Concerns about the application of resistance exercise with blood-flow restriction and thrombosis risk in hemodialysis patients

Background:Hemodialysis(HD)per se is a risk factor for thrombosis.Considering the growing body of evidence on blood-flow restriction(BFR)exercise in HD patients,identification of possible risk factors related to the prothrombotic agent D-dimer is required for the safety and feasibility of this training model.The aim of the present study was to identify risk factors associated with higher D-dimer levels and to determine the acute effect of resistance exercise(RE)with BFR on this molecule.Methods:Two hundred and six HD patients volunteered for this study(all with a glomerular filtration rate of<15 mL/min/1.73 m^(2)).The RE+BFR session consisted of 50%arterial occlusion pressure during 50 min sessions of HD(intradialytic exercise).RE repetitions included concentric and eccentric lifting phases(each lasting 2 s)and were supervised by a strength and conditioning specialist.Results:Several variables were associated with elevated levels of D-dimer,including higher blood glucose,citrate use,recent cardiovascular events,recent intercurrents,higher inflammatory status,catheter as vascular access,older patients(>70 years old),and HD vintage.Furthermore,RE+BFR significantly increases D-dimer after 4 h.Patients with borderline baseline D-dimer levels(400-490 ng/mL)displayed increased risk of elevating D-dimer over the normal range(-500 ng/mL).Conclusion:These results identified factors associated with a heightened prothrombotic state and may assist in the screening process for HD patients who wish to undergo RE+BFR.D-dimer and/or other fibrinolysis factors should be assessed at baseline and throughout the protocol as a precautionary measure to maximize safety during RE+BFR.

Mechanisms underlying the role of endoplasmic reticulum stress in the placental injury and fetal growth restriction in an ovine gestation model

Background Exposure to bisphenol A(BPA),an environmental pollutant known for its endocrine-disrupting properties,during gestation has been reported to increase the risk of fetal growth restriction(FGR)in an ovine model of pregnancy.We hypothesized that the FGR results from the BPA-induced insufficiency and barrier dysfunction of the placenta,oxidative stress,inflammatory responses,autophagy and endoplasmic reticulum stress(ERS).However,precise mechanisms underlying the BPA-induced placental dysfunction,and subsequently,FGR,as well as the potential involvement of placental ERS in these complications,remain to be investigated.Methods In vivo experiment,16 twin-pregnant(from d 40 to 130 of gestation)Hu ewes were randomly distributed into two groups(8 ewes each).One group served as a control and received corn oil once a day,whereas the other group received BPA(5 mg/kg/d as a subcutaneous injection).In vitro study,ovine trophoblast cells(OTCs)were exposed to 4 treatments,6 replicates each.The OTCs were treated with 400μmol/L BPA,400μmol/L BPA+0.5μg/m L tunicamycin(Tm;ERS activator),400μmol/L BPA+1μmol/L 4-phenyl butyric acid(4-PBA;ERS antagonist)and DMEM/F12 complete medium(control),for 24 h.Results In vivo experiments,pregnant Hu ewes receiving the BPA from 40 to 130 days of pregnancy experienced a decrease in placental efficiency,progesterone(P4)level and fetal weight,and an increase in placental estrogen(E2)level,together with barrier dysfunctions,OS,inflammatory responses,autophagy and ERS in type A cotyledons.In vitro experiment,the OTCs exposed to BPA for 24 h showed an increase in the E2 level and related protein and gene expressions of autophagy,ERS,pro-apoptosis and inflammatory response,and a decrease in the P4 level and the related protein and gene expressions of antioxidant,anti-apoptosis and barrier function.Moreover,treating the OTCs with Tm aggravated BPA-induced dysfunction of barrier and endocrine(the increased E2 level and decreased P4 level),OS,inflammatory responses,autophagy,and ERS.However,treating the OTCs with 4-PBA reversed the counteracted effects of Tm mentioned above.Conclusions In general,the results reveal that BPA exposure can cause ERS in the ovine placenta and OTCs,and ERS induction might aggravate BPA-induced dysfunction of the placental barrier and endocrine,OS,inflammatory responses,and autophagy.These data offer novel mechanistic insights into whether ERS is involved in BPA-mediated placental dysfunction and fetal development.

