Introduction: More than two-thirds of patients with type 1 diabetes (T1D) are overweight (OW) and/or obese (OB) in the USA and Western Europe, resulting in insulin resistance as in type 2 diabetes. None of the currently available glucagon like polypeptide 1 (GLP-1) analogs are approved for patients with T1D. A higher dose of semaglutide has been approved by the Food and Drug Administration (FDA) for subjects with body mass index (BMI) >27 kg/m2. We evaluated the real-world use of semaglutide in patients with T1D. Methods: This was a retrospective chart review study of 50 OW or OB patients with T1D who were initiated on semaglutide and followed for 1 year. The control group comprised of 50 computer-matched patients (for sex, race, weight, BMI, and diabetes duration) during a similar time period and were not on any weight loss medications. Results: Most patients (92%) were non-Hispanic white in both arms. Mean ± standard deviation (SD) age and duration of diabetes were 42 ± 11 and 27 ± 12 years, respectively. The continuous glucose monitors (CGM), insulin pump use, baseline BMI and body weight were also similar in the two groups. Baseline glycosylated hemoglobin (HbA1c) was insignificantly lower in the semaglutide group (7.6% vs. 8.2%, respectively; P = non-significant [NS]). Total daily insulin dose (TDD) and insulin dose per kg body weight were higher in the semaglutide group at baseline with no difference in basal or prandial insulin dose. There were significantly greater declines in mean (±SD), BMI (7.9% ± 2.6%), body weight (15.9 lbs ± 5.4 lbs), HbA1c, CGM glucose SD and coefficient of variation (CV), and increase in CGM time in range (TIR) in the semaglutide group compared to the control group with no difference in insulin dose changes, time above range (TAR), or time below range (TBR). Conclusions: We conclude that use of semaglutide in patients who are OW and/or OB with T1D was effective in lowering body weight and BMI, and improving glycemic metrics in this pilot real-world study. We strongly recommend performing prospective, large-randomized clinical trials with newer GLP-1 analogs like semaglutide and tirzepatide (twin-cretin) for subjects with T1D associated with OW and/or OB.

UNASSIGNED: The frequency of sexual dysfunctions reported by HIV/AIDS patients is significantly higher than that of their peers. Sexual dysfunction and its predictors may result in increased viral loads, worsening HIV infection, and infectivity. To mitigate its consequences, appropriate evaluation and intervention are required.
UNASSIGNED: A cross-sectional study design was conducted among 336 HIV/AIDS-positive individuals at one hospital in southwest Ethiopia. To assess sexual dysfunctions, a tool called the Changes in Sexual Functioning Questionnaire (CSFQ-14) was used. Data analysis was done with SPSS version 20. Bivariate and multivariable logistic regressions were used to identify independent predictor variables, and statistical significance was declared at a p-value of <0.05.
UNASSIGNED: 98.53% of the sample completed the questionnaire accordingly. The frequency of SD was 72.0% (95% CI = 67.4-77.0). The frequency of SD was reported to be more prevalent among males (76.8% (95% CI = 70.6-81.6)) than that of females (66.2% (95% CI = 59.5-73.5)). Among the domains of sexual dysfunction, sexual pleasure problems (96.70%, (95% CI: 94.60-98.50)) were the higher figure of SD, and sexual desire problems (82.40%, (95% CI: 78.60-86.60)); were the least prevalent sexual dysfunctions. Predictors of the SD were age, social anxiety, nicotine use, poor sleep quality, and time of resuming ART medication.
UNASSIGNED: The frequency of SD was 72.0%. Predictors of the SD were age, social anxiety, nicotine use, poor sleep quality, and time of resuming ART medication.

Sleep deprivation (SD) weakens the immune system and leads to increased susceptibility to infectious or inflammatory diseases. However, it is still unclear how SD affects humoral immunity. In the present study, sleep disturbance was conducted using an sleep deprivation instrument, and the bacterial endotoxin lipopolysaccharide (LPS) was used to activate the immune response. It was found that SD-pretreatment reduced LPS-induced IgG2b+ B cells and IgG2b isotype antibody production in lymphocytes of spleen. And, SD-pretreatment decreased the proportion of CD4+T cells, production of CD4+T cells derived TGF-β1 and its contribution in helping IgG2b production. Additionally, BMAL1 and CLOCK were selectively up-regulated in lymphocytes after SD. Importantly, BMAL1 and CLOCK deficiency contributed to TGF-β1 expression and production of IgG2b+ B cells. Thus, our results provide a novel insight to explain the involvement of BMAL1 and CLOCK under SD stress condition, and their roles in inhibiting TGF-β1 expression and contributing to reduction of LPS induced IgG2b production.

In bacteriophage λ lysogens, the λcI repressor is encoded by the leaderless transcript (lmRNA) initiated at the λpRM promoter. Translation is enhanced in rpsB mutants deficient in ribosomal protein uS2. Although translation initiation of lmRNA is conserved in bacteria, archaea, and eukaryotes, structural insight of a lmRNA translation initiation complex is missing. Here, we use cryo-EM to solve the structures of the uS2-deficient 70S ribosome of host E. coli mutant rpsB11 and the wild-type 70S complex with λcI lmRNA and fmet-tRNAfMet. Importantly, the uS2-deficient 70S ribosome also lacks protein bS21. The anti-Shine-Dalgarno (aSD) region is structurally supported by bS21, so that the absence of the latter causes the aSD to divert from the normal mRNA exit pathway, easing the exit of lmRNA. A π-stacking interaction between the monitor base A1493 and A(+4) of lmRNA potentially acts as a recognition signal. Coulomb charge flow, along with peristalsis-like dynamics within the mRNA entry channel due to the increased 30S head rotation caused by the absence of uS2, are likely to facilitate the propagation of lmRNA through the ribosome. These findings lay the groundwork for future research on the mechanism of translation and the co-evolution of lmRNA and mRNA that includes the emergence of a defined ribosome-binding site of the transcript.

Serpin E1/PAI-1, N-terminal pro-brain natriuretic peptide (NTpro-BNP) and neuropilin-1 are markers which have been associated with endothelial dysfunction. However, data on the levels of these markers in PE is limited. The limited data on the pathophysiology of PE in relation to these markers necessitated the study. This was a multicentre case-control study conducted at the Obstetrics and Gynaecology Department of the Tamale Teaching Hospital, the Bawku Presbyterian Hospital and the Bolgatanga Regional Hospital. Out of 520 consenting pregnant women, 127 pregnant women met the inclusion criteria (53 with PE and 74 controls) and were included in this study. Venous, placental, cord and peripheral blood were collected for biomarker assay, haematological parameters and placental parasite determination. Placental tissue sections were obtained for placental malaria and histopathological lesions associated with hypoperfusion. Maternal heart rate and foetal umbilical artery Doppler impedance indices; resistance index (RI) and systolic diastolic (SD) ratio were determined to confirm utero-placental hypoperfusion. Significantly higher proportions of foeto-maternal complications; eclampsia, low birth weight (LBW), neonatal intensive care unit admissions (NICU), intrauterine growth restriction (IUGR), caesarian deliveries and early gestational age at delivery were associated with PE. Women with PE had lower concentrations of platelet (p = 0.02) whereas red cell distribution width (RDW) was markedly elevated (p = 0.01). NTPro-BNP concentration was markedly elevated (p = 0.01) in women with PE whereas neuropilin-1 concentration was lower (p = 0.03) compared to the non-PE group. Maternal heart rate was elevated in women with PE and Doppler resistance indices (RI and SD) were significantly elevated in foetuses of PE women than foetuses of the controls. Placental mal-perfusion lesions were higher in women with PE compared to the non-PE group. Women with PE had increased risk of adverse foeto-maternal complications, significantly associated with placental mal-perfusion lesions, had reduced platelet concentration and elevated RDW-CV levels. NTPro-BNP, RI and SD are elevated in women with PE whereas neuropilin-1 concentration is reduced. Significant changes in these pathological variables in PE women is indicative of significant derangement in endothelial function culminating in adverse maternal and perinatal outcomes of pregnancy.

System dynamics (SD) is widely recognized as a tool for simulating spatial and temporal dynamics in life cycle assessment (LCA) studies of the product system. However, there is no agreement on how SD and LCA could be applied effectively together in a consistent way. To address this gap, this research conducted a systematic literature review, analyzing 54 scientific articles published worldwide between 2010 and 2023, to explore the joint application of LCA with SD. The study aimed to answer three research questions: (1) What can be considered an integration of LCA and SD? (2) How can SD and LCA be effectively integrated? and (3)What are the advantages and constraints of this integration? The results highlighted the popularity of LCA and SD as impact assessment tools for sustainable design, each with its own strengths and limitations. Two primary integration types were identified when LCA was jointly applied with SD: (1) inclusion of the life cycle inventory and characterization factors in an SD model, and (2) inclusion of SD model results in an LCA. In the second type of integration, SD models the components of the technical system, and its outcomes served as input for scenario analysis, providing temporal and potentially spatial inventory data for the LCA model. The integrated approach offers a comprehensive understanding of product sustainability, aids decision-making, and enhances stakeholder engagement. The study also identifies knowledge gaps in the joint application of SD and LCA for environmental scenario analysis, suggesting the incorporation of optimization tools and strategy guidance for policy makers.

