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Predictive factors for hyperglycaemic progression in patients with schizophrenia or bipolar disorder
- Ichiro Kusumi, Yuki Arai, Ryo Okubo, Minoru Honda, Yasuhiro Matsuda, Yukihiko Matsuda, Akihiko Tochigi, Yoshiteru Takekita, Hiroyoshi Yamanaka, Keiichi Uemura, Koichi Ito, Kiyoshi Tsuchiya, Jun Yamada, Bunta Yoshimura, Nobuyuki Mitsui, Sigehiro Matsubara, Takayuki Segawa, Nobuyuki Nishi, Yasufumi Sugawara, Yuki Kako, Ikuta Shinkawa, Kaoru Shinohara, Akiko Konishi, Junichi Iga, Naoki Hashimoto, Shinsaku Inomata, Noriko Tsukamoto, Hiroto Ito, Yoichi M. Ito, Norihiro Sato
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- Journal:
- BJPsych Open / Volume 4 / Issue 6 / November 2018
- Published online by Cambridge University Press:
- 30 October 2018, pp. 454-460
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Background
Patients with schizophrenia or bipolar disorder have a high risk of developing type 2 diabetes.
AimsTo identify predictive factors for hyperglycaemic progression in individuals with schizophrenia or bipolar disorder and to determine whether hyperglycaemic progression rates differ among antipsychotics in regular clinical practice.
MethodWe recruited 1166 patients who initially had normal or prediabetic glucose levels for a nationwide, multisite, l-year prospective cohort study to determine predictive factors for hyperglycaemic progression. We also examined whether hyperglycaemic progression varied among patients receiving monotherapy with the six most frequently used antipsychotics.
ResultsHigh baseline serum triglycerides and coexisting hypertension significantly predicted hyperglycaemic progression. The six most frequently used antipsychotics did not significantly differ in their associated hyperglycaemic progression rates over the 1-year observation period.
ConclusionsClinicians should carefully evaluate baseline serum triglycerides and coexisting hypertension and perform strict longitudinal monitoring irrespective of the antipsychotic used.
Declaration of interestThe authors report no financial or other relationship that is relevant to the subject of this article. Relevant financial activities outside the submitted work are as follows. I.K. has received honoraria from Astellas, Chugai Pharmaceutical, Daiichi Sankyo, Dainippon Sumitomo Pharma, Eisai, Eli Lilly, Janssen Pharmaceutical, Kyowa Hakko Kirin, Meiji Seika Pharma, MSD, Nippon Chemiphar, Novartis Pharma, Ono Pharmaceutical, Otsuka Pharmaceutical, Pfizer, Tanabe Mitsubishi Pharma, Shionogi and Yoshitomiyakuhin; has received research/grant support from AbbVie GK, Asahi Kasei Pharma, Astellas, Boehringer Ingelheim, Chugai Pharmaceutical, Daiichi Sankyo, Dainippon Sumitomo Pharma, Eisai, Eli Lilly, GlaxoSmithKline, Kyowa Hakko Kirin, Meiji Seika Pharma, MSD, Novartis Pharma, Ono Pharmaceutical, Otsuka Pharmaceutical, Pfizer, Takeda Pharmaceutical, Tanabe Mitsubishi Pharma, Shionogi and Yoshitomiyakuhin; and is a member of the advisory boards of Dainippon Sumitomo Pharma and Tanabe Mitsubishi Pharma. Y.T. has received speaker's honoraria from Dainippon-Sumitomo Pharma, Otsuka, Meiji-Seika Pharma, Janssen Pharmaceutical, Daiichi-Sankyo Company, UCB Japan and Ono Pharmaceutical. K.U. has received honoraria from Dainippon Sumitomo Pharma, Eisai, Eli Lilly, Janssen Pharmaceutical, Kyowa Hakko Kirin, Meiji Seika Pharma, MSD, Takeda Pharmaceutical, Hisamitsu Pharmaceutical, Otsuka Pharmaceutical, Pfizer, Tanabe Mitsubishi Pharma, Shionogi and Yoshitomiyakuhin. B.Y. has received speaker's honoraria from Otsuka Pharmaceutical and Janssen Pharmaceutical. J. I. has received honoraria from Dainippon Sumitomo Pharma, Eli Lilly, Janssen Pharmaceutical, Meiji Seika Pharma, MSD, Novartis Pharma, Otsuka Pharmaceutical and Mochida Pharma.
