Validation of a suite of ERP and QEEG biomarkers in a pre-competitive, industry-led study in subjects with schizophrenia and healthy volunteers

OBJECTIVE

Complexity and lack of standardization have mostly limited the use of event-related potentials (ERPs) and quantitative EEG (QEEG) biomarkers in drug development to small early phase trials. We present results from a clinical study on healthy volunteers (HV) and patients with schizophrenia (SZ) that assessed test-retest, group differences, variance, and correlation with functional assessments for ERP and QEEG measures collected at clinical and commercial trial sites with standardized instrumentation and methods, and analyzed through an automated data analysis pipeline.

METHODS

81 HV and 80 SZ were tested at one of four study sites. Subjects were administered two ERP/EEG testing sessions on separate visits. Sessions included a mismatch negativity paradigm, a 40 Hz auditory steady-state response paradigm, an eyes-closed resting state EEG, and an active auditory oddball paradigm. SZ subjects were also tested on the Brief Assessment of Cognition (BAC), Positive and Negative Syndrome Scale (PANSS), and Virtual Reality Functional Capacity Assessment Tool (VRFCAT).

RESULTS

Standardized ERP/EEG instrumentation and methods ensured few test failures. The automated data analysis pipeline allowed for near real-time analysis with no human intervention. Test-retest reliability was fair-to-excellent for most of the outcome measures. SZ subjects showed significant deficits in ERP and QEEG measures consistent with published academic literature. A subset of ERP and QEEG measures correlated with functional assessments administered to the SZ subjects.

CONCLUSIONS

With standardized instrumentation and methods, complex ERP/EEG testing sessions can be reliably performed at clinical and commercial trial sites to produce high-quality data in near real-time.

More than the half number of the severe CAD patients without features of metabolic syndrome had hyperlipoprotein(a)-emia

Background

It was reported that insulin suppresses apolipoprotein(a) synthesis in primary cultures of cynomolgus monkey hepatocytes (Neele DM. Diabetologia 1999). Therefore, there is a possibility that inverse association exists between lipoprotein(a); Lp(a) and metabolic syndrome (Mets) with insulin resistance/ hyperinsulinemia for the coronary atherosclerosis.

Purpose

The purpose is to examine the association between Lp(a) and Mets on the CAD patients.

Method

847 male subjects with angiographically demonstrated CAD were enrolled. The subjects were divided into the five groups according to the scored numbers by the counting of Mets components shown below (presence 1, absence 0); 1. BMI ≥25kg/m2, 2. comorbidity of hypertension, 3. triglyceride ≥150mg/dL and/or HDL cholesterol <40mg/dL, 4. fasting plasma glucose ≥110mg/dL and/or comorbidity of diabetes mellitus (Group 0; without any Mets components, Group 4; with all Mets component). The insulin levels (μU/mL) and the prevalence of hyperLp(a)-emia (≥30 mg/dL) were compared between in Group 0 and in Group 4. The blood samples for laboratory tests were collected after an over night fast.

Result

As the scored numbers increased, the insulin levels increased (Group 0; 5.1 μU/mL versus Group 4; 11.4 μU/mL: p<0.0001) and the prevalence of hyperlipoprotein(a)-emia decreased (Group 0; 41.6% versus Group 4; 21.4%: p<0.01). The prevalence of hyperLp(a)-emia increased as the severity of coronary atherosclerosis aggravated (Figure 1; one vessel disease 21.5%, two vessel disease 27.0% three vessel disease 32.1%: one vessel disease versus three vessel disease p<0.01). Especially to limited the three vessel disease subjects (Figure 2), the prevalence of hyperlipoprotein(a)-emia in Group 0 was markedly high (56.7%).

Conclusion

More than the half number of severe CAD patients without features of Mets had hyperLp(a)-emia.

Funding Acknowledgement

Type of funding sources: None. Figure 1Figure 2

The inverse association between lipoprotein(a) levels and metabolic syndorome and its components on coronary artery disease patients

Purpose

Neele DM (Diabetologia 1999) showed that insulin suppressed apolipoprotein(a) synthesis by primary cultures of cynomolgus monkey hepatocytes. Therefore, there is a possibility that inverse association exists between lipoprotein(a) [Lp(a)] and metabolic syndorome (Mets) with insulin resistance/hyperinsulinemia for coronary atherosclerosis. Sung KC (Nutr Metab Cardiovasc Dis 2013) described the inverse association between Lp(a) levels and Mets and its components on an asian occupational cohort. And high levels of Lp(a) were associated with preclinical atherosclerosis, as evaluated by coronary calcium score with cardiac computed tomography. There is no similar examination on coronary artery disease (CAD) patients. The purpose is to examine similar considerations on CAD patients.

Method

610 subjects with angiographically demonstrated CAD were enrolled. The patients who receiving medication for dyslipidemia and Insulin administration were excluded. The blood samples for laboratory tests were collected after an over night fast. Subjects were divided into four groups according to quartiles of Lp(a) levels (mg/dL). Ranges of quartile groups of Lp(a) were Q1: <9.0, Q2: 9.0–<16.0, Q3: 16.0–<30.0, Q4: ≥30.0.

