Increasing Incidence of Hospitalization for Stroke and Transient Ischemic Attack in Young Adults:A Registry-Based Study

BACKGROUND: Studies have reported increasing incidence of ischemic stroke in adults younger than 50 to 55 years. Information on temporal trends of other stroke subtypes and transient ischemic attack (TIA) is sparse. The aim of this study was to investigate temporal trends of the incidence of hospitalizations for TIA and stroke including sex‐ and subtype‐specific trends in young adults aged 15 to 30 years. METHODS AND RESULTS: From the Danish National Patient Register, we identified all cases of first‐ever stroke and TIA (age 15–30 years) in Denmark, who were hospitalized during the study period of 1994 to 2012. Incidence rates and estimated annual percentage changes (EAPCs) were estimated by using Poisson regression. During the study period, 4156 cases of first‐ever hospitalization for stroke/TIA were identified. The age‐standardized incidence rates of hospitalizations for stroke increased significantly (EAPC 1.83% [95% CI 1.11–2.55%]) from 11.97/100 000 person‐years (PY) in 1994 to 16.77/100 000 PY in 2012. TIA hospitalizations increased from 1.93/100 000 PY in 1994 to 5.81/100 000 PY in 2012 and after 2006 more markedly in men than in women (EAPC 16.61% [95% CI 10.45–23.12%]). The incidence of hospitalizations for ischemic stroke was markedly lower among men, but increased significantly from 2006 (EAPC 14.60% [95% CI 6.22–23.63%]). The incidences of hospitalizations for intracerebral hemorrhage and subarachnoid hemorrhage remained stable during the study period. CONCLUSIONS: The incidence rates of first‐time hospitalizations for ischemic stroke and TIA in young Danish adults have increased substantially since the mid 1990s. The increase was particularly prominent in the most recent years

Estimating a Personalized Basal Insulin Dose from Short-Term Closed-Loop Data in Type 2 Diabetes

In type 2 diabetes (T2D) treatment, finding a safe and effective basal insulin dose is a challenge. The dose-response is highly individual and to ensure safety, people with T2D titrate by slowly increasing the daily insulin dose to meet treatment targets. This titration can take months. To ease and accelerate the process, we use short-term artificial pancreas (AP) treatment tailored for initial titration and apply it as a diagnostic tool. Specifically, we present a method to automatically estimate a personalized daily dose of basal insulin from closed-loop data collected with an AP. Based on AP-data from a stochastic simulation model, we employ the continuous-discrete extended Kalman filter and a maximum likelihood approach to estimate parameters in a simple dose-response model for 100 virtual people. With the identified model, we compute a daily dose of basal insulin to meet treatment targets for each individual. We test the personalized dose and evaluate the treatment outcomes against clinical reference values. In the tested simulation setup, the proposed method is feasible. However, more extensive tests will reveal whether it can be deemed safe for clinical implementation.Comment: 6 pages, 4 figures, 1 table. Accepted for publication in Proceedings of the 2022 61st IEEE Conference on Decision and Control (CDC

Phenotypic and genetic characterization of a novel phenotype in pigs characterized by juvenile hairlessness and age dependent emphysema

<p>Abstract</p> <p>Background</p> <p>A pig phenotype characterized by juvenile hairlessness, thin skin and age dependent lung emphysema has been discovered in a Danish pig herd. The trait shows autosomal co-dominant inheritance with all three genotypes distinguishable. Since the phenotype shows resemblance to the integrin β₆-/- knockout phenotype seen in mice, the two genes encoding the two subunits of integrin α_vβ₆, i.e. <it>ITGB6 </it>and <it>ITGAV</it>, were considered candidate genes for this trait.</p> <p>Results</p> <p>The mutated pig phenotype is characterized by hairlessness until puberty, thin skin with few hair follicles and absence of <it>musculi arrectores pili</it>, and at puberty or later localized areas of emphysema are seen in the lungs. Comparative mapping predicted that the porcine <it>ITGB6 </it>and<it>ITGAV </it>orthologs map to SSC15. In an experimental family (n = 113), showing segregation of the trait, the candidate region was confirmed by linkage analysis with four microsatellite markers. Mapping of the porcine <it>ITGB6 </it>and <it>ITGAV </it>in the IMpRH radiation hybrid panel confirmed the comparative mapping information. Sequencing of the <it>ITGB6 </it>and <it>ITGAV </it>coding sequences from affected and normal pigs revealed no evidence of a causative mutation, but alternative splicing of the <it>ITGB6 </it>pre-mRNA was detected. For both <it>ITGB6 </it>and <it>ITGAV </it>quantitative PCR revealed no significant difference in the expression levels in normal and affected animals. In a western blot, ITGB6 was detected in lung protein samples of all three genotypes. This result was supported by flow cytometric analyses which showed comparable reactions of kidney cells from affected and normal pigs with an integrin α_vβ₆monoclonal antibody. Also, immunohistochemical staining of lung tissue with an integrin β₆antibody showed immunoreaction in both normal and affected pigs.</p> <p>Conclusion</p> <p>A phenotype resembling the integrin β₆-/- knockout phenotype seen in mice has been characterized in the pig. The candidate region on SSC15 has been confirmed by linkage analysis but molecular and functional analyses have excluded that the mutated phenotype is caused by structural mutations in or ablation of any of the two candidate genes.</p

