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Geometric series exists in nature: Evidence from sorted area sequences of floral parts and leaves 几何级数存在于自然界:从分类的花和叶的面积序列的证据
IF 5.2 3区 综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES Pub Date : 2025-01-02 DOI: 10.1111/nyas.15282
Peijian Shi, Bailian Larry Li, Jinfeng Wang, Youying Mu, Weihao Yao, Meng Lian, Linli Deng, Karl J. Niklas
The concept of a geometric series (GS) plays an important role in mathematics. However, it has been neglected in describing biological size series. Herein, we show that a GS describes the nonreproductive (perianth) parts of the flowers of four Magnoliaceae species and two Rosaceae species and the leaves of 60 Alangium chinense and 60 Shibataea chinensis shoots. The sorted areas of floral parts and leaves formed a sequence that was fitted by a GS with the mean of the quotients of two adjacent members in the sequence as the common ratio of a GS. The mean absolute percent error (MAPE) was used to measure the goodness of fit of each GS. Over 99.7% of the MAPE values (371 out of the 372 tested flowers) were less than 10%, and over 97.8% of the MAPE values were less than 5%. Likewise, over 77.5% of the MAPE values (93 out of the 120 tested shoots) were less than 10%, and over 35% of the MAPE values were less than 5%. These analyses provide empirical evidence that the GS exists in nature, and confirm the usefulness of a classical algebraic formula for the study of plant developmental biology.
几何级数的概念在数学中占有重要的地位。然而,在描述生物尺寸序列时,它一直被忽视。在此,我们证明了一个GS描述了4个木兰科物种和2个蔷薇科物种的花的非生殖(花被)部分,以及60个Alangium chinense和60个Shibataea chinensis嫩枝的叶子。花和叶的分类面积形成一个序列,用GS拟合序列中相邻两个成员商的平均值作为GS的公比。使用平均绝对误差(MAPE)来衡量每个GS的拟合优度。超过99.7%(371株)的MAPE值小于10%,超过97.8%(372株)的MAPE值小于5%。同样,超过77.5%的MAPE值小于10%(120株中有93株),超过35%的MAPE值小于5%。这些分析提供了GS在自然界中存在的经验证据,并证实了经典代数公式在植物发育生物学研究中的实用性。
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引用次数: 0
The rhythm of horse gaits 马的步态节奏
IF 5.2 3区 综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES Pub Date : 2024-12-28 DOI: 10.1111/nyas.15271
Lia Laffi, Teresa Raimondi, Carola Ferrante, Eleonora Pagliara, Andrea Bertuglia, Elodie Floriane Briefer, Marco Gamba, Andrea Ravignani
What makes animal gaits so audibly rhythmic? To answer this question, we recorded the footfall sound of 19 horses and quantified the rhythmic differences in the temporal structure of three natural gaits: walk, trot, and canter. Our analyses show that each gait displays a strikingly specific rhythmic pattern and that all gaits are organized according to small‐integer ratios, those found when adjacent temporal intervals are related by a mathematically simple relationship of integer numbers. Walk and trot exhibit an isochronous structure (1:1)—similar to a ticking clock—while canter is characterized by three small‐integer ratios (1:1, 1:2, 2:1). While walk and trot both show isochrony, trot has a slower tempo and is more precise and accurate, like a metronome. Our results quantitatively discriminate horse gaits based on rhythm, revealing striking commonalities with human music and some animal communicative signals. Gait and vocal rhythmicity share key features, and the former likely predates the latter; we suggest this supports gait‐based hypotheses for the evolution of rhythm. Specifically, the perception of locomotor rhythmicity may have evolved in different species under pressure for predator recognition and mate selection; it may have been later exapted for rhythmic vocal communication.