Cooperative UAV search strategy based on DMPC-AACO algorithm in restricted communication scenarios

Improvement of integrated battlefield situational awareness in complex environments involving dynamic factors such as restricted communications and electromagnetic interference(EMI)has become a contentious research problem.In certain mission environments,due to the impact of many interference sources on real-time communication or mission requirements such as the need to implement communication regulations,the mission stages are represented as a dynamic combination of several communication-available and communication-unavailable stages.Furthermore,the data interaction between unmanned aerial vehicles(UAVs)can only be performed in specific communication-available stages.Traditional cooperative search algorithms cannot handle such situations well.To solve this problem,this study constructed a distributed model predictive control(DMPC)architecture for a collaborative control of UAVs and used the Voronoi diagram generation method to re-plan the search areas of all UAVs in real time to avoid repetition of search areas and UAV collisions while improving the search efficiency and safety factor.An attention mechanism ant-colony optimization(AACO)algorithm is proposed for UAV search-control decision planning.The search strategy is adaptively updated by introducing an attention mechanism for regular instruction information,a priori information,and emergent information of the mission to satisfy different search expectations to the maximum extent.Simulation results show that the proposed algorithm achieves better search performance than traditional algorithms in restricted communication constraint scenarios.

Associations of serum D-dimer and glycosylated hemoglobin levels with third-trimester fetal growth restriction in gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for the first time during pregnancy and can affect fetal growth and development.AIM To investigate the associations of serum D-dimer(D-D)and glycosylated hemoglobin(HbA1c)levels with third-trimester fetal growth restriction(FGR)in GDM patients.METHODS The clinical data of 164 pregnant women who were diagnosed with GDM and delivered at the Obstetrics and Gynecology Hospital of Fudan University from January 2021 to January 2023 were analyzed retrospectively.Among these women,63 whose fetuses had FGR were included in the FGR group,and 101 women whose fetuses had normal body weights were included in the normal body weight group(normal group).Fasting venous blood samples were collected from the elbow at 28-30 wk gestation and 1-3 d before delivery to measure serum D-D and HbA1c levels for comparative analysis.The diagnostic value of serum D-D and HbA1c levels for FGR was evaluated by receiver operating characteristic analysis,and the influencing factors of third-trimester FGR in GDM patients were analyzed by logistic regression.RESULTS Serum fasting blood glucose,fasting insulin,D-D and HbA1c levels were significantly greater in the FGR group than in the normal group,while the homeostasis model assessment of insulin resistance values were lower(P<0.05).Regarding the diagnosis of FGR based on serum D-D and HbA1c levels,the areas under the curves(AUCs)were 0.826 and 0.848,the cutoff values were 3.04 mg/L and 5.80%,the sensitivities were 81.0%and 79.4%,and the specificities were 88.1%and 87.1%,respectively.The AUC of serum D-D plus HbA1c levels for diagnosing FGR was 0.928,and the sensitivity and specificity were 84.1%and 91.1%,respectively.High D-D and HbA1c levels were risk factors for third-trimester FGR in GDM patients(P<0.05).CONCLUSION D-D and HbA1c levels can indicate the occurrence of FGR in GDM patients in the third trimester of pregnancy to some extent,and their combination can be used as an important index for the early prediction of FGR.

Intermittent fasting boosts antitumor immunity by restricting CD11b^(+)Ly6C^(low)Ly6G^(low) cell viability through glucose metabolism in murine breast tumor model

Intermittent fasting can benefit breast cancer patients undergoing chemotherapy or immunotherapy.However,it is still uncertain how to select immunotherapy drugs to combine with intermittent fasting.Herein we observed that two cycles of fasting treatment significantly inhibited breast tumor growth and lung tissue metastasis,as well as prolonged overall survival in mice bearing 4T1 and 4T07 breast cancer.During this process,both the immunosuppressive monocytic-(M-)and granulocytic-(G-)myeloid-derived suppressor cell(MDSC)decreased,accompanied by an increase in interleukin(IL)7R^(+)and granzyme B^(+)T cells in the tumor microenvironment.Interestingly,we observed that Ly6G^(low)G-MDSC sharply decreased after fasting treatment,and the cell surface markers and protein mass spectrometry data showed potential therapeutic targets.Mechanistic investigation revealed that glucose metabolism restriction suppressed the splenic granulocytemonocyte progenitor and the generation of colony-stimulating factors and IL-6,which both contributed to the accumulation of G-MDSC.On the other hand,glucose metabolism restriction can directly induce the apoptosis of Ly6G^(low)G-MDSC,but not Ly6G^(high)subsets.In summary,these results suggest that glucose metabolism restriction induced by fasting treatment attenuates the immune-suppressive milieu and enhances the activation of CD3^(+)T cells,providing potential solutions for enhancing immune-based cancer interventions.

