Q1 Q4 Research Articles

Definition of a drilling protocol for mini dental implants in different bone qualities

Mini dental implants (MDI) have proven to be a good alternative of the conventional implants to support lower overdentures in elderly edentulous patients with narrow residual ridge. The aim of the present study was to define drilling protocols for each diameter of the MDI in each bone quality. The number and the diameter of the drilling bur and the drilling depth was investigated.A total of 48 MDIs with a ball head and transgingival collar were used to the drilling protocol in four different bone qualities (Q1–Q4). All available four diameters of the implants were included: 1.8mm, 2.1mm, 2.4mm, and 2.9mm. The length of all implants was 15mm. Three different protocols were prepared for each of the four bone qualities and for each implant diameter. The insertion torques and the primary stability of the implants were measured in their final position.Regardless of implant diameter and bone quality, the insertion torque was significantly higher using drilling protocol 1 than 3 and using drilling protocol 2 than 3 as well. The insertion torque was significantly higher in bone quality Q1 than in Q2–Q4. The unscrewing resulted in considerably increase in the torque, which exceeded the insertion torques by up to two times. This repeatedly led to the bending and fractures of implants.

3D-printed Surgical Training Model Based on Real Patient Situations for Dental Education.

Background: Most simulation models used at university dental clinics are typodonts. Usually, models show idealized eugnathic situations, which are rarely encountered in everyday practice. The aim of this study was to use 3D printing technology to manufacture individualized surgical training models for root tip resection (apicoectomy) on the basis of real patient data and to compare their suitability for dental education against a commercial typodont model. Methods: The training model was designed using CAD/CAM (computer-aided design/computer-aided manufacturing) technology. The printer used to manufacture the models employed the PolyJet technique. Dental students, about one year before their final examinations, acted as test persons and evaluated the simulation models on a visual analogue scale (VAS) with four questions (Q1–Q4). Results: A training model for root tip resection was constructed and printed employing two different materials (hard and soft) to differentiate anatomical structures within the model. The exercise was rated by 35 participants for the typodont model and 33 students for the 3D-printed model. Wilcoxon rank sum tests were carried out to identify differences in the assessments of the two model types. The alternative hypothesis for each test was: “The rating for the typodont model is higher than that for the 3D-printed model”. As the p-values reveal, the alternative hypothesis has to be rejected in all cases. For both models, the gingiva mask was criticized. Conclusions: Individual 3D-printed surgical training models based on real patient data offer a realistic alternative to industrially manufactured typodont models. However, there is still room for improvement with respect to the gingiva mask for learning surgical incision and flap formation.

Women in contemporary cancer research.

Despite recent advances, gender inequality persists in many scientific fields including medicine. Thus far, no study has extensively analyzed the gender composition of contemporary researchers in the oncology field. We examined 40 oncological journals (Web of Science, Oncology category) with different impact factors (Q1-Q4) and extracted all the articles and reviews published during 2015-2017 in order to identify the gender of their authors. Our data showed that women represent about 38% of all the authorships, both in articles and reviews. In relative terms, women are overrepresented as first authors of articles (43.8%), and clearly underrepresented as last or senior authors (<30%). This double pattern, also observed in other medical fields, suggests that age, or more specifically, seniority, may play some role in the gender composition of cancer researchers. Examining the pattern of collaboration, an interesting finding was observed: the articles signed by a woman in the first or in the last position roughly showed gender parity in the byline. We also found some differences in the content of the articles depending on which gender occupies the first and last positions of the authorships.

Low alanine aminotransferase levels predict low muscle strength in older patients with diabetes: A nationwide cross-sectional study in Korea.

