An adventurous journey toward and away from fern apomixis: Insights from genome size and spore abortion patterns

PREMISE

Apomixis in ferns is relatively common and obligatory. Sterile hybrids may restore fertility via apomixis at a cost of long-term genetic stagnation. In this study, we outlined apomixis as a possible temporary phase leading to sexuality and analyzed factors relating to transitioning to and away from apomixis, such as unreduced and reduced spore formation in apomict and apo-sex hybrid ferns.

METHODS

We analyzed the genome size of 15 fern species or hybrids ("taxa") via flow cytometry. The number of reduced and unreduced gametophytes was established as a proxy for viable spore formation of either type. We also calculated the spore abortion ratio (sign of reduced spores) in several taxa, including the apo-sex hybrid Dryopteris × critica and its 16 apomictically formed offspring.

RESULTS

Four of 15 sampled taxa yielded offspring variable in genome size. Specifically, each variable taxon formed one viable reduced plant among 12-451 sampled gametophytes per taxon. Thus, haploid spore formation in the studied apomicts was very rare but possible. Spore abortion analyses indicated gradually decreasing abortion (haploid spore formation) over time. In Dryopteris × critica, abortion decreased from 93.8% to mean 89.5% in one generation.

CONCLUSIONS

Our results support apomixis as a transitionary phase toward sexuality. Newly formed apomicts hybridize with sexual relatives and continue to form haploid spores early on. Thus, they may get the genomic content necessary for regular meiosis and restore sexuality. If the missing relative goes extinct, the lineage gets locked into apomixis as may be the case with the Dryopteris affinis complex.

Personality Traits Associated with Treatment Choice with an Explicit Statistical Prediction After an Explanation in a Negative Context: A Study in Patients with Glaucoma

Purpose

Over 50% of patients with early-stage glaucoma discontinue topical therapy within the first 6 months of treatment initiation. This risk of discontinuation could be reduced by how the ophthalmologist explains the treatment plan. Ophthalmologists can explain the treatment plan to patients in either positive or negative contexts. Although explanations in a negative context can be selected depending on the medical situation, identification of patients who will choose the treatment with explicit statistical prediction after an explanation in a negative context is important; personality traits are related to these emotional decisions. Therefore, in the present study, we examined the personality traits associated with choice of treatment with explicit statistical prediction after an explanation in a negative context.

Patients and Methods

A total of 147 patients with glaucoma were recruited for this study. The questionnaire booklets used contained positively framed or negatively framed versions of an "Asian disease problem" to enable examination of the influence of the way in which a problem is framed (framing effect) on the participants' decision-making. The Japanese version of the Ten-Item Personality Inventory was used to estimate the personality traits of the participants.

Results

Low conscientiousness was identified as the only variable that was strongly predictive of the choice of treatment with explicit statistical prediction (β = -0.44, z = 2.19, p = 0.03). In addition, while the association was not statistically significant, low neuroticism was found to be weakly predictive of the choice of uncertain treatment (β = -0.37, z = 1.73, p = 0.08).

Conclusion

In conclusion, we showed that low levels of conscientiousness predict the choice of treatment with explicit statistical prediction (ie, topical treatment) for glaucoma after an explanation in a negative context.

Waves in planetary dynamos

This Special Topic focuses on magnetohydrodynamic (MHD) processes in the deep interiors of planets, in which their fluid dynamos are in operation. The dynamo-generated, global, magnetic fields provide a background for our solar-terrestrial environment. Probing the processes within the dynamos is a significant theoretical and computational challenge and any window into interior dynamics greatly increases our understanding. Such a window is provided by exploring rapid dynamics, particularly MHD waves about the dynamo-defined basic state. This field is the subject of current attention as geophysical observations and numerical modellings advance. We here pay particular attention to torsional Alfvén waves/oscillations and magnetic Rossby waves, which may be regarded as typical axisymmetric and nonaxisymmetric modes, respectively, amongst a wide variety of wave classes of rapidly rotating MHD fluids. The excitation of those waves has been evidenced for the Earth - whilst their presence has also been suggested for Jupiter. We shall overview their dynamics, summarise our current understanding, and give open questions for future perspectives.

