The protective effects of vitamin D and calcium on colorectal neoplasms are known. Bone mineral density (BMD) may be a reliable biomarker that reflects the long-term anticancer effect of vitamin D ...and calcium. This study aimed to evaluate the association between BMD and colorectal adenomas including high-risk adenoma.
A multicenter, cross-sectional, case-control study was conducted among participants with average risk of colorectal cancer who underwent BMD and screening colonoscopy between 2015 and 2019. The main outcome was the detection of colorectal neoplasms. The variable under consideration was low BMD (osteopenia/osteoporosis). The logistic regression model included baseline demographics, components of metabolic syndrome, fatty liver disease status, and aspirin and multivitamin use.
A total of 2,109 subjects were enrolled. The mean age was 52.1±10.8 years and 42.6% were male. The adenoma detection rate was 43%. Colorectal adenoma and high-risk adenoma were both more prevalent in subjects with low BMD than those with normal BMD (48.2% vs 38.8% and 12.1% vs 9.1%). In the univariate analysis, old age, male sex, smoking, metabolic components, fatty liver, and osteoporosis were significantly associated with the risk of adenoma and high-risk adenoma. In the multivariate analysis, osteoporosis was independently associated with risk of colorectal adenoma (odds ratio OR, 1.65; 95% confidence interval CI, 1.11 to 2.46; p=0.014) and high-risk adenoma (OR, 1.94; 95% CI, 1.14 to 3.29; p=0.014).
Osteoporosis is an independent risk factor of colorectal adenoma and high-risk adenoma.
Ulcerative colitis (UC) is an inflammatory bowel disease for which new serological markers are required. The purpose of this study was to assess the role of the mucosa-associated epithelial chemokine ...CCL28 in UC.
The study included 50 patients; of these, 25 were patients with UC, and 25 were healthy controls. The levels of serum CCL28 were analyzed using enzyme-linked immunosorbent assay. CCL28 expression was analyzed by immunohistochemistry (IHC) in 15 representative colon tissues biopsied based on disease activity (UC patients with severe activity, five samples; UC patients with mild activity, five samples; healthy controls, five samples).
The serum CCL28 levels were remarkably higher (p<0.05) in patients with UC (median, 235.7 pg/mL; IQR, 63.8 to 117.2 pg/mL) than in healthy controls (median, 48.9, pg/mL; IQR, 35.9 to 42.0 pg/mL). However, there was no significant difference in serum CCL28 according to disease extent or activity. In contrast, IHC analysis revealed a significant difference in CCL28 consistent with disease status, disease extent, and disease activity.
CCL28 could be useful for diagnosing UC. However, further validations of CCL28 on disease activity and severity are needed.
Hemophagocytic lymphohistiocytosis (HLH) is a rare systemic inflammatory disease commonly characterized by histiocyte infiltration in multiple organs, such as the liver, spleen, lymph nodes, bone ...marrow, and central nervous system. The clinical features of HLH include fever, splenomegaly, cytopenia, hypertriglyceridemia, hypofibrinogenemia, and elevated blood ferritin levels. HLH is categorized as either primary or secondary. Coronavirus disease 2019 (COVID-19) vaccines may occasionally trigger secondary HLH, which is related to hyperinflammatory syndrome.
A 58-year-old woman, previously diagnosed with Graves' disease, presented with cognitive decline 2 weeks after receiving the first dose of the ChAdOx1 nCoV-19 vaccine. Brain MRI revealed a hyperintense lesion on T2-weighted and fluid-attenuated inversion recovery images in the bilateral subcortical white matter and right periventricular area. Vaccination-associated acute disseminated encephalomyelitis was suspected and methylprednisolone and intravenous immunoglobulin (IVIg) were administered. From the 5th day of IVIg administration, the patient developed fever and pancytopenia. In the findings of bone marrow biopsy, hemophagocytosis was not observed; however, six of the eight diagnostic criteria for HLH-2004 were met, raising the possibility of HLH. Although there was no definitive method to confirm causality, considering the temporal sequence, suspicion arose regarding vaccine-induced HLH. Splenectomy was considered for therapeutic and diagnostic purposes; however, the patient died on the 28th day of hospitalization owing to multiple organ failure.
To date, 23 cases of COVID-19 vaccine-related HLH have been reported. Additionally, HLH in COVID-19 patients has been reported in various case reports. To the best of our knowledge, this is the first reported case of central nervous system involvement in HLH related to any type of COVID-19 vaccine. This case suggests that even when there are no systemic symptoms after COVID-19 vaccination, HLH should be considered as a differential diagnosis if brain lesions are suggestive of CNS demyelinating disease.
