Symptom Improvement of ulceRative colitis after an Induction dose of UStekinumab in Japanese clinical practice (SIRIUS), measured using patient-reported outcomes: a prospective observational study.

INTRODUCTION: Ulcerative colitis (UC) is an idiopathic, chronic inflammatory disease of the large intestine. Ustekinumab is a monoclonal antibody against the p40 subunit of interleukin-12 and interleukin-23 and has proven efficacy in inducing and maintaining remission in adult patients with moderate-to-severe UC. In the Symptom Improvement of ulceRative colitis after an Induction dose of Ustekinumab study, we will document the initial treatment response (daily patient-reported outcomes for 8 weeks from first infusion) and treatment patterns of patients wih UC receiving an induction dose of ustekinumab in the real-world setting in Japan. We will also investigate the relationship between the treatment response at week 8 and early indicators of response and determine patient factors that may define the appropriate dosing interval for maintenance therapy. METHODS AND ANALYSIS: For this single-arm, prospective observational study at 24 centres in Japan with a follow-up period of 16/20 weeks, we aim to recruit 140 patients with moderate-to-severe UC between July 2021 and July 2022. All surveys will be conducted in Japanese and patient-reported outcomes relating to rectal bleeding, stool frequency, abdominal pain, nocturnal diarrhoea, tenesmus and perception of UC symptoms will be recorded using a smartphone application, where the patients can enter their initial response to ustekinumab induction therapy on a daily basis. Dosing intervals and the reasons for selecting this interval, and concomitant medications taken during treatment with ustekinumab will be collected by a physician questionnaire at the end of the study. On completion of primary end point (8-week patient-reported outcomes) data collection, results will be reported sequentially. ETHICS AND DISSEMINATION: The study has been approved by the ethics committee of each facility involved and the Institutional Review Board of the non-profit organisation MINS. TRIAL REGISTRATION NUMBER: UMIN000043753, NCT04963725.

Isotopic ratio and vertical distribution of radionuclides in soil affected by the accident of Fukushima Dai-ichi nuclear power plants.

The results of γ analyses of soil samples obtained from 50 locations in Fukushima prefecture on April 20, 2011, revealed the presence of a spectrum of radionuclides resulted from the accident of the Fukushima Dai-ichi nuclear power plant (FDNPP). The sum γ radioactivity concentration ranged in more than 3 orders of magnitude, depending on the sampling locations. The contamination of soils in the northwest of the FDNPP was considerable. The (131)I/(137)Cs activity ratios of the soil samples plotted as a function of the distance from the F1 NPPs exhibited three distinctive patterns. Such patterns would reflect not only the different deposition behaviors of these radionuclides, but also on the conditions of associated release events such as temperature and compositions and physicochemical forms of released radionuclides. The (136)Cs/(137)Cs activity ratio, on the other hand, was considered to only reflect the difference in isotopic compositions of source materials. Two locations close to the NPP in the northwest direction were found to be depleted in short-lived (136)Cs. This likely suggested the presence of distinct sources with different (136)Cs/(137)Cs isotopic ratios, although their details were unknown at present. Vertical γ activity profiles of (131)I and (137)Cs were also investigated, using 20-30 cm soil cores in several locations. About 70% or more of the radionuclides were present in the uppermost 2-cm regions. It was found that the profiles of (131)I/(137)Cs activity ratios showed maxima in the 2-4 cm regions, suggesting slightly larger migration of the former nuclide.

Surface speciation of Eu3+ adsorbed on kaolinite by time-resolved laser fluorescence spectroscopy (TRLFS) and parallel factor analysis (PARAFAC).

