Rapidly Growing Bilateral Pseudoangiomatous Stromal Hyperplasia of the Breast

A tumoral pseudoangiomatous stromal hyperplasia (PASH) that causes huge breast enlargement is very rare. Only two cases of huge tumoral PASHs have been reported in the English medical literature. We report here on a surgically confirmed case of bilateral huge tumoral PASH in a 47-year-old woman, and we present the imaging and histopathology findings. We also review the relevant medical literature

Serum 25-hydroxy vitamin D and the risk of low muscle mass in young and middle-aged Korean adults

Objective: Despite the known benefit of vitamin D in reducing sarcopenia risk in older adults, its effect against muscle loss in the young population is unknown. We aimed to examine the association of serum 25-hydroxy vitamin D [25(OH)D] level and its changes over time with the risk of incident low muscle mass (LMM) in young and middle-aged adults.Design: This study is a cohort study.Methods: The study included Korean adults (median age: 36.9 years) without LMM at baseline followed up for a median of 3.9 years (maximum: 7.3 years). LMM was defined as the appendicular skeletal muscle (ASM) mass by body weight (ASM/weight) of 1 s.d. below the sex-specific mean for the young reference group. Cox proportional hazard models were used to estimate hazard ratios (HRs) with 95% CIs.Results: Of the 192,908 individuals without LMM at baseline, 19,526 developed LMM. After adjusting for potential confounders, the multivariable-adjusted HRs (95% CIs) for incident LMM comparing 25(OH)D levels of 25-&lt;50, 50-&lt;75, and ≥75 nmol/L to 25(OH)D &lt;25 nmol/L were 0.93 (0.90-0.97), 0.85 (0.81-0.89), and 0.77 (0.71-0.83), respectively. The inverse association of 25(OH)D with incident LMM was consistently observed in young (aged &lt;40 years) and older individuals (aged ≥40 years). Individuals with increased 25(OH)D levels (&lt;50-≥50 nmol/L) or persistently adequate 25(OH)D levels (≥50 nmol/L) between baseline and follow-up visit had a lower risk of incident LMM than those with persistently low 25(OH)D levels.Conclusions: Maintaining sufficient serum 25(OH)D could prevent unfavourable changes in muscle mass in both young and middle-aged Korean adults.</p

Depression and increased risk of nonalcoholic fatty liver disease in individuals with obesity

Aims: the longitudinal relationship between depression and the risk of nonalcoholic fatty liver disease (NAFLD) is uncertain. We examined: a) the association between depressive symptoms and incident hepatic steatosis (HS), both with and without liver fibrosis; and b) the influence of obesity on this association. Methods: cohort of 142,005 Korean adults with neither HS nor excessive alcohol consumption at baseline were followed for up to 8.9 years. The validated Center for Epidemiologic Studies-Depression score (CES-D) was assessed at baseline, and subjects were categorized as non-depressed (a CES-D &lt;8, reference) or depression (CES-D ≥16). HS was diagnosed by ultrasonography. Liver fibrosis was assessed by the fibrosis-4 index (FIB-4). Parametric proportional hazards models were used to estimate the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Results: during a median follow-up of 4.0 years, 27,810 people with incident HS and 134 with incident HS plus high FIB-4 were identified. Compared with the non-depressed category, the aHR (95% CIs) for incident HS was 1.24 (1.15-1.34) for CES-D ≥16 among obese individuals, and 1.00 (0.95-1.05) for CES-D ≥16 among non-obese individuals (P for interaction with obesity &lt;0.001). The aHR (95% CIs) for developing HS plus high FIB-4 was 3.41 (1.33-8.74) for CES-D≥16 among obese individuals, and 1.22 (0.60-2.47) for CES-D≥16 among non-obese individuals (P for interaction =0.201). Conclusions: depression was associated with an increased risk of incident HS and HS plus high probability of advanced fibrosis, especially among obese individuals

