促进糖尿病患者足溃疡愈合的干预措施指南(2023年更新版)——《国际糖尿病足工作组:糖尿病相关的足病预防与管理指南(2023)》的一部分

创面处理的原则,包括清创、创面准备和使用涉及改变创面生理以促进愈合的新技术,在试图治愈慢性糖尿病相关的足溃疡时是至关重要的。此外,糖尿病相关的足溃疡的发病率和治疗成本不断上升,这就需要结合作为金标准的多学科治疗已有共识,运用高质量的疗效和成本效益证据来支持和加强慢性糖尿病相关的足溃疡创面愈合的干预措施。本指南是2023年国际糖尿病足工作组(IWGDF)针对促进糖尿病患者足溃疡愈合的干预措施的循证指南。它是对2019年IWGDF指南的更新。我们遵循推荐、评估、发展、评价分级(GRADE)方法,以患者-干预-对照-结果(PICO)形式设计临床问题从而得出重要结果,进行系统综述,制定评判表汇总,并为每个问题撰写推荐和理由。每条推荐的形式都是基于系统综述中发现的证据,并使用GRADE评判汇总项目,包括理想和不理想的效果、证据的可信度、对患者的价值、所需的资源、成本效益、公平性、可行性和可接受性;我们制定的推荐由作者同意并由独立专家和利益相关者审查。根据系统综述和从证据到决策过程的结果,我们提出29条推荐。我们对使用干预措施改善糖尿病患者足溃疡的愈合提出了一些有条件的支持性推荐。这些推荐包括蔗糖八硫酸盐敷料的使用,对手术后的创面使用负压疗法,使用胎盘衍生产品,使用自体白细胞、血小板、纤维蛋白贴剂,使用局部氧疗,以及使用高压氧,但我们强调在任何情况下这些推荐应在单独应用最佳标准治疗无法治愈伤口且有资源可用于干预的情况下使用。这些关于创面愈合的推荐应该有助于提高糖尿病伴足溃疡患者的疗效,我们希望这些推荐能得到广泛的实施。然而,尽管作为推荐基础的许多证据的准确性正在提高,但总体上仍然很差,我们鼓励在这一领域进行更多、质量更好的试验,包括那些有关卫生经济学分析的试验。

Corrigendum to“Nitrosamines crisis in pharmaceuticals-Insights on toxicological implications,root causes and risk assessment:A systematic review”[J.Pharm.Anal.14(2024)100919]

Original statement in the Section 2:2.Literature search Our primary screening of 180 articles yielded the relevant data for this study.2.1.Study selection A total of 180 articles spanning from 1960 to the present day,including original research,reviews,case reports and studies reporting nitrosamine impurities above the no-observed-adverse-effect levels(NOAEL)established by regulatory agencies,were initially screened.During the primary screening,we considered factors such as relevance,publication date,access to the full article text,and content.

The loaded matrix:neurotrophin-enriched hydrogels for stem cell brain repair in Parkinson's disease

More than 200 years after Parkinson's disease was first described by the English surgeon whose name would eventually be given to the condition,available treatments remain purely symptomatic,leaving a critical unmet clinical need for a diseasemodifying therapy.

Survey on Video Security:Examining Threats,Challenges,and Future Trends

Videos represent the most prevailing form of digital media for communication,information dissemination,and monitoring.However,theirwidespread use has increased the risks of unauthorised access andmanipulation,posing significant challenges.In response,various protection approaches have been developed to secure,authenticate,and ensure the integrity of digital videos.This study provides a comprehensive survey of the challenges associated with maintaining the confidentiality,integrity,and availability of video content,and examining how it can be manipulated.It then investigates current developments in the field of video security by exploring two critical research questions.First,it examine the techniques used by adversaries to compromise video data and evaluate their impact.Understanding these attack methodologies is crucial for developing effective defense mechanisms.Second,it explores the various security approaches that can be employed to protect video data,enhancing its transparency,integrity,and trustworthiness.It compares the effectiveness of these approaches across different use cases,including surveillance,video on demand(VoD),and medical videos related to disease diagnostics.Finally,it identifies potential research opportunities to enhance video data protection in response to the evolving threat landscape.Through this investigation,this study aims to contribute to the ongoing efforts in securing video data,providing insights that are vital for researchers,practitioners,and policymakers dedicated to enhancing the safety and reliability of video content in our digital world.

