Cognitive function among hemodialysis patients in Japan

<p>Abstract</p> <p>Background</p> <p>Over 290,000 patients are undergoing hemodialysis (HD) in Japan. With old age, the odds of undergoing HD treatment sharply increase, as does the prevalence of cognitive impairment. The aim of the present work was to assess cognitive impairment in HD patients and its relation to clinical characteristics.</p> <p>Methods</p> <p>Using a cross-sectional design, we administered the Mini-Mental State Examination (MMSE) to 154 HD outpatients and 852 participants from the Iwaki Health Promotion Project 2010, representing the general population.</p> <p>Results</p> <p>The prevalence of cognitive impairment based on the MMSE was 18.8% in HD patients. HD patients showed a higher prevalence of cognitive impairment in older groups (50 years and older). In a logistic regression model with age, gender and amount of education as covariates, undergoing HD was a significant independent factor (OR = 2.28, 95% CI 1.33 to 3.94) associated with a lower MMSE score. Among HD patients, we found that level of education was associated with MMSE score.</p> <p>Conclusions</p> <p>There is a high prevalence of cognitive impairment among HD patients that has adverse implications for hospitalization and shortens their life expectancy. HD treatment was an independent risk factor for cognitive impairment. Clinicians should carefully monitor and treat cognitive impairment in HD patients. Further studies are required to determine the reasons for cognitive impairment in HD patients.</p

Effects of different representations of stomatal conductance response to humidity across the African continent under warmer CO2-enriched climate conditions

General circulation models (GCMs) forecast higher global vapor pressure deficit (VPD) but unchanged global relative humidity (RH) in future climates. A literature survey revealed that 50% of Earth system models (ESMs) and land surface models (LSMs) embedded within GCMs employ RH as an atmospheric aridity index when describing stomatal conductance (gs), whereas the remaining 50% employ VPD. The consequences of using RH or VPD in gs models for water cycling and vegetation productivity in future climates on large spatial and temporal scales remain to be explored. Process-based global dynamic vegetation model runs, changes in the hydrological cycle, and concomitant vegetation productivity for the 21st century projected climate were conducted by altering only gs responses to VPD or RH and not changing any other formulations. In the simulations of the African continent under a 21st century warming trend, both stomatal functions of VPD and RH resulted in similar gross geographic patterns in primary production (GPP). However, continental total GPP was larger for the VPD response than that for the RH response. Transpiration rates were lower, resulting in a 13% increase in water-use efficiency for the VPD response compared with its RH counterpart

Study of Sumida River, Part-1; Its COD and EC characteristics from data collected in spring, 2021

The Sumida River, a typical urban river in Tokyo, has been recognized as a site for fostering Tokyo’s urbanlife that serves as a venue of leisure and relaxation for its residents. As the Teikyo University of Science(TUS) is located near the Sumida River, students spend a lot of time nearby. Clarifying the characteristics ofSumida River, and teaching it to students, are important not only for enhancing environmental awarenessamong students, but also local environment conservation. In this study, chemical oxygen demand (COD)and electric conductivity (EC) data, major sources of contamination, and the characteristics of the river wereanalyzed and interpreted as follows. 1) Although our COD and EC data showed that Sumida River wasaffected by tidal movement, the river water in our research area (from Otakebashi Bridge to Senju-OhashiBridge) might exhibit backward and forward movements, and it was slightly affected by sea water from theTokyo Bay. 2) Major chemical contaminant sources of investigated area were determined to be the Miyagiwastewater purification facility (WPF) and the Mikawajima WPF at the upstream and downstream sides ofthe TUS, respectively. 3) We presume a two-fraction zone in the Sumida River from our analytical resultsand public data, including a "high COD zone" with an upstream stagnant zone upper the Shirahige Bridge,and a "low COD zone" with a downstream flush zone under the Shirahige Bridge. Raising environmentalawareness concerning the urban river among its residents presumably might contribute to maintaining itsclean and safe environment. We came to conclusion that the importance of educating the citizens aboutkeeping urban rivers environmentally clean and safe for the future generations

Study of Sumida River, Part 2: Analysis of Identification of COD and EC Characteristics in Fall 2021