Low alanine aminotransferase (ALT) level is associated with frailty in the older adult population. We investigated the usefulness of ALT in predicting low muscle strength among older patients with diabetes. We included 550 men aged ≥50 years and 525 postmenopausal women. All participants had diabetes, and data were based on the 2014-2016 Korea National Health and Nutrition Examination Survey. Participants with ALT levels confounded by hepatic causes or who had a cerebrovascular accident were excluded. The accompanying metabolic disorders and the associated parameters were evaluated. Low muscle strength was defined as handgrip strength below the Korean-specific cut-off value. In men and women, when ALT level was divided into quartiles (Q1-Q4), a positive correlation between ALT and body mass index, triglycerides, fasting plasma glucose, glycated hemoglobin levels and handgrip strength was observed, whereas a negative correlation was observed with age and duration of diabetes (P < 0.05, all). After adjusting for age, sex, protein intake, aerobic exercise, body mass index, duration of diabetes, glycated hemoglobin and triglycerides, the lower ALT quartiles ([Q1 and Q2) showed a higher risk for low muscle strength compared with Q4 (OR 2.123 and 2.437; P = 0.060 and 0.029). The cut-off ALT level for low muscle strength was 18.5 IU/L. Older patients with diabetes with ALT levels below low-to-normal should not be considered metabolically healthy. Clinicians should pay special attention to the risk of low muscle strength in individuals with ALT levels of ≤18.5 IU/L, independent of any associated metabolic disorders. Geriatr Gerontol Int 2020; 20: 271-276.

Associations between Triglyceride-Glucose Index and Micro- and Macro-angiopathies in Type 2 Diabetes Mellitus.

The aim of this study was to investigate the associations between the triglyceride-glucose (TyG) index, a marker of insulin resistance, and microangiopathies and macroangiopathies in patients with type 2 diabetes mellitus (DM). Our study enrolled 1990 type 2 diabetic patients from local hospitals in Taiwan during the period of 2002–2004. Multivariate logistic regression analysis was used to identify the factors related to microangiopathies, macroangiopathiess and TyG index. The patients were stratified by TyG index quartile (Q1–Q4). Adjusted odds ratios (aORs) of albuminuria for Q3 versus Q1 and Q4 versus Q1 were 1.424 (95% confidence interval [CI], 1.062–1.910, p = 0.018) and 1.948 (95% CI, 1.437–2.642, p < 0.001), respectively. The aOR of cerebrovascular disease (CVA) was 2.264 for Q4 versus Q1 (95% CI, 1.243–4.122, p = 0.008), but there were no significant associations with diabetic retinopathy (DR), coronary artery disease (CAD) or peripheral artery occlusive disease (PAOD). Significant stepwise increases were found in CVA (p = 0.0013) and albuminuria ≥30 mg/g (p < 0.001) corresponding to TyG index quartiles, but not DR (p = 0.573), CAD (p = 0.880) or PAOD (p = 0.223). There was a significant association between a high TyG index and a high risk of microalbuminuria and CVA in the study cohort. Further studies to investigate the use of medications in patients with DM to prevent micro- and macro-angiopathies are thus warranted.

Lung function as a predictor of incident type 2 diabetes in community-dwelling adults: A longitudinal finding over 12 years from the Korean Genome and Epidemiology Study

AimReduced lung function is associated with type 2 diabetes (T2D), but there are limited data in East Asian populations on the relationship between them. For this reason, this study investigated the longitudinal relationship of lung function with incident T2D in Korean adults. MethodsThe study included 7583 non-diabetic adults aged 40–69 years from the Korean Genome and Epidemiology Study. Participants were divided into four groups according to gender-specific quartiles (Q1–Q4) of %PFVC and %PFEV1. Also, HRs with 95% CIs for incident T2D were prospectively analyzed as per American Diabetes Association criteria using multivariate Cox proportional-hazards regression models. ResultsDuring a 12-year follow-up, 1403 (18.5%) participants presented with newly developed T2D. HRs (95% CIs) of incident T2D in Q1 vs. Q4 (reference) of %PFVC were 1.67 (1.35–2.07) for men and 1.77 (1.39–2.24) for women and, of %PFEV1, 1.58 (1.28–1.95) for men and 1.61 (1.27–2.03) for women, after adjusting for age, waist circumference, smoking status, alcohol intake, regular exercise, education levels, monthly household income, family history of diabetes, HOMA-IR, triglycerides, HDL cholesterol and high-sensitivity C-reactive protein levels. ConclusionReduced lung function precedes and significantly predicts the future development of T2D independently of obesity, smoking and inflammation in community-dwelling middle-aged and elderly people.

Influence of PM2.5 Exposure Level on the Association between Alzheimer's Disease and Allergic Rhinitis: A National Population-Based Cohort Study.

Alzheimer’s disease (AD) is an irreversible neurodegenerative disease that leads to dementia, health impairment, and high economic cost. Allergic rhinitis (AR) is a chronic inflammatory and allergic disease of the respiratory system that leads to health problems and has major effects on the daily lives of patients and their caregivers. Particulate matter (PM) refers to air pollutants 2.5 μm or less in diameter that are a source of concern because of their role in numerous diseases, including AR and other neurodegenerative diseases. To date, no study has demonstrated how PM2.5 exacerbates AR and results in AD. We conducted a national population-based cohort study by obtaining patient data from the National Health Insurance Research Database of Taiwan for the 2008–2013 period. PM2.5 concentration data were obtained from the ambient air quality monitoring network established by the Environmental Protection Administration of Taiwan. Monthly PM2.5 exposure levels were categorized into quartiles from Q1–Q4. The Cox proportional hazards analysis, after adjusting for age, sex, low income, and urbanization level, revealed that patients with AR had an elevated risk of developing AD (hazard ratio (HR): 2.008). In addition, the cumulative incidence of AD in the AR group was significantly higher than in the comparison group. The PM2.5 levels at Q2–Q4 (crude HR: 1.663–8.315; adjusted HR: 1.812–8.981) were stratified on the basis of the PM2.5 exposure group and revealed that AR patients exposed to PM2.5 are significantly prone to develop AD. In addition, the logistic regression analyses, after adjustment, demonstrated that an increase in the PM2.5 exposure level at Q2–Q4 (adjusted odds ratio (OR): 2.656–5.604) increased the risk of AR in AD patients. In conclusion, an increased PM2.5 exposure level could be correlated with AR, which could in turn cause AD. AR increased the risk of AD, in which exposure to PM2.5 increases the higher probability of AD.

Is Long-term Ambient Air Pollutant Exposure a Risk Factor for Irritable Bowel Syndrome in Children? A 12-year Longitudinal Cohort Study.

Background/AimsRecent studies suggest that air pollution may play a role in gastrointestinal disorders. However, the effect of long-term exposure to air pollution on childhood irritable bowel syndrome (IBS) is unclear. Hence, we conducted a nationwide cohort study to investigate the association between long-term air pollution exposure and the incidence and risk of IBS in Taiwanese children during 2000–2012.MethodsWe collected data from the Taiwan National Health Insurance Research Database, linked to the Taiwan Air Quality-Monitoring Database according to the insurant living area and the air quality-monitoring station locations. Children < 18 years old, identified from January 1st, 2000, were followed-up until IBS diagnosis or December 31st, 2012. The daily average air pollutant concentrations were categorized into 4 quartile-based groups (Q1–Q4). We measured the incidence rate, hazard ratios (HRs), and 95% confidence intervals for IBS stratified by the quartiles of air pollutant concentration.ResultsA total of 3537 children (1.39%) were diagnosed with IBS within the cohort during the follow-up period. The incidence rate for IBS increased from 0.84 to 1.76, from 0.73 to 1.68, from 0.85 to 1.98, and from 0.52 to 3.22 per 1000 person-years, with increase in the carbon monoxide, nitrogen dioxide, non-methane hydrocarbon, and methane quartile (from Q1 to Q4) exposure concentration, respectively. The adjusted HR for IBS increased with elevated carbon monoxide, nitrogen dioxide, non-methane hydrocarbon, and methane exposure in Q4 to 1.98, 2.14, 2.19, and 5.87, respectively, compared with Q1.ConclusionLong-term ambient air pollutant exposure is an environmental risk factor for childhood IBS.

