Predictors of relapse of polymyositis/dermatomyositis associated interstitial lung disease.

Background: Polymyositis/dermatomyositis (PM/DM) patients often develop interstitial lung disease (ILD), which can lead to relapse despite anti-inflammatory treatments. This study aims to elucidate the clinical characteristics of relapses in PM/DM-associated ILD patients. Methods: We gathered clinical data, including laboratory results, pulmonary function tests, chest high-resolution computed tomography findings from patients treated at Okinawa Chubu Hospital between January 1, 2010 and December 31, 2018. Results: We identified a total of 74 patients, comprising 21 men and 53 women. Among them, 38 patients remained relapse-free with maintenance therapy, while 36 experienced relapses despite immunosuppressive management. We followed these patients until June 30, 2023, and 13 patients died. The median survival period was 51.4 months (range, 0.3-214 months). When comparing clinical variables, relapsed patients tended to be younger (49.9 vs. 64.1 years), reported myalgia and rash more frequently (63.9% vs. 28.9% and 61.15% vs. 21.1%, respectively). In terms of laboratory findings, lactate dehydrogenase (LDH) levels were higher in relapsed patients (613±464 vs. 381±203 U/L). Radiological findings showed that ground glass opacity (GGO) was more prevalent in relapsed patients (58.3% vs. 16.7%). A Cox-proportional hazards model for relapse demonstrated that serum LDH [hazard ratio (HR) 1.005, 95% confidence interval (CI): 1.000-1.009, P=0.02] and GGO (HR 1.863, 95% CI: 1.103-3.147, P=0.02) were valuable predictors of relapse. Receiver operating characteristic curve analysis of serum LDH indicated that a threshold of 450 correctly classified relapse in PM/DM-associated ILD patients. Conclusions: Serum LDH and GGO may serve as predictors of relapse in PM/DM-associated ILD patients.

Soy-Based High-Protein Spheric Foods with the Appearance of Familiar Sugary Snacks.

Excessive consumption of sugary foods increases the likelihood of obesity, as well as the preventable risk of lifestyle illnesses such as diabetes and cardiovascular diseases. Frequent intake of sweet snacks is considered to increase the risk of overweight/obesity in industrial nations. However, we cannot stop snacking against our better judgment. Therefore, in this study, we sought to develop high-protein, low-carb "mock snacks" to satisfy snack lovers' appetites and nutrition. Soy protein-based, ball-shaped food products with 57.7% (w/w) protein and 3.6% sugar have been developed. The addition of canola oil made them melty in the mouth without sacrificing their crispiness. Moreover, evaluation of the surface topography of the "soy balls" by 3D laser scanning demonstrated their high degree of sphericity. Conclusively, the snacks developed here may be one of the healthy alternatives for the current sugary ones.

Hepatic FASN deficiency differentially affects nonalcoholic fatty liver disease and diabetes in mouse obesity models.

Nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes are interacting comorbidities of obesity, and increased hepatic de novo lipogenesis (DNL), driven by hyperinsulinemia and carbohydrate overload, contributes to their pathogenesis. Fatty acid synthase (FASN), a key enzyme of hepatic DNL, is upregulated in association with insulin resistance. However, the therapeutic potential of targeting FASN in hepatocytes for obesity-associated metabolic diseases is unknown. Here, we show that hepatic FASN deficiency differentially affects NAFLD and diabetes depending on the etiology of obesity. Hepatocyte-specific ablation of FASN ameliorated NAFLD and diabetes in melanocortin 4 receptor-deficient mice but not in mice with diet-induced obesity. In leptin-deficient mice, FASN ablation alleviated hepatic steatosis and improved glucose tolerance but exacerbated fed hyperglycemia and liver dysfunction. The beneficial effects of hepatic FASN deficiency on NAFLD and glucose metabolism were associated with suppression of DNL and attenuation of gluconeogenesis and fatty acid oxidation, respectively. The exacerbation of fed hyperglycemia by FASN ablation in leptin-deficient mice appeared attributable to impairment of hepatic glucose uptake triggered by glycogen accumulation and citrate-mediated inhibition of glycolysis. Further investigation of the therapeutic potential of hepatic FASN inhibition for NAFLD and diabetes in humans should thus consider the etiology of obesity.

