The association between ultrafiltration rate and mortality in a co- hort of chronic hemodialysis patients with and without diabetes mellitus: a 7-year retrospective observational study.

Background: The ultrafiltration rate (UFR) is one of the important factors involved in long-term mortality in hemodialysis (HD) patients. Presence of diabetes mellitus often affects UFR due to abrupt hypotension during dialysis. In this study, we aimed to find the optimal UFR to improve the mortality in this population with and without diabetes mellitus (DM).Methods: The effect of the UFR on mortality was retrospectively evaluated in 707 patients un- dergoing regular HD from 1 June 2010 to 30 June 2017. The relationship between the UFR and mortality in patients in the non-DM group and those in the DM group was evaluated. Logistic regression analyses were used to select the determinants of mortality. Receiver operating char- acteristic (ROC) curve analyses and survival analysis were used to determine the optimal cutoff points of UFR for mortality.Results: The cutoff UFR values of the non-DM and DM groups were 12.07 ml/hr/kg and 9.66 ml/ hr/kg, respectively. A survival curve showed that in the non-DM group, the 7-year survival rate of patients with a UFR <12.07 ml/hr/kg was 72.6% and that in those with a UFR ≥12.07 ml/hr/kg was 19.6% (p<0.0001). In the DM group, the 7-year survival rate of those with a UFR <9.66 ml/ hr/kg was 66.7%, and it was 33.4% in those with a UFR ≥9.66 ml/hr/kg (p<0.0001).Conclusion: Lower UFR is essential for the long-term mortality of HD patients, and optimal UFR would be different between patients with and without DM

T2-Weighted Cardiac Magnetic Resonance Imaging of Edema in Myocardial Diseases

The purpose of this paper is to describe imaging techniques and findings of T2-weighted magnetic resonance imaging (MRI) of edema in myocardial diseases. T2-weighted cardiac MRI is acquired by combining acceleration techniques with motion and signal suppression techniques. The MRI findings should be interpreted based on coronary artery supply, intramural distribution, and comparison with delayed-enhancement MRI. In acute myocardial diseases, such as acute myocardial infarction and myocarditis, the edema is larger than myocardial scarring, whereas the edema can be smaller than the scarring in some types of nonischemic cardiomyopathy, including hypertrophic cardiomyopathy. T2-weighted MRI of edema identifies myocardial edema associated with ischemia, inflammation, vasculitis, or intervention in the myocardium and provides information complementary to delayed-enhancement MRI

Incidence of Serious Upper Gastrointestinal Bleeding in Patients Taking Non-steroidal Anti-infl ammatory Drugs in Japan

Upper gastrointestinal bleeding is a major adverse event of non-steroidal anti-inflammatory drugs (NSAIDs), and co-administration of proton pump inhibitors and H2 receptor antagonists has been established as a means of preventing such an eff ect. However, the incidence of bleeding associated with NSAID-induced ulcers under conditions where such strong anti-acid agents are used for prevention has yet to be clarified. We aimed to determine the annual incidence of serious upper gastrointestinal ulcer bleeding among Japanese patients in whom NSAIDs were used in our hospital. Before commencing the study, we recommended to all the physicians in our hospital the best method for caring for NSAID users, focusing on the concomitant use of proton pump inhibitors or H2 receptor antagonists. We conducted a cohort study involving 17,270 patients for whom NSAIDs had been newly prescribed. Bleeding from gastric ulcers was observed in 8 of the 17,270 patients using NSAIDs (0.05%). The pooled incidence rate for bleeding was calculated as 2.65 (95% confidence interval, 2.56-2.74) and 1.29 (1.27-1.31) per 1,000 patient years for low-dose aspirin and non-aspirin NSAID users, respectively. None of the bleeding ulcer patients required blood transfusion or were in serious condition. In conclusion, gastric ulcer bleeding occurred in low-dose aspirin or non-aspirin NSAID users, but its incidence was low and outcomes were not serious when adequate preventive measures were taken.</p

