This study presents the first experimental evidence of direct H
2
production from seawater without harmful gas emissions (
e.g.
, CO
2
, Cl
2
), which uses multiphoton ionization water splitting with ...a femtosecond pulse laser. According to H
2
analysis using a gas chromatograph, the H
2
production rate in seawater was 70 μmol h
−1
, which was approximately 3.3 times more than the ultrapure water case reported in the literature. This positive effect derives from focusing through the cuvette wall and the more significant Kerr effect in seawater. Such ion enhancement was observed in the case of seawater and diluted seawater compared with the ultrapure water case, but excessive salt can lead to ion suppression and adverse effects. These differences in salