Pth1r in Neural Crest Cells Regulates Nasal Cartilage Differentiation

Neural crest cells (NCC) arise from the dorsal margin of the neural plate border and comprise a unique cell population that migrates to and creates the craniofacial region. Although factors including Shh, Fgf8, and bone morphogenetic proteins have been shown to regulate these biological events, the role of parathyroid hormone 1 receptor (Pth1r) has been less studied. We generated an NCC-specific mouse model for Pth1r and researched gene expression, function, and interaction focusing on nasal cartilage framework and midfacial development. Wnt1-Cre;Pth1rfl/fl;Tomatofl/+ mice had perinatal lethality, but we observed short snout and jaws, tongue protrusion, reduced NCC-derived cranial length, increased mineralization in nasal septum and hyoid bones, and less bone mineralization at interfrontal suture in mutants at E18.5. Importantly, the mutant nasal septum and turbinate cartilage histologically revealed gradual, premature accelerated hypertrophic differentiation. We then studied the underlying molecular mechanisms by performing RNA seq analysis and unexpectedly found that expression of Ihh and related signaling molecules was enhanced in mutant nasomaxillary tissues. To see if Pth1r and Ihh signaling are associated, we generated a Wnt1-Cre; Ihhfl/fl;Pth1rfl/fl;Tomatofl/+ (DKO) mouse and compared the phenotypes to those of each single knockout mouse: Wnt1-Cre; Ihhfl/fl;Pth1rfl/+;Tomatofl/+ (Ihh-CKO) and Wnt1-Cre;Ihhfl/+;Pth1rfl/fl;Tomatofl/+ (Pth1r-CKO). Ihh-CKO mice displayed a milder effect. Of note, the excessive hypertrophic conversion of the nasal cartilage framework observed in Pth1r-CKO was somewhat rescued DKO embryos. Further, a half cAMP responsive element and the 4 similar sequences containing 2 mismatches were identified from the promoter to the first intron in Ihh gene. Gli1-CreERT2;Pth1rfl/fl;Tomatofl/+, a Pth1r-deficient model targeted in hedgehog responsive cells, demonstrated the enlarged hypertrophic layer and significantly more Tomato-positive chondrocytes accumulated in the nasal septum and ethmoidal endochondral ossification. Collectively, the data suggest a relevant Pth1r/Ihh interaction. Our findings obtained from novel mouse models for Pth1r signaling illuminate previously unknown aspects in craniofacial biology and development.

Effect of Daikenchuto Therapy on Risk of Rectal Bleeding after IMRT for Prostate Cancer

PURPOSE/OBJECTIVE(S)

Rectal bleeding due to radiation proctitis after treatment in radiation therapy for prostate cancer is a typical late toxicity symptom. The rate of rectal bleeding has been reduced by using IMRT, IGRT and peri-rectal hydrogel spacer. On the other hand, few reports have attempted to reduce the rate of rectal bleeding by medication. It has been reported that Daikenchuto (DKT), a traditional Japanese herbal medicine, has the effects of accelerating gastrointestinal motility and anti-fibrosis. We retrospectively investigated the rate of rectal bleeding in patients between concurrently administered and not administered DKT for bowel control during IMRT for prostate cancer.

MATERIALS/METHODS

The subjects were 102 patients who underwent definitive IMRT for prostate cancer between 2014 and 2021 in our hospital. The DKT therapy concurrent use group were included 46 patients (45%), who were administered DKT per 10.0 g / day or 15.0 g / day. The irradiation was carried out, confirming the rectal volume every time by the image-guided radiotherapy using cone beam CT in all cases. The curative doses fractionation of IMRT were 78 Gy in 2 Gy per fraction (40%) or 70 Gy in 2.5 Gy per fraction (60%). We compared the rate of rectal bleeding after IMRT with and without DKT. Late rectal bleeding toxicity was scored using the Common Terminology Criteria for Adverse Events ver. 5.0 criteria. The associated factors of rectal bleeding were examined using the Cox proportional hazard model for multivariate analysis.

RESULTS

In the DKT therapy group, the median follow-up period was 31 months (Range: 17-84 months), and the rectal bleeding rate was Grade 1 in 2 patients (4%) and Grade ≥ 2 in none. The median observation period in the non-DKT therapy group was 48 months (Range: 17-101 months), and the rectal bleeding rate was Grade 1 in 12 patients (21%), Grade 2 in 6 patients (10%), and there were no events of Grade ≥ 3. In univariate analysis, DKT therapy, dose fractionation and planned rectal doses (V50, V55, V60, V65, V70 and V75 converted to EQD23) were significant factors for rectal bleeding. Multivariate analysis showed that the DKT therapy was a significant independent factor in reducing the rate of rectal bleeding (HR: 0.105, 95% CI: 0.01-0.50, P = 0.003).

CONCLUSION

It was statistically suggested in this study that the DKT therapy further reduced the rate of rectal bleeding in IMRT for prostate cancer.