Unidirectional emission from a cardioid-shaped microcavity laser

We find unidirectional emission in a cardioid-shaped microcavity laser. When a deformation parameter is well adjusted, rays starting around a period-5 unstable periodic orbit emit unidirectionally. To confirm the emission direction, we fabricate a laser by using an InGaAsP semiconductor and investigate emission characteristics. When the laser is excited by current injection with a dc current, resonances localized on the period-5 unstable periodic orbit emit unidirectionally. © 2016 Optical Society of America.1

Landslide susceptibility mapping using certainty factor, index of entropy and logistic regression models in GIS and their comparison at Mugling-Narayanghat road section in Nepal Himalaya

Landslide susceptibility maps are vital for disaster management and for planning development activities in the mountainous country like Nepal. In the present study, landslide susceptibility assessment of Mugling-Narayanghat road and its surrounding area is made using bivariate (certainty factor and index of entropy) and multivariate (logistic regression) models. At first, a landslide inventory map was prepared using earlier reports and aerial photographs as well as by carrying out field survey. As a result, 321 landslides were mapped and out of which 241 (75 %) were randomly selected for building landslide susceptibility models, while the remaining 80 (25 %) were used for validating the models. The effectiveness of landslide susceptibility assessment using GIS and statistics is based on appropriate selection of the factors which play a dominant role in slope stability. In this case study, the following landslide conditioning factors were evaluated: slope gradient; slope aspect; altitude; plan curvature; lithology; land use; distance from faults, rivers and roads; topographic wetness index; stream power index; and sediment transport index. These factors were prepared from topographic map, drainage map, road map, and the geological map. Finally, the validation of landslide susceptibility map was carried out using receiver operating characteristic (ROC) curves. The ROC plot estimation results showed that the susceptibility map using index of entropy model with AUC value of 0.9016 has highest prediction accuracy of 90.16 %. Similarly, the susceptibility maps produced using logistic regression model and certainty factor model showed 86.29 and 83.57 % of prediction accuracy, respectively. Furthermore, the ROC plot showed that the success rate of all the three models performed more than 80 % accuracy (i.e. 89.15 % for IOE model, 89.10 % for LR model and 87.21 % for CF model). Hence, it is concluded that all the models employed in this study showed reasonably good accuracy in predicting the landslide susceptibility of Mugling-Narayanghat road section. These landslide susceptibility maps can be used for preliminary land use planning and hazard mitigation purpose.ArticleNATURAL HAZARDS. 65(1):135-165 (2013)journal articl

Glycemic status, insulin resistance, and mortality from lung cancer among individuals with and without diabetes

Background: The effects of glycemic status and insulin resistance on lung cancer remain unclear. We investigated the associations between both glycemic status and insulin resistance, and lung cancer mortality, in a young and middle-aged population with and without diabetes. Methods: This cohort study involved individuals who participated in routine health examinations. Lung cancer mortality was identified using national death records. Cox-proportional hazards models were used to calculate hazard ratios (HRs) with 95% CIs for lung cancer mortality risk. Results: Among 666,888 individuals (mean age 39.9±10.9 years) followed for 8.3 years (interquartile range, 4.6–12.7), 602 lung cancer deaths occurred. Among individuals without diabetes, the multivariable-adjusted HRs (95% CI) for lung cancer mortality comparing hemoglobin A1c categories (5.7–5.9, 6.0–6.4, and ≥ 6.5% or 36–38, 39–46, and ≥ 48 mmol/mol, respectively) with the reference (&lt; 5.7% or &lt; 36 mmol/mol) were 1.39 (1.13–1.71), 1.72 (1.33–2.20), and 2.22 (1.56–3.17), respectively. Lung cancer mortality was associated with fasting blood glucose categories in a dose-response manner (P for trend = 0.001) and with previously diagnosed diabetes. Insulin resistance (HOMA-IR ≥ 2.5) in individuals without diabetes was also associated with lung cancer mortality (multivariable-adjusted HR, 1.41; 95% CI, 1.13–1.75). These associations remained after adjusting for changing status in glucose, hemoglobin A1c, insulin resistance, smoking status, and other confounders during follow-up as time-varying covariates. Conclusions: Glycemic status within both diabetes and prediabetes ranges and insulin resistance were independently associated with an increased risk of lung cancer mortality. Keywords Diabetes mellitus, Glycated hemoglobin A1c, Hyperglycemia, Insulin resistance, Lung cancer<br/

Landslide susceptibility mapping using certainty factor, index of entropy and logistic regression models in GIS and their comparison at Mugling-Narayanghat road section in Nepal Himalaya.

