Increment of C-peptide after glucagon injection determines the progressive nature of Japanese type 2 diabetes: a long-term follow-up study.

Type 2 diabetes (T2D) is characterized by a steady worsening of ß-cell dysfunction as the disease progresses. The objective of this study was to estimate the decline of insulin secretion in Japanese type 2 diabetic patients (T2D-patients) by glucagon injection over an observation period of more than 10 years. Thirty-three T2D-patients were followed for 10.4 ± 1.4 years. Fasting C-peptide immunoreactivity (FCPR), the 6 min value of CPR after glucagon injection (6MCPR), and the increment of CPR (ΔCPR) were measured at baseline and follow-up. FCPR, 6MCPR, ΔCPR were significantly lower at follow-up than at baseline (p<0.05, p<0.005, and p<0.0005, respectively). The annual change of ΔCPR was significantly (p<0.05) greater than the annual change of FCPR (-0.062 ± 0.076 ng/mL/year and -0.025 ± 0.067 ng/mL/year, respectively). In contrast, CPR-index (an index of ß-cell function) and SUIT-index (secretory units of islets in transplantation) calculated based on fasting blood samples were unaltered. The annual changes of FCPR, 6MCPR, and ΔCPR were negatively correlated with the FCPR, 6MCPR, and ΔCPR values at baseline, respectively. Duration of diabetes, BMI, diabetic retinopathy, and secondary sulfonylurea failure at baseline were not correlated with the annual changes of FCPR, 6MCPR, and ΔCPR. In conclusion, our longitudinal observations suggest that ß-cell function progressively declines in Japanese T2D-patients. The annual declines of ΔCPR were more prominent than the annual declines of FCPR. ΔCPR after glucagon injection may be more useful for estimating individual longitudinal insulin secretion than fasting blood samples.

Ruptured mycotic coronary artery aneurysm hybrid treatment with covered stent and surgical debridement.

We present a case of a ruptured mycotic coronary aneurysm effectively treated with covered stents and phased surgery. The covered stent, however, became occluded two years later. Because of the low invasiveness, a covered stent treatment may be advantageous over conventional surgery but trade off long-term vascular patency. Learning objective: To recognize the presence of a ruptured infectious coronary aneurysm after a primary coronary stenting for ST-elevation myocardial infarction.To discuss the treatment strategies for a ruptured infectious coronary aneurysm with a covered stent.

Public Engagement with Science via Social Media: A Case of Communicating the Pandemic on Twitter.

The poster describes a project which analyzes interactions between laypeople and experts via social media. Our aim is to understand how experts and the general public interact with each other on social media, and how we can use current data to improve these interactions in the future. We created a Twitter bot to obtain data from 15 COVID-19 experts and 7 federal government-sponsored public health organizations from English-speaking countries. The data were analyzed in R to investigate the relationships among Followers, Favorites, Retweets, and Hashtag Count per tweet. The preliminary analysis indicated statistically significant differences between various variables including: Number of Favorites, Number of Retweets, Number of Hashtags, and Number of Followers; the results shed light on the current relationship between the public and experts on social media.

Investigating mediated public engagement with science on the "science" subreddit: From the participants' perspective.

While public engagement with science activities traditionally inhabits physical environments (i.e., museum exhibits), as the Internet becomes more ubiquitous, new types of public engagement with science mediated through information technologies have emerged. Instead of having scientific findings filtered through traditional mediators, scientists have begun to take advantage of social media in order to communicate directly with the general public. This paper focuses on technology mediated public engagement with science in an online environment, specifically the sub-Reddit called "r/science", on a popular platform, Reddit, in which we investigated the factors contributing to user engagement and perceived effects of science communication from the users' perspectives. The survey instrument including user engagement scales, perceived effects of science communication, and demographics were distributed among 2000 participants in the r/science Ask Me Anything (AMA) series. We analyzed 146 survey responses using descriptive statistics and ordinal logistic regression. The findings indicated that the participants were generally engaged compared to ones in other studies that used the same user engagement scales and perceived positive effects on science communication, except when it came to building trust. Furthermore, we found that time spent on this particular platform appeared to be the most important factor when it came to positive perceived effects of r/science AMAs. This type of mediated public engagement has been insufficiently investigated, most particularly in terms of the examination of participants' perspectives. This void is addressed in this study. The findings from the study will also be informative to similar platforms that support mediated public engagement with science.

A Novel Heterozygous Missense Variant in the CIAO1 Gene in a Family with Alzheimer's Disease: The Val67Ile Variant Promotes the Interaction of CIAO1 and Amyloid-ß Protein Precursor.