Time-resolved laser fluorescence spectroscopy (TRLFS) is an effective speciation technique for fluorescent metal ions and can be further extended by the parallel factor analysis (PARAFAC). The adsorption of Eu(3+) on kaolinite as well as gibbsite as a reference mineral was investigated by TRLFS together with batch adsorption measurements. The PAFAFAC modeling provided the fluorescence spectra, decay lifetimes, and relative intensity profiles of three Eu(3+) surface complexes with kaolinite; an outer-sphere (factor A) complex and two inner-sphere (factors B and C) complexes. Their intensity profiles qualitatively explained the measured adsorption of Eu(3+). Based on the TRLFS results in varied H(2)O/D(2)O media, it was shown that the outer-sphere complex exhibited more rapid fluorescence decay than Eu(3+) aquo ion, because of the energy transfer to the surface. Factor B was an inner-sphere complex, which became dominant at relatively high pH, high salt concentration and low Eu(3+) concentration. Its spectrum and lifetime were similar to those of Eu(3+) adsorbed on gibbsite, suggesting its occurrence on the edge face of the gibbsite layer of kaolinite. From the comparison with the spectra and lifetimes of crystalline or aqueous Eu(OH)(3), factor C was considered as a poly-nuclear surface complex of Eu(3+) formed at relatively high Eu(3+) concentration.

Application of parallel factor analysis for time-resolved laser fluorescence spectroscopy: implication for metal speciation study.

Time-resolved laser fluorescence spectroscopy (TRLFS) is an analytical technique capable of discriminating different chemical species of a fluorescent metal ion such as UO(2)(2+), Cm(3+), and lanthanides. Although TRLFS has been widely used to investigate the speciation of the fluorescent metal ions, extracting quantitative and structural information from multiple TRLFS data measured as a function of chemical and physical parameters is not a simple task. The purpose of this study is to apply parallel factor analysis (PARAFAC) for the interpretation of a series of TRLFS data. PARAFAC is a robust technique because it utilizes the entire information contained in a multiway TRLFS data set. The complexation of Eu(3+) by acetate was studied as a test case for the PARAFAC decomposition. It is shown that three factors are necessary and sufficient to explain the systematic variations in the original data set. The resulting spectra, decay, and relative concentrations of the factors were all in agreement with the fluorescent properties and the complexation behaviors of Eu(3+)-acetate complexes. Based on these results, it was concluded that PARAFAC is a promising data analysis tool for TRLFS used for the speciation studies of fluorescent metal ions.

Adsorption of heterogeneously charged nanoparticles on a variably charged surface by the extended surface complexation approach: charge regulation, chemical heterogeneity, and surface complexation.

Adsorption of randomly branched polyelectrolytes, "hairy" particles and internally structured macromolecules, collectively denoted as heterogeneously charged nanoparticles, on charged surfaces is important in many technological and natural processes. In this paper, we will focus on (1) the charge regulation of both the nanoparticle and the surface and (2) the surface complexation between the particle functional groups and the surface sites and will theoretically study the adsorption using the extended surface complexation approach. The model explicitly considers the electrochemical potential of a nanoparticle with an average (smeared-out) structure and charge both in bulk solution and on the surface to obtain the equilibrium adsorption. The chemical heterogeneity of the particle is described by a distribution of the protonation constant. Detailed analysis of the chemical potential of the adsorbed nanoparticle reveals that the pH and salt dependence of the adsorption can be largely explained by the balance between an energy gain resulting from the particle and surface charge regulation and the surface complexation and an energy loss from the unfavorable interparticle electrostatic repulsion close to the surface. This conclusion is also supported by the strong impacts that the chemical heterogeneity of the particle functional groups, the magnitude of the surface complexation, the number of the functional groups, and the size of the particle have on the adsorption.

The incidence and cross-sectional area of the meniscofemoral ligament.

