Because type 2 diabetes (T2D) has become increasingly prevalent among young adults, the study of the association of T2D with psychiatric disorders in young adults is important for early detection and ...timely intervention.
To determine whether a diagnosis of a psychiatric disorder is associated with increased risk of developing T2D in young adults.
This large-scale prospective cohort study used data collected by the South Korean National Health Insurance Service between 2009 and 2012, representing 97% of the South Korean population. Young adults aged 20 to 39 years with and without diagnoses of psychiatric disorders were included in the study. Young adults with missing data and those with a history of T2D were excluded from the study. The cohort was followed up to monitor development of T2D until December 2018. Data were analyzed from March 2021 to February 2022.
Diagnosis of 1 of 5 psychiatric disorders, including schizophrenia, bipolar disorder, depressive disorder, anxiety disorder, and sleep disorder.
The primary outcome was newly diagnosed T2D during a follow-up period of 7.59 years. The incidence rate of T2D was calculated as the number of new cases per 1000 person-years during the follow-up period. The Cox proportional hazards regression model was used to estimate the hazard ratios (HRs) and 95% CIs for T2D incidence. Exploratory analyses were performed for subgroups stratified by age and sex.
In total, 6 457 991 young adults (mean SD age, 30.74 4.98 years; 3 821 858 men 59.18%) were followed up, including 658 430 individuals with psychiatric disorders. The cumulative incidence of T2D differed significantly between individuals with and without psychiatric disorders (log-rank test, P < .001). Incidence rates of T2D for individuals with and without psychiatric disorders were 2.89 and 2.56 per 1000 person-years, respectively. Individuals with a diagnosis of any psychiatric disorder showed a higher risk of developing T2D than those without a diagnosis (adjusted HR, 1.20; 95% CI, 1.17-1.22). The adjusted HRs for T2D were 2.04 (95% CI, 1.83-2.28) for individuals with schizophrenia, 1.91 (95% CI, 1.73-2.12) for individuals with bipolar disorder, 1.24 (95% CI, 1.20-1.28) for individuals with depressive disorder, 1.13 (95% CI, 1.11-1.16) for individuals with anxiety disorder, and 1.31 (95% CI, 1.27-1.35) for individuals with sleep disorder.
In this large-scale prospective cohort study of young adults, 5 psychiatric disorders were significantly associated with an increased risk of developing T2D. Young adults with schizophrenia and bipolar disorder in particular were at a higher risk of T2D. These results have important implications for early detection of and timely intervention in T2D for young adults with psychiatric disorders.
This study sought to investigate the impact of low tube voltage scanning heterogeneity of coronary luminal attenuation on plaque quantification and characterization with coronary computed tomography ...angiography (CCTA).
The impact of low tube voltage and coronary luminal attenuation on quantitative coronary plaque remains uncertain.
A total of 1,236 consecutive patients (age: 60 ± 9 years; 41% female) who underwent serial CCTA at an interval of ≥2 years were included from an international registry. Patients with prior revascularization or nonanalyzable coronary CTAs were excluded. Total coronary plaque volume was assessed and subclassified based on specific Hounsfield unit (HU) threshold: necrotic core, fibrofatty plaque, and fibrous plaque and dense calcium. Luminal attenuation was measured in the aorta.
With increasing luminal HU (<350, 350-500, and >500 HU), percent calcified plaque was increased (16%, 27%, and 40% in the median; P < 0.001), and fibrofatty plaque (26%, 13%, and 4%; P < 0.001) and necrotic core (1.6%, 0.3%, and 0.0%; P < 0.001) were decreased. Higher tube voltage scanning (80, 100, and 120 kV) resulted in decreasing luminal attenuation (689 ± 135, 497 ± 89, and 391 ± 73 HU; P < 0.001) and calcified plaque volume (59%, 34%, and 23%; P < 0.001) and increased fibrofatty plaque (3%, 9%, and 18%; P < 0.001) and necrotic core (0.2%, 0.1%, and 0.6%; P < 0.001). Mediation analysis showed that the impact of 100 kV on plaque composition, compared with 120 kV, was primarily caused by an indirect effect through blood pool attenuation. Tube voltage scanning of 80 kV maintained a direct effect on fibrofatty plaque and necrotic core in addition to an indirect effect through the luminal attenuation.