Landslide susceptibility maps are vital for disaster management and for planning development activities in the mountainous country like Nepal. In the present study, landslide susceptibility assessment of Mugling–Narayanghat road and its surrounding area is made using bivariate (certainty factor and index of entropy) and multivariate (logistic regression) models. At first, a landslide inventory map was prepared using earlier reports and aerial photographs as well as by carrying out field survey. As a result, 321 landslides were mapped and out of which 241 (75 %) were randomly selected for building landslide susceptibility models, while the remaining 80 (25 %) were used for validating the models. The effectiveness of landslide susceptibility assessment using GIS and statistics is based on appropriate selection of the factors which play a dominant role in slope stability. In this case study, the following landslide conditioning factors were evaluated: slope gradient; slope aspect; altitude; plan curvature; lithology; land use; distance from faults, rivers and roads; topographic wetness index; stream power index; and sediment transport index. These factors were prepared from topographic map, drainage map, road map, and the geological map. Finally, the validation of landslide susceptibility map was carried out using receiver operating characteristic (ROC) curves. The ROC plot estimation results showed that the susceptibility map using index of entropy model with AUC value of 0.9016 has highest prediction accuracy of 90.16 %. Similarly, the susceptibility maps produced using logistic regression model and certainty factor model showed 86.29 and 83.57 % of prediction accuracy, respectively. Furthermore, the ROC plot showed that the success rate of all the three models performed more than 80 % accuracy (i.e. 89.15 % for IOE model, 89.10 % for LR model and 87.21 % for CF model). Hence, it is concluded that all the models employed in this study showed reasonably good accuracy in predicting the landslide susceptibility of Mugling–Narayanghat road section. These landslide susceptibility maps can be used for preliminary land use planning and hazard mitigation purpose

Sleep Duration, Sleep Quality, and the Development of Nonalcoholic Fatty Liver Disease:A Cohort Study

INTRODUCTION: The longitudinal relationship between sleep duration, sleep quality, and the risk of nonalcoholic fatty liver disease (NAFLD) is unknown. We aimed to examine the association between sleep duration, sleep quality, and NAFLD development.METHODS: Using the Pittsburgh Sleep Quality Index, sleep duration and quality were evaluated for 143,306 NAFLD-free Korean adults with a mean age of 36.6 years, who were followed for an average of 4.0 years. Hepatic steatosis (HS) was assessed using ultrasonography and liver fibrosis by the fibrosis-4 index (FIB-4) or the NAFLD fibrosis score. Flexible parametric proportional hazard models were used to determine the hazard ratios (HRs) and 95% confidence intervals.RESULTS: There were 27,817 subjects with incident HS, of whom 1,471 had incident HS plus intermediate/high FIB-4. Multivariable-adjusted HRs (95% confidence intervals) for incident HS comparing sleep durations of ≤5, 6, 8, and ≥ 9 hours with 7 hours were 1.19 (1.14-1.23), 1.07 (1.04-1.10), 0.98 (0.94-1.02), and 0.95 (0.87-1.03), respectively. The corresponding HRs for incident HS plus intermediate/high FIB-4 were 1.30 (1.11-1.54), 1.14 (1.01-1.29), 1.11 (0.93-1.33), and 1.08 (0.71-1.63). The association between sleep duration and HS plus intermediate/high FIB-4 was inverse in individuals with good sleep quality but tended to be U-shaped in those with poor sleep quality. The results were similar if FIB-4 was replaced by the NAFLD fibrosis score.DISCUSSION: In young adults, short sleep duration was independently associated with an increased risk of incident NAFLD with or without intermediate/high fibrosis score, suggesting a role for inadequate sleep quantity in NAFLD risk and severity.</p