In the field of visualization, understanding users’ analytical reasoning is important for evaluating the effectiveness of visualization applications. Several studies have been conducted to capture ...and analyze user interactions to comprehend this reasoning process. However, few have successfully linked these interactions to users’ reasoning processes. This paper introduces an approach that addresses the limitation by correlating semantic user interactions with analysis decisions using an interactive wire transaction analysis system and a visual state transition matrix, both designed as visual analytics applications. The system enables interactive analysis for evaluating financial fraud in wire transactions. It also allows mapping captured user interactions and analytical decisions back onto the visualization to reveal their decision differences. The visual state transition matrix further aids in understanding users’ analytical flows, revealing their decision-making processes. Classification machine learning algorithms are applied to evaluate the effectiveness of our approach in understanding users’ analytical reasoning process by connecting the captured semantic user interactions to their decisions (i.e., suspicious, not suspicious, and inconclusive) on wire transactions. With the algorithms, an average of 72% accuracy is determined to classify the semantic user interactions. For classifying individual decisions, the average accuracy is 70%. Notably, the accuracy for classifying ‘inconclusive’ decisions is 83%. Overall, the proposed approach improves the understanding of users’ analytical decisions and provides a robust method for evaluating user interactions in visualization tools.
We aimed to assess the relationship between lifestyle-related variables, metabolic syndrome, and lower urinary tract symptoms (LUTS) in men ≥ 40 years. We also assessed the impact of these variables ...on quality of life. From 2014 to 2020, 5355 men who underwent health check-ups with I-PSS questionnaires at our institute were included in the analysis. The impact of LUTS on sleep disorders and moderate to severe degrees of stress were assessed. Multivariate analysis was performed to determine the variables associated with LUTS and prostate volume. Moderate and severe LUTS were present in 1317 (24.6%) and 211 (3.9%) men, respectively. Moderate and severe LUTS were significantly associated with the presence of sleep disorders and stress. On multivariable analysis, age, amount of life-long smoking, marital status, income, job, and decreased HDL-cholesterol were associated with the presence of moderate to severe LUTS. Although older age and the amount of life-long smoking was associated with both voiding and storage sub-score, socioeconomic status, including marital status and income were only associated with storage sub-score. In men ≥ 40 years, stable socioeconomic status, in addition to older age, and life-long smoking amount are associated with the presence of moderate to severe LUTS, which worsens sleep quality and stress level, by worsen storage sub-score.
Coronavirus disease 2019 (COVID-19) has strained healthcare systems worldwide. Predicting COVID-19 severity could optimize resource allocation, like oxygen devices and intensive care. If machine ...learning model could forecast the severity of COVID-19 patients, hospital resource allocation would be more comfortable. This study evaluated machine learning models using electronic records from 3,996 COVID-19 patients to forecast mild, moderate, or severe disease up to 2 days in advance. A deep neural network (DNN) model achieved 91.8% accuracy, 0.96 AUROC, and 0.90 AUPRC for 2-day predictions, regardless of disease phase. Tree-based models like random forest achieved slightly better metrics (random forest: 94.1% of accuracy, 0.98 AUROC, 0.95 AUPRC; Gradient boost: 94.1% of accuracy, 0.98 AUROC, 0.94 AUPRC), prioritizing treatment factors like steroid use. However, the DNN relied more on fixed patient factors like demographics and symptoms in aspect to SHAP value importance. Since treatment patterns vary between hospitals, the DNN may be more generalizable than tree-based models (random forest, gradient boost model). The results demonstrate accurate short-term forecasting of COVID-19 severity using routine clinical data. DNN models may balance predictive performance and generalizability better than other methods. Severity predictions by machine learning model could facilitate resource planning, like ICU arrangement and oxygen devices.
Metabolic syndrome (MS) is a global health problem associated with an increased risk of diabetes mellitus (DM), cardiovascular disease (CVD), and cancer. Body composition parameters, including ...obesity, visceral adiposity, and sarcopenia contribute to the development of MS and CVD. Previous studies have investigated the association of individual body composition parameters with MS. Studies analyzing the association between multiple body composition parameters and MS have been rare. We aimed to investigate the association between MS and multiple body composition parameters, including obesity, visceral adiposity, and sarcopenia.
A total of 13,620 subjects who underwent voluntary routine checkups at the Health Care Center of our institution between October 2014 and December 2019 were enrolled. Only data from the first examination of subjects who underwent repeated checkups were included. Clinical and laboratory data were collected. Skeletal muscle mass and visceral fat area (VFA) were measured using bioelectrical impedance analysis. Appendicular skeletal muscle mass (ASM) was divided by body weight (in kg) and expressed as a percentage (calculated as, ASM% = ASM × 100/Weight). Data were compared between the groups based on obesity, VFA, and ASM%. Logistic regression analysis was performed to determine the risk of MS in each group.
