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Abstract Background Osteoporotic vertebral fractures are often clinically silent and unrecognized. The present study aimed to determine whether routine chest radiographs could be a potential screening tool for identifying missed vertebral fractures in men aged over 50 years or postmenopausal women, especially those with type 2 diabetes mellitus (T2DM). In this study, we aimed to determine the prevalence of undetected vertebral fractures in elderly Chinese patients with and without T2DM. Methods Clinical data and chest radiographs of 567 individuals with T2DM (T2DM group) and 583 without diabetes (nondiabetic group) at a tertiary hospital in central south China were extracted from the records. Vertebral fractures were specifically looked for on chest radiographs and classified using the Genant semi-quantitative scale. Prevalence was compared between the two groups. Results Mean age and sex composition were comparable between the two groups. Mean weight and body mass index were significantly lower in the T2DM group. In both groups, fractures mostly involved the T11–12 and L1 vertebrae. Moderate/severe fractures were identified in 33.3% individuals in the T2DM group (31.4% men and 36.0% women) versus 23.2% individuals (20.9% men and 25.5% women) in the nondiabetic group. Conclusions Routine chest radiographs could be a useful screening tool for identifying asymptomatic vertebral fractures. Trial registration The study was designed as an observational retrospective study, therefore a trial registration was not necessary.

Abstract Background The occurrence of hypomagnesemia in patients with primary hyperparathyroidism (PHPT) has been noted previously; however, the association of hypomagnesemia and severity of primary hyperparathyroidism remains unknown. The present study aimed to evaluate the association of hypomagnesemia with biochemical and clinical manifestations in patients with PHPT. Methods This was a retrospective study conducted at a tertiary hospital. We obtained data from 307 patients with PHPT from January 2010 through August 2020. Data on demographics, history, laboratory findings, bone densitometry findings, and clinical presentation and complications were collected and were compared in normal magnesium group vs hypomagnesemia group. Results Among the 307 patients with PHPT included in our study, 77 patients (33/102 [32.4%] males and 44/205 [21.5%] females) had hypomagnesemia. Mean hemoglobin levels in the hypomagnesemia group were significantly lower than those in the normal magnesium group in both males and females. In contrast, patients with hypomagnesemia had a higher mean serum calcium and parathyroid hormone than individuals with normal magnesium. The typical symptoms of PHPT, such as nephrolithiasis, bone pain/fractures, polyuria, or polydipsia, were more common in the hypomagnesemia group. In addition, patients with hypomagnesemia had a higher prevalence of osteoporosis, anemia, and hypercalcemic crisis. Even after adjusting for potential confounders, including age, sex, body mass index, estimated glomerular filtration rate, and parathyroid hormone levels, these associations remained essentially unchanged. Conclusion Biochemical and clinical evidence indicates that patients with PHPT with hypomagnesemia have more severe hyperparathyroidism than those without hypomagnesemia. In addition, PHPT patients with hypomagnesemia had a higher prevalence of osteoporosis, anemia, and hypercalcemic crisis.

Aim: To assess the global and regional burden of hip fractures associated with type 1 diabetes (T1D) from 1990 to 2021. Materials and Methods: The population attributable fraction was calculated by combining the published risk ratio with T1D prevalence (age ≥ 20 years) from the Global Burden of Disease study to estimate the T1D‐associated hip‐fracture burden. Trends were assessed using the age‐standardized incidence rate (ASIR) and estimated annual percentage change (EAPC). Results: The global incidence of T1D‐related hip fractures was 290 180 in 2021 with an ASIR of 3.96 (95% confidence interval: 1.92‐5.87) per 100 000 population and a male‐to‐female ratio of 0.54. At the super‐regional level, the highest incidence (204 610) and ASIR (13.09 per 100 000 population; 6.40‐25.53) were observed in high‐income regions, in particular in Australasia and Western Europe. Notably, Australasia exhibited the highest EAPC, 2.90% in T1D‐associated ASIR, followed by East Asia (2.73%). The incidence among those aged 45‐64 years grew significantly in 14 regions over the past decade. Nationally, the ASIR increased in 166 countries from 1990 to 2021. Conclusions: High‐income regions experienced the greatest burden of T1D‐associated hip fracture, while Australasia and East Asia witnessed the largest increase over the last 32 years. Prioritizing the promotion of T1D treatment and hip‐fracture screening for middle‐aged females living with T1D is crucial in these regions. [ABSTRACT FROM AUTHOR]