Calculated Serum Osmolality, Acute Kidney Injury, and Relationship to Mortality after Percutaneous Coronary Intervention

Background: Data on the associations between serum osmolality (sOsmo) and acute kidney injury (AKI) as well as short- and long-term mortality in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) are limited. Objectives: To investigate the association between sOsmo and development of AKI and clinical outcomes in patients undergoing PCI. Methods: We investigated 1,927 consecutive patients undergoing PCI from the registry of a single center. Patients were divided into quartiles according to sOsmo at admission (Q1–Q4). sOsmo was calculated using the following equation: (1.86 × serum sodium [mmol/L]) + (glucose [mg/dL] / 18) + (blood urea nitrogen [mg/dL] / 2.8) + 9. The primary endpoint was AKI, per Kidney Disease: Improving Global Outcomes (KDIGO) definition. The secondary endpoints were 30-day and 1-year all-cause mortality. Results: Patients with the highest sOsmo (Q4) were older and more likely female, with significantly more cardiovascular risk factors and comorbidities compared to those with lower sOsmo (Q1–Q3). Incidence of AKI was highest in Q4 and lowest in Q2. In the multivariate logistic regression model, high sOsmo independently predicted the development of AKI (OR 2.00, 95% CI 1.26–3.19, p = 0.003). Patients with Q4 had a higher risk of 1-year mortality compared to patients with Q2 (HR 2.11, 95% CI 1.10–4.15; p = 0.031), but not after adding AKI to the multivariate model (HR 1.71, 95% CI 0.87–3.39; p = 0.12). Conclusion: sOsmo is a valid and easily obtainable predictor of AKI after PCI. High sOsmo is associated with increased risk of AKI and 1-year mortality in patients undergoing PCI. Further research is warranted to clarify whether the use of an sOsmo-directed hydration protocol might reduce the incidence of AKI in patients undergoing PCI.

The Relationships between Thyroid Hormone Levels and Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia.

PurposeWe examined the association between thyroid hormone and lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH).Materials and MethodsA total of 5,708 middle aged men were included. LUTS/BPH were assessed using the international prostate symptom score (IPSS), total prostate volume (TPV), maximal flow rate (Qmax), and a full metabolic workup. Thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels were measured using chemiluminescence immunoassay. We divided participants into quartiles based on their TSH and FT4 levels: first to fourth quartile (Q1–Q4).ResultsThere was a significant increase in the percentage of men with IPSS>7, Qmax<10 mL/s, and TPV≥30 mL with increase of FT4 quartile. The adjusted odds ratio (OR) for TPV≥30 mL and IPSS>7 were significantly different between FT4 quartile groups (ORs; [5–95 percentile interval], p; TPV≥30 mL, Q1: 0.000 [references]; Q2: 1.140 [0.911–1.361], p=0.291; Q3: 1.260 [1.030–1.541], p=0.025; Q4: 1.367 [1.122–1.665], p=0.002; IPSS>7: Q1: 0.000 [references]; Q2: 0.969 [0.836–1.123], p=0.677; Q3: 1.123 [0.965–1.308], p=0.133; Q4: 1.221 [1.049–1.420], p=0.010). In men with above median levels of testosterone, the FT4 correlated positively with TPV, even after adjusting for confounders. However, the FT4 was not correlated with TPV in men with below median levels of testosterone. TSH was not related to LUTS/BPH measurements.ConclusionsTPV, IPSS, and Qmax were significantly related to FT4. TPV and IPSS were significantly and independently related to FT4. Additionally, the relationship between FT4 and TPV was distinct when testosterone levels are high.