The Sumida River streamside makes up a part of the Kitasenjyu campus at Teikyo University of Science(TUS). It is essential for university students and faculty members to learn its environmental and chemical characteristics from the viewpoint of environmental education. A water analysis of the Sumida River was conducted in the fall season (Fall 2021) at 10 locations around the Kitasenjyu campus, along with a 24-hour continuous survey in front of the No. 7 building. The fall analysis was performed using the same procedure as the previous analysis in spring (Spring 2021). The conclusions we reached are as follows: 1) Discharge water from the Mikawagima wastewater purification facility (WPF) was found to be the primary source of chemical contamination in the study area, causing an increase in COD (chemical oxygen demand). Upstream, Miyagi WPF was presumed to be the primary source of the chemical contamination. 2) The discharged high COD water from these WPFs was diffused by the tidal movement of Tokyo Bay and then was homogenized in the study area. 3) From our survey on the streaming motion of the Sumida River and public COD data from the Tokyo metropolitan government, we redefined the boundary between high and low COD zones set under the Agastuma Bridge. 4) Urethane foam with photocatalysis material of TiO2 was synthesized as a novel wastewater treatment material. As it displayed good decomposition characteristics oforganic material in tested water, porous and robust materials with TiO2 for continuous outdoor use should be investigated to achieve practical applications shortly

Malignant transformation arising from mature cystic teratoma of the ovary presenting as ovarian torsion: a case report and literature review

Objective: Ovarian torsion is an acute gynecological condition. Torsion is more likely to occur with benign rather than malignant tumors. Mature cystic teratoma of the ovary (MCTO) is frequent in women of reproductive age; however, the incidence of malignant transformation is approximately 2%. We report a case of malignant transformation of MCTO presenting as ovarian tumor torsion. Case report: A 51-year-old premenopausal woman was diagnosed with mature cystic teratoma in the left ovary 7 years ago. The patient visited our hospital because she had been experiencing of pain in left lower abdomen for the past two days. She was diagnosed with ovarian tumor torsion and underwent emergency surgery. The left ovarian tumor was twisted, and left salpingo-oophorectomy was performed. Histopathological examination revealed squamous cell carcinoma arising from the MCTO. We carefully followed the patients without performing staging laparotomy. On postoperative day 112, multiple lymph node metastases in the pelvic and para-aortic areas were found by positron-emission tomography and computed tomography. After referral to a university hospital, total hysterectomy, right salpingo-oophorectomy, partial omentectomy, and pelvic and paraaortic lymphadenectomy were performed. Metastases of squamous cell carcinoma were confirmed in the pelvic and para-aortic lymph nodes. Six courses of adjuvant chemotherapy with paclitaxel and carboplatin were given following radical surgery to prevent the recurrence of malignant transformation of MCTO. No recurrence of the disease has been observed during 2 years of follow-up. Conclusio: When physicians diagnose large ovarian tumor torsion cases, preoperative examinations should be performed, with the possibility of malignancy in mind

Involvement of (pro)renin receptor in the glomerular filtration barrier

(Pro)renin receptor-bound prorenin not only causes the generation of angiotensin II via the nonproteolytic activation of prorenin, it also activates the receptor’s own intracellular signaling pathways independent of the generated angiotensin II. Within the kidneys, the (pro)renin receptor is not only present in the glomerular mesangium, it is also abundant in podocytes, which play an important role in the maintenance of the glomerular filtration barrier. Recent in vivo studies have demonstrated that the overexpression of the (pro)renin receptor to a degree similar to that observed in hypertensive rat kidneys leads to slowly progressive nephropathy with proteinuria. In addition, the handle region peptide, which acts as a decoy peptide and competitively inhibits the binding of prorenin to the receptor, is more beneficial than an angiotensin-converting enzyme inhibitor with regard to alleviating proteinuria and glomerulosclerosis in experimental animal models of diabetes and essential hypertension. Thus, the (pro)renin receptor may be upregulated in podocytes under hypertensive conditions and may contribute to the breakdown of the glomerular filtration barrier

Efficacy and safety of once-monthly pasireotide in Cushing's disease: A 12 month clinical trial

