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One-dimensional flexible supercapacitor yarns are of considerable interest for future wearable electronics. The bottleneck in this field is how to develop devices of high energy and power density, by using economically viable materials and scalable fabrication technologies. Here we report a hierarchical graphene–metallic textile composite electrode concept to address this challenge. The hierarchical composite electrodes consist of low-cost graphene sheets immobilized on the surface of Ni-coated cotton yarns, which are fabricated by highly scalable electroless deposition of Ni and electrochemical deposition of graphene on commercial cotton yarns. Remarkably, the volumetric energy density and power density of the all solid-state supercapacitor yarn made of one pair of these composite electrodes are 6.1 mWh cm −3 and 1,400 mW cm −3 , respectively. In addition, this SC yarn is lightweight, highly flexible, strong, durable in life cycle and bending fatigue tests, and integratable into various wearable electronic devices. It is challenging to fabricate flexible and wearable supercapacitors with high energy and power densities using cost-effective materials and scalable processes. Here, the authors present a supercapacitor yarn based on graphene and metallic textile composites, which shows potential to fulfil those requirements.

AbstractObjectiveTo assess the prevalence of diabetes and its risk factors.DesignPopulation based, cross sectional study.Setting31 provinces in mainland China with nationally representative cross sectional data from 2015 to 2017.Participants75 880 participants aged 18 and older—a nationally representative sample of the mainland Chinese population.Main outcome measuresPrevalence of diabetes among adults living in China, and the prevalence by sex, regions, and ethnic groups, estimated by the 2018 American Diabetes Association (ADA) and the World Health Organization diagnostic criteria. Demographic characteristics, lifestyle, and history of disease were recorded by participants on a questionnaire. Anthropometric and clinical assessments were made of serum concentrations of fasting plasma glucose (one measurement), two hour plasma glucose, and glycated haemoglobin (HbA1c).ResultsThe weighted prevalence of total diabetes (n=9772), self-reported diabetes (n=4464), newly diagnosed diabetes (n=5308), and prediabetes (n=27 230) diagnosed by the ADA criteria were 12.8% (95% confidence interval 12.0% to 13.6%), 6.0% (5.4% to 6.7%), 6.8% (6.1% to 7.4%), and 35.2% (33.5% to 37.0%), respectively, among adults living in China. The weighted prevalence of total diabetes was higher among adults aged 50 and older and among men. The prevalence of total diabetes in 31 provinces ranged from 6.2% in Guizhou to 19.9% in Inner Mongolia. Han ethnicity had the highest prevalence of diabetes (12.8%) and Hui ethnicity had the lowest (6.3%) among five investigated ethnicities. The weighted prevalence of total diabetes (n=8385) using the WHO criteria was 11.2% (95% confidence interval 10.5% to 11.9%).ConclusionThe prevalence of diabetes has increased slightly from 2007 to 2017 among adults living in China. The findings indicate that diabetes is an important public health problem in China.

Hydrogel electrolyte is widely used in solid energy storage devices because of its high ionic conductivity, environmental friendliness, and non‐leakage property. However, hydrogel electrolyte is not resistant to freezing. Here, a high proton conductive zwitterionic hydrogel electrolyte with super conductivity of 1.51 mS cm–1 at −50 °C is fabricated by random copolymerization of acrylamide and zwitterionic monomer in the presence of 1 m H2SO4 and ethylene glycol (EG). The antifreezing performance and low temperature conductivity are ascribed to hydrogen bonds and ionic bonds between the components and water molecules in the system and can be tuned by changing the monomer ratio and EG contents. The proton hopping migration on the ionic group of the polymer chains and Grotthuss proton transport mechanism are responsible for the high proton conductivity while Grotthuss transport is dominated at the glassy state of the polymer chains. The electrolyte‐assembled supercapacitor (SC) offers high specific capacitance of 93.5 F g–1 at 25 °C and 62.0 F g–1 at −50 °C with a capacitance retention of 91.1% and 81.5% after 10 000 cycles, respectively. The SC can even work at −70 °C. The electrolyte outperforms most reported antifreezing hydrogel electrolytes and has high potential in low‐temperature devices. A serial of proton antifreezing hydrogel electrolytes are fabricated. An extreme low‐temperature conductivity of 1.51 mS cm–1 at −50 °C is obtained. The proton transfer is facilitated by hopping on the zwitterionic group and Grotthuss proton conductivity mechanism. The electrolyte‐assembled supercapacitor demonstrates good electrochemical performance at low temperature of −50 °C.