Body mass index and VFA were significantly higher in subjects with MS than in those without MS. ASM% was significantly lower in subjects with MS than in those without MS. Subjects with obesity, visceral adiposity, or sarcopenia had a higher prevalence of MS than those without. As the number of metabolic components increased from 0 to 5, we identified a decreasing trend of ASM% and an increasing trend of VFA and BMI (P for trend < 0.001 for all). In the paired analyses, all the three body composition parameters showed additive effects in predicting MS. In the logistic regression analysis, the three parameters were associated with an increased risk of MS after adjustment for age, sex, hypertension, DM, dyslipidemia, smoking, alcohol intake, and C-reactive protein.
Obesity, visceral adiposity, and sarcopenia showed additive effects on MS prediction. Subjects with obesity, visceral adiposity, or sarcopenia were significantly associated with the increased risk of MS after adjustment for multiple confounders. Increasing skeletal muscle and reducing visceral fat may be strategies for the prevention or treatment of MS.
As global warming increases day/night temperatures as well as frequencies of heat waves, studying physiological responses in long-term heat stress is required for sustainable yield production in the ...future. In this study, effects of long-term heat stress on photosynthetic, morphological, and yield parameters of three cherry tomato accessions, HR17, HR22, and HR24, were evaluated. The experiment was conducted under two temperature greenhouse conditions, where temperature set-point for ventilation was 30 °C and 35 °C during the day for 57 days, respectively. Plants were harvested on the 35th days and 57th days after heat treatments, and their physiological and morphological characteristics and yield traits were measured. Under control conditions, HR17 and HR22 had 0.5–0.6 harvest index, while HR24 had 0.3 harvest index. On 35th days after heat treatment, although yield loss percentage of HR17 was high (43%), it produced the highest fruit yield among all three accessions. However, after longer heat treatment, HR24 produced the highest fruit yields among all accessions with the smallest yield loss (34%). Furthermore, yield loss was highly associated with reductions in nitrogen use efficiency and water content in plant body under heat stress. The results of this study will provide breeders with a new insight into selecting heat-tolerant genotypes in cherry tomatoes.
The influence of body fat on arterial stiffness remains controversial. This study was performed to investigate the associations between four different types of body fat parameters and brachial-ankle ...pulse wave velocity (baPWV). A total of 3758 subjects (mean age, 53.4 ± 8.8 years; females, 36.3%) who underwent health check-up were retrospectively analyzed. Anthropometric parameters including body mass index (BMI), waist circumference (WC) and waist-hip ratio (WHR) were assessed, and visceral fat area (VFA) was calculated by bioelectrical impedance analysis. In simple linear correlation analyses, baPWV was associated with WC, WHR and VFA (P < 0.001 for each), but not with BMI (P = 0.175). In multivariable analyses, BMI and WC were not associated with baPWV (P > 0.05 for each). Even after controlling for potential confounders, higher baPWV was significantly associated not only with higher WHR for > 0.90 in men and > 0.85 in women: odds ratio (OR), 1.23; 95% confidence interval (CI), 1.06-1.42; P = 0.005; for the highest tertile compared to the lowest tertile: OR, 1.38; 95% CI, 1.15-1.66; P < 0.001, but also with higher VFA (for ≥ 100 cm
: OR, 1.39; 95% CI, 1.20-1.60; P < 0.001; for the highest tertile compared to the lowest tertile: OR, 1.77; 95% CI, 1.48-2.12; P < 0.001). Our study showed that baPWV was correlated with WHR and VFA, but not with BMI and WC. This implies that arterial stiffness may be more strongly associated with abdominal obesity than overall obesity.
The harmonic noise produced in an enclosure is actively controlled with phase compensators. The active controller is designed in the frequency domain using optimal control theory. This controller can ...be implemented in a simple form of FIR filter to ensure stability. The FIR filter has a time delay of half the filter length to satisfy causality. This time delay corresponds to the phase shift of the response of the harmonic components. Phase compensators are used to correct this response, and the requirements for the phase compensators are determined from a numerical analysis. The performance of the controller is investigated with various types of phase compensation. The results show that the performance is better with time-domain compensation, regardless of the target frequency. The acoustic power reduction of the system is also determined by experiments. The results for the real control model show that the acoustic power is reduced by approximately 15 dB and 10 dB for the first and second harmonic components, respectively, while the overall acoustic power reduction is about 10 dB. To control the harmonic noise transmitted through an enclosure window, a controller for acoustic power reduction can be designed by applying a time delay for the fundamental frequency.
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