Masticatory Behavior Change with a Wearable Chewing Counter: A Randomized Controlled Trial

Because a relationship has been reported between masticatory behavior, obesity, and postprandial blood glucose, it is recommended to chew well and take a longer time to eat. The purpose of this study was to examine the possibility of changing masticatory behavior using a small ear-hung wearable chewing counter, which can monitor masticatory behavior without disturbing daily meals. In total, 235 healthy volunteers participated in a 4-wk randomized controlled trial and were divided into 3 groups. All participants were instructed about the importance of mastication at the first visit. During the intervention, group B used the chewing counter without an algorithm during each meal (notification of the number of chews after meal), and group C used the chewing counter with a masticatory behavior change algorithm (setting a target value and displaying the number of chews in real time). Group A was set as the control group. The number of chews and the meal time when consuming 1 rice ball (100 g) were measured before and after the intervention using the chewing counter, and the rate of change in these values was evaluated. Participants also provided a subjective evaluation of their changes in masticatory behavior. The number of chews and the meal time of 1 rice ball increased significantly in groups B and C compared with before the intervention, and the rate of change was significantly higher in group C than in group A and group B. In addition, the subjective evaluation of the change in the number of chews was highest in group C. Self-monitoring of masticatory behavior by providing a target value and the degree of achievement for the number of chews using a wearable chewing counter with a behavioral change algorithm could promote effective change in masticatory behavior and lead to an increased number of chews. (Trial ID: UMIN000034476).

Establishment of an allotetraploid fern species, Lepisorus yamaokae Seriz., between two highly niche-differentiated parental species

PREMISE

The successful establishment of polyploid species is hypothesized to be promoted by niche differentiation from the parental species or by range shifts during climate oscillations. However, few studies have considered both of these factors simultaneously. We resolved the origin of a tetraploid fern, Lepisorus yamaokae, and explored a pattern of niche differentiation among the allotetraploid and parental species in past and current climates.

METHODS

We reconstructed phylogenetic trees based on plastid marker and single-copy nuclear genes to resolve the allopolyploid origin of L. yamaokae. We also evaluated climatic niche differentiation among L. yamaokae and its two parental species using species distribution models in geographic space and principal component analysis.

RESULTS

We infer that L. yamaokae had a single allotetraploid origin from L. annuifrons and L. uchiyamae. Climatic niche analyses show that the parental species currently occupy different niche spaces. The predicted distribution of the parental species at the Last Glacial Maximum (LGM) suggests more opportunities for hybridization during the LGM or during other recent temporary range shifts. Lepisorus yamaokae has a narrower niche than the additive niche of the parental species. We also observed niche conservatism in L. yamaokae.

CONCLUSIONS

Range shifts of the parental species during climatic oscillations in the Quaternary likely facilitated the formation and establishment of L. yamaokae. Further, the genetic intermediacy of L. yamaokae may have enabled a niche shift in its microenvironment, resulting in its successful establishment without a macroclimatic niche shift in L. yamaokae.

Club-mosses (Diphasiastrum, Lycopodiaceae) from the Far East - Introgression and possible cryptic speciation

Hybridization occurs often in the genus Diphasiastrum (Lycopodiaceae), which corroborates reports for the two other recognized lycophyte families, Isoëtaceae and Selaginellaceae. Here we investigate the case of D. alpinum and D. sitchense from the Russian Far East (Kamchatka). Their hybrid, D. × takedae, was morphologically recognizable in 16 out of 22 accessions showing molecular signatures of hybridization; the remaining accessions displayed the morphology of either D. alpinum (3) or D. sitchense (3). We sequenced markers for chloroplast microsatellites (cp, 175 accessions from Kamchatka) and for the two nuclear markers RPB and LFY (175 and 152 accessions). A selection of 42 accessions, including all hybrid accessions, was analysed via genotyping by sequencing (GBS). We found multiple, but apparently uniparental hybridization, clearly characterized by a deviating group of haplotypes for D. sitchense and all hybrids. All accessions showing molecular signatures of hybridization in nuclear markers revealed the parental haplotype of D. sitchense, however only the LFY marker differentiated between the parent species. GBS, including 69,819 quality-filtered single nucleotid polymorphisms, unambiguously identified the hybrids and revealed introgression to occur. Most of the hybrids were F₁, but three turned out to be backcrosses with D. alpinum (one) and with D. sitchense (two). These observations are in contrast to prior findings on three European species and their intermediates where all three hybrids turned out to be independent F₁ crosses without evidence of recent backcrossing. In this study, backcrossing was detected, which indicates a limited fertility of the hybrid taxon D. × takedae. A comparison of accessions of Kamchatkian D. alpinum with plants from Europe indicated possible cryptic speciation. Accessions from the Far East had (i) a lower DNA content (7.0 vs. 7.5 pg/2C), (ii) different prevailing cp haplotypes, and (iii) RPB genotypes, and (iv) a clearly different SNP pattern in GBS. Diphasiastrum sitchense and the similar D. nikoënse, for the latter additional accessions from Japan were investigated, appeared as forms of one diverse species, sharing genotypes in both nuclear markers, although chloroplast haplotypes and DNA content show slight variations.

Association between personality traits and experience of adverse periocular reactions to topical prostaglandin analogues

Background

Aesthetically unappealing adverse periocular reactions to prostaglandin (PG) eye-drops are a major challenge in glaucoma treatment. This study analysed the personality traits of patients with glaucoma based on a five-factor model and examined the associations between these factors and adverse periocular reactions.

