Middle Group Research Articles

O10 HEART RATE VARIABILITY AS EARLY MARKER OF CARDIAC INJURY IN HYPERTENSIVE YOUNG ADULTS

Background: Hypertension remains a life-threatening risk factor for cardiovascular diseases globally. It is not only common to middle age or aged group but also affect young individuals. Heart rate variability (HRV) gives an inference of the overall cardiac function and health of an individual. Thus, the aim of this study was to investigate whether HRV could be an early marker and a valid alternative to biochemical probes for the early detection of cardiac injury and systemic inflammation in hypertensive young adults. Materials and methods: A total number of 300 participants were recruited by fixed sampling of the case control study grouped into normotensive and hypertensive young groups. Informed consent was obtained from all participants before the procedure. Blood pressure with some anthropometric data were collected. Afterward, each participant’s HRV data was acquired by conducting a 5-minute resting ECG. Then, 5 ml of blood was taken through sterile venepuncture, centrifuged at 3000 rpm for 15 mins and biochemical analysis was performed for plasma troponin-I, troponin-T and inflammatory markers (TNF-alpha and NF-kappaB). Results: HRV assessment showed significant decrease in HRV parameters of parasympathetic activity (SDNN, RMSSD, HF) in the hypertensive young group. LF also showed significant decrease in the hypertensive group. But, LF/HF (sympatho-vagal balance) showed significant increase in the hypertensive group. LF correlates with plasma TNF-α (r = -0.6167) and NF-kB (r = -0.6673) at p = 0.0003 and p<0.0001, respectively. In addition, LF correlates with plasma Troponin-I (r = -0.6393) and Troponin-T (r = -0.5719) at p = 0.0001 and p = 0.0010, respectively. LF/HF had no correlation with these biomarkers. Thus, HRV correlates with plasma troponin-I, troponin-T, TNF-alpha and NF-kappaB in hypertensive young adults. Conclusion: HRV can be used as an early marker of cardiac injury and inflammation in young hypertensive individuals.

Production and Marketing Constraints Faced by the Chinese Onion (Allium chinense) Growers in Nagaland

The present study was conducted to examine the in-depth information of the socio-economic and constraints faced by the respondents during the production and marketing of Chinese onion in the concerned place of study. The data were collected through personal interview schedule by the researcher by adopting the purposive simple random technique from one district and two blocks were purposely selected and three villages from each block were selected by random method, which has make a total of 90 respondents selected from the six numbers of selected villages. The study revealed that majority of the farmers (62.00%) belonged to the middle age group (40 to 61 years). The study revealed that majority of the respondents had small sized field (0.008 to 0.024 ha). Among the various constraints in technology adoption to production, problems due to pest and diseases, lack of irrigation facility, lack of proper market, were the major challenges. Lack of all weather roads, no support prices and no reliable sources of distant market information were the major constraint faced in the marketing of Chinese onion.

Impact of fat content on lumbar spine DWI performance: A sex-based comparative study

PurposeSex-based differences in lumbar spine's fat content in adults are minimal, but significant variations exist in diffusion-weighted imaging (DWI) signal characteristics. This study aimed to investigate fat content’s impact on DWI performance in lumbar spine and potential sex differences. MethodsA retrospective analysis was conducted on upper abdominal MRI examinations in asymptomatic adult. The lumbar 1 vertebral apparent diffusion coefficient (ADC) values and fat fraction were measured. Using DWI images (b = 800 s/mm2), the lumbar 1 vertebral signal was categorized into high and iso-low signal groups. A univariate and multivariate analysis was conducted to investigate the influence of fat fraction on DWI performance. Finally, the participants were divided into three groups to analyze sex differences in the effect of fat content on DWI performance. Results202 subjects, 99 men were included. Fat content significantly influenced lumbar spine DWI signal in both sexes (p < 0.05). The effect on ADC values was significant only in women (p < 0.001). Women demonstrated a significantly higher proportion of high DWI signal than men in the low (p = 0.002) and middle (p = 0.012) fat content groups. Additionally, women had higher ADC values in the low fat group (p = 0.004) but lower values in the high fat group (p = 0.004). ConclusionFat content significantly impacts the DWI signal of lumbar spine, with a slight sex difference observed. These sex differences suggest that DWI signals may provide valuable information about the bone marrow beyond fat content.