Pth1r Signal in Gli1+ Cells Maintains Postnatal Cranial Base Synchondrosis

Cranial base synchondroses are the endochondral ossification centers for cranial base growth and thus indispensable for proper skull, brain, and midfacial development. The synchondroses are composed of mirror-image growth plates that are continuously maintained from the embryonic to postnatal stage through chondrocyte differentiation. Several factors, including Pth1r signaling, are known to control fetal synchondrosis development. However, there are currently no reports regarding any role for Pth1r signaling in postnatal cranial base and synchondrosis development. Also, the mesenchymal cells that source Pth1r signaling for synchondroses are not known. Here, we employed an inducible mouse model, a hedgehog-responsive Gli1-CreERT2 driver, focusing on the postnatal study. We performed 2 inducible protocols using Gli1-CreERT2;Tomatofl/+ mice that uncovered distinct patterning of Gli1-positive and Gli1-negative chondrocytes in the synchondrosis cartilage. Moreover, we generated Gli1-CreERT2;Pth1rfl/fl;Tomatofl/+ mice to assess their functions in postnatal synchondrosis and found that the mutants had survived postnatally. The mutant skulls morphologically presented unambiguous phenotypes where we noticed the shortened cranial base and premature synchondrosis closure. Histologically, gradual disorganization in mutant synchondroses caused an uncommon remaining central zone between hypertrophic zones on both sides while the successive differentiation of round, flat, and hypertrophic chondrocytes was observed in control sections. These mutant synchondroses disappeared and were finally replaced by bone. Of note, the mutant fusing synchondroses lost their characteristic patterning of Gli1-positive and Gli1-negative chondrocytes, suggesting that loss of Pth1r signaling alters the distribution of hedgehog-responsive chondrocytes. Moreover, we performed laser microdissection and RNA sequencing to characterize the flat proliferative and round resting chondrocytes where we found flat chondrocytes have a characteristic feature of both chondrocyte proliferation and maturation. Taken together, these data demonstrate that Pth1r signaling in Gli1-positive cells is essential for postnatal development and maintenance in cranial base synchondroses. Our findings will elucidate previously unknown aspects of Pth1r functions in cranial biology and development.

Geriatric nutritional risk index as the prognostic factor in older patients with fragility hip fractures

This study investigated the long-term survival and incidence of secondary fractures after fragility hip fractures. The 5-year survival rate was 62%, and the mortality risk was seen in patients with GNRI < 92. The 5-year incidence of secondary fracture was 22%, which was significantly higher in patients with a BMI < 20.

BACKGROUND

Malnutrition negatively influences the postoperative survival of patients with fragility hip fractures (FHFs); however, little is known about their association over the long term.

OBJECTIVE

This study evaluated the ability of the geriatric nutritional risk index (GNRI) as a risk factor for long-term mortality after FHFs.

METHODS

This study included 623 Japanese patients with FHFs over the age of 60 years. We prospectively collected data on admission and during hospitalization and assessed the patients' conditions after discharge through a questionnaire. We examined the long-term mortality and the incidence of secondary FHFs and assessed the prognostic factors.

RESULTS

The mean observation period was 4.0 years (range 0-7 years). The average age at the time of admission was 82 years (range 60-101 years). The overall survival after FHFs (1 year, 91%; 5 years, 62%) and the incidence of secondary FHFs were high (1 year, 4%; 5 years, 22%). The multivariate Cox proportional hazard analysis revealed the risk factors for mortality as older age (hazard ratio [HR] 1.04), male sex (HR 1.96), lower GNRI score (HR 0.96), comorbidities (malignancy, HR 2.51; ischemic heart disease, HR 2.24; revised Hasegawa dementia scale ≤ 20, HR 1.64), no use of active vitamin D3 on admission (HR 0.46), and a lower Barthel index (BI) (on admission, HR 1.00; at discharge, HR 0.99). The GNRI scores were divided into four risk categories: major risk (GNRI, < 82), moderate risk (82-91), low risk (92-98), and no risk (> 98). Patients at major and moderate risks of GNRI had a significantly lower overall survival rate (p < 0.001). Lower body mass index (BMI) was also identified as a prognostic factor for secondary FHFs (HR 0.88 [p = 0.004]).

CONCLUSIONS

We showed that older age, male sex, a lower GNRI score, comorbidities, and a lower BI are risk factors for mortality following FHFs. GNRI is a novel and simple predictor of long-term survival after FHFs.

Formation of NV centers in diamond by a femtosecond laser single pulse

The NV centers in a diamond were successfully created by the femtosecond laser single pulse. We also investigated the effect on the diamond lattice induced by the different laser pulse widths from both experimental and theoretical perspectives. Interestingly, in spite of the high thermal conductivity of a diamond, we found that there is a suitable pulse repetition rate of several tens kHz for the formation of NV center ensembles by the femtosecond laser pulse irradiation.

Climate change linked to functional homogenization of a subtropical estuarine system

Climate change causes marine species to shift and expand their distributions, often leading to changes in species diversity. While increased biodiversity is often assumed to confer positive benefits on ecosystem functioning, many examples have shown that the relationship is specific to the ecosystem and function studied and is often driven by functional composition and diversity. In the northwestern Gulf of Mexico, tropical species expansion was shown to have increased estuarine fish and invertebrate diversity; however, it is not yet known how those increases have affected functional diversity. To address this knowledge gap, two metrics of functional diversity, functional richness (FRic) and functional dispersion (FDis), were estimated in each year for a 38‐year study period, for each of the eight major bays along the Texas coast. Then, the community‐weighted mean (CWM) trait values for each of the functional traits are calculated to assess how functional composition has changed through time. Finally, principal component analysis (PCA) was used to identify species contributing most to changing functional diversity. We found significant increases in log‐functional richness in both spring and fall, and significant decreases in functional dispersion in spring, suggesting that although new functional types are entering the bays, assemblages are becoming more dominated by similar functional types. Community‐weighted trait means showed significant increases in the relative abundance of traits associated with large, long‐lived, higher trophic level species, suggesting an increase in periodic and equilibrium life‐history strategists within the bays. PCA identified mainly native sciaenid species as contributing most to functional diversity trends although several tropical species also show increasing trends through time. We conclude that the climate‐driven species expansion in the northwestern Gulf of Mexico led to a decrease in functional dispersion due to increasing relative abundance of species with similar life‐history characteristics, and thus the communities have become more functionally homogeneous.