BACKGROUND: The incidence, morphologic characteristics, and cross-sectional area of meniscofemoral ligaments of the knee are still not clarified. HYPOTHESIS: The incidence of meniscofemoral ligaments is very high, and they contribute significantly to the cross-sectional area of the posterior cruciate ligament complex. STUDY DESIGN: Descriptive laboratory study. METHODS: Clinical study: During arthroscopic anterior cruciate ligament reconstruction, the presence of a meniscofemoral ligament was confirmed in 38 patients (16 men, 22 women; mean age, 23.6 years) by observation and probing. Laboratory study: Posterior cruciate ligaments with the lateral meniscus attached were obtained as specimens from 30 patients (3 men, 27 women; mean age, 71.9 years) during total knee arthroplasty. The posterior cruciate ligament and meniscofemoral ligaments were observed, and the cross-sectional area was measured using an area micrometer. RESULTS: Clinical study: The anterior meniscofemoral ligament was found in 36.8% of patients, the posterior meniscofemoral ligament was found in 71.1%, and both ligaments were found in 26.7%. The overall incidence of at least 1 meniscofemoral ligament was 84.2%. Laboratory study: The anterior meniscofemoral ligament was present in 5 (16.7%) cases, and the posterior meniscofemoral ligament was present in all cases (100.0%). The cross-sectional area of the posterior cruciate ligament proper was 50.1 +/- 16.9 mm(2), that of the anterior meniscofemoral ligament was 2.3 +/- 1.2 mm(2), and that of the posterior meniscofemoral ligament was 7.5 +/- 2.5 mm(2). The mean ratio of the cross-sectional area of meniscofemoral ligaments to the posterior cruciate ligament proper was 17.2% (4.0%-38.9%). The origin of the posterior meniscofemoral ligament from the posterior horn of the lateral meniscus could be classified into 5 types. CONCLUSION: The meniscofemoral ligaments contributed significantly to the cross-sectional area of the posterior cruciate ligament complex.

Analysis of copper binding in the ternary system Cu2+/humic acid/goethite at neutral to acidic pH.

Binding of heavy metal and actinide ions to natural colloids, such as humic substances (HSs) and metal (hydr)-oxides, plays an important role in the ecotoxicological behavior of these ions. Several thermodynamic models have been constructed to predict the speciation of these ions in metal/HS or metal/oxide binary systems. However, in natural environments the adsorption of HSs on oxides can influence the binding of target metals, leading to deviation from the additivity of calibrated binary models. In this study binding of copper (Cu2+) to the purified Aldrich humic acid (PAHA)/goethite complex in the neutral to acidic pH region was investigated by measuring Cu2+ binding isotherms. The measured isotherms were compared with the results obtained for the binary systems under similar conditions. The comparison revealed that Cu2+ binding in the ternary system is enhanced with respect to the sum of Cu2+ binding in the corresponding binary systems. From the analysis of the charging behavior of the adsorbed PAHA as well as the smeared-out potential profile near the PAHA/goethite interface, the increase of Cu2+ binding to the complex was mainly attributed to the decrease of proton competition to the functional groups of the adsorbed PAHA and the change of the electrostatic potential in the vicinity of the goethite surface.

Chemical exchange reaction of glycinatocopper(II) complex in water: a theoretical study.

The axial water exchange on glycinatocopper(II) complexes was theoretically investigated by using density functional theory (DFT) calculations. Glycinatocopper(II) complexes are well-known by the diffusion controlled exchange of axial ligands. Calculations using explicitly coordinating water molecules and solvent models showed that bis-glycinatocopper(II) complexes have a four-coordinate planar structure, in which waters are excluded from the axial positions of Cu(II) due to the Jahn-Teller effect. This may be because coordinating axial waters induce the discrepancy in the most stable ligand field splittings of inner 3d and outer 4d orbitals of the Cu(II) cation. To estimate the reactivity of the axial water exchange, we calculated the rate constant by calculating Gibbs free energies for the activation. As a result, we obtained the rate constant as k = 3.61 x 10(10) s(-1) in aqueous solution at T = 298.15 K. This rate constant is slightly larger than that of the diffusion controlled exchange of axial waters, which is experimentally observed in the order of 10(9) s(-1). Finally, we determined the structures of tris-glycinatocopper(II) complexes. It was consequently found that the third glycine is coordinated to Cu with the amino groups as experimentally observed.

Stoichiometry, stability constants and coordination geometry of Eu(III) 5-sulfosalicylate complex in aqueous system-A TRLIFS study.

