The Japanese Clinical Practice Guideline for acute kidney injury 2016

Acute kidney injury (AKI) is a syndrome which has a broad range of etiologic factors depending on different clinical settings. Because AKI has significant impacts on prognosis in any clinical settings, early detection and intervention are necessary to improve the outcomes of AKI patients. This clinical guideline for AKI was developed by a multidisciplinary approach with nephrology, intensive care medicine, blood purification, and pediatrics. Of note, clinical practice for AKI management which was widely performed in Japan was also evaluated with comprehensive literature search

Deformation of mineral crystals in cortical bone depending on structural anisotropy

The deformation mechanism of bone at different hierarchical levels has been of wide interest. The important features of bone, its anisotropy and orientation dependent deformation are equally important, which have also gained a long run discussion. Most of the studies are concentrated on protein-rich collagen fibres and matrix, where different deformation mechanisms at the lower length scales are proposed. But in relation to this, how the mineral particles behave depending on their distribution is yet to be revealed in detail. In the present work, we demonstrate mineral crystals deformation and arrangement characteristics on the basis of experimental outcomes. Using X-ray diffraction procedures, we quantified the mineral strains, degree of orientation of the crystallites and their evolution under different applied step-loads in bovine femoral cortical specimens having different alignment with the femoral axis direction. We provide a direct quantitative comparison of these parameters in the specimens having preferential orientations roughly at 0, 30, 45, 75 and 90 degrees with reference to the loading direction. The mineral strains in the compliant specimens, i.e. 0 and 30 degrees oriented specimens were observed to differ with the stiffer specimens, i.e. 75 and 90 degrees oriented specimens, whereas the 45 degrees oriented specimen show almost equal strains at different loads. These were explained by the degree of orientation with reference to the loading direction and the preferential orientation direction of the specimens. On the basis of observed parameters, we describe deformation phenomena of mineral particles to occur ill different stages, which consist of redistribution stage, elastic strain stage and inelastic strain stage. These phenomena are expected to occur at different scales and rates depending on the orientation and distribution of crystals

Development of Fast-Neutron Directional Detector for Fusion Neutron Profile Monitor at LHD

Fast-neutron directional detectors using scintillating optical fibers have been adopted for neutron emission profile measurement in magnetic confinement fusion devices. Because of their benefits of rapid response and directional properties to reduce restrictions on shielding, they are anticipated for installation in the Large Helical Device (LHD) of the National Institute for Fusion Science (NIFS). As described herein, the system design has been re-examined based on the results of recent experiments and simulations. Results show that fast neutrons with high energy of 14 MeV are attenuated by a self-shielding effect of scintillating fiber. Moreover, it has been demonstrated that the scintillation photons are attenuated in several centimeters before reaching the photon detector. The control of the photon transmission efficiency is important to enhance the directional property of the system. Along with reduced effects of the background gamma rays, adopting a thin scintillating fiber is effective. Further evaluation should be conducted to design a detector system considering the detecting efficiency, directional property, and gamma ray effect for application to an actual radiation field of the LHD

The Effect of a mHealth App (KENPO-app) for Specific Health Guidance on Weight Changes in Adults With Obesity and Hypertension: Pilot Randomized Controlled Trial

BackgroundCommercial smartphone apps that promote self-monitoring of weight loss are widely available. The development of disease-specific apps has begun, but there is no app for specific health guidance (SHG) to prevent metabolic syndrome, type 2 diabetes, and cardiovascular diseases in middle-aged adults in Japan. ObjectiveThis study aimed to determine the efficacy of an SHG mobile health app in facilitating weight loss in Japanese adults with obesity and hypertension. MethodsIn a 12-week, statistician-blinded, randomized parallel controlled trial, 78 overweight and obese men aged 40-69 years were assigned in a 1:1 ratio to either the usual support plus KENPO-app group (intervention group) or the active control group. KENPO-app (release April 10, 2019; OMRON Healthcare Co., Ltd.) was developed by the study team and focus groups and uses behavior change techniques (ie, self-monitoring and goal-setting theory). This app was developed for SHG based on the four specific health checkups and guidance system in Japan: (1) focusing primarily on achieving the target (weight loss of ≥2 kg); (2) assessing healthy eating, exercise habits, smoking habits, relaxation, and self-weighing; (3) providing information on the results of specific health checkups; and (4) starting an intervention period of 6 months with the interim assessment at 3 months. The initial assessment explored the following: personality traits (4 types), health checkup data concerns (10 items), symptom concerns (10 items), and the aim of the intervention (weight loss, improving fitness, symptoms, laboratory data). Chatbot-supported health information on health and health behavior was selected from 392 quizzes based on app data and was provided to participants. The KENPO-app had chatbot-supported feedback and information provision combined with a self-monitoring tool (weight, steps, and blood pressure). Data on active exercise, healthy eating, and healthy lifestyle habits were obtained using a web-based self-administered questionnaire at baseline and 12 weeks. ResultsThe trial’s retention rate was 95% (74/78). The adherence to daily self-weighing, wearing the pedometer, and blood pressure monitoring in the KENPO-app group was significantly higher than those in the active control group. Compared with the active control group, the median body weight and BMI of the intervention group significantly decreased at 3 months (–0.4, IQR –2.0 to 0.6 kg vs –1.1, IQR –2.7 to –0.5 kg; P=.03; –0.1, IQR –0.6 to 0.3 kg vs –0.4, IQR –0.8 to –0.2 kg; P=.02, respectively). The intervention increased the percentage of participants who self-reported taking ≥8000 steps, eating vegetables before rice, eating slowly, and relaxing. Personality traits were associated with the degree of weight loss in the intervention group. ConclusionsThe SHG-specific KENPO-app was feasible and induced modest but significant weight loss in adults with obesity. Trial RegistrationUniversity Hospital Medical Information Network Center UMIN000046263; https://tinyurl.com/bderys3

Knockdown of <i>wfs1</i>, a fly homolog of Wolfram syndrome 1, in the nervous system increases susceptibility to age- and stress-induced neuronal dysfunction and degeneration in <i>Drosophila</i>

<div><p>Wolfram syndrome (WS), caused by loss-of-function mutations in the Wolfram syndrome 1 gene (<i>WFS1</i>), is characterized by juvenile-onset diabetes mellitus, bilateral optic atrophy, and a wide spectrum of neurological and psychiatric manifestations. <i>WFS1</i> encodes an endoplasmic reticulum (ER)-resident transmembrane protein, and mutations in this gene lead to pancreatic β-cell death induced by high levels of ER stress. However, the mechanisms underlying neurodegeneration caused by <i>WFS1</i> deficiency remain elusive. Here, we investigated the role of <i>WFS1</i> in the maintenance of neuronal integrity <i>in vivo</i> by knocking down the expression of <i>wfs1</i>, the <i>Drosophila</i> homolog of <i>WFS1</i>, in the central nervous system. Neuronal knockdown of <i>wfs1</i> caused age-dependent behavioral deficits and neurodegeneration in the fly brain. Knockdown of <i>wfs1</i> in neurons and glial cells resulted in premature death and significantly exacerbated behavioral deficits in flies, suggesting that <i>wfs1</i> has important functions in both cell types. Although <i>wfs1</i> knockdown alone did not promote ER stress, it increased the susceptibility to oxidative stress-, excitotoxicity- or tauopathy-induced behavioral deficits, and neurodegeneration. The glutamate release inhibitor riluzole significantly suppressed premature death phenotypes induced by neuronal and glial knockdown of <i>wfs1</i>. This study highlights the protective role of <i>wfs1</i> against age-associated neurodegeneration and furthers our understanding of potential disease-modifying factors that determine susceptibility and resilience to age-associated neurodegenerative diseases.</p></div