Methods

One hundred and forty-seven patients with glaucoma were surveyed anonymously regarding their personality traits and how often adverse periocular reactions were experienced.

Results

The analysis included 117 valid responses (71 men and 46 women, age: 61.9±11.5 years). Patients who experienced hypertrichosis of the eyelashes scored significantly higher on extraversion (p<0.05), with no significant differences in the other four personality traits. Patients who experienced eyelid hyperpigmentation and deepening of the upper eyelid sulcus showed no significant differences in any of the personality traits. Younger patients scored significantly higher on hypertrichosis (p<0.05).

Conclusion

The experience of adverse reactions differed according to patient age and personality traits. Therefore, eye-drops should be chosen based on these factors.

Trial registration number

UMIN000035155.

Lepisorusmedioximus (Polypodiales, Polypodiaceae), a new species from Shan State of Myanmar

A new species of the species-rich fern genus Lepisorus (Polypodiales, Polypodiaceae) has been found to occur in Shan state, Myanmar. Lepisorusmedioximus is described based on morphological characters and phylogenetic evidence. Phylogenetic analyses showed that the specimens of L.medioximus formed a distinct clade nested in the Pseudovittaria clade. The morphological comparison demonstrated that the species is distinct from phylogenetically related species, namely L.elegans, L.contortus, and L.tosaensis, in the morphology of the rhizome scales, size, and shape of the lamina, position of sori, and paraphyses.

Thylacopterisminuta (Polypodiaceae), a new fern species from Myanmar

The genus Thylacopteris is a small, phylogenetically isolated genus belonging to the fern family Polypodiaceae. This study describes a new species, Thylacopterisminuta, based on collections obtained during field surveys of Shan State, Myanmar. This new species is distinct from other species of Thylacopteris in its small size and presence of sclerenchyma strands in the rhizome. This species is also distinct from the only other species of Thylacopteris with molecular data available, T.papillosa, in a plastid rbcL phylogeny of Polypodiaceae. This new discovery of Thylacopteris from Myanmar suggests that this genus is still overlooked in Southeast Asia.

Apomictic fern fathers: an experimental approach to the reproductive characteristics of sexual, apomict, and hybrid fern gametophytes

PREMISE

Apomixis and hybridization are two essential and complementary factors in the evolution of plants, including ferns. Hybridization combines characteristics from different species, while apomixis conserves features within a lineage. When combined, these two processes result in apo-sex hybrids. The conditions leading to the formation of these hybrids are poorly understood in ferns.

METHODS

We cultivated spores from 66 fern samples (43 apomicts, 7 apo-sex hybrids, and 16 sexuals), and measured their development in vitro over 16 weeks. We evaluated germination, lateral meristem formation rates, sexual expression, and production of sporophytes and then compared ontogenetic patterns among the three groups.

RESULTS

The three examined groups formed antheridia (male gametangia) but differed in overall gametophyte development. Sexual species created archegonia (female, 86% of viable samples), but no sporophytes. Apomicts rarely created nonfunctional archegonia (8%) but usually produced apogamous sporophytes (75%). Surprisingly, apomictic and sexual species showed similar development speed. The sexually reproducing parents of viable studied hybrids formed about twice as many meristic gametophytes as the apomictic parents (39% vs. 20%, respectively).

CONCLUSIONS

We present the most thorough comparison of gametangial development of sexual and apomictic ferns, to date. Despite expectations, apomictic reproduction might not lead to earlier sporophyte formation. Apomicts produce functional sperm and thus can contribute this type of gamete to their hybrids. The development patterns found in the parents of hybrids indicate a possible increase of hybridization rates by antheridiogens. The apo-sex hybrids always inherit the apomictic reproductive strategy and are thus capable of self-perpetuation.

Twenty-Four-Hour Intraocular Pressure Control with Omidenepag Isopropyl 0.002% in Patients with Glaucoma and Ocular Hypertension

Purpose

To clarify the intraocular pressure (IOP)-lowering effect of a selective prostanoid EP2 receptor agonist, omidenepag isopropyl (OMDI) during a 24-hour period.

Patients and Methods

Subjects aged ≥20 years and with diagnosed, untreated primary open-angle glaucoma or ocular hypertension were enrolled. IOP measurements were performed every 4 hours over a 24-hour period using a Goldmann applanation tonometer (GAT) and Icare PRO tonometer (PRO). The baseline 24-hour IOP was measured in untreated subjects. After the baseline measurements, participants were given OMDI 1 drop once daily at night for 4 weeks. At week 4, the IOP measurement was repeated under the same conditions. Diurnal (9 am, 1 pm, 5 pm) and nocturnal (9 pm, 1 am, 5 am) IOP measurements were compared between baseline and treatment with OMDI. Safety measures included adverse events, slit-lamp biomicroscopy, visual acuity, heart rate and blood pressure.

