Association of Muscle Mass Loss with Diabetes Development in Liver Transplantation Recipients.

BACKGRUOUND: Post-transplant diabetes mellitus (PTDM) is one of the most significant complications after transplantation. Patients with end-stage liver diseases requiring transplantation are prone to sarcopenia, but the association between sarcopenia and PTDM remains to be elucidated. We aimed to investigate the effect of postoperative muscle mass loss on PTDM development. METHODS: A total of 500 patients who underwent liver transplantation at a tertiary care hospital between 2005 and 2020 were included. Skeletal muscle area at the level of the L3-L5 vertebrae was measured using computed tomography scans performed before and 1 year after the transplantation. The associations between the change in the muscle area after the transplantation and the incidence of PTDM was investigated using a Cox proportional hazard model. RESULTS: During the follow-up period (median, 4.9 years), PTDM occurred in 165 patients (33%). The muscle mass loss was greater in patients who developed PTDM than in those without PTDM. Muscle depletion significantly increased risk of developing PTDM after adjustment for other confounding factors (hazard ratio, 1.50; 95% confidence interval, 1.23 to 1.84; P=0.001). Of the 357 subjects who had muscle mass loss, 124 (34.7%) developed PTDM, whereas of the 143 patients in the muscle mass maintenance group, 41 (28.7%) developed PTDM. The cumulative incidence of PTDM was significantly higher in patients with muscle loss than in patients without muscle loss (P=0.034). CONCLUSION: Muscle depletion after liver transplantation is associated with increased risk of PTDM development.

Effect of Sodium-Glucose Cotransporter-2 Inhibitors versus Dipeptidyl Peptidase 4 Inhibitors on Cardiovascular Function in Patients with Type 2 Diabetes Mellitus and Coronary Artery Disease.

BACKGROUND: Randomized controlled trials demonstrated lowering risks of cardiovascular events with sodium-glucose cotransporter-2 (SGLT2) inhibitors in patients with type 2 diabetes mellitus (T2DM) and high cardiovascular risk. We analyzed the effects of cardiovascular function on SGLT2 inhibitors compared with dipeptidyl peptidase-4 (DPP4) inhibitors in T2DM with atherosclerotic cardiovascular disease (ASCVD) or heart failure (HF). METHODS: This is a retrospective, observational, single center study. Data from 89 patients with ASCVD or HF from January 2015 to February 2018 were analyzed regarding the effect of SGLT2 inhibitors and DPP4 inhibitors. Cardiovascular function was assessed by 2-D echocardiography and N-terminal prohormone of brain natriuretic peptide (NT-pro BNP). RESULTS: A total of 89 patients with T2DM were considered in two groups of SGLT2 inhibitors (n=41) and DPP4 inhibitors (n=48). The mean follow-up period was 2 years, with a total of 89 patient-years. Despite no significant change in systolic function, SGLT2 inhibitors improved cardiovascular function, as demonstrated by a reduced left ventricular ejection fraction less than 40%, ratio of mitral peak velocity of early filling velocity to early diastolic mitral annular velocity, ratio of early to late ventricular filling velocities, and NT-pro BNP compared with the DPP4 inhibitor group. CONCLUSION: SGLT2 inhibitors improve cardiovascular function in T2DM with coronary artery disease compared to DPP4 inhibitors.

Balancing participation and risks in children's Internet use: the role of internet literacy and parental mediation.

This study analyzed the survey data from 566 Korean children between the ages of 10 and 15 to examine the role of Internet literacy and parental mediation in solving the dilemma of children's Internet use. According to the findings, children's online participation was associated with increased exposure to online risks. The association was moderated by Internet skills and parental restrictive mediation; that is, for children with a high level of Internet skills and for children who received more restrictive mediation, the positive association between online participation and online risks weakened, but was still significant. The limited roles of Internet skills and parental restrictive mediation in children's Internet use were discussed in the context of media education.

Predicting children's media use in the USA: differences in cross-sectional and longitudinal analysis.

The purpose of this paper is to examine the predictors of children's media use in the USA, comparing cross-sectional and longitudinal analyses. Data come from Waves I and 2 of the Child Development Supplement (CDS-I; CDS-II), a nationally representative sample of American children aged 0-12 in 1997 and 5-18 in 2002. Twenty-four hour time use diaries are used to assess children's time spent with media (television, video games, computers, and reading). Predictors examined include socio-demographics, neighbourhood quality, family factors, and other media use. Ordinary least square (OLS) multiple regressions were performed by three age groups (preschoolers, early school age, and preadolescence). The findings suggest that neighbourhood quality, parental limits and family conflict are significant predictors of children's media use within time or over time, but the significance depends on the type of media and child's developmental stage. In addition, children's television viewing and reading habits are formed early in life and reinforced over time. This study is among the first to provide empirical evidence for the effect of early contextual factors on the life course of children's media use from a developmental perspective.

Measuring Children's Media Use in the Digital Age: Issues and Challenges.

In this new and rapidly changing era of digital technology, there is increasing consensus among media scholars that there is an urgent need to develop measurement approaches which more adequately capture media use The overarching goal of this paper is facilitate the development of measurement approaches appropriate for capturing children's media use in the digital age. The paper outlines various approaches to measurement, focusing mainly on those which have figured prominently in major existing studies of children's media use. We identify issues related to each technique, including advantages and disadvantages. We also include a review of existing empirical comparisons of various methodologies. The paper is intended to foster discussion of the best ways to further research and knowledge regarding the impact of media on children.

Children's Internet use in a family context: influence on family relationships and parental mediation.

We conducted a survey of 222 fourth-, fifth-, and sixth-grade Korean children to examine (a) whether children's Internet use influences declines in family time and family communication and (b) how parental mediation techniques are related to children's online activities. According to the findings, total time using the Internet was related to perceived declines in family time but not related to family communication. The influence of the Internet on family time and family communication differed by the type of children's online activities. The analysis of the relationship between parental mediation techniques and children's online activities indicated that parents' recommendation of useful Web sites and co-using were positively related to frequency of children's educational online activities. However, parental restrictions on time and Web sites did not alter children's actual Internet usage.