Efficacy of drug-coated balloon catheters for patients with short-term recurrent dysfunction of arteriovenous fistula.

BACKGROUND: In this study, we aimed at clarifying the usefulness of drug-coated balloon catheters (DCBs) for arteriovenous fistulas (AVFs) that repeatedly undergo restenosis over a short period and to examine the factors that influence the patency period after DCB use. METHODS: This retrospective observational study was conducted using IN.PACT AV in 29 cases of AVFs with repeated restenosis within approximately 3 months, and temporary patency before and after DCB use in the same patients was compared. For target participants, the flow volume, resistive index (RI), and vascular diameter of the brachial artery were measured using an ultrasound diagnostic device. Stenosis diameter, reference vessel diameter, and stenosis length of the lesion were measured before and after DCB dilatation using digital subtraction angiography. RESULTS: Before DCB angioplasty, the postintervention primary patency at 3 months was 66%, and the average interval was 92 ± 21 days (mean ± standard deviation). After DCB angioplasty, the postintervention primary patency rates at 3 and 6 months were 92% and 36%, respectively. The postintervention primary patency was significantly higher after than before DCB angioplasty (p < 0.0001). A sub-analysis was performed on 25 patients who were followed up for 4 months or more after DCB. The RI values before and after dilatation with DCB significantly differed between the patency group 4 or more months after DCB and the patency group less than 4 months after DCB. CONCLUSION: For AVFs that require frequent PTA over a short period of time, DCB improved the patency rate 3 months after PTA, but the improvement effect at 6 months was limited. The effect of DCB on prolonging the patency rate of AVFs that require frequent PTA over a short period of time may be correlated with the RI value before and after PTA.

Synthesis of a Mesoporous SnO2 Catalyst Support and the Effect of Its Pore Size on the Performance of Polymer Electrolyte Fuel Cells.

The aim of this study was to clarify the effectiveness and challenges of applying mesoporous tin oxide (SnO2)-based supports for Pt catalysts in the cathodes of polymer electrolyte fuel cells (PEFCs) to simultaneously achieve high performance and high durability. Recently, the focus of PEFC application in automobiles has shifted to heavy-duty vehicles (HDVs), which require high durability, high energy-conversion efficiency, and high power density. It has been reported that employing mesoporous carbon supports improves the initial performance by mitigating catalyst poisoning caused by sulfonic acid groups of the ionomer as well as by reducing the oxygen transport resistance through the Pt/ionomer interface. However, carbon materials in the cathode can degrade oxidatively during long-term operation, and more stable materials are desired. In this study, we synthesized connected mesoporous Sb-doped tin oxides (CMSbTOs) with controlled mesopore sizes in the range of 4-11 nm and tested their performance and durability as cathode catalyst supports. The CMSbTO supports exhibited higher fuel cell performance at a pore size of 7.3 nm than the solid-core SnO2-based, solid-core carbon, and mesoporous carbon supports under dry conditions, which can be attributed to the mitigation of the formation of the Pt/ionomer interface and the better proton conductivity within the mesopores even at the low-humidity conditions. In addition, the CMSbTO supports exhibited high durability under oxidative conditions. These results demonstrate the promising applicability of mesoporous tin oxide supports in PEFCs for HDVs. The remaining challenges, including the requirements for improving performance under wet conditions and stability under reductive conditions, are also discussed.

Hospitalizations for non-SARS-CoV-2 respiratory infectious diseases among patients on hemodialysis: A comparison before and during the coronavirus disease 2019 pandemic.

