Elucidation of the Mechanism and Significance of the Erythrocyte Sedimentation Rate from Clinical Laboratory Data

The erythrocyte sedimentation rate (ESR) is a widely used marker of inflammation, but the detailed mechanisms underlying the ESR remain unclear. We retrospectively collected laboratory data from our hospital’s laboratory information system, and performed multiple linear regression analysis and correlation analysis to determine relationships between the ESR and other laboratory test parameters. The alpha-2, beta-2, and gamma fractions from serum protein electrophoresis, serum immunoglobulin (Ig) G, IgA, IgM, and complement C3 levels, plasma fibrinogen levels, and platelet count showed positive effects on the ESR; however, the serum albumin level showed negative effects. Since erythrocytes are negatively charged, an increase in positively charged proteins and a decrease in negatively charged albumin were suggested to increase the ESR. Notably, C-reactive protein (CRP) showed the third-strongest correlation with the ESR despite having no significant effect on the ESR. We also reviewed cases with discordant ESR and CRP levels to compare the disease profiles of high ESR/low CRP patients and low ESR/high CRP patients. The patients with high ESR/low CRP had a completely different disease profile from those with low ESR/high CRP. Since the ESR and CRP have different roles, they should be used as markers in a context-dependent manner

Identification of a Novel ACVRL1 Gene Mutation (c.100T>A, p.Cys34Ser) in a Japanese Patient with Possible Hereditary Hemorrhagic Telangiectasia (Osler-Weber-Rendu Disease)

Hereditary hemorrhagic telangiectasia (HHT; also known as Osler-Weber-Rendu disease) is an autosomal dominant genetic disorder that causes frequent epistaxis, mucocutaneous telangiectasia, and visceral arteriovenous malformations. Four genes (ENG, ACVRL1, SMAD4, and GDF2) have been identified as pathogenic in HHT. We describe the case of a 50-year-old Japanese man highly suspected of having HHT due to recurrent epistaxis, mucocutaneous telangiectasia, and a family history. Genomic analysis revealed a novel missense mutation of c.100T>A, p.Cys34Ser in the patient’s ACVRL1 gene. We used 6 freeware programs to perform an in silico analysis of this mutation. The results demonstrated the mutation’s high pathogenicity

Sex differences in the evaluation of proteinuria using the urine dipstick test

BackgroundThe urine protein dipstick test is widely used, but false-positive and false-negative results may occur. This study aimed to compare the urine protein dipstick test with a urine protein quantification method.MethodsThe data were extracted using the Abbott Diagnostic Support System, which analyzes the inspection results using multiple parameters. This study included 41,058 specimens tested using the urine dipstick test and protein creatinine ratio from patients aged ≥18 years. The proteinuria creatinine ratio was classified according to the Kidney Disease Outcomes Quality Initiative guidelines.ResultsUrine protein on the dipstick test was negative in 15,548 samples (37.9%), trace in 6,422 samples (15.6%), and ≥1+ in 19,088 samples (46.5%). Among the trace proteinuria samples, A1 (<0.15 g/gCr), A2 (0.15–0.49 g/gCr), and A3 (≥0.5 g/gCr) category proteinuria accounted for 31.2, 44.8, and 24.0% of samples, respectively. All trace proteinuria specimens with a specific gravity of <1.010 were classified as A2 and A3 category proteinuria. In the trace proteinuria cases, women had a lower specific gravity and a higher percentage of A2 or A3 category proteinuria than men. The sensitivity in the “dipstick proteinuria” ≥ trace” group was higher than that in the “dipstick proteinuria ≥ 1+” group within the lower specific gravity group. The sensitivity in the “dipstick proteinuria ≥ 1+” group was higher for men than for women, and the sensitivity in the “dipstick proteinuria ≥ trace” group was higher than that in the “dipstick proteinuria ≥ 1+” group for women.ConclusionPathological proteinuria assessment requires caution; this study suggests that evaluating the specific gravity of urine specimens with trace proteinuria is essential. Particularly for women, the sensitivity of the urine dipstick test is low, and caution is needed even with trace specimens

Optimization of quantum noise in space gravitational-wave antenna DECIGO with optical-spring quantum locking considering mixture of vacuum fluctuations in homodyne detection

Quantum locking using optical spring and homodyne detection has been devised to reduce quantum noise that limits the sensitivity of DECIGO, a space-based gravitational wave antenna in the frequency band around 0.1 Hz for detection of primordial gravitational waves. The reduction in the upper limit of energy density ${\Omega}_{\mathrm{GW}}$ from $2{\times}10^{-15}$ to $1{\times}10^{-16}$, as inferred from recent observations, necessitates improved sensitivity in DECIGO to meet its primary science goals. To accurately evaluate the effectiveness of this method, this paper considers a detection mechanism that takes into account the influence of vacuum fluctuations on homodyne detection. In addition, an advanced signal processing method is devised to efficiently utilize signals from each photodetector, and design parameters for this configuration are optimized for the quantum noise. Our results show that this method is effective in reducing quantum noise, despite the detrimental impact of vacuum fluctuations on its sensitivity.Comment: 12 pages, 5 figure