Familial dementia is a rare inherited disease involving progressive impairment of memory, thinking, and behavior. We report a novel heterozygous pathogenic variant (c.199G > A, p.Val67Ile) in the CIAO1 gene that appears to be co-segregated with Alzheimer's disease in a Japanese family. Biochemical analysis of CIAO1 protein revealed that the variant increases the interaction of CIAO1 with immature amyloid-ß protein precursor (AßPP), but not mature or soluble AßPP, indicating plausible CIAO1 involvement in AßPP processing. Our study indicates that a heterozygous variant in the CIAO1 gene may be closely related to autosomal dominant familial dementia.

[Human parvovirus B19 infection in 15 adults--two-year Toho University Hospital study].

Human parvovirus B19 infection in adults features clinical symptoms and laboratory abnormal findings unlike those in children commonly associated with cheek rash. We diagnosed 15 adult cases based on the positive increase in anti-parvovirus B19 IgM antibody (8.89 +/- 7.86 mean +/- SD, enzyme immunoassay (EIA)). Antibody titer was measured in 78 patients clinically showing fever, edema, exanthema, arthralgia, and myalgia among 11,040 outpatients first visiting the hospital from January 2005 to December 2007. Based on clinical and laboratory findings for these 15 cases, we recommended that physicians taking anti-parvovirus B19 antibody blood samples note whether (1) the level of C reactive protein is negative or low and without leucocytosis; (2) a miliary rash is observed in short duration (rarely facial); (3) arthralgia and/or myalgia is present in the extremities (sometimes asymmetrical); (4) edema is present in the extremities, especially finger, ankle, or sole of the foot; (5) contact has been made with ill children; (6) flu-like symptoms occur such as fatigue, headache, or fever;and (7) normo- or hypocomplementemia and/or antinuclear antibody is positive. Patients who fulfill requirement (1) plus at least three of requirements (2) through (7) should have a blood sample taken. We retrospectively studied 78 cases using these requirements, finding their sensitivity to be 100% (15/15), specificity to be 88.9% (56/63), positive predictive value to be 68.1% (15/22) and negative predictive value to be 100% (56/56). These requirements are thus useful in selecting patients for measuring antibody titer and definitively diagnosing severe or persistent parvovirus B19 infection occationally observed in adults.

Role of nitrergic nerves in the regulation of motility of the omasum and abomasum in healthy sheep (Ovis aries).

We examined the physiological role of nitrergic nerves in the regulation of omasal and abomasal motility in conscious healthy sheep and omasal muscle specimens. Nitric oxide (NO)-donor, S-nitroso-acethyl-dl-penicillamine (SNAP, 3-30 nmol/kg per min, i.v.) significantly inhibited omasal electromyographic (EMG) activity, whereas it did not alter EMG activity in the abomasal antrum. However, NO synthase inhibitor, Nomega-nitro-l-arginine-methyl ester (L-NAME, 0.3-3.0 micromol/kg per min, i.v.) did not alter EMG activity of the omasum and abomasum. In the in vitro experiments, SNAP application (6-200 micromol/l) significantly inhibited bethanechol (10 micromol/l)-induced contraction of longitudinal and circular muscles of the omasum. L-NAME application (0.03-3.0 mmol/l) enhanced electric field stimulation-induced contractions of the circular muscles. The results suggest that the omasal muscles are responsive to exogenous NO and that nitrergic nerves innervate the circular muscle layer of the omasum, however, nitrergic nerves are not or scarcely involved the physiological regulation of omasal and possibly abomasal motility in healthy sheep.

An emerging form of public engagement with science: Ask Me Anything (AMA) sessions on Reddit r/science.

Originally, online public engagement with science tended to be one directional-from experts to the general population via news media. Such an arrangement allowed for little to no direct interaction between the public and scientists. However, the emergence of social media has opened the door to meaningful engagement between scientists and the general public. The current study examines scientists' perspectives on the interactions between laypeople and scientists by asking questions and sharing information on social media platforms, specifically, through Ask Me Anything (AMA) sessions on Reddit's "Science" subreddit (r/science). By analyzing the content of six different r/science AMAs and surveying scientists who participated as r/science AMA hosts, our research attempts to gain a richer understanding of direct communication between scientists and lay audiences online. We had three main questions: (1) who are the participant scientists hosting r/science AMAs, (2) what are their experiences like as hosts, and (3) what type of discussions do they have on this platform? Survey results suggested that these scientists recognize the promising interactive nature of Reddit and are interested in continuing to use this platform as a tool for public engagement. Survey respondents generally had positive experiences as AMA hosts, but further research is needed to examine negative experiences. Overall, this study has significant implications for how scientists can engage public audiences online and more effectively communicate scientific findings to the general populace.