A cross-sectional study to assess the risk of carpal tunnel syndrome among middle age group

Carpal tunnel syndrome (CTS) is a syndrome begins with pain, numbness, and paraesthesia’s in the first three digits and the lateral half of the fourth digit with symptoms of pain at the wrist, spreading across the hand to forearm or extending beyond the elbow which progresses to hand weakness, impaired fine motor coordination, clumsiness, and eventually atrophy of the thenar muscles. Aim: The present study aims to assess the risk of carpel tunnel syndrome among middle age group. Methods: In this study Non-Experimental Research study design and random sampling technique is used and a total of 601 samples were assessed. Questionnaire and physical examination related carpel tunnel syndrome are assessed. Results: The age were grouped into 25-35 yrs (60.7%) and 36-45 yrs (38.2%). The occupation was categorised as sedentary (23%), moderate workers (50%) and heavy workers (25.8%0. The mean risk score is 10(78.5%). There is a significant association between moderate workers and overweight category fall into the high risk of carpel tunnel syndrome. Conclusion: The study concluded that people who work moderately in the fields of IT. Teaching. Administrative Staff. Tailoring associated with overweight showed high risk for carpel tunnel syndrome.

Unveiling the Yin and Yang of expansionary monetary policy: Differential impact on inequality in China based on a national-level survey

This study explores the impact of expansionary monetary policy (EMP) on both income and wealth inequality in China using data from a national-level survey, with a particular focus on the discernible trend of wealth inequality surpassing income inequality since the beginning of the 21st century. Our findings unveil a non-uniform relationship between EMP and income inequality. While it serves to mitigate disparities between middle and low-income groups, it simultaneously exacerbates gaps between middle and high-income groups. In terms of the impact on wealth inequality, EMP exacerbates disparities by amplifying the wealth of low, middle, and high-wealth strata, with the effect escalating from lower to higher wealth groups. Moreover, this study identifies the burgeoning real estate market as the pivotal factor amplifying the policy's influence on wealth inequality. By elucidating the varied effects of EMP on income and wealth inequality, this study provides policymakers in transitioning economies with valuable insights to address inequality issues.

Effect of Distraction Arthroplasty in the Treatment of Moderate-to-Severe Ankle Arthritis.

Currently, the traditional treatment of moderate-to-severe ankle arthritis is joint fusion or joint replacement. The aim of this article is to explore the clinical efficacy of distraction arthroplasty in the treatment of moderate-to-severe ankle arthritis. A retrospective analysis was conducted with a total of 34 cases who were diagnosed with moderate-to-severe ankle arthritis and treated by distraction arthroplasty from January 2007 to November 2021. The average age was 42.3 years. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and pain visual analog scale (VAS) were used to evaluate ankle pain and functional improvement before surgery and at the last follow-up. Based on age, the patients were divided into the ≤45-year-old group [young group, 15 cases, age (36.37 ± 4.31) years old] and the >45-year-old group [middle-aged and elderly group, 19 cases, age (53.74 ± 3.17) years old]. The analysis included comparing preoperative and postoperative AOFAS ankle-hindfoot and VAS scores and the influence of age on distraction arthroplasty. All 34 patients were followed up, and the follow-up time ranged from 13 to 143 months, with an average of 45.3 months. The follow-up times for the young and middle-to-elderly groups were (33.19 ± 21.37) months and (55.63 ± 29.69) months, respectively. At the last follow-up, the AOFAS ankle-hindfoot and VAS scores were significantly improved compared with the preoperative assessment (p < 0.05). According to the etiological analysis, except for Pilon fracture, which showed no differences pre- and postoperation in the AOFAS ankle-hindfoot score and VAS score (p > 0.05), all other patients showed significant differences in these two scores (p < 0.05). The difference in preoperative AOFAS ankle-hindfoot scores between the young and middle-to-elderly groups was statistically significant (t = 3.422, p = 0.021). The preoperative and postoperative comparison of preoperative VAS scores, AOFAS ankle-hindfoot scores, and VAS scores before and after surgery showed no differences (p > 0.05). The joint space width (JSW) of 10 patients who were followed up for more than 5 years was (2.9 ± 0.5) mm. Two patients who were followed up for more than 10 years showed 3.3 and 3.0 mm, respectively, JSW. Distraction arthroplasty with the Ilizarov external fixator can achieve satisfactory results in the treatment of moderate-to-severe ankle arthritis (except arthritis caused by Pilon fracture surgery). Age has no statistical impact on the efficacy of distraction arthroplasty.