When analyzing the hydraulic vibration stability of hydrodynamic systems, a real elastic water column (EWC) is often simplified as a rigid water column (RWC) to derive theoretical stability criteria. This method is believed to yield results that deviate quantitatively from reality without causing qualitative errors. To examine this approach, this study first established a reservoir-pipe-valve-turbine system. Next, a theoretical stability criterion based on the RWC assumption was derived. Finally, the theoretical stability criterion of the real EWC (which was proven using the method of characteristics) was proposed to test the correctness of the RWC assumption, both numerically and theoretically. Results indicated discrepancies between RWC-based predictions and EWC time-domain outcomes, lacking consistent similarities. Specifically, in some cases, the RWC formula indicated instability, while the EWC theoretical criterion and numerical verification suggested stability. In other cases, the RWC formula indicated stability, while the EWC theoretical criterion and numerical verification suggested instability. Meanwhile, there were also cases where both the RWC formula and EWC theoretical criterion yielded consistent results. As the RWC assumption disregards water-hammer wave propagation and hydrodynamic system reflection effects, the validity of its conclusion is uncertain. Hence, when the RWC-based system stability contradicts the EWC theoretical criterion, the latter should guide system design decisions. [ABSTRACT FROM AUTHOR]

Although the burden of the human immunodeficiency virus (HIV) in the Asia-Pacific region is increasingly severe, comprehensive evidence of the burden of HIV is scarce. We aimed to report the burden of HIV in people aged 15-79 years from 1990 to 2019 using data from the Global Burden of Disease Study (GBD) 2019. We analyzed rates of age-standardized disability-adjusted life years (ASDR), age-standardized mortality (ASMR), and age-standardized incidence (ASIR) in our age-period-cohort analysis by sociodemographic index (SDI). According to HIV reports in 2019 from 29 countries in the Asia-Pacific region, the low SDI group in Papua New Guinea had the highest ASDR, ASMR, and ASIR. From 1990 to 2019, the ASDR, ASIR, and ASMR of persons with acquired immune deficiency syndrome (AIDS) increased in 21 (72%) of the 29 countries in the Asia-Pacific region. During the same period, the disability-adjusted life years (DALYs) of AIDS patients in the low SDI group in the region grew the fastest, particularly in Nepal. The incidence of HIV among individuals aged 20-30 years in the low-middle SDI group was higher than that of those in the other age groups. In 2019, unsafe sex was the main cause of HIV-related ASDR in the region's 29 countries, followed by drug use. The severity of the burden of HIV/AIDS in the Asia-Pacific region is increasing, especially among low SDI groups. Specific public health policies should be formulated based on the socioeconomic development level of each country to alleviate the burden of HIV/AIDS., (© 2024 Wiley Periodicals LLC.)

Tumors require a vascular supply to grow and can achieve this via the expression of pro-angiogenic growth factors. Many potential oncogenic mutations have been identified in tumor angiogenesis. Somatic mutations in the small GTPase KRAS are the most common activating lesions found in human cancer, and are generally associated with poor response to standard therapies. Biguanides, such as the diabetes therapeutics metformin and phenformin, have demonstrated anti-tumor activity both in vitro and in vivo. The extracellular regulated protein kinases (ERK) signaling is known to be a major cellular target of biguanides. Based on KRAS activates several down-stream effectors leading to the stimulation of the RAF/mitogen-activated protein kinase/extracellular signal-regulated kinase (RAF/MEK/ERK) and phosphatidylinositol-3-kinase (PI3K) pathways, we investigated the anti-tumor effects of biguanides on the proliferation of KRAS-mutated tumor cells in vitro and on KRAS-driven tumor growth in vivo. In cancer cells harboring oncogenic KRAS, phenformin switches off the ERK pathway and inhibit the expression of pro-angiogenic molecules. In tumor xenografts harboring the KRAS mutation, phenformin extensively modifies the tumor growth causing abrogation of angiogenesis. These results strongly suggest that significant therapeutic advantage may be achieved by phenformin anti-angiogenesis for the treatment of tumor.