Trends in Treatment for Patients with Late-onset Rheumatoid Arthritis in Japan: Data from the NinJa Study.

OBJECTIVES: To investigate trends in the treatment of patients with late-onset rheumatoid arthritis (LORA) using data from the National Database of Rheumatic Diseases in Japan (NinJa). METHODS: Patients registered in the NinJa were classified according to disease onset: at <65 years (young-onset rheumatoid arthritis [YORA]); at 65-74 years (early LORA); and at ≥75 years (late LORA). Chronological changes in the treatment and disease activity were compared. RESULTS: A total of 7,178, 13,171, 15,295, and 15,943 patients were evaluated in 2010, 2013, 2016, and 2019, respectively. In all groups, the use of methotrexate gradually decreased, whereas that of biological/targeted synthetic disease-modifying antirheumatic drugs (DMARDs) increased; the use of tumor necrosis factor inhibitors (TNFi) decreased, whereas that of non-TNFi increased. LORA was characterized by more single DMARD use, and less methotrexate and biological/targeted synthetic DMARD use. TNFi and interleukin-6 inhibitors were used less frequently, whereas abatacept was utilized more frequently in late versus early LORA. Conventional synthetic DMARD (excluding methotrexate) and glucocorticoid use was higher in late versus early LORA. CONCLUSIONS: This analysis revealed chronological changes in the treatment of LORA in Japan. Differences between early and late LORA suggest that patients are not a homogeneous population.

Comprehensive evaluation of the influence of sex differences on composite disease activity indices for rheumatoid arthritis: results from a nationwide observational cohort study.

BACKGROUND: The effects and their magnitudes of sex on disease activity indices for rheumatoid arthritis are not clear. We aimed to comprehensively evaluate the influence of sex on disease activity indices in the real-world setting using a large observational database. METHODS: We analyzed 14,958 patients registered in the National Database of Rheumatic Diseases in Japan (NinJa) in 2017. We evaluated the sex differences in the 28-joint disease activity score (DAS28) using erythrocyte sedimentation rate (ESR), DAS28 using C-reactive protein (DAS28-CRP), Simplified Disease Activity Index (SDAI), and Clinical Disease Activity Index by disease activity category using Cliff's delta and regression analysis. Differences in the share of components of indices were evaluated using permutational multivariate analysis of variance. Correction equations were constructed to estimate the number of misclassification in male patients who achieve DAS28-ESR remission. RESULTS: DAS28-ESR showed higher values in female patients than male patients in remission despite no obvious difference in other indices or disease activity categories. Among the components of DAS28-ESR, only ESR was higher in female patients than male patients in remission. In DAS28-CRP and SDAI, 28-tender joint count was higher and CRP was lower in female patients than male patients. In addition, the profiles in the components were different between female and male patients, especially among those with high disease activity. Using correction equations, almost 12% of male patients with DAS28-ESR remission were estimated to be misclassified, mainly due to differences in ESR. CONCLUSION: Among the disease activity indices, significant sex difference was observed only in DAS28-ESR remission. The degree of misclassification in DAS28-ESR remission would be unignorable.

Numerical study of transient aerodynamic forces acting on a ski jumper considering dynamic posture change from takeoff to landing.

This study was designed to develop a computational fluid dynamics (CFD) method for unsteady analysis of a series of ski jump movements with attitude changes, and to analyse the aerodynamic characteristics of an expert jumper over the entire ski jump movement. Two ski jumpers participated in this study. A sensor-based motion capture suit was used to capture the jumper's posture during the actual ski jump. A three-dimensional computer graphics animation was created by superimposing the joint angles obtained from the motion measurements of the 3D shape of the athlete. The unsteady aerodynamic forces acting on the ski jumper, from the takeoff to the landing, were then calculated using CFD. A time-varying spatially uniform flow was specified as the inflow boundary condition of the computational domain. The results indicated that both the lift and drag forces of the expert jumper increase rapidly during the initial flight when the jumper's posture changes drastically. Thereafter, drag force decreased considerably, but the decrease in the lift force was less drastic. Later in the flight phase, the lift force acting on the expert jumper increased, and throughout the flight phase, the lift-drag ratio of the expert jumper remained higher than that of the unskilled jumper.

Spatial distribution and benthic risk assessment of cyclic, linear, and modified methylsiloxanes in sediments from Tokyo Bay catchment basin, Japan: Si-based mass profiles in extractable organosilicon.