The adverse effects of the phenylpyrazole, fipronil, on juvenile white shrimp Litopenaeus setiferus

Chemical pesticides are commonly used world-wide, and they can flow into estuaries and affect non-targeted organisms. We evaluated the effects of six concentrations of the phenylpyrazole, fipronil (0.0, 0.005, 0.01, 0.1, 1.0, and 3.0 μg/L), which are environmentally relevant, on white shrimp Litopenaeus setiferus (initially averaging 0.80 ± 0.08 g/shrimp). Compared with the control, survivorship of shrimp over 45 days declined significantly at the higher concentration treatments. Growth was affected at all concentrations, and the percent weight gain decreased significantly. Inter-molt intervals were longer in all treatments. Changes in swimming and feeding behavior of shrimp were observed under all treatments, and change in body color was observed at higher concentration treatments. Lipid content in shrimp decreased significantly while ash content increased with fipronil concentration. Fipronil adversely affected white shrimp under the concentrations observed in the environment and monitoring of fipronil use is needed in coastal areas.

Predictive factors of non-treatment and non-persistence to osteoporosis medication after fragility hip fractures at 3 years after discharge: a multicentre, prospective cohort study in the northern Kyushu district of Japan

We examined osteoporosis medication use and factors affecting persistence in 497 patients with fragility hip fractures. Only 25.5% of patients received continuous medication for 3 years, and 44.1% of patients received no treatment. Low Barthel index at discharge was a risk factor for both non-treatment and non-persistence to osteoporosis medication.

PURPOSE

Fragility hip fractures (FHF) caused by osteoporosis decrease the quality of life and worsen life expectancy. Use of osteoporosis medication may be an efficient method in the prevention of secondary FHF. However, previous studies have reported low rates of osteoporosis medication and persistence after FHF. This study aimed to evaluate osteoporosis medication use and factors affecting persistence in patients with FHF in the northern Kyushu area of Japan.

METHODS

A total of 497 FHF patients aged ≥ 60 years with a 3-year follow-up were included. We prospectively collected data from questionnaires sent every 6 months regarding compliance with osteoporosis medication. We compared baseline characteristics among three groups: no treatment (NT), no persistence (NP), and persistence (P), and conducted multivariable regression models to determine covariates associated with non-treatment (NT vs. NP/P) and non-persistence (NP vs. P).

RESULTS

There were 219 (44.1%), 151 (30.4%), and 127 (25.5%) patients in the NT, NP, and P groups, respectively. Factors associated with non-treatment were male sex, chronic kidney disease, no previous osteoporosis treatment, and low Barthel index (BI) at discharge. The only factor associated with non-persistence was a low BI at discharge. Factors associated with a low BI at discharge were male sex, older age, trochanteric fracture, and surgical delay.

CONCLUSION

Low BI at discharge is a risk factor for both non-treatment and non-persistence to osteoporosis medication. Therefore, appropriate interventions to improve BI may result in persistence to osteoporosis medication.

Assessment of a small-scale fishery: Lane Snapper (Lutjanus synagris) using a length metric method

Small-scale fisheries are hard to assess because of the limited availability of data. Therefore, a method requiring easy-to-obtain catch-data is important for the assessment and management of small-scale fisheries. The objective of this study was to assess the effect of fishing gear selectivity on a length-based metric method proposed by Froese by estimating three indicators using catch-data from Lane Snapper (Lutjanus synagris) collected in Honduras. These indicators are (1) the percentage of mature individuals in the catch, (2) the percentage of fish within the range of estimated optimal lengths to be captured, and (3) the percentage of fish larger than the optimal length. These indicators determine the level of overfishing. The indicators were estimated separately for catch-data corresponding to gill nets, and each indicator was estimated with and without selectivity correction. Selectivity and mesh sizes of the fishing gear had a major impact on the estimation of indicators 1 and 2. As for indicator 3, it consistently showed a high level of exploitation. The three estimated indicators suggested that the Lane Snapper fishery in Honduras is experiencing overfishing. Overall, the method appears to be promising for the assessment of small-scale fisheries, but it should be used cautiously.

Effects of cyclic stretching exercise on long-lasting hyperalgesia, joint contracture, and muscle injury following cast immobilization in rats

The effects of exercise on mechanical hyperalgesia, joint contracture, and muscle injury resulting from immobilization are not completely understood. This study aimed to investigate the effects of cyclic stretching on these parameters in a rat model of chronic post-cast pain (CPCP). Seventeen 8-week-old Wistar rats were randomly assigned to (1) control group, (2) immobilization (CPCP) group, or (3) immobilization and stretching exercise (CPCP+STR) group. In the CPCP and CPCP+STR groups, both hindlimbs of each rat were immobilized in full plantar flexion with a plaster cast for a 4-week period. In the CPCP+STR group, cyclic stretching exercise was performed 6 days/week for 2 weeks, beginning immediately after cast removal prior to reloading. Although mechanical hyperalgesia in the plantar skin and calf muscle, ankle joint contracture, and gastrocnemius muscle injury were observed in both immobilized groups, these changes were significantly less severe in the CPCP+STR group than in the CPCP group. These results clearly demonstrate the beneficial effect of cyclic stretching exercises on widespread mechanical hyperalgesia, joint contracture, and muscle injury in a rat model of CPCP.

Monitoring the build-up of hydrogen polarization for polarized hydrogen-deuteride (HD) targets with nuclear magnetic resonance (NMR) at 17 T

We report on the frozen-spin polarized hydrogen-deuteride (HD) targets for photoproduction experiments at SPring-8/LEPS. Pure HD gas with a small amount of ortho-H₂ (∼0.1%) and a very small amount of para-D₂ (∼0.001%) was liquefied and solidified by liquid helium. The temperature of the produced solid HD was reduced to about 30 mK with a dilution refrigerator. A magnetic field (17 T) was applied to the HD to grow the polarization with the static method. After the aging of the HD at low temperatures in the presence of a high-magnetic field strength for three months, the polarization froze. Almost all ortho-H₂ molecules were converted to para-H₂ molecules. Most remaining para-D₂ molecules were converted to ortho-D₂ molecules. The para-H₂ and ortho-D₂ molecules exhibited weak spin interactions with the HD. If the concentrations of the ortho-H₂ and para-D₂ were reduced appropriately at the beginning of the aging process, the aging time can be shortened. We have developed a new nuclear magnetic resonance (NMR) system to measure the relaxation times (T₁) of the ¹H and ²H nuclei with two frequency sweeps at the respective frequencies of 726 MHz and 111 MHz and succeeded in the monitoring of the polarization build-up at decreasing temperatures from 600 mK to 30 mK at 17 T. Automatic NMR measurements with the frequency sweeps enabled us to omit the use of a manual tuning circuit and to remove magnetic field sweeps with eddy current heat. This technique enables us to optimize the concentration of the ortho-H₂ and to efficiently polarize the HD target within a shortened aging time.

