Factors associated with therapeutic failure in young, middle-aged, and early-phase elderly patients without diabetes mellitus or chronic kidney disease (n = 5397) (logistic regression analysis).

<p>a) Odds ratio</p><p>b) 95% confidence interval</p><p>*<i>P</i><0.05</p><p>**<i>P</i><0.01.</p><p>Factors associated with therapeutic failure in young, middle-aged, and early-phase elderly patients without diabetes mellitus or chronic kidney disease (n = 5397) (logistic regression analysis).</p

Achievement of Target Blood Pressure Levels among Japanese Workers with Hypertension and Healthy Lifestyle Characteristics Associated with Therapeutic Failure

<div><p>Background</p><p>Few studies have examined Japanese with regard to the achievement rates for target blood pressure levels, or the relationship between these rates and healthy lifestyle characteristics in patients with hypertension as defined by the newly established hypertension management guidelines (JSH2014). The aim of this study was to elucidate achievement rates and examine healthy lifestyle characteristics associated with achievement status among Japanese.</p><p>Methods</p><p>This cross-sectional study, conducted in January-December 2012, examined blood pressure control and healthy lifestyle characteristics in 8,001 Japanese workers with hypertension (mean age, 57.0 years; 78.8% were men) who participated in a workplace health checkup. Data were collected from workplace medical checkup records and participants’ self-administered questionnaires. We divided into 5 groups [G1; young, middle-aged, and early-phase elderly patients (65–74 years old) without diabetes mellitus or chronic kidney disease (CKD) (<140/90 mmHg), G2; late-phase elderly patients (≥75 years old) without diabetes mellitus or CKD (<150/90 mmHg), G3; diabetic patients (<130/80 mmHg), G4; patients with CKD (<130/80 mmHg), and G5; patients with cerebrovascular and/or coronary artery diseases (<140/90 mmHg)] according to JSH2014. And then, achievement rates were calculated in each group. Multivariate analysis identified healthy lifestyle characteristics associated with “therapeutic failure” of target blood pressure.</p><p>Results</p><p>Target blood pressures were achieved by 60.2% of young, middle-aged, and early-phase elderly patients (G1), 71.4% of late-phase elderly patients (G2), 30.5% of diabetic patients (G3), 33.4% of those with chronic kidney disease (G4), and 66.0% of those with cerebrovascular and/or coronary artery diseases (G5). A body mass index of 18.5–24.9 and non-daily alcohol consumption were protective factors, and adequate sleep was found to contribute to therapeutic success.</p><p>Discussion</p><p>We found low achievement rates for treatment goals among patients with chronic kidney disease and diabetes mellitus. Maintaining an ideal body weight and adequate alcohol consumption may help with blood pressure control. Lifestyle modification may be necessary for better management of hypertension.</p></div

Participant characteristics at baseline survey (N = 8,001).

<p>a) Standard deviation</p><p>b) Total number of healthy lifestyle characteristics was calculated by summing the items listed in Breslow’s seven health practices associated with mortality.</p><p>Participant characteristics at baseline survey (N = 8,001).</p

Factors associated with therapeutic failure in patients with cerebrovascular and/or coronary artery disease (n = 409) (logistic regression analysis).

<p>a) Odds ratio</p><p>b) 95% confidence interval</p><p>*<i>P</i><0.05</p><p>**<i>P</i><0.01.</p><p>Factors associated with therapeutic failure in patients with cerebrovascular and/or coronary artery disease (n = 409) (logistic regression analysis).</p

Factors associated with therapeutic failure in failure in diabetes mellitus (n = 1,074) (logistic regression analysis).

<p>a) Odds ratio</p><p>b) 95% confidence interval</p><p>*<i>P</i><0.05</p><p>**<i>P</i><0.01.</p><p>Factors associated with therapeutic failure in failure in diabetes mellitus (n = 1,074) (logistic regression analysis).</p

Mean blood pressures and achievement rates for target blood pressure levels.

<p>a) Standard deviation.</p><p>Mean blood pressures and achievement rates for target blood pressure levels.</p

Factors associated with therapeutic failure in chronic kidney disease (n = 961) (logistic regression analysis).

