Is Pulse Pressure a Predictor of New-Onset Diabetes in High-Risk Hypertensive Patients?: A subanalysis of the Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial

OBJECTIVE: Hypertensive patients have an increased risk of developing diabetes. Accumulating evidence suggests a close relation between metabolic disturbance and increased arterial stiffness. Here, we examined the association between pulse pressure and the risk of new-onset diabetes in high-risk Japanese hypertensive patients. RESEARCH DESIGN AND METHODS: The Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial examined the effects of candesartan and amlodipine on the incidence of cardiovascular events in 4, 728 high-risk Japanese hypertensive patients. In the present study, we analyzed the relationship between pulse pressure at baseline and new-onset diabetes in 2, 685 patients without diabetes at baseline (male 1, 471; mean age 63.7 years; mean BMI 24.8 kg/m(2)) as a subanalysis of the CASE-J trial. RESULTS: During 3.3 +/- 0.8 years of follow-up, 97 patients (3.6%) developed diabetes. In multiple Cox regression analysis, pulse pressure was an independent predictor for new-onset diabetes (hazard ratio [HR] per 1 SD increase 1.44 [95% CI 1.15-1.79]) as were male sex, BMI, and additional use of diuretics, whereas age and heart rate were not. Plots of HRs for new-onset diabetes considering both systolic and diastolic blood pressure (DBP) revealed that a higher pulse pressure with a lower DBP, indicating that the increased pulse pressure was largely due to increased arterial stiffness, was strongly associated with the risk of new-onset diabetes. CONCLUSIONS: Pulse pressure is an independent predictor of new-onset diabetes in high-risk Japanese hypertensive patients. Increased arterial stiffness may be involved in the development of diabetes

Ultrasonic Sensitivity of Strain-Insensitive Fiber Bragg Grating Sensors and Evaluation of Ultrasound-Induced Strain

In conventional ultrasound detection in structures, a fiber Bragg grating (FBG) is glued on or embedded in the structure. However, application of strain to the structure can influence the sensitivity of the FBG toward ultrasound and can prevent its effective detection. An FBG can work as a strain-insensitive ultrasound sensor when it is not directly glued to the monitored structure, but is instead applied to a small thin plate to form a mobile sensor. Another possible configuration is to affix an FBG-inscribed optical fiber without the grating section attached to the monitored structure. In the present study, sensitivity to ultrasound propagated through an aluminum plate was compared for a strain-insensitive FBG sensor and an FBG sensor installed in a conventional manner. Strains induced by ultrasound from a piezoelectric transducer and by quasi-acoustic emission of a pencil lead break were also quantitatively evaluated from the response amplitude of the FBG sensor. Experimental results showed that the reduction in the signal-to-noise ratio for ultrasound detection with strain-insensitive FBG sensors, relative to traditionally-installed FBG sensors, was only 6 dB, and the ultrasound-induced strain varied within a range of sub-micron strains

The effect of a prostaglandin E-1 derivative on the symptoms and quality of life of patients with lumbar spinal stenosis

Quality of life (QOL) is a concern for patients with lumbar spinal stenosis (LSS). In this study, QOL was examined using the 5-item EuroQol (EQ-5D). QOL and activities of daily living (ADL) were surveyed for 91 patients who visited 18 medical institutions in our prefecture and were diagnosed with LSS-associated intermittent claudication. A second survey was performed after a parts per thousand yen6 weeks for 79 of the subjects to evaluate therapy with limaprost (an oral prostaglandin E1 derivative) or etodolac (an NSAID). Symptoms, maximum walking time, QOL, ADL items, and relationships among these variables were investigated for all 91 patients. Leg pain, leg numbness, and low back pain while walking were surveyed by use of VAS scores (0-100). Leg pain, leg numbness, and low back pain while walking (VAS a parts per thousand yen25) were present in 83.5, 62.6, and 54.9 % of the patients in the first survey, and approximately half of the patients had a maximum walking time 30 min, showing that maximum walking time affected health-related QOL. Of the 79 patients who completed the second survey, 56 had taken limaprost and 23 (control group) had received etodolac. Limaprost improved possible walking time, reduced ADL interference, and significantly increased the EQ-5D utility score, whereas no significant changes occurred in the control group. Maximum walking time was prolonged by a parts per thousand yen10 min and the EQ-5D utility value was improved by a parts per thousand yen0.1 points in significantly more patients in the limaprost group than in the control group. According to the findings of this survey, at an average of 8 weeks after administration limaprost improved symptoms, QOL, and ADL in LSS patients whereas treatment with an NSAID reduced pain but did not have any other effects.ArticleJOURNAL OF ORTHOPAEDIC SCIENCE. 18(2):208-215 (2013)journal articl

Mechanical properties and damage behavior of tapered unidirectional CFRP laminates

An understanding of damage mechanisms induced by drop-off plies in tapered composite laminates is crucial. This study investigated the mechanical properties and damage behaviors of asymmetric tapered unidirectional carbon fiber-reinforced plastic laminates. Damage observations of laminates with simultaneous tapered and staggered tapered structures under monotonic and cyclic tensile loads were done by an optical microscope and X-ray radiography. Based on the results, matrix cracks in the resin pocket and delamination occurred earliest in the simultaneous tapered specimen due to a greater stress concentration in a single large resin pocket in the structure. Intralaminar damages in the staggered tapered specimen with a shorter step spacing occurred mainly in the lower dropped ply as there was a more significant interaction between the neighboring steps in the specimen. The drastic decrease in the stress concentration after the occurrence of damages in the neighboring step(s) then suppressed the occurrence of intralaminar damages in the upper dropped ply. This is in contrast to the specimen with a longer step spacing where the intralaminar damages occurred in both dropped plies due to the distributed stress distribution. Delamination propagated between the dropped plies and continuous (belt and core) plies for both staggered laminates regardless of the length of the step spacing at higher applied stress levels. The results showed that internal ply-drop configuration and step spacing in staggered tapered structures contribute to significant differences in the mechanical properties and damage behavior in the laminates

Is the information on infection prevention measures against COVID-19 reaching the target audience? A cross-sectional survey among eating and drinking services in Tokyo, Japan

Objectives: The study aims to evaluate information gathering behaviour (IGB) and its effectiveness in eating and drinking services for infection control during COVID-19. Study design: A cross-sectional survey using anonymous self-administered questionnaires was conducted in October 2021. Participants were asked what IGB they use to obtain infection control measures, to what extent they understand the measures (and, if they do not understand them, what inhibits their comprehension), and which IGBs they do not currently use and why. Methods: The sample included 957 eating and drinking services in Ota City, Tokyo. The response rate was 14.5%. Binomial logistic regression was used to analyse the factors associated with the baseline characteristics using Stata v.17.0. Results: The highest proportion of respondents used television (88.0%); another large proportion (38.9%) used guidelines. Regarding difficulty in understanding the retrieved information, ‘difficulty in coming up with specific actions’ had the highest ratio for every IGB. Regarding reasons for not currently using IGB, ‘it takes too much time to extract the necessary information’ showed the highest ratios of all IGBs. Individuals over 60 years had a negative relationship with the use of guidelines and the Internet. Participants also advised that they did not use time-consuming guidelines. Conclusion: Current information dissemination methods for information on COVID-19 infection control may not successfully convey information or reach their target populations. This study indicates the need for specific expressions and layouts to effectively share information on COVID-19. Also, special means of communication must be established to cater to individuals aged 60 and above