Neuroinflammation as a therapeutic target in Huntington's disease

In 1872, George Huntington presented his essay “On Chorea” to the Meigs and Mason Academy of Medicine and, in doing so, detailed a disease that would later bear his name. Huntington's disease(HD) is a genetic, neurodegenerative disease that manifests as the loss of motor control,cognitive impairment,and mood and psychiatric changes in paents.

Glial response in the midcingulate cortex in Huntington’s disease

Huntington’s disease(HD)is a genetic disease characterized by the progressive degeneration of the striatum and cortex.Patients can present with a variety of symptoms that can broadly be classified into motor symptoms,inclusive of choreatic movements and rigidity,mood and psychiatric symptoms,such as depression and apathy,and cognitive symptoms,such as cognitive decline.The causal mutation underlying HD results from an expansion of a CAG repeat sequence on the IT15 gene,resulting in the formation and accumulation of a mutant huntingtin protein.

Nitrosamines crisis in pharmaceuticals-Insights on toxicological implications,root causes and risk assessment:A systematic review

The presence of N-nitroso compounds,particularly N-nitrosamines,in pharmaceutical products has raised global safety concerns due to their significant genotoxic and mutagenic effects.This systematic review investigates their toxicity in active pharmaceutical ingredients(APIs),drug products,and pharmaceutical excipients,along with novel analytical strategies for detection,root cause analysis,reformulation strategies,and regulatory guidelines for nitrosamines.This review emphasizes the molecular toxicity of N-nitroso compounds,focusing on genotoxic,mutagenic,carcinogenic,and other physiological effects.Additionally,it addresses the ongoing nitrosamine crisis,the development of nitrosamine-free products,and the importance of sensitive detection methods and precise risk evaluation.This comprehensive overview will aid molecular biologists,analytical scientists,formulation scientists in research and development sector,and researchers involved in management of nitrosamine-induced toxicity and promoting safer pharmaceutical products.

Endoscopic push through tragal cartilage tympanoplasty: A 10-year retrospective review of our technique and outcomes

BACKGROUND Endoscopic ear surgery(EES)provides a magnified,high-definition view of the otological surgical field.EES allows otologists to avoid surgical incisions and associated postoperative complications.It is an ideal technique for the perfor-mance and teaching of tympanoplasty.AIM To examine the efficacy of total Endoscopic Push Through Tragal Cartilage Tympanoplasty(EPTTCT),at our institution over a 10-year period.METHODS A retrospective analysis of 168 cases of EPTTCT for closure of small to medium tympanic membrane perforations from 2013-2023 was conducted.Patient sex,age range(pediatric vs adult),etiology of injury,success rate,complications,and postoperative hearing status were collected.RESULTS Graft uptake results indicated success in 94%of patients,with less than a 2%complication rate.Postoperative pure tone audiometry demonstrated hearing status improvement in 69%of patients.CONCLUSION EPTTCT has been shown to be effective in tympanic membrane perforation closures with minimal complications.This study further demonstrates the efficacy and safety of these procedures in a single-center review.

The Combination Effect of Daphne Extract and Imatinib on the Antiproliferative Activity of the K562 Cell Line

Background: Herbal medicine is well-known among the ancient medical sciences. Healing properties have been observed in some species of Daphne plant. The effect of Daphne plant extract on the K562 cell line has been previously studied, and Gleevec is a well-known and effective medicine for the treatment of chronic myelogenous leukemia. Material and Methods: In this study, the simultaneous effects of using herbal medicine and a target therapy medicine on the K562 cell line were investigated. The presence of some species of Daphne in Iran motivated us to evaluate the cytotoxic effect of Daphne mucronata on human leukemia cancer cells. The antiproliferative activity of the dichloromethane extract of Daphne mucronate (Thymelaeaceae), a new anticancer medicinal plant, was evaluated. Cell viability was quantitated by MTT assay. Apoptotic and necrotic changes in the cell membrane were examined using flow cytometry. Changes in Bax and Bcl2 gene expression were investigated using real-time PCR. The MIC and the IC50 of the crude extract were calculated, and the MIC and IC50 of the Daphne extract in combination of imatinib were tested in the K-562 cell line. Results: K-562 cells responded to the extract treatments in a dose-dependent manner, and the increase in the expression of Bcl2 and decrease in the expression of the Bax gene intensified with increasing extract concentration. Flow cytometry revealed that most of the cells underwent necrosis. Conclusion: Daphne extract effectively decreased the viability of the K562 cell line. The necrotic effect of the Daphne extract was evaluated, and an increase in the gene expression of Bcl2 was observed in cells exposed to the Daphne extract. The combination of Daphne extracts with imatinib enhances the cytotoxic effect of imatinib.

