Objective
This study aimed to compare the association between fasting plasma glucose (FPG) and glycosylated hemoglobin A1c (HbA1c) levels using the second derivative of photoplethysmogram (SDPTG) ...index and the cardio-ankle vascular index (CAVI).
Methods
Electronic medical records of 276 participants (160 men, 116 women) who visited the health promotion center of a university hospital were examined. Age, sex, body mass index (BMI), blood pressure, and lipid profile were considered as risk factors for arterial stiffness, together with the FPG, HbA1c, CAVI, and SDPTG indices. Hierarchical regression models were constructed, and all participants were divided into low-normal, high-normal, prediabetic, and diabetic groups to examine the group-based differences in CAVI and SDPTG indices.
Results
FPG and HbA1c were independently predictive of increased CAVI, and their predictive powers for CAVI were equivalent (
β
= 0.214 and 0.200, respectively). Risk factors, including age, BMI, and male sex, were also predictive of CAVI (
β
= 0.593-0.630, -0.256 – -0.280, and 0.142-0.178, respectively). None of the FPG and HbA1c values were predictive of the SDPTG indices. The CAVI was higher in the diabetes group than in the other three groups according to HbA1c level, while the d/a index of the SDPTG decreased in the prediabetes group and increased in the diabetes group.
Conclusions
CAVI may not be substituted for SDPTG indices when evaluating arterial stiffness based on the glucose level. Moreover, the progression rate of arterial stiffness may differ between the diabetic and nondiabetic stages.
Background:
Costal chondrocyte–derived pellet-type autologous chondrocyte implantation (CCP-ACI) has been introduced as a new therapeutic option for the treatment of articular cartilage defects. We ...had previously conducted a randomized controlled trial comparing CCP-ACI versus microfracture at 1 year postoperatively.
Purpose:
To compare the efficacy and safety of CCP-ACI versus microfracture for the treatment of articular cartilage defects of the knee at 5 years postoperatively.
Study Design:
Randomized controlled trial; Level of evidence, 2.
Methods:
This study describes the mean 5-year follow-up of a previously published prospective clinical trial. The previous prospective trial compared the results of CCP-ACI versus microfracture until 1 year of follow-up. Of the 30 patients who were included in the previous study, 25 were followed up for 5 years. Patients were evaluated based on clinical outcome scores (Lysholm score, International Knee Documentation Committee score, Knee injury and Osteoarthritis Outcome Score KOOS, and visual analog scale for pain), magnetic resonance imaging findings, and rates of treatment failure at last follow-up.
Results:
The MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) score in the CCP-ACI group was significantly higher than that in the microfracture group at 5 years (62.3 vs 26.7, respectively; P < .0001). The Lysholm score and KOOS score in the CCP-ACI group were significantly higher than those in the microfracture group at 5 years (84.5 vs 64.9, respectively, and 390.9 vs 303.0, respectively; P = .023 and P = .017, respectively). There was 1 case of treatment failure that occurred in the microfracture group.
Conclusion:
The present randomized controlled trial indicated that the results of both procedures clinically and statistically significantly improved at 1 and 5 years’ follow-up in treating cartilage defects, but the results of CCP-ACI were superior to those of microfracture. Magnetic resonance imaging conducted at 1 year and 5 years after CCP-ACI revealed statistically significant superior structural integration with native cartilage tissue compared with microfracture.
Registration:
NCT03545269 (ClinicalTrials.gov)
This study aimed to compare the effectiveness of paced breathing (PB) versus su-soku practice (spontaneous breathing with counting numbers) on autonomic function and brain activity and examine the ...associations between personality traits, brain activity, and autonomic function.
A three-way crossover study design.
Thirty healthy Korean participants (15 men: 28.5 ± 4.7 years; 15 women: 27.7 ± 4.8 years) were asked to answer the Korean version of the 125-Temperament and Character Inventory (TCI). Three-way crossover design included normal PB (0.25 Hz), slow PB (0.1 Hz), and su-soku practice. Participants were randomly assigned to one of three groups (group A: su-soku/normal PB/slow PB; group B: normal PB/slow PB/su-soku; group C: slow PB/su-soku/normal PB).
