Comparison of the effects of forefoot joint-preserving arthroplasty and resection-replacement arthroplasty on walking plantar pressure distribution and patient-based outcomes in patients with rheumatoid arthritis

Purpose: The purpose of this retrospective study is to clarify the difference in plantar pressure distribution during walking and related patient-based outcomes between forefoot joint-preserving arthroplasty and resection-replacement arthroplasty in patients with rheumatoid arthritis (RA). Methods: Four groups of patients were recruited. Group1 included 22 feet of 11 healthy controls (age 48.6 years), Group2 included 36 feet of 28 RA patients with deformed non-operated feet (age 64.8 years, Disease activity score assessing 28 joints with CRP [DAS28-CRP] 2.3), Group3 included 27 feet of 20 RA patients with metatarsal head resection-replacement arthroplasty (age 60.7 years, post-operative duration 5.6 years, DAS28-CRP 2.4), and Group4 included 34 feet of 29 RA patients with metatarsophalangeal (MTP) joint-preserving arthroplasty (age 64.6 years, post-operative duration 3.2 years, DAS28-CRP 2.3). Patients were cross-sectionally examined by F-SCAN II to evaluate walking plantar pressure, and the self-administered foot evaluation questionnaire (SAFE-Q). Twenty joint-preserving arthroplasty feet were longitudinally examined at both pre- and post-operation. Results: In the 1st MTP joint, Group4 showed higher pressure distribution (13.7%) than Group2 (8.0%) and Group3 (6.7%) (P<0.001). In the 2nd-3rd MTP joint, Group4 showed lower pressure distribution (9.0%) than Group2 (14.5%) (P<0.001) and Group3 (11.5%) (P<0.05). On longitudinal analysis, Group4 showed increased 1st MTP joint pressure (8.5% vs. 14.7%; P<0.001) and decreased 2nd-3rd MTP joint pressure (15.2% vs. 10.7%; P<0.01) distribution. In the SAFE-Q subscale scores, Group4 showed higher scores than Group3 in pain and pain-related scores (84.1 vs. 71.7; P<0.01) and in shoe-related scores (62.5 vs. 43.1; P<0.01). Conclusions: Joint-preserving arthroplasty resulted in higher 1st MTP joint and lower 2nd-3rd MTP joint pressures than resection-replacement arthroplasty, which were associated with better patient-based outcomes.Ebina K., Hirao M., Takagi K., et al. (2017) Comparison of the effects of forefoot joint-preserving arthroplasty and resection-replacement arthroplasty on walking plantar pressure distribution and patient-based outcomes in patients with rheumatoid arthritis. PLoS ONE 12(8): e0183805. doi: 10.1371/journal.pone.0183805

Familial and sporadic chronic progressive degenerative parietal ataxia

Background & objective: Parietal ataxia has been mainly reported as a consequence of acute ischemic stroke, while degenerative parietal ataxia has not been reported. Methods: We investigated clinical characteristics, neuroimaging data, and genetic analysis of patients with cerebellar ataxia plus parietal atrophy. Results: We identified seven patients, including five patients from two families, with chronic progressive cerebellar ataxia due to degenerative parietal atrophy but not stroke. Age at onset of ataxia was 57.6 +/- 6.9 years. All patients showed chronic progressive cerebellar ataxia with severity of ataxic gait > limb ataxia > dysarthria. Patients showed no cognitive dysfunction, muscle weakness, or parkinsonism, and only two patients showed mild sensory disturbances. The seven patients showed lateralized limb ataxia with greater contralateral parietal lobe atrophy by magnetic resonance imaging, and hypoperfusion by single photon emission computed tomography, without any abnormal cerebellar pathology (i.e., crossed cerebellar diaschisis). Pathogenic mutations in the microtubule-associated protein tau gene were not found using two single nucleotide polymorphisms. Conclusions: This is the first description showing unique clinical features of familial and sporadic chronic progressive degenerative parietal ataxia

Comparison of the effects of denosumab between a native vitamin D combination and an active vitamin D combination in patients with postmenopausal osteoporosis