Simultaneous nitrification and autotrophic denitrification in fluidized bed reactors using pyrite and elemental sulfur as electron donors

In this study, simultaneous nitrification and autotrophic denitrification (SNAD) with either elemental sulfur or pyrite were investigated in fluidized bed reactors in mesophilic conditions. The reactor performance was evaluated at different ammonium (12-40 mg/L of NH4+-N), nitrate (35-45 mg/L of NO3--N), and dissolved oxygen (DO) (0.1-1.5 mg/L) concentrations, with a hydraulic retention time of 12 h. The pyrite reactor supported the SNAD process with a maximum nitrogen removal efficiency of 139.5 mg/(L·d) when the DO concentration was in the range of 0.8-1.5 mg/L. This range, however, limited the denitrification efficiency of the reactor, which decreased from 90.0% ± 5.3% in phases II-V to 67.9% ± 7.2% in phases VI and VII. Sulfate precipitated as iron sulfate (FeSO4/Fe2(SO4)3) and sodium sulfate (Na2SO4) minerals during the experiment. The sulfur reactor did not respond well to nitrification with a low and unstable ammonium removal efficiency, while denitrification occurred with a nitrate removal efficiency of 97.8%. In the pyrite system, the nitrifying bacterium Nitrosomonas sp. was present, and its relative abundance increased from 0.1% to 1.1%, while the autotrophic denitrifying genera Terrimonas, Ferruginibacter, and Denitratimonas dominated the community. Thiobacillus, Sulfurovum, and Trichlorobacter were the most abundant genera in the sulfur reactor during the entire experiment.

Adhesive hydrogels in osteoarthritis:from design to application

Osteoarthritis(OA)is the most common type of degenerative joint disease which affects 7%of the global population and more than 500 million people worldwide.One research frontier is the development of hydrogels for OA treatment,which operate either as functional scaffolds of tissue engineering or as delivery vehicles of functional additives.Both approaches address the big challenge:establishing stable integration of such delivery systems or implants.Adhesive hydrogels provide possible solutions to this challenge.However,few studies have described the current advances in using adhesive hydrogel for OA treatment.This review summarizes the commonly used hydrogels with their adhesion mechanisms and components.Additionally,recognizing that OA is a complex disease involving different biological mechanisms,the bioactive therapeutic strategies are also presented.By presenting the adhesive hydrogels in an interdisciplinary way,including both the fields of chemistry and biology,this review will attempt to provide a comprehensive insight for designing novel bioadhesive systems for OA therapy.

A review of science–policy interface for water governance in the Caspian Sea

Science and policy have been interlinked for decades and perform essential nexus conditions in the governing aspects of environmental scenarios.This review paper examines the present challenges in the science–policy interface in terms of water governance in the Caspian Sea and identifies effective conditions that may be used in the current context to enhance the mechanism.The evaluation of the science–policy link in the water policy of the Caspian Sea reveals a gap between knowledge producer and governance system,impeding the translation of scientific information into action.Complicated and context-dependent solutions make it challenging to establish effective science–policy processes in the Caspian Sea water governance settings.Establishing a common governing authority,implementing water and resource management regulations,and protecting the natural environment through legal frameworks are crucial steps to address these concerns and ensure sustainable development.Collaboration among coastal states is essential in environmental,economic,and social aspects of regional development.However,the lack of a comprehensive approach,coherent activities,and effective utilization of national and regional power has hindered efforts to halt the environmental degradation of the Caspian Sea.Local governments need to recognize their responsibility to protect and utilize the Caspian Sea for present and future generations,considering both environmental and human security.The interlinkage of the Caspian Sea water governance with the Organization for Economic Co-operation and Development(OECD)water governance principles offers a framework for policymakers to assess gaps and make necessary amendments to existing mechanisms.Effective science–policy interaction,engagement of diverse stakeholders,institutionalizing agreements,and addressing collective action issues are critical for successful water governance.

Investigating the causes of Lake Urmia shrinkage:climate change or anthropogenic factors?

In the current scenario,Lake Urmia,one of the vastest hyper saline lakes on the Earth,has been affected by serious environmental degradation.Using different satellite images and observational data,this study investigated the changes in the lake for the period 1970–2020 based on the effects of climate change and several human-induced processes on Lake Urmia,such as population growth,excessive dam construction,low irrigation water use efficiency,poor water resources management,increased sediment flow into the lake,and lack of political and legal frameworks.The results indicated that between 1970 and 1997,the process of change in Lake Urmia was slow;however;the shrinkage was faster between 1998 and 2018,with about 30.00%of the lake area disappearing.As per the findings,anthropogenic factors had a much greater impact on Lake Urmia than climate change and prolonged drought;the mismanagement of water consumption in the agricultural sector and surface and underground water withdrawals in the basin have resulted in a sharp decrease in the lake's surface.These challenges have serious implications for water resources management in Lake Urmia Basin.Therefore,we provided a comprehensive overview of anthropogenic factors on the changes in Lake Urmia along with existing opportunities for better water resources management in Lake Urmia Basin.This study serves as a guideline framework for climate scientists and hydrologists in order to assess the effects of different factors on lake water resources and for decision-makers to formulate strategies and plans according to the management task.

Metabotropic glutamate receptor 1 alpha:a unique receptor variant with variable implications for Alzheimer’s disease pathogenesis

Alzheimer’s disease (AD) is the leading neurodegenerative disorder globally.Despite this,there is minimal effective therapeutics proven to reduce or prevent the progression of this disease.Glutamate is the main excitatory neurotransmitter within the central nervous system and plays a crucial role in neuronal and synaptic functions.

Is EAAT2 a potential therapeutic intervention target for Alzheimer's disease?

Alzheimer's disease(AD)is the most common form of dementia worldwide,impairing memory and cognitive functions due to widespread neuronal death.The global incidence of this neurodegenerative disorder is predicted to increase rapidly in the near future.This growth in prevalence of AD will create a large burden for health systems worldwide.

Parity-check and G-matrix based intelligent early stopping criterion for belief propagation decoder for polar codes

The error correction performance of Belief Propagation(BP)decoding for polar codes is satisfactory compared with the Successive Cancellation(SC)decoding.Nevertheless,it has to complete a fixed number of iterations,which results in high computational complexity.This necessitates an intelligent identification of successful BP decoding for early termination of the decoding process to avoid unnecessary iterations and minimize the computational complexity of BP decoding.This paper proposes a hybrid technique that combines the“paritycheck”with the“G-matrix”to reduce the computational complexity of BP decoder for polar codes.The proposed hybrid technique takes advantage of the parity-check to intelligently identify the valid codeword at an early stage and terminate the BP decoding process,which minimizes the overhead of the G-matrix and reduces the computational complexity of BP decoding.We explore a detailed mechanism incorporating the parity bits as outer code and prove that the proposed hybrid technique minimizes the computational complexity while preserving the BP error correction performance.Moreover,mathematical formulation for the proposed hybrid technique that minimizes the computation cost of the G-matrix is elaborated.The performance of the proposed hybrid technique is validated by comparing it with the state-of-the-art early stopping criteria for BP decoding.Simulation results show that the proposed hybrid technique reduces the iterations by about 90%of BP decoding in a high Signal-to-Noise Ratio(SNR)(i.e.,3.5~4 dB),and approaches the error correction performance of G-matrix and conventional BP decoder for polar codes.

