Robust prognostic prediction model developed with integrated biological markers for acute myocardial infarction

Commonly used prediction methods for acute myocardial infarction (AMI) were created before contemporary percutaneous coronary intervention was recognized as the primary therapy. Although several studies have used machine learning techniques for prognostic prediction of patients with AMI, its clinical application has not been achieved. Here, we developed an online application tool using a machine learning model to predict in-hospital mortality in patients with AMI. A total of 2, 553 cases of ST-elevation AMI were assigned to 80% training subset for cross validation and 20% test subset for model performance evaluation. We implemented random forest classifier for the binary classification of in-hospital mortality. The selected best feature set consisted of ten clinical and biological markers including max creatine phosphokinase, hemoglobin, heart rate, creatinine, systolic blood pressure, blood sugar, age, Killip class, white blood cells, and c-reactive protein. Our model achieved high performance: the area under the curve of the receiver operating characteristic curve for the test subset, 0.95: sensitivity, 0.89: specificity, 0.91: precision, 0.43: accuracy, 0.91 respectively, which outperformed common scoring methods. The freely available application tool for prognostic prediction can contribute to risk triage and decision-making in patient-centered modern clinical practice for AMI

太田川水系におけるナガレトビケラ科幼虫各種の分布様式の違いについて

太田川水系の全体を網羅するいろいろな幼虫群集を調べることによって，ナガレトビケラ科幼虫の分布様式を比較した。合計15種が採集され，どの環境パラメータについても，分布範囲と平均値は種間で著しく異なった。Rhyacophila bilobata，R. shikotsuensisおよびR. sp. RFは，源流からの距離，川幅および流域面積について，狭い範囲と小さな標準偏差を示した。各パラメータを標準化し，8つのパラメータについての分布平均に基づいてクラスター分析を行った。すべて原始的な種であるR. bilobata，R. clemensとR. sp. RKからなるクラスターは，高標高，急な川床勾配，小規模，貧栄養で低温の水域に適応してきたと推定された。共に派生的な種であるR. nigrocephalaとR.yamanakensisからなるクラスターは，低標高，緩い川床勾配，大規模，富栄養で高温の水域に適応してきたと推定された。さらに，Nigrocephalaグループの一員であるR. nigrocephalaがR.nigrocephalaのクラスターを形成したのに対し，同グループのR. kawamuraeはApsilochoremasutshanumのクラスターに加わった。これらの結果は，祖先種の本来の生息地は源流域であること，分布制限要因は種間で異なること，さらに近縁種間で何らかの棲み分けがあることを示唆する。The distribution pattern was compared among the caddisfly larvae of the family Rhyacophilidae by examining the various larval communities covering a total basin of the Ohta River, Japan. A total of 15 species were collected, among which the distribution range and the mean was remarkably different for any environmental parameter. Rhyacophila bilobata, R. shikotsuensis and R. sp. RF showed a narrow range and small standard deviation for distance from riverhead, river width and valley area. Each parameter was standardized, and cluster analysis was performed on the basis of the means of 8 parameters for distribution of each species. A cluster, involving R. bilobata, R. clemens and R. sp. RK, all primitive, was estimated to have adapted to high altitude, steep riverbed slope, small-scale, oligotrophic and low-temperature waters. Another cluster, involving R. nigrocephala and R. yamanakensis, both derivative, was estimated to have adapted to low altitude, loose slope, large-scale, eutrophic and high-temperature waters. Besides, R. kawamurae, a species of Nigrocephala group, participated in an Apsilochorema sutshanum-cluster whereas R. nigrocephala, another species of the same group, constructed a R. nigrocephala-cluster. These suggest that the original habitat of the ancestral species be headwaters, that strongly restricting factors be different among species and that there be some habitat-partitionings among the sibling species

Ghrelin inhibits insulin secretion through the AMPK–UCP2 pathway in β cells

AbstractGhrelin inhibits insulin secretion partly via induction of IA-2β. However, the orexigenic effect of ghrelin is mediated by the AMP-activated protein kinase (AMPK)–uncoupling protein 2 (UCP2) pathway. Here, we demonstrate that ghrelin’s inhibitory effect on insulin secretion also occurs through the AMPK-UCP2 pathway. Ghrelin increased AMPK phosphorylation and UCP2 mRNA expression in MIN6 insulinoma cells. Overexpression or downregulation of UCP2 attenuated or enhanced insulin secretion, respectively. Furthermore, AMPK activator had a similar effect to ghrelin on UCP2 and insulin secretion in MIN6 cells. In conclusion, ghrelin’s inhibitory effect on insulin secretion is partly mediated by the AMPK-UCP2 pathway, which is independent of the IA-2β pathway