UNASSIGNED: Stretch marks, also known as striae cutis distensae (SD), are visible linear scars that occur in regions of dermal damage due to skin stretching. Stretch marks are not serious health issues, but they may have a major psychological effect on patients. Due to poor skin color improvement or prolonged skin atrophy, there is no standard treatment for SD. Fillers have been studied for their effectiveness in the treatment of SD.
UNASSIGNED: This systematic review aims to determine the efficacy of fillers on SD.
UNASSIGNED: This systematic review is reported following PRISMA guidance. We included all relevant articles published up to November 2022 in the following electronic databases: Science Direct, Midline, the Web of Science, CINAHL, and Google Scholar. The initial search yielded 119, of which seven were included after applying inclusion and exclusion criteria.
UNASSIGNED: The systematic review included a total of 184 female participants who were over the age of 18 years old. Three studies used jet volumetric remodeling (JVR) to inject HA pneumatically. One study injected polycaprolactone filler. One study used calcium hydroxylapatite, micro-needling, and ascorbic acid. MFU-V and CaHA were given in one study. One study delivered MFU-V using micro-focused ultrasound. All studies showed that it reduces SD with only mild, temporary side effects. More favor was given to combining CaHA and MFU-V, which had the fewest side effects compared to other dermal fillers.
UNASSIGNED: As monotherapy or combination therapy, injectable dermal fillers may treat SD with minimal adverse effects. We suggest that more RCTs look into injectable dermal filler to find out what is best for patients with SD and compare it to other treatment methods in terms of results, costs, and side effects to provide satisfactory practice and basic guideline interventions for these cases.

In recent years, with the global recognition of the concept of sustainable development, the international market attaches great importance to the Environment, Society, and Governance (ESG) investment performance of enterprises. The \"carbon peaking and carbon neutrality\" goal puts forward requirements for Chinese enterprises to carry out ESG investment. As a large state-owned enterprise in China, power grid companies need to take the lead in ESG investment. Based on the System Dynamics (SD) theory, this paper establishes the simulation model of ESG-responsible investment of power grid companies, including the environmental investment sub-module, social investment sub-module, and governance investment sub-module. Taking a provincial Power Grid Company as an example, the numerical simulation of ESG investment of power grid companies is carried out. The actual input-output efficiency of ESG investment of power grid companies is reflected through the mapping relationship between key indicators and investment amount, and the ESG investment scale and investment weight of the Power Company in the coming years are predicted. Compared with the traditional static analysis method, this model can provide a theoretical basis for power grid companies to carry out ESG investment decisions.

Introduction Although seborrheic dermatitis (SD) is not lethal, it has a significant impact on the quality of life. Many cases of SD are managed with ketoconazole, but luliconazole has shown an equivalent or lower minimum inhibitory concentration (MIC), but not many studies have been done for its efficacy and safety in SD. With this in mind, we set out to conduct a study comparing the effectiveness, safety, and tolerability of Lulican™ (luliconazole 1% + salicylic acid 3% + ZPTO 1%) shampoo and Ketoconazole (Ketoconazole 2% + ZPTO 1%) shampoo in the treatment of SD. Materials and methods In this prospective, randomized, multi-center study, mild to moderate scalp SD patients were prescribed Lulican™ or Ketoconazole shampoo three times a week for a duration of four weeks. Effectiveness assessment was done with the Seborrheic-Dermatitis-Severity-Score (SDSS) and Physician-Global-Assessment (PGA), and quality of life was assessed with the help of the Scalpdex-23 questionnaire. Results At four weeks, 68% and 57.9% reduction was seen in SDSS in Lulican™ and Ketoconazole shampoo, respectively. Moreover, 58% and 44% of patients achieved excellent to moderate responses as per PGA with Lulican™ and ketoconazole shampoo, respectively. For safety, no statistical difference was reported, but product tolerability and subjective cosmetic acceptability were significantly better in the Lulican™ group as compared to the Ketoconazole group at the end of four weeks. The mean Scalpdex-23 score at week four was reduced by 35.7% and 21.1% in Lulican™ and ketoconazole groups, respectively (p<0.05). Conclusion While both treatments were successful in alleviating SD symptoms and were well tolerated, Lulican™ stood out as a preferred treatment option due to better quality of life (QoL) improvement in SD.

Almost one billion people worldwide are affected by Obstructive Sleep Apnea (OSA). Affected individuals experience disordered breathing patterns during sleep, which results in fatigue, daytime drowsiness, and/or sleep deprivation. Working under the influence of these symptoms significantly impairs work productivity and leads to occupational accidents and errors. This impact is seen in healthcare workers (HCWs) who are not immune to these conditions. However, poorly controlled OSA in this subset of individuals takes a heavy toll on patient care due to the increased risk of medical errors and can also alter the mental and physical well-being of the affected HCW in various ways. OSA and safety issues have been recognized and mitigated among the airline and transport industries; however, the healthcare industry lags in addressing these concerns. This article reviews hypersomnolence and sleep disorder as key clinical features of OSA and their effect on HCW safety.