Effects of restrictions on maternal feed intake on the immune indexes of umbilical cord blood and liver Toll-like receptor signaling pathways in fetal goats during pregnancy

Background: Liver has important immune function during fetal development and after birth.However,the effect of maternal malnutrition on immune function of the fetal liver is rarely reported.In this study,twelve pregnant goats(Xiangdong black goat,at d 45 of gestation) were assigned to the control group(fed 100% of nutritional requirements) and the restriction group(fed 60% of the intake of the control group) during gestation from d 55 to100.Fetal goats were harvested at d 100 of gestation and immune indexes and amino acid profiles of the umbilical cord blood and liver Toll-like receptors(TLRs) signaling pathways were measured.Results: Maternal body weight in the restriction group was lower than the control group(P < 0.05).Maternal feed intake restriction decreased(P < 0.05) heart weight,heart index,alkaline phosphatase and serum amyloid protein A in the umbilical cord blood(UCB).Moreover,only histidine was decreased in the restricted group(P = 0.084),and there were no differences in other amino acids contents in the UCB between the two groups(P > 0.05).The TLR2 and TLR4 mRNA expression in the fetal liver in the restriction group was greater(P < 0.05) than that in the control group.Furthermore,the mRNA expression levels of myeloid differentiation primary response 88(MyD88),TNF receptor associated factor 6,nuclear factor kappa B subunit 1,NFKB inhibitor alpha,IFN-β,TGF-β,TNF-α and IL-1β in the restricted group were upregulated(P < 0.05),and the expression of TLR3(P = 0.099) tended to be higher in the restricted group.However,protein levels of TLR2,TLR4,IκBα,phosphorylated IκBα,phosphorylated IκBα/total IκBα,TRIF and MyD88 were not affected(P > 0.05) by maternal intake restriction.Conclusions: These results revealed that the restriction of maternal feed intake influenced the development of heart and hepatic protein synthesis at the acute phase of fetal goats and upregulated the mRNA expression of genes involved in MyD88-dependent signaling pathways and of target cytokines.

Assessing the Effect of Global Travel and Contact Restrictions on Mitigating the COVID-19 Pandemic

Travel restrictions and physical distancing have been implemented across the world to mitigate the coronavirus disease 2019(COVID-19)pandemic,but studies are needed to understand their effectiveness across regions and time.Based on the population mobility metrics derived from mobile phone geolocation data across 135 countries or territories during the first wave of the pandemic in 2020,we built a metapopulation epidemiological model to measure the effect of travel and contact restrictions on containing COVID-19 outbreaks across regions.We found that if these interventions had not been deployed,the cumulative number of cases could have shown a 97-fold(interquartile range 79–116)increase,as of May 31,2020.However,their effectiveness depended upon the timing,duration,and intensity of the interventions,with variations in case severity seen across populations,regions,and seasons.Additionally,before effective vaccines are widely available and herd immunity is achieved,our results emphasize that a certain degree of physical distancing at the relaxation of the intervention stage will likely be needed to avoid rapid resurgences and subsequent lockdowns.

Improvement of the Preliminary Test Estimator When Stochastic Restrictions are Available in Linear Regression Model

Ridge type estimators are used to estimate regression parameters in a multiple linear regression model when multicolinearity exists among predictor variables. When different estimators are available, preliminary test estimation procedure is adopted to select a suitable estimator. In this paper, two ridge estimators, the Stochastic Restricted Liu Estimator and Liu Estimator are combined to define a new preliminary test estimator, namely the Preliminary Test Stochastic Restricted Liu Estimator (PTSRLE). The stochastic properties of the proposed estimator are derived, and the performance of PTSRLE is compared with SRLE in the sense of mean square error matrix (MSEM) and scalar mean square error (SMSE) for the two cases in which the stochastic restrictions are correct and not correct. Moreover the SMSE of PTSRLE based on Wald (WA), Likelihood Ratio (LR) and Lagrangian Multiplier (LM) tests are derived, and the performance of PTSRLE is compared using WA, LR and LM tests as a function of the shrinkage parameter d with respect to the SMSE. Finally a numerical example is given to illustrate some of the theoretical findings.

A systematic strategy for multi-period heat exchanger network retrofit under multiple practical restrictions

A systematic strategy for retrofit of the multi-period heat exchanger network (HEN) on the basis of the multi-objective optimization is developed. In this three-stage procedure, a simplified multi-objective optimization model of the multi-period HEN is first established and then solved to target the retrofit, aiming to minimizing the total annual cost and total annual CO_2 emissions. The obtained Pareto front represents series of retrofit targets under different emission limitations, from which the most desirable one can be selected. The matching of the existing and the required heat exchangers is further implemented to finalize the retrofit, which will meet the practical retrofit requirements and matching restrictions. The application of the proposed procedure is illustrated through a case study of a HEN in a vacuum gas oil hydro-treating unit.