Results

The inverse association Lp(a) levels and Mets and its component. The comparison of Q1 (bottom quartile) versus Q4 (top quartile) was shown below; the comorbidity rate of Mets 19.5% versus 8.0% (p<0.01), BMI (kg/m2) 23.5 versus 22.7 (p<0.05), trigyceride (mg/dL) 144.0 versus 107.5 (p<0.0001), HDL cholesterol (mg/dL) 46.8 versus 50.7 (p<0.05), the comorbidity rate of hypertension 60.4% versus 50.7% (p=0.084), glucose (mg/dL) 107.1 versus 100.6 (p<0.05), insulin (μU/mL) 8.49 versus 5.85 (p<0.0001), HOMA-R 2.26 versus 1.44 (p<0.0001). The mean number of diseased coronary vessel was higher in the Q4 group (2.07) than in the Q1 group (1.87) (p<0.05).

Conclusion

There was the inverse association between Lp(a) levels and Mets and its components on CAD patients. The robust association was found between Lp(a) levels and severity of coronary atherosclerosis despite this inverse correlation.

Funding Acknowledgement

Type of funding source: None

Genetically fused charged peptides induce rapid crystallization of proteins

We utilized electrostatic interaction to induce rapid crystallization of streptavidin. Simply mixing streptavidins possessing either a positively or negatively charged peptide at their C-terminus generated diffraction-quality crystals in a few hours. We modified the streptavidin crystals with fluorescent molecules using biotin, demonstrating the concept of protein crystals as functional biomaterials.

Reconstructing bifurcation diagrams only from time-series data generated by electronic circuits in discrete-time dynamical systems

Bifurcation-diagram reconstruction estimates various attractors of a system without observing all of them but only from observing several attractors with different parameter values. Therefore, the bifurcation-diagram reconstruction can be used to investigate how attractors change with the parameter values, especially for real-world engineering and physical systems for which only a limited number of attractors can be observed. Although bifurcation diagrams of various systems have been reconstructed from time-series data generated in numerical experiments, the systems that have been targeted for reconstructing bifurcation diagrams from time series measured from physical phenomena so far have only been continuous-time dynamical systems. In this paper, we reconstruct bifurcation diagrams only from time-series data generated by electronic circuits in discrete-time dynamical systems with different parameter values. The generated time-series datasets are perturbed by dynamical noise and contaminated by observational noise. To reconstruct the bifurcation diagrams only from the time-series datasets, we use an extreme learning machine as a time-series predictor because it has a good generalization property. Hereby, we expect that the bifurcation-diagram reconstruction with the extreme learning machine is robust against dynamical noise and observational noise. For quantitatively verifying the robustness, the Lyapunov exponents of the reconstructed bifurcation diagrams are compared with those of the bifurcation diagrams generated in numerical experiments and by the electronic circuits.

Abstract P1-11-01: Oral care evaluation to prevent oral mucositis in estrogen receptor positive metastatic breast cancer patients treated with everolimus (Oral Care-BC): A randomized controlled phase III trial

Introduction

Oral mucositis is a clinically significant complication of mucotoxic cancer therapy. The incidence of oral mucositis (any grade) as an adverse drug reaction of everolimus is 58%, while an analysis of Asian people has reported its occurrence as 81%.This study hypothesizes that the occurrence of oral mucositis will reduce with professional oral care (POC) administered prior to everolimus treatment.

Method:

This was a randomized, multi-center, open-label, phase III study, to evaluate the efficacy of POC in preventing mucositis induced by everolimus in postmenopausal, estrogen receptor (ER)-positive, metastatic breast cancer patients. Patients were randomized into POC and control groups (1:1 ratio). All patients received everolimus with exemestane and continued the everolimus until disease progression. In the POC group, patients were subjected to teeth surface cleaning, scaling and tongue cleaning, before initiating everolimus, and continued to receive weekly POC from dentist or oral surgeons throughout the 8 weeks of treatment. In the control group, patients brushed their own teeth and gargled with 0.9% sodium chloride solution or water. The primary end-point was to measure the incidence of all grades of oral mucositis. Target accrual was 200 patients with a 2-sided type I error rate of 5% and 80% power to detect 25% risk reduction. This trial has been registered at ClinicalTrials.gov, number NCT 02069093.

Result:

Between May 26, 2014 and Dec 28, 2017, we enrolled 174 women from 31 institutions; 168 were evaluable for efficacy but 5 were excluded (had not received the protocol treatment [n=4]; no efficacy data [n=1]). In 8 weeks, the incidence of grade 1 oral mucositis was significantly different between the POC group (76.5%, 62 of 81 patients) and control group (89.7%, 78 of 87 patients) (p=0.035). The incidence of grade 2 (severe) oral mucositis was also significantly different between the POC group (34.6%, 28 of 81 patients) and control group (54%, 47 of 87 patients) (p= 0.015). As a result of oral mucositis, 18 (22.2%) patients in the POC group and 28 (32.2%) in the control group had to undergo everolimus dose reduction.