Age Differences and Self-Concept Predict Indonesian Females’ Mental health

The biopsychosocial challenges make females more prone to experiencing mental problems that can lead to extensive repercussions, affecting multiple generations cause of their significant roles in a family and society. However, mental health problems in Indonesia are still not handled optimally and the expenses for their medical care are not inexpensive. It’s important to explore factors that influence mental health to reduce the costs. So, this study aims to identify the influences of age differences and self-concept on females’ mental health in the general population of Indonesian adults. Methods: The study employed cross-sectional research, utilizing an uncontrolled quota sampling method and collecting data via the online survey. Results: Mental health can be predicted based on the self-concept (p &lt; .001) and age differences (p &lt; .01) of Indonesian females. Females with a significant problem of mental health are 0.76 times less likely to have high self-concept than moderate self-concept, whereas females with no significant problem of mental health are 0.96 times less likely to be found in the young adult group than in the middle year group. Conclusion: Self-concept plays one of the significant factors in shaping the mental health of adult females in Indonesia, and young adult females are the more vulnerable to mental problems. Further research about the self-concept enhancement implementation related to reducing mental treatment costs is needed.

Smartphone-Based Sit-to-Stand Analysis for Mobility Assessment in Middle Age.

Mobility can decline in middle age and growing evidence highlights the importance of assessing mobility at this stage of life. Smartphone-based accelerometry during sit-to-stand has been shown to identify mobility impairments, but its utility in detecting subtle mobility deterioration in middle age has not been tested. This study aimed to examine whether smartphone-based accelerometry data measured during sit-to-stand tests performed on a regular chair and a cushioned sofa could be useful for detecting subtle changes in mobility in middle age. Twenty-three young (25.0±2.5 years), 25 middle-aged (52.0±5.2 years), and 17 older adults (70.0±4.1 years) performed the 5-times sit-to-stand test on both a standard chair and a sofa. A smartphone attached to the participants' lower back was used to measure lower-limb muscle power, maximal vertical velocity (MVV) during rising, the duration of the total task and the subphase of transition from sitting to standing (SiToSt), and repetition variability using the dynamic time warping method. Middle-aged adults had reduced lower-limb muscle power compared to young adults (5.25 ± 1.08 vs 6.19 ± 1.38 W/kg, p = .034), being more pronounced on the sofa (6.23 ± 1.61 vs 8.08 ± 2.17 W/kg, p = .004). Differences between middle-aged and young adults in terms of MVV (p = .011) and SiToSt duration (p = .038) were only detected on the sofa, and the middle-aged adults showed less variability compared to the older adults on the chair (p = .018). There was no difference in total task duration between the middle-aged group and the young or older adults in either condition. Most common tests are limited in their ability to detect early mobility deterioration in midlife due to a ceiling effect. Our results, which show the potential of smartphone-based sit-to-stand assessment in detecting subtle mobility decline in midlife, could serve as a screening tool for this purpose.

Profile of Sarcopenia in Elderly Patients at The Medical Rehabilitation Outpatient Department Dr. Soetomo General Academic Hospital

The elderly group is the age group that is most susceptible to geriatric syndromes, one of which is sarcopenia. Sarcopenia is a syndrome characterized by a progressive and overall decrease in muscle mass and skeletal muscle strength with an increased risk of disability, decreased quality of life, and death. Currently, research on sarcopenia profiles, particularly in Indonesia, is still limited. This research data is expected to help determine policies to improve the quality of services in the health sector. This study used the SARC-F questionnaire and the risk factor questionnaire for sarcopenia in elderly patients at the Medical Rehabilitation Outpatient Department RSUD Dr. Soetomo and has been permitted by the Penelitian dan Pengembangan (LitBang) section RSUD Dr. Soetomo, Surabaya. Several variables used in this study were gender, age, weight, height, body mass index (BMI), other diseases, physical activity, mood, and sarcopenia. There were 25 elderly patients at the Medical Rehabilitation Outpatient Department at RSUD Dr. Soetomo, Surabaya in November 2022”January 2023 which met the research inclusion criteria. The age of elderly patients at the Medical Rehabilitation Outpatient Department at RSUD Dr. Soetomo ranged from 60”81 years old, with an average of 60.48 years old. Female is the most common gender among the elderly patients at the Medical Rehabilitation Outpatient Department RSUD Dr. Soetomo, there are 17 (68%) female elderly patients. 80% of the elderly patients were in the young elderly group (60”69 years old), 16% in the middle elderly group (70”79 years old), and 4% in the old elderly group (≥80 years old). Age, gender, other diseases, and physical activity are risk factors that have a significant correlation with sarcopenia among elderly patients at the Medical Rehabilitation Outpatient Department RSUD Dr. Soetomo.