Results

Of 27 participants enrolled, 25 patients (20 males and 5 females, average age 52.2 ± 8.5 years) completed the study. In the sitting position, the baseline diurnal and nocturnal mean IOPs (GAT) were 19.1 ± 2.1 mmHg and 18.2 ± 2.6 mmHg, respectively, the diurnal and nocturnal mean IOP reduction from baseline were -2.8 ± 2.6 mmHg (p < 0.0001) and -3.3 ± 2.9 mmHg (p < 0.0001), respectively, mean 24-hour IOP (GAT) was significantly lower with the OMDI treatment (-3.1 ± 2.5 mmHg, p < 0.0001). In the supine position, the baseline nocturnal mean IOP (PRO) was 17.99 ± 2.22 mmHg, and the nocturnal mean IOP reduction from baseline was -1.78 ± 2.37 mmHg (p = 0.0009) after 4 weeks of the treatment. Nine adverse events were observed in 8 patients including mild conjunctival hyperemia (n = 8) and mild iritis (n=1). There were no significant effects on systemic safety.

Conclusion

Once daily OMDI treatment was able to produce stable 24-hour IOP reduction.

Two new hybrids of the genus Diplazium (Athyriaceae) from Japan

In this study, we describe the ferns Diplazium × kanayamaense hyb. nov. and D. × tsukushiense hyb. nov. and further compare them to parental species D. chinense, D. deciduum and D. fauriei in terms of morphological characteristics, plastids and nuclear DNA markers. These new hybrids have been determined to be endemic to western Japan. The International Union for Conservation of Nature and Natural Resources status was evaluated for D. × kanayamaense as endangered (EN) and D. × tsukushiense as critically endangered (CR).

Deparia × nanakuraensis K.Hori (Athyriaceae), a new hybrid pteridophyte from Japan

I describe Deparia × nanakuraensishyb. nov. and discuss differences in morphological characteristics between parental species D. pterorachis and D. viridifrons with chromosome counting, plastid, and nuclear DNA markers. The new hybrid is endemic to the eastern and northern parts of Japan. Based on the criteria of the International Union for Conservation of Nature and Natural Resources, this new species is here considered Data Deficient. The ploidy level is diploid sterile.

Athyrium bipinnatum K.Hori (Athyriaceae), a new cornopteroid fern from Japan

I describe Athyrium bipinnatum sp. nov. and discuss morphological differences between closely related species. The new species is endemic to Japan, occurring on the islands of Honshu, Kyushu, and Shikoku. Based on the criteria of the International union for conservation of nature and natural resources, this new species is here considered endangered.

Automatic detection of early gastric cancer in endoscopic images using a transferring convolutional neural network

Endoscopic image diagnosis assisted by machine learning is useful for reducing misdetection and interobserver variability. Although many results have been reported, few effective methods are available to automatically detect early gastric cancer. Early gastric cancer have poor morphological features, which implies that automatic detection methods can be extremely difficult to construct. In this study, we proposed a convolutional neural network-based automatic detection scheme to assist the diagnosis of early gastric cancer in endoscopic images. We performed transfer learning using two classes (cancer and normal) of image datasets that have detailed texture information on lesions derived from a small number of annotated images. The accuracy of our trained network was 87.6%, and the sensitivity and specificity were well balanced, which is important for future practical use. We also succeeded in presenting a candidate region of early gastric cancer as a heat map of unknown images. The detection accuracy was 82.8%. This means that our proposed scheme may offer substantial assistance to endoscopists in decision making.

Basic study of random sampling for compressed sensing using MRI simulator

INTRODUCTION

Magnetic resonance imaging (MRI) is a tomography technology that enables the depiction of anatomical structures with information about various features. Compressed sensing (CS) technology has recently been used for magnetic resonance image reconstruction from sparse information. Random sampling methods based on the various probability density function (PDF) are being developed to allow the efficient application of CS technology. Accurate numerical simulation is obviously important for the evaluation of the sampling method that are developed. In this study, the simulation method with MRI simulator and actual MRI scanner was carried out. Moreover, the difference between the result acquired from our simulation and basic one was revealed.

METHODS

We first examined a basic method using a 2D Shepp-Logan phantom. This method was only conducted with k-space data obtained from the 2D Fourier transform of the original image. Our method of numerical simulation was applied with the MRI simulator (Bloch Solver, MRI simulations Inc.), an actual MRI system (Vantage Titan 3T, Canon Medical Systems) and a phantom (CAGN-3.0T phantom, Kato Medience). The real and imaginary part of the k-space were acquired with the MRI simulator using a phase map that was imaged by the actual MRI scanner. Random sampling was performed with two types of PDF and image reconstruction was processed by projection onto convex sets (POCS). Hermitian symmetry is a point-symmetry respect to origin and each point located on the opposite side maintains a relation of complex conjugate. Thus, there is no need to acquire data that formed in point-symmetry with the data that had already been acquired. We used the gaussian random sampling method (GA) and a method that considered Hermitian symmetry (GH). The image quality was evaluated using the normalized root mean squared error (NRMSE).

