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

INUNDATION OF THE CHIKUMA RIVER DUE TO THE TYPHOON HAGIBIS IN OCTOBER 2019 AND ISSUES OF EFFECTIVENESS IN EVACUATION PLANS OF ELDERLY WELFARE FACILITIES FOR THE LARGEST EXPECTED RAINFALL

In the heavy rain disaster caused by typhoon HAGBIS in 2019, the collapse of the Chikuma River embankment caused widespread inundation damage in Nagano City. We conducted an inundation trace survey, the flood inundation calculation, and interview surveys of 6 elderly welfare facilities which were damaged by inundation. From the results, the relationships between the evacuation behavior of each facility and the inundation process were analyzed. In addition, we considered the issues of evacuation safety planning in the event of the largest expected flood

Cryoimmunologic Investigations in Patients With Prostatic Carcinoma

Transurethral cryosurgery was performed with liquid nitrogen in 18 patients with prostatic carcinomas. The clinical course and the effect of cryosurgery on immune competence of patients were observed. After cryosurgery, pain was relieved in 5 of 6 patients, dysuria was improved in 7 of 12 patients, and the prostatic mass was reduced in 14 of 18 patients. Elevated serum acid phosphatase levels returned to normal in 5 cases. Changes of serum protein fractions were variable. Serum complement levels were high in advanced cases. Changes of immunoglobulins were variable. Serum anti-prostatic antibody could not be detected by passive hemagglutination test and by indirect immunofluorescent examination. DNCB skin reaction and blastoid transformation of lymphocytes were raised after therapy. The cellular immune competence may be enhanced by cryosurgery, while the humoral immune competence is scarcely influenced by the therapy. It has been reported that remission of metastatic lesions occured after cryosurgery for advanced prostatic carcinoma (Soanes et al.1)). Furthermore, it was suggested that immune competence of the patient with carcinoma may be enhanced after cryosurgery (Ablin2)). In an attempt to examine the effect of cryosurgery on immune competence, we observed clinical and immunologic responses after treatment in 18 patients with prostatic carcinoma

Enzymatic and Immunological Studies of Prostatic Acid Phosphatase

Levels of serum acid phosphatase are elevated in prostatic cancer patients as compared with those of normal human. Prostatic cancer patients with bone metastasis show about 2 to 5 fold increased activities of serum acid phosphatase while patients without bone metastasis show slight increase (about 20%) of the activity. When we analysed serum acid phosphatase isozyme pattern with DEAE cellulose column chromatography, profiles of these enzymes of normal and prostatic cancer patients differ greatly. In normal human, three distinct isozymes I, II and III of serum acid phosphatase were observed. Acid phosphatase of prostatic adenoma tissue surgically removed from prostatic hypertrophy patients consists of two isozymes II and III which are chromatographically corresponding to those isozymes of serum acid phosphatase. Serological analyses and inhibitor- enzyme specificities led us to conclude that serum isozymes II and III are derived from prostatic gland. In cancer patients without bone metastasis, a greatly increased activity of isozyme III and normal level of isozyme II in serum acid phosphatase were observed. However in prostatic cancer patient with advanced bone metastasis, a huge increase of serum isozyme II activity was observed whereas isozyme III is at an undertectable level. These isozyme variations in serum acid phosphatase suggest that assay of each isozyme is a valuable approach for diagnosis and judgement of prognosis of prostatic cancer

A new prognostic index for overall survival in malignant pleural mesothelioma: the rPHS (regimen, PS, histology or stage) index.

