With the advances in diabetes care, the trend of incident cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM) has been decreasing over past decades. However, given that CVD ...is still a major cause of death in patients with diabetes and that the risk of CVD in patients with T2DM is more than twice that in those without DM, there are still considerable challenges to the prevention of CVD in diabetes. Accordingly, there have been several research efforts to decrease cardiovascular (CV) risk in T2DM. Large-scale genome-wide association studies (GWAS) and clinical cohort studies have investigated the effects of factors, such as genetic determinants, hypoglycaemia, and insulin resistance, on CVD and can account for the unexplained CV risk in T2DM. Lifestyle modification is a widely accepted cornerstone method to prevent CVD as the first-line strategy in T2DM. Recent reports from large CV outcome trials have proven the positive CV effects of sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RAs) in patients with high CVD risk. Overall, current practice guidelines for the management of CVD in T2DM are moving from a glucocentric strategy to a more individualised patient-centred approach. This review will discuss the current epidemiologic trends of CVD in T2DM and the risk factors linking T2DM to CVD, including genetic contribution, hypoglycaemia, and insulin resistance, and proper care strategies, including lifestyle and therapeutic approaches.
•Despite a decreasing trend in incidence, cardiovascular disease (CVD) still remains the major complication of diabetes.•Evidence supports attributing unexplained CV risk in T2DM to genetic components, hypoglycaemia, and insulin resistance.•Intensive lifestyle modification and nutrient off-loading could be more appropriate than increasing medication dose.•In established CVD, GLP-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors should be considered.
Abstract
Electrocatalysis, whose reaction venue locates at the catalyst–electrolyte interface, is controlled by the electron transfer across the electric double layer, envisaging a mechanistic link ...between the electron transfer rate and the electric double layer structure. A fine example is in the CO
2
reduction reaction, of which rate shows a strong dependence on the alkali metal cation (M
+
) identity, but there is yet to be a unified molecular picture for that. Using quantum-mechanics-based atom-scale simulation, we herein scrutinize the M
+
-coupling capability to possible intermediates, and establish H
+
- and M
+
-associated ET mechanisms for CH
4
and CO/C
2
H
4
formations, respectively. These theoretical scenarios are successfully underpinned by Nernstian shifts of polarization curves with the H
+
or M
+
concentrations and the first-order kinetics of CO/C
2
H
4
formation on the electrode surface charge density. Our finding further rationalizes the merit of using Nafion-coated electrode for enhanced C2 production in terms of enhanced surface charge density.
Controlling metal–support interactions is important for tuning the catalytic properties of supported metal catalysts. Here, premade Pd particles are supported on stable polymers containing different ...ligating functionalities to control the metal–polymer interactions and their catalytic properties in industrially relevant acetylene partial hydrogenation. The polymers containing strongly ligating groups (e.g., Ar‐SH and Ar‐S‐Ar) can form a polymer overlayer on the Pd surface, which enables selective acetylene adsorption and partial hydrogenation to ethylene without deactivation. In contrast, polymers with weakly ligating groups (e.g., Ar‐O‐Ar) do not form an overlayer, resulting in non‐selective hydrogenation and fast deactivation, similar to Pd catalysts on conventional inorganic supports. The results imply that tuning the metal–polymer interactions via rational polymer design can provide an efficient way of synthesizing selective and stable catalysts for hydrogenation.
We synthesized a series of polymers with similar framework structures but different metal‐ligating functionalities as supports for Pd catalysts to control the dynamic metal–polymer interactions (DMPI) and catalytic properties. The polymers containing strongly ligating groups can form a polymer overlayer on the Pd surface via DMPI, which enables selective acetylene adsorption and partial hydrogenation to ethylene without deactivation.
•Selected variables have a significant influence on yields of synthesis gas.•(CO2+H2O)/CH4 affects the temperature which can achieve the maximum conversion.•Coke is formed at low temperatures even ...with excess oxidizing agent.•The occurrence of RWGS becomes critical in real chemical reactions.•Equilibrium conversions are maintained for 500h without detectable deactivation.