INTRODUCTION: The impact of coronavirus disease 2019 (COVID-19) infection control on other infections in patients with dialysis has not received sufficient consideration. METHODS: We compared hospitalization and mortality rates among patients who underwent hemodialysis (HD) at three dialysis centers before (March 2018-February 2020) and during (March 2020-February 2022) the COVID-19 pandemic. RESULTS: This study included 1696 patients undergoing HD (mean age, 70 years; 1099 men). Compared to before the COVID-19 pandemic, the emergency hospitalization rate (per 100 dialysis patient-years) for non-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) respiratory infectious diseases (IDs) (7.0 vs. 4.1, p < 0.001) significantly decreased during the COVID-19 pandemic, whereas the hospitalization rates for other IDs were comparable. The mortality rates for non-SARS-CoV-2 respiratory IDs were comparable before and during the COVID-19 pandemic. CONCLUSIONS: Hospitalizations for non-SARS-CoV-2 respiratory IDs among patients undergoing HD may have decreased owing to the implementation of infection control measures for COVID-19.

Molecular species profiles of plasma ceramides in different clinical types of X-linked adrenoleukodystrophy.

X-linked adrenoleukodystrophy (X-ALD) is a genetic disorder associated with peroxisomal dysfunction. Patients with this rare disease accumulate very long-chain fatty acids (VLCFAs) in their bodies because of impairment of peroxisomal VLCFA ?-oxidation. Several clinical types of X-ALD, ranging from mild (axonopathy in the spinal cord) to severe (cerebral demyelination), are known. However, the molecular basis for this phenotypic variability remains largely unknown. In this study, we determined plasma ceramide (CER) profile using liquid chromatography-tandem mass spectrometry. We characterized the molecular species profile of CER in the plasma of patients with mild (adrenomyeloneuropathy;AMN) and severe (cerebral) X-ALD. Eleven X-ALD patients (five cerebral, five AMN, and one carrier) and 10 healthy volunteers participated in this study. Elevation of C26:0 CER was found to be a common feature regardless of the clinical types. The level of C26:1 CER was significantly higher in AMN but not in cerebral type, than that in healthy controls. The C26:1 CER level in the cerebral type was significantly lower than that in the AMN type. These results suggest that a high level of C26:0 CER, along with a control level of C26:1 CER, is a characteristic feature of the cerebral type X-ALD. J. Med. Invest. 70 : 403-410, August, 2023.

Sintering Metal-Organic Framework Gels for Application as Structural Adhesives.

Metal-organic frameworks (MOFs)/coordination polymers are promising materials for gas separation, fuel storage, catalysis, and biopharmaceuticals. However, most applied research on MOFs is limited to these functional materials thus far. This study focuses on the potential of MOFs as structural adhesives. A sintering technique is applied to a zeolitic imidazolate framework-67 (ZIF-67) gel that enables the joining of Cu substrates, resulting in a shear strength of over 30 MPa, which is comparable to that of conventional structural adhesives. Additionally, systematic experiments are performed to evaluate the effects of temperature and pressure on adhesion, indicating that the removal of excess 2-methylimidazole and the by-product (acetic acid) from the sintered material by vaporization results in a microstructure composed of large spherical ZIF-67 crystals that are densely aggregated, which is essential for achieving a high shear strength.

Difelikefalin for Hemodialysis Patients with Pruritus in Japan.

Difelikefalin for Hemodialysis Patients with PruritusDifelikefalin has been developed for the treatment of pruritus in hemodialysis patients. In this randomized trial of 230 Japanese patients with moderate-to-severe pruritus and undergoing maintenance hemodialysis, difelikefalin (0.5 µg/kg three times per week intravenously for 4 weeks) significantly reduced itching and improved quality of life.

Interfacial Distribution of Nafion Ionomer Thin Films on Nitrogen-Modified Carbon Surfaces.