First published online: April 2, 2015[Objective] Existing prognostic indices for malignant pleural mesothelioma do not incorporate the recent advances in oncology care. The purpose of this study was to provide a prognostic index for overall survival in malignant pleural mesothelioma patients treated with chemotherapy with pemetrexed or best supportive care in the recent clinical setting. [Methods] A retrospective cohort study was performed in two hospitals in Japan (2007–13). The primary outcome was overall survival. The Cox proportional hazards model was used for multivariable analyses to identify prognostic factors. A final model was chosen based on both clinical and statistical significance. [Results] A total of 283 patients (chemotherapy: n = 228, best supportive care: n = 55) were enrolled in the study. On multivariate analysis, regimen including platinum plus pemetrexed, a performance status >0, non-epithelial histological type and Stage IV disease predicted poor overall survival in chemotherapy patients. As hazard ratios of individual risk factors were approximately similar, a prognostic index for overall survival was constructed by counting the risk factors. Median overall survival in chemotherapy patients decreased by each one-point increase in this count: 1030 days for zero; 658 days for one; 373 days for two; 327 days for three; 125 days for four. Internal validation using the bootstrapping technique showed robustness of the model (c-index, 0.677; 95% confidence interval, 0.624–0.729). Further, the discrimination was consistent in best supportive care patients (c-index, 0.799; 95% confidence interval, 0.725–0.874). [Conclusions] This novel index can provide clinicians and malignant pleural mesothelioma patients with a better framework for discussing prognosis at the time of diagnosis

Bullet-shaped magnetosomes and metagenomic-based magnetosome gene profiles in a deep-sea hydrothermal vent chimney

Magnetosome-producing microorganisms can sense and move toward the redox gradient and have been extensively studied in terrestrial and shallow marine sediment environments. However, given the difficulty of sampling, magnetotactic bacteria (MTB) are poorly explored in deep-sea hydrothermal fields. In this study, a deep-sea hydrothermal vent chimney from the Southern Mariana Trough was collected using a remotely operated submersible. The mineralogical and geochemical characterization of the vent chimney sample showed an internal iron redox gradient. Additionally, the electron microscopy of particles collected by magnetic separation from the chimney sample revealed MTB cells with bullet-shaped magnetosomes, and there were minor occurrences of cuboctahedral and hexagonal prismatic magnetosomes. Genome-resolved metagenomic analysis was performed to identify microorganisms that formed magnetosomes. A metagenome-assembled genome (MAG) affiliated with Nitrospinae had magnetosome genes such as mamA, mamI, mamM, mamP, and mamQ. Furthermore, a diagnostic feature of MTB genomes, such as magnetosome gene clusters (MGCs), including mamA, mamP, and mamQ, was also confirmed in the Nitrospinae-affiliated MAG. Two lines of evidence support the occurrence of MTB in a deep-sea, inactive hydrothermal vent environment

Difference of co-extracted electron current and beam acceleration in a negative ion source with hydrogen-isotope ions

Improvement of the performance on a hydrogen/deuterium negative ion source for a nuclear fusion device is reported. In particular, the suppression of the co-extracted electron current, Ie, is an important issue to ensure the stable beam acceleration. Improvement of the Ie has been confirmed by optimizing the magnetic field of the electron deflection magnet in the extraction grid. Two other new methods for reduction of the Ie were validated. The first was an electron fence whose rods were set between the rows of apertures on a plasma grid. The electron and negative ion current ratio, approximately Ie/Iacc, was greatly improved from 0.7 to 0.25 in deuterium. The second was an outer iron yoke which enhanced the magnetic flux density 19% inside the arc discharge chamber. The Ie/Iacc using the outer yoke decreased by 0.1 compared with using a normal magnetic filter in a deuterium operation. These attempts have improved the total deuterium injection beam power of 8.4 MW by three negative ion based NBIs

No relationship exists between PBP 2a amounts expressed in different MRSA strains obtained clinically and their β-lactam MIC values

After establishing a linear relationship between the amount of penicillinbinding protein (PBP) 2a and membrane proteins of methicillin-resistant Staphylococcus aureus (MRSA) COL by dot-blot analysis using an antibody against PBP 2a, we determined the PBP 2a quantities in membrane fractions prepared from 14 different MRSA cells. Methicillin-sensitive S. aureus ATCC 6538P was used as a quality control strain. The amounts of PBP 2a diverged among the strains, and no relationship to β-lactam MIC values were observed in the corresponding strains