Special Issue "Strategies to Develop High-Quality Gluten-Free Products Welcomed by Consumers".

Extensive and long-term efforts on wheat breeding [...].

Abdominal Pain and Petechial Rash in a 95-Year-Old Farmer.

A 95-year-old farmer taking prednisolone for bullous pemphigoid had 24 hours of abdominal pain, 2 weeks of diarrhea, and 3 months of intermittent abdominal bloating and anorexia. Evaluation showed purpuric macules and small thumbprint-like patches on her upper abdomen and central chest and a white blood cell count of 13 600/µL (89.9% neutrophils, 0.2% eosinophils). What is the diagnosis and what would you do next?

A Narrative Mini Review on Current Status of Hypoallergenic Wheat Development for IgE-Mediated Wheat Allergy, Wheat-Dependent Exercise-Induced Anaphylaxis.

Immunoglobulin E (IgE)-mediated food allergies to wheat that develop after school age typically shows a type of wheat-dependent exercise-induced anaphylaxis (WDEIA). At present, avoidance of wheat products or postprandial rest after ingesting wheat is recommended for patients with WDEIA, depending on the severity of the allergy symptoms. ω5-Gliadin has been identified as the major allergen in WDEIA. In addition, α/ß-, γ-, and ω1,2-gliadins, high and low molecular weight-glutenins, and a few water-soluble wheat proteins have been identified as IgE-binding allergens in a small proportion of patients with IgE-mediated wheat allergies. A variety of approaches have been manufactured to develop hypoallergenic wheat products that can be consumed by patients with IgE-mediated wheat allergies. In order to analyze such approaches, and to contribute to the further improvement, this study outlined the current status of these hypoallergenic wheat productions, including wheat lines with a reduced allergenicity that are mostly constructed for the patients sensitized to ω5-gliadin, hypoallergenic wheat by enzymic degradation/ion exchanger deamidation, and hypoallergenic wheat by thioredoxin treatment. The wheat products obtained by these approaches significantly reduced the reactivity of Serum IgE in wheat-allergic patients. However, either these were not effective on some populations of the patients, or low-level IgE-reactivity to some allergens of the products was observed in the patients. These results highlight some of the difficulties faced in creating hypoallergenic wheat products or hypoallergenic wheat lines through either traditional breeding or biotechnology approaches in developing hypoallergenic wheat completely safe for all the patients allergic to wheat.

Hemp: A Sustainable Plant with High Industrial Value in Food Processing.

In the era of SDGs, useful plants which provide valuable industrial outputs and at the same time pose less impact on the environment should be explored. Hemp seems one of the most relevant gluten-free crop plants to meet such requirements. Its high nutritional value is comparable to soy. Moreover, almost the whole body of the hemp plant has a wide array of utility: industrial production of food, fiber, and construction materials. In view of environmental sustainability, hemp requires less pesticides or water in cultivation compared to cotton, a representative fiber plant. This short review investigates hemp's sustainability as a plant as well as its utility value as a highly nutritional material in the food industry. Recent application research of hemp protein in food processing includes plant milk, emulsifiers, fortification of gluten-free bread, plant-based meat production, as well as membrane formation. These studies have revealed distinctive properties of hemp protein, especially in relation to disulfide (S-S)/sulfhydryl (-SH)-mediated interactions with protein from other sources. While its cultivation area and industrial use were limited for a while over confusion with marijuana, the market for industrial hemp is growing rapidly because it has been highly reevaluated in multiple areas of industry. Conclusively, with its sustainability as a plant as well as its distinctive useful property of the seed protein, hemp has promising value in the development of new foods.

Intravenous Tranexamic Acid in Percutaneous Kidney Biopsy: A Randomized Controlled Trial.