Predictive factors of mortality of patients with fragility hip fractures at 1 year after discharge: A multicenter, retrospective study in the northern Kyushu district of Japan

PURPOSE

Fragility hip fractures (FHFs) are associated with a high risk of mortality, but the relative contribution of various factors remains controversial. This study aimed to evaluate predictive factors of mortality at 1 year after discharge in Japan.

METHODS

A total of 497 patients aged 60 years or older who sustained FHFs during follow-up were included in this study. Expected variables were finally assessed using multivariable Cox proportional hazards models.

RESULTS

The 1-year mortality rate was 9.1% (95% confidence interval: 6.8-12.0%, n = 45). Log-rank test revealed that previous fractures (p = 0.003), Barthel index (BI) at discharge (p = 0.011), and place-to-discharge (p = 0.004) were significantly associated with mortality for male patients. Meanwhile, body mass index (BMI; p = 0.023), total Charlson comorbidity index (TCCI; p = 0.005), smoking (p = 0.007), length of hospital stay (LOS; p = 0.009), and BI (p = 0.004) were the counterparts for females. By multivariate analyses, previous vertebral fractures (hazard ratio (HR) 3.33; p = 0.044), and BI <30 (HR 5.42, p = 0.013) were the predictive variables of mortality for male patients. BMI <18.5 kg/m² (HR 2.70, p = 0.023), TCCI ≥5 (HR 2.61, p = 0.032), smoking history (HR 3.59, p = 0.018), LOS <14 days (HR 13.9; p = 0.007), and BI <30 (HR 2.76; p = 0.049) were the counterparts for females.

CONCLUSIONS

Previous vertebral fractures and BI <30 were the predictive variables of mortality for male patients, and BMI <18.5 kg/m², TCCI ≥5, smoking history, LOS <14 days, and BI <30 were those for females. Decreased BI is one of the independent and preventable risk factors. A comprehensive therapeutic approach should be considered to prevent deterioration of activities of daily living and a higher risk of mortality.

FRI0172 THE INFLUENCE OF CALCINEURIN INHIBITORS ON DEVELOPMENT OF CANCER IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A RETROSPECTIVE OBSERVATIONAL STUDY IN THE LUNA REGISTRY

Background:

It has been reported that the incidence of cancer in patients with systemic lupus erythematosus (SLE) is higher than that in healthy individuals, but the findings are inconsistent1. In the transplantation field, a few studies indicated an association between the use of immunosuppressants and an increased risk of cancer2. Calcineurin inhibitors (CNIs), which include cyclosporine and tacrolimus, have been used for >30 years to treat renal and extrarenal manifestations of SLE, but the effects of exposure to CNIs among SLE patients have not been established.

Objectives:

We investigated the incidence of various cancers (including cervical dysplasia) among SLE patients registered in the LUpus registry of NAtionwide institution (LUNA). We also investigate whether the registrants’ exposure to CNIs increased the risk of cancer.

Methods:

We calculated the standardized incidence ratio (SIR) of cancer among SLE patients based on the age-standardized incidence rate of cancer reported by Japan’s Ministry of Health, Labour and Welfare. A multivariate analysis of the risk of cancer was performed using the covariates of age, smoking history, CNI treatment history, maximum steroid dose in the past, and Systemic Lupus International Collaboration Clinics/American College of Rheumatology Damage Index [SDI]) value (excluding the occurrence of cancer) at the time of the patient’s registration.

Results:

We studied 714 patients (663 females; 88.9%).The median age at registry was 44 [interquartile range (IQR): 35–56] years. The median past max. steroid dose was 40 mg/day (IQR: 30–60 mg/day), and the SDI at registration was 1 (IQR 0–2). Smoking history was present in 248 patients (34.9%), and 53 patients (7.4%) experienced cancer complications. Gynecologic malignancies accounted for 71% of all cancers, including 12 cervical dysplasia cases. The standardized incidence rate of cancer in these SLE patients was 1.46 (95%CI: 1.07–1.85, p<0.01). The multivariate analysis showed that a CNI treatment history was not a risk factor for the development of cancer (OR 1.76, 95%CI: 0.63–4.88, p=0.30). After the covariance was adjusted for the propensity score, the risk of cancer in the CNIs group was not increased compared to the non-CNIs group (adjusted OR 2.46, 95%CI: 0.68–8.91, p=0.20).

Conclusion:

The incidence of cancer in SLE was higher in the LUNA cohort than in the general population. Our results suggest that CNI treatment for individuals with SLE is not a risk factor for the development of cancer.

References:

[1]Ladouceur A. et.al, Expert Rev Clin Immunol. 2018 Oct;14(10):793-802.

[2]Gutierrez-Dalmau A. et.al, Drugs 2007;67(8):1167-98.

Disclosure of Interests:

None declared

AB0387 TREATMENT STATUS FOR OSTEOPOROSIS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: CROSS-SECTIONAL ANALYSIS FROM A LUPUS REGISTRY OF NATIONWIDE INSTITUTIONS (LUNA)

Background:

Osteoporosis is one of the most important adverse effects of glucocorticoids in patients with systemic lupus erythematosus (SLE). Because osteoporosis is accelerated by chronic kidney disease (CKD), more attention should be paid to the treatment for osteoporosis in SLE patients with CKD. Many treatment options for osteoporosis have emerged recently, but treatment status in patients with SLE is not elucidated.

Objectives:

The purpose of this study is to elucidate the treatment status for osteoporosis in patients with SLE among the CKD stages.