The complex formation between Eu(III) and 5-sulfosalicylate, (HSSA)(2-), has been investigated by means of TRLIFS (time resolved laser induced fluorescence spectroscopy). The concentration of free ligand in the solution was determined from the fluorescence emission of 5-sulfosalicylate by subtracting the dynamic quenching effect from the observed quenching of fluorescence emission by means of lifetime analysis, and the stoichiometry and the corresponding formation constants were obtained. A carboxylate coordinated complex, Eu(HSSA)(+), and also a chelate complex, Eu(SSA), were identified, and the formation constants of the complex Eu(HSSA)(2+) for the reaction, Eu(3+)+ HSSA(2-)[rightward arrow] Eu(HSSA)(+), and the deprotonation constant of the chelating reaction, Eu(HSSA)(+)--> Eu(SSA)+ H(+), were calculated at log beta(1,1)= 1.79 and log K'=-5.78, respectively. TRLIFS using the fluorescence emission from Eu(III) was performed in order to determine the number of coordination waters of the complex Eu(HSSA)(2+). The quenching of the Eu(III) fluorescence caused by (SSA)(3-) disturbed the lifetime analysis of the 'intrinsic lifetime' of Eu(III) in Eu(HSSA)(2+), however the problem was successfully solved by the analysis of emission intensity and lifetime, and the formulation of the complex was determined as [Eu(HSSA)8H(2)O](2+) with the explicit involvement of the coordinated waters.

Adsorption of humic acid on goethite: isotherms, charge adjustments, and potential profiles.

The adsorption of natural organic matter (NOM) on mineral (hydr)oxide plays an important role in the evaluation of the speciation of toxic metal ions in the environment. Because both NOM and mineral oxide have variable charges that adjust upon adsorption, a good understanding of proton binding is required before the binding of metal ions can be understood. In this study, the adsorption of purified Aldrich humic acid (PAHA) on goethite was examined as a function of the environmental conditions (pH, salt concentration, and free concentration of PAHA) together with the proton adsorption to PAHA, goethite, and their mixtures. The induced charges on both components were separated on the basis of the difference between the charge/pH curves of the mixture and those of the single components. The electrostatic potential profile across the adsorbed layer was obtained as a numerical solution of the Poisson-Boltzmann equation using the charge density of the adsorbed PAHA and the goethite surface. From the quantitative evaluation of the induced charge on both components, it is revealed that the degree of the charge adjustment is related to the electrostatic affinity between the PAHA segments and the goethite surface, the electrostatic repulsion between the PAHA segments, and the electrostatic shielding by salt ions. Considering the charge distribution of the adsorbed PAHA at the goethite surface, it is concluded that the change of the charge adjustment is sensitive to that of the conformation of the adsorbed PAHA. From the detailed inspection of the assumptions made and the comparison with the reported theoretical calculations, the obtained potential profiles are considered to broadly reflect the true potential profiles. Because a charge adjustment is not frequently considered in detail in relation to the NOM adsorption on metal (hydr)oxides, the obtained results can form the basis for the further development of modeling of the adsorption of NOM on (hydr)oxide surfaces.

Description of a new endoscopic posterior cruciate ligament reconstruction and comparison with a 2-incision technique.

PURPOSE: We introduce our technique (a new route for the graft) of endoscopic posterior cruciate ligament (PCL) reconstruction and describe the advantages in comparison with the conventional surgical technique. TYPE OF STUDY: Nonrandomized control study. METHODS: The idea of this surgical technique is to minimize graft angulation at the inner edge of the bone tunnel. The tibial entry point of the guide pin is under the tibial lateral subcondylar flare, approximately 1 to 2 cm anterior to the posterior cortex. This creates less graft angulation on the posterior aspect of the tibia. A new drill system has been devised to allow antegrade femoral drilling starting from inside the notch. This method also allows better femoral tunnel orientation. As a substitute graft material, we use autogenous hamstring tendons, and we secure them with an EndoButton (Smith & Nephew, Andover, MA) and post screw. From 1992 to 1995, 43 2-incision PCL reconstructions using autogenous hamstring tendons were performed. From 1995 to 2001, 90 endoscopic PCL reconstructions using looped autogenous hamstring tendons and an EndoButton were performed. Cases were specified according to the inclusion criteria of this study. As a result, 51 patients were included in this study. The 2-incision group comprised 22 patients, and the endoscopic group comprised 29 patients. The clinical evaluation was performed using the International Knee Documentation Committee (IKDC) form. The quadriceps strength was measured using Biodex System II (Biodex, New York, NY). The period of time to achieve 90 degrees flexion after surgery was also compared. RESULTS: No significant differences were seen between the 2 groups tested with respect to the overall IKDC rating score. Side-to-side differences of anteroposterior total laxity (KT-1000, manual maximum) was 3.95 +/- 1.96 mm in the 2-incision group and 2.38 +/- 1.42 mm in the endoscopic group (P <.05). The average time to achieving 90 degrees of flexion after surgery was 16.6 +/- 8.6 days in the 2-incision group and 12.1 +/- 3.5 days in the endoscopic group. Achievement of range of motion in the endoscopic group was significantly shorter. The peak torque of isokinetic contraction in the endoscopic group was significantly greater than in the 2-incision group 1 year after surgery. CONCLUSIONS: Better posterior stability and quicker postoperative recovery of range of motion and muscle strength were advantages of the endoscopic technique over the 2-incision technique in PCL reconstruction.