Oxidative stress in retinal pigment epithelium (RPE) is considered to be a major contributor to the development and progression of age-related macular degeneration (AMD). Previous investigations have shown that sodium tanshinone IIA sulfonate (STS) can alleviate oxidative stress in haemorrhagic shock-induced organ damage and cigarette smoke-induced chronic obstructive pulmonary disease in mice. However, whether STS has a protective effect in ARPE-19 cells under oxidative stress and its exact mechanisms have not yet been fully elucidated. In the present study, we utilized H 2 O 2 to establish an oxidative stress environment. Our findings show that STS activated the PI3K/AKT/mTOR pathway to inhibit autophagy and diminished the expression of the autophagic proteins Beclin 1, ATG3, ATG7 and ATG9 in ARPE-19 cells under oxidative stress. Detection of the intrinsic apoptosis-related factors BAX, mitochondrial membrane potential (MMP), caspase-9, caspase-3 and BCL-2, as well as the extrinsic apoptosis-related factors c-FLIP, v-FLIP and caspase-8, confirmed that STS inhibited the intrinsic and extrinsic apoptotic pathways, and attenuated apoptosis in ARPE-19 cells under oxidative stress conditions. These findings shed new light on the protective effects of STS in ARPE-19 cells and its mechanisms under oxidative stress to provide novel and promising therapeutic strategies for AMD.

Delirium is a frequent complication in critically ill patients and is associated with adverse outcomes such as long-term cognitive impairment and increased mortality. The relationship between the dynamic changes in blood glucose and the onset of acute delirium remains unclear. This study aims to explore the effect of 24-h blood glucose trajectory on acute delirium in patients via latent category trajectory modeling, and additionally investigate its association with in-hospital mortality in this population. This retrospective cohort study examined patients in the intensive care unit (ICU) using the MIMIC-IV database. Changes in the trajectories of blood glucose within 24 h after admission to the ICU were categorized using latent category trajectory modeling. The outcome examined was the occurrence of acute delirium during ICU hospitalization, with the secondary outcome being in-hospital mortality. The study included 21,940 critically ill patients, of which 2,633 developed acute delirium during ICU hospitalization. The blood glucose trajectories within 24 h were classified into four categories using the LCMM model. After fully adjusting for various confounders, Classes 4 and 2 were associated with a higher risk of acute delirium compared with Class 1, and the respective ORs (95% CIs) were 1.34 (1.08–1.64) and 1.18 (1.04–1.35). For the secondary outcome, a similar trend was observed between Class and in-hospital mortality: OR (95% CI) was 1.62 (1.29–2.02) for Class 4 and 1.45 (1.25–1.67) for Class 2. The 24-h blood glucose trajectory is significantly associated with both the risk of acute delirium and in-hospital mortality in critically ill patients. Focusing on levels of blood glucose trajectory may be beneficial to assess the potential risk of acute delirium and in-hospital mortality.

Background: Severe hypoglycemia can cause cognitive impairment in diabetic patients, but the underlying molecular mechanism remains unclear. Objective: To assess the effect of severe hypoglycemia on cognitive function in diabetic mice to clarify the relationship between the mechanism and dysfunction of pericytes and the blood–brain barrier (BBB). Method: We established type 1 diabetes mellitus in 80 male C57BL/6J mice by intraperitoneal injection of streptozotocin (150 mg/kg). Further intraperitoneal injection of short-acting insulin induced severe hypoglycemia. The mice were divided into normal, diabetes, and diabetic + severe hypoglycemia groups, and their blood glucose and general weight index were examined. Pericyte and BBB morphology and function were detected by histological and western blot analyses, BBB permeability was detected by Evans blue staining, and cognitive function was detected with the Morris water maze. Results: Severe hypoglycemia aggravated the histological damage, BBB damage, brain edema, and pericyte loss in the diabetic mice. It also reduced the expression of the BBB tight junction proteins occludin and claudin-5, the expression of the pericyte-specific markers PDGFR-β (platelet-derived growth factor receptor-β) and α-SMA, and increased the expression of the inflammatory factor MMP9. At the same time, diabetic mice with severe hypoglycemia had significantly reduced cognitive function. Conclusion: Severe hypoglycemia leads to cognitive dysfunction in diabetic mice, and its possible mechanism is related to pericyte dysfunction and BBB destruction.

Background The hypertension cure rate of unilateral adrenalectomy in primary aldosteronism (PA) patients varies widely in existing studies. Methods We conducted an observational meta-analysis to summarize the pooled hypertension cure rate of unilateral adrenalectomy in PA patients. Comprehensive electronic searches of PubMed, Embase, Cochrane, China National Knowledge Internet (CNKI), WanFang, SinoMed and Chongqing VIP databases were performed from initial state to May 20, 2016. We manually selected eligible studies from references in accordance with the inclusion criteria. The pooled hypertension cure rate of unilateral adrenalectomy in PA patients was calculated using the DerSimonian–Laird method to produce a random-effects model. Results Forty-three studies comprising approximately 4000 PA patients were included. The pooled hypertension cure rate was 50.6% (95% CI: 42.9–58.2%) for unilateral adrenalectomy in PA. Subgroup analyses showed that the hypertension cure rate was 61.3% (95% CI: 49.4–73.3%) in Chinese studies and 43.7% (95% CI: 38.0–49.4%) for other countries. Furthermore, the hypertension cure rate at 6-month follow-up was 53.3% (95% CI: 36.0–70.5%) and 49.6% (95% CI: 40.9–58.3%) for follow-up exceeding 6 months. The pooled hypertension cure rate was 50.9% (95% CI: 40.5–61.3%) from 2001 to 2010 and 50.2% (95% CI: 39.0–61.5%) from 2011 to 2016. Conclusions The hypertension cure rate for unilateral adrenalectomy in PA is not optimal. Large clinical trials are required to verify the utility of potential preoperative predictors in developing a novel and effective prediction model.

