Anomalous Coexistence of Ferroelectric Phases (P∥aP\parallel a and P∥cP\parallel c) in Orthorhombic Eu1−y_{1-y}Yy_yMnO3_3 (y>0.5y>0.5) Crystals

We have investigated the magnetic and dielectric properties of orthorhombic Eu$_{1-y}$Y$_y$MnO$_3$ ($0\leq y\leq 0.6$) single crystals without the presence of the 4$f$ magnetic moments of the rare-earth ions. In $y\geq 0.2$, the magnetic-structure driven ferroelectricity is observed. The ferroelectric transition temperature is steeply reducing with increasing $y$. In $y\geq 0.52$, two ferroelectric phases ($P\parallel a$ and $P\parallel c$) are coexistent at low temperatures. In these phases, ferroelectricity has different origin, which is evidenced by the distinctive poling-electric-field dependence of electric polarization. Namely, the electric polarization along the c axis ($P_c$) is easily saturated by a poling electric field, therefore $P_c$ is caused by the $bc$ spiral antiferromagnetic order. On the other hand, the electric polarization along the a axis ($P_a$) is probably attributed to the collinear $E$-type antiferromagnetic order, because $P_a$ is unsaturated even in a poling field of $10^6$ V/m.Comment: 10 pages, 4figures, to be published in Journal of the Physical Society of Japa

Changes in the Corneal Endothelium of Aphakic Patients Following Extended Soft Contact Lens Wear

The contact lenses used for visual correction of aphakia are mostly soft contact lenses for extended wear because most aphakic patients are elderly. The effects of extended wear of such contact lenses on corneal endothelial cells have been recently reported. In this study, two groups, an extended wear SCL group and a spectacles group, were compared with respect to various parameters by means of specular microscopy following surgery for cataract. The SCL group consisted of 16 subjects and 16 eyes. The average age at operation was 67.8 years and the wearing period was 1 to 5 years after operation. The spectacles group consisted of 14 subjects and 16 eyes; the average age at operation was 70.1 years, and the wearing period was 1 to 5 years after surgery. Using a wide field specular microscope (mode1 SP-1), endothelial cells in the central part of the cornea were observed and photographed. The endothelial cell picture was then enlarged to a final magnification of 450 times, and the image was analyzed using the KC-8VA cell analyzer system. There was no significant difference in the mean cell area (μm2) and mean cell density (cell counts/mm2) between the two groups, but the coefficient of variation (CV) was significantly elevated in the SCL group after operation. The percentage of hexagonal cells was also significantly lower in the SCL group after operation. Therefore extended wear of soft contact lenses appears to make corneal endothelial cells unstable and accelerates changes in cornet endothelial cells due to aging

Associations of Psychosocial Factors with Maternal Confidence Among Japanese and Vietnamese Mothers

We conducted this cross-sectional study among 392 Japanese and 294 Vietnamese mothers who attended routine child health visits in a Japanese city and at a tertiary hospital in Vietnam, in order to investigate the prevalence and associated sociodemographic, parenting, and psychological characteristics of low maternal confidence in child rearing among them. All data were collected from medical files in Japan, and from medical files and self-administered questionnaires in Vietnam. The proportion of mothers without secure feeling of confidence in the present study was 22% in Japan and 66% in Vietnam. Significant factors associated with a lack of confidence were first-time motherhood and unintended pregnancy in the Japanese dataset and younger age in the Vietnamese dataset. In both groups, a higher proportion of mothers who lacked confidence reported negative parenting outcomes than did confident mothers. Among the three psychological measurements (mood, self-efficacy and depression), higher self-efficacy was associated independently with a significantly reduced risk of not having confidence in child rearing. These results suggest the importance of developing parenting support programs to help Japanese and Vietnamese mothers, particularly those who are young, first-time mothers or who became pregnant unexpectedly, improve their self-efficacy

Effect of Hydrogen Peroxide and High Glucose on the Glucose Metabolism of Lymphoma-derived U937 Cells

Our study aimed to clarify specific oxidative stress and glucose metabolic disorders in hemodialysis patients, by examining hydrogen peroxide (H2O2) - and high glucose-induced oxidative stress, glucose transport and the failure of glycolysis. As an in vitro blood cell model of end-stage renal disease (ESRD) in patients with diabetes, human monocytic U937 cells of malignant lymphoma origin were exposed to high glucose (28.9mM) for 6 days, with 5mM H2O2 added on the last day. The generation of intracellular reactive oxygen species (ROS), glucose levels, lactate levels, AMP-activated protein kinase (AMPK) activity and Glut4 levels were examined. Exposure of U937 cells to H2O2 resulted in a significant increase in intracellular ROS generation and glucose levels. Under high glucose conditions, treatment with H2O2 significantly promoted these actions. In H2O2-induced U937 cells, AMPK activity and Glut4 levels were significantly increased, but lactate and pyruvate levels were significantly decreased. Thus, exposure of U937 cells to H2O2 and a high glucose load promoted an increase in intracellular ROS, and exposure to H2O2 induced increased glucose transport and high intracellular glucose due to reduced glycolytic metabolism. This suggests that reduced glycolytic metabolism might be induced in states of high oxidative stress in hemodialysis patients with diabetes