BACKGROUND: Tranexamic acid is frequently reported to reduce bleeding-related complications in major surgery and trauma. We aimed to investigate whether tranexamic acid reduced hematoma size after percutaneous kidney biopsy. METHODS: We conducted a double-blind, parallel three-group, randomized placebo-controlled trial at a teaching hospital in Japan between January 2016 and July 2018. Adult patients with clinical indication for ultrasound-guided percutaneous biopsy of a native kidney were included. Participants were randomly assigned into three groups: high-dose tranexamic acid (1,000 mg in total), low-dose tranexamic acid (500 mg in total), or placebo (counterpart saline). Intervention drugs were intravenously administered twice, as a bolus just before the biopsy and as a continuous infusion initiated just after the biopsy. Primary outcome was post-biopsy perirenal hematoma size as measured by ultrasound on the morning after the biopsy. RESULTS: We assessed 90 adult patients for study eligibility, of whom 56 were randomly allocated into the three groups: 20 for high-dose tranexamic acid, 19 for low-dose tranexamic acid, and 17 for placebo. The median size of perirenal hematoma was 200 mm2 (interquartile range, 21-650) in the high-dose tranexamic acid group, 52 mm2 (0-139) in the low-dose tranexamic acid group, and 0 mm2 (0-339) in the placebo group (p = 0.048 for high-dose tranexamic acid vs. placebo). CONCLUSION: In this trial, the median size of post-kidney biopsy hematoma was unexpectedly larger in the high-dose tranexamic acid group than in the placebo group. Although our results do not support the routine use of tranexamic acid in percutaneous kidney biopsy at present, further studies are needed to confirm the results.

High temperatures and pressures during cooking hinder the nanofibrillation of purified pulp.

Kraft pulp is an abundant raw material for producing cellulose nanofibers. However, our previous study demonstrated that kraft cooking hinders the nanofibrillation of never-dried pulp. Therefore, this study aims to elucidate the specific factors of kraft cooking hindering nanofibrillation, particularly the effects of high temperature and pressure. Undried purified pulp, produced using the Wise method, was subjected to high temperature and pressure conditions, with and without subsequent alkali treatment. After fibrillating the pulps for different durations, the degree of nanofibrillation was evaluated by sedimentation tests. Undried Wise-based pulp, with excellent nanofibrillation ability, becomes less capable of nanofibrillation after cooking at high temperature and pressure. Thus, even in the undried state, harsh cooking is considered to have caused irreversible aggregation of microfibrils or hornification in the pulp cell wall. Moreover, high temperatures and pressure should be avoided when removing the matrix, e.g., lignin and hemicellulose, for producing pulp for cellulose nanofibers.

Multifunctional cellulosic materials prepared by a reactive DES based zero-waste system.

Energy consumption and post-treatment of chemical reagent residues are important issues that hinder the sustainable production of the natural building blocks of cellulose nanofibrils (CNFs). In this study, we realize a low-energy, zero-waste process for CNF production by designing a novel reactive deep eutectic solvent (DES), the residue of which can be directly used as a plant growth regulator. After pretreatment with the DES, cellulose fibers self-delaminate into thin layers referred to as pseudo-CNFs, as their strength, toughness and transmittance are comparable to those of CNFs. Pseudo-CNFs break into smaller particles during recycling and thus display unique mechanical upcycling. After facile fibrillation, the obtained CNFs can independently form freestanding sub-micrometer films that show a strong, full coloration, which is demonstrated for the first time. Our concept can enable a green process, and the developed cellulosic materials may find various applications as structural materials and optical coatings.

Hindrance to nanofibrillation of undried pulp produced by the kraft cooking process.

