The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016)

Background and purposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 and published in the Journal of JSICM, [2017; Volume 24 (supplement 2)] https://doi.org/10.3918/jsicm.24S0001 and Journal of Japanese Association for Acute Medicine [2017; Volume 28, (supplement 1)] http://onlinelibrary.wiley.com/doi/10.1002/jja2.2017.28.issue-S1/issuetoc.This abridged English edition of the J-SSCG 2016 was produced with permission from the Japanese Association of Acute Medicine and the Japanese Society for Intensive Care Medicine.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ) and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two-thirds (> 66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J-SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation, and its supporting evidence were also added to each recommendation statement. We conducted meta-analyses for 29 CQs. Thirty-seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for five CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese-specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non-specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals

The Effects of Nitrogen and Plasma Power on Electrochemical Properties of Boron-Doped Diamond Electrodes Grown by MPCVD

The influences of nitrogen addition and the attenuation of microwave power during microwave plasma-assisted chemical vapor deposition (MPCVD) of diamond films on electrochemical properties of the grown films were investigated. Although diamond films grown in the presence of a small amount of nitrogen did not contain sp2 carbon and appeared to be normally deposited films, the electrical and electrochemical properties were different from films grown under an atmosphere without nitrogen. Especially, the potential windows of diamond films grown in the presence of nitrogen at low microwave power were very wide and extended to 3.6 V in sulfuric acid solution, which is comparable to the widest value of the potential window of diamond electrodes reported till now. It was also found that the attenuation of the plasma power during MPCVD by itself was effective in the expansion of the potential window because of the defect-free growth of diamond crystals

An evolutionarily conserved protein CHORD regulates scaling of dendritic arbors with body size.

体の大きさに合わせて神経細胞の大きさを制御するしくみを解明. 京都大学プレスリリース. 2014-03-17.Most organs scale proportionally with body size through regulation of individual cell size and/or cell number. Here we addressed how postmitotic and morphologically complex cells such as neurons scale with the body size by using the dendritic arbor of one Drosophila sensory neuron as an assay system. In small adults eclosed under a limited-nutrition condition, the wild-type neuron preserved the branching complexity of the arbor, but scaled down the entire arbor, making a "miniature". In contrast, mutant neurons for the Insulin/IGF signaling (IIS) or TORC1 pathway exhibited "undergrowth", which was characterized by decreases in both the branching complexity and the arbor size, despite a normal diet. These contrasting phenotypes hinted that a novel regulatory mechanism contributes to the dendritic scaling in wild-type neurons. Indeed, we isolated a mutation in the gene CHORD/morgana that uncoupled the neuron size and the body size: CHORD mutant neurons generated miniature dendritic arbors regardless of the body size. CHORD encodes an evolutionarily conserved co-chaperone of HSP90. Our results support the notion that dendritic growth and branching are controlled by partly separate mechanisms. The IIS/TORC1 pathways control both growth and branching to avert underdevelopment, whereas CHORD together with TORC2 realizes proportional scaling of the entire arbor

CARBON DIOXIDE FLUXS AT WATER AND SEDIMENT IN THE URBAN COASTAL TIDAL FLAT OF OSAKABAY

本研究では大阪湾沿岸部の13地点の干潟を対象に水質項目，底質環境，水面と堆積物のCO2フラックスを定量化し，その関係性を明らかにすることを目的に調査を行った．大阪湾の干潟は全体的に砂質で構成されており，化学的性状から好気的な環境であった．水面におけるCO2フラックスは13地点中8地点で放出を示し，湾奥の河川の影響が強い地点でCO2は放出傾向にあった．堆積物における1日当たりのCO2フラックスは矢倉海岸と男里川を除いてCO2は放出であり，1日当たりのCO2フラックスは水面より高いことから，堆積物では有機物の分解の場としてCO2は放出されていることが推察された．以上のことから，干潟では水面からCO2は放出傾向であり，堆積物は干出することで，有機物の分解が促進されてCO2は放出していることが考えられた．The objective of this study was to quantify the relationships between water surface and sediment CO2 fluxes on 13 tidal flats in the coastal area of Osaka Bay. The tidal flats are generally composed of sandy sediments, and their chemical properties indicate an aerobic environment. CO2 fluxes at the water surface of the tidal flats showed a release at 8 of the 13 sites, and CO2 tended to be released at the sites with strong river influence at inner part of Osaka bay. The daily CO2 flux in the sediments was higher than that in the water surface, suggesting that CO2 is released in the sediments as decomposition of organic matter. These results suggest that CO2 tends to be released from the water surface on tidal flats, and that CO2 at sediments is released by the decomposition of organic matter accelerated in low tide