Conclusion:

POC reduced the incidence and severity of oral mucositis in patients receiving everolimus and exemestane. This could be a new standard in oral care for patients undergoing this treatment.

Primary Analysis: Incidence Probability of Oral Mucositis POC Group (n=81) Controll (n=87)P-valuneOral Mucositis over Grade1n% n% Yes6276.5 7889.70.035No1923.5 910.3        Risk Difference, % (95% CI)-11.83 (-22.80, -0.85)    POC: Professional oral Care

Citation Format: Niikura N, Nakatukasa K, Amamiya T, Watanabe K-i, Hata H, Kikawa Y, Taniike N, Yamanaka T, Mitsunaga S, Nakagami K, Adachi M, Kondo N, Horii K, Hayashi N, Naito M, Kashiwabara K, Yamashita T, Umeda M, Mukai H, Ota Y. Oral care evaluation to prevent oral mucositis in estrogen receptor positive metastatic breast cancer patients treated with everolimus (Oral Care-BC): A randomized controlled phase III trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-11-01.

Treatment with Bifemelane for Optic Nerve Damage following High Intraocular Pressure in Rat Eyes

This study found that pretreatment with 4-(o-benzylphenoxy)-N- methylbuty-lamine hydrochloride (bifemelane hydrochloride, Celeport) reduced ischemia-reperfusion injury in rat eyes. Bifemelane (25 mg/kg) was injected intraperitoneally 30 minutes before an ischemic insult, then acute ischemia of the retina and optic disc was induced by increasing intraocular pressure to 110 mmHg for 45 minutes. After one week, the axonal count of the optic nerve was investigated using electron microscopy. The control group consisted of vehicle-treated eyes which received normal saline. The axon count was 93.4 +/- 7.9 for the bifemelane treated group, and 79.2 +/- 6.4 for the controls. The axon count in the treated group was significantly higher. These results suggest that bifemelane, which prevents cerebral nerve cell damage from ischemia, can reduce ischemic retinal nerve cell injury.

Estimation of global soil respiration by accounting for land-use changes derived from remote sensing data

Soil respiration is one of the largest carbon fluxes from terrestrial ecosystems. Estimating global soil respiration is difficult because of its high spatiotemporal variability and sensitivity to land-use change. Satellite monitoring provides useful data for estimating the global carbon budget, but few studies have estimated global soil respiration using satellite data. We provide preliminary insights into the estimation of global soil respiration in 2001 and 2009 using empirically derived soil temperature equations for 17 ecosystems obtained by field studies, as well as MODIS climate data and land-use maps at a 4-km resolution. The daytime surface temperature from winter to early summer based on the MODIS data tended to be higher than the field-observed soil temperatures in subarctic and temperate ecosystems. The estimated global soil respiration was 94.8 and 93.8 Pg C yr^-1 in 2001 and 2009, respectively. However, the MODIS land-use maps had insufficient spatial resolution to evaluate the effect of land-use change on soil respiration. The spatial variation of soil respiration (Q₁₀) values was higher but its spatial variation was lower in high-latitude areas than in other areas. However, Q₁₀ in tropical areas was more variable and was not accurately estimated (the values were >7.5 or <1.0) because of the low seasonal variation in soil respiration in tropical ecosystems. To solve these problems, it will be necessary to validate our results using a combination of remote sensing data at higher spatial resolution and field observations for many different ecosystems, and it will be necessary to account for the effects of more soil factors in the predictive equations.

Spin/orbital and magnetic quantum number selective magnetization measurements for CoFeB/MgO multilayer films

Spin selective magnetic hysteresis (SSMH) curves, orbital selective magnetic hysteresis (OSMH) curves and magnetic quantum number selective SSMH curves are obtained for CoFeB/MgO multilayer films by combining magnetic Compton profile measurements and superconducting quantum interference device (SQUID) magnetometer measurements. Although the SQUID magnetometer measurements do not show perpendicular magnetic anisotropy (PMA) in the CoFeB/MgO multilayer film, PMA behavior is observed in the OSMH and SSMH curves for the |m|  =  2 magnetic quantum number states. These facts indicate that magnetization switching behavior is dominated by the orbital magnetization of the |m|  =  2 magnetic quantum number states.

Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5)

Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organization Global Alliance against Chronic Respiratory Diseases (GARD). The European Innovation Partnership on Active and Healthy Ageing has proposed a 5-step framework for developing an individual scaling up strategy: (1) what to scale up: (1-a) databases of good practices, (1-b) assessment of viability of the scaling up of good practices, (1-c) classification of good practices for local replication and (2) how to scale up: (2-a) facilitating partnerships for scaling up, (2-b) implementation of key success factors and lessons learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing.