The Korean version of the 125-TCI scores, electroencephalography (EEG), heart rate variability (HRV), and respiratory curve data.
EEG parameters between normal PB, slow PB, and su-soku showed no significant differences. High frequency and approximate entropy during normal PB and su-soku were higher than those during slow PB. Alpha band power related to well-focused alertness had strong negative correlations with the standard deviation of R-R intervals and square root of the mean of the sum of the squares of differences between adjacent R-R intervals during su-soku practice, while theta band power related to drowsiness had strong positive correlations with very low-frequency power during normal PB. Reflective and analytical individuals tended to be highly focused and alert during su-soku and normal PB, while anxious and unwilling individuals tended to focus on counting in and be drowsier during normal PB.
This study’s findings suggest that the association between brain activity and autonomic function is affected by meditation type and personality traits.
•Associations of autonomic and brain functions with personality by paced breathing (PB) and su-soku practice were examined.•Reflective individuals were alert during su-soku and normal PB, while unwilling individuals were drowsier during normal PB.•Association between brain activity and autonomic function is affected by meditation type and personality traits.
The grid-forming distributed generators (GFM-DGs) have attracted much attention as a key technology for realizing 100% renewable energy grids. This paper presents a novel control strategy to ensure ...the reliable operation of a renewable energy source (RES)-based GFM-DG even during weather variations. The GFM-DG connects a RES to the grid via source- and grid-side converters, with the converters' common DC-link voltage <inline-formula> <tex-math notation="LaTeX">V_{DC} </tex-math></inline-formula> indicating the power balance between the RES and the grid. We begin by identifying the limitation of conventional strategies in maintaining <inline-formula> <tex-math notation="LaTeX">V_{DC} </tex-math></inline-formula> against severe weather. To address the limitation, we propose a coordinated strategy for both source- and grid-side converters to regulate <inline-formula> <tex-math notation="LaTeX">V_{DC} </tex-math></inline-formula> cooperatively, ensuring GFM-DG stability even in adverse weather conditions while also achieving decentralized power sharing and contributions to frequency inertia and damping. The proposed strategy is applicable to photovoltaic- and wind turbine-based generators, as well as energy storage systems. A guideline for control parameter design and stability margin analysis for weather conditions are also provided. The effectiveness of the proposed strategy is validated via small-signal analysis and simulation case studies under various conditions of 100% renewable energy grids, characterized by severe weather, load demand changes, actual line impedances, and a grid fault.
The 25-item Phlegm Pattern Questionnaire (PPQ) has been widely used to examine the relationship between the phlegm pattern (PP), quality of life, tongue colour, vocal qualities, and dysfunctional ...breathing. However, the concerns of response burden and differences in the respondent’s abilities or item difficulty for the original version of the PPQ have not been sufficiently addressed. This study aimed to develop a short-form PPQ using Rasch analysis, an item response theory. Based on the retrospective data, the response order, differential item functioning (DIF), dimensionality, reliability, concurrent validity, and fitting errors were examined for 291 normal participants and 61 inpatients. The discriminative ability of the short-form PPQ was examined using receiver operating characteristic curve analysis. Along with Rasch analysis, another short-form PPQ was developed using equidiscriminative item-total correlation (EITC) analysis and the results between the two short-form PPQs were compared accordingly. Rasch analysis results suggested a 6-point response category for the PPQ, and finally, 8 items without fitting errors or DIF variability were selected for the PPQ (PPQ-8). The PPQ-8 had satisfactory reliability (person separation index = 2.23), unidimensionality (unexplained variance in the first contrast = 1.598), fitting levels (infit mean square, 0.80–1.39; outfit mean square, 0.79–1.34), sensitivity (70.5%), and specificity (76.5%). The PPQ-8 had a moderate discriminative ability of the PP (area under the curve = 0.759), and the cut-off point was 23. Although the 8-item PPQ developed using EITC analysis showed similar levels of reliability, validity, and discriminative ability of the PP to the PPQ-8, it could not present the information of item hierarchy and differences in the respondents’ abilities. In conclusion, the PPQ-8 by Rasch analysis is recommended for future use to evaluate the clinical severity of PP.