Chemically modified carbon supports for the cathode catalyst layers of polymer electrolyte fuel cells (PEFCs) show considerable promise for boosting the oxygen reduction reaction. This study evaluated the ionomer distribution of Nafion ionomer thin films on nitrogen (N)-modified carbon surfaces along their depth direction. Neutron reflectivity (NR) measurements performed using the double-contrast technique with H2O and D2O revealed that the introduction of N functional groups to carbon thin films promoted ionomer adsorption onto the surface under wet conditions (22 °C, 85% relative humidity). Molecular dynamics (MD) simulations conducted to verify the origin of the robust contact between the ionomer and N-modified carbon surface revealed an ionomer adsorption mechanism on the N-modified carbon surfaces, which involved Coulomb interactions between the positively charged carbon surface and the ionomer side chains with negatively charged sulfonic acid groups. The positive surface charge, which was determined using the contents of the N functional groups estimated by X-ray photoelectron spectroscopy, was found to be sufficient as an impetus for ionomer adsorption. This strategy involving NR measurements and MD simulations can provide insights into the solid-ionomer interfacial structures in a cathode catalyst layer and can therefore be extensively employed in studies on PEFCs.

Lysophosphatidic acid, ceramide 1-phosphate and sphingosine 1-phosphate in peripheral blood of patients with idiopathic pulmonary fibrosis.

Idiopathic pulmonary fibrosis (IPF) is the most common idiopathic interstitial pneumonias. Lysophosphatidic acid (LPA) and sphingosine 1-phosphate (S1P) are signaling lipids that evoke growth factor-like responses to many cells. Recent studies revealed the involvement of LPA and S1P in the pathology of IPF. In this study, we determined LPA, S1P and ceramide 1-phosphate (C1P) in peripheral blood plasma of IPF patients, and examined correlation to the vital capacity of lung (VC), an indicator of development of fibrosis. Blood plasma samples were taken from eleven patients with IPF and seven healthy volunteers. The lipids of the sample were extracted and subjected to liquid chromatography-tandem mass spectrometry for analysis. Results showed that there is a significant negative correlation between VC and plasma LPA levels, indicating that IPF patients with advanced fibrosis had higher concentration of LPA in their plasma. Average of S1P levels were significantly higher in IPF patients than those in healthy subjects. Although it is not statistically significant, a similar correlation trend that observed in LPA levels also found between VC and S1P levels. These results indicated that plasma LPA and S1P may be associated with deterioration of pulmonary function of IPF patients. J. Med. Invest. 69 : 196-203, August, 2022.

Association between tumor response to systemic therapy and patient-reported disease symptoms.

BACKGROUND: The association of treatment-induced tumor shrinkage with symptom palliation for patients with lung cancer remains unknown. We investigated this correlation using the Edmonton Symptom Assessment System-Revised. METHODS: Using the in-hospital cancer registry, we identified patients receiving chemotherapy and/or immunotherapy for newly diagnosed advanced or metastatic lung cancer. Tumor response and post-treatment Edmonton Symptom Assessment System-Revised were obtained after 2-3 treatment cycles. Patients were divided into groups with or without >30% unidirectional tumor shrinkage (objective response [OR] or non-OR [N-OR] groups, respectively). They were further classified as good-objective response (>50% unidirectional tumor shrinkage), moderate-objective response (30-50% shrinkage), progressive disease (>20% tumor growth or new lesion) or stable disease (SD; N-objective response and non-progressive disease). The primary endpoint was change in the total Edmonton Symptom Assessment System-Revised score from baseline. The Mann-Whitney U test was used for analysis. RESULTS: In total, 113 patients were enrolled. The total Edmonton Symptom Assessment System-Revised score was significantly more improved in the OR group versus the N-OR group (median: 5 vs. 2, respectively; P = 0.013). This association was more prominent in patients with small-cell lung cancer and large-cell neuroendocrine tumor than those with other histology. Sensitivity analyses showed that the total Edmonton Symptom Assessment System-Revised score was more improved in the OR group versus the SD group (median: 5 vs. 3, respectively; P = 0.029) and in the 'good-OR' group versus the 'moderate-OR and SD' group (median: 7.5 vs. 2, respectively; P = 0.003), suggesting that greater tumor shrinkage led to more symptom amelioration. CONCLUSIONS: Tumor shrinkage was associated with Edmonton Symptom Assessment System-Revised score improvement in patients with lung cancer receiving systemic therapy.