Methods:

Using data from lupus registry of nationwide institutions (LUNA), a cross-sectional analysis was performed. We firstly described treatment status for osteoporosis in all enrolled patients. Secondary, treatment status for osteoporosis was compared among CKD stages. Finally, bone damage in Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) was compared among CKD stages.

Results:

The median age (interquartile range [IQR]) of enrolled 917 patients was 44 (34- 57) years and 809 patients (88%) were female. CKD stages were follows: CKD stage 1, 234 (26%); CKD stage 2, 465 (51%); CKD stage 3, 189 (21%); CKD stage 4, 9 (1%); CKD stage 5, 16 (2%). Median (IQR) age, female sex, and median (IQR) previous maximum dose of prednisolone in patients with and without CKD (≥CKD stage 3) were 56 (46.5-66) and 41 (32-50), 191 (89%) and 615 (88%), and 40 (30-60) and 40 (30-55) mg/day, respectively. Bisphosphonate was administered in 388 (42%) patients, vitamin D supplements in 448 (49%), Ca supplements in 36 (4%), denosumab in 20 (2%) and teriparatide in 14 (2%), respectively. Of enrolled patients, any treatment for osteoporosis was not administered in 226 (25%) patients. In spite of more frequent bone damage in patients with CKD compared to those without CKD (15% vs 10%, p=0.036), treatment status did not differ between patients with and without CKD (bisphosphonate: 41% vs 46%, p=0.29; vitamin D supplements: 50% vs 44%, p=0.14).

Conclusion:

About a quarter of patients with SLE did not take any treatment for osteoporosis. Treatment for osteoporosis might be strengthened to prevent bone damage in SLE patients with CKD.

Disclosure of Interests:

KEN-EI SADA Speakers bureau: I received speaker’s fee from GSK and Astra Zeneca K.K., Keigo Hayashi: None declared, Yosuke ASANO: None declared, Yu Katayama: None declared, Sumie Hiramatsu Asano: None declared, Keiji Ohashi: None declared, Michiko Morishita: None declared, Haruki Watanabe: None declared, Mariko Narazaki: None declared, Yoshinori Matsumoto: None declared, Nobuyuki Yajima: None declared, Ryusuke Yoshimi: None declared, Yasuhiro Shimojima: None declared, Shigeru Ono: None declared, Hiroshi Kajiyama: None declared, Kunihiro Ichinose: None declared, Shuzo Sato: None declared, Michio Fujiwara: None declared, Jun Wada: None declared

Changes in taxonomic and functional diversity of fish communities after catastrophic habitat alteration caused by construction of Three Gorges Dam

Habitat alterations that result from anthropogenic disturbance impact both the abiotic and biotic conditions of ecosystems, causing changes in biodiversity in many parts of the world. Recently, the use of functional diversity has been suggested as an approach to better evaluate the effects of such disturbance on particular communities. Here, we investigated the temporal changes in species and functional diversities of fish communities in the downstream area of the Three Gorges Dam (TGD) before, during, and after impoundment. We found two regime shifts in the fish community in 2004 and 2013 following impoundment. Although taxonomic diversity declined sharply at the first regime shift, it increased at the second shift. On the other hand, functional diversity declined throughout the same period, indicating the loss of functional diversity despite increased species diversity. Our analysis also showed that the fish communities shifted from under-dispersion to over-dispersion due to both a decrease in the relative abundance of migratory fish and an increase in the number of fish adapted to the new hydrologic conditions. Our results indicated that the impacts of dams on downstream fish communities may change over time. Interactions between species may become more important when the environment is stable.

AB0413 INVESTIGATION OF THE ASSOCIATION OF CARDIOVASCULAR EVENTS AND ANTI- SS-A ANTIBODIES AS RISK OF DEVELOPMENT IN PATIENTS WITH LUPUS NEPHRITIS FROM THE LUNA REGISTRY: A CROSS-SECTIONAL STUDY

Background:

Cardiovascular disease(CVD) has been identified as a major cause of morbidity and mortality in patients with lupus nephritis(LN)1) 2). There is a clear causal relationship between the onset of neonatal lupus (cardiac complications) and SS-A antibodies3) 4), but no association has been reported in adults. In recent years, there have been reports from overseas that suggest the association between CVD and anti-SS-A antibody in adult systemic lupus erythematosus (SLE) patients5) 6). So far, no studies have not been reported to evaluate the relationship between anti-SS-A antibody and the risk of developing CVD in LN in a large cohort of patients with SLE in Japan.

Objectives:

The aim of this study was to evaluate the association between anti-SS-A antibody and the risk of developing CVD in LN patients using a multicenter registration study [Lupus registry of nationwide institution (LUNA)] in Japan.

Methods:

We identified 931 patients diagnosed with SLE in the Lupus registry of nationwide institution (LUNA), and further identified 275 LN patients with known the presence or absence of both development of CVD and presence of anti-SS-A antibody. We defined the exposure factor as anti-SS-A antibody, and the outcome as CVD. SELENA-SLEDAI score (at diagnosis), eGFR <60%, HbA1c, BMI, and steroid pulse treatment history were used as confounding factors and we analyzed using logistic regression analysis.

Results:

We found 68 patients (24.7%) complicated with CVD, including percarditis (7.3%), cerebrovascular disorder (6.2%), peripheral Arterial Disease (6.2%), Ischemic heart disease (2.9%),venous thromboembolism (2.9%),pulmonary hypertension (1.5%), vulvular heart disease (1.1%), and cardiomyopathy (0.4%). In univariate analysis, there was no significant difference in the occurrence of CVD depending on the presence or absence of anti-SS-A antibody (p = 0.32), and the results of multivariate analysis showed no significant difference in anti-SS-A antibody [p = 0.23, odds: 0.41, 95% confidence interval (0.09-1.89)].

Conclusion:

The association between anti-SS-A antibody and the development of CVD in LN patients in Japan has not been identified.