Experimental study on the instability of wake of axisymmetric streamlined body
- MASAHITO ASAI, AYUMU INASAWA, YASUFUMI KONISHI, SHINICHI HOSHINO, SHOHEI TAKAGI
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- Journal:
- Journal of Fluid Mechanics / Volume 675 / 25 May 2011
- Published online by Cambridge University Press:
- 29 March 2011, pp. 574-595
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The instability of wake of an axisymmetric body with the NACA aerofoil section was experimentally studied under low background turbulence. The body was suspended using a magnetic suspension and balance system to avoid undesirable influences of mechanical supports on the disturbance development. The Reynolds number based on the chord length of the aerofoil section ranged from 5.3 × 104 to 2.1 × 105. For the body with a NACA0015 aerofoil section where there is no boundary-layer separation on the body surface, the wake was convectively unstable, even at the highest Reynolds number examined. Although the wake maintained axisymmetry of mean flow, the instability waves often took a planar-symmetric form, indicating that the occurrence of disturbance can be influenced by minute variations in the position and orientation of the suspended body. For bodies with thicker NACA0018 and NACA0024 aerofoil sections where the flow involved a region of absolute instability immediately downstream of the trailing edge, the global mode could grow rapidly and attain saturation amplitude within a very short distance from the trailing edge despite that the region of absolute instability was limited only to small streamwise distance, about one tenth of the instability wavelength. The predominant frequency of vortex shedding was found to be very close to the absolute frequency near the trailing edge, especially at the upstream boundary of the region of absolute instability. This is consistent with the theoretical model for the development of a nonlinear global mode. It was also found that the mean flow axisymmetry was broken around the critical Reynolds number for global instability, which led to the appearance and growth of a planar-symmetric global mode.
Growth and breakdown of low-speed streaks leading to wall turbulence
- MASAHITO ASAI, YASUFUMI KONISHI, YUKI OIZUMI, MICHIO NISHIOKA
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- Journal:
- Journal of Fluid Mechanics / Volume 586 / 10 September 2007
- Published online by Cambridge University Press:
- 14 August 2007, pp. 371-396
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Two-dimensional local wall suction is applied to a fully developed turbulent boundary layer such that near-wall turbulence structures are completely sucked out, but most of the turbulent vortices in the original outer layer can survive the suction and cause the resulting laminar flow to undergo re-transition. This enables us to observe and clarify the whole process by which the suction-surviving strong vortical motions give rise to near-wall low-speed streaks and eventually generate wall turbulence. Hot-wire and particle image velocimetry (PIV) measurements show that low-frequency velocity fluctuations, which are markedly suppressed near the wall by the local wall suction, soon start to grow downstream of the suction. The growth of low-frequency fluctuations is algebraic. This characterizes the streak growth caused by the suction-surviving turbulent vortices. The low-speed streaks obtain almost the same spanwise spacing as that of the original turbulent boundary layer without the suction even in the initial stage of the streak development. This indicates that the suction-surviving turbulent vortices are efficient in exciting the necessary ingredients for the wall turbulence, namely, low-speed streaks of the correct scale. After attaining near-saturation, the low-speed streaks soon undergo sinuous instability to lead to re-transition. Flow visualization shows that the streak instability and its subsequent breakdown occur at random in space and time in spite of the spanwise arrangement of streaks being almost periodic. Even under the high-intensity turbulence conditions, the sinuous instability amplifies disturbances of almost the same wavelength as predicted from the linear stability theory, though the actual growth is in the form of a wave packet with not more than two waves. It should be emphasized that the mean velocity develops the log-law profile as the streak breakdown proceeds. The transient growth and eventual breakdown of low-speed streaks are also discussed in connection with the critical condition for the wall-turbulence generation.