An efficient perovskite solar cell with symmetrical Zn(ii) phthalocyanine infiltrated buffering porous Al2O3 as the hybrid interfacial hole-transporting layer

A new Zn(ii) phthalocyanine (Pc) based low bandgap HTM is introduced for perovskite solar cells. Steady state and time-resolved photoluminescence (PL) measurements indicated an evenly matched hole extraction efficiency between sym-HTPcH and spiro-OMeTAD. On account of the low film quality and resulting high recombination, Zn(ii) Pc normally cannot work as an effective HTM. We adopted insulating Al₂O₃ for the infiltration of sym-HTPcH to form a hybrid interfacial buffer layer, affording perovskite solar cells (PSCs) with an average PCE value of up to 12.3%, which is a significant improvement with respect to the control cell without the meso-Al₂O₃ layer (4.21%) and is the highest value ever reported for Zn(ii) phthalocyanine based devices under AM1.5G standard conditions. A hysteresis test revealed that our device structure with the new HTM exhibited a balanced charge extraction behaviour.

Swallowing Function and Nutritional Status in Japanese Elderly People Receiving Home-care Services: A 1-year Longitudinal Study

OBJECTIVES

Malnutrition is a serious health concern for frail elderly people. Poor oral function leading to insufficient food intake can contribute to the development of malnutrition. In the present study, we explored the longitudinal association of malnutrition with oral function, including oral health status and swallowing function, in elderly people receiving home nursing care.

DESIGN

Prospective observational cohort study with 1-year follow-up.

SETTING

Two mid-sized cities in Fukuoka, Japan from November 2010 to March 2012.

PARTICIPANTS

One hundred and ninety-seven individuals, aged ≥ 60 years, living at home and receiving home-care services because of physical disabilities, without malnutrition.

MEASUREMENTS

Oral health status, swallowing function, taking modified-texture diets such as minced or pureed foods, nutritional status, cognitive function, and activities of daily living were assessed at baseline. The associations between malnutrition at 1-year follow-up and these related factors were analyzed using a logistic regression model.

RESULTS

Swallowing disorders [risk ratio (RR): 5.21, 95% confidence interval (95% CI): 1.65-16.43] were associated with malnutrition. On the other hand, oral health status did not have a direct association with malnutrition.

CONCLUSION

Swallowing disorders may be associated with the incidence of malnutrition in elderly people receiving home-care. The findings indicate that maintaining swallowing function may contribute to the prevention of malnutrition in frail elderly people.

MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation

Several unmet needs have been identified in allergic rhinitis: identification of the time of onset of the pollen season, optimal control of rhinitis and comorbidities, patient stratification, multidisciplinary team for integrated care pathways, innovation in clinical trials and, above all, patient empowerment. MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) is a simple system centred around the patient which was devised to fill many of these gaps using Information and Communications Technology (ICT) tools and a clinical decision support system (CDSS) based on the most widely used guideline in allergic rhinitis and its asthma comorbidity (ARIA 2015 revision). It is one of the implementation systems of Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). Three tools are used for the electronic monitoring of allergic diseases: a cell phone-based daily visual analogue scale (VAS) assessment of disease control, CARAT (Control of Allergic Rhinitis and Asthma Test) and e-Allergy screening (premedical system of early diagnosis of allergy and asthma based on online tools). These tools are combined with a clinical decision support system (CDSS) and are available in many languages. An e-CRF and an e-learning tool complete MASK. MASK is flexible and other tools can be added. It appears to be an advanced, global and integrated ICT answer for many unmet needs in allergic diseases which will improve policies and standards.

High CO2 concentration increases relative leaf carbon gain under dynamic light in Dipterocarpus sublamellatus seedlings in a tropical rain forest, Malaysia

Understory plants in tropical forests often experience a low-light environment combined with high CO2 concentration. We hypothesized that the high CO2 concentration may compensate for leaf carbon loss caused by the low light, through increasing light-use efficiency of both steady-state and dynamic photosynthetic properties. To test the hypothesis, we examined CO2 gas exchange in response to an artificial lightfleck in Dipterocarpus sublamellatus Foxw. seedlings under contrasting CO2 conditions: 350 and 700 μmol CO2 mol(-1) air in a tropical rain forest, Pasoh, Malaysia. Total photosynthetic carbon gain from the lightfleck was about double when subjected to the high CO2 when compared with the low CO2 concentration. The increase of light-use efficiency in dynamic photosynthesis contributed 7% of the increased carbon gain, most of which was due to reduction of photosynthetic induction to light increase under the high CO2. The light compensation point of photosynthesis decreased by 58% and the apparent quantum yield increased by 26% at the high CO2 compared with those at the low CO2. The study suggests that high CO2 increases photosynthetic light-use efficiency under both steady-state and fluctuating light conditions, which should be considered in assessing the leaf carbon gain of understory plants in low-light environments.

Microbunching instability in relativistic electron bunches: direct observations of the microstructures using ultrafast YBCO detectors

Relativistic electron bunches circulating in accelerators are subjected to a dynamical instability leading to microstructures at millimeter to centimeter scale. Although this is a well-known fact, direct experimental observations of the structures, or the field that they emit, remained up to now an open problem. Here, we report the direct, shot-by-shot, time-resolved recording of the shapes (including envelope and carrier) of the pulses of coherent synchrotron radiation that are emitted, and that are a "signature" of the electron bunch microstructure. The experiments are performed on the UVSOR-III storage ring, using electrical field sensitive YBa2Cu3O(7-x) thin-film ultrafast detectors. The observed patterns are subjected to permanent drifts, that can be explained from a reasoning in phase space, using macroparticle simulations.

