Evaluation of mechanical properties of nanoparticles using a constant-volume shear tester

Nanoparticles have advantageous small-size and surface effects that impart them with unique mechanical properties. To evaluate these properties, a constant-volume shear tester that can precisely measure stresses on the shear plane was used. Six samples, namely, hydrophilic and hydrophobic silica, alumina, and titania nanoparticles, were prepared for the shear tests. For each sample, a single shear test provided the void fraction, stress relaxation ratio, stress transmission ratio, powder yield locus, consolidation yield locus, critical state line, shear cohesion, and flow function. All the tests were conducted under ambient conditions using powder beds, in which the void fractions were in the range of 0.89–0.96. A series of analyses demonstrated that the hydrophilic nanoparticles have lower flowability than the hydrophobic nanoparticles, indicating that moisture on the surface increases the cohesion and inhibits the flow

Effect of Numbness Caused by Diabetic Neuropathy on Daily Activities : Questionnaire survey from a nursing viewpoint

しびれは患者には苦痛で不安な症状であり, 医療者側にとっても病気の診断と経過観察の上で見過ごすことができないものである。しかし, しびれに関しては神経医療分野以外で研究対象に取り上げられることは少なく, 患者がしびれを訴えた場合にも, それに対処する医療者の姿勢はともすれば消極的になりがちである。その理由の一つは, しびれが他者にとっては把握しにくい自覚症状であるからである。本研究では, 糖尿病患者726名で, しびれの客観的把握と看護支援の検討を試みた。アンケートは第1段階でしびれの有無ごとの分類, 第2段階でしびれ無群(I群), 現在しびれ有群(II群), 過去にしびれ有群(III群)の3種類に区分した.有群281人(II, III群)のうち, しびれと, それに伴った自律神経障害, およびそれらによる不快感や日常生活支障を感じた者は194人で, 有群の69.0%, 対象者全体の26.9%を占めた。しびれの強度と日常生活支障項目(25項目)数は有意に相関しており, 精神的支障は約4割, 身体的支障は約6割であった。支障項目のうち, 手指を使用する項目と上肢のしびれ感との関連が有意であり, 特に利き手の可能性が高い右上肢にその傾向が顕著であった。25項目中, 頻度の高い上位14項目で精神的支障項目, 全身・下肢支障項目, 上肢支障項目に分類し, 全身・下肢支障項目+上肢支障項目を身体的支障項目とすると, しびれの強度が強いほど精神的支障が占める割合は増加し, 身体的支障が占める割合は減少し, 身体的支障は精神的支障に影響を与え, 精神的支障の背景には強度のしびれとそれに伴う身体的支障が存在している可能性が高かった。看護者は, 身体的支障への支援だけでなく, しびれという「体験」を認識・理解し, 個々人にあった精神的支援を行うことが重要だといえる。Numbness was objectively evaluated in 726 diabetics and their correct nursing was also examined. The patients were classified into 3 groups : no numbness (Group I), current numbness (Group II), and previous numbness (Group III). Among 281 patients with current or previous numbness, 194 (69.00f the 281 patients and 26.90f all subjects) had autonomic disorders and impairment of daily activities associated with numbness. The severity of numbness was significantly correlated with the number of impairments (25 items) of daily activities, with about 40% being mental and 60% being physical. Impairments related to the fingers were significantly correlated with upper limb numbness, with a stronger correlation for numbness of the right upper limb probably because most subjects were right-handed. The top 14 impairments were classified into a mental group, systemic and lower limb group, and upper limb group. We found that mental impairments increased and physical impairments decreased as numbness became worse. It was considered likely that physical impairment was influenced by mental factors and that it existed in the background of mental impairments. It is important for nurses to provide both physical and mental support for patients by recognizing numbness

Differential evolution of cell-associated virus in blood and genital tract of HIV-infected females undergoing HAART

