Health state utility values and patient-reported outcomes before and after vertebral and non-vertebral fractures in an osteoporosis clinical trial

We assessed the health state utility value (HSUV) reductions associated with vertebral fractures using data collected in the Japanese Osteoporosis Intervention Trial-03 (JOINT-03). Our analysis revealed that assessment of HSUVs after morphometric vertebral fracture is important to capture the burden of vertebral fractures.

INTRODUCTION

Evaluation of the HSUV after fracture is important to calculate the quality-adjusted life years (QALYs) of osteoporosis patients, which is essential information in the context of health economic evaluation.

METHODS

JOINT-03 study patients were aged ≥65 years and treated with risedronate and vitamin K₂ or risedronate alone. Radiographic information and patient-reported outcomes measured by EQ-5D and a visual analogue scale (VAS) were assessed at registration and followed up after 6, 12, and 24 months. According to differences among the dates of these assessments and the radiographic information, we classified the follow-up HSUVs calculated based on EQ-5D results into before or after fracture categories regardless of clinical symptoms.

RESULTS

Among 2922 follow-up HSUVs, 201 HSUVs were categorized as HSUVs that were observed after incident vertebral fractures on X-ray films. The median time from the detection of an incident vertebral fracture until the EQ-5D assessment was 53 days (25th percentile, 0 day; 75th percentile, 357 days). The impact of incident vertebral fractures on HSUVs was quantified as -0.03. Among the five health profile domains on the EQ-5D, an incident vertebral fracture had significant effects on anxiety/depression, self-care, and usual activities.

CONCLUSIONS

The results suggest that incident morphometric vertebral fracture was associated with impairment of the HSUV for patients with osteoporosis not only immediately but also several months after the fracture.

Measurement of effect of electron cyclotron heating in a tandem mirror plasma using a semiconductor detector array and an electrostatic energy analyzer

Temporally and spatially resolved soft x-ray and end-loss-electron analyses of the electron cyclotron heated plasmas are carried out by using a semiconductor detector array and an electrostatic energy analyzer in the GAMMA 10 tandem mirror. The flux and the energy spectrum of the end loss electrons are measured by a multi-grid energy analyzer. Recently, the electron cyclotron heating power modulation experiments have been started in order to generate and control the high heat flux and to make the edge localized mode-like intermittent heat load pattern for the divertor simulation studies by the use of these detectors for electron properties.

Analysis method for Thomson scattering diagnostics in GAMMA 10/PDX

We have developed an analysis method to improve the accuracies of electron temperature measurement by employing a fitting technique for the raw Thomson scattering (TS) signals. Least square fitting of the raw TS signals enabled reduction of the error in the electron temperature measurement. We applied the analysis method to a multi-pass (MP) TS system. Because the interval between the MPTS signals is very short, it is difficult to separately analyze each Thomson scattering signal intensity by using the raw signals. We used the fitting method to obtain the original TS scattering signals from the measured raw MPTS signals to obtain the electron temperatures in each pass.

Fano resonance of Li-doped KTa(1-x)NbxO3 single crystals studied by Raman scattering

The enhancement of functionality of perovskite ferroelectrics by local structure is one of current interests. By the Li-doping to KTa_1−xNb_xO₃ (KTN), the large piezoelectric and electro-optic effects were reported. In order to give new insights into the mechanism of doping, the microscopic origin of the Fano resonance induced by the local structure was investigated in 5%Li-doped KTN single crystals by Raman scattering. The coupling between the continuum states and the transverse optical phonon near 196 cm⁻¹ (Slater mode) caused a Fano resonance. In the vicinity of the cubic-tetragonal phase transition temperature, T_C-T = 31 °C, the almost disappearance of the Fano resonance and the remarkable change of the central peak (CP) intensity were observed upon heating. The local symmetry of the polar nanoregions (PNRs), which was responsible for the symmetry breaking in the cubic phase, was determined to E(x, y) symmetry by the angular dependence of Raman scattering. The electric field induced the significant change in the intensity of both CP and Fano resonance. From these experimental results, it is concluded that the origin of the Fano resonance in Li-doped KTN crystals is the coupling between polarization fluctuations of PNRs and the Slater mode, both belong to the E(x, y) symmetry.