Formation of N-acyl-phosphatidylethanolamines by cytosolic phospholipase A2ε in an ex vivo murine model of brain ischemia.

N-Acyl-phosphatidylethanolamines (NAPEs), a minor class of membrane glycerophospholipids, accumulate along with their bioactive metabolites, N-acylethanolamines (NAEs) during ischemia. NAPEs can be formed through N-acylation of phosphatidylethanolamine by cytosolic phospholipase A2ε (cPLA2ε, also known as PLA2G4E) or members of the phospholipase A and acyltransferase (PLAAT) family. However, the enzyme responsible for the NAPE production in brain ischemia has not yet been clarified. Here, we investigated a possible role of cPLA2ε using cPLA2ε-deficient (Pla2g4e-/-) mice. As analyzed with brain homogenates of wild-type mice, the age dependency of Ca2+-dependent NAPE-forming activity showed a bell-shape pattern being the highest at the first week of postnatal life, and the activity was completely abolished in Pla2g4e-/- mice. However, liquid chromatography-tandem mass spectrometry revealed that the NAPE levels of normal brain were similar between wild-type and Pla2g4e-/- mice. In contrast, post-mortal accumulations of NAPEs and most species of NAEs were only observed in decapitated brains of wild-type mice. These results suggested that cPLA2ε is responsible for Ca2+-dependent formation of NAPEs in the brain as well as the accumulation of NAPEs and NAEs during ischemia, while other enzyme(s) appeared to be involved in the maintenance of basal NAPE levels.

Effects of Lithium Bis(oxalate)borate Electrolyte Additive on the Formation of a Solid Electrolyte Interphase on Amorphous Carbon Electrodes by Operando Time-Slicing Neutron Reflectometry.

Comprehensive analyses were performed using neutron reflectivity and hard X-ray photoelectron spectroscopy to understand the structure and composition of the solid electrolyte interphase (SEI) layer during charge-discharge processes and because of the addition of lithium bis(oxalate)borate (LiBOB) to improve the battery performance. The chemical composition of the SEI was assessed using these methods, and the amount of Li+ intercalated in the anode during the electrochemical reaction was evaluated. The results demonstrated that Li2C2O4 was produced initially but later decomposed to Li2CO3 on the first charge cycle. Presumably, the SEI layer formed by the decomposition of LiBOB was a single dense layer and chemically stable during the further charge-discharge processes owing to the difference in the reaction process. Therefore, the reduced Li+ transfer resistance and charging capacity accounted for the substantial improvement contributed by adding LiBOB. Moreover, the charges used for the intercalation of Li+ and SEI formation during the two-cycle processes were analyzed. The addition of LiBOB increased the discharge capacity of the anode and provided an additional charge used for SEI formation, presumably for decomposing Li2C2O4, which could reflect the durability of the Li-ion batteries. The electrode, electrolyte, and charge-discharge reactions affect the SEI properties and consequently the electrochemical reactions. Therefore, additional investigations under different charge-discharge conditions would reveal important characteristics such as the charge and discharge efficiency, output performance, and safety.

A practical method for determining film thickness using X-ray absorption spectroscopy in total electron yield mode.

Thin films formed on surfaces have a large impact on the properties of materials and devices. In this study, a method is proposed using X-ray absorption spectroscopy to derive the film thickness of a thin film formed on a substrate using the spectral separation and logarithmic equation, which is a modified version of the formula used in electron spectroscopy. In the equation, the decay length in X-ray absorption spectroscopy is longer than in electron spectroscopy due to a cascade of inelastic scattering of electrons generated in a solid. The modification factor, representing a multiple of the decay length, was experimentally determined using oxidized Si and Cu with films of thickness 19 nm and 39 nm, respectively. The validity of the proposed method was verified, and the results indicated that the method can be used in the analysis of various materials with thin films.

Experience of symptom control, anxiety and associating factors in a palliative care unit evaluated with Support Team Assessment Schedule Japanese version.