RESULTS AND DISCUSSION

In the basic simulation, the average and standard deviation of NRMSE from GH was better than that from GA because consideration of the Hermitian symmetry enables the efficient acquisition of data. However, in our method of numerical simulation, the average and standard deviation of the NRMSE from GH was worse than that from GA. In this simulation method, the phase error was included in the real and imaginary part of the k-space; thus, the Hermitian symmetry cannot hold and the calculation error of reconstruction images from GH stood out.

CONCLUSION

The method of numerical simulation with the MRI simulator using a phase map was close to the actual conditions and was considered to be useful for the validation of new sampling methods. The random sampling method using GH is expected to be useful for the highly efficient acquisition of data under ideal conditions; however, more accurate phase correction is necessary to apply the actual measurement data.

Origin of the Diplaziumhachijoense complex (Athyriaceae)

We analyzed the phylogeny of the Diplaziumhachijoense complex using plastid trnL-F and low-copy nuclear marker AK1 DNA sequences. Based on allele constitution, triploid apogamous species of the D.hachijoense complex appeared to have originated from the hybridization of triploid apogamous species and diploid sexual species by recurrent hybridization events. These results suggested that triploid apogamous ferns can achieve hybridization with diploid sexual species by producing diploid spores with irregular meiosis in sporogenesis. Furthermore, the present study predicted the involvement of several unknown species associated with hybridization. More sampling of Callipteris species from China and adjacent areas is required to determine the relationships among unknown species and the D.hachijoense complex.

Long-term follow-up of custom cross-pin fixation of 56 tumour endoprosthesis stems: a single-institution experience

AIMS

Aseptic loosening is a major cause of failure in cemented endoprosthetic reconstructions. This paper presents the long-term outcomes of a custom-designed cross-pin fixation construct designed to minimize rotational stress and subsequent aseptic loosening in selected patients. The paper will also examine the long-term survivorship and modes of failure when using this technique.

PATIENTS AND METHODS

A review of 658 consecutive, prospectively collected cemented endoprosthetic reconstructions for oncological diagnoses at a single centre between 1980 and 2017 was performed. A total of 51 patients were identified with 56 endoprosthetic implants with cross-pin fixation, 21 of which were implanted following primary resection of tumour. Locations included distal femoral (n = 36), proximal femoral (n = 7), intercalary (n = 6), proximal humeral (n = 3), proximal tibial (n = 3), and distal humeral (n = 1).

RESULTS

The median follow-up was 132 months (interquartile range (IQR) 44 to 189). In all, 20 stems required revision: eight for infection, five for structural failure, five for aseptic loosening, and two for tumour progression. Mechanical survivorship at five, ten, and 15 years was 84%, 78%, and 78%, respectively. Mechanical failure rate varied by location, with no mechanical failures of proximal femoral constructs and distal femoral survivorship of 82%, 77%, and 77% at five, ten, and 15 years. The survivorship of primary constructs at five years was 74%, with no failure after 40 months, while the survivorship for revision constructs was 89%, 80%, and 80% at five, ten, and 15 years.

CONCLUSION

The rate of mechanical survivorship in our series is similar to those reported for other methods of reconstruction for short diaphyseal segments, such as compressive osseointegration. The mechanical failure rate differed by location, while there was no substantial difference in long-term survival between primary and revision reconstructions. Overall, custom cross-pin fixation is a viable option for endoprosthetic reconstruction of short metaphyseal segments with an acceptable rate of mechanical failure. Cite this article: Bone Joint J 2019;101-B:724-731.

Combustion Study of Different Transitional Metal Oxide based on AN/MgAl Composites Gas Generators

Ammonium nitrate (AN)-based composite gas generator have attracted a considerable amount of attention because of the clean burning nature of AN as an oxidizer. However, ammonium nitrate-based gas generator has several major problems, namely, poor ignitability, a low burning rate, low energy, and high hygroscopicity. The addition of different transitional metal oxides and MgAl mechanical alloyed proved to be effective in improving the burning characteristics of AN-based gas generator. In this research work, combustion study of different transition metal oxide based on AN/MgAl composites gas generators was studied. Gas generators were combusted at the pressure of 1 MPa, 3 MPa and 5 MPa in the combustion chamber and the burning rates were determined. It was stated that the addition of metal oxides into the composition of the gas generators improves ignition at low pressure and increases the burning rate. The use of the mechanical MgAl alloys as a fuel allowed the ignition of the gas generator at a lower temperature. The method of thermogravimetric/differential thermal analyzer (TG/DTA) was used to investigate the effect of metal oxides addition on the AN/MgAl-based gas generators thermal decomposition characteristics.