是什么让动物的步态如此有节奏?为了回答这个问题,我们记录了19匹马的脚步声,并量化了三种自然步态(步行、小跑和慢跑)在时间结构上的节奏差异。我们的分析表明,每一种步态都显示出一种惊人的特定节奏模式,所有的步态都是根据小整数比率组织的,当相邻的时间间隔由数学上简单的整数关系联系起来时,这些比率就被发现了。步行和小跑表现出等时结构(1:1),类似于滴答作响的时钟,而跑步则表现为三个小整数比例(1:1,1:2,2:1)。虽然步行和小跑都表现出等时性,但小跑的速度更慢,更精确,更准确,就像节拍器一样。我们的研究结果基于节奏定量区分马的步态,揭示了与人类音乐和一些动物交流信号的惊人共性。步态和声音节奏有共同的关键特征,前者可能早于后者;我们认为这支持了节律进化的基于步态的假设。具体来说,运动节律的感知可能是在不同物种在捕食者识别和配偶选择的压力下进化出来的;它可能后来被用于有节奏的声音交流。
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引用次数: 0
Behavior-change lifestyle interventions for the treatment of obesity in children and adolescents: A scoping review 行为改变生活方式干预治疗儿童和青少年肥胖:范围综述
IF 5.2 3区 综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES Pub Date : 2024-12-23 DOI: 10.1111/nyas.15278
Liubai Li, Feng Sun, Jian Du, Zhixia Li, Tianjiao Chen, Xuanyu Shi
Behavior-change lifestyle interventions are fundamental in children and adolescent obesity management. This scoping review discusses optimal behavior-change lifestyle interventions in the treatment of overweight and obesity in children and adolescents. A literature search on diet, physical activity, and behavioral intervention for obesity treatment in children and adolescents aged 0–19 years was conducted in the Cochrane Library, MEDLINE (OVID), EMBASE, and ClinicalTrials.gov. Systematic reviews and meta-analyses with randomized controlled trials (RCTs) published in English from June 2016 to November 2022 were retrieved to identify recent advancements. Obesity outcomes included body weight, body mass index (BMI), BMI z-score, and fat percentage, among others. The 28 located reviews included: four studies on diet therapy; five on physical activity (exercise training); one on sedentary activities; 18 on multicomponent behavior-change lifestyle interventions, including three that incorporated gaming; three with eHealth, mobile health (mHealth), or telehealth, with one in each category; and two on motivational interviewing. Behavior-change lifestyle interventions to reduce obesity in children and adolescents were associated with moderate effects, with low-quality evidence for diet therapy and high-quality evidence for exercise training, both for weight or BMI reduction. Long-term intensive multicomponent behavioral interventions with parental involvement demonstrated better effects.
行为改变生活方式干预是儿童和青少年肥胖管理的基础。本综述讨论了儿童和青少年超重和肥胖的最佳行为改变生活方式干预措施。我们在Cochrane图书馆、MEDLINE (OVID)、EMBASE和ClinicalTrials.gov中检索了0-19岁儿童和青少年肥胖治疗的饮食、身体活动和行为干预方面的文献。检索了2016年6月至2022年11月发表的英文随机对照试验(rct)的系统评价和荟萃分析,以确定最近的进展。肥胖结局包括体重、身体质量指数(BMI)、BMI z-score和脂肪百分比等。这28篇综述包括:4项关于饮食疗法的研究;五是体育活动(运动训练);一个是关于久坐的活动;18项关于多组分行为改变生活方式干预的研究,其中3项涉及游戏;三个是电子医疗、移动医疗(mHealth)或远程医疗,每个类别各有一个;第二个是动机性访谈。行为改变生活方式干预减少儿童和青少年肥胖的效果中等,饮食疗法的低质量证据和运动训练的高质量证据,无论是体重还是体重指数的降低。父母参与的长期强化多成分行为干预效果较好。
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引用次数: 0
The role of macroautophagy in substance use disorders 巨噬在物质使用障碍中的作用
IF 5.2 3区 综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES Pub Date : 2024-12-23 DOI: 10.1111/nyas.15272
Zhaoying Yu, Shujun Lin, Xinshuang Gong, Zhiting Zou, Xiangdong Yang, Yuer Ruan, Liyin Qian, Yu Liu, Zizhen Si
Macroautophagy, a universal cellular process, sends cellular material to lysosomes for breakdown and is often activated by stressors like hypoxia or drug exposure. It is vital for protein balance, neurotransmitter release, synaptic function, and neuron survival. The role of macroautophagy in substance use disorders is dual. On one hand, substances like cocaine, methamphetamine, opiates, and alcohol can activate macroautophagy pathways to degrade various neuroinflammatory factors in neuronal cells, providing a protective function. On the other hand, long-term and excessive use of addictive substances can inhibit macroautophagy pathways, obstructing the fusion of autophagosomes with lysosomes and losing the original protective function. This review first summarizes the key proteins and signaling pathways involved in macroautophagy, including mTORC1, AMPK, and endoplasmic reticulum stress, and suggests that the regulation of macroautophagy plays a central role in drug-rewarding behavior and addiction. Second, we focus on the interactions between macroautophagy and neuroinflammation induced by drugs, evaluating the potential of macroautophagy modulators as therapeutic strategies for substance use disorder (SUD), and identifying autophagy-related biomarkers that can be used for early diagnosis and monitoring of treatment response. Our review summarizes the important scientific basis involved in macroautophagy pathways for the development of new therapies for SUD.