AbstractPBMC and vaginal cell (VC) viruses were studied from 5 HIV-infected females for the presence of drug-resistance and non-drug resistance associated mutations. A 1318-bp fragment of polymerase gene was amplified from PBMC and VC proviral DNA. Four of the 5 PBMC viruses exhibited drug resistance-associated mutations in reverse transcriptase and protease genes, whereas only 2 VC viruses contained drug resistance-associated mutations. However, all 5 females showed non-drug resistance-associated mutations both in PBMC and VC virus suggesting continuous evolution of the virus in these compartments. The emergence of drug resistance was slower in PBMC and VC viruses than that observed in the cell-free plasma (P) and vaginal secretion (VS) viruses. Phylogenetic analysis revealed that VC virus was closer to PBMC virus than either cell-free viruses (P and VS) suggesting comparable evolution among cell-associated viruses

HIV infection and aging: enhanced Interferon- and Tumor Necrosis Factor-alpha production by the CD8(+) CD28(-) T subset

BACKGROUND: T cells from HIV(+) and aged individuals show parallels in terms of suppressed proliferative activity and interleukin-2 (I1-2) production and an increased number of CD8(+) CD28(-) T cells. In order to compare cytokine production from T cells from these two states, CD4(+) and CD8(+) T cells from HIV(+) aged, and normal young donors (controls) were monitored for cytokine production by flow cytometry, quantitative PCR and ELISA upon activation by PMA and anti-CD3. In addition, the CD8(+) T cell subsets CD28(+) and CD28(-) from the HIV(+) and the aged groups were evaluated for cytokine production by flow cytometry, and compared with those from young controls. RESULTS: Flow cytometric analysis indicated that CD8(+) T cells from both HIV(+) and aged donors showed an increase of approximately 2–3 fold over controls in percentage of cells producing inflammatory cytokines IFN-γ and TNF-α. Similar analysis also revealed that the production of interleukins-4,6 and 10, production was very low (1–2% of cells) and unchanged in these cells. Quantitative PCR also showed a substantial increase (4–5 fold) in IFN-γ and TNF-α mRNA from HIV(+) and aged CD8(+) T cells, as did ELISA for secreted IFN-γ and TNF-α (2.3–4 fold). Flow cytometric analysis showed that the CD8(+) CD28(-) T cell subset accounts for approximately 80–86% of the IFN-γ and TNF-α production from the CD8(+) subset in the aged and HIV(+) states. The CD4(+) T cell, while not significantly changed in the HIV(+) or aged states in terms of IFN-γ production, showed a small but significant increase in TNF-α production in both states. CONCLUSIONS: Our data appear compatible with physiologic conditions existing in HIV(+) and aged individuals, i.e. elevated serum levels and elevated CD8(+) T cell production of IFN-γ and TNF-α. Thus, the capacity for increased production of cytokines IFN-γ and TNF-α in the aged individual by the dominant CD8(+) CD28(-) subset may have a profound influence on the clinical state by aggravating inflammatory pathologies such as rheumatoid arthritis, and possibly Alzheimer's disease and Crohn's disease. In AIDS, these cytokines may contribute to wasting and cachexia. We theorize that the predominant phenotypic change to the cytotoxic CD8(+) CD28(-) T cell subsets in both the HIV(+) and the aged states may reflect a natural "endpoint" in CD8(+) T cell differentiation induced after a lifetime of immune activity (toward viruses, etc) in the aged, and after a massive accelerated response to HIV in the HIV-positive individual

A case of laparoscopic and endoscopic cooperative surgery for sigmoidovesical fistula

We performed laparoscopic and endoscopic cooperative surgery (LECS) for partial colectomy with partial cystectomy in an 80-year-old woman with sigmoidovesical fistula secondary to sigmoid diverticulitis. LECS was designed for local resection of the stomach for gastric submucosal tumors using the endoscopic submucosal dissection (ESD) technique. While conventional open abdominal surgery is very invasive, LECS has enabled surgeons to perform minimally invasive surgery. Although there have been no reported cases in which the bladder was laparoscopically resected after sigmoidovesical fistula division, we were able to safely resect the fistula and preserve the urethral opening by performing laparoscopic and cystoscopic cooperative surgery. There are no previously reported cases in which LECS was performed for partial sigmoidectomy and partial cystectomy ; therefore, we report this as a valuable case, with a review of the literature. We hope that further studies involving more patients will lead to the establishment of this procedure