Age-related Changes in Energy Intake and Weight in Community-dwelling Middle-aged and Elderly Japanese

OBJECTIVE

This study attempts to describe trends in energy intake and weight change over 12 years according to age at first participation in the study.

DESIGN

Prospective cohort study.

SETTING

The National Institute for Longevity Sciences - Longitudinal Study of Aging (NILS-LSA), a community-based study.

PARTICIPANTS

Participants included 922 men and 879 women who participated in the first study-wave (age 40-79 years) and also participated in at least one study-wave from the second to seventh study-wave. Each study-wave was conducted biennially. For individuals, the entire follow-up period was 12 years.

MEASUREMENTS

Energy intake was calculated from 3-day dietary records with photographs. Weight and height were measured under a fasting state. To estimate linear changes in energy intake and weight over 12 years according to age at first study-wave, we used the mixed-effects model.

RESULTS

Mean (SD) follow-up time and number of study-wave visits were 9.5 (3.7) years and 5.4 (1.8) times, respectively. The fixed effect of the interaction of age and time in energy intake and weight was statistically or marginally statistically significant both in men (p<0.01) and in women (p<0.06). In men, when energy intake was estimated according to age, the rate of decrease in energy intake increased from -6.8 to -33.8 kcal/year for ages 40-79 years. In women, the rate of decrease in energy intake slightly increased in older age groups (-9.1 to -16.7 kcal/year for ages 40-79 years). Weight increased in males in their 40s (0.07 kg/year from age 40) and started to decline by age 53. In women, weight started to decline around age 47 (-0.04 kg/year).

CONCLUSION

Twelve-year longitudinal data showed energy intake declined both in men and women in their 40s, and the rate of decrease increased in older males. Weight started to decline in men in their mid-50s and women in their late 40s. Further studies that focus on energy intake and weight reduction are needed to prevent weight loss or underweight in an increasingly aging society.

Immunogenic cell death by oncolytic herpes simplex virus type 1 in squamous cell carcinoma cells

Molecules essential for the induction of immunogenic cell death (ICD) are called damage-associated molecular patterns (DAMPs). The effects of oncolytic herpes simplex virus type 1 (HSV-1) on the production of DAMPs were examined in squamous cell carcinoma (SCC) cells. The cytopathic effects of HSV-1 RH2 were observed in mouse SCCVII cells infected at a high multiplicity of infection (MOI), and the amounts of viable cells were decreased. After being infected with RH2, ATP and high mobility group box 1 (HMGB1) were released extracellulary, while calreticulin (CRT) translocated to the cell membrane. A flow-cytometric analysis revealed an increase in the number of annexin-V and propidium iodide (PI)-stained cells; and the amount of cleaved poly (ADP-ribose) polymerase (PARP) was increased. The killing effect of RH2 was reduced by pan-caspase inhibitor z-VAD-fmk and the caspase-1 inhibitor z-YVAD-fmk, suggesting the involvement of apoptosis and pyroptosis. In C3H mice bearing synergic SCCVII tumors, the growth of tumors injected with the supernatant of RH2-infected cells was less than that of tumors injected with phosphate-buffered saline (PBS). These results indicate that oncolytic HSV-1 RH2 produces DAMPs from SCC cells to induce cell death. This may contribute to the enhancement of tumor immunity by oncolytic HSV-1.

Human papilloma virus detection in oropharyngeal cancer with gargle samples

Human papilloma virus detection in oropharyngeal cancer with gargle samples.

OBJECTIVE

human papilloma virus (HPV) is a major risk factor for oropharyngeal squamous cell carcinoma (OPSCC) and knowledge of a patient's HPV status is clinically important in terms of treatment and prognosis. The practicality of using oral gargle samples to reliably detect HPV in patients with OPSCC remains unclear. Therefore, we evaluated the feasibility of HPV detection in gargle samples of OPSCC patients using an HPV-dedicated nucleic acid amplification test (cobas 4800 HPV Test; Roche Diagnostics K.K.).