Long-term Follow-up Study of Onychomycosis: Cure Rate and Dropout Rate with Oral Antifungal Treatments

The "complete cure" of onychomycosis requires long-term treatment with a systemic antifungal agent. Therefore, to properly assess the effects of an antifungal agent on onychomycosis requires a long follow-up. We have conducted a retrospective analysis of the patients treated with griseofulvin (GRF) from 1962 to 1992 and a clinical study to compare the long-term effect of GRF with that of a new oral antifungal agent, itraconazole (ITCZ), for patients who received treatment from 1992 to 1995. For the retrospective study, 281 patients who were microscopically diagnosed as having onychomycosis at the Department of Dermatology, Faculty of Medicine, University of Tokyo, and received GRF administration in 1962, 1972, 1982, and 1992, were evaluated for cure rate and dropout rate. The total cure rate was 29.2%, but the cure rate was 68.8% for the patients who continued their medication for more than one year. For the comparative study, 139 patients who received the treatment at the same institution between 1992 and 1995 were evaluated. The cure rate and the dropout rate for GRF were found to be 23.8% (23/97) and 52.6% (51/97) respectively. The cure rate and the dropout rate for ITCZ were found to be 50.0% (21/42) and 38.1% (15/42). When the two treatment protocols were compared for their long-term effects, we found that most of the patients treated with ITCZ were cured within 3 years, and about 30% of the patients treated with GRF remained uncured even after long-term administration of the agent. Furthermore, from a multiple regression analysis, the GRF/ITCZ administration required to cure onychomycosis was estimated to be 3.92 + 0.161 [Age (years)] + 0.635 [Number of infected toenails] months. The results of this study suggest that the biggest problem associated with the treatment of onychomycosis with an oral antifungal agent is compliance in long-term therapy. Notably, the final cure rate of ITCZ therapy went over 90%, suggesting that the low dose continuous therapy, the standard treatment protocol in Japan, was a key contributing factor for the higher cure rate for ITCZ.

Soil and water warming accelerates phenology and down-regulation of leaf photosynthesis of rice plants grown under free-air CO2 enrichment (FACE)

To enable prediction of future rice production in a changing climate, we need to understand the interactive effects of temperature and elevated [CO2] (E[CO2]). We therefore examined if the effect of E[CO2] on the light-saturated leaf photosynthetic rate (Asat) was affected by soil and water temperature (NT, normal; ET, elevated) under open-field conditions at the rice free-air CO2 enrichment (FACE) facility in Shizukuishi, Japan, in 2007 and 2008. Season-long E[CO2] (+200 µmol mol(-1)) increased Asat by 26%, when averaged over two years, temperature regimes and growth stages. The effect of ET (+2°C) on Asat was not significant at active tillering and heading, but became negative and significant at mid-grain filling; Asat in E[CO2]-ET was higher than in ambient [CO2] (A[CO2])-NT by only 4%. Photosynthetic down-regulation at E[CO2] also became apparent at mid-grain filling; Asat compared at the same [CO2] in the leaf cuvette was significantly lower in plants grown in E[CO2] than in those grown in A[CO2]. The additive effects of E[CO2] and ET decreased Asat by 23% compared with that of A[CO2]-NT plants. Although total crop nitrogen (N) uptake was increased by ET, N allocation to the leaves and to Rubisco was reduced under ET and E[CO2] at mid-grain filling, which resulted in a significant decrease (32%) in the maximum rate of ribulose-1,5-bisphosphate carboxylation on a leaf area basis. Because the change in N allocation was associated with the accelerated phenology in E[CO2]-ET plants, we conclude that soil and water warming accelerates photosynthetic down-regulation at E[CO2].

Relationship between psychological factors and arthralgia in patients with rheumatoid arthritis

Abstract Various factors were assessed in terms of their contribution to arthralgia in a rheumatoid arthritis patient. Eighty-two outpatients (62 women and 20 men) with rheumatoid arthritis (RA) were examined with respect to the subjective degree of arthralgia, age, disease duration, dysfunction, steroid dose, steroid period, depression, anxiety, extroversion, neurotic disorder, and number of caretakers. The results were explained on the basis of stepwise regression analysis and psychological and clinical data. We analyzed results of a correlation coefficient test on the mutual relationship between variables. Stepwise regression analysis was performed to assess factors of arthralgia in terms of "depression," "mean activity," "morning stiffness," and "steroid dose." Depression is a factor of arthralgia as shown in this study, but it is clear that other factors are also involved. Anxiety was a factor distinct from the activity of RA. The factor contributing most to arthralgia was found to be depression, whereas anxiety had no effect.