Association of glucocorticoid doses and emotional health in lupus low disease activity state (LLDAS): a cross-sectional study

Background While survival of systemic lupus erythematosus (SLE) patients has improved substantially, problems remain in the management of their emotional health. Medium to high-dose glucocorticoid doses are known to worsen emotional health; the effect is unclear among patients receiving relatively low-dose glucocorticoids. This study aims to investigate the association between low glucocorticoid doses and emotional health in lupus low disease activity state (LLDAS). Methods This cross-sectional study drew on data from SLE patients in 10 Japanese institutions. The participants were adult patients with SLE duration of >= 1 year who met LLDAS criteria at the study visit from April 2018 through September 2019. The exposure was the daily glucocorticoid dose (mg oral prednisolone). The outcome was the emotional health score of the lupus patient-reported outcome scale (range: 0 to 100). Multiple linear regression analysis was performed with adjustment for confounders including disease-related damage, activity, and psychotropic drug use. Results Of 192 patients enrolled, 175 were included in the analysis. Their characteristics were as follows: female, 89.7%; median age, 47 years (interquartile range (IQR): 37.0, 61.0). Median glucocorticoid dose was 4.0 mg (IQR 2.0, 5.0), and median emotional health score 79.2 (IQR 58.3, 91.7). Multiple linear regression analysis showed daily glucocorticoid doses to be associated with worse emotional health (beta coefficient = - 2.54 [95% confidence interval - 4.48 to - 0.60], P = 0.01). Conclusions Daily glucocorticoid doses were inversely associated with emotional health among SLE patients in LLDAS. Further studies are needed to determine whether glucocorticoid tapering leads to clinically significant improvements in emotional health

Monocyte or white blood cell counts and β₂ microglobulin predict the durable efficacy of daratumumab with lenalidomide

BACKGROUND: Daratumumab is one of the most widely used treatments for relapsed/refractory multiple myeloma (MM) patients. However, not all patients achieve a lasting therapeutic response with daratumumab. OBJECTIVES: We hypothesized that a durable response to daratumumab could be predicted by the balance between the MM tumor burden and host immune status. DESIGN: We conducted a retrospective study using the real-world data in the Kansai Myeloma Forum (KMF) database. METHODS: We retrospectively analyzed 324 relapsed/refractory MM patients who were treated with daratumumab in the KMF database. RESULTS: In this study, 196 patients were treated with daratumumab, lenalidomide, and dexamethasone (DLd) regimen and 128 patients were treated with daratumumab, bortezomib, and dexamethasone (DBd) regimen. The median age at treatment, number of prior treatment regimens and time-to-next-treatment (TTNT) were 68, 4 and 8.02 months, respectively. A multivariate analysis showed that the TTNT under the DLd regimen was longer with either higher monocyte counts (analysis 1), higher white blood cell (WBC) counts (analysis 2), lower β2 microglobulin (B2MG < 5.5 mg/L) or fewer prior regimens (<4). No parameters were correlated with TTNT under the DBd regimen. CONCLUSION: We propose a simple scoring model to predict a durable effect of the DLd regimen by classifying patients into three categories based on either monocyte counts (0 points for ⩾200/μl; 1 point for <200/μl) or WBC counts (0 points for ⩾3500/μl; 1 point for <3500/μl) plus B2MG (0 points for <5.5 mg/L; 1 point for ⩾5.5 mg/L). Patients with a score of 0 showed significantly longer TTNT and significantly better survival compared to those with a score of 1 or 2 (both p < 0.001). To confirm this concept, our results will need to be validated in other cohorts