The aim of this 12-month, retrospective study was to compare the effects of denosumab (DMAb; 60 mg subcutaneously every 6 months) plus native vitamin D (VD) (cholecalciferol) combination therapy with DMAb plus active VD analog (alfacalcidol) combination therapy in patients with postmenopausal osteoporosis. Patients [N = 127; mean age 75.6 years (range 58–93 years); 28 treatment-naïve patients, 59 patients treated with oral bisphosphonate therapy, 40 patients treated with teriparatide daily] were allocated to either (1) the DMAb plus native VD group (n = 60; cholecalciferol, 10 μg, plus calcium, 610 mg/day; 13 treatment-naïve patients, 28 patients treated with oral bisphosphonate therapy, and 19 patients treated with teriparatide daily) or (2) the DMAb plus active VD group [n = 67; alfacalcidol, 0.8 ± 0.0 μg, plus calcium, 99.2 ± 8.5 mg/day; 15 treatment-naïve patients, 31 patients treated with oral bisphosphonate therapy, and 21 patients treated with teriparatide daily) on the basis of each physician’s decision. Changes in bone mineral density (BMD), serum bone turnover marker levels, and fracture incidence were monitored every 6 months. There were no significant differences in baseline age, BMD, bone turnover marker levels, and prior treatments between the two groups. After 12 months, compared with the DMAb plus native VD group, the DMAb plus active VD group showed similar increases in the BMD of the lumbar spine (6.4% vs 6.5%) and total hip (3.3% vs 3.4%), but significantly greater increases in the BMD of the femoral neck (1.0% vs 4.9%, P < 0.001) and the distal part of the forearm (third of radius) (−0.8% vs 3.9%, P < 0.01). These tendencies were similar regardless of the differences in the prior treatments. The rates of decrease of bone turnover marker levels were similar for tartrate-resistant acid phosphatase isoform 5b (−49.0% vs −49.0%), procollagen type I N-terminal propeptide (−45.9% vs −49.3%), and undercarboxylated osteocalcin (−56.0 vs −66.5%), whereas serum intact parathyroid hormone levels were significantly lower in the DMAb plus active VD group (47.6 pg/mL vs 30.4 pg/mL, P < 0.001). The rate of hypocalcemia was 1.7% in the DMAb plus native VD group and 1.5% in the DMAb plus active VD group, and the rate of clinical fracture incidence was 8.3% in the DMAb plus native VD group and 4.5% in the DMAb plus active VD group, with no significant difference between the groups. DMAb with active VD combination therapy may be a more effective treatment option than DMAb with native VD combination therapy in terms of increasing BMD of the femoral neck and distal part of the forearm and also maintaining serum intact parathyroid hormone at lower levels.This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s00774-016-0792-5Ebina K., Kashii M., Hirao M., et al. Comparison of the effects of denosumab between a native vitamin D combination and an active vitamin D combination in patients with postmenopausal osteoporosis. Journal of Bone and Mineral Metabolism 35, 571 (2017); https://doi.org/10.1007/s00774-016-0792-5

An Optimized Photoelectron Track Reconstruction Method for Photoelectric X-Ray Polarimeters

We present a data processing algorithm for angular reconstruction and event selection applied to 2-D photoelectron track images from X-ray polarimeters. The method reconstructs the initial emission angle of a photoelectron from the initial portion of the track, which is obtained by continuously cutting a track until the image moments or number of pixels fall below tunable thresholds. In addition, event selection which rejects round tracks quantified with eccentricity and circularity is performed so that polarimetry sensitivity considering a trade-off between the modulation factor and signal acceptance is maximized. The modulation factors with applying track selection are 26.6 0.4, 46.1 0.4, 62.3 0.4, and 61.8 0.3% at 2.7, 4.5, 6.4, and 8.0 keV, respectively, using the same data previously analyzed by Iwakiri et al. (2016), where the corresponding numbers are 26.90.4, 43.40.4, 54.40.3, and 59.1 0.3%. The method improves polarimeter sensitivity by 5%10% at the high energy end of the band previously presented (Iwakiri et al. 2016)

