模糊系统进行了研究,系统地分析了Type-2模糊系统的基本理论和基本框架,给出了该系统在具体处理实际问题时应采用的相应方法,阐述了Type-2模糊系统应用发展方向并提出今后需要解决的问题。