Testing hypothetical bias in a choice experiment: An application to the value of the carbon footprint of mandarin oranges.

This study investigates "hypothetical bias," defined as the difference in the willingness to pay for a product attribute between hypothetical and non-hypothetical conditions in a choice experiment, for the carbon footprint of mandarin oranges in Japan. We conducted the following four treatments: a non-hypothetical lab economic experiment, a hypothetical lab survey, a hypothetical online survey, and a hypothetical online survey with cheap-talk. Each treatment asked participants to choose one of three oranges based on price and carbon emissions level. Next, participants were asked to answer questions on demographics and the following three kinds of environmental factors: environmental consciousness, purchasing behavior for goods with eco-labels, and daily environmental behavior. Using the random parameter logit model, the willingness to pay per 1g of carbon emission reduction were 0.53 JPY, 0.52 JPY, 0.54 JPY, and 0.58 JPY in the non-hypothetical lab economic experiment, hypothetical lab survey, hypothetical online survey and hypothetical online survey with cheap-talk, respectively. The complete combinatorial test of the willingness to pay for carbon emission reductions indicates no hypothetical bias between any treatment combinations. Our findings reveal that environmental attributes for food are less likely to show hypothetical bias than other goods. The results of the main effect with an interaction term show that environmental consciousness reduces the coefficients of carbon emissions in all treatments. Therefore, a psychological scale is useful for showing whether hypothetical bias emerges with treatment or participants' personal backgrounds.

Effect of disclosing the relation between effort and unit reliability on system reliability: An economic experiment.

The purpose is to experimentally examine the effect of disclosing the risk probability of each unit in a production system on human behavior and the resulting system reliability. We used an economic experiment based on the theoretical model of Hausken (2002) to evaluate the effect of disclosing the relation between effort and unit reliability. We conducted first the non-disclosed-risk experiment and then the disclosed-risk experiment within subjects in both series and parallel systems. Our experimental results show that disclosing the relation between effort and unit reliability has two positive effects. First, subjects succeeded in improving the system reliability while cutting back on efforts to reduce the risk of their units when the risk probability was disclosed. In each system, the disclosed-risk condition achieves significantly higher system reliability on average than does the non-disclosed-risk condition, although the average level of effort is significantly lower under the disclosed-risk condition than under the non-disclosed-risk condition. Second, disclosing the risk probability simplified the subjects' decision-making process and reduced its cost because subjects made their decisions on the amount of effort to exert based only on the risk probability information without considering other factors, such as the number of accidents.

Ipragliflozin lowers small, dense low-density lipoprotein cholesterol levels in Japanese patients with type 2 diabetes mellitus.

AIMS: This preliminary randomized, parallel-group comparative study evaluated the efficacy of ipragliflozin for reduction of small dense low-density lipoprotein cholesterol (sd LDL-C) levels in Japanese patients with type 2 diabetes mellitus (T2DM). METHODS: Sixty-two patients with T2DM (age, 56 ± 8 years; hemoglobin A1c levels, 8.1 ± 0.9%; BMI, 27.5 ± 3.3 kg/m2) were randomly assigned in a 2:1 ratio to receive ipragliflozin (50 mg/day) (treatment group; n = 40) or continued treatment (control group; n = 22) for 12 weeks. The primary endpoints were changes in sd LDL-C levels detected using the LipoPhor AS® system; the secondary endpoints included changes in the sd LDL-C/large buoyant LDL-C (lb LDL-C) ratio, a surrogate marker for LDL particle size, and percent changes in routine lipid parameters. RESULTS: The treatment group exhibited a statistically significant reduction from baseline for LDL-C levels (-0.37 mg/dL vs. 14.4 mg/dL, p = 0.038), sd LDL-C levels (-1.28 mg/dL vs. 2.81 mg/dL, p = 0.012), and sd LDL-C/lb LDL-C ratio (-3.20% vs. 4.58%, p = 0.040) compared with the control group. Multiple regression analysis among all subjects revealed change in TG levels (p = 0.011) and LDL-C levels (p = 0.024) as well as change in body weight (p = 0.006) as independent factors contributing to the reduction in sd LDL-C. CONCLUSIONS: Ipragliflozin may have a potential for lowering sd LDL-C levels associated with increasing LDL particle size in Japanese patients with T2DM.

Non-high-density cholesterol level as a predictor of maximum carotid intima-media thickness in Japanese subjects with type 2 diabetes: a comparison with low-density lipoprotein level.