The antioxidant N-acetyl cysteine suppresses lidocaine-induced intracellular reactive oxygen species production and cell death in neuronal SH-SY5Y cells

Analysis of cell apoptosis by FACS. Levels of cell apoptosis were measured using an Annexin V-FITC Apoptosis Detection Kit (BioVision, Milpitas, CA, USA), according to the manufacturer’s instructions. For these analyses, SH-SY5Y cells were seeded into 6-well plates (3 × 105 cells/well) and incubated overnight. The following day, cells were treated with the indicated concentrations of the appropriate drug(s) for varying lengths of time and harvested by centrifugation at 1200 rpm for 3 min. The culture supernatants were discharged, and the resulting pellets were resuspended in a mixture comprised of 500 μl binding buffer, 5 μl Annexing V-FITC, and 5 μl propidium iodide (PI; 50 μg/ml) for 5 min at room temperature in the dark and analyzed using a FACSCalibur flow cytometer (BD Biosciences, San Jose, CA, USA). (PDF 2009 kb

ショクドウガン ジュツゴ ニ メチシリン タイセイ ヒョウヒ ブドウキュウキン ニヨル ハイエン オ ガッペイ シタ 1レイ

Methicilin-resistant Staphylococcus aureus (MRSA) is well known as the causative agent in severe infections, but we had recognized methicilin-resistant Staphylococcus epidermidis(MRSE) was not the pathogen. However, MRSE has become to be caused of serious infectious diseases to compromised hosts. A case of severe pneumonia after esophagectomy due to MRSE is reported.A 60 year-old man underwent an esophagectomy for esophageal cancer. During artificial ventilation, on the 6th postoperative day, high fever and leucocytosis were observed, and chest X-P showed severe pneumonia. A tracheotomy was performed and only MRSE was isolated from the sputum. Vancomycin and minocycline were used intravenously. The pneumonia improved gradually and the respirator removed on the 20th postoperative day. MRSE is considered less pathogenic than MRSA, but it is necessary that MRSE is recognized one of the important causes of severe infection after major operations

ピコ秒・フェムト秒時間分解分光法によるジアリールエテン類のフォトクロミック反応ダイナミックスの研究

2002年分子構造総合討論会, 2002年10月1日-10月4日, 神戸国際会議場(神戸), 3A0

Impact of a learning health system on acute care and medical complications after intracerebral hemorrhage

Introduction: Patients with stroke often experience pneumonia during the acute stage after stroke onset. Oral care may be effective in reducing the risk of stroke‐associated pneumonia (SAP). We aimed to determine the changes in oral care, as well as the incidence of SAP, in patients with intracerebral hemorrhage, following implementation of a learning health system in our hospital. Methods: We retrospectively analyzed the data of 1716 patients with intracerebral hemorrhage who were hospitalized at a single stroke center in Japan between January 2012 and December 2018. Data were stratified on the basis of three periods of evolving oral care: period A, during which conventional, empirically driven oral care was provided (n = 725); period B, during which standardized oral care was introduced, with SAP prophylaxis based on known risk factors (n = 469); and period C, during which oral care was risk‐appropriate based on learning health system data (n = 522). Logistic regression analysis was performed to evaluate associations between each of the three treatment approaches and the risk of SAP. Results: Among the included patients, the mean age was 71.3 ± 13.6 years; 52.6% of patients were men. During the course of each period, the frequency of oral care within 24 hours of admission increased (P < .001), as did the adherence rate to oral care ≥3 times per day (P < .001). After adjustment for confounding factors, a change in the risk of SAP was not observed in period B; however, the risk significantly decreased in period C (odds ratio 0.61; 95% confidence interval 0.43‐0.87) compared with period A. These associations were maintained for SAP diagnosed using strict clinical criteria or after exclusion of 174 patients who underwent neurosurgical treatment. Conclusions: Risk‐appropriate care informed by the use of learning health system data could improve care and potentially reduce the risk of SAP in patients with intracerebral hemorrhage in the acute stage