Two-stage reconstruction with autografts for knee dislocations.

Traumatic knee dislocations are severe injuries that involve damage to the anterior cruciate ligament, the posterior cruciate ligament, and the lateral or medial ligamentous structures. There are no established methods of treatment. The objective of the current study was to report the clinical outcome of a two-stage autologous reconstruction on nine knees (eight patients). The mean followup was 40.1 months. The first stage of the reconstruction was done at a mean of 2 weeks after the injury, and the posterior cruciate ligament was reconstructed by an arthroscopically assisted technique using contralateral autogenous hamstring tendon as the graft material. Three months later, the second stage of the reconstruction was done for the ligaments that had not healed with conservative treatment. Arthroscopically assisted anterior cruciate ligament reconstruction was done on all of the knees using the ipsilateral autogenous hamstring tendon or bone-patellar tendon-bone as the graft material. At the same time, a medial collateral ligament reconstruction using an autogenous semitendinosus tendon was done on one knee, and reconstruction of the posterolateral ligamentous structures using a biceps tendon was done on three knees. Each of the knees that was reconstructed was capable of full extension, and the mean degree of passive flexion was 139.5 degrees +/- 5.2 degrees. The mean side-to-side difference in anteroposterior total laxity (KT-1000 arthrometer, manual maximum) was 2.3 +/- 1.9 mm. None of the knees had lateral or medial instability. All of the injured ligaments were able to be reconstructed with autografts, and severe contracture was able to be prevented. A good clinical outcome can be achieved when two-stage reconstruction is used for traumatic knee dislocations.

A new endoscopic posterior cruciate ligament reconstruction: Minimization of graft angulation.

PURPOSE: The purpose of this report is to present a new surgical technique for endoscopic posterior cruciate ligament (PCL) reconstruction and to elucidate the preliminary results. Surgical Technique: The concept of this surgical technique is to minimize the graft angulation at the inner edge of the bone tunnel. The tibial entry point of the guide pin is under the tibial lateral subcondylar flare approximately 1 to 2 cm anterior to the posterior cortex and 4 cm distal to the joint surface. This creates less graft angulation on the posterior aspect of the tibia. A new drill system has been devised to allow antegrade femoral drilling starting from inside the notch. This method also allows better femoral tunnel orientation. As a substitute graft material, we use autogenous hamstring tendons, and we secure them with an EndoButton (Smith & Nephew, Mansfield, MA) and post screw. METHODS: Since 1995, 40 knees have undergone endoscopic PCL reconstruction. Twenty-one patients were evaluated after a minimum follow-up of 1 year (17.9 +/- 7.7 mo). The clinical evaluation was performed using the International Knee Documentation Committee (IKDC) form. RESULTS: The range of motion was rated as A for 17 cases, B in 3 cases, and C in one case. The total anteroposterior translation (KT-1000, manual-maximum) showed a range of 1.0 to 5.5 mm (mean, 2.8 mm). The ratings of the ligament examination were A in 9 cases and B in 12 cases. The final IKDC evaluation was A (normal) in 3 cases, B (nearly normal) in 17 cases, and C (abnormal) in 1 case. CONCLUSIONS: A good clinical outcome was achieved with our endoscopic PCL reconstruction. The reduction of the graft angulation may contribute to the good results for PCL reconstruction.