CHARACTERISTICS OF CARBON FLOW ON PELAGIC ECOSYSTEMS AT HYPERNUTRIENT AREA IN AMAGASAKI CANAL

本研究では，大阪湾湾奥に位置する尼崎運河における植物プランクトン，動物プランクトンおよびコウロエンカワヒバリガイの現存量・生産速度を定量化することで，一次生産者から二次生産者へ至る年間の炭素フローを算出し，転送効率について評価した．植物プランクトンによる一次生産速度は他の水域に比べて高く，動物プランクトンの個体数，二次生産速度は低かった．年間を通して，植物プランクトンから動物プランクトン，コウロエンカワヒバリガイの転送効率はそれぞれ0.76%，7.8%であり，合わせて8.6%の有機炭素が二次生産者へ移行していた．運河ではコウロエンカワヒバリガイは効率よく成長して炭素を固定しているが，動物プランクトンは食物連鎖において魚類の現存量・生産速度に影響していることが示唆された．The purpose of this study was to reveal the carbon flow from primary producer (phytoplankton) to secondary producers (zooplankton and Xenostrobus securis), transfer efficiency at hyper-nutrient area in the Amagasaki Canal of inner part of Osaka Bay. The primary production rate was higher than that of other water area, while zooplankton biomass and secondary production rate were lower. The production rate of X. securis was about 1/12 of that of phytoplankton, but biomass was about 29 times higher. Transfer efficiency from phytoplankton to zooplankton and X. securis was 0.76% and 7.8%, respectively. These results suggested that X. securis grew efficiently and fixed organic carbon, zooplankton were not functioning properly as intermediaries in the food chain between phytoplankton and fishes

Short-term effects of liraglutide on visceral fat adiposity, appetite, and food preference: a pilot study of obese Japanese patients with type 2 diabetes

<p>Abstract</p> <p>Background</p> <p>To examine the effects of liraglutide, a glucagon-like peptide-1 (GLP-1) analogue, on visceral fat adiposity, appetite, food preference, and biomarkers of cardiovascular system in Japanese patients with type 2 diabetes.</p> <p>Methods</p> <p>The study subjects were 20 inpatients with type 2 diabetes treated with liraglutide [age; 61.2 ± 14.0 years, duration of diabetes; 16.9 ± 6.6 years, glycated hemoglobin (HbA1c); 9.1 ± 1.2%, body mass index (BMI); 28.3 ± 5.2 kg/m², mean ± SD]. After improvement in glycemic control by insulin or oral glucose-lowering agents, patients were switched to liraglutide. We assessed the estimated visceral fat area (eVFA) by abdominal bioelectrical impedance analysis, glycemic control by the 75-g oral glucose tolerance test (OGTT) and eating behavior by the Japan Society for the Study of Obesity questionnaire.</p> <p>Results</p> <p>Treatment with liraglutide (dose range: 0.3 to 0.9 mg/day) for 20.0 ± 6.4 days significantly reduced waist circumference, waist/hip ratio, eVFA. It also significantly improved the scores of eating behavior, food preference and the urge for fat intake and tended to reduce scores for sense of hunger. Liraglutide increased serum C-peptide immunoreactivity and disposition index.</p> <p>Conclusions</p> <p>Short-term treatment with liraglutide improved visceral fat adiposity, appetite, food preference and the urge for fat intake in obese Japanese patients with type 2 diabetes.</p

Efficacy of liraglutide, a glucagon-like peptide-1 (GLP-1) analogue, on body weight, eating behavior, and glycemic control, in Japanese obese type 2 diabetes

Abstract Background We recently reported that short-term treatment with liraglutide (20.0 ± 6.4 days) reduced body weight and improved some scales of eating behavior in Japanese type 2 diabetes inpatients. However, it remained uncertain whether such liraglutide-induced improvement is maintained after discharge from the hospital. The aim of the present study was to determine the long-term effects of liraglutide on body weight, glycemic control, and eating behavior in Japanese obese type 2 diabetics. Methods Patients with obesity (body mass index (BMI) >25 kg/m2) and type 2 diabetes were hospitalized at Osaka University Hospital between November 2010 and December 2011. BMI and glycated hemoglobin (HbA1c) were examined on admission, at discharge and at 1, 3, and 6 months after discharge. For the liraglutide group (BMI; 31.3 ± 5.3 kg/m2, n = 29), patients were introduced to liraglutide after correction of hyperglycemic by insulin or oral glucose-lowering drugs and maintained on liraglutide after discharge. Eating behavior was assessed in patients treated with liraglutide using The Guideline For Obesity questionnaire issued by the Japan Society for the Study of Obesity, at admission, discharge, 3 and 6 months after discharge. For the insulin group (BMI; 29.1 ± 3.0 kg/m2, n = 28), each patient was treated with insulin during hospitalization and glycemic control maintained by insulin after discharge. Results Liraglutide induced significant and persistent weight loss from admission up to 6 months after discharge, while no change in body weight after discharge was noted in the insulin group. Liraglutide produced significant improvements in all major scores of eating behavior questionnaire items and such effect was maintained at 6 months after discharge. Weight loss correlated significantly with the decrease in scores for recognition of weight and constitution, sense of hunger, and eating style. Conclusion Liraglutide produced meaningful long-term weight loss and significantly improved eating behavior in obese Japanese patients with type 2 diabetes.</p