A Restricted SIR Model with Vaccination Effect for the Epidemic Outbreaks Concerning COVID-19

This paper presents a restricted SIRmathematicalmodel to analyze the evolution of a contagious infectious disease outbreak(COVID-19)using available data.The new model focuses on two main concepts:first,it can present multiple waves of the disease,and second,it analyzes how far an infection can be eradicated with the help of vaccination.The stability analysis of the equilibrium points for the suggested model is initially investigated by identifying the matching equilibrium points and examining their stability.The basic reproduction number is calculated,and the positivity of the solutions is established.Numerical simulations are performed to determine if it is multipeak and evaluate vaccination’s effects.In addition,the proposed model is compared to the literature already published and the effectiveness of vaccination has been recorded.

Modelling the Violation of Restrictions Pertaining to Deforestation in a Given Land Right

This paper develops a model that could be used to visualize and predict the violation of restrictions in a given forest. The violation of restriction in this case is assumed to be the difference in areal extent between two forest cover scenes with time;termed “deforestation”. It analyses the relationship in forest cover changes overtime in Ganye Forest Reserve and Glide Cross Country Farm in Adamawa state, Nigeria. Cadastral maps of the forest reserve and farmland were used as the base maps, while the satellite images served as the spatio-temporal data. Landsat ETM+ images of 2003, 2008 and 2013 were used to identify, determine and estimate the violation of restrictions. The result shows that the violation of restrictions could be reliably determined for both the forest reserve and farmland and forecast made in order to predict future occurrence. It also revealed a continuous deforestation in the forest reserve, while in the farmland regeneration of forest stock was noticed. This information is very vital for forest management, planning and decision making in a viable land administration domain.

Necessary Conditions for Optimal Control of Diffusions with Hard Terminal State Restrictions

Necessary conditions are proved for certain problems of optimal control of diffusions where hard end constraints occur. The main results apply to several dimensional problems, where some of the state equations involve Brownian motions, but not the equations corresponding to states being hard restricted at the terminal time. The necessary conditions are stated in terms of weak variations. Two versions of necessary conditions are given, one version involving solutions of variational equations, the other one involving first order adjoint equations.

Restrictions on Purely Kinetic K-Essence

We restrict purely kinetic k-essence.Assuming that the equation of state is a power law of the kinetic energy,i.e.w=w0Xα,we find thatαmust be positive to obtain accelerated phases,constrained from the conditions for stability and causality.In this case the k-essence behaves like a phantom.We also study the evolutions of the equation of state and the speed of sound with numerical simulations.

Restrictions and Countermeasures of Rural Vocational Education in Urban-rural Integration

Developing rural vocational education is of great significance to urban-rural integration: developing rural vocational education is helpful to cultivating new farmers for construction of new socialist countryside,favorable to improving farmers' ability of finding jobs and starting undertaking, and beneficial to transfer of rural surplus labor and acceleration of urbanization. Restrictions on development rural vocational education mainly include: low value cognition of society and social assessment of rural vocational education; out of balance of cost and expected return of rural vocational education; the quality of supply of rural vocational education failure to satisfy demand of socio-economic development; imperfect rural vocational education system. In view of these,following countermeasures and suggestions are put forward: strengthen propaganda and guidance to build environment of public opinion for rural vocational education; push forward rural vocational compulsory education system to lay social foundation for rural vocational education; reinforce policy support to assist in building rural vocational education system; improve education system to build overall framework of rural vocational education; perfect laws and regulations to establish system and norm for development of rural vocational education.

Probability Criterion for a Dynamic Financial Model with Short-Selling Allowed

Probability criterion has its practical significance, and its investment decision-making is determined by the expected discounted wealth. In a complete, standard financial market with short-selling allowed, this paper probes into the investment decision-making with probability criterion. The upper limit of criterion function is obtained. The corresponding discounted wealth process and hedging portfolio process are provided. Finally, an illustrative example of one-dimensional constant-coefficient financial market is given.