Among the major abiotic stresses, salt and drought have considerably affected agricultural development globally by interfering with gene expression profiles and cell metabolism. Transcription factors play crucial roles in activating or inhibiting the expression of stress-related genes in response to abiotic stress in plants. In this study, the Zea mays L. SQUAMOSA promoter-binding protein gene (ZmSBP17) was identified, and the molecular regulatory mechanism of osmotic stress tolerance was analyzed. Phylogenetic analysis confirmed that ZmSBP17 is part of the SBP gene family and is closely related to OsSBP17. The ZmSBP17-GFP fusion protein exhibited green fluorescence in the nucleus, as determined via tobacco epidermal transient transformation system. Acting as a transcriptional activator, the overexpression of ZmSBP17 in Arabidopsis significantly enhanced the expression of genes encoding superoxide dismutases (CSD1/2, MSD1), catalases (CAT1/2), ascorbate peroxidase 1 (APX1), and myeloblastosis transcription factors (AtMYB53/65), which increased the activity of reactive oxygen species (ROS)-scavenging enzymes and reduced ROS levels. Additionally, the expression of abiotic stress-related genes, such as AtDREB2A and AtNHX1, was significantly upregulated by ZmSBP17. Furthermore, ZmSBP17 specifically bound to cis-acting elements containing GTAC core sequences in the promoters of stress-related genes, suggesting that ZmSBP17 regulates the transcription of certain genes by recognizing these sequences. These results indicate that the overexpression of ZmSBP17 in Arabidopsis thaliana significantly increased tolerance to osmotic stress during the germination and seedling stages, which may enhance our understanding of the biological functions of SBPs in maize under abiotic stresses.

Glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1RAs) are promising weight-loss drugs, but real-world data concerning the liability of GLP-1RAs in gastrointestinal safety are lacking. We examined the differences in gastrointestinal safety between semaglutide and liraglutide. We used the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database and retrieved data during the first three years of semaglutide and liraglutide approved by the FDA. Thirteen main gastrointestinal adverse drug reactions (GADRs) were evaluated. Patient demographics, treatment information, and outcome of events were summarized. Disproportionality analyses were conducted by estimating the reporting odds ratios (RORs) and 95% confidence intervals (CIs). In the reported cases of semaglutide (n = 2047) and liraglutide (n = 4175), semaglutide had a higher pooled ROR and later pooled time-to-onset median of GADRs compared with those of liraglutide (5.53, 95% CI 5.23-5.85 vs 3.95, 95% CI 3.81-4.10; 7 days, Q1-Q3: 0-48 vs 4 days, Q1-Q3: 0-34.5). The thirteen GADRs associated with these two GLP-1RAs showed a significant difference in the profile of reporting risk and time-to-onset. GLP-1RAs produce a spectrum of distinct classes of GADRs. The individual properties of GADRs between semaglutide and liraglutide might enable incretin-based treatment of obesity to be \"tailored\" to the needs of each patient.

Background This study aimed to assess the prognostic significance of serum lipoprotein(a) [Lp(a)] levels regarding overall survival (OS) and progression-free survival (PFS) among patients diagnosed with pancreatic cancer (PC). Methods A retrospective cohort of 364 pathologically confirmed PC patients treated at the Affiliated Hospital of Qingdao University between January 2019 and December 2022 was analyzed. The optimal cutoff for Lp(a) was identified using X-tile software, allowing categorization into high and low Lp(a) groups. To minimize selection bias, propensity score matching (PSM) was utilized. Survival outcomes were compared using Kaplan–Meier curves and log-rank tests. Cox proportional hazards models were applied to identify independent prognostic variables affecting OS and PFS. Results Patients with high Lp(a) had significantly shorter OS and PFS both before and after PSM (post-PSM OS: 12.28 vs. 27.67 months, P  = 0.003; PFS: 7.00 vs. 11.30 months, P  = 0.002). Multivariate Cox analysis confirmed high Lp(a) as an independent predictor of poor OS [HR = 2.11 (1.17–3.81), P  = 0.013] and PFS [HR = 2.14 (1.20–3.83), P  = 0.010]. In the surgical subgroup ( n  = 215), high Lp(a) was also associated with worse OS (16.43 vs. 35.47 months, P  = 0.02) and PFS (8.40 vs. 11.77 months, P  = 0.036). Multivariate analysis in this subgroup showed that high Lp(a) remained an independent risk factor for OS [HR = 2.82 (1.36–5.87), P  = 0.006] and PFS [HR = 2.01 (1.06–3.86), P  = 0.034]. Conclusion Elevated serum Lp(a) is an independent predictor of reduced OS and PFS in patients with pancreatic cancer. In contrast to conventional lipid profiles, the genetic stability of Lp(a) makes it a reliable baseline prognostic marker.