Geriatric Nutritional Risk Index (GNRI) and Creatinine Index Equally Predict the Risk of Mortality in Hemodialysis Patients: J-DOPPS

The geriatric nutritional risk index (GNRI) and creatinine (Cr) index are indexes often used as nutritional surrogates in patients receiving hemodialysis. However, few studies have directly compared the clinical characteristics of these two indexes. We investigated 3, 536 hemodialysis patients enrolled in the Japan DOPPS phases 4 and 5. The primary outcome was all-cause mortality and the main exposures were the GNRI and Cr index. We confirmed and compared the association between these indexes and mortality risk as estimated by a multivariable-adjusted Cox proportional hazards model. During the median 2.2-year follow-up period, 414 patients died of any cause. In the multivariable-adjusted model, lower GNRI and Cr index were both associated with increased risk of all-cause mortality, and these associations were further confirmed by restricted cubic spline curves. The predictability of all-cause mortality, as represented by the c-statistic, was comparable between the two indexes. Furthermore, baseline nutritional surrogates that corresponded with lower GNRI or Cr index values were comparable between the two indexes. Given that calculating the GNRI is simpler than calculating the Cr index, our data suggest that the GNRI may be preferable to the Cr index for predicting clinical outcomes in patients undergoing maintenance hemodialysis

ショウギョウ エンゲキ トシテノ 「ニワカ」 ト ドラマセイ : サガ ニワカ・チクシ ミスコ ゲキダン オ チュウシン ニ

主に西日本で上演される民俗芸能の「俄」は、地域共同体のメンバーが他のメンバーを相手に演じる奉納芸・祝福芸である。昭和以降、一部の俄は演者や劇団の職業化が進み、通常の商業演劇と大差のない「商業俄」となった。本来、民俗芸能の俄は地域共同体のメンバーが演じる素人性や、当意即妙な言葉の掛け合いによる即興性を本質とするが、商業俄では職業俳優がこれを演じ、上演台本を用いて笑いをとるようになった。そして民俗芸能の俄が商業演劇の俄へと展開する際に新たに獲得したもののひとつがドラマ性である。即興性とはおよそ相容れない性質のドラマ性は、演劇が不特定多数の人々を観客としてまとめあげる上で重要な要素である。商業俄である佐賀俄・筑紫美主子劇団の場合、俄劇団の組織化、職業化、興行化、そしてドラマ性の獲得は、商業演劇ならではの内的発展の他、第二次世界大戦中の慰問公演や検閲といった外部の影響が大きく作用した。つまり筑紫美主子劇団は、一方では民俗芸能の俄から遠ざかりつつ、他方では商業俄としての性格を確立したのである。本論文では、佐賀俄・筑紫美主子劇団を取り上げ、演劇における重要な要素であるドラマ性に注目しながら、演劇―特に商業演劇としての俄の特徴について考察する

Improvement of mechanical properties by microstructural evolution of biomedical Co-Cr-W-Ni alloys with the addition of Mn and Si

We investigated changes in the microstructure and mechanical properties of biomedical Co-20Cr-15W-10Ni alloys (mass%) containing 8 mass% Mn and 0-3 mass% Si due to hot forging, solution treatment, cold swaging, and static recrystallization. The η-phase (M₆X-M₁₂X type cubic structure, M: metallic elements, X: C and/or N, space group: Fd-3m (227)) and CoWSi type Laves phase (C14 MgZn2 type hexagonal structure, space group: P63/mmc (194)) were confirmed as precipitates in the as-cast and as-forged alloys. To the best of our knowledge, this is the first report that reveals the formation of CoWSi type Laves phase precipitates in Co-Cr-W-Ni-based alloys. The addition of Si promoted the formation of precipitates of both η-phase and CoWSi type Laves phase. The solution-treated 8Mn+(0, 1)Si-added alloys exhibited TWIP-like plastic deformation behavior with an increasing work-hardening rate during the early to middle stages of plastic deformation. This plastic deformation behavior is effective in achieving both the low yield stress and high strength required to develop a high-performance balloon-expandable stent. The 8Mn+2Si-added alloy retained the CoWSi type Laves phase even after solution treatment, such that the ductility decreased but the strength improved. Additions of Mn and Si are effective in improving the ductility and strength of the Co-Cr-W-Ni alloy, respectively.Ueki K., Yanagihara S., Ueda K., et al. Improvement of mechanical properties by microstructural evolution of biomedical Co-Cr-W-Ni alloys with the addition of Mn and Si. Materials Transactions 62, 229 (2021); https://doi.org/10.2320/matertrans.MT-M2020300