AIM: To determine whether non-high-density lipoprotein cholesterol (non-HDL-C) level, in comparison with low-density lipoprotein cholesterol (LDL-C) level, is useful for predicting the values of various surrogate atherosclerosis markers in Japanese subjects with type 2 diabetes (T2DM). METHODS: Data were retrieved from medical records of 265 subjects with T2DM who underwent laboratory tests to evaluate for atherosclerosis by using the following parameters: brachial-ankle pulse wave velocity, mean and maximum carotid intima-media thickness (mean CIMT and max-CIMT), and ankle-brachial index, with simultaneous fasting blood sampling for routine lipid parameters. RESULTS: In a multiple stepwise regression analysis, non-HDL-C level, but not LDL-C level, positively correlated with max-CIMT (ß coefficient = 0.14, F = 6.84). Stepwise logistic regression analysis revealed that a 0.26 mmol/L (10 mg/dL) increase in non-HDL-C level, but not LDL-C level, was significantly associated with high risk of max-CIMT (≥1.1 mm; odds ratio, 1.096; 95 % confidence interval, 1.003-1.202; p = 0.046). However, in a receiver operating characteristic curve (ROC) analysis, the addition of non-HDL-C level to the three significant independent variables obtained from the stepwise analyses did not significantly increased the area under the ROC curve (from 0.7789 to 0.7864, p = 0.4343). CONCLUSIONS: Non-HDL-C levels may be non-inferior to LDL-C level for the prediction of high-risk max-CIMT in Japanese subjects with T2DM.

Long-term survival after resection of pancreatic ductal adenocarcinoma with para-aortic lymph node metastasis: case report.

Pancreatic cancer patients with para-aortic lymph node metastasis have a poor prognosis and patients living longer than 3 years are rare. We had a patient with pancreatic cancer who survived for more than 10 years after removal of the para-aortic lymph node metastasis. A 57-year-old woman was diagnosed with pancreatic head cancer and underwent a pancreaticoduodenectomy with subtotal gastric resection following Whipple reconstruction in 2000. Para-aortic lymph node metastasis was detected during the operation by intraoperative pathological diagnosis and an extended lymphadenectomy was performed with vascular skeletonization of the celiac and superior mesenteric arteries. In 2004, a low-density area was detected around the superior mesenteric artery (SMA) 5 cm from its root and she was treated with gemcitabine, and the area was undetectable after 3 years of treatment. In 2010, computed tomography showed a low-density area around the same lesion with an increased carcinoembryonic antigen level. After 4 months of gemcitabine treatment, we resected the tumor en bloc with the associated superior mesenteric vein and perineural tissue. Histopathological examination of the resected specimen revealed a well-differentiated tubular adenocarcinoma that closely resembled the original primary pancreatic cancer, indicating perineural recurrence 10 years after the initial resection. She had no recurrence around the SMA for more than one year. Although a meta-analysis has not proved the efficacy of preventive radical dissection, this case indicates that a patient with well-differentiated, chemotherapy-responsive pancreatic cancer with para-aortic lymph node metastasis could have a long survival time through extended dissection of the lymph nodes.

The glycated albumin to glycated haemoglobin ratio increases along with the fibrosis stage in non-alcoholic steatohepatitis.

BACKGROUND: We previously reported that the indicator of glycaemic control, glycated albumin (GA) levels, are low in relation to glycaemia in patients with high alanine aminotransferase (ALT) levels in non-alcoholic fatty liver disease because of chronic inflammation, and that the GA/glycated haemoglobin ratio (G/H ratio) is inversely correlated with hepatic function in patients with chronic liver disease. The severity of liver fibrosis is known to be a good indicator for surveillance, and for determining the prognosis and optimal treatment of non-alcoholic steatohepatitis (NASH). In this study, we aimed to investigate the clinical usefulness of measuring the G/H ratio for predicting the severity of liver fibrosis in patients with NASH. METHODS: The study subjects were 36 patients with histologically diagnosed NASH (19 men, 17 women; mean age 54.8±12.2 years, body mass index 28.3±5.0 kg/m2). The relationships of the G/H ratio to hepatic function tests and fibrosis stage in the liver were investigated. RESULTS: The G/H ratio in patients with NASH was inversely correlated with ALT (P<0.001) and platelet count (P<0.0001). Furthermore, the G/H ratio was positively correlated with the fibrosis stage in liver (P=0.003). CONCLUSIONS: These results suggest that the G/H ratio increases along with the fibrosis stage in patients with NASH.

The flow angle beneath the gastrojejunostomy predicts delayed gastric emptying in Roux-en-Y reconstruction after distal gastrectomy.