References:

[1]Lupus. 2000;9(3):166-9

[2]Arthritis Rheum.2019 Mar;71(3):403-410,

[3]J Intern Med 265:653-662, 2009

[4]Nat Clin Pract Rheumatol 5:139-148, 2009

[5]Ann Rheum Dis 1990;49:627-629

[6]Chest. 2018 Jan;153(1):143-151. Doi:

Disclosure of Interests:

None declared

Correction to: Comprehensive genetic analyses using targeted next-generation sequencing and genotype-phenotype correlations in 53 Japanese patients with osteogenesis imperfecta

The original article has been corrected.

Surgery-related predictable risk factors influencing postoperative clinical outcomes for thoracic myelopathy caused by ossification of the posterior longitudinal ligament: a multicenter retrospective study

OBJECTIVE

Compression of the spinal cord by thoracic ossification of the posterior longitudinal ligament (T-OPLL) often causes severe thoracic myelopathy. Although surgery is the most effective treatment for T-OPLL, problems associated with surgical intervention require resolution because surgical outcomes are not always favorable, and a small number of patients experience deterioration of their neurological status after surgery. The aim of the present study was to examine the surgery-related risk factors contributing to poor clinical outcomes for myelopathy caused by T-OPLL.

METHODS

Data were extracted from the records of 55 patients with thoracic myelopathy due to T-OPLL at institutions in the Fukuoka Spine Group. The mean follow-up period was 5.3 years. Surgical outcomes were assessed using the Japanese Orthopaedic Association (JOA) scale. To investigate the definitive factors associated with surgical outcomes, univariate and multivariate regression analyses were performed with several patient-related and surgery-related factors, including preoperative comorbidities, radiological findings, JOA score, surgical methods, surgical outcomes, and complications.

RESULTS

Neurological status improved in 33 patients (60.0%) and deteriorated in 10 patients (18.2%) after surgery. The use of instrumentation was significantly associated with an improved outcome. In the comparison of surgical approaches, posterior decompression and fusion resulted in a significantly higher neurological recovery rate than did anterior decompression via a posterior approach and fusion or decompression alone. It was also found that postoperative neurological status was significantly poorer when there were fewer instrumented spinal levels than decompression levels. CSF leakage was a predictable risk factor for deterioration following surgery.

CONCLUSIONS

It is important to identify preventable risk factors for poor surgical outcomes for T-OPLL. The findings of the present study suggest that intraoperative CSF leakage and a lower number of instrumented spinal fusion levels than decompression levels were exacerbating factors for the neurological improvement in T-OPLL surgery.

Climate-related factors cause changes in the diversity of fish and invertebrates in subtropical coast of the Gulf of Mexico

Climate change impacts physical and chemical properties of the oceans, and these changes affect the ecology of marine organisms. One important ecological consequence of climate change is the distribution shift of marine species toward higher latitudes. Here, the prevalence of nearly 150 species of fish and invertebrates were investigated to find changes in their distributions over 35 years along a subtropical coast within the Gulf of Mexico. Our results show that 90 species increased their occupancy probability, while 33 decreased (remaining species neither increase or decrease), and the ranges of many species expanded. Using rarefaction analysis, which allows for the estimation of species diversity, we show that species diversity has increased across the coast of Texas. Climate-mediated environmental variables are related to the changes in the occupancy probability, suggesting the expansion of tropical species into the region is increasing diversity.

Comprehensive genetic analyses using targeted next-generation sequencing and genotype-phenotype correlations in 53 Japanese patients with osteogenesis imperfecta

To elucidate mutation spectrum and genotype-phenotype correlations in Japanese patients with OI, we conducted comprehensive genetic analyses using NGS, as this had not been analyzed comprehensively in this patient population. Most mutations were located on COL1A1 and COL1A2. Glycine substitutions in COL1A1 resulted in the severe phenotype.

INTRODUCTION

Most cases of osteogenesis imperfecta (OI) are caused by mutations in COL1A1 or COL1A2, which encode α chains of type I collagen. However, mutations in at least 16 other genes also cause OI. The mutation spectrum in Japanese patients with OI has not been comprehensively analyzed, as it is difficult to identify using classical Sanger sequencing. In this study, we aimed to reveal the mutation spectrum and genotype-phenotype correlations in Japanese patients with OI using next-generation sequencing (NGS).

METHODS

We designed a capture panel for sequencing 15 candidate OI genes and 19 candidate genes that are associated with bone fragility or Wnt signaling. Using NGS, we examined 53 Japanese patients with OI from unrelated families.

RESULTS

Pathogenic mutations were detected in 43 out of 53 individuals. All mutations were heterozygous. Among the 43 individuals, 40 variants were identified including 15 novel mutations. We found these mutations in COL1A1 (n = 30, 69.8%), COL1A2 (n = 12, 27.9%), and IFITM5 (n = 1, 2.3%). Patients with glycine substitution on COL1A1 had a higher frequency of fractures and were more severely short-statured. Although no significant genotype-phenotype correlation was observed for bone mineral density, the trabecular bone score was significantly lower in patients with glycine substitutions.

CONCLUSION

We identified pathogenic mutations in 81% of our Japanese patients with OI. Most mutations were located on COL1A1 and COL1A2. This study revealed that glycine substitutions on COL1A1 resulted in the severe phenotype among Japanese patients with OI.

Minimum viable population size and population growth rate of freshwater fishes and their relationships with life history traits

The minimum viable population (MVP) size has been compared for a wide range of organisms in conservation biology, but a limited number of studies investigated it for freshwater fishes, which exhibit diverse life history strategies. In this study, the MVP size and population growth rate of 36 fish species in the Yangtze River were estimated and compared with their life-history traits. The results indicated that the MVP size ranged from 42 to 320 individuals, and instantaneous per-capita population growth rate ranged from 0.009 to 0.188 per year. MVP size and population growth rate were significantly associated with three life history traits: the age at maturity, generation time, and fecundity. Long-lived species with delayed maturation, long generation time, and high fecundity had a greater MVP size and a lower population growth rate than short-lived species. Therefore, our results emphasize a need for prioritizing our conservation effort more on long-lived species.