Effects of tauroursodeoxycholate on arsenic-induced hepatic injury in mice: A comparative transcriptomic analysis

BackgroundProlonged exposure to excessive arsenic (As) and its compounds can cause damage to multiple systems, including respiratory, cardiovascular, immune, nervous, and endocrine systems. Manifestations include changes in skin pigmentation, excessive keratosis on palms and soles, gastrointestinal symptoms, and anemia. The liver as an important detoxification organ of the body, is a significant target organ for arsenic toxicity, and liver diseases are common. So far, the molecular mechanism has not been fully elucidated. Evidence suggests that taurodeoxycholic acid (TUDCA) has a protective role in arsenic-induced liver injury. This study aims to reveal potential target genes at the transcriptional level following TUDCA intervention, providing insights for the intervention of arsenic-induced liver injury. MethodsThe TUDCA intervention model of arsenic liver injury in C57BL/6 N mice was established. The experiment was divided into two phases and lasted for 24 weeks. The phase I trial (12 weeks) was divided into control, low, middle and high groups according to the dose of As. The phaseⅡtrial (12 weeks) was administered in combination with 10 mg/L sodium arsenite (the first stage high arsenic group) and TUDCA, so subsequent groups was named with H indicating high arsenic. Divide into four groups: control group(C), TUDCA solvent control group(H-Vehicle), TUDCA combined with As group(H-TUDCA), arsenic group (As). As was ingested through free water and TUDCA was administered to mice by gavage at a dose of 0.1 mL/10 g.b.w (100 mg/kg) once a day for 12 weeks. The differential expression gene (DEG) profile was obtained from the second batch of mouse liver tissues by RNA sequencing technology. Comparative transcriptomic analysis methods were used to identify co-varying DEGs between arsenic induction and TUDCA intervention, along with their associated pathways. QRT-PCR was utilized for validation. ResultsTranscriptome results showed that 487 DEGs were identified after arsenic induction. TUDCA intervention identified 231 DEGs (p-values < 0.05 and | log2(fold change) | > 1). The comparison of "AS vs C" and "H_TUDCA vs AS" identified 65 covariant DEGs, and further screened the TUDCA pathways and related genes among these genes，six pathways and 11 genes (Ccl21a, Ccr7, Mdm2, Slc2a4, Akr1b7, Pnpla3, Dusp8, Hspa1a, Cyp7a1, Cybrd1, Trpm6) were obtained. Next, we screened for covariant DEGs among the top 50 potential hub genes in arsenic-induced DEGS, and obtained 7 (Hbb-bs, Hspa1a, Mdm2, Slc2a4, Ptk6, Egr1, and Dusp8). Finally, the intersection of Hub gene and pathway gene was selected as the target genes Dusp8, Hspa1a, Mdm2 and Slc2a4. The sequencing results showed that the mRNA expressions of Dusp8, Hspa1a and Mdm2 were significantly increased after arsenic induction, while the expression of Slc2a4 was significantly decreased (P<0.05). Conversely, TUDCA intervention reversed these DEGs changes, consistent with QRT-PCR validation results. ConclusionThis study contributes to understanding the potential health effects of arsenic-induced liver injury, identifying new potential targets, and providing references for TUDCA intervention.