Various physical and psychosocial difficulties including anxiety affect cancer patients. Patient surroundings also have psychological effects on caregiving. Assessing the current status of palliative care intervention, specifically examining anxiety and its associated factors, is important to improve palliative care unit (PCU) patient quality of life (QOL). This study retrospectively assessed 199 patients admitted to a PCU during August 2018-June 2019. Data for symptom control, anxiety level, disease insight, and communication level obtained using Support Team Assessment Schedule Japanese version (STAS-J) were evaluated on admission and after 2 weeks. Palliative Prognostic Index (PPI) and laboratory data were collected at admission. Patient anxiety was significantly severer and more frequent in groups with severer functional impairment (p = 0.003) and those requiring symptom control (p = 0.006). Nevertheless, no relation was found between dyspnea and anxiety (p = 0.135). Patients with edema more frequently experienced anxiety (p = 0.068). Patient survival was significantly shorter when family anxiety was higher after 2 weeks (p = 0.021). Symptoms, edema, and disabilities in daily living correlate with patient anxiety. Dyspnea is associated with anxiety, but its emergence might be attributable mainly to physical factors in this population. Family members might sensitize changes reflecting worsened general conditions earlier than the patients.

Eutectic salt mixture-assisted sodium-vapor-induced synthesis of Pt-Ca nanoparticles, and their microstructural and electrocatalytic properties.

We have fabricated Pt-Ca nanoparticles with oxygen reduction reaction catalytic activity via a sodium vapor-induced synthesis method. Prior addition of NaCl to form a eutectic mixture of CaCl2 and NaCl facilitated the formation of intermetallic Pt2Ca nanoparticles. Pt3Mg and Pt5Sr nanoparticles also were suggested to be producible.

Electrochemical CO2 reduction over nanoparticles derived from an oxidized Cu-Ni intermetallic alloy.

Oxide-derived Cu-Ni (3-32 at%-Ni) alloy nanoparticles with a size of 10 nm enhance selectivity for ethylene and ethanol formation over oxide-derived Cu nanoparticles by electrochemical CO2 reduction. X-ray absorption spectroscopy measurements suggest that Ni (generally recognized as an element to avoid) is in a mixed phase of oxidized and metallic states.

Sodium Vapor-Induced Synthesis of Intermetallic Pt5Ce Compound Nanoparticles.

We have developed a synthetic route that uses sodium for the production of intermetallic Pt5Ce nanoparticles (ca. 6 nm average diameter) supported on carbon powder. Sodium melt was demonstrated to reduce a powder mixture of PtCl2 and CeCl3 to form submicrometer Pt5Ce particles with the simultaneous formation of NaCl. The NaCl-CeCl3 melt mixture and Na melt were formed during heating, which led to a uniform reaction between Pt and Ce, and the melt induced grain growth. The synthetic procedures were then modified to supply sodium vapor to the vicinity of the metal sources supported on carbon powder with an aim to suppress grain growth. Pt5Ce nanoparticles were successfully formed on the carbon support with high loading and dispersity.

Microbiomes of colored dental biofilms in children with or without severe caries experience.

BACKGROUND: Biofilm coloration can compromise maturation and increase the risk of oral disease in adulthood, though children with colored biofilm do not always demonstrate a poor oral health status. AIM: The microbial compositions of colored and white biofilms in children were compared. DESIGN: Thirty-two dental biofilm samples from 16 children (age < 13 years) were analyzed using 16S rRNA pyrosequencing, then the subjects were divided into severe caries and healthy (caries-free) groups. Correlations between microbiomes and oral health status were also examined. RESULTS: Phylogenetic analysis revealed no distinctly different patterns between colored and white biofilms. In the severe caries group, genus Actinomyces, Cardiobacterium, Kingella, Lautropia, and Veillonella, and family Neisseriaceae were detected, though abundance was significantly different between colored and white biofilm specimens, in contrast to the healthy group. In addition, five colored biofilm samples from the severe caries group contained greater than 15% Actinomyces, which led us to consider that genus to be possibly associated with formation of colored biofilm in children. CONCLUSIONS: Our findings indicate that differences in bacterial composition between colored and white biofilms are higher in individuals with severe caries. Additional research may reveal the significance of colored dental biofilm in children.