An online listserv for nurse practitioners: a viable venue for continuous nursing professional development?

This study reports the results of a qualitative study involving a large and longstanding online nurse listserv in the United States. A sample of 27 critical care and advanced-practice nurse practitioners was interviewed using semi-structured individual interviews. This study found evidence that participation in an online listserv offers a viable avenue for the continuous professional development of nurses by providing nurses the opportunity to make more informed decisions about their professional practice and keeping abreast with up-to-date changes in their specialty areas when they shared knowledge with one another. Follow-up interviews with 10 nurses who frequently shared their knowledge revealed six motivators that helped promote knowledge sharing: (a) reciprocity, (b) collectivism, (c) personal gain, (d) respectful environment, (e) altruism, and (f) technology. Implications for sustaining knowledge sharing in an online listserv are discussed. The finding will inform educators and administrators who support continuing education and professional development of healthcare professionals.

Using egocentric analysis to investigate professional networks and productivity of graduate students and faculty in life sciences in Japan, Singapore, and Taiwan.

Prior studies showed that scientists' professional networks contribute to research productivity, but little work has examined what factors predict the formation of professional networks. This study sought to 1) examine what factors predict the formation of international ties between faculty and graduate students and 2) identify how these international ties would affect publication productivity in three East Asian countries. Face-to-face surveys and in-depth semi-structured interviews were conducted with a sample of faculty and doctoral students in life sciences at 10 research institutions in Japan, Singapore, and Taiwan. Our final sample consisted of 290 respondents (84 faculty and 206 doctoral students) and 1,435 network members. We used egocentric social network analysis to examine the structure of international ties and how they relate to research productivity. Our findings suggest that overseas graduate training can be a key factor in graduate students' development of international ties in these countries. Those with a higher proportion of international ties in their professional networks were likely to have published more papers and written more manuscripts. For faculty, international ties did not affect the number of manuscripts written or of papers published, but did correlate with an increase in publishing in top journals. The networks we examined were identified by asking study participants with whom they discuss their research. Because the relationships may not appear in explicit co-authorship networks, these networks were not officially recorded elsewhere. This study sheds light on the relationships of these invisible support networks to researcher productivity.

Hydrogen and methane gases are frequently detected in the stomach.

AIM: To investigate the incidence of bacterial overgrowth in the stomach by using a new endoscopic method in which intragastric hydrogen and methane gases are collected and analyzed. METHODS: Studies were performed in 490 consecutive patients undergoing esophagogastroscopy. At endoscopy, we intubated the stomach without inflation by air, and 20 mL of intragastric gas was collected through the biopsy channel using a 30 mL syringe. Intragastric hydrogen and methane concentrations were immediately measured by gaschromatography. H pylori infection was also determined by serology. RESULTS: Most of intragastric hydrogen and methane levels were less than 15 ppm (parts per million). The median hydrogen and methane values (interquartile range) were 3 (1-8) ppm and 2 (1-5) ppm, respectively. The high hydrogen and methane levels for indication of fermentation were decided if the patient had the values more than 90 percentile range in each sample. When a patient had a high level of hydrogen or methane in one or more samples, the patient was considered to have fermentation. The overall incidence of intragastric fermentation was 15.4% (73/473). Intragastric methane levels were higher in the postoperative group than in other groups. None of the mean hydrogen or methane values was related to H pylori infection. CONCLUSION: Hydrogen and methane gases are more frequently detected in the stomach than expected, regardless of the presence of abdominal symptoms. Previous gastric surgery influences on the growth of methane-producing bacteria in the fasting stomach.

Seventy-five gram glucose tolerance test to assess carbohydrate malabsorption and small bowel bacterial overgrowth.