巨噬是一种普遍的细胞过程,它将细胞物质送到溶酶体进行分解,通常由缺氧或药物暴露等应激源激活。它对蛋白质平衡、神经递质释放、突触功能和神经元存活至关重要。巨噬在物质使用障碍中的作用是双重的。一方面,可卡因、甲基苯丙胺、阿片类药物、酒精等物质可以激活巨噬通路,降解神经元细胞中的各种神经炎症因子,起到保护作用。另一方面,长期过量使用成瘾物质会抑制巨噬途径,阻碍自噬体与溶酶体融合,失去原有的保护功能。本文首先总结了巨噬过程中涉及的关键蛋白和信号通路,包括mTORC1、AMPK和内质网应激,并指出巨噬过程的调控在药物奖励行为和成瘾中起着核心作用。其次,我们关注巨噬与药物诱导的神经炎症之间的相互作用,评估巨噬调节剂作为药物使用障碍(SUD)治疗策略的潜力,并确定可用于早期诊断和治疗反应监测的自噬相关生物标志物。本文综述了巨噬途径对开发SUD新疗法的重要科学依据。
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引用次数: 0
Stable isotope tempestology of tropical cyclones across the North Atlantic and Eastern Pacific Ocean basins 北大西洋和东太平洋盆地热带气旋的稳定同位素风暴学
IF 5.2 3区 综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES Pub Date : 2024-12-19 DOI: 10.1111/nyas.15274
Ricardo Sánchez-Murillo, Dimitris A. Herrera, Kegan K. Farrick, Germain Esquivel-Hernández, Rolando Sánchez-Gutiérrez, Javier Barberena-Moncada, Jorge Guatemala-Herrera, Yelba Flores-Meza, Roberto Cerón-Pineda, Laura Gil-Urrutia, Jorge Cardona-Hernández, Tania Peña-Paz, Junior O. Hernández-Ortiz, Wendy Harrison-Smith, Geoffrey Marshall, Aurel Persoiu, Juan Pérez-Quezadas, Miguel Mejía-González, Luis González-Hita, Marcia Barrera de Calderón, Alejandro García-Moya, Debora Hernández, Kristen Welsh, Rene M. Price, Diego A. Riveros-Iregui, Ny Riavo G. Voarintsoa, Joshua C. Bregy, Minerva Sánchez-Llull, Carlos Alonso-Hernández, Saúl Santos-García, Ana M. Durán-Quesada, Christian Birkel, Jan Boll, Kim M. Cobb, Adrián F. Obando-Amador, Ingrid M. Vargas-Azofeifa, Doerthe Tetzlaff, Chris Soulsby, Sylvia G. Dee
Tropical cyclones (TCs) are one of the major natural hazards to island and coastal communities and ecosystems. However, isotopic compositions of TC-derived precipitation (P) in surface water (SW) and groundwater (GW) reservoirs are still lacking. We tested the three main assumptions of the isotope storm “spike” hypothesis (sudden spikes in isotopic ratios). Our database covers 40 TCs and is divided into recent (N = 778; 2012–2023) and archived (N = 236; 1984–1995) rainfall isotope observations and SW/GW isotope monitoring (N = 6013; 2014–2023). Seasonal rainfall contribution from TCs ranged from less than 1% to over 54% (4% on average) between 1984 and 2023. Mean δ18O compositions across TCs domains were significantly lower than the regional (noncyclonic) δ18O mean (−5.24 ± 4.27‰): maritime (−6.29 ± 3.28‰), coastal (−7.78 ± 4.28‰), and inland (−9.80 ± 5.18‰) values. Coastal and maritime TC convection resulted in large rainfall amounts with high isotope compositions. This could bias past climate reconstructions toward unrealistic drier conditions. Significant δ18O and d-excess differences were found between storm intensities. P/SW and P/GW isotope ratios revealed the rapid propagation of TC excursions in freshwater systems. Our findings highlight the potential of TC isotope observations for diagnosing intensity and frequency in paleoproxies beyond idealized TC models.