Extracellular Vesicle and Particle Biomarkers Define Multiple Human Cancers.

There is an unmet clinical need for improved tissue and liquid biopsy tools for cancer detection. We investigated the proteomic profile of extracellular vesicles and particles (EVPs) in 426 human samples from tissue explants (TEs), plasma, and other bodily fluids. Among traditional exosome markers, CD9, HSPA8, ALIX, and HSP90AB1 represent pan-EVP markers, while ACTB, MSN, and RAP1B are novel pan-EVP markers. To confirm that EVPs are ideal diagnostic tools, we analyzed proteomes of TE- (n = 151) and plasma-derived (n = 120) EVPs. Comparison of TE EVPs identified proteins (e.g., VCAN, TNC, and THBS2) that distinguish tumors from normal tissues with 90% sensitivity/94% specificity. Machine-learning classification of plasma-derived EVP cargo, including immunoglobulins, revealed 95% sensitivity/90% specificity in detecting cancer. Finally, we defined a panel of tumor-type-specific EVP proteins in TEs and plasma, which can classify tumors of unknown primary origin. Thus, EVP proteins can serve as reliable biomarkers for cancer detection and determining cancer type.

Improving photosensitivity without changing thermal reactivity in photochromic diarylbenzenes based on accurate prediction by DFT calculations.

1,2-Diarylbenzenes (DABs) have been developed as a new family of fast T-type photochromic switches. However, the molecular design strategy for DABs with desired optical and thermal properties is not established. In this work, we explored the best functional in quantum chemical calculations to predict the properties of DABs. Furthermore, we newly designed and synthesized DABs based on the calculation using the best functional, resulting in the improvement of the photosensitivity in the UV-A region (i.e. a shift of absorption to lower energies and an increase in the absorption coefficient) without changing the thermal back-reaction rate.

Insulinoma-associated Protein 1 (INSM1) Is a Better Marker for the Diagnosis and Prognosis Estimation of Small Cell Lung Carcinoma Than Neuroendocrine Phenotype Markers Such as Chromogranin A, Synaptophysin, and CD56.

To diagnose small cell lung carcinoma (SCLC), neuroendocrine (NE) phenotype markers such as chromogranin A, synaptophysin, and CD56 are helpful. However, because they are dispensable, SCLCs occur without apparent NE phenotypes. Insulinoma-associated protein 1 (INSM1) is a transcription factor for NE differentiation and has emerged as a single practical marker for SCLC. Using the surgical samples of 141 pulmonary NE tumors (78 SCLCs, 44 large cell NE carcinomas, and 19 carcinoids), and 246 non-NE carcinomas, we examined the immunohistochemical expression and prognostic relevance of INSM1 in association with NE phenotype markers. We evaluated its sensitivity and specificity for SCLC diagnosis, as well as its usefulness to diagnose SCLC without NE marker expression and to estimate the prognosis. INSM1 was expressed in SCLCs (92%, 72/78), large cell NE carcinomas (68%, 30/44), and carcinoids (95%, 18/19). In addition, among SCLCs with no expression of NE phenotype markers (n=12), 9 (75%) were positive for INSM1. These data suggest the superiority of INSM1 to the phenotype markers. Only 7% of adenocarcinomas (9/134) and 4% of squamous cell carcinomas (4/112) were positive for INSM1. SCLC with low-INSM1 expression (n=28) had a significantly better prognosis (P=0.040) than the high-INSM1 group (n=50). Our study revealed that INSM1 is highly sensitive and specific to detect SCLC and can estimate prognosis. INSM1 will be a promising marker for SCLC.