AIM: To investigate non-invasively the incidence of absorption of carbohydrates in diabetic patients during an oral glucose tolerance test (OGTT) and to determine whether malabsorption may be associated with insulin secretion and insulin resistance. METHODS: A standard 75-g OGTT was performed in 82 diabetic patients. The patients received 75 g of anhydrous glucose in 225 mL of water after an overnight fasting and breath samples were collected at baseline and up to 120 min after ingestion. Breath hydrogen and methane concentrations were measured. Blood glucose and serum insulin concentrations were measured before ingestion and at 30, 60, 90, 120 min post-ingestion. RESULTS: When carbohydrate malabsorption was defined as subjects with an increase of at least 10 ppm (parts per million) in hydrogen or methane excretion within a 2-h period, 28 (34%) had carbohydrate malabsorption. According to the result of increased breath test, 21 (75%) patients were classified as small bowel bacterial overgrowth and 7 (25%) as glucose malabsorption. Patients with carbohydrate malabsorption were older and had poor glycemic control as compared with those without carbohydrate malabsorption. The HOMA value, the sum of serum insulin during the test and the Delta insulin/Delta glucose ratio were greater in patients with carbohydrate malabsorption. CONCLUSION: Insulin resistance may be overestimated by using these markers if the patient has carbohydrate malabsorption, or that carbohydrate malabsorption may be present prior to the development of insulin resistance. Hence carbohydrate malabsorption should be taken into account for estimating insulin resistance and beta-cell function.

Type 1 diabetes patients have lower strength in femoral bone determined by quantitative computed tomography: A cross-sectional study.

AIMS/INTRODUCTION: Previous studies have reported osteoporosis measured by dual-energy X-ray absorptiometry in younger patients with type 1 diabetes. Limitations of 2-D imaging, however, limit the precision of dual-energy X-ray absorptiometry for the measurement of bone mineral density and bone strength. MATERIALS AND METHODS: Three-dimensional quantitative computed tomography was used to calculate volumetric-bone mineral density (vBMD) and strength in femoral bone subfractions. A total of 17 male type 1 diabetes patients and 18 sex-matched healthy controls aged from 18 to 49 years were investigated in the present cross-sectional study. Patients with overt nephropathy were excluded. RESULTS: Type 1 diabetes patients had significantly lower cortical vBMD in the femoral neck, and significantly lower total vBMD, cortical thickness and cortical cross-sectional area (cortical CSA) in the intertrochanter. Bone strength estimated by the buckling ratio (an index of cortical instability) of the intertrochanter was significantly higher in type 1 diabetes patients. The following serum bone markers were comparable between the two groups: bone-specific alkaline phosphatase, N-terminal propeptide of type 1 procollagen, osteocalcin, pentosidine and homocysteine. Serum insulin-like growth factor-1 values were significantly lower in the type 1 diabetes patients than in controls. Serum insulin-like growth factor-1values were positively correlated with serum bone formation markers, and the total vBMD of the femoral neck and lumbar spine in type 1 diabetes patients. CONCLUSIONS: The present study is the first investigation by quantitative computed tomography measurement to show cortical instability and lower vBMD in the intertrochanter of young and middle-aged type 1 diabetes patients. Low insulin-like growth factor-1 might be a causative factor for osteoporosis in type 1 diabetes.

Teneligliptin, a Dipeptidyl Peptidase-4 Inhibitor, Improves Early-Phase Insulin Secretion in Drug-Naïve Patients with Type 2 Diabetes.

INTRODUCTION: It remains unknown whether dipeptidyl peptidase-4 (DPP-4) inhibitors improve early-phase insulin secretion in Japanese patients with type 2 diabetes (T2D), a disease characterized by impaired insulin secretion. We investigated the changes in insulin secretion before and after treatment with the DPP-4 inhibitor teneligliptin in patients with T2D with a low insulinogenic index (IGI) determined by the oral glucose tolerance test (OGTT). METHODS: An open-label, prospective clinical study was conducted. Thirteen drug-naïve patients (mean age 55.5 ± 3.9 years) with T2D underwent OGTT before and after teneligliptin 20 mg/day monotherapy. Plasma levels of glucose (PG), insulin, and C-peptide were measured at 0, 30, 60, 90, and 120 min after glucose loading in the OGTT. Homeostasis model assessment (HOMA)-ß, IGI, and the total or incremental area under the curve (AUC) for PG and insulin were measured. AUC120min for the secretory units of islets in transplantation (SUIT) index was also measured. RESULTS: HbA1c significantly decreased from 8.3 ± 0.4% at baseline to 6.3 ± 0.2% after 12 weeks of teneligliptin treatment (p < 0.05). Incremental AUC120min PG also significantly decreased, and ß-cell function assessed by IGI30min, AUC120min insulin, and the AUC120min SUIT index significantly increased (0.16 ± 0.05 vs. 0.28 ± 0.06, 2692 ± 333 µU·2h/mL vs. 3537 ± 361 µU·2h/mL, and 4261 ± 442 vs. 8290 ± 1147, respectively; all p < 0.05). HOMA-ß was unchanged. The reduction in incremental AUC120min PG was significantly associated with the augmentation of IGI30min and the AUC120min SUIT index. No severe adverse events were observed. CONCLUSIONS: Twelve weeks of teneligliptin treatment improved IGI30min, AUC120min, and the SUIT index in drug-naïve Japanese patients with T2D.