Low tube voltage usage affected plaque morphology, mainly through an increase in luminal HU with a resultant increase in calcified plaque and a reduction in fibrofatty and necrotic core. These findings should be considered as CCTA-based plaque measures are being used to guide medical management and, in particular, when being used as a measure of treatment response. (Progression of Atherosclerotic Plaque Determined by Computed Tomographic Angiography Imaging PARADIGM; NCT02803411).
Specific antibody deficiency (SAD) involves a deficient response to a polysaccharide vaccine despite having normal immunoglobulin levels. The failure of the polysaccharide response can be observed as ...a component of various primary antibody deficiencies. However, only a few studies have described the clinical and immunological profiles in SAD and/or other primary immunodeficiencies (PIDs) in adults.
A total of 47 patients who had a clinical history suggestive of antibody deficiency or had already been diagnosed with various antibody deficiencies were enrolled. Polysaccharide responses to 7 pneumococcal serotypes (4, 6B, 9V, 14, 18C, 19F and 23F) were measured using the World Health Organization enzyme-linked immunosorbent assay (WHO-ELISA), and postvaccination immunoglobulin G (IgG) titers were compared to clinical and laboratory parameters.
Based on the American Academy of Allergy, Asthma, and Immunology (AAAAI) criteria for the WHO-ELISA, 11 (23.4%) patients were diagnosed as having SAD. Sixteen-three percent of them had combined with other types of PID, such as IgG subclass deficiency and hypogammaglobulinemia. Postvaccination IgG titers for the serotypes 4/9V/18C correlated with IgG2 (
= 0.012,
= 0.001, and
= 0.004) and for 6B/9V/14 with IgG3 (
= 0.003,
= 0.041, and
= 0.036, respectively). The IgG3 subclass levels negatively correlated with forced expiratory volume in 1 second (FEV1, %) and FEV1/forced vital capacity (
< 0.001 and
= 0.001, respectively).
SAD can be diagnosed in patients with normal IgG levels as well as in those deficient in IgG or the IgG3 subclass, implicating that restricted responses to
polysaccharide antigens commonly exist in patients with predominantly antibody deficiency.
In recent years, light detection and ranging (LiDAR) sensors have been widely utilized in various applications, including robotics and autonomous driving. However, LiDAR sensors have relatively low ...resolutions, take considerable time to acquire laser range measurements, and require significant resources to process and store large-scale point clouds. To tackle these issues, many depth image sampling algorithms have been proposed, but their performances are unsatisfactory in complex on-road environments, especially when the sampling rate of measuring equipment is relatively low. Although region-of-interest (ROI)-based sampling has achieved some promising results for LiDAR sampling in on-road environments, the rate of ROI sampling has not been thoroughly investigated, which has limited reconstruction performance. To address this problem, this article proposes a solution to the budget distribution optimization problem to find optimal sampling rates according to the characteristics of each region. A simple yet effective mean absolute error (MAE)-aware model of reconstruction errors was developed and employed to analytically derive optimal sampling rates. In addition, a practical LiDAR sampling framework for autonomous driving was developed. Experimental results demonstrate that the proposed method outperforms all previous approaches in terms of both the object and overall scene reconstruction performances.
Introduction
The purpose of this study was to compare the sagittal spinopelvic parameters between young normal asymptomatic adults and older normal asymptomatic adults without localized segmental ...disc degeneration.