Intra-seasonal variation of injury patterns among German Bundesliga soccer players

ObjectiveHigh fluctuations in injury-risk during the playing season in soccer have been reported. As seasons are structured in periods with homogenous loads and intensities, we investigated injury-risk over season periods, contrarily to previous studies adopting a month-based approach. DesignCohort study; Level of evidence, 2. MethodsIncidence-rate ratios (IRRs) for match and training injuries were compared across six consecutive seasons of German Bundesliga, divided into six periods each: Pre-season (PS), winter-break (WB), quarter 1–4: (Q1–Q4). ResultsSignificant variations in injury-risk were observed for match and training injuries. IRRs in matches was 1.30 (95% CI: 1.11–1.53) times higher in Q3 and 1.53 (95% CI: 1.31–1.78) higher in Q4 compared to Q1. For training injuries, IRR peaked in Q1 and Q3 followed by a marked decrease in each subsequent quarter. Compared to Q4, IRR was 1.62 (95% CI: 1.40–1.86) times higher during Q3 and 1.78 (95% CI: 1.53–2.07) times higher in Q1. IRR was significantly higher in the competitive season compared to pre-season across match (IRR: 2.00, 95% CI: 1.30–3.00) and training (IRR: 1.27, 95% CI: 1.11–1.43) injuries. ConclusionsThe increased match IRRs later during the season indicate that, in practice, coaches should consider putting even more emphasis on recovery in the last part of the season. Moreover, training injuries seem to indicate a carry-over effect. Further studies need to investigate how training during preparatory phases can be implemented in a way that prevents injuries during the competitive season.

Follicular fluid humanin concentration is related to ovarian reserve markers and clinical pregnancy after IVF-ICSI: a pilot study.

Is humanin present in the human ovary and follicular fluid? What relationship exists between humanin concentration in the follicular fluid and ovarian reserve and clinical outcomes after IVF and intracytoplasmic sperm injection (ICSI)? Follicular fluid samples were collected from 179 patients undergoing their first IVF or ICSI cycle during oocyte retrieval. Ovarian tissues were collected from two patients undergoing surgery for ovarian cysts. Ovarian humanin localization was analysed using immunofluorescence staining. Expression of humanin in granulosa cells was confirmed by reverse transcription polymerase chain reaction (RT-PCR) analysis. Follicular fluid humanin levels were evaluated with enzyme-linked immunosorbent assay. Relationships between follicular fluid humanin levels and ovarian reserve markers and clinical outcomes were analysed. Strong humanin expression was found in the granulosa cells, oocytes and stromal cells of the ovary. Agarose gel electrophoresis of RT-PCR products showed rich humanin mRNA expression in human granulosa cells (119 bp). Follicular fluid humanin concentrations ranged from 86.40 to 417.60 pg/ml. They significantly correlated with FSH (r = -0.21; P < 0.01), LH (r = -0.18; P = 0.02), antral follicle count (r = 0.27; P < 0.01), anti-Müllerian hormone (r = 0.24; P = 0.03) and inhibin B (r = 0.46; P < 0.01) levels. Patients were subdivided into four groups according to follicular fluid humanin concentration quartiles (Q1-Q4). Patients in Q4 were more likely to achieve a pregnancy than Q1 (OR = 3.60; 95% CI 1.09 to 11.84). Humanin concentration in the follicular fluid was positively associated with ovarian reserve and clinical pregnancy rate.

Association Between Intake of Red and Processed Meat and Survival in Patients With Colorectal Cancer in a Pooled Analysis

Red and processed meat intake is associated with colorectal cancer (CRC) incidence, but it is not clear if intake is associated with patient survival after diagnosis. We pooled data from 7627 patients with stage I-IV CRC from 10 studies in the International Survival Analysis in Colorectal Cancer Consortium. Cox proportional hazards regression models were used to evaluate the associations of intake of red and processed meat before diagnosis with overall and CRC-specific survival. Among 7627 patients with CRC, 2338 died, including 1576 from CRC, over a median follow-up time of 5.1 years. In multivariable-adjusted analyses, higher intake of red or processed meat was not associated with overall survival of patients with stage I-III CRC: Q4 vs Q1 red meat hazard ratio [HR], 1.08 (95% CI, 0.93-1.26) and Q4 vs Q1 processed meat HR, 1.10 (95% CI, 0.93-1.32) or with CRC-specific survival: Q4 vs Q1 red meat HR, 1.09 (95% CI, 0.89-1.33) and Q4 vs Q1 processed meat HR, 1.11 (95% CI, 0.87-1.42). Results were similar for patients with stage IV CRC. However, patients with stage I-III CRC who reported an intake of processed meat abovethe study-specific medians had a higher risk of death from any cause (HR, 1.12; 95% CI, 1.01-1.25) than patients who reported eating at or less than the median. In this large consortium of CRC patient cohorts, intake of red and processed meat before a diagnosis of CRC was not associated with shorter survival time after diagnosis, although a possible weak adverse association cannot be excluded. Studies that evaluate dietary data from several time points before and after cancer diagnosis are required to confirm these findings.