Kraft pulp is the most common and economically advantageous raw material for making cellulose nanofibers (CNFs). However, when kraft pulp is subjected to mechanical fibrillation, unfibrillated pulp always remains, even though the pulp is undried. In this study, the effect of the kraft pulping process on the fibrillation of undried pulp was studied. The fibrillation ability was compared with that of undried pulp prepared using Wise method and alkaline treatment. Suspensions of undried pulps were mechanically fibrillated with a high-speed blender for different durations. The degree of fibrillation of pulps was evaluated using sedimentation, morphologies from field emission scanning electron microscopy, specific surface area, and water retention values. Every analysis showed that undried, kraft-based pulp was less fibrillated than undried, wise-based pulp. These results suggested that the kraft cooking process at high temperature hindered the fibrillation of pulp. This might be related to the aggregation occur in cellulose.

Effective Use of Plant Proteins for the Development of "New" Foods.

Diversity in our diet mirrors modern society. Affluent lifestyles and extended longevity have caused the prevalence of diabetes and sarcopenia, which has led to the increased demand of low-carb, high-protein foods. Expansion of the global population and Westernization of Asian diets have surged the number of meat eaters, which has eventually disrupted the supply-demand balance of meat. In contrast, some people do not eat meat for religious reasons or due to veganism. With these multiple circumstances, our society has begun to resort to obtaining protein from plant sources rather than animal origins. This "protein shift" urges food researchers to develop high-quality foods based on plant proteins. Meanwhile, patients with food allergies, especially gluten-related ones, are reported to be increasing. Additionally, growing popularity of the gluten-free diet demands development of foods without using ingredients of wheat origin. Besides, consumers prefer "clean-label" products in which products are expected to contain fewer artificial compounds. These diversified demands on foods have spurred the development of "new" foods in view of food-processing technologies as well as selection of the primary ingredients. In this short review, examples of foodstuffs that have achieved tremendous recent progress are introduced: effective use of plant protein realized low-carb, high protein, gluten-free bread/pasta. Basic manufacturing principles of plant-based vegan cheese have also been established. We will also discuss on the strategy of effective development of new foods in view of the better communication with consumers as well as efficient use of plant proteins.

After-effects of acute footshock stress on sleep states and rhythmic masticatory muscle activity during sleep in guinea pigs.

This study investigated the effects of acute footshock stress (FS) on the occurrence of rhythmic masticatory muscle activity (RMMA) during sleep in guinea pigs. Animals were prepared for chronic recordings from electroencephalogram, electrooculogram and electromyograms of neck and masseter muscles. The signals were recorded for six hours on the two successive days: the first day with stress-free condition (non-FS condition) and the second day with acute FS (FS condition). Sleep/wake states and RMMA were scored visually. Sleep variables and the frequency of RMMA occurring during non-rapid eye movement (NREM) sleep were compared during 6-h periods between the two conditions. Compared to non-FS condition, the amount of total sleep and NREM sleep significantly reduced during 2 h following the acute FS in the FS condition. Similarly, the frequency of RMMA significantly increased during 2 h following the acute FS for the FS condition compared to non-FS condition. During 2-6 h after FS in the FS condition, sleep variables and the frequency of RMMA did not differ from those without FS in the non-FS condition. These results suggest that acute experimental stress can induce transient changes in sleep-wake states and the occurrence of RMMA in experimental animals.

Efficacy of Group Cognitive Behavior Therapy Targeting Time Management for Adults with Attention Deficit/Hyperactivity Disorder in Japan: A Randomized Control Pilot Trial.

OBJECTIVE: Time-processing disorders in adults is a priority area for intervention. Time management program, which has been demonstrated to be effective in children with ADHD, has not been examined in adults. We anticipate the need for the development of specialized programs for adults. This is because it has been reported that time processing disorders have different patterns in childhood and adulthood. This study aimed to evaluate the therapeutic effect of a gCBT program focusing on time management for adults with ADHD. METHOD: Adults with ADHD were randomly assigned to gCBT (n = 24) or a treatment as usual group (n = 24). Outcome measures were masked clinically rated, self-reported, and family-reported ADHD symptoms. RESULTS: The gCBT group significantly reduced ADHD symptoms on all measures. CONCLUSION: Interventions focused on time management have been shown to be effective not only in children with ADHD but also in adult patients.