Materials and methods
Standing sagittal radiographs of the whole spine including the pelvis in 342 adult male volunteers (Group 1:
n
= 184, average age 21.2 years, range 19–28 vs. Group 2:
n
= 158, average age 63.8 years, range 53–79) were analyzed prospectively. Volunteers with history of spine operation, spinal disease, chronic pain in their back or legs, scoliosis, spondylolisthesis, 1–3 segmental disc space narrowing, and/or compression fractures in radiographs were excluded. The following parameters were included: thoracic kyphosis between T5 upper endplate (UEP) and T12 lower endplate (LEP), thoracolumbar kyphosis (T10 UEP − L2 LEP), T12 LEP-horizontal (H) angle (minus denotes EP above the H line), lumbar lordosis (T12 LEP − S1 UEP), lower lumbar lordosis (L4 UEP − S1 UEP), sacral slope, pelvic incidence and distances from C7 plumb/T12 plumb to the postero-superior endplate of S1. Group 2 (old men group) demonstrated larger thoracic kyphosis (30.1° ± 8.6° vs. 21.1° ± 7.8° in Group 1,
P
< 0.001), thoracolumbar kyphosis (10.0° ± 7.5° vs. 2.8° ± 7.1° in Group 1,
P
< 0.001), total lumbar lordosis at T12–S1 (57.3° ± 8.8° vs. 52.2° ± 9.2° in Group 1,
P
< 0.001), lower lumbar lordosis at L4–S1 (39.4° ± 6.7° vs. 32.4° ± 6.4° in Group 1,
P
< 0.001), a higher ratio of lower to total lumbar lordosis (69.5 ± 11.6 vs. 62.7 ± 10.6 % in Group 1,
P
< 0.001) and T12 LEP-H angle (−20.4° ± 5.7° vs. −15.7° ± 5.1° in Group 1,
P
< 0.001). There were no significant differences in sacral slope (36.5° ± 7.3° in Group 1 vs. 36.8° ± 6.7° in Group 2,
P
= 0.67) and pelvic incidence (46.5° ± 7.7° in Group 1 vs. 48.2° ± 8.5° in Group 2,
P
= 0.06). There was no significant difference in the measurement of distance from C7 plumb to the postero-superior endplate of S1 (−0.7 ± 2.4 cm in Group 1 vs. −0.3 ± 2.7 cm in Group 2,
P
= 0.197). However, the distance from T12 plumb to the postero-superior endplate of S1 (−0.7 ± 1.7 cm in Group 1 vs. −2.2 ± 1.7 cm in Group 2,
P
< 0.001) demonstrated a significant difference.
Conclusion
The old men group demonstrated a significant increase in thoracic kyphosis, thoracolumbar kyphosis, total and lower lumbar lordosis, a higher ratio of lower to total lumbar lordosis, and a longer distance from T12 plumb to the postero-superior endplate of S1 without changes in sacral slope and global sagittal balance.
Cerebral mitochondrial dysfunction during post-cardiac arrest syndrome (PCAS) remains unclear, resulting in a lack of therapeutic options that protect against cerebral ischemia-reperfusion injury. We ...aimed to assess mitochondrial dysfunction in the hippocampus after cardiac arrest and whether vagus nerve stimulation (VNS) can improve mitochondrial dysfunction and neurological outcomes. In an asphyxial cardiac arrest model, male Sprague-Dawley rats were assigned to the vagus nerve isolation (CA) or VNS (CA + VNS) group. Cardiopulmonary resuscitation was performed 450 s after pulseless electrical activity. After the return of spontaneous circulation (ROSC), left cervical VNS was performed for 3 h in the CA + VNS group. Mitochondrial respiratory function was evaluated using high-resolution respirometry of the hippocampal tissue. The neurologic deficit score (NDS) and overall performance category (OPC) were assessed at 24, 48, and 72 h after resuscitation. The leak respiration and oxidative phosphorylation capacity of complex I (OXPHOS CI) at 6 h after ROSC were significantly higher in the CA + VNS group than in the CA group (
= 0.0308 and 0.0401, respectively). Compared with the trends of NDS and OPC in the CA group, the trends of those in the CA + VNS group were significantly different, thus suggesting a favorable neurological outcome in the CA + VNS group (
= 0.0087 and 0.0064 between times × groups interaction, respectively). VNS ameliorated mitochondrial dysfunction after ROSC and improved neurological outcomes in an asphyxial cardiac arrest rat model.
Background and Aim: Capsule endoscopy (CE) has proven to be highly effective at detecting small bowel lesions in a variety of clinical conditions, but studies concerning the practical impact of CE ...on small bowel tumors are still scarce, especially in the Asian population. The aim of this study was to evaluate the diagnostic and therapeutic impact of CE in the field of small bowel tumors.
Methods: CE records consecutively pooled from the beginning of use of CE in Korea, October 2001 until April 2008, in 14 centers throughout Korea were reviewed. Clinical information and CE video images of small bowel tumors were analyzed.
Results: A total of 1332 cases undergoing CE were reviewed with all clinical indications. Small bowel tumors were diagnosed with CE in 57 (4.3%) of 1332 patients. The tumors were malignant in 33 cases, and included three adenocarcinomas, eight lymphomas, 20 gastrointestinal stromal tumors, and two metastatic cancers. The most frequent indications for CE in malignant tumors were obscure gastrointestinal bleeding, followed by abdominal pain and weight loss. Thirty of 57 tumors were identified exclusively by CE (diagnostic impact = 30/57), and they were smaller in size (mean, range: 14.3 mm, 2–35 mm) compared to the other tumors detected in radiological studies (48.7 mm, 10–110 mm). Seven patients underwent surgical resection (therapeutic impact = 7/57).