Development of Low-Yield Stress Co–Cr–W–Ni Alloy by Adding 6 Mass Pct Mn for Balloon-Expandable Stents

This is the first report presenting the development of a Co–Cr–W–Ni–Mn alloy by adding 6 mass pct Mn to ASTM F90 Co–20Cr–15W–10Ni (CCWN, mass pct) alloy for use as balloon-expandable stents with an excellent balance of mechanical properties and corrosion resistance. The effects of Mn addition on the microstructures as well as the mechanical and corrosion properties were investigated after hot forging, solution treatment, swaging, and static recrystallization. The Mn-added alloy with a grain size of ~ 20 µm (recrystallization condition: 1523 K, 150 seconds) exhibited an ultimate tensile strength of 1131 MPa, 0.2 pct proof stress of 535 MPa, and plastic elongation of 66 pct. Additionally, it exhibited higher ductility and lower yield stress while maintaining high strength compared to the ASTM F90 CCWN alloy. The formation of intersecting stacking faults was suppressed by increasing the stacking fault energy (SFE) with Mn addition, resulting in a lower yield stress. The low-yield stress is effective in suppressing stent recoil. In addition, strain-induced martensitic transformation during plastic deformation was suppressed by increasing the SFE, thereby improving the ductility. The Mn-added alloys also exhibited good corrosion resistance, similar to the ASTM F90 CCWN alloy. Mn-added Co–Cr–W–Ni alloys are suitable for use as balloon-expandable stents.Yanagihara S., Ueki K., Ueda K., et al. Development of Low-Yield Stress Co–Cr–W–Ni Alloy by Adding 6 Mass Pct Mn for Balloon-Expandable Stents. Metallurgical and Materials Transactions A: Physical Metallurgy and Materials Science, 52, 9, 4137. https://doi.org/10.1007/s11661-021-06374-7

Synchronous improvement in strength and ductility of biomedical Co–Cr–Mo alloys by unique low-temperature heat treatment

The microstructure and tensile properties of Co–27Cr–6Mo (mass%) alloys heat-treated at 673–1373 K were studied. Lower elongation was observed after heat treatment at 1073 K due to formation of carbonitride precipitates. In contrast, when low-temperature heat treatment (LTHT) was applied at 673–873 K, both the ultimate tensile strength and elongation synchronously improved compared with the solution-treated alloy. Electron backscatter diffraction analysis for plastic-strained alloys and in situ X-ray diffraction analysis under stress-induced conditions revealed that the strain-induced martensitic transformation (SIMT) of the γ(fcc)-phase to ε(hcp)-phase during plastic deformation was suppressed by the LTHT. Stacking faults (thin ε-phase) were observed to collide in the LTHT alloys. The following mechanisms for the synchronous improvement in the tensile strength and elongation after LHTH are proposed. First, stacking faults with multiple variants were formed during LTHT. Then, the ε-phase of a single variant formed by SIMT during plastic deformation collides with preexisting multi-variant stacking faults formed during LTHT, increasing the tensile strength. In addition, the SIMT during plastic deformation is suppressed in the high-plastic-strain region by the collision. This decreases the total amount of ε-phase formed during plastic deformation, which improves the ductility. We demonstrated that LTHT of Co–Cr–Mo alloys effectively improves the performance and mechanical safety of spinal fixation implants, which often fracture because of fatigue cracking.Ueki K., Abe M., Ueda K., et al. Synchronous improvement in strength and ductility of biomedical Co–Cr–Mo alloys by unique low-temperature heat treatment. Materials Science and Engineering A, 739, 53. https://doi.org/10.1016/j.msea.2018.10.016