Pleiotropic Effects of Linagliptin Monotherapy on Levels of Nitric Oxide, Nitric Oxide Synthase, and Superoxide Dismutase in Hemodialysis Patients with Diabetes

Linagliptin is an anti-diabetic drug and the only bile-excreted dipeptidyl peptidase-4 inhibitor. Malnutrition-inflammation-atherosclerosis syndrome is an important prognostic factor for hemodialysis patients, and we previously reported anti-inflammatory effects of linagliptin in hemodialysis patients with diabetes. Inflammation can accelerate oxidative stress, vasoconstriction, and platelet aggregation. However, few studies have investigated the pleiotropic effects of linagliptin treatment on inflammation in hemodialysis patients. In this study, we have extended our previous investigations of these effects in a longer and more thorough follow-up of hemodialysis patients with diabetes. We examined 20 hemodialysis patients with diabetes who were not receiving oral diabetes drugs or insulin therapy and who exhibited inadequate glycemic control (glycated albumin levels＞20%). Linagliptin (5mg) was administered daily, and we evaluated the patients’ superoxide dismutase, 8-hydroxydeoxyguanosine, nitric oxide, nitric oxide synthase, and asymmetric dimethylarginine levels in serum at baseline and after 1, 3, and 6 months of treatment. After 6 months of treatment, superoxide dismutase levels had significantly decreased from 8.8±0.5U/ml to 7.0±0.5U/ml. Nitric oxide synthase levels were significantly increased at 3 and 6 months (maximum, 94.2±13.2µg/ml; baseline, 31.6±5.5µg/ml). After 3 months of treatment, nitric oxide levels had significantly increased from 64.5±6.6µmol/l to 104±15.4µmol/l, and remained significantly elevated at 6 months. Asymmetric dimethylarginine and 8-hydroxydeoxyguanosine levels did not change during the 6-month treatment course, and no patients exhibited hypoglycemia or other significant adverse effects. Linagliptin treatment significantly changed various markers of inflammation relevant to the atherosclerosis in malnutrition-inflammation-atherosclerosis syndrome. Therefore, linagliptin monotherapy has pleiotropic effects on inflammation in hemodialysis patients with diabetes, and may improve their prognosis

HbA1c and telemedicine during COVID-19

Aims/Introduction: To investigate whether the COVID-19 pandemic affected behavioral changes and glycemic control in patients with diabetes and to conduct a survey of telemedicine during the pandemic. Materials and Methods: In this retrospective study, a total of 2,348 patients were included from 15 medical facilities. Patients were surveyed about their lifestyle changes and attitudes toward telemedicine. Hemoglobin A1c (HbA1c) levels were compared among before (from June 1 to August 31, 2019) and in the first (from June 1 to August 31, 2020) and in the second (from June 1 to August 31, 2021) year of the pandemic. A survey of physician attitudes toward telemedicine was also conducted. Results: The HbA1c levels were comparable between 2019 (7.27 ± 0.97%), 2020 (7.28 ± 0.92%), and 2021 (7.25 ± 0.94%) without statistical difference between each of those 3 years. Prescriptions for diabetes medications increased during the period. The frequency of eating out was drastically reduced (51.7% in 2019; 30.1% in 2020), and physical activity decreased during the pandemic (48.1% in 2019; 41.4% in 2020; 43.3% in 2021). Both patients and physicians cited increased convenience and reduced risk of infection as their expectations for telemedicine, while the lack of physician–patient interaction and the impossibility of consultation and examination were cited as sources of concern. Conclusions: Our data suggest that glycemic control did not deteriorate during the COVID-19 pandemic with appropriate intensification of diabetes treatment in patients with diabetes who continued to attend specialized diabetes care facilities, and that patients and physicians shared the same expectations and concerns about telemedicine

Cerebral air embolism as a complication of peptic ulcer in the gastric tube: case report

<p>Abstract</p> <p>Background</p> <p>The reported incidence of ulcer formation in the gastric tube in esophageal replacement is rare.</p> <p>Case Presentation</p> <p>This is the first report of a case of cerebral air embolism as a result of spontaneous perforation of an ulcer in the constructed gastric tube into the pulmonary vein during post-operative follow-up in a patient with esophageal cancer.</p> <p>Conclusions</p> <p>Cerebral air embolism is a rare complication of penetrating gastric ulcer, but should be considered in patients with a history of esophagectomy with gastric conduit that present with acute neurologic findings.</p