Photoprotection of evergreen and drought-deciduous tree leaves to overcome the dry season in monsoonal tropical dry forests in Thailand

In tropical dry forests, uppermost-canopy leaves of evergreen trees possess the ability to use water more conservatively compared with drought-deciduous trees, which may result from significant differences in the photoprotective mechanisms between functional types. We examined the seasonal variations in leaf gas exchange, chlorophyll fluorescence and the amounts of photosynthetic pigments within lamina of the uppermost-canopy leaves of three drought-deciduous trees (Vitex peduncularis Wall., Xylia xylocarpa (Roxb.) W. Theob., Shorea siamensis Miq.), a semi-deciduous tree (Irvingia malayana Miq.) and two evergreen trees (Hopea ferrea Lanessan and Syzygium cumini (L.) Skeels) in Thailand. Area-based maximum carbon assimilation rates (Amax) decreased during the dry season, except in S. siamensis. The electron transport rate (ETR) remained unchanged in deciduous trees, but decreased during the dry season in evergreen and semi-deciduous trees. In the principal component analysis, the first axis (Axis 1) accounted for 44.3% of the total variation and distinguished deciduous from evergreen trees. Along Axis 1, evergreen trees were characterized by a high Stern-Volmer non-photochemical quenching coefficient (NPQ), high xanthophyll cycle pigments/chlorophyll and a high de-epoxidation state of the xanthophyll cycle, whereas the deciduous trees were characterized by a high ETR, a high quantum yield of PSII (ΦPSII = (Fm(') -F)/Fm(')) and a high mass-based Amax under high-light conditions. These findings indicate that drought-deciduous trees showing less conservative water use tend to dissipate a large proportion of electron flow through photosynthesis or alternative pathways. In contrast, the evergreens showed more conservative water use, reduced Amax and ETR and enhanced NPQ and xanthophyll cycle pigments/chlorophyll during the dry season, indicating that down-regulated photosynthesis with enhanced thermal dissipation of excess light energy played an important role in photoprotection. Trees with different water uses and leaf lifespans appear to employ different photoprotective mechanisms to overcome the unfavorable dry-season drought. Our data may suggest that future changes in precipitation will strongly impinge on forest structure and functions.

Fabrication of Y2O3-Doped Zirconia/Gadolinia-Doped Ceria Bilayer Electrolyte Thin Film SOFC Cells of SOFCs by Single-Pulsed Laser Deposition Processing

An 8 -mol. % Y₂O₃-doped zirconia/10-mol. % GdO₂-doped ceria (YSZ/GDC) bilayer electrolyte and a Gd_0.5Sr_0.5CoO₃ (GSCO) cathode were deposited by a single-processing, pulsed laser deposition (PLD) method to fabricate anode support cells. No additional heat treatment was needed. Laser frequencies of 10, 20, and 100 Hz were used to deposit bilayer electrolytes between the NiO–YSZ (NiO:YSZ = 60:40 wt. %) anode substrate and the GSCO cathode thin film. The GDC thin film produced at 10 Hz was smooth, well-crystallized, and highly dense. The crystallinity of the GSCO cathode on the GDC was also improved. We concluded the GDC crystallinity affected the crystallinity of the cathode thin film. The resistivity of the YSZ single layer (5.7 μm thickness) was 1.4 times higher than that of the YSZ/GDC bilayer (YSZ 3.0 μm thickness, GDC 2.7 μm thickness) at 600 °C and that of the YSZ-GDC interface became low. The optimum YSZ thickness was found to be approximately 3.0 μm, at which thickness there was effective blocking of the passage of hydrogen molecules and electrons. A cell with a YSZ (3.0 μm thickness, fabricated at 20 Hz)/GDC (5.0 μm thickness, fabricated at 10 Hz) bilayer and GSCO cathode thin film exhibited a maximum power density of 400 mW·cm^–2 at a comparatively low temperature of 600 °C.

Photon-induced positron annihilation lifetime spectroscopy using ultrashort laser-Compton-scattered gamma-ray pulses

High-energy ultrashort gamma-ray pulses can be generated via laser Compton scattering with 90° collisions at the UVSOR-II electron storage ring. As an applied study of ultrashort gamma-ray pulses, a new photon-induced positron annihilation lifetime spectroscopy approach has been developed. Ultrashort gamma-ray pulses with a maximum energy of 6.6 MeV and pulse width of 2.2 ps created positrons throughout bulk lead via pair production. Annihilation gamma rays were detected by a BaF2 scintillator mounted on a photomultiplier tube. A positron lifetime spectrum was obtained by measuring the time difference between the RF frequency of the electron storage ring and the detection time of the annihilation gamma rays. We calculated the response of the BaF2 scintillator and the time jitter caused by the variation in the total path length of the ultrashort gamma-ray pulses, annihilation gamma rays, and scintillation light using a Monte Carlo simulation code. The positron lifetime for bulk lead was successfully measured.