Displacement-noise-free interferometeric gravitational-wave detector using unidirectional neutrons with four speeds

For further gravitational wave (GW) detections, it is significant to invent a technique to reduce all kinds of mirror displacement noise dominant at low frequencies for ground-based detectors. The neutron displacement-noise-free interferometer (DFI) is one of the tools to reduce all the mirror displacement noise at lower frequencies. In this paper, we describe a further simplified configuration of a neutron DFI in terms of neutron incidence direction. In the new configuration, neutrons enter the interferometer with unidirectional incidence at four speeds as opposed to two bidirectional incidences of opposite directions at two speeds as reported previously. This simplification of the neutron DFI is significant for proof-of-principle experiments

First-step experiment in developing optical-spring quantum locking for DECIGO: sensitivity optimization for simulated quantum noise by completing the square

DECi-hertz Interferometer Gravitational Wave Observatory (DECIGO) is a future mission for a space-borne laser interferometer. DECIGO has 1,000-km-long arm cavities mainly to detect the primordial gravitational waves (PGW) at lower frequencies around 0.1 Hz. Observations in the electromagnetic spectrum have lowered the bounds on the upper limit of PGW energy density ($\Omega_{\rm gw} \sim 10^{-15} \to 10^{-16}$). As a result, DECIGO's target sensitivity, which is mainly limited by quantum noise, needs further improvement. To maximize the feasibility of detection while constrained by DECIGO's large diffraction loss, a quantum locking technique with an optical spring was theoretically proposed to improve the signal-to-noise ratio of the PGW. In this paper, we experimentally verify one key element of the optical-spring quantum locking: sensitivity optimization by completing the square of multiple detector outputs. This experiment is operated on a simplified tabletop optical setup with classical noise simulating quantum noise. We succeed in getting the best of the sensitivities with two different laser powers by the square completion method.Comment: 10 pages, 14 figure

Work-related allergy in medical doctors: atopy, exposure to domestic animals, eczema induced by common chemicals and membership of the surgical profession as potential risk factors

Purpose To investigate the risk factors associated with work-related allergy-like symptoms in medical doctors. Methods Self-administered questionnaire survey and CAP test were conducted among medical school students in the 4th grade of their 6-year medical course in 1993–1996 and 1999–2001. Follow-up questionnaires were sent in 2004 to the graduates. These questionnaires enquired into personal and family history of allergic diseases, lifestyle, history of allergy-like symptoms including work-relatedness and occupational history as medical doctors. Relationships between allergy-like symptoms and relevant factors were evaluated by multivariate logistic regression analysis. Results Of 261 respondents at the follow-up survey, 139 (53.3%) and 54 (20.7%) had a history of any allergy-like symptoms and any work-related allergy-like symptoms, respectively. Female gender and family history of allergic diseases were signiWcantly associated with any allergy-like symptoms. Personal history of allergic disease, exposure to domestic animals, eczema caused by rubber gloves, metallic accessories, or cosmetics during schooling days, and membership of the surgical profession were signiW- cant risk factors for work-related allergy-like symptoms. On the contrary, to work-related allergy-like symptoms, gender, age, and smoking status were not signiWcantly related, and consumption of prepared foods was inversely related. Conclusions Personal history of atopy and eczema induced by common goods and the history of keeping domestic animals may be predictors of work-related allergy-like symptoms in doctors. After graduation from medical school, physicians start with exposure to various allergens and irritants at work, which relate to work-related allergy-like symptoms, especially for surgeons

Genome-Wide Association Meta-analysis Identifies Novel Variants Associated With Fasting Plasma Glucose in East Asians

Fasting plasma glucose (FPG) has been recognized as an important indicator for the overall glycemic state preceding the onset of metabolic diseases. So far, most indentified genome-wide association loci for FPG were derived from populations with European ancestry, with a few exceptions. To extend a thorough catalog for FPG loci, we conducted meta-analyses of 13 genome-wide association studies in up to 24,740 nondiabetic subjects with East Asian ancestry. Follow-up replication analyses in up to an additional 21,345 participants identified three new FPG loci reaching genome-wide significance in or near PDK1-RAPGEF4, KANK1, and IGF1R. Our results could provide additional insight into the genetic variation implicated in fasting glucose regulation

Genetic associations at 53 loci highlight cell types and biological pathways relevant for kidney function.

Reduced glomerular filtration rate defines chronic kidney disease and is associated with cardiovascular and all-cause mortality. We conducted a meta-analysis of genome-wide association studies for estimated glomerular filtration rate (eGFR), combining data across 133,413 individuals with replication in up to 42,166 individuals. We identify 24 new and confirm 29 previously identified loci. Of these 53 loci, 19 associate with eGFR among individuals with diabetes. Using bioinformatics, we show that identified genes at eGFR loci are enriched for expression in kidney tissues and in pathways relevant for kidney development and transmembrane transporter activity, kidney structure, and regulation of glucose metabolism. Chromatin state mapping and DNase I hypersensitivity analyses across adult tissues demonstrate preferential mapping of associated variants to regulatory regions in kidney but not extra-renal tissues. These findings suggest that genetic determinants of eGFR are mediated largely through direct effects within the kidney and highlight important cell types and biological pathways