BACKGROUND: Delayed gastric emptying without mechanical obstruction after Roux-en-Y reconstruction has been defined as Roux stasis syndrome. It occurs in 10-30% of patients after such reconstruction. So far, the cause of this stasis has not been completely identified. This study aimed to reduce Roux stasis using surgical techniques. METHODS: From November 2007 to October 2010, we performed 101 distal gastrectomies with Roux-en-Y reconstruction. All the gastrojejunostomies were performed with end-to-end anastomoses. Roux stasis was analyzed with respect to tumor location, extent of the dissection, tumor progression, operation time, antecolic/retrocolic reconstruction, and the shape of the gastrojejunostomy. The shape of the gastrojejunostomy was evaluated by contrast gastroradiography 4 days after the operation. RESULTS: Roux stasis syndrome was observed in 17 of the 101 patients. There was no relationship between the extent of the dissection, tumor progression, or operation time and the occurrence of Roux stasis. There was no difference in the incidence of Roux stasis between antecolic and retrocolic reconstructions. However, the group that displayed a straight anastomotic shape on contrast radiography demonstrated an apparently lower incidence of Roux stasis (p = 0.0003). In addition, Roux-en-Y reconstruction following gastric cancer was more frequently followed by Roux stasis in the antrum than in the midstomach (p = 0.0036). Cases of Roux stasis occurred 11.8 days after surgery on average and resolved within 2 weeks on average. CONCLUSIONS: Our findings demonstrate the substantial benefits of a straight anastomosis of the gastrojejunostomy for the prevention of Roux stasis syndrome.

Obesity may attenuate the HbA1c-lowering effect of sitagliptin in Japanese type 2 diabetic patients.

UNLABELLED: Aims/Introduction: The aim of the present study was to assess the independent predictors of the HbA1c-lowering effect of sitagliptin in Japanese type 2 diabetic patients. MATERIALS AND METHODS: Data were retrieved from the medical records of 151 type 2 diabetic patients who had been taking sitagliptin 25 or 50 mg once daily for inadequate glycemic control for at least 12 weeks, with or without other oral hypoglycemic agents. Spearman's rank correlation coefficients were calculated to investigate correlations between two independent continuous variables. Multiple stepwise regression analysis was used to identify independent predictors of reductions in HbA1c levels after 12 weeks of sitagliptin treatment (ΔHbA1c). RESULTS: In all patients combined, Spearman's rank correlation coefficients showed that ΔHbA1c was significantly correlated with baseline HbA1c alone (r = 0.371, P < 0.0001). However, multiple linear regression analysis among all patients using baseline variables revealed that the independent factors contributing to ΔHbA1c, in order of importance, were method of prescribing (P < 0.0001), baseline HbA1c (P < 0.0001), body mass index (BMI; P = 0.004), and duration of diabetes (P = 0.024). CONCLUSIONS: Our analysis may provide novel evidence that increased BMI contributes, in part, to attenuation of the HbA1c-lowering effect of sitagliptin in Japanese type 2 diabetic patients. Analysis of a larger population over a longer period of time is warranted to confirm these findings. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00156.x, 2011).

Glycated albumin levels are higher relative to HbA1c levels in people with autoimmune acute-onset type 1 diabetes mellitus than in people with type 2 diabetes mellitus at the time of diagnosis.

Glycated albumin (GA) is a new glycemic control indicator. GA/HbA1c ratio in autoimmune acute-onset type 1 diabetes mellitus patients was significantly higher than in type 2 diabetes mellitus patients at the time of diagnosis. This difference might reflect speed of increase in plasma glucose after the onset of diabetes.

Entropy and heat capacity calculations of simulated crystal-hexatic smectic-B-smectic-A liquid-crystal phase transitions.

Entropy and heat capacity are calculated in phase sequence of crystal, hexatic smectic- B , and smectic- A liquid crystals through constant pressure and temperature molecular-dynamics simulations of parallel soft spherocylinders. The transition from crystal to hexatic smectic- B phase is continuous while the transition to smectic- A phase is first order. The dependence of the phase sequence against the molecular shape anisotropy is investigated and there exists a triple point at a rather small anisotropy. Hopping diffusion of molecules is observed in the hexatic smectic- B phase.

Characteristics of undiagnosed diabetes mellitus in a population undergoing health screening in Japan: target populations for efficient screening.

AIMS: To estimate the prevalence of undiagnosed diabetes mellitus and its relationship with various risk factors in a population undergoing health screening in Japan. METHODS: Oral glucose tolerance tests were carried out in a total sample of 14,674 Japanese subjects undergoing health screening, aged 20-83 years and without known diabetes. The prevalence of glucose tolerance categories (1999 WHO criteria) was adjusted for sample probabilities. The optimal FPG cut-off point for screening diabetes was estimated using ROC curve analysis for the continuous value of FPG corresponding to a 2-h PG of 200 mg/dl. The number needed to screen (NNTS) to identify one person with undiagnosed diabetes with various risk factors was estimated using the following equation: the number of undiagnosed diabetic plus nondiabetic subjects/the number of undiagnosed diabetic subjects. RESULTS: The prevalence of undiagnosed diabetes among men and women was 6.4% (NNTS 15.7) and 3.2% (NNTS 31.7), respectively. The optimal FPG cut-off point for screening diabetes among men and women was 105 and 106 mg/dl, respectively. NNTS was lower in individuals with more risk factors, e.g. aging (> or =50), BMI (> or =25), hypertension (SBP> or =140 mmHg and/or DBP> or =90 mmHg) and dyslipidemia (TC> or =220 and/or HDL-C<40 and/or TG> or =150 mg/dl), resulting in the lowest NNTS in individuals having all four risk factors among men (6.1) and women (6.7), respectively. CONCLUSIONS: In Japan, screening for diabetes may be more efficient among individuals having an FPG of more than 105-106 mg/dl and with more risk factors, especially in men.