Overcoming the strength-ductility trade-off by the combination of static recrystallization and low-temperature heat-treatment in Co-Cr-W-Ni alloy for stent application

A process combining swaging, static recrystallization, and heat treatment at 873 K (low-temperature heat-treatment, LTHT) was developed for achieving both high ultimate strength and high ductility in Co-20Cr-15W-10Ni (mass%, CCWN) alloy for stent application. The alloys swaged to a sectional area reduction rate of 58.3% were annealed at 1373–1473 K for 30–300 s. Under annealing at 1373 K for 300 s, a fine grain structure with an average grain size of ~6 μm formed, while under annealing at 1473 K, a structure with an average grain size of 12 μm formed after 120 s. In the alloys annealed at 1373–1448 K, the formation of η-phase precipitates (M6X-M12X type, M: metallic elements, X: C and/or N) was observed, while no precipitates were observed in the alloys annealed at 1473 K. The improvement in ultimate strength by grain refinement was confirmed. Alloys annealed at 1473 K showed higher ductility compared to those annealed at 1373–1448 K even if the grain size was similar. It is considered that the η-phase precipitates deteriorated the ductility of the annealed alloys. LTHT suppressed the strain-induced martensitic γ-to-ε transformation to improve the ductility of the fine-grained as well as coarse-grained alloys. Thus, regardless of the grain size, it is newly evidenced that LTHT effectively improves ductility in CCWN alloy. By combining high-temperature short-time annealing and LTHT, both the ultimate strength and ductility of Co-20Cr-15W-10Ni (mass%) alloy improved, and it was possible to provide properties suitable for next-generation balloon-expandable stents with Co-20Cr-15W-10Ni (mass%) alloy.Ueki K., Yanagihara S., Ueda K., et al. Overcoming the strength-ductility trade-off by the combination of static recrystallization and low-temperature heat-treatment in Co-Cr-W-Ni alloy for stent application. Materials Science and Engineering A, 766, 138400. https://doi.org/10.1016/j.msea.2019.138400

Statins Activate Human PPARα Promoter and Increase PPARα mRNA Expression and Activation in HepG2 Cells

Statins increase peroxisome proliferator-activated receptor α (PPARα) mRNA expression, but the mechanism of this increased PPARα production remains elusive. To examine the regulation of PPARα production, we examined the effect of 7 statins (atorvastatin, cerivastatin, fluvastatin, pitavastatin, pravastatin, rosuvastatin, and simvastatin) on human PPARα promoter activity, mRNA expression, nuclear protein levels, and transcriptional activity. The main results are as follows. (1) Majority of statins enhanced PPARα promoter activity in a dose-dependent manner in HepG2 cells transfected with the human PPARα promoter. This enhancement may be mediated by statin-induced HNF-4α. (2) PPARα mRNA expression was increased by statin treatment. (3) The PPARα levels in nuclear fractions were increased by statin treatment. (4) Simvastatin, pravastatin, and cerivastatin markedly enhanced transcriptional activity in 293T cells cotransfected with acyl-coenzyme A oxidase promoter and PPARα/RXRα expression vectors. In summary, these data demonstrate that PPARα production and activation are upregulated through the PPARα promoter activity by statin treatment

Antibacterial Cu-doped calcium phosphate coating on pure titanium

Cu-doped amorphous calcium phosphate (ACP) coatings were fabricated on the surface of pure titanium (Ti) by electrochemical deposition at initial electrolyte temperatures of 35, 45, and 55°C. The antibacterial activities of the coatings were then evaluated by the plate counting method using Escherichia coli as the indicator. The Cu concentrations on the surfaces of samples are increased from 6.90 to 15.05 mass% as initial electrolyte temperature is increased from 35 to 55°C. The Cu-doped ACP coatings show that they can fully inhibit the growth of E. coli.Li Q., Yang J., Li J., et al. Antibacterial Cu-doped calcium phosphate coating on pure titanium. Materials Transactions 62, 1052 (2021); https://doi.org/10.2320/matertrans.MT-M2021005