Combustion Characteristics of HAN-based Green Propellant Assisted with Nanoporous Active Carbons

Combustion of hydroxylammonium nitrate (95 wt.% HAN) ‒ water solution in presence of high specific surface area activated carbons is investigated in a constant-pressure bomb within the pressure range of 1‒6 MPa. The linear burning rate increased for the system of HAN admixed with activated carbons compared to those of the HAN alone. Moreover, the thermal decomposition of HAN (95 wt.%) ‒ water solution spiked with activated carbons was assessed by DTA – TG method. In the presence of activated carbons, the ability to trigger the decomposition at a lower temperature (86 °C vs 185 °C) was observed. The volatile products formed in the course of thermal decomposition of HAN, spiked with activated carbons were characterized by electron ionization mass spectrometry analysis. Primary products of HAN decomposition: m/z = 33 (NH2OH) and m/z = 63 (HNO3), which are further responsible for the formation of secondary products such as N2O, NO, HNO2, NO2, O2 etc. Significant reduction of NOx emissions during thermal decomposition of HAN (95 wt.%) ‒ water solution was observed (ca. 30%) in presence of activated carbons.

Development of a novel algorithm for detecting glucocorticoid-induced diabetes mellitus using a medical information database

WHAT IS KNOWN AND OBJECTIVE

Glucocorticoid-induced diabetes mellitus (GIDM) increases the risk of diabetes mellitus (DM)-related complications but is generally difficult to detect in clinical settings. The criteria for diagnosing GIDM have not been established. Recently, medical information databases (MIDs) have been used in post-marketing surveillance (PMS) studies. We conducted a pharmacoepidemiological study to develop an algorithm for detecting GIDM using MID.

METHODS

We selected 1214 inpatients who were newly prescribed with a typical glucocorticoid, prednisolone, during hospitalization from 2008 to 2014 from an MID of Hamamatsu University Hospital in Japan. GIDM was screened based on fasting blood glucose (FBG) and haemoglobin A1c (HbA1c) levels according to the current Japan Diabetes Society (JDS) DM criteria, and its predictability was evaluated by an expert's review of medical records. We investigated further candidate screening factors using receiver operating characteristics analysis.

RESULTS

Sixty-three inpatients were identified by the JDS DM criteria. Of these, 33 patients were definitely diagnosed as having GIDM by expert's review (positive predictive value = 52·4%). To develop a highly predictive algorithm, we compared the characteristics of inpatients diagnosed with definite GIDM and those diagnosed as non-GIDM. The maximum levels of HbA1c in patients with GIDM were significantly higher than those of patients with non-GIDM (66·9 mmol/mol vs. 58·7 mmol/mol, P < 0·001). The patients with GIDM had significantly higher relative increase in maximum level of HbA1c (RIM-HbA1c) than those with non-GIDM (0·3 vs. 0·03, P < 0·001). However, we did not observe a significant difference in those of fasting blood glucose (FBG) levels. We applied the RIM-HbA1c as a second screening factor to improve the detection of GIDM. It showed that a 13% increase in RIM-HbA1c separated patients with from patients without GIDM.

WHAT IS NEW AND CONCLUSIONS

Patients with GIDM had significantly higher RIM-HbA1c than patients with non-GIDM. There was a 13% increase in RIM-HbA1c in patients with GIDM compared to the others. Our detection algorithm for GIDM using an MID achieved high sensitivity and specificity, and was superior to one based only on the current JDS DM criteria. Our results suggest that monitoring changes in HbA1c levels is important for detecting GIDM and adds to current diagnostic criteria for type 2 DM.

Influence of Human Jaw Movement on Cerebral Blood Flow

Temporal changes in cerebral blood flow induced by jaw movement have yet to be investigated. To assess the influence of pattern and intensity of muscle contraction during jaw movement on task-induced change in cerebral blood flow, we performed bilateral transcranial Doppler ultrasound examination during clenching, gum chewing, and tooth tapping in healthy volunteers. A random-effects model analysis revealed a significant increase in middle cerebral artery blood flow velocity during clenching (high muscle activity) and gum chewing (moderate muscle activity), compared with the preceding rest period; however, such an increase was not detected during tooth tapping (low muscle activity). Cerebral blood flow was greater on the working side during the intensive isometric contraction of the masseter muscle in clenching. These results suggest that task-induced change in cerebral blood flow during jaw movement is influenced by the change in peripheral circulation evoked by muscle contraction.