Conclusion: CE effectively identifies small bowel tumors that are undetectable by conventional radiological studies (diagnostic impact = 52.6%) and can critically change the therapeutic course (therapeutic impact = 12.3%).
Objectives
We investigated whether quantification of global left ventricular (LV) strain by tissue tracking-CMR (TT-CMR) can estimate the infarct size and clinical outcomes in patients with acute ...myocardial infarction (MI).
Methods
We retrospectively registered 247 consecutive patients (58 ± 12 years; male, 81%) who underwent 1.5-T CMR within 1 month after ST-segment elevation MI (median, 4 days; interquartile range, 3–6 days), and 20 age- and sex-matched controls (58 ± 11 years; male, 80%). TT-CMR analysis was applied to cine-images to measure global LV radial, circumferential and longitudinal peak strains (GRS, GCS and GLS, respectively). Adverse cardiac events were defined as cardiac death and hospitalization for heart failure.
Results
During the follow-up (median, 7.8 years), 20 patients (8.1%) experienced adverse events. LV myocardial deformation was significantly decreased in MI patients compared to controls and closely related to the infarct size. The GRS, GCS and GLS were all significant predictors of adverse cardiac events. In particular, a GLS > −14.1% was independently associated with a > 5-fold increased risk for adverse events, even after adjustment for the LV ejection fraction and infarct size.
Conclusions
TT-CMR-derived LV strain is significantly related to the infarct size and adverse events. GLS measurement provides strong prognostic information in MI patients.
Key Points
• TT-CMR provides reliable quantification of LV strain in MI patients.
• TT-CMR allows prediction of the infarct size and adverse events.
• In particular, GLS by TT-CMR had independent prognostic value in MI patients.
Microfibrillated cellulosic fibrous product was successfully obtained from Korean white pine (Pinus koraiensis Sieb. et Zucc.) by using two alternative pretreatments (steam and ozone treatments) ...followed by disk milling (DM). The steam and ozone treatments were effective in extracting some of the hemicelluloses and degrading lignin, respectively, with both types of treatment resulting in the improvement of mechanical fibrillation as a result of loosening of the cell wall structure. The obtained products showed nanoscopic fibrous morphology even though hemicelluloses and lignin components remained. The specific surface area and filtration time were increased using the DM treatment after both treatments, and the values increased further with longer periods of DM. The paper sheets of the fibrillated products after both the alternative treatments had higher tensile properties at the same DM time scale than the sheets of the products obtained without treatment. Tensile strength was further increased by increasing sheet density showing the highest tensile strength and modulus of 125 MPa and 20 GPa, respectively.
Although acute coronary syndrome culprit lesions occur more frequently in the proximal coronary artery, whether the proximal clustering of high-risk plaque is reflected in earlier-stage ...atherosclerosis remains unclarified. We evaluated the longitudinal distribution of stable atherosclerotic lesions on coronary computed tomography angiography (CCTA) in 1,478 patients (mean age, 61 years; men, 58%) enrolled from a prospective multinational registry of consecutive patients undergoing serial CCTA. Of 3,202 coronary artery lesions identified, 2,140 left lesions were classified (based on the minimal lumen diameter location) into left main (LM, n = 128), proximal (n = 739), and other (n = 1,273), and 1,062 right lesions were classified into proximal (n = 355) and other (n = 707). Plaque volume (PV) was the highest in proximal lesions (median, 26.1 mm3), followed by LM (20.6 mm3) and other lesions (15.0 mm3, p <0.001), for left lesions, and was lager in proximal (25.8 mm3) than in other lesions (15.2 mm3, p <0.001) for right lesions. On both sides, proximally located lesions tended to have greater necrotic core and fibrofatty components than other lesions (left: LM, 10.6%; proximal, 5.8%; other, 3.4% of the total PV, p <0.001; right: proximal, 8.4%; other 3.1%, p <0.001), with less calcified plaque component (left: LM, 18.3%; proximal, 30.3%; other, 37.7%, p <0.001; right: proximal, 23.3%, other, 36.6%, p <0.001), and tended to progress rapidly (adjusted odds ratios: left: LM, reference; proximal, 0.95, p = 0.803; other, 0.64, p = 0.017; right: proximal, reference; other, 0.52, p <0.001). Proximally located plaques were larger, with more risky composition, and progressed more rapidly.
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