Under endoplasmic reticulum (ER)‐stress conditions, the unfolded protein response (UPR) generates a defense mechanism in mammalian cells. The regulation of UPR signaling is important in oocyte ...maturation, embryo development, and female reproduction of pigs. Recent studies have shown that melatonin plays an important role as an antioxidant to improve pig oocyte maturation. However, there is no report on the role of melatonin in the regulation of UPR signaling and ER‐stress during in vitro maturation (IVM) of porcine oocytes. Therefore, the objective of this study was to investigate the antioxidative effects of melatonin on porcine oocyte maturation through the regulation of ER‐stress and UPR signaling. We investigated the changes in the mRNA/protein expression levels of three UPR signal genes (Bip/Grp78, ATF4, P90/50ATF6, sXbp1, and CHOP) on oocytes, cumulus cells, and cumulus‐oocyte complexes (COCs) during IVM (metaphase I; 22 hours and metaphase II; 44 hours) by Western blot and reverse transcription‐polymerase chain reaction analysis. Treatment with the ER‐stress inducer, tunicamycin (Tm), significantly increased expression of UPR markers. Additionally, cumulus cell expansion and meiotic maturation of oocytes were reduced in COCs of Tm‐treated groups (1, 5, and 10 μg/mL). We confirmed the reducing effects of melatonin (0.1 μmol/L) on ER‐stress after pretreatment with Tm (5 μg/mL; 22 hours) in maturing COCs. Addition of melatonin (0.1 μmol/L) to Tm‐pretreated COCs recovered meiotic maturation rates and expression of most UPR markers. In conclusion, we confirmed a role for melatonin in the modulation of UPR signal pathways and reducing ER‐stress during IVM of porcine oocytes.
Background & Aims
Elevated liver enzymes are associated with later development of type 2 diabetes mellitus. The objective of this study was to assess the association between prepregnancy liver enzyme ...levels and subsequent risk of gestational diabetes mellitus.
Methods
Data from a total of 236,109 women who participated in the National Health Screening Examination between 2011 and 2015 was analysed. Multivariate logistic regression analyses were performed to estimate the risk of developing gestational diabetes mellitus in relation to pregravid liver enzyme levels. Subgroup analyses were performed according to pregravid obesity and metabolic syndrome (MetS).
Results
Approximately 5.7% and 1.1% of women developed gestational diabetes mellitus with and without insulin treatment requirement respectively. Pregravid gamma‐glutamyl transferase and alanine aminotransferase levels with greater than or equal to the 4th quartile were associated with significantly increased risks of gestational diabetes mellitus requiring insulin treatment in women with obesity and with MetS, (odds ratios ORs with 6.228 and 9.505, respectively, P < .001 for both). In women without obesity and without MetS, the risks of gestational diabetes mellitus requiring insulin treatment were also significant (ORs with 2.837 and 3.029, respectively, P < .001 for both). The elevated pregravid liver enzymes were associated with gestational diabetes mellitus without insulin treatment requirement, but minimally.
Conclusions/interpretation
The elevated pregravid liver enzyme levels were significantly associated with the subsequent risk of gestational diabetes mellitus, especially gestational diabetes mellitus requiring insulin treatment, not only in women with obesity or MetS, but also in women without obesity or MetS.
Mobile energy storage devices (MESDs) operate as medium- or large-sized batteries that can be loaded onto electric trucks and connected to charging stations to provide various ancillary services for ...distribution grids. This article proposes a new strategy for MESD operation, in which their power outputs and paths are co-optimally scheduled to minimize the total energy loss in both power and transportation networks. The distances moved by MESDs and time at different locations are modeled using a set of linear equations, considering the time-varying traffic flow. The linear transit model is integrated with linearized constraints to support the reliable operation of the distribution grid. In particular, an optimal scheduling problem is formulated considering the maximum limits on incremental variations in bus voltages and line power flows for active and reactive power outputs of MESDs. A mixed-integer linear programming solver can be readily applied to the optimization problem, ensuring the global optimality of the solution. Simulation case studies are carried out under various power and transportation network conditions. The results of these case studies confirm that the proposed strategy using MESDs is effective in reducing total energy losses, compared to conventional methods using stationary batteries and plug-in electric vehicles.
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