Adaptivity or agency? Educational technology design for conceptual learning of materials science

AbstractAs the use of computers in education increases, adaptive learning platforms are becoming more common. However, these adaptive systems are typically designed to support acquisition of declarative knowledge and/or procedural fluency but rarely address conceptual learning. In this work, we developed the Crystallography Adaptive Learning Module (CALM) for materials science to provide students a tool for individualized conceptual learning. We used a randomized quasi‐experimental design comparing two instructional designs with different levels of computer‐provided direction and student agency. Undergraduate students were randomly assigned to one of two different instructional designs; one design had students complete an individualized, adaptive path using the CALM (N = 80), and the other gave students the freedom to explore CALM's learning resources but with limited guidance (N = 85). Within these two designs, we also investigated students among different cumulative grade point average (GPA) groups. While there was no statistically significant difference in the measure of conceptual understanding between instructional designs or among the groups with the same GPA, there is evidence to suggest the CALM improves conceptual understanding of students in the middle GPA group. Students using CALM also showed increased participation with the interactive learning videos compared to the other design. The number of videos watched in each instructional condition aligns with overall academic performance as the low GPA group received the most assigned supplements but watched the least videos by choice. This study provides insight for technology developers on how to develop educational adaptive technology systems that provide a proper level of student agency to promote conceptual understanding in challenging STEM topics.

Correlation of aortic root dimensions and mortality in acute heart failure: A nationwide prospective cohort study

BackgroundAn association between increased aortic root dimensions (ARD) and elevated risk of cardiovascular mortality has been reported in the general population. However, evidence regarding the association between ARD and mortality in patients with acute heart failure (AHF) is limited. MethodsIn a nationwide prospective cohort of the China Patient-Centered Evaluative Assessment of Cardiac Events Prospective Heart Failure Study, ARD was measured during diastole using echocardiography and indexed to body mass index (BMI). Cox proportional hazard models were used to validate the association between BMI-indexed ARD and mortality. Additionally, the relationship between BMI-indexed ARD and mortality was presented using restricted cubic spline in all populations, and both sexes. ResultsA total of 2125 participants with ARD were included in the final analysis, among of 38.4 % were women, with a median age of 67 years. Over a median follow-up period of 54.4 (interquartile range: 30.1 to 59.7) months, 895 deaths occurred, with 750 attributed to cardiovascular causes and 145 to non-cardiovascular causes. Compared to the highest tertile group of BMI-indexed ARD, the lowest tertile group had a lower risk of cardiovascular mortality (hazard ratio [HR], 0.71; 95 % confidence interval [CI], 0.58 to 0.87; P < 0.001) and all-cause mortality (HR, 0.68; 95 % CI, 0.56 to 0.81; P < 0.001). Similarly, the middle tertile group also had a lower risk of cardiovascular mortality (HR, 0.78; 95 % CI, 0.65 to 0.93; P = 0.007) and all-cause mortality (HR, 0.75; 95 % CI, 0.63 to 0.89; P < 0.001). Considering the competing risks, the lowest BMI-indexed ARD groups showed a significant mortality risk of cardiovascular mortality in all populations, and both sexes. Moreover, the relationship between BMI-indexed ARD and mortality was linear in males, while a “J” shaped relationship was observed in females. ConclusionLower BMI-indexed ARD was associated with a decreased risk of all-cause and cardiovascular mortality than those with higher BMI-indexed ARD in AHF. Additionally, a discrepancy was observed between the sexes in the relationship between BMI-indexed ARD and mortality. These findings contribute to the prompt identification of potential mortality risks in patients with AHF.

Gender differences in major depressive disorder at different ages: a REST-meta-MDD project-based study

BackgroundMajor depressive disorder (MDD) is a highly heterogeneous disease, with differences in clinical manifestations among depression patients based on onset ages and genders. The neural mechanisms underlying these differences remain unclear. In this study, we utilized resting state functional imaging data from a large sample database and adopted the ReHo method to investigate gender differences in local brain function in MDD patients across different onset age groups.MethodsThe study included 364 MDD patients and 695 healthy participants who were part of the REST-meta-MDD project. Regional homogeneity (ReHo) assessed gender disparities in MDD and healthy individuals within groups delineated by gender and onset age (young group: 18–29 years; middle-aged group: 30–45 years).ResultsAmong the young MDD groups, there were significant gender differences in the right superior frontal gyrus, right inferior frontal gyrus, left superior temporal gyrus, and right superior parietal lobule, with male MDD patients having higher ReHo values compared to females. When compared to healthy males, male MDD patients exhibited elevated ReHo values in the right superior parietal lobule. In the middle-aged groups, a marked ReHo difference was observed in the bilateral cerebellum posterior lobe, with female MDD patients showing higher ReHo values.ConclusionsThe functional mechanisms of MDD differ between genders and show distinct variations across different onset age groups. These findings underscore the importance of developing personalized interventions that address the unique needs of MDD patients, tailored to their gender and age, and necessitate the development of antidepressant medications targeted at each gender-age subgroup.