热带气旋是危害岛屿和沿海社区及生态系统的主要自然灾害之一。然而,地表水(SW)和地下水(GW)水库中tc衍生降水(P)的同位素组成仍然缺乏。我们测试了同位素风暴“尖峰”假说(同位素比率的突然尖峰)的三个主要假设。我们的数据库涵盖了40个tc,分为最近的(N = 778;2012-2023)和存档(N = 236;1984-1995年)降水同位素观测和SW/GW同位素监测(N = 6013);2014 - 2023)。在1984年至2023年期间,tc对季节降雨的贡献从不足1%到54%以上(平均4%)不等。各tc域δ18O平均值显著低于区域(非气旋)δ18O平均值(- 5.24±4.27‰)、海洋(- 6.29±3.28‰)、沿海(- 7.78±4.28‰)和内陆(- 9.80±5.18‰)。沿海和海洋TC对流导致大量降水和高同位素组成。这可能会使过去的气候重建偏向于不现实的干旱条件。不同风暴强度的δ18O和d-excess存在显著差异。P/SW和P/GW同位素比值揭示了淡水系统中TC漂移的快速传播。我们的发现突出了TC同位素观测在诊断古代用物强度和频率方面的潜力,超出了理想的TC模型。
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引用次数: 0
Systematic review of the efficacy of yoga and mindfulness in the management of pediatric obesity 瑜伽和正念治疗小儿肥胖疗效的系统综述
IF 5.2 3区 综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES Pub Date : 2024-12-19 DOI: 10.1111/nyas.15245
Mardia López-Alarcón, Miguel A. Villasis-Keever, José R. Fernández
The neuroplasticity of adolescents could make them responsive to interventions affecting brain maturation such as yoga and mindfulness. We aimed to determine their efficacy and safety for the management of children and adolescents with obesity. A systematic search using MEDLINE, EMBASE, and PsycInfo was performed up to March 2024. We considered randomized controlled trials (RCTs) using yoga or mindfulness alone (or combined with standard therapy) compared to placebo, nothing, or standard therapy for weight loss. Methodological quality of studies was assessed with the Risk of Bias 2 tool. The primary outcomes were changes in weight and adiposity (kg, body mass index [BMI], BMI z-score, fat mass, waist circumference, waist-to-hip ratio). We assessed 4 yoga and 7 mindfulness RCTs, including 620 participants 8–19 years old. The number of participants varied per type of intervention (yoga, n = 10–63; mindfulness, n = 11–47). Comparators were no-intervention or active controls. All yoga trials reported anthropometric improvements, but all trials combined yoga with extra physical activity. Five out of seven mindfulness trials reported anthropometric improvements. The methodological quality of the RCTs was low. No safety information was reported. The effect of yoga and mindfulness on psychological and metabolic variables was inconsistent. This evidence is insufficient to recommend yoga or mindfulness for the management of adolescents with obesity.
青少年的神经可塑性使他们对瑜伽和正念等影响大脑成熟的干预措施反应灵敏。我们的目的是确定这些干预措施对儿童和青少年肥胖症治疗的有效性和安全性。截至 2024 年 3 月,我们使用 MEDLINE、EMBASE 和 PsycInfo 进行了系统性检索。我们考虑了单独使用瑜伽或正念(或与标准疗法相结合)与使用安慰剂、不使用任何疗法或标准疗法进行减肥比较的随机对照试验(RCT)。研究的方法学质量采用 "偏倚风险 2 "工具进行评估。主要结果是体重和脂肪率(公斤、体重指数[BMI]、BMI z-score、脂肪量、腰围、腰臀比)的变化。我们评估了 4 项瑜伽和 7 项正念 RCT,包括 620 名 8-19 岁的参与者。每种干预类型的参与者人数各不相同(瑜伽,n = 10-63;正念,n = 11-47)。对照组为无干预或积极对照组。所有瑜伽试验都报告了人体测量指标的改善情况,但所有试验都将瑜伽与额外的体育活动相结合。七项正念试验中有五项报告了人体测量指标的改善情况。研究性试验的方法质量较低。未报告安全性信息。瑜伽和正念对心理和代谢变量的影响并不一致。这些证据不足以推荐将瑜伽或正念用于青少年肥胖症的治疗。
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引用次数: 0
A systematic review of longitudinal risk and protective factors for loneliness in youth 青少年孤独感的纵向风险和保护因素的系统回顾
IF 5.2 3区 综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES Pub Date : 2024-12-12 DOI: 10.1111/nyas.15266
Susanne Buecker, Kimberly Petersen, Anne Neuber, Yixuan Zheng, Daniel Hayes, Pamela Qualter
To effectively tackle loneliness in youth, prevention and intervention strategies should be based on solid evidence regarding risk and protective factors in this age group. This systematic literature review identifies and narratively synthesizes longitudinal studies of risk and protective factors for loneliness in children and adolescents aged below 25 years. A systematic literature search was conducted in October 2023 using PsycINFO and MEDLINE, resulting in n = 398 articles, with n = 105 articles meeting the inclusion criteria. The examined factors included demographic (e.g., gender), socioeconomic (e.g., income sufficiency), social (e.g., peer acceptance), mental health (e.g., depression), physical health (e.g., disabilities), health behavior (e.g., sport participation), and psychological factors (e.g., shyness). Additionally, adverse childhood experiences (e.g., child maltreatment) and environmental factors (e.g., neighborhood characteristics) were investigated. Despite the wide range of potential risk and protective factors examined, relatively few studies provided strong evidence for a prospective association with loneliness. Risk factors that were consistently identified across multiple longitudinal studies included low peer acceptance and peer victimization, depression, social anxiety, internalizing symptoms, low self-esteem, shyness, and neuroticism. Additional replication is required to evaluate factors that have shown significant associations with loneliness in only a limited number of longitudinal studies (e.g., aggression).