METHODOLOGY

15 patients with histologically proven OPSCC were evaluated from May 2014 to March 2015. Swab sam- ples served as positive controls and were tested using both the Hybrid Capture II HPV Test (HC-II; Digene Corporation) and the cobas 4800 HPV Test. Oral gargle samples were tested using the cobas 4800 HPV Test. Five of the 15 patients were confirmed to be HPV-positive by a combination of p16 immunohistochemistry, HPV-DNA in situ hybridization and nucleic acid amplification.

RESULTS

the sensitivity and specificity of the gargling method were 60% and 100%, respectively. No false-positives were obtained. Detection of HPV in two very small tumours rising from the base of the tongue was difficult and these cases were overlooked as HPV-negative.

CONCLUSIONS

use of the gargling method to determine HPV positivity in OPSCC patients appears feasible, except in patients with very small tumours. Real-time polymerase chain reaction using gargle samples may have greater clinical efficacy than the swabbing method.

NMR investigation of the quasi-one-dimensional superconductor K(2)Cr(3)As(3)

We report ^{75}As NMR measurements on the new quasi-one-dimensional superconductor K_{2}Cr_{3}As_{3} (T_{c}∼6.1  K) [J. K. Bao et al., Phys. Rev. X 5, 011013 (2015)]. We found evidence for strong enhancement of Cr spin fluctuations above T_{c} in the [Cr_{3}As_{3}]_{∞} double-walled subnanotubes based on the nuclear spin-lattice relaxation rate 1/T_{1}. The power-law temperature dependence, 1/T_{1}T∼T^{-γ} (γ∼0.25), is consistent with the Tomonaga-Luttinger liquid. Moreover, absence of the Hebel-Slichter coherence peak of 1/T_{1} just below T_{c} suggests an unconventional nature of superconductivity.

Soft x-ray intensity profile measurements of electron cyclotron heated plasmas using semiconductor detector arrays in GAMMA 10 tandem mirror

Temporally and spatially resolved soft x-ray analyses of electron cyclotron heated plasmas are carried out by using semiconductor detector arrays in the GAMMA 10 tandem mirror. The detector array has 16-channel for the measurements of plasma x-ray profiles so as to make x-ray tomographic reconstructions. The characteristics of the detector array make it possible to obtain spatially resolved plasma electron temperatures down to a few tens eV and investigate various magnetohydrodynamic activities. High power electron cyclotron heating experiment for the central-cell region in GAMMA 10 has been started in order to reduce the electron drag by increasing the electron temperature.

First results of electron temperature measurements by the use of multi-pass Thomson scattering system in GAMMA 10

A multi-pass Thomson scattering (TS) has the advantage of enhancing scattered signals. We constructed a multi-pass TS system for a polarisation-based system and an image relaying system modelled on the GAMMA 10 TS system. We undertook Raman scattering experiments both for the multi-pass setting and for checking the optical components. Moreover, we applied the system to the electron temperature measurements in the GAMMA 10 plasma for the first time. The integrated scattering signal was magnified by approximately three times by using the multi-pass TS system with four passes. The electron temperature measurement accuracy is improved by using this multi-pass system.

Synthesis of Quinolactacideviaan Acyl Migration Reaction and Dehydrogenation with Manganese Dioxide, and Its Insecticidal Activities

Quinolactacide isolated from Penicillium citrinum F 1539 was synthesized and evaluated for its insecticidal activities. The key steps of the total synthesis were an acyl migration reaction of the enol ester intermediate and dehydrogenation of tetrahydroquinolactacide with manganese dioxide. The synthesized quinolactacide showed 100% and 42% mortality against the green peach aphid (Myzus persicae) and diamondback moth (Plutella xylostella) at 500 ppm, respectively.

Serum docosahexaenoic and eicosapentaenoic acid and risk of cognitive decline over 10 years among elderly Japanese

BACKGROUND/OBJECTIVES

To clarify the association of serum docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) levels with cognitive decline over 10 years.