Empirical study on sustainable energy development goals: Analysis of rural roof distributed photovoltaic systems in Jiangsu, China

Rural rooftop distributed photovoltaic systems (RRDPVS) play a crucial role in China's energy strategy to achieve sustainable development goals (SDGs). Over the past years, RRDPVS have experienced rapid development in China. This study focuses on identifying relevant factors and analyzing their influence on the growth of RRDPVS in Jiangsu Province. Based on county-level panel data spanning 39 months across 64 countries, an empirical model is built for analyzing the newly installed capacity of RRDPVS with the consideration of local natural resources and socio-economic conditions. It is a cross-disciplinary study in the field of economics and energy. In summary, natural resource factors have less influence and socio-economic factors have more influence on the newly installed capacity of RRDPVS at this stage. The results of regression models show that elements of natural endowment, such as solar resources, air temperature and air quality index PM2.5 have insignificant effects on the amount of newly installed capacity. The absence of government strategic guidance has resulted in the indiscriminate construction of RRDPVS in low-quality status. The results of the analyses from the socio-economic perspective show that most rural residents installed RRDPVS are the low-income group, whereas middle- and upper-income residents are less interested in installation. It is necessary to appropriately raise public awareness of the use of clean and low-carbon green energy, in order to expand the audience of RRDPVS and increase the penetration rate of the system among middle and high-income groups. The finding of this study offers insights into establishing a robust policy framework for renewable energy utilization to achieve SDGs, and promotes feasible solutions for the transformation of rural photovoltaics in China and other developing countries.

The risk of long-term opioid use among immigrants: a national registry-linkage study.

We aimed to investigate the association between being an immigrant and long-term prescription opioid use in Norway in 2010-2019. Nested case-control study. The cases were all persons 18 years of age or older with long-term opioid use - that is, the use of prescription opioids longer than 3 months (N=215,642). Cases were matched to four controls who filled at least one opioid prescription, but never developed long-term opioid use in the study period (N=862,568) on sex, age and year of starting long-term/short-term opioid use. Being an immigrant was defined as being born outside of Norway to two foreign-born parents and four foreign-born grandparents. Adjusting for socioeconomic variables and clinical confounders, analyses were stratified on three age groups (18-44 years, 45-67 years and ⩾68 years). For the youngest age group, being an immigrant was inversely associated with long-term opioid use (adjusted odds ratio 0.75; 95% confidence interval [0.72-0.77]) compared with being native-born people. For this age group, the odds ratio differed between people born in Africa (0.56 [0.52-0.62]), Central or South America (0.70 [0.62-0.79]), Europe outside the European Union (EU) (0.71 [0.65-0.77]), Asia including Turkey (0.80 [0.77-0.84]) and EU/European Economic Area (EEA) (0.81 [0.77-0.85]). For the middle age group, increased odds were found for immigrants versus natives (1.05 [1.02-1.08]) in particular for those born in North America (1.26 [1.13-1.40]) and the EU/EEA (1.13 [1.09-1.18]). There was no association in the oldest group. Compared with native-born people, immigrants had lower odds of long-term opioid use among younger adults, higher odds among middle-aged and similar odds among older adults.

Long-term clinical recovery and treatment resistance in first-episode psychosis: a 10-year follow-up study