为了有效地解决青年的孤独问题,预防和干预策略应基于有关这一年龄组的风险和保护因素的确凿证据。本系统文献综述确定并叙述综合了25岁以下儿童和青少年孤独感的风险和保护因素的纵向研究。我们于2023年10月使用PsycINFO和MEDLINE进行系统文献检索,共检索到n = 398篇文章,其中n = 105篇符合纳入标准。研究的因素包括人口统计(如性别)、社会经济(如收入充足)、社会(如同伴接纳)、心理健康(如抑郁)、身体健康(如残疾)、健康行为(如参加体育运动)和心理因素(如害羞)。此外,还调查了不良童年经历(如儿童虐待)和环境因素(如邻里特征)。尽管研究了广泛的潜在风险和保护因素,但相对较少的研究提供了与孤独感相关的有力证据。在多个纵向研究中一致确定的风险因素包括低同伴接受度和同伴受害、抑郁、社交焦虑、内化症状、低自尊、害羞和神经质。仅在有限数量的纵向研究(如攻击性)中显示与孤独有显著关联的因素,需要进一步的重复研究来评估。
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引用次数: 0
Enhanced wet grip with North American river otter paws 增强湿抓地力与北美河水獭的爪子
IF 5.2 3区 综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES Pub Date : 2024-12-12 DOI: 10.1111/nyas.15263
Alexis C. Noel, Jason Lieb, Benjamin Seleb, Mary Thatcher, Soohwan Kim, Aqua T. Asberry, Jason H. Nadler, David L. Hu
The semi-aquatic North American river otter (Lontra canadensis) has the unique challenge of navigating slippery algae-coated rocks. Unlike other river otter species, each rear paw of the North American river otter has a series of soft, circular, and keratinized plantar pads similar to the felt pads on the boots of fly fishermen. Surrounding these soft pads is a textured epidermal layer. In this combined experimental and numerical study, we investigate the influence of the plantar pads and surrounding skin on the otter's grip. We filmed an otter walking and performed materials testing and histology on preserved otter paws. We present experiments and numerical modeling of how the otter paw may help evacuate water when contacting the river bed. We hope this study will draw interest into natural amphibious grip mechanisms for use in sports and the military.
半水生的北美水獭(Lontra canadensis)有一个独特的挑战,即在光滑的藻类覆盖的岩石上航行。与其他种类的河獭不同,北美河獭的每个后爪都有一系列柔软的圆形角化足底垫,类似于飞渔民靴子上的毛毡垫。在这些软垫的周围是有纹理的表皮层。在这个结合实验和数值研究中,我们研究了足底垫和周围皮肤对水獭抓地力的影响。我们拍摄了一只水獭走路,并对保存下来的水獭爪子进行了材料测试和组织学检查。我们提出的实验和数值模拟如何水獭爪可能有助于疏散水时,接触河床。我们希望这项研究能引起人们对运动和军事中使用的天然两栖抓地力机制的兴趣。
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引用次数: 0
Effect of trait anxiety on visual working memory capacity: The role of filtering efficiency 特质焦虑对视觉工作记忆容量的影响:过滤效率的作用
IF 5.2 3区 综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES Pub Date : 2024-12-12 DOI: 10.1111/nyas.15277
Mengxin Yin, Huaihuai Wei, Mingxuan Zou, Yuqing He, Hui Hu, Xiuchao Wang
Previous research has consistently shown that high trait anxiety (HTA) reduces spatial and verbal working memory capacity. However, its effects on visual working memory (VWM) are inconsistent, and the underlying mechanisms remain unclear. This study investigates the impact of trait anxiety on VWM capacity and the role of filtering efficiency through two experiments. Experiment 1 utilized a change detection task (CDT) with 2–5 colored squares. The results indicated that low trait anxiety (LTA) individuals had significantly higher K scores than individuals with HTA, particularly under high memory load, indicating limitations in VWM capacity within the HTA group. Additionally, the contralateral delay activity (CDA) amplitude in the HTA group stabilized earlier than in the LTA group, further suggesting a deficit in VWM capacity among HTA individuals. Experiment 2 introduced neutral distractors. Under low load conditions, both groups were unaffected by the distractors. However, under high load, the HTA group was susceptible to interference, whereas the LTA group effectively filtered out distractors. CDA patterns revealed that individuals with HTA could filter distractors under low load but not under high load, whereas LTA individuals showed effective filtering under both conditions.