Thermodynamic equilibrium analysis of the combined steam and carbon dioxide reforming of methane (CSCRM) and side reactions was performed using total Gibbs free energy minimization. The effects of (CO2+H2O)/CH4 ratio (0.9–2.9), CO2:H2O ratio (3:1–1:3), and temperature (500–1000°C) on the equilibrium conversions, yields, coke yield, and H2/CO ratio were investigated. A (CO2+H2O)/CH4 ratio greater than 1.2, a CO2:H2O ratio of 1:2.1, and a temperature of at least 850°C are preferable reaction conditions for the synthesis gas preparation in the gas to liquid process. Simulated conditions were applied to the CSCRM reaction and the experimental data were compared with the thermodynamic equilibrium results. The thermodynamic equilibrium results were mostly consistent with the experimental data, but the reverse water gas shift reaction rapidly occurred in the real chemical reaction and under excess oxidizing agent conditions. In addition, a long-term stability test (under simulated conditions) showed that the equilibrium conversion was maintained for 500h and that the coke formation on the used catalyst was not observed.
To design electrochemical interfaces for efficient electric-chemical energy interconversion, it is critical to reveal the electric double layer (EDL) structure and relate it with electrochemical ...activity; nonetheless, this has been a long-standing challenge. Of particular, no molecular-level theories have fully explained the characteristic two peaks arising in the potential-dependence of the EDL capacitance, which is sensitively dependent on the EDL structure. We herein demonstrate that our first-principles-based molecular simulation reproduces the experimental capacitance peaks. The origin of two peaks emerging at anodic and cathodic potentials is unveiled to be an electrosorption of ions and a structural phase transition, respectively. We further find a cation complexation gradually modifies the EDL structure and the field strength, which linearly scales the carbon dioxide reduction activity. This study deciphers the complex structural response of the EDL and highlights its catalytic importance, which bridges the mechanistic gap between the EDL structure and electrocatalysis.
Numerous previous studies have shown an association between general obesity and hepatocellular carcinoma (HCC). However, relatively few reports on the association of central obesity and HCC are ...available in Asian populations. Therefore, we investigated the association between WC representing central obesity and the risk of HCC in addition to BMI representing general obesity and the risk of HCC in Korea. A total of 10 505 818 participants who received the National Health Insurance Service (NHIS) health checkups in 2009 were screened for study eligibility, and 26 979 cases of HCC occurred during the 7.3 years of mean follow‐up. General obesity increased the risk of HCC with hazard ratios (HRs) of 1.14 (95% CI, 1.11‐1.18) for BMI 25.0‐<30.0 kg/m2 and 1.52 (95% CI, 1.43‐1.61) for BMI ≥30 kg/m2 compared to those whose BMI is within the normal range. Central obesity was also associated with a higher risk of HCC. For the participants with a WC ≥105 cm in men and WC ≥100 cm in women, the risk of HCC was higher than that of the reference group (HR = 1.69, 95% CI, 1.54‐1.85). The HRs were 1.13 (95% CI, 1.07‐1.19) for nonobese participants with central obesity, and 1.34 (95% CI, 1.30‐1.38) for obese participants with central obesity compared to those without both conditions. Our findings suggest that the risk of HCC increases even more when general obesity is combined with central obesity. Moreover, central obesity is associated with the risk of HCC, regardless of general obesity.
What's new?
To date, relatively few reports are available on the association between central obesity and hepatocellular carcinoma (HCC) risk in Asia. In Asian countries, large population‐based National Health Information databases are extremely limited. This large Korean national population‐based cohort study found that general obesity and central obesity are associated with increased risk of HCC. Moreover, central obesity is associated with risk of HCC, regardless of general obesity. The study presents further evidence that obesity contributes to the development of HCC and that clinical measures should be taken to prevent and manage HCC development in obese people.