SUBJECTS/METHODS

This study was part of the National Institute for Longevity Sciences - Longitudinal Study of Aging, and was conducted with 232 male and 198 female Japanese community-dwelling subjects aged 60-79 years in the second wave (2000-2002). Cognitive function was assessed with the Mini-Mental State Examination (MMSE) in both the second and seventh (2010-2012) waves. Fasting venous blood samples were collected in the morning, and serum DHA and EPA levels were measured. Multiple logistic regression analysis was performed among participants with an MMSE score ≥ 24 in the second wave (n=430) to estimate the odds ratio (OR) and 95% confidence interval (CI) for MMSE score ≤ 23 or MMSE score decline ≥ 4 10 years later. These estimates were based on baseline tertiles of serum DHA or EPA levels, and controlled for age, sex, education, MMSE score at baseline, alcohol consumption, current smoking, body mass index and disease history.

RESULTS

Fifteen (3.5%) subjects whose MMSE score was ≤ 23 and 36 (8.3%) subjects whose MMSE score declined to ≥ 4 showed cognitive decline. Multivariate-adjusted OR (95% CI) for the lowest through highest tertiles of serum DHA to MMSE score ≤ 23 or decline ≥ 4 were 1.00 (reference), 0.11 (0.02-0.58) and 0.17 (0.04-0.74), or 1.00 (reference), 0.22 (0.08-0.61) and 0.31 (0.12-0.75), respectively (P for trend=0.01 or 0.04). Serum EPA was not associated with cognitive decline.

CONCLUSIONS

The study gives some indication that a moderately high level of serum DHA might prevent cognitive decline among community-dwelling elderly Japanese individuals.

Control of cerebrospinal fluid otorrhea via C-arm-guided reduction of the zygomatic arch as a part of the temporal bone: interdisciplinary approach to an unusual craniomaxillofacial fracture

Maxillofacial fractures are often associated with blunt head injuries, of which skull base trauma is a common component. However, most oral and maxillofacial surgeons do not provide definitive management of temporal bone fractures involving the skull base and their sequelae. Persistent cerebrospinal fluid (CSF) leakage that is refractory to conservative measures usually requires surgical closure to decrease the risk of meningitis. In general, reduction of the displaced fragment of the skull base in temporal bone fractures is not considered a priority. We describe an unusual case of craniomaxillofacial injury exhibiting CSF otorrhea because of a temporal bone fracture with a fragment that included the zygomatic arch. The persistent traumatic leakage was stopped after C-arm-guided reduction of the depressed zygomatic arch. This technique facilitated minimal and only necessary manipulation, without overcorrection, thereby avoiding additional damage to the surrounding tissues. The present case illustrates the definitive contribution of therapeutic measures based on maxillofacial surgery as part of an interdisciplinary approach to the management of the complications of severe head injuries; more invasive neurosurgery was thus avoided.

Hydrogen sulphide increases hepatic differentiation of human tooth pulp stem cells compared with human bone marrow stem cells

AIM

To determine the differences in stem cell properties, in hepatic differentiation and in the effects of hydrogen sulphide (H2 S) on hepatic differentiation between human bone marrow stem cells (hBMC) and stem cells from human exfoliated primary tooth pulp (SHED).

METHODOLOGY

CD117(+) cells were magnetically separated and subjected to hepatic differentiation. CD117(+) cell lineages were characterized for transcription factors indicative of stem cells by qRT-PCR. For the last 9 days of the differentiation, the test cells were exposed to 0.1 ng mL(-1) H2 S. Immunocytochemistry and flow cytometry of albumin, alpha-fetoprotein and carbamoyl phosphate synthetase were carried out after differentiation. Urea concentration and glycogen synthesis were also determined.

RESULTS

Genes expressed in SHED were also expressed in BMC. No difference in expression level of hepatic markers was shown by immunofluorescence. SHED showed more positive cells than hBMC (P < 0.01). H2 S increased the number of positive cells in both cultures (P < 0.01). Urea concentration and glycogen synthesis increased significantly after H2 S exposure (P < 0.001 and P < 0.05, respectively). Real-time PCR data were analysed by RT(2) profiler RT-PCR Array Data Analysis version 3.5 (Qiagen), and ELISA data were analysed by Bonferroni's multiple comparison using Windows spss version 16 (SPSS Inc, Chicago, IL, USA). Bonferroni's multiple comparison test was also carried out after angle transformation for the percentage data of flow cytometer using Windows spss(®) version 16 (SPSS Inc). Statistical significance was accepted at P < 0.05.