Salt-sensitive hypertension in conscious rats induced by chronic nitric oxide blockade.

This study examined the effects of alterations in salt-intake on blood pressure (BP) in rats chronically treated intravenously with or without the nitric oxide synthase (NOS) inhibitor N(G)-nitro-L-arginine methyl ester (L-NAME) (8.6 mg/kg/day). The changes in mean arterial pressure (MAP), the renal cortical and medullary blood flow (CBF and MBF), and the sodium balance were determined by implanted optical fibers and laser-Doppler flow measurement techniques in the conscious rats. The results showed that high salt intake (7.4 mEq/day) elevates CBF (139% +/- 15%), but has no significant effect on MAP or MBF in control rats; in L-NAME-treated rats, high salt intake elevates MAP, produces no change in CBF, and decreases MBF (51% +/- 14%), as well as increasing the sodium balance (0.26 +/- 0.23 mEq/day to 1.29 +/- 0.47 mEq/day). The present experiments indicated that NO appears to maintain the MBF during high salt intake and to prevent the changes in MAP, and, in the absence of NO, salt-sensitive hypertension develops. Nitric oxide plays an important role in the development of salt-sensitive hypertension with the change of MBF.

Research experiences and mentoring practices in selected east Asian graduate programs: predictors of research productivity among doctoral students in molecular biology.

Although doctoral mentors recognize the benefits of providing quality advisement and close guidance, those of sharing project management responsibilities with mentees are still not well recognized. We observed that mentees, who have the opportunity to co-manage projects, generate more written output. Here we examine the link between research productivity, doctoral mentoring practices (DMP), and doctoral research experiences (DRE) of mentees in programs in the non-West. Inspired by previous findings that early career productivity is a strong predictor of later productivity, we examine the research productivity of 210 molecular biology doctoral students in selected programs in Japan, Singapore, and Taiwan. Using principal component (PC) analysis, we derive two sets of PCs: one set from 15 DMP and another set from 16 DRE items. We model research productivity using Poisson and negative-binomial regression models with these sets as predictors. Our findings suggest a need to re-think extant practices and to allocate resources toward professional career development in training future scientists. We contend that doctoral science training must not only be an occasion for future scientists to learn scientific and technical skills, but it must also be the opportunity to experience, to acquire, and to hone research management skills.

Antepartum ornithine transcarbamylase deficiency.

Ornithine transcarbamylase deficiency (OTCD) is the most common type urea cycle enzyme deficiencies. This syndrome results from a deficiency of the mitochondrial enzyme ornithine transcarbamylase, which catalyzes the conversion of ornithine and carbamoyl phosphate to citrullin. Our case was a 28-year-old female diagnosed with OTCD following neurocognitive deficit during her first pregnancy. Although hyperammonemia was suspected as the cause of the patient's mental changes, there was no evidence of chronic liver disease. Plasma amino acid and urine organic acid analysis revealed OTCD. After combined modality treatment with arginine, sodium benzoate and hemodialysis, the patient's plasma ammonia level stabilized and her mental status returned to normal. At last she recovered without any damage left.

High prevalence of gastroesophageal reflux symptoms in patients with both acute and nonacute cough.

Although there have been many studies that showed a close association between gastroesophageal reflux disease (GERD) symptoms and chronic cough, it has been unknown whether acute cough is also associated with GERD. The aim of this study was to evaluate the relationship between GERD and respiratory symptoms in general practice. 1725 consecutive patients who first attended our hospital were enrolled in the present study. They were asked to respond the F-scale questionnaire regardless of their chief complaints. Over all, 656 (38%) patients were diagnosed as GERD and 226 (13%) had respiratory symptoms. Patients with respiratory symptoms had GERD symptoms more frequently than patients without respiratory symptoms (p < 0.05). Forty-three (37%) of 115 patients with acute cough and 48 (43%) of 111 with nonacute cough had GERD symptoms, suggesting that development of GERD is not associated with the period of respiratory symptoms. Patients with respiratory symptoms are at a significantly increased risk of developing GERD. Whether or not treatment for GERD or respiratory diseases is useful for the prevention of respiratory symptoms and GERD, respectively, should not be driving management decisions in primary care.