Association between nonalcoholic fatty liver disease and serum magnesium level in patients with type 2 diabetes mellitus

Objective To investigate the association between nonalcoholic fatty liver disease (NAFLD) and serum magnesium level in patients with type 2 diabetic mellitus (T2DM). Methods Clinical data of 1 273 consecutive patients with T2DM admitted in hospital from June 2013 to June 2017 were retrospectively analyzed. According to the quartile of serum magnesium levels, patients were divided into 4 groups: Q1 group (≤ 0.79 mmol/L, n=376), Q2 group (0.80-0.84 mmol/L, n=296), Q3 group (0.85-0.89 mmol/L, n=287) , and Q4 group (≥0.90 mmol/L, n=314). Logistic regression was used to analyze the association between NAFLD and serum magnesium level. Results The average age of the study population was (56.4±13.8) years, males accounted for 52.7%(671/1 273), NAFLD patients accounted for 58.4%(743/1 273). The prevalence of NAFLD in Q4, Q3, Q2 and Q1 groups was 53.8%(169/314), 52.6%(151/287), 57.4%(170/296) and 67.3%(253/376), respectively (χ2=19.00, P=0.000). Logistic regression showed that compared with the Q4 group, OR(95%CI) for NAFLD in the Q1 group was 1.49 (1.03-2.16), Ptrend=0.011 after adjusting for age, sex, duration of diabetes, BMI, systolic blood pressure, alcohol consumption, TG, glycosylated hemoglobin and serum uric acid. After further adjusting for estimated glomerular filtration rate (eGFR), OR(95%CI) for NAFLD was 1.33 (0.92-1.94) and Ptrend=0.065 in the Q1 group compared with the Q4 group. Conclusion Reduction in serum magnesium is associated with an increased risk of NAFLD in T2DM patients, and eGFR may be a confounding factor. Key words: Diabetes mellitus, type 2; Fatty liver; Magnesium, serum; Cross-sectional studies

Association of dietary macronutrient composition and non-alcoholic fatty liver disease in an ageing population: the Rotterdam Study

ObjectiveA healthy lifestyle is the first-line treatment in non-alcoholic fatty liver disease (NAFLD), but specific dietary recommendations are lacking. Therefore, we aimed to determine whether dietary macronutrient composition is associated...

The association between whole blood concentrations of heavy metals in pregnant women and premature births: The Japan Environment and Children's Study (JECS)