ガイコクジン ケンシュウセイ ノ イブンカ テキオウ ニ カンスルジュウダンテキ ブンセキ

本研究の目的は、国際交流基金日本語国際センターの日本語教師長期研修プログラムに参加した外国人研修生の異文化適応の実態を明らかにすることである。平成10年10月、12月、平成11 年6月の3時点において質問紙調査を実施した結果、37名の有効回答が得られた。調査内容は、学習領域、心身健康領域、対人関係領域、日本文化領域、住居・経済領域の5領域への適応度および孤独感である。適応と調査時期との関係を検討するために、1要因分散分析を行った結果 、次の2点が明らかとなった。(1)領域(学習、日本文化、住居・経済)において時間的変化の効果 が認められた。(2)適応過程はU型のみならず正の直線型、負の直線型を示した。次に、研修生の(a)出身地域または(b)日本語レベル別に、適応と調査時期の関係を検討するために、それぞれ 2要因分散分析を行った。その結果 、(a)について、学習領域で出身地域の主効果がみられ、ヨーロッパ出身者が東および南アジア出身者よりも適応度が高いことがわかった。(b)については、次の3点が明らかになった。(1)学習領域で日本語クラスの主効果 がみられ、Aクラスの得点がCおよびDクラスの得点よりも高かった。(2)学習領域で調査時期の主効果 がみられ、全てのクラスがU型適応を示すことがわかった。(3)住居・経済領域で交互作用がみられ、単純主効果 を検討したところ、10月時点においてCクラスの適応得点が低いこと、AおよびBクラスが負の直線型適応を示すことがわかった。また(a) (b)ともに、(1)日本文化領域で時間の経過に伴い適応得点が上昇し、(2)住居・経済領域で時間の経過に伴い適応得点が減少した。以上の結果 から、次の3点が考察された。(1)異文化適応は領域により適応の過程が異なり、必ずしもU型曲線をたどるとは限らない。(2)個人の異文化適応状態は時間の経過とともに変化する。(3)時期に応じた援助内容を提供する必要がある。今後は、さらにデータを蓄積するとともに、研修生の心身健康状態の正確な理解方法の検討がのぞまれる

Preparation of concentrated multilayer graphene dispersions and TiO2-graphene composites for enhanced hydrogen production

Photocatalytic hydrogen (H2) production is an attractive hydrogen production technology. It is initiated by charge-separation in titanium (IV) dioxide (TiO2) upon photoexcitation. Electrons reduce water to generate H2 while holes oxidize hydroxide to generate hydroxyl radicals. TiO2 is widely used because it is inexpensive, chemically stable, nontoxic, and environmentally friendly. The activity of TiO2 is limited, but adding a supporting noble metal nanoparticle such as platinum greatly enhances it. Due to resource risks and cost issues, we consider using graphene as an alternative to noble metal nanoparticles. Herein we report a new method to prepare a concentrated multilayer graphene solution and hydrogen production from an aqueous methanol solution. When we used graphene with different sheet sizes or improved the aggregation of TiO2 (TIO-9), the H2 evolution rate is 1.6 times higher than that of pristine TIO-9. The contact state and the dispersed state of graphene and TiO2 play important roles in improving the activity

The Quiescent Intracluster Medium in the Core of the Perseus Cluster

Clusters of galaxies are the most massive gravitationally-bound objects in the Universe and are still forming. They are thus important probes of cosmological parameters and a host of astrophysical processes. Knowledge of the dynamics of the pervasive hot gas, which dominates in mass over stars in a cluster, is a crucial missing ingredient. It can enable new insights into mechanical energy injection by the central supermassive black hole and the use of hydrostatic equilibrium for the determination of cluster masses. X-rays from the core of the Perseus cluster are emitted by the 50 million K diffuse hot plasma filling its gravitational potential well. The Active Galactic Nucleus of the central galaxy NGC1275 is pumping jetted energy into the surrounding intracluster medium, creating buoyant bubbles filled with relativistic plasma. These likely induce motions in the intracluster medium and heat the inner gas preventing runaway radiative cooling; a process known as Active Galactic Nucleus Feedback. Here we report on Hitomi X-ray observations of the Perseus cluster core, which reveal a remarkably quiescent atmosphere where the gas has a line-of-sight velocity dispersion of 164+/-10 km/s in a region 30-60 kpc from the central nucleus. A gradient in the line-of-sight velocity of 150+/-70 km/s is found across the 60 kpc image of the cluster core. Turbulent pressure support in the gas is 4% or less of the thermodynamic pressure, with large scale shear at most doubling that estimate. We infer that total cluster masses determined from hydrostatic equilibrium in the central regions need little correction for turbulent pressure.Comment: 31 pages, 11 Figs, published in Nature July