Allergic Rhinitis and its Impact on Asthma (ARIA): achievements in 10 years and future needs

Allergic rhinitis (AR) and asthma represent global health problems for all age groups. Asthma and rhinitis frequently coexist in the same subjects. Allergic Rhinitis and its Impact on Asthma (ARIA) was initiated during a World Health Organization workshop in 1999 (published in 2001). ARIA has reclassified AR as mild/moderate-severe and intermittent/persistent. This classification closely reflects patients' needs and underlines the close relationship between rhinitis and asthma. Patients, clinicians, and other health care professionals are confronted with various treatment choices for the management of AR. This contributes to considerable variation in clinical practice, and worldwide, patients, clinicians, and other health care professionals are faced with uncertainty about the relative merits and downsides of the various treatment options. In its 2010 Revision, ARIA developed clinical practice guidelines for the management of AR and asthma comorbidities based on the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system. ARIA is disseminated and implemented in more than 50 countries of the world. Ten years after the publication of the ARIA World Health Organization workshop report, it is important to make a summary of its achievements and identify the still unmet clinical, research, and implementation needs to strengthen the 2011 European Union Priority on allergy and asthma in children.

MRP-1/CD9 and KAI1/CD82 expression in normal and various cancer tissues

As part of our evaluation of MRP-1/CD9 and KAI1/CD82 as prognostic predictors among patients with cancer, we have extended our studies to solid tumors of a variety of anatomical sites. Normal tissues were included for comparison. Immunohistochemical techniques were used throughout. Our results indicate that MRP-1/CD9 was strongly expressed by many normal tissues, including the epithelium of the gastrointestinal tract, alveolar epithelium of the lung, urothelium and smooth muscle. Expression was weak in the pituitary gland, spleen and hepatocytes, and absent in testes and spinal cord. KAI1/CD82 was also expressed by many normal tissues, but was absent in some MRP-1/CD9-positive tissues (e.g., smooth muscle, adrenal cortex, urothelium, myelin of peripheral nerves, epithelium of amnion). On the other hand, KAI1/CD82 was strongly expressed in spinal cord gray matter, which was MRP-1/CD9-negative. Expression of these glycoproteins was detected in almost all types of tumors examined. In certain cancers, MRP-1/CD9 and KAI1/CD82 positivity was inversely related to lymph node involvement. Whereas lymph node metastases were present in 22.2% of lung cancer patients whose tumors were MRP-1/CD9 and KAI1/CD82-positive, 65.5% of patients with MRP-1/CD9 and KAI1/CD82-reduced/negative tumors had lymph node metastases. A similar inverse relationship was seen in colon cancer and breast cancer patients with respect to MRP-1/CD9 expression. The present data, together with our previous results suggest that evaluating the MRP1/CD9 and KAI1/CD82 status of cancers of the lung, breast and colon may provide useful information on the metastatic potential of the tumors.

Case of anti-glomerular basement membrane antibody-induced glomerulonephritis with cytomegalovirus-induced thrombotic microangiopathy

Although the involvement of cytomegalovirus (CMV) infections in the development of thrombotic microangiopathy (TMA) in HIV patients and transplant recipients has been reported, it is still controversial whether CMV itself can cause TMA. We report herein a rare case with rapid improvement of TMA by ganciclovir treatment in a patient who is neither HIV-positive nor a transplant recipient, suggesting a pathogenic role for CMV in TMA.

Evaluation of the efficacy and safety of the combination of gemcitabine and nedaplatin for elderly patients with advanced non-small-cell lung cancer

OBJECTIVE

The aim of the present study was to retrospectively assess the safety and efficacy of the combination of gemcitabine and nedaplatin in elderly patients with advanced non-small-cell lung cancer (NSCLC).

METHODS

Patients ≥75 years with previously untreated NSCLC who underwent chemotherapy consisting of gemcitabine (800 mg/m(2) on days 1 and 8) and nedaplatin (80 mg/m(2) on day 1) every 3 weeks were retrospectively analyzed.

RESULTS

Of the 35 patients, 28 were men and 7 were women, with a mean age of 78 years (range 75-87); 10 patients had stage IIIB disease and 25 patients had stage IV disease. The overall response rate was 45.7% (95% confidence interval 28.8-63.4). The median survival time was 14 months (range 3-44). Grade 3-4 toxicities included neutropenia in 74.3%, thrombocytopenia in 48.6%, anemia in 34.3%, hepatic dysfunction in 11.4%, and infection in 2.9%. There were no treatment-related deaths. There were no differences in response rate and survival between patients aged 75-79 years and patients ≥80 years, although grade 3-4 thrombocytopenia and anemia were significantly more frequent in patients ≥80 years.

CONCLUSION

Our results suggest that the combination of gemcitabine and nedaplatin is effective and well tolerated for selected elderly patients with advanced NSCLC.

Prevalence and impact of rhinitis in asthma. SACRA, a cross-sectional nation-wide study in Japan

BACKGROUND

Asthma and rhinitis are common co-morbidities everywhere in the world but nation-wide studies assessing rhinitis in asthmatics using questionnaires based on guidelines are not available.

OBJECTIVE

To assess the prevalence, classification, and severity of rhinitis using the Allergic Rhinitis and its Impact on Asthma (ARIA) criteria in Japanese patients with diagnosed and treated asthma.

METHODS

The study was performed from March to August 2009. Patients in physicians' waiting rooms, or physicians themselves, filled out questionnaires on rhinitis and asthma based on ARIA and Global Initiative for Asthma (GINA) diagnostic guides. The patients answered questions on the severity of the diseases and a Visual Analog Scale. Their physicians made the diagnosis of rhinitis.