Illness trajectories in people with first-episode psychosis (FEP) vary significantly over time. Identifying early-course parameters predicting outcomes is essential, but long-term data still needs to be provided. We conducted a 10-year follow-up study of a comprehensive first-episode psychosis (FEP) cohort investigating the prevalence of clinical recovery (CR) and treatment resistance (TR) after ten years, as well as clinical, demographic, and pre-illness predictors of long-term outcomes. 102 participants with FEP DSM-IV Schizophrenia spectrum disorders were recruited within their first year of treatment. The Treatment Response and Resistance in Psychosis Working Group (TRRIP) and the Remission in Schizophrenia Working Group (RSWG) criteria were used to define TR and CR, respectively. At 10-year follow-up, 29 (29%) of the participants were classified as in CR, while 32 (31%) were classified as TR. We also identified a larger middle group (n = 41, 40%) consisting of participants in partial recovery. 7% of all participants had tried Clozapine at the 10-year follow-up. Logistic regression analyses identified insidious onset (OR = 4.16) and baseline disorganized symptoms (OR = 2.96) as significantly associated with an increased risk of developing TR. Good premorbid academic adjustment (OR = 1.60) and acute onset (OR = 3.40) were associated with an increased chance of CR. We identified three long-term outcome groups by using recent consensus definitions. We also identified the potential importance of assessing baseline disorganized symptoms and monitoring patients with insidious onset more closely. Further, the findings suggest that clinicians should pay close attention to early-course parameters and provide adequate treatment to improve long-term outcomes of FEP.

Serum Magnesium and Glycemic Status in Newly Diagnosed T2DM Patients in Tertiary Care Hospital of Bangladesh

Background: Diabetes mellitus is a major global health issue. Trace elements play important role as co-factors for various events in this context. Recently, an inverse relationship between serum magnesium and glycemic control has been observed and magnesium is thought to be low in with type-2 diabetes mellitus (T2DM). Objective: This study aimed to see serum magnesium and HbA1c in newly diagnosed T2DM. Methodology: This cross-sectional study included 100 newly detected diabetes subjects (age: 40.65±11.65 years, mean ± SD; m/f: 35/65) diagnosed according to American Diabetic Association (ADA) 2016 diagnostic criteria for diabetes. 5 ml of blood was collected for serum magnesium and HbA1c measurement by utilizing atomic absorption Spectrometricanalysis and NGSP certified Bio-Rad D-10TM Hemoglobin A1c Program 220-0101 USA. All data were analyzed by SPSS (version 22.0). Results: Magnesium and HbA1c were 1.99±0.23 mg/dl and 8.65±2.18% (mean±SD). About 9% were hypomagnesemic and 91% eumagnesemic. Socioeconomically 50% were middle income group, family history was present in 48% and 11% had history of smoking. Magnesium (meanSD) was statistically similar between males and females (1.99±0.22 vs. 1.99±0.24 mg/dl, p=0.974), urban and rural subjects (1.98±0.24 vs. 1.99±0.22 mg/dl, p=0.754), subjects with or without family history of diabetes (1.95±0.22 vs. 2.02±0.23 mg/dl, p=0.117), in subjects with BMI &lt;25 Kg/m2 and 25 Kg/m2 (2.01±0.25 vs. 1.98±0.22 mg/dl, p= 0.526) as well as among various HbA1c cut-off values (&lt;6.5 vs. 6.5− 9 vs. &gt;9%: 2.08 ±0.15 vs. 1.98±0.24 vs. 1.99±0.23; p=0.257). However, magnesium level was statistically and significantly different among the age groups (&lt;25 yrs vs. 25-34 yrs vs. 35-44 yrs vs. 45-54 yrs vs. 55 yrs: 1.91±0.28 vs. 2.00±0.23 vs. 1.93±0.20 vs. 1.96±0.26 vs. 2.16±0.13 mg/dl, meanSD; p= 0.018). None of the variables showed any correlation with magnesium except age (r=0.220, p=0.028) nor any was significant independent predictor for hypomag

Discussion on the relationship between pathological changes of sciatic nerve and Sarm1 protein expression in rats with n-hexane poisoning

Objective: To explore the potential evidence of active peripheral nerve necrosis when n-hexane produces toxic effects on peripheral nerves. Methods: In May 2023, 36 SPF grade SD male rats with a body weight of 200-220 g were divided into 4 groups with 9 rats in each group and given normal saline and different doses of n-hexane (168, 675, 2 700 mg/kg) by gavage for 6 consecutive weeks (5 days/week). Three rats in each group were killed at the 2nd, 4th and 6th week, respectively. The spinal cord to sciatic nerve tissue was broken and the supernatant was extracted for SDS-PAGE protein isolation. The expression level of Sarm1 protein was analyzed with the β-Actin color strip of internal reference protein by Western blot. The expression of Sarm1 protein was analyzed by the gray ratio of the two. At the 6th week, the sciatic nerve sections of the each group were observed by light microscope and electron microscope. Results: The number of axons was obviously reduced by light microscopy. According to electron microscope, myelin lesions were mainly local disintegration, deformation, and different thickness. The deformation of axonal surface became smaller. The axons in the nerve bundle membrane showed degeneration and reduction. The gray ratio of Sarm1 protein and internal reference protein bands in each group had no significant change at the second week of exposure, and the ratio of SARM1 protein to internal reference protein bands was 1.47 in the high dose group at the fourth week, and 1.51 and 1.89 in the middle and high dose group at the sixth week, respectively. Conclusion: Waller's degeneration was observed in sciatic neuropathologic manifestations of n-hexane-poisoned rats, and the expression level of Sarm1 protein increased.