Coordination of Tongue Pressure and Jaw Movement in Mastication

The tongue plays an important role in mastication and swallowing by its contact with the hard palate. Using an experimental palatal plate with 7 pressure sensors, and recording jaw movement using mandibular kinesiography, we assessed, in healthy subjects, the coordination of tongue and jaw movements during the entire masticatory sequence of solids, by measuring tongue pressure against the hard palate. Tongue pressure appeared during the occlusal phase, reached a peak near the start of opening, and disappeared during opening. Specific patterns in order, duration, and magnitude of tongue pressure were seen at the 7 pressure sensors in each chewing stroke. Magnitude and duration were significantly larger in the late stage of chewing (8 strokes before initial swallowing) than in the early stage (until 8 strokes after starting mastication). The normal pattern of tongue contact against the hard palate, control of tongue activity, and coordination with jaw movement during mastication is described.

Validation of the distress and impact thermometer and the changes of mood during the first 6 months of treatment in gynecological cancer patients: a Kansai Clinical Oncology Group (KCOG)-G1103 prospective study

PURPOSE

To verify distress and impact thermometer (DIT) for screening emotional distress in gynecological cancer patients by Hospital Anxiety and Depression Scale total (HADS-T) as gold standard and to assess emotional changes by DIT and HADS-T.

METHODS

A prospective study was conducted in newly diagnosed gynecological cancer patients during the peri-treatment period after the cancer diagnosis followed by 6-month. We defined a HADS-T score of ≥11 as being indicative of emotional distress.

RESULTS

117 patients were enrolled between May 1, 2011 and March 31, 2012, and 95 were eligible. The median age was 54 years (range 31-77). (1) From the baseline to 3-month, distress (DIT-D) ≥4 with Impact (DIT-I) ≥2 exhibited sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) of 0.776 [95 % confidential interval (CI) 0.688, 0.850], 0.889 (95 % CI 0.824, 0.954), 0.868 (95 % CI 0.792, 0.949), and 0.808 (95 % CI 0.731, 0.886), respectively. (2) At 6-month, DIT-D ≥2 with DIT-I ≥1 exhibited sensitivity, specificity, PPV and NPV of 0.893 (95 % CI 0.778, 1), 0.825 (95 % CI 0.707, 0.942), 0.781 (95 % CI 0.638, 0.928), and 0.917 (95 % CI 0.826, 1). (3) At 6-month, the HADS-T, DIT-D, and DIT-I scores in individual patients were significantly reduced by a mean of 4.57 (p < 0.0001), 2.34 (p < 0.0001), and 1.10 (p = 0.0031), respectively, compared with those scores of baseline (Student's paired t test), but still remained high.

CONCLUSIONS

(1) On acute phase within 3-month setting, DIT; DIT-D ≥4 with DIT-I ≥2, is a reliable cut-off to screen emotional distress among gynecological cancer patients. (2) The patients' moods had improved, but not completely recovered at 6-month after the diagnosis.

Gynandroblastoma of postmenopausal women: a case report

Gynandroblastoma, an extremely rare ovarian tumour that usually consists of both Sertoli stromal cell and granulosa cell tumours, often produces both androgenic and estrogenic effects. The authors herein report a case of gynandroblastoma with the longest disease-free period reported to date. A 66-year-old woman without metrorrhagia or hirsutism presented with abdominal pain and slightly elevated serum estradiol levels. Her uterus was enlarged, and endometrial curettage performed to reduce endometrial thickness prior to laparotomy led to a diagnosis of atypical endometrial hyperplasia. She was diagnosed of ovarian tumour. The pathology report revealed that the right ovarian tumour was a "gynandroblastoma". Such lesions are classified as borderline malignant. Postoperative adjuvant therapy was not administered in this case because only a few recurrent or fatal cases have been reported. The lesion was classified as pTlaN0M0 according to Union for International Cancer Control (UICC). The patient is alive and has been disease-free for 77 months post-surgery.

Proton pump inhibitor after endoscopic resection for esophageal squamous cell cancer: multicenter prospective randomized controlled trial

BACKGROUND

Whether proton pump inhibitors (PPIs) relieve heartburn or precordial pain after endoscopic resection (ER) for esophageal squamous cell carcinoma (ESCC) remains unclear. The aim of this study was to investigate the efficacy of PPI therapy for these symptoms after ER for ESCC.

METHODS

We conducted a multicenter prospective randomized controlled trial among 15 hospitals in Japan. In total, 229 patients with cT1a ESCC were randomly assigned to receive PPI therapy for 5 weeks after ER (the PPI group, n = 115) or follow-up without PPI therapy (the non-PPI group, n = 114). The primary end point was the incidence of gastroesophageal reflux disease (GERD)-like symptoms after ER from a self-reported questionnaire (Frequency Scale for Symptoms of GERD). Secondary end points were ulcer healing rate at 5 weeks, incidence of pain, improvement rate of symptoms in those who started PPI therapy because of GERD-like symptoms in the non-PPI group, and adverse events.