Failing the challenge: Diabetes apps & long-term daily adoption

Diabetes spending is responsible for more than 10% of worldwide health costs. Mobile health has emerged as a strategy for supporting healthier lifestyles and relieving over-burdened medical systems. In 2013 only 1.2% of diabetics with a smartphone were estimated to be using a diabetes app. We looked at the real-world behavior of people with diabetes who had used these apps, in order to learn more about the effects of these products in their lives. Participants were interviewed about their views and experiences on diabetes and non-diabetes related apps. We found the majority of participants were no longer using apps as part of their daily diabetes self-management, despite a generally positive assessment of these products. The lack of “stickiness” (the tendency to stay and return to a product), suggests that significant barriers to adoption remain to be solved

Real-time interferometric refractive index change measurement for the direct detection of enzymatic reactions and the determination of enzyme kinetics

Back scatter interferometry (BSI) is a sensitive method for detecting changes in the bulk refractive index of a solution in a microfluidic system. Here we demonstrate that BSI can be used to directly detect enzymatic reactions and, for the first time, derive kinetic parameters. While many methods in biomedical assays rely on detectable biproducts to produce a signal, direct detection is possible if the substrate or the product exert distinct differences in their specific refractive index so that the total refractive index changes during the enzymatic reaction. In this study, both the conversion of glucose to glucose-6-phosphate, catalyzed by hexokinase, and the conversion of adenosine-triphosphate to adenosine di-phosphate and mono-phosphate, catalyzed by apyrase, were monitored by BSI. When adding hexokinase to glucose solutions containing adenosine-triphosphate, the conversion can be directly followed by BSI, which shows the increasing refractive index and a final plateau corresponding to the particular concentration. From the initial reaction velocities, KM was found to be 0.33 mM using Michaelis&#8315;Menten kinetics. The experiments with apyrase indicate that the refractive index also depends on the presence of various ions that must be taken into account when using this technique. This study clearly demonstrates that measuring changes in the refractive index can be used for the direct determination of substrate concentrations and enzyme kinetics

Effects of Transdermal Fentanyl Treatment on Acute Pain and Inflammation in Rats with Adjuvant-induced Monoarthritis

Eliminating unnecessary pain is an important requirement of performing animal experimentation, including reducing and controlling pain of animals used in pain research. The goal of this study was to refine an adjuvant-induced monoarthritis model in rats by providing analgesia with a transdermal fentanyl solution (TFS). Male and female Sprague-Dawley rats, single- or pair-housed, were injected with 20 μL of complete Freund adjuvant (CFA) into the left ankle joint. CFA-injected rats treated with a single dose of transdermal fentanyl solution (0.33 or 1 mg/kg) were compared with an untreated CFA-injected group and sham groups that received either no treatment or TFS treatment (1 mg/kg) during 72 h. At the tested doses, TFS reduced mechanical hyperalgesia and improved the mobility, stance, rearing, and lameness scores at 6 h after CFA injection. Joint circumferences were not reduced by TFS treatment, and no significant differences were detected between the 2 doses of TFS, or between single- and pair-housed rats. Treatment with TFS did not appear to interfere with model development and characteristics. However, overall, the analgesic effect was transient, and several opioid-related side effects were observed