We investigated the spatial distribution, mass profiles, and benthic risk assessment of a wide range of methylsiloxanes (MSs), including 7 cyclic MSs (CMSs; D3-D9; the number refers to the number of SiO bonds), 13 linear MSs (LMSs; L3-L15), and 15 modified and other MSs (MMSs) in sediments from the Tokyo Bay catchment basin, Japan. We observed widespread distribution of MSs (ΣCMS, ΣLMS, and ΣMMS) in the sediment samples, with concentrations of 1.0-6180 ng/g dry weight (dw), 1.8-10,100 ng/g dw, and < 0.31-210 ng/g dw, respectively. Our study is the first to measure various MMSs modified with hydrogen, vinyl, or phenyl groups; however, only methyltris(trimethylsiloxy)silane and phenyltris(trimethylsiloxy)silane were detected with high occurrence frequency. Notably, no elevated concentrations of MSs were observed downstream of silicone manufacturers, whereas the sediment was characterized by a specific D4/D5 ratio. With the Si-based mass profiles in extractable organosilicon (EOSi), the measured CMSs, LMSs, and MMSs accounted for 5.4%, 7.8%, and 0.2%, respectively. Unidentified EOSi (unknown fraction) constituted a major proportion of the EOSi in the sediment, with a mean of 87%, suggesting that the organosilicon environmental emissions were more than the measured MSs. In risk assessment of the adverse effects of D4, D5, and D6 in sediment on benthic organisms, the respective distributions indicated no overlap between the 95th percentile field sediment concentration and the 5th percentile chronic sediment no-effect concentration in organic carbon-normalized concentration. Although the hazard quotient compared with the predicted no-effect concentration for D5 and D6 exceeded the threshold level (hazard quotient ≥1), the results of probabilistic risk assessment for the three CMSs were not high enough to indicate a threat to benthic organisms in the study area.

Convenience of Hgb-O detected by optical method in XN-series hematology analyzers in evaluating hemoglobin concentration in samples with chylous turbidity.

The chylous turbidity of blood samples is one of the causes of false-high hemoglobin (Hgb) concentration measurements by the colorimetric method, which has been widely applied in hematology analyzers. In such cases, additional manual procedures are required to correct Hgb concentrations. We therefore examined the effectiveness of an optical method for measuring Hgb concentrations in samples with chylous turbidity using Hgb-O in the reticulocyte channel equipped in XN-series analyzers (Sysmex, Kobe, Japan). Hgb-O showed excellent basic performance, including linear correlation and invariability with sodium lauryl sulfate (SLS)-Hgb detected by the colorimetric method. In the analysis of samples from healthy volunteers supplemented with fat emulsion, chylous turbidity did not affect Hgb-O but SLS-Hgb, which was falsely increased according to the dose of fat emulsion. Actually, SLS-Hgb was falsely elevated in 34 of 40 chylous turbidity 3+ samples. The remaining 6 samples were measured in hematology analyzers where Hgb-O was inconsistent with SLS-Hgb in the internal quality control records. For these samples, the correction factors calculated from the internal quality control records could contribute to providing the corrected Hgb-O value. These findings suggested that the optical method was effective and convenient for accurately evaluating Hgb concentrations in samples with extremely chylous turbidity.

Development of a strategic approach for comprehensive detection of organophosphate pesticide metabolites in urine: Extrapolation of cadusafos and prothiofos metabolomics data of mice to humans.

OBJECTIVES: The comprehensive detection of environmental chemicals in biospecimens, an indispensable task in exposome research, is advancing. This study aimed to develop an exposomic approach to identify urinary metabolites of organophosphate (OP) pesticides, specifically cadusafos and prothiofos metabolites, as an example chemical group, using an original metabolome dataset generated from animal experiments. METHODS: Urine samples from 73 university students were analyzed using liquid chromatography-high-resolution mass spectrometry. The metabolome data, including the exact masses, retention time (tR ), and tandem mass spectra obtained from the human samples, were compared with the existing reference databases and with our original metabolome dataset for cadusafos and prothiofos, which was produced from mice to whom two doses of these OPs were orally administered. RESULTS: Using the existing databases, one chromatographic peak was annotated as 2,4-dichlorophenol, which could be a prothiofos metabolite. Using our original dataset, one peak was annotated as a putative cadusafos metabolite and three peaks as putative prothiofos metabolites. Of these, all three peaks suggestive of prothiofos metabolites, 2,4-dichlorophenol, 3,4,5-trihydroxy-6-(2,4-dichlorophenoxy) oxane-2-carboxylic acid, and (2,4-dichlorophenyl) hydrogen sulfate were confirmed as authentic compounds by comparing their peak data with both the original dataset and peak data of the standard reagents. The putative cadusafos metabolite was identified as a level C compound (metabolite candidate with limited plausibility). CONCLUSIONS: Our developed method successfully identified prothiofos metabolites that are usually not a target of biomonitoring studies. Our approach is extensively applicable to various environmental contaminants beyond OP pesticides.

Development of a rapid and comprehensive method for identifying organic micropollutants with high ecological risk to the aquatic environment.

Currently, tens-of-thousands of chemicals are used in Japan, and their presence in and impact on aquatic ecosystems are poorly understood. Because conventional risk evaluation processes using target analysis and biological tests are time-consuming and costly, it is challenging to investigate all substances. Therefore, we aimed to develop a rapid and highly efficient screening scheme for identifying hazardous organic micropollutants (OMPs) in aquatic ecosystems. The scheme is divided into two steps: chemical analysis and risk evaluation. First, a comprehensive screening method (CSM) using gas chromatography (GC)-mass spectrometry (MS) and a database containing nearly 1000 compounds is used to identify known compounds, and nontargeted analysis is carried out using a GC × GC-time-of-flight (TOF)MS to detect compounds not registered in the database. Secondly, the predicted toxicity values obtained by quantitative structure-activity relationship (QSAR) are used to evaluate and rank the ecological risk of each detected OMPs and to identify priority compounds for detailed survey. To assess the proposed scheme, we surveyed representative urban rivers in Japan and ranked the potential toxicity of the identified compounds. The total number of compounds detected in water from each river ranged from 29 to 87, and the total concentrations ranged from 2.3 to 63 µg L-1. Pharmaceuticals and personal care products, such as crotamiton and galaxolide, were identified in the urban rivers and found to have high ecotoxicity rankings. Thus, the scheme combining CSM and risk evaluation using QSAR is a novel screening that can identify candidates with high ecological risk in aquatic environment rapidly and efficiently.

GAPS-megacities: A new global platform for investigating persistent organic pollutants and chemicals of emerging concern in urban air.

A pilot study was initiated in 2018 under the Global Atmospheric Passive Sampling (GAPS) Network named GAPS-Megacities. This study included 20 megacities/major cities across the globe with the goal of better understanding and comparing ambient air levels of persistent organic pollutants and other chemicals of emerging concern, to which humans residing in large cities are exposed. The first results from the initial period of sampling are reported for 19 cities for several classes of flame retardants (FRs) including organophosphate esters (OPEs), polybrominated diphenyl ethers (PBDEs), and halogenated flame retardants (HFRs) including new flame retardants (NFRs), tetrabromobisphenol A (TBBPA) and hexabromocyclododecane (HBCDD). The two cities, New York (USA) and London (UK) stood out with ∼3.5 to 30 times higher total FR concentrations as compared to other major cities, with total concentrations of OPEs of 15,100 and 14,100 pg/m3, respectively. Atmospheric concentrations of OPEs significantly dominated the FR profile at all sites, with total concentrations in air that were 2-5 orders of magnitude higher compared to other targeted chemical classes. A moderately strong and significant correlation (r = 0.625, p < 0.001) was observed for Gross Domestic Product index of the cities with total OPEs levels. Although large differences in FR levels were observed between some cities, when averaged across the five United Nations regions, the FR classes were more evenly distributed and varied by less than a factor of five. Results for Toronto, which is a 'reference city' for this study, agreed well with a more in-depth investigation of the level of FRs over different seasons and across eight sites representing different urban source sectors (e.g. traffic, industrial, residential and background). Future sampling periods under this project will investigate trace metals and other contaminant classes, linkages to toxicology, non-targeted analysis, and eventually temporal trends. The study provides a unique urban platform for evaluating global exposome.

Development of pictogram system for natural disaster reduction through Internet

The purpose of this study is to develop a pictogram system for natural disaster reduction. Long lasting and tangible achievement of IDNDR is needed which may be used in all over the world for many coming generations. As Neurath said "World divide, pictures unite", pictograms could be a powerful communication tool as well as an educational tool to improve global disaster awareness. In this project, we formed a multi-disciplinary team to compile "A database of pictograms for natural disaster reduction", which we intend to release our copyrights to be used widely and freely as an achievement of IDNDR through internet. We developed the lexicon and grammar of the pictograms for natural disaster reduction. Over 700 pictograms in use were collected for evaluation, and new designs were also added to complete the list of concepts related to natural hazards and their disaster management. Home page will be introduce for worldwide participation in this project.(AU)