Micellar Effects on the Hydrolysis Reaction of an Anionic Surfactant in Aqueous Solution

The hydrolysis mechanisms of 2-sulfoalkanoic acid methyl ester salts (methyl ester sulfonate, MES) were studied. Under acidic, neutral, and alkaline conditions, the hydrolysis rates of MES were strongly affected by the state of aggregation and the hydrolysis rate changed at the critical micelle concentration (CMC). Under acidic conditions, the hydrolysis rates of MES were enhanced by micellar formation and correlated quantitatively with the amount of protons bound on the micellar surfaces being measured by the electric conductivity along with fluorescence and hydrogen-ion electrode measurements. MES having longer acyl chain lengths showed higher hydrolysis rates above the CMC because of the many bound protons and the higher degree of counterion binding to the micelle, β. The rates were affected by the type of counterion and followed the order of sodium > potassium > calcium salts of MES. In alkaline conditions, the rates of MES hydrolysis were suppressed to lower values by micelle formation and MES with longer acyl chain lengths showed lower rates above the CMC. Additionally, the hydrolysis rates of MES under neutral conditions were suppressed to a very low value by micelle formation. These mechanisms of inhibitory effect of hydrolysis by the aggregation should be dominated by the electrical repulsive interactions between hydroxyl anions and anionic micellar surfaces, as well as by interference with the penetration of the hydroxyl anion to the ester group in the micelles for alkaline hydrolysis and by interference from water molecules for neutral hydrolysis.

A coupled recreational anglers' decision and fish population dynamics model

The effective management of fish populations requires understanding of both the biology of the species being managed and the behavior of the humans who harvest those species. For many marine fisheries, recreational harvests represent a significant portion of the total fishing mortality. For such fisheries, therefore, a model that captures the dynamics of angler choices and the fish population would be a valuable tool for fisheries management. In this study, we provide such a model, focusing on red drum and spotted seatrout, which are the two of the main recreational fishing targets in the Gulf of Mexico. The biological models are in the form of vector autoregressive models. The anglers' decision model takes the discrete choice approach, in which anglers first decide whether to go fishing and then determine the location to fish based on the distance and expected catch of two species of fish if they decide to go fishing. The coupled model predicts that, under the level of fluctuation in the abundance of the two species experienced in the past 35 years, the number of trips that might be taken by anglers fluctuates moderately. This fluctuation is magnified as the cost of travel decreases because the anglers can travel long distance to seek better fishing conditions. On the other hand, as the cost of travel increases, their preference to fish in nearby areas increases regardless of the expected catch in other locations and variation in the trips taken declines. The model demonstrates the importance of incorporating anglers' decision processes in understanding the changes in a fishing effort level. Although the model in this study still has a room for further improvement, it can be used for more effective management of fish and potentially other populations.

Characteristics of patients with fragility hip fractures in the northern Kyushu district in Japan: a multicenter prospective registry based on an electronic data capture system

Osteoporosis has become a worldwide public health problem, in part due to the fact that it increases the risk of fragility hip fractures (FHFs). The epidemiological assessment of FHFs is critical for their prevention; however, datasets for FHFs in Japan remain scarce. This was a multicenter, prospective, observational study in the northern district of Kyushu Island. Inclusion criteria were age > 60 years with a diagnosis of FHF and acquisition of clinical data by an electronic data capture system. Of 1294 registered patients, 1146 enrolled in the study. Nearly one third of patients (31.8%) had a history of previous fragility fractures. The percentage of patients receiving osteoporosis treatment on admission was 21.5%. Almost all patients underwent surgical treatment (99.1%), though fewer than 30% had surgery within 48 h after hospitalization. Bone mineral density (BMD) was evaluated during hospitalization in only 50.4% of patients. The rate of osteoporosis treatment increased from 21.5% on admission to 39.3% during hospitalization. The main reasons that prescribers did not administer osteoporosis treatment during hospitalization were forgetfulness (28.4%) and clinical judgment (13.6%). Age and female ratio were significantly higher in patients with previous FHFs than in those without. There was a significant difference in the rate of osteoporosis treatment or L-spine BMD values in patients with or without previous FHFs on admission. In conclusion, this study confirmed that the evaluation and treatment of osteoporosis and FHFs is still suboptimal in Japan, even in urban districts.

Enhanced TLR2 responses in multiple sclerosis

The roles of the microbiome and innate immunity in the pathogenesis of multiple sclerosis (MS) remain unclear. We have previously documented abnormally low levels of a microbiome‐derived Toll‐like receptor (TLR)2‐stimulating bacterial lipid in the blood of MS patients and postulated that this is indicative of a deficiency in the innate immune regulating function of the microbiome in MS. We postulated further that the resulting enhanced TLR2 responsiveness plays a critical role in the pathogenesis of MS. As proof‐of‐concept, we reported that decreasing systemic TLR2 responsiveness by administering very low‐dose TLR2 ligands attenuated significantly the mouse model of MS, experimental autoimmune encephalomyelitis. Studies of Toll‐like receptor responses in patients with MS have been conflicting. Importantly, most of these investigations have focused on the response to TLR4 ligation and few have characterized TLR2 responses in MS. In the present study, our goal was to characterize TLR2 responses of MS patients using multiple approaches. Studying a total of 26 MS patients and 32 healthy controls, we now document for the first time that a large fraction of MS patients (50%) demonstrate enhanced responsiveness to TLR2 stimulation. Interestingly, the enhanced TLR2 responders include a significant fraction of those with progressive forms of MS, a subset of patients considered unresponsive to adaptive immune system‐targeting therapies. Our results suggest the presence of a pathologically relevant TLR2 related innate immune abnormality in patients with both relapsing–remitting and progressive MS. These findings may have significant implications for understanding the role of innate immunity in the pathogenesis of MS.