Long-term implications of fetal growth restriction

Fetal growth restriction(FGR),or intrauterine growth restriction(IUGR),is a complication of pregnancy where the fetus does not achieve its genetic growth potential.FGR is characterized by a pathological retardation of intrauterine growth velocity in the curve of intrauterine growth.However,the FGR definition is still debated,and there is a lack of a uniform definition in the literature.True IUGR,compared to constitutional smallness,is a pathological condition in which the placenta fails to deliver an adequate supply of oxygen and nutrients to the developing fetus.Infants with IUGR,compared to appropriately grown gestational age infants,have a significantly higher risk of mortality and neonatal complications with long-term consequences.Several studies have demonstrated how suboptimal fetal growth leads to long-lasting physiological alterations for the developing fetus as well as for the newborn and adult in the future.The long-term effects of fetal growth retardation may be adaptations to poor oxygen and nutrient supply that are effective in the fetal period but deleterious in the long term through structural or functional alterations.Epidemiologic studies showed that FGR could be a contributing factor for adult chronic diseases including cardiovascular disease,metabolic syndrome,diabetes,respiratory diseases and impaired lung function,and chronic kidney disease.In this review we discussed pathophysiologic mechanisms of FGR-related complications and potential preventive measures for FGR.

Changes and Restrictions

The development of the United States of America in its history over the past more than 200 years demonstrates that, the strategic line of thought of this nation is rather clear. In other words, America is a "nation that is never content. " This can be seen from its development from thirteen colonies to a big power stretching cross two oceans, then the only superpower in today’s world. The words and deeds of U. S. important political figures and public opinions as well reveal that at pre-

Caloric restriction-mimetics for the reduction of heart failure risk in aging heart: with consideration of gender-related differences

The literature is full of claims regarding the consumption of polyphenol or polyamine-rich foods that offer some protection from developing cardiovascular disease(CVD). This is achieved by preventing cardiac hypertrophy and protecting blood vessels through improving the function of endothelium. However, do these interventions work in the aged human hearts? Cardiac aging is accompanied by an increase in left ventricular hypertrophy, along with diastolic and systolic dysfunction. It also confers significant cardiovascular risks for both sexes. The incidence and prevalence of CVD increase sharply at an earlier age in men than women. Furthermore, the patterns of heart failure differ between sexes, as do the lifetime risk factors. Do caloric restriction(CR)-mimetics, rich in polyphenol or polyamine, delay or reverse cardiac aging equally in both men and women? This review will discuss three areas:(1) mechanisms underlying age-related cardiac remodeling;(2) gender-related differences and potential mechanisms underlying diminished cardiac response in older men and women;(3) we select a few polyphenol or polyamine rich compounds as the CRmimetics, such as resveratrol, quercetin, curcumin, epigallocatechin gallate and spermidine, due to their capability to extend health-span and induce autophagy. We outline their abilities and issues on retarding aging in animal hearts and preventing CVD in humans. We discuss the confounding factors that should be considered for developing therapeutic strategies against cardiac aging in humans.

Quadratic Loss of Isotonic Normal Means under Simultaneous Order Restrictions

For two normal populations with unknown means μ and unknown variances σ2, assume that there are simple order restrictions among the means and variances: μ1 < μ2 and σ12 >σ22 > 0. This case is said to be simultaneous order restriction by Shi (Maximum likelihood estimation of means and variances from normal populations under simultaneous order restrictions, J. Multivariate Anal., 50(1994), 282-293.) and an iterative algorithm of computing the order restricted maximum likelihood estimates of μi and σi2 was given in that paper. This paper shows that the restricted maximum likelihood estimate of μi has smaller mean square loss than the usual estimate xi under some conditions.

Measuring the Social Net Benefits of COVID-19 Restrictions: The Case of Reduced Vehicle Use in a Pollution-Prone Region of Utah

A number of natural experiments have recently found that COVID-19 restrictions imposed in nations worldwide are correlated with short-term reductions—in some cases dramatic reductions—in mobile-source air pollutants. Noticeably absent from these studies are estimates of the social net benefits associated with the changes in human behavior underlying the pandemic-induced effects. Using readily available data provided by the state of Utah and the U.S. Environmental Protection Agency’s Co-Benefits Risk Assessment Health Impacts Screening and Mapping Tool (COBRA), we find that daily social net benefit was positive during a pandemic-induced shutdown from March to April, 2020 in Utah’s Wasatch Front region solely when COBRA’s “high” health benefit estimate from combined reductions in PM2.5 and NOx concentrations are weighed against the region’s “low” vehicle-trip cost estimate. All other scenarios correspond with negative net benefit estimates, i.e., when high and low benefit estimates of reductions solely in PM2.5 concentrations as well as for combined reductions in PM2.5 and NOx concentrations are weighed against the region’s high vehicle-trip cost estimate. Generally speaking, social net benefits are higher for two of the Wasatch Front’s four counties.