A Comprehensive Ultrasound Investigation of Lower Facial and Neck Structure.

The jawline and neck significantly influence facial aesthetics. Botulinum toxin and filler are highly favored as minimally invasive jawline rejuvenation procedures. However, little evidence exists on the age-related skin and superficial fat tissue transformations in healthy individuals to guide targeted interventions. A quantitative sonographic assessment was conducted on 51 patients. Total soft tissue thickness (the skin and superficial fat compartments) was measured at eight sites along the jawline and four sites at the neck. Among them, 21 patients received botulinum toxin A (BTX-A) injections for jawline lift. Three-dimensional images and questionaries were obtained before and after the treatment. In this ultrasound study, total superficial soft tissue thickness decreased significantly from the prejowl sulcus to the lateral cheek, with the jowl showing the greatest thickness. Vertically, significant differences in thickness were noted between superior and inferior points, especially at the inferior prejowl sulcus for the middle-aged and the jowl for the elderly group when comparing across age groups. Soft tissue thickness at the neck decreased from zones 1 to 3, consistent in all age groups. BMI and age positively correlated with soft tissue thickness at the jawline and neck. Regarding BTX-A injections, participants described a pain-free injection process, of which 85.7% reported substantial aesthetic improvement and sharpening of the submental-cervical angle. This study quantified age-related changes in superficial soft tissues at the jawline and neck regions with ultrasound imaging. With aging, soft tissue thickness alters with high region-specificity. Tailoring interventions to the specific alterations within each age group can achieve optimal results with enhanced safety. This study provided a quantitative analysis of skin and superficial fat compartment thicknesses for the young, middle-aged, and elderly groups. This study illustrated how skin and superficial fat compartments change with age in a regionally specific manner for both the jawline and neck regions. This study revealed a positive association between BMI and age with skin and superficial fat tissue thicknesses, especially in areas like the jowl, submental, and neck. This study provided guidance for a safe and effective botulinum toxin. A injection method focusing on the injection depths and regions to achieve optimal jawline rejuvenation outcomes and patient experience. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Correlation between psychological traits and the use of smart medical services in young and middle-aged adults: An observational study

BACKGROUND Psychological problems affect economic development. However, there is a huge gap between mental health service resources and mental health service needs. Existing mental health service technology and platforms cannot meet all the diverse mental health needs of people. Smart medicine is a new medical system based online that can effectively improve the quality and efficiency of medical services and make mental health services accessible. AIM To explore the level of intelligent medical use among young and middle-aged people and its correlation with psychological factors. METHODS Convenience sampling was used to select 200 young and middle-aged patients with medical experience at the Third People's Hospital of Chengdu between January 2022 and January 2023 as the research subjects. The general condition Questionnaire, Eysenck Personality Questionnaire, Symptom Checklist-90, General Health Questionnaire, and Smart Medical Service Use Intention Questionnaire were used to collect data. Pearson’s correlation was used to analyze the correlation between the participants’ willingness to use smart medical services and their personality characteristics, psychological symptoms, and mental health. RESULTS The results revealed that the mental health of young and middle-aged people was poor, and some had psychological problems such as anxiety, depression, and physical discomfort. Familiarity, acceptance, and usage of smart healthcare in this population are at a medium level, and these levels correlate with psychological characteristics. Acceptance was positively correlated with E, and negatively correlated with P, anxiety, fear, anxiety/insomnia, and social dysfunction. The degree of use was negatively correlated with P, obsessive-compulsive symptoms, depression, anxiety, hostility, paranoia, and somatic symptoms. CONCLUSION The familiarity, acceptance, and usage of smart medical services among the middle-aged and young groups are related to various psychological characteristics.