Lethal and sub-lethal effects of the insecticide fipronil on juvenile brown shrimp Farfantepenaeus aztecus

Chemical pesticides are widely used around the world, but at the same time, they may cause direct or indirect risks to many non-target organisms. Recent increased use of insecticides in coastal areas, for example to control invasive tawny crazy ants, raises concern that insecticides may affect ecologically and/or commercially important species found in estuaries. Here, we investigated the lethal and sub-lethal effects of fipronil on juvenile brown shrimp Farfantepenaeus aztecus over 29 days at five different nominal concentrations (0.1, 1.0, 3.0, 6.4, and 10.0 µg/L) in a laboratory experiment. Exposure to all of the fipronil treatments resulted in all individuals dying before the end of the experiment; whereas, no individual died in the control (0.0 µg/L). The 96-hour LC₅₀ was determined to be 1.3 µg/L. Shrimp also experienced weight loss under all of the fipronil treatments. Inter-moult interval was increased from 12.2 ± 1.64 day in the control group to 15.5 ± 0.53 day in the 1.0 μg/L treatment. Lipid content of shrimp increased significantly in a concentration-dependent manner. Finally, behavioral and body color changes were also observed under the fipronil treatments. We conclude F. aztecus is very sensitive to fipronil and monitoring is needed in coastal areas.

Risk factors for surgical site infection after major hepatobiliary and pancreatic surgery

Major hepatobiliary and pancreatic (HP) surgeries are complex procedures associated with a high incidence of surgical site infection (SSI) and are commonly performed in patients with cancer in Japan. This study was performed to investigate the risk factors for SSI, including incisional and organ/space SSI, in HP surgery. The following procedures were included in the study: hepatectomy with and without biliary tract resection, pancreatectomy [pancreaticoduodenectomy (PD), others], and open cholecystectomy. In total, 735 patients were analyzed. The incidence of SSI was 17.8% (incisional, 5.2%; organ/space, 15.5%; both 2.9%). The highest incidence of SSI was observed in patients who underwent hepatectomy with biliary tract resection (39.1%), followed by pancreatectomy (PD, 28.8%; others, 29.8%). Almost all SSIs after these three procedures were classified as organ/space (39.1%, 25.0%, and 27.7%, respectively), and these procedures were risk factors for not only total SSI but also organ/space SSI in the multivariate analysis. An American Society of Anesthesiologists physical status of ≥3 was a risk factor for incisional SSI. Preoperative biliary drainage, prolonged surgery, concomitant surgery, and massive intraoperative bleeding were associated with SSI. In conclusion, the main type of SSI was organ/space SSI after HP surgery, and different risk factors were identified between organ/space and incisional SSI. Procedure-related factors and preoperative biliary drainage were independent risk factors for SSI. To prevent SSI, the indication for preoperative biliary drainage should be carefully evaluated in patients undergoing HP surgery.

Differential Cross Section and Photon-Beam Asymmetry for the γ[over →]p → π^{-}Δ^{++}(1232) Reaction at Forward π^{-} Angles for E_{γ}=1.5-2.95 GeV

Differential cross sections and photon-beam asymmetries for the γ[over →]p→π^{-}Δ^{++}(1232) reaction have been measured for 0.7<cosθ_{π}^{c.m.}<1 and E_{γ}=1.5-2.95  GeV at SPring-8/LEPS. The first-ever high statistics cross-section data are obtained in this kinematical region, and the asymmetry data for 1.5<E_{γ}(GeV)<2.8 are obtained for the first time. This reaction has a unique feature for studying the production mechanisms of a pure uu[over ¯] quark pair in the final state from the proton. Although there is no distinct peak structure in the cross sections, a non-negligible excess over the theoretical predictions is observed at E_{γ}=1.5-1.8  GeV. The asymmetries are found to be negative in most of the present kinematical regions, suggesting the dominance of π exchange in the t channel. The negative asymmetries at forward meson production angles are different from the asymmetries previously measured for the photoproduction reactions producing a dd[over ¯] or an ss[over ¯] quark pair in the final state. Advanced theoretical models introducing nucleon resonances and additional unnatural-parity exchanges are needed to reproduce the present data.

Constructing stage-structured matrix population models from life tables: comparison of methods

A matrix population model is a convenient tool for summarizing per capita survival and reproduction rates (collectively vital rates) of a population and can be used for calculating an asymptotic finite population growth rate (λ) and generation time. These two pieces of information can be used for determining the status of a threatened species. The use of stage-structured population models has increased in recent years, and the vital rates in such models are often estimated using a life table analysis. However, potential bias introduced when converting age-structured vital rates estimated from a life table into parameters for a stage-structured population model has not been assessed comprehensively. The objective of this study was to investigate the performance of methods for such conversions using simulated life histories of organisms. The underlying models incorporate various types of life history and true population growth rates of varying levels. The performance was measured by comparing differences in λ and the generation time calculated using the Euler-Lotka equation, age-structured population matrices, and several stage-structured population matrices that were obtained by applying different conversion methods. The results show that the discretization of age introduces only small bias in λ or generation time. Similarly, assuming a fixed age of maturation at the mean age of maturation does not introduce much bias. However, aggregating age-specific survival rates into a stage-specific survival rate and estimating a stage-transition rate can introduce substantial bias depending on the organism’s life history type and the true values of λ. In order to aggregate survival rates, the use of the weighted arithmetic mean was the most robust method for estimating λ. Here, the weights are given by survivorship curve after discounting with λ. To estimate a stage-transition rate, matching the proportion of individuals transitioning, with λ used for discounting the rate, was the best approach. However, stage-structured models performed poorly in estimating generation time, regardless of the methods used for constructing the models. Based on the results, we recommend using an age-structured matrix population model or the Euler-Lotka equation for calculating λ and generation time when life table data are available. Then, these age-structured vital rates can be converted into a stage-structured model for further analyses.