RESULTS

No significant difference was observed in the incidence of GERD-like symptoms after ER between the non-PPI and PPI groups (30 % vs 34 %, respectively). No significant differences were observed in the ulcer healing rate at 5 weeks (84 % vs 85 %) and incidence of pain within 1 week (36 % vs 45 %). In nine of ten patients (90 %) who started PPI therapy because of GERD-like symptoms in the non-PPI group, PPI administration relieved GERD-like symptoms. No adverse events related to PPI administration were observed.

CONCLUSION

PPI therapy is not efficacious in reducing symptoms and did not promote healing of ulcers in patients undergoing ER for ESCC.

Tongue pressure production during swallowing in patients with mandibular prognathism

Abnormalities of swallowing in patients with mandibular prognathism have not been evaluated quantitatively. The aim of this study was to compare tongue pressure production for bolus transfer between volunteers with normal occlusion and patients with mandibular prognathism. The control group had 10 female volunteers with normal occlusion, and the patient group had 10 women with mandibular prognathism. Tongue pressure was measured by a palatal sensor sheet at five sites on swallowing 4 mL of a tasteless and odourless jelly.

RESULTS

The tongue pressure waveform differed between the control and patient groups. The incidence of a double-peak tongue pressure waveform was more frequent in the patient group. In both groups, the exertion of tongue pressure began at the anterior point of the sensor sheet, followed by the peripheral parts. Although the order of expression of tongue pressure was the same for the two groups, maximum tongue pressure at all parts of the sensor sheet was lower in the patient group than in the control group. Furthermore, swallowing time was longer in the patient group than in the control group at the peripheral parts of the palate. These results clearly show the difference in tongue pressure production during swallowing between patients with mandibular prognathism and volunteers with normal occlusion. The current findings suggest that maxillofacial morphology may affect tongue movement during swallowing.

Reticulate evolution in the apogamous Dryopteris varia complex (Dryopteridaceae, subg. Erythrovariae, sect. Variae) and its related sexual species in Japan

Apogamous fern species are often difficult to distinguish from related species because of their continuous morphological variations. To clarify the genetic relationships among the members of the Dryopteris varia complex, we analyzed the nucleotide sequences of the plastid gene rbcL and the nuclear gene PgiC. We also analyzed the diploid sexual species D. caudipinna and D. chinensis, which have not been included in the complex, but were recently shown to be closely related to the complex in a molecular phylogenetic study. The PgiC sequences of the diploid sexual species, D. varia, D. saxifraga, D. sp. 'protobissetiana' (undescribed diploid sexual species), D. caudipinna, and D. chinensis, were well differentiated and hence designated A, B, C, D, and E, respectively. Thus, the PgiC constitution of apogamous species in the complex was as follows: D. bissetiana, B + C; D. kobayashii, B + C + E); D. pacifica, A + C, A + B + C, or A + C + D; D. sacrosancta, A + C + E; and D. saxifragivaria, B + C. These results suggest that these apogamous species are formed by hybridizations of species including not only the three diploid sexual species of the D. varia complex (A, B, and C) but also the two diploid sexual species D. caudipinna (D) and D. chinensis (E), which do not belong to the complex.

Environmental radiation at Izu-Oshima after the Fukushima Daiichi nuclear power plant accident

Environmental radiation at Izu-Oshima Island was observed 6 months after the accident at the Fukushima Daiichi Nuclear Power Plant (F1-NPP). A car-borne survey of the dose rate in air was conducted over the entire island and the results were compared with measurements performed in 2005 (i.e. before the accident). The activity concentrations of (134)Cs and (137)Cs were also measured using a germanium detector. The dose rate in air was found to be 2.9 ± 1.2 times higher than that in 2005 and (134)Cs was detected on Izu-Oshima Island. These results are attributed to the accident at the F1-NPP.

Functional-characterization of developing tumor vascular system and drug delivery (review)

This review summarizes our recent experiments on the process of tumor vascularization and character of tumor vessels. By vitalscopic observation with transparent chambers in rats, we found that the sites where tumor vessels originated were usually terminal portions of terminal arterioles and that an intricate tumor vascular network was constructed from incorporated preexisting vessels and newly formed vessels by three different modes, i.e., sprouting, cross-connecting and splitting. Observation and hydrogen clearance studies showed that tumor blood flow changed remarkably during the development of the tumor vascular network. At an early stage of tumor growth, there were some regions of high flow in the tumor. At an advanced stage, however, there was a rapid increase in low-flow or no-flow areas which were resistant to access of anticancer drugs and oxygen. Angiotensin II-induced hypertension produced a several-fold increase in tumor blood flow without increasing tissue blood flow of normal tissues. These good conditions for drug delivery to tumor tissue are able to enhance therapeutic effects of chemotherapy, irradiation, antibody and photodynamic therapy.