先前的研究一致表明,高特质焦虑(HTA)会降低空间和语言工作记忆能力。然而,其对视觉工作记忆(VWM)的影响并不一致,其潜在机制尚不清楚。本研究通过两个实验探讨特质焦虑对VWM能力的影响以及过滤效率的作用。实验1采用2-5个彩色方格的变化检测任务(CDT)。结果表明,低特质焦虑(LTA)个体的K得分显著高于高特质焦虑(HTA)个体,特别是在高记忆负荷下,这表明HTA组的VWM能力存在局限性。此外,HTA组的对侧延迟活动(CDA)振幅比LTA组稳定得更早,进一步表明HTA个体的VWM能力存在缺陷。实验2引入中性干扰物。在低负荷条件下,两组都不受干扰物的影响。然而,在高负荷下,HTA组容易受到干扰,而LTA组有效滤除干扰。CDA模式显示,HTA个体在低负荷条件下能够过滤干扰物,但在高负荷条件下不能过滤,而LTA个体在两种条件下都能有效过滤。
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引用次数: 0
Diabetes and cardiovascular disease in older adults 老年人的糖尿病和心血管疾病
IF 5.2 3区 综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES Pub Date : 2024-12-12 DOI: 10.1111/nyas.15259
Anika Bilal, Richard Pratley
An aging population combined with a rapidly increasing prevalence of diabetes foreshadows a global epidemic of cardiovascular and kidney disease that threatens to halt improvements in life and health-span and will have particularly severe consequences in older adults. The management of diabetes has been transformed with the recent development of newer anti-hyperglycemic agents that have demonstrated superior efficacy. However, the utility of these drugs extends beyond glycemic control to benefits for managing obesity, cardiovascular disease (CVD), chronic kidney disease, and heart failure. Numerous cardiovascular and kidney outcomes trials of these drugs have played an instrumental role in shaping current guidelines for the management of diabetes and CVD. Older adults with diabetes are diverse in terms of their comorbidities, diabetic complications, and cognitive and functional status. Therefore, there is an unmet need for personalized management of diabetes and CVD in this population. In this review, we provide an overview of the epidemiological burden and management of diabetes and CVD in older adults. We then focus on randomized cardiovascular and kidney outcome trials with anti-hyperglycemic agents to propose an evidence-based approach to the management of diabetes in older adults with high risk of cardiovascular and kidney disease.
人口老龄化加上糖尿病发病率的迅速上升,预示着心血管和肾脏疾病将在全球流行,有可能使生命和健康寿命的改善停止,并将对老年人产生特别严重的后果。糖尿病的管理已经改变与最近的发展新的抗高血糖药物,已证明优越的疗效。然而,这些药物的效用超出了血糖控制,对肥胖、心血管疾病(CVD)、慢性肾脏疾病和心力衰竭也有益处。这些药物的大量心血管和肾脏结局试验在形成当前糖尿病和心血管疾病管理指南方面发挥了重要作用。老年糖尿病患者的合并症、糖尿病并发症、认知和功能状态各不相同。因此,这一人群对糖尿病和心血管疾病个性化管理的需求尚未得到满足。在这篇综述中,我们概述了老年人糖尿病和心血管疾病的流行病学负担和管理。然后,我们将重点放在使用降糖药物的随机心血管和肾脏结局试验上,以提出一种基于证据的方法来管理心血管和肾脏疾病高风险的老年人糖尿病。
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引用次数: 0
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