<p>a) Odds ratio</p><p>b) 95% confidence interval</p><p>*<i>P</i><0.05</p><p>**<i>P</i><0.01.</p><p>Factors associated with therapeutic failure in chronic kidney disease (n = 961) (logistic regression analysis).</p

Topological Organization of Functional Brain Networks in Healthy Children: Differences in Relation to Age, Sex, and Intelligence

<div><p>Recent studies have demonstrated developmental changes of functional brain networks derived from functional connectivity using graph theoretical analysis, which has been rapidly translated to studies of brain network organization. However, little is known about sex- and IQ-related differences in the topological organization of functional brain networks during development. In this study, resting-state fMRI (rs-fMRI) was used to map the functional brain networks in 51 healthy children. We then investigated the effects of age, sex, and IQ on economic small-world properties and regional nodal properties of the functional brain networks. At a global level of whole networks, we found significant age-related increases in the small-worldness and local efficiency, significant higher values of the global efficiency in boys compared with girls, and no significant IQ-related difference. Age-related increases in the regional nodal properties were found predominately in the frontal brain regions, whereas the parietal, temporal, and occipital brain regions showed age-related decreases. Significant sex-related differences in the regional nodal properties were found in various brain regions, primarily related to the default mode, language, and vision systems. Positive correlations between IQ and the regional nodal properties were found in several brain regions related to the attention system, whereas negative correlations were found in various brain regions primarily involved in the default mode, emotion, and language systems. Together, our findings of the network topology of the functional brain networks in healthy children and its relationship with age, sex, and IQ bring new insights into the understanding of brain maturation and cognitive development during childhood and adolescence.</p> </div

The Relationships between Metabolic Disorders (Hypertension, Dyslipidemia, and Impaired Glucose Tolerance) and Computed Tomography-Based Indices of Hepatic Steatosis or Visceral Fat Accumulation in Middle-Aged Japanese Men

<div><p>Background</p><p>Most studies on the relationships between metabolic disorders (hypertension, dyslipidemia, and impaired glucose tolerance) and hepatic steatosis (HS) or visceral fat accumulation (VFA) have been cross-sectional, and thus, these relationships remain unclear. We conducted a retrospective cohort study to clarify the relationships between components of metabolic disorders and HS/VFA.</p><p>Methods</p><p>The participants were 615 middle-aged men who were free from serious liver disorders, diabetes, and HS/VFA and underwent multiple general health check-ups at our institution between 2009 and 2013. The data from the initial and final check-ups were used. HS and VFA were assessed by computed tomography. HS was defined as a liver to spleen attenuation ratio of ≤1.0. VFA was defined as a visceral fat cross-sectional area of ≥100 cm² at the level of the navel. Metabolic disorders were defined using Japan’s metabolic syndrome diagnostic criteria. The participants were divided into four groups based on the presence (+) or absence (-) of HS/VFA. The onset rates of each metabolic disorder were compared among the four groups.</p><p>Results</p><p>Among the participants, 521, 55, 24, and 15 were classified as HS(-)/VFA(-), HS(-)/VFA(+), HS(+)/VFA(-), and HS(+)/VFA(+), respectively, at the end of the study. Impaired glucose tolerance was more common among the participants that exhibited HS or VFA (p = 0.05). On the other hand, dyslipidemia was more common among the participants that displayed VFA (p = 0.01).</p><p>Conclusions</p><p>It is likely that VFA is associated with impaired glucose tolerance and dyslipidemia, while HS might be associated with impaired glucose tolerance. Unfortunately, our study failed to detect associations between HS/VFA and metabolic disorders due to the low number of subjects that exhibited fat accumulation. Although our observational study had major limitations, we consider that it obtained some interesting results. HS and VFA might affect different metabolic disorders. Further large-scale longitudinal studies are needed to reveal the relationships between the components of metabolic disorders and HS/VFA.</p></div

Effect of age on regional nodal properties.

<p>Significant linear positive, linear negative, quadratic positive, and quadratic negative correlations are indicated by red, green, yellow, and blue spheres, respectively. The significances of p<0.05 and p<0.01(uncorrected) are shown by spheres in small and big size, respectively. For a description of the abbreviations, see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0055347#pone.0055347.s001" target="_blank">Table S1</a>.</p