BackgroundHeavy metals are widely distributed in the environment. Recent reports have demonstrated the risk of preterm birth following heavy metal exposure. Preterm births are classified as early and late, depending on the duration of pregnancy, and are associated with increased risk of congenital illnesses such as heart failure, asthma, etc. Particularly, early preterm births carry a higher risk of mortality; however, the differential effects of heavy metal exposure on early and late preterm births are unknown. ObjectivesTo analyze the association between maternal whole blood concentrations of heavy metals, such as cadmium (Cd), lead (Pb), mercury (Hg), selenium (Se), and manganese (Mn) that are common toxicants in Japan, and early and late preterm births. MethodsThe data of 14,847 pregnant women who were participants of the Japan Environment and Children's Study were used. Data of the self-questionnaire pertaining to the first trimester (T1), second/third trimester (T2), and medical records after delivery were analyzed. We divided preterm birth into two groups: early preterm (22 to < 34 weeks) and late preterm (34 to < 37 weeks). Maternal blood samples for measuring heavy metal concentrations were collected in T2 (pregnancy weeks: 14–39). The participants were classified into four quartiles (Q1–Q4) according to increasing heavy metal levels. ResultsThe rate of preterm birth was 4.5%. After controlling for confounding factors, such as age, pre-pregnancy body mass index, smoking, partner's smoking, drinking habits, gravidity, parity, number of cesarean deliveries, uterine infections, household income, educational levels, and sex of infant, Cd levels were found, by multivariable logistic regression analysis, to be significantly associated with early preterm birth (p = 0.002), with odds ratio for early preterm birth of 1.91 (95% confidence interval: 1.12–3.27, P = 0.018) in subjects of Q4 compared with in subjects with term birth (≧ 37 weeks). ConclusionMaternal blood Cd levels during pregnancy are positively associated with the risk of early preterm birth among Japanese women. Identification of the main source of maternal Cd exposure may contribute to the prevention of early preterm births and health maintenance of mothers and their infants in the future.

Application of Science‒Technology‒Society Studies in Information Security Research

The research question and problem statement I posed to answer simply has been: what kind of patterns and specific discourses can be identified around the keywords of “information security” and “social construction” in information systems and its related reference fields such as social sciences, management studies, decision sciences extended to psychology. We may start summarizing the conclusions by stating that “information security” and “social construction” in the SCOPUS domain offers a wide range of literature in the social sciences and related subject areas; the initial search resulted in 406 article hits, whose basic bibliographic parameters with keywords and abstracts were downloaded. I categorized this sample according to the journals H-index, the Scimago Journal &amp; Country Rank (SJR) Q1‒Q4 ranking and the individual papers’ citations, into five—socalled structural—clusters. Three papers were identified as the highest referenced and most influential, and analysed separately. The other were clustered as follows: 30 papers were classified into CL1, a high impact cluster due to its high citation and H-index, 122 papers were grouped into CL2, a mature cluster, due to their publishing date and medium referencing, 71 papers fell into CL3, a high potential cluster, due to their high H-index and recent appearance and, finally 152 papers were clustered into CL4, the mainstream of the sample due to their medium impact and wide spread of publishing dates. These clusters were further analysed with basic text mining techniques: word counting, key word analysis, textual clusters and N-Gram analysis, and concordance analysis. I found that clusters are different as far as the academic discourse on information security evolves, and each contain unique added value to the social construction of information security amongst users, institutions, technology and public policy. Finally, conclusion and further research opportunities are presented.

High and low body mass index may predict severe disease course in children with inflammatory bowel disease

Objectives: Inflammatory bowel disease (IBD) has been historically associated with underweight and malnutrition. The impact of both underweight and obesity on the clinical course of IBD in adults is controversial. This study described the association between body mass index (BMI) at diagnosis to disease course in children with IBD.Methods: We reviewed the medical records of children with IBD from the database of the ‘Dana-Dwek’ Children’s Hospital between 2010 and 2016. Demographic and anthropometric data were collected as were disease characteristics, course and therapy. Patients were categorized in quartiles according to BMI percentiles at diagnosis (Q1–Q4).Results: Of 100 children who were identified, 62 had Crohn’s disease (CD) and 38 had ulcerative colitis (UC). The median age (interquartile range, IQR) at diagnosis was 13.7 (range 11.9–15.2) years. The median (IQR) follow-up was 2.1 (1.2–3.8) years. At diagnosis, 46 children (46%) were in Q1, 20 (20%) in Q2, 19 (19%) in Q3 and 15 (15%) in Q4. Prolonged time to diagnosis was associated with BMI in Q1 and Q4, as well as high disease activity at diagnosis (p < .001). In a multivariate analysis, BMI in the lower and upper quartiles was associated with disease exacerbation (HR 3.212 and 4.651, respectively, p = .016) and anti-tumor necrosis factor (TNF) therapy (HR 4.489 and 3.972, respectively, p = .021).Conclusions: BMI in the lower and upper quartiles was associated with more severe disease course in children with IBD. BMI may serve as a simple and highly accessible predictor of pediatric IBD course and prognosis.