Development of Gas Multiplier Counters (GMCs) Onboard the 6U CubeSat X-Ray Observatory NinjaSat

We report the development of Gas Multiplier Counters (GMCs) onboard the 6U CubeSat X-ray observatory NinjaSat, scheduled to be launched in October 2023. GMC is a 1U-size non-imaging gas X-ray detector sensitive to 2–50 keV X-rays, and two identical GMCs are mounted on NinjaSat. GMC consists of a gas cell filled with a xenon/argon/dimethyl ether (75%/24%/1%) gas mixture with a pressure of 1.2 atm at 0◦C, a high voltage supply and analog signal processing board, a digital signal processing board, an X-ray collimator of a 2.1◦ field of view, and an iron-55 calibration source. The most significant feature of the GMC is its large effective area of 32 cm2 at 6 keV, which is more than two orders of magnitude larger than the X-ray detectors onboard previously launched CubeSats. We have achieved this at a low cost and in a short development time by employing a gas detector that can easily increase its effective area and using a space-proven gas electron multiplier. GMC was characterized with X-rays from an X-ray generator in a laboratory and monochromatic X-rays on the BL-14A beamline at the KEK synchrotron radiation facility. In this paper, we present the design of GMC and the preliminary results of the detector calibration

NinjaSat: 6U CubeSat Observatory for Bright X-Ray Sources

NinjaSat is a 6U CubeSat observatory designed for long-term monitoring of bright X-ray sources, such as binary systems between normal stars and black holes or neutron stars. NinjaSat is the first Japanese CubeSat dedicated to astronomical observation, and it is also a mission to demonstrate that even a small satellite, which can be developed quickly and inexpensively, unlike large satellites, can perform excellent scientific observations. NinjaSat realizes the world’s highest X-ray sensitivity in CubeSat missions by using gas X-ray detectors filling the entire space allocated for science payloads. The fabrication of the flight model payloads began in 2021, and testing at the payload component level was completed in August 2022; as of April 2023, the payloads were integrated into the Nano Avionics 6U bus (M6P) in Lithuania. After four months of testing, the payload will be stored in the Exolaunch deployer in August and launched by the SpaceX Transporter-9 mission in October 2023. This paper will describe the scientific objectives, satellite structure, payloads, and operations of NinjaSat

Development of Radiation Belt Monitors for the 6U CubeSat X-Ray Observatory NinjaSat

NinjaSat is a 6U CubeSat-sized X-ray observatory to be launched into the low Earth orbit at an altitude of 550 km, and is scheduled for launch this October. NinjaSat is equipped with two 1U-sized gas X-ray detectors (GMC) and is expected to operate mainly for astronomical observations of bright X-ray objects in the sky, such as neutron stars and black holes. Since high voltages are applied to the gas cells of GMC, two radiation belt monitors (RBM) will also be installed to protect GMC from electrical discharges potentially caused by excessively high rate of charged particles. NinjaSat RBM will play a fail-safe function in the voltage suppression operation of GMC in the auroral zone and South Atlantic Anomaly, and also protect GMC from charged particles such as protons and electrons that arrive unexpectedly due to solar flares or other low-Earth orbit radiation events. RBM uses a 9 mm x 9 mm Si-PIN photodiode as a charged particle sensor. By taking advantage of the difference in sensor response to protons and electrons, the sensor is designed to simultaneously count charged particle rates at multiple energy thresholds so that GMC protection function will operate even if either the proton or electron rate increases. RBM can count up to about 10 kcps with almost no loss of counts, and proton beam tests have confirmed that the response performance is sufficient to protect GMC against excessively high charged particle rates above 10 Mcps without choking the circuitry. The flight models of the RBM have passed the thermal vacuum and vibration tests last year. The developed RBM occupies only about 6% of the 1U CubeSat size in volume and weighs only 70g. In addition, since the RBM uses inexpensive, commercially available sensors, it could be installed on small satellites other than NinjaSat with relatively small development resources