Spectral Analysis and Validation of Parietal Signals for Different Arm Movements

Brain signal analysis plays a significant role in attaining data related to motor activities.The parietal region of the brain plays a vital role in muscular movements.This approach aims to demonstrate a unique technique to identify an ideal region of the human brain that generates signals responsible for muscular movements;perform statistical analysis to provide an absolute characterization of the signal and validate the obtained results using a prototype arm.This can enhance the practical implementation of these frequency extractions for future neuro-prosthetic applications and the characterization of neurological diseases like Parkinson’s disease(PD).To play out this handling method,electroencepha-logram(EEG)signals are gained while the subject is performing different wrist and elbow movements.Then,the frontal brain signals and just the parietal signals are separated from the obtained EEG signal by utilizing a band pass filter.Then,feature extraction is carried out using Fast Fourier Transform(FFT).Subse-quently,the extraction process is done by Daubechies(db4)and Haar wavelet(db1)in MATLAB and classified using the Levenberg-Marquardt Algorithm.The results of the frequency changes that occurred during various wrist move-ments in the parietal region are compared with the frequency changes that occurred in frontal EEG signals.This proposed algorithm also uses the deep learn-ing pattern analysis network to evaluate the matching sequence for each action that takes place.Maximum accuracy of 97.2%and maximum error range of 0.6684%are achieved during the analysis.Results of this research confirm that the Levenberg-Marquardt algorithm,along with the newly developed deep learn-ing hybrid PatternNet,provides a more accurate range of frequency changes than any other classifier used in previous works of literature.Based on the analysis,the peak-to-peak value is used to define the threshold for the prototype arm,which performs all the intended degrees of freedom(DOF),verifying the results.These results would aid the specialists in their decision-making by facilitating the ana-lysis and interpretation of brain signals in the field of neuroscience,specifically in tremor analysis in PD.

Prognostic prediction and expression validation of NSD3 in pan-cancer analyses

Background:Nuclear receptor binding SET domain protein-3(NSD3)is a histone lysine methyltransferase and a crucial regulator of carcinogenesis in several cancers.We aimed to investigate the prognostic value and potential function of NSD3 in 33 types of human cancer.Methods:The data were obtained from The Cancer Genome Atlas.Kaplan-Meier analysis,CIBERSORT,gene set enrichment analysis,and gene set variation analysis were performed.The expression of NSD3 was measured using quantitative real-time polymerase chain reaction and western blot.Results:The expression of NSD3 was altered in pan-cancer samples.Patients with higher levels of NDS3 generally had shorter overall survival and disease-specific survival.Levels of NSD3 were positively correlated with DNA copy number variation(CNV)in pan-cancer.NSD3 expression was also associated with tumor mutation burden and microsatellite instability.The levels of immune-cell infiltration differed significantly between high and low NSD3 expression.NSD3 negatively correlated with levels of CD8+T cells.Functional enrichment analysis showed that while NSD3 expression was positively associated with several immune cell-related and histone methylation-related pathways,it was negatively correlated with cell metabolism-related,drug transport-related,and drug metabolismrelated pathways.NSD3 levels in the cell lines tested were significantly different.In U251 and NCI-H23 cells,silencing NSD3 inhibited cell proliferation and promoted apoptosis.Conclusions:NSD3 expression was changed in pan-cancer samples that was also verified in cell lines.NSD3 was associated with CNV and immune-cell infiltration.A poor prognosis was predicted in patients with high expression of NSD3.NSD3 might hence be a potential marker for predicting tumor prognosis.

Predictive Modeling for Analysis of Coronavirus Symptoms Using Logistic Regression

This paper presents a case study on the IPUMS NHIS database,which provides data from censuses and surveys on the health of the U.S.population,including data related to COVID-19.By addressing gaps in previous studies,we propose a machine learning approach to train predictive models for identifying and measuring factors that affect the severity of COVID-19 symptoms.Our experiments focus on four groups of factors:demographic,socio-economic,health condition,and related to COVID-19 vaccination.By analysing the sensitivity of the variables used to train the models and the VEC(variable effect characteristics)analysis on the variable values,we identify and measure importance of various factors that influence the severity of COVID-19 symptoms.

利用网格采样法比较潮间带沉积物不同粒度区域重金属含量特征

采用网格采样法,在渤海湾潮间带泥质区、泥沙过渡区和粉沙区分别以10 m和1 m为间隔,采集了384个表层沉积物样品,对Al、Fe、Ti、Mn、Ba、Sr、Zn、Cr、Ni、Cu 10种重金属含量特征进行研究,对比了潮间带不同粒度沉积物中重金属的蓄积特征.结果表明,10种重金属在淤泥、泥沙混合、粉沙3种研究区的总含量分别为147.37、98.68和94.27 g.kg-1,粒度变化造成重金属含量的显著分异;除Ba、Sr倾向在富含长石的粗颗粒区富集外,多数重金属元素呈现细颗粒区富集倾向;Sr含量受粒度变化影响最大,而Cr、Ti含量受粒度变化影响相对较小.