Abstract Background Context Little is known about the effect of rod stiffness as a risk factor for proximal junctional kyphosis (PJK) after adult spinal deformity (ASD) surgery. Purpose The aim of ...this study was to compare radiographical outcomes after the use of cobalt chrome multiple-rod constructs (CoCr MRC) and titanium alloy two-rod constructs (Ti TRC) for the ASD) surgery with minimum 1-year follow-up. Study Design Retrospective case-control study in two institutes. Patients Sample We included 54 patients who underwent ASD surgery with fusion to sacrum in two academic institutes between 2002 and 2015. Outcome Measures Radiographical outcomes were measured on the standing lateral radiographs before surgery, 1 month postoperatively and at ultimate follow-up. They were composed of pre-and postoperative sagittal vertical axis (SVA), pre-and postoperative lumbar lordosis (LL), pre-and postoperative thoracic kyphosis (TK)+ LL+ pelvic incidence (PI), pre-and postoperative PI minus LL, level of upper instrumented level (UIV), evaluation of fusion after surgery, the presence of proximal junctional kyphosis (PJK), and the occurrence of rod fracture. Methods We reviewed the medical records of 54 patients who underwent ASD surgery. Of these, 20 patients had CoCr MRC and 34 patients had Ti TRC. Baseline data and radiographical measurements were compared between two groups. . The Mann-Whitney U test, the chi square test, and the Fisher exact test were used to compare outcomes between groups. Results Patients of the groups were similar in terms of age, gender, diagnosis, number of three column osteotomy, levels fused, bone mineral density, preoperative TK, pre-and postoperative TK+LL+PI, SVA difference, LL change, pre-and postoperative PI minus LL and the location of UIV (upper-or lower thoracic). However, there were significant differences in the occurrence of PJK and rod breakage (PJK : CoCr MRC: 12 (60%) vs Ti TRC: 9 (26.5%), P =0.015; the occurrence of rod breakage : CoCr MRC: 0 (0%) vs Ti TRC: 11 (32.4%), P =0.004). The time of PJK was less than 12 months after surgery in CoCr MRC group. However, 55.5% (5/9) of PJK developed over 12 months after surgery in Ti TRC group. Conclusions Increasing the rod stiffness by use of CoCr and MRC can prevent rod breakage, however, adversely affects the occurrence and the time of PJK.
Diabetes is well established as a chronic disease with a high health burden due to mortality or morbidity from the final outcomes of vascular complications. An increased duration of hyperglycemia is ...associated with abnormal metabolism. Advanced glycation end products (AGEs) are nonenzymatic glycated forms of free amino acids that lead to abnormal crosslinking of extra-cellular and intracellular proteins by disrupting the normal structure. Furthermore, the interaction of AGEs and their receptors induces several pathways by promoting oxidative stress and inflammation. In this review, we discuss the role of AGEs in diabetic vascular complications, especially type 2 DM, based on recent clinical studies.
To estimate the trends in the prevalence of severe hypoglycemia (SH) in patients with type 2 diabetes in Korea, we investigated the total number of SH episodes among type 2 diabetes patients aged ≥30 ...years who visited the emergency department between 2002 and 2019, using the Korean National Health Insurance Service database. The prevalence of SH events increased from 2002 to 2012; however, it has decreased gradually since 2012. In 2019, the prevalence of SH was 0.6%, with an incidence rate of 4.43 per 1,000 person‐years. Approximately 23,000 SH events occur every year in Korea. Although the incidence is steadily decreasing, there are a considerable number of SH events in type 2 diabetes patients. The decline in the incidence of SH seems to most likely be due to the increased prescription rate of hypoglycemic agents without hypoglycemia risk, less‐strict treatment goals and the individualization of therapy.
The prevalence of severe hypoglycemia in type 2 diabetes patients was 0.29% in 2002 and 0.60% in 2019. The incidence rate for severe hypoglycemia in type 2 diabetes patients was 4.43 per 1,000 people in 2019. Although the prevalence and incidence rate showed decreasing tendencies, the absolute number of patients experiencing severe hypoglycemia in type 2 diabetes has been steadily increasing.
Aging is a fundamental biological process. Characterization of genetic and environmental factors that influence lifespan is a crucial step toward understanding the mechanisms of aging at the organism ...level. To capture the different effects of genetic and environmental factors on lifespan, appropriate statistical analyses are needed.
We developed an online application for survival analysis (OASIS) that helps conduct various novel statistical tasks involved in analyzing survival data in a user-friendly manner. OASIS provides standard survival analysis results including Kaplan-Meier estimates and mean/median survival time by taking censored survival data. OASIS also provides various statistical tests including comparison of mean survival time, overall survival curve, and survival rate at specific time point. To visualize survival data, OASIS generates survival and log cumulative hazard plots that enable researchers to easily interpret their experimental results. Furthermore, we provide statistical methods that can analyze variances among survival datasets. In addition, users can analyze proportional effects of risk factors on survival.
OASIS provides a platform that is essential to facilitate efficient statistical analyses of survival data in the field of aging research. Web application and a detailed description of algorithms are accessible from http://sbi.postech.ac.kr/oasis.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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