Constant surface-tension molecular-dynamics simulation methods for anisotropic systems.

We propose a simulation method for liquid-liquid interface under constant surface tension and constant normal pressure. The method introduces an anisotropic factor in the cell dynamics which avoids artifacts such as continuous expansion or contraction of the cell lengths. This allows simulation of a full range of surface tensions including when the value is 0, i. e, hydrostatic pressure.

Molecular dynamic simulation methods for anisotropic liquids.

Methods of molecular dynamics simulations for anisotropic molecules are presented. The new methods, with an anisotropic factor in the cell dynamics, dramatically reduce the artifacts related to cell shapes and overcome the difficulties of simulating anisotropic molecules under constant hydrostatic pressure or constant volume. The methods are especially effective for anisotropic liquids, such as smectic liquid crystals and membranes, of which the stacks of layers are compressible (elastic in direction perpendicular to the layers) while the layer itself is liquid and only elastic under uniform compressive force. The methods can also be used for crystals and isotropic liquids as well.

Extracellular mycobacterial DNA-binding protein 1 participates in mycobacterium-lung epithelial cell interaction through hyaluronic acid.

Mycobacterium tuberculosis infects not only host macrophages but also nonprofessional phagocytes, such as alveolar epithelial cells. Glycosaminoglycans (GAGs) are considered as the component of mycobacterial adherence to epithelial cells. Here we show that extracellularly occurring mycobacterial DNA-binding protein 1 (MDP1) promotes mycobacterial infection to A549 human lung epithelial cells through hyaluronic acid (HA). Both surface plasmon resonance analysis and enzyme-linked immunosorbent assay revealed that MDP1 bound to HA, heparin, and chondroitin sulfate. Utilizing synthetic peptides, we next defined heparin-binding site of 20 amino acids from 31 to 50 of MDP1, which is responsible for the specific DNA-binding site of MDP1. MDP1 bound to A549 cells, and exogenous DNA and HA interfered with the interaction. The binding was also abolished by treatment of A549 cells with hyaluronidase, suggesting that HA participates in the MDP1-A549 cell interaction. Adherence of bacillus Calmette-Guérin (BCG) and M. tuberculosis to A549 cells was inhibited by addition of HA, DNA, and anti-MDP1 antibody, showing that MDP1 participates in the interaction between mycobacteria-alveolar epithelial cells. Simultaneous treatment of intratracheal BCG-infected mice with HA reduced the growth of BCG in vivo. Taken together, theses results suggest that HA participates in Mycobacterium-lung epithelium interaction and has potential for therapeutic and prophylactic interventions in mycobacterial infection.

[A case of primary pulmonary proteinosis with bilateral pneumothorax].

A 40-year-old man was admitted to our hospital because of chronic cough and mild exertional dyspnea. Radiographs of the chest showed diffuse infiltrative shadows in both lung fields. A diagnosis of pulmonary alveolar proteinosis (PAP) was made by examination with a flexible bronchoscope and bronchoalveolar lavage, with transbronchial biopsy. After diagnosis, the patient underwent whole-lung lavage with temporary improvement. Due to the recurrence of his illness, he needed a total of four whole-lung lavages over the course of his illness. However, the exertional dyspnea became progressively worse. Bilateral pneumothorax developed suddenly and led to his death. This case indicates the possibility that deterioration of PAP despite whole-lung lavage may sometimes be followed by pneumothorax.

Interaction of particles in a deformed nematic liquid crystal.

We investigate how the interaction of particles mediated by an elastic deformation of a nematic liquid crystal is influenced by the initial deformation of the director field. To this end, we calculate the interaction energy between particles in a nematic cell with hybrid boundary conditions, homeotropic on the surface of one confining plate and planar on the other. We find an analytic form of the interaction energy in the case of weak anchoring on the surface of the particle. This interaction energy sensitively depends on the position of the two particles as well as the interparticle distance and can be nonmonotonic with a minimum in its landscape. This nontrivial energy landscape might lead to a chainlike superstructure of particles.