RESULTS

In this study, 1910 physicians enrolled 29,518 asthmatics; 15,051 (51.0%) questionnaires were administered by physician, and 26,680 (90.4%) patients were evaluable. Self- and physician-administered questionnaires gave similar results. Rhinitis was diagnosed in 68.5% of patients with self-administered questionnaires and 66.2% with physician-administered questionnaires. In this study, 994 (7.6%) patients with self-administered and 561 (5.2%) patients with physician-administered questionnaires indicated rhinitis symptoms on the questionnaires without a physician's diagnosis of rhinitis. Most patients with the physician's diagnosis of rhinitis had moderate/severe rhinitis. Asthma control was significantly impaired in patients with a physician's diagnosis of rhinitis for all GINA clinical criteria except exacerbations. There were significantly more patients with uncontrolled asthma as defined by GINA in those with a physician's diagnosis of rhinitis (25.4% and 29.7%) by comparison with those without rhinitis (18.0% and 22.8%).

CONCLUSION

Rhinitis is common in asthma and impairs asthma control.

Asthma programmes in diverse regions of the world: challenges, successes and lessons learnt

International surveys have demonstrated that asthma is still underdiagnosed and undertreated in many parts of the world. Despite improvements in the standard of asthma care delivered in many areas, as evidenced by improved global asthma mortality data, much information on projects and programmes undertaken in resource-limited regions of the world is not in the public domain. The aim of this report is to review projects and programmes in diverse regions around the world so that health care providers, planners and consumers may draw on the successes, failures and lessons learnt. Such real world experiences may contribute to achieving Global Initiative for Asthma goals of asthma control. Asthma projects and programmes in Argentina, Australia, Brazil, China, Japan, Mexico, Philippines, Russia, South Africa and Turkey were discussed by a group of experts in asthma care, the Advancing Asthma Care Network, from their respective countries, over a course of three satellite meetings in 2010. Collective analyses consistently identified low rates of dissemination and implementation of national and international treatment guidelines, low levels of continuing medical education and training of primary health care professionals and access and distribution of inhaled corticosteroids to be major barriers that are critical to the overall success of a national asthma management programme. In the less developed asthma programmes, under-recognition and undertreatment further limited the success of the programmes. Evidence from well-established national asthma management programmes suggests that establishment of a successful programme entails a logical progression through specific developmental stages, starting with political/stakeholder endorsement and commitment, followed by epidemiological evaluation, evaluation of disease burden, evaluation of access to care and best therapy, and finally optimisation and maintenance therapy for individual patients.

Formation of Au Colloid Particles in Silica Glass by Ion Implantation

Formation of Au colloid particles and their optical property have been investigated in silica glasses implanted with Au+ ions at an acceleration energy of 1.5MeV and fluence levels of 1016-1017 ions/cm2. The Au colloid particles are formed in the as-implanted glasses. It is inferred that the average radius of Au colloid particles depends on the fluence level, although the fluence level does not affect the distribution of Au atomic concentration. The heat-treatment little affects the Au atomic distribution. The Au colloid particles grow to 4.3nm in average radius during heat treatment. It is revealed that the large nonlinear optical property of the Au+ -ion-implanted silica glass is attributed to the high concentration of the Au colloid particles in the narrow region.

Induction of insulin-like growth factor-I by interleukin-17F in bronchial epithelial cells

BACKGROUND

Increased expression of IL-17F has been noted in the airway of asthmatic patients, but its role in asthma has not been fully elucidated. Insulin-like growth FACTOR-I (IGF-I) is known to be involved in airway remodelling and inflammation, while its regulatory mechanisms remain to be defined.

OBJECTIVE

To further clarify the biological function of IL-17F, we investigated whether IL-17F is able to regulate the expression of IGF-I in bronchial epithelial cells.

METHODS

Bronchial epithelial cells were stimulated with IL-17F in the presence or absence of T-helper type 2 cytokines. Various kinase inhibitors were added to the culture to identify the key signalling events leading to the expression of IGF-I, in conjunction with the use of short interfering RNAs (siRNAs) targeting mitogen- and stress-activated protein kinase (MSK) 1, p90 ribosomal S6 kinase (p90RSK), and cyclic AMP response element-binding protein (CREB).

RESULTS

IL-17F significantly induced IGF-I gene and protein expression, and co-stimulation with IL-4 and IL-13 augmented its production. MAP kinase kinase (MEK) inhibitors and the Raf1 kinase inhibitor significantly inhibited IGF-I production, and the combination of PD98059 and Raf1 kinase inhibitor showed further inhibition. Overexpression of Raf1 and Ras dominant-negative mutants inhibited its expression. MSK1 inhibitors significantly blocked IL17F-induced IGF-I expression. Moreover, transfection of the siRNAs targeting MSK1, p90RSK, and CREB blocked its expression.

CONCLUSIONS

In bronchial epithelial cells, IL-17F is able to induce the expression of IGF-I via the Raf1-MEK1/2-ERK1/2-MSK1/p90RSK-CREB pathway in vitro.