Effectiveness and Tolerability of Therapy With Once-Weekly Exenatide Versus Basal Insulin Among Injectable-Naive Patients With Type 2 Diabetes in a Real-World Setting in the United States.

A propensity-matched cohort study compared injectable-naive patients with type 2 diabetes initiating exenatide once weekly (EQW) or basal insulin (BI), from 2012 through 2015, within a U.S. electronic health record database. A1C and weight were obtained as observed or multiply imputed values at baseline and quarterly for 1 year (Q1–Q4). Hypoglycemia and gastrointestinal symptoms were identified using diagnostic codes and clinical notes. EQW (n = 2,008) and BI (n = 4,016) cohorts were comparable at baseline (mean A1C and weight: EQW, 8.3% and 107.5 kg, respectively; BI, 8.5% and 107.9 kg, respectively). A1C declined in Q2: –0.69 and –0.50 percentage points for EQW and BI, respectively, with little further change in year 1. The EQW cohort lost 0.9 kg in Q1 and 1.9 kg by the end of the year; no weight change was observed in the BI cohort. Among EQW and BI cohorts, 25.9% and 14.3% achieved both glycemic control and weight loss, respectively. In the EQW and BI cohorts, the incidence of hypoglycemia per 1,000 person-years was 52.5 and 65.7, respectively. The incidence of nausea was greater among EQW relative to BI initiators (relative rate 1.18). EQW offers an advantage compared to BI in achieving glycemic control and weight loss and a lower incidence of hypoglycemia, but is associated with greater risk of gastrointestinal symptoms.

Cardiorespiratory Fitness Stipulates Presence and Normalization of NAFLD In a Community‐Based Adults Enrolled in a Lifestyle Modification Program

RATIONALENon‐alcoholic fatty‐liver disease(NAFLD) is the most frequent liver disease in western countries and has obesity as its main risk and cardiovascular mortality as worse outcome. NAFLD might be secondary to environmental factors such as energy dense food and sedentary lifestyle.PURPOSETo characterize the effects of physical activity and fitness on the presence of NAFLD in a community‐based adults submitted to a Lifestyle Modification Program(LiSM).METHODSBaseline data from 1010 individuals, selected for the LiSM, from 2005 to 2017, were cross‐sectionally analysed for medical, anthropometry, plasma biochemistry, physical activity (IPAQ version 8) and fitness(hand grip, flexibility and cardiorespiratory‐Balke's treadmill protocol). The algorithm based on BMI, waist circumference (WC), triglycerides and GGT was used to develop the “fatty liver index” (FLI), which varies between 0 and 100 with a FLI ≥ 60 ruling in the NAFLD. Longitudinal analysis were undertaken in data from 583 subjects submitted to a 10‐wk LiSM intervention with daily supervised mixed‐physical exercises(5x/wk, 80min/session/60–80% VO2max) and dietary counseling. FLI values were splitted into quartiles for comparison with co‐variables. SAS version 9.2 was used to complete ANOVA and evaluated FLI quartiles(Q1–Q4). Tukey's post hoc was applied with significance level set at p&lt;0.05.ResultsFLI quartiles were Q1(&lt;36.5), Q2(36.6–59.8), Q3(59.9–84.7) and Q4(&gt;84.8). Q4 was predominantly male, lower schooling, lower income and in (self‐ perceptive) bad health. Q4 showed also lower physical activity and lower aerobic fitness without changes in flexibility and strength. FLI correlated negatively with VO2max(r=−0.49, p&lt;0.00001)values. After LiSM, 95 subjects had reduced their FLI from ≥60(M0) to &lt;60(M1). In a (%)muscle mass dependent effect, VO2max determined the FLI responses to LiSM,ConclusionPhysical inactivity/aerobic fitness were risk factors for higher FLI, overcome by LiSM effects on aerobic conditioning.Support or Funding InformationSuported by CNPq and CAPESThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.