CONCLUSIONS

Stem cells from human exfoliated primary tooth pulp and BMC have similar properties. The level of hepatic differentiation in SHED compared with BMC was the same or higher. H2 S increased the level of hepatic differentiation.

Cereal Intake Increases and Dairy Products Decrease Risk of Cognitive Decline among Elderly Female Japanese

BACKGROUND

If cognitive decline can be prevented through changes in daily diet with no medical intervention, it will be highly significant for dementia prevention.

OBJECTIVES

This longitudinal study examined the associations of different food intakes on cognitive decline among Japanese subjects.

DESIGN

Prospective cohort study.

SETTING

The National Institute for Longevity Sciences - Longitudinal Study of Aging, a community-based study.

PARTICIPANTS

Participants included 298 males and 272 females aged 60 to 81 years at baseline who participated in the follow-up study (third to seventh wave) at least one time.

MEASUREMENTS

Cognitive function was assessed with the Mini-Mental State Examination (MMSE) in all study waves. Nutritional intake was assessed using a 3-day dietary record in the second wave. Cumulative data among participants with an MMSE >27 in the second wave were analyzed using a generalized estimating equation. Multivariate adjusted odds ratios (OR) and 95% confidence intervals (CI) for an MMSE score ≤27 in each study wave according to a 1 standard deviation (SD) increase of each food intake at baseline were estimated, after adjusting for age, follow-up time, MMSE score at baseline, education, body mass index, annual household income, current smoking status, energy intake, and history of diseases.

RESULTS

In men, after adjusting for age, and follow-up period, MMSE score at baseline, the adjusted OR for a decline in MMSE score was 1.20 (95% CI, 1.02-1.42; p=0.032) with a 1-SD increase in cereal intake. After adjusting for education and other confounding variables, the OR for a decrease in MMSE score did not reach statistical significance for this variable. In women, multivariate adjusted OR for MMSE decline was 1.43 (95% CI, 1.15-1.77; p=0.001) with a 1-SD increase in cereal intake and 0.80 (95% CI, 0.65-0.98; p=0.034) with a 1-SD increase in milk and dairy product intake.

CONCLUSIONS

This study indicates that a 1-SD (108 g/day) decrease in cereal intake and a 1-SD (128 g/day) increase in milk and dairy product intake may have an influence of cognitive decline in community-dwelling Japanese women aged 60 years and older. Further studies are needed in order to explore the potential causal relationship.

Mandibular fracture patterns consistent with posterior maxillary fractures involving the posterior maxillary sinus, pterygoid plate or both: CT characteristics

OBJECTIVES

The aim of this study was to determine the incidence of posterior maxillary fractures involving the posterior maxillary sinus wall, pterygoid plate or both, unrelated to major midface fractures in patients with mandibular fractures, and to characterize associated fractures.

METHODS

A CT study was performed in patients with mandibular fractures to identify posterior maxillary fractures. Patients aged under 16 years, those with mandibular fractures involving only dentoalveolar components and those with concurrent major midfacial fractures were excluded.

RESULTS

13 (6.7%) of 194 patients with mandibular fractures also had posterior maxillary fractures (case group). The injury pattern correlated with the external force directed to the lateral side of the mandible (p < 0.001), alcohol consumption (p = 0.049), the presence of multifocal fractures (p = 0.002) and the fracture regions in the symphysis/parasymphysis (p = 0.001) and the angle/ramus (p = 0.001). No significant difference between the case and non-case groups was seen for age, sex or cause of trauma. Non-displaced fractures in the ipsilateral posterior mandible occurred with significant frequency (p = 0.001) when the posterior maxillary fractures involved only the sinus.

CONCLUSIONS

Mandibular fractures accompanied by posterior maxillary fractures are not rare. The finding of a unilateral posterior maxillary fracture on CT may aid the efficient radiological examination of the mandible based on possible patterns of associated fractures, as follows: in the ipsilateral posterior region as a direct fracture when the impact is a medially directed force, and in the symphysis/parasymphysis or contralateral condylar neck as an indirect fracture.