© 2017 Elsevier Ltd. Background: Cushing's disease is a rare debilitating endocrine disorder for which few prospective interventional studies have been done. We report results of the first phase 3 trial assessing long-acting intramuscular pasireotide in patients with Cushing's disease. Methods: In this phase 3 clinical trial we recruited patients aged 18 years or older with persistent, recurrent, or de-novo (non-surgical candidates) Cushing's disease who had a mean urinary free cortisol (mUFC) concentration (from three 24 h samples) of 1·5-5·0 times the upper limit of normal (ULN), a normal or greater than normal morning plasma adrenocorticotropic hormone concentration, and a pituitary source of Cushing's syndrome, from 57 sites across 19 countries. Exclusion criteria included previous pasireotide treatment, mitotane therapy within 6 months, and pituitary irradiation within 10 years. We randomly allocated patients 1:1 (block size of four) using an interactive-response-technology system to intramuscular pasireotide 10 mg or 30 mg every 4 weeks for 12 months (in the core phase). We stratified randomisation by screening mUFC concentration (1·5 to < 2·0 × ULN and 2·0-5·0 × ULN). The dose could be uptitrated (from 10 mg to 30 mg or from 30 mg to 40 mg) at month 4 if the mUFC concentration was greater than 1·5 × ULN, and at month 7, month 9, or month 12 if the mUFC concentration was greater than 1·0 × ULN. Investigators, patients, site personnel, and those assessing outcomes were masked to dose group allocation. The primary endpoint was the proportion of patients in each group with an mUFC concentration of less than or equal to the ULN at month 7. Efficacy analyses were based on intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01374906. Findings: Between Dec 28, 2011, and Dec 9, 2014, we randomly allocated 150 patients to receive pasireotide 10 mg (74 [49%] patients) or 30 mg (76 [51%] patients). The primary efficacy endpoint was met by 31 (41·9% [95% CI 30·5-53·9]) of 74 patients in the 10 mg group and 31 (40·8% [29·7-52·7] ) of 76 in the 30 mg group. The most common adverse events were hyperglycaemia (36 [49%] in the 10 mg group and 36 [47%] in the 30 mg group), diarrhoea (26 [35%] and 33 [43%] ), cholelithiasis (15 [20%] and 34 [45%] ), diabetes mellitus (14 [19%] and 18 [24%] ), and nausea (15 [20%] and 16 [21%] ). Serious adverse events suspected to be study drug related were reported in eight (11%) patients in the 10 mg group and four (5%) in the 30 mg group. Two (3%) patients in the 30 mg group died during the study (pulmonary artery thrombosis and cardiorespiratory failure); neither death was judged to be related to the study drug. Interpretation: Long-acting pasireotide normalised mUFC concentration in about 40% of patients with Cushing's disease at month 7 and had a similar safety profile to that of twice-daily subcutaneous pasireotide. Long-acting pasireotide is an efficacious treatment option for some patients with Cushing's disease who have persistent or recurrent disease after initial surgery or are not surgical candidates, and provides a convenient monthly administration schedule. Funding: Novartis Pharma AG

Balance and Behavior of Carbon Dioxide at an Urban Forest Inferred from the Isotopic and Meteorological Approaches

From the 17th International Radiocarbon Conference held in Jerusalem, Israel, June 18-23, 2000.Diurnal variations in δ14C, delta-13C and the concentration of atmospheric carbon dioxide in an urban forest were measured on 9 February 1999 to discriminate and quantify contributions from different CO2 sources. The biogenic CO2 concentration remained relatively constant throughout the day. However, anthropogenic CO2 concentration fluctuated with the atmospheric CO2 concentration, and seemed to be controlled by wind velocity and the amount of exhaust gases from fossil fuel burning. The vertical profiles of anthropogenic, biogenic, and total CO2 showed a constant concentration within forest during daytime because of the large vertical CO2 influx, strong winds, and neutral atmospheric condition. The biogenic contribution at night decreased from the forest floor upwards with a smooth gradient, while the anthropogenic contribution showed a direct mirror because of the location of respective CO2 sources—the vertical gradient of wind velocity and the horizontal CO2 supplyThe Radiocarbon archives are made available by Radiocarbon and the University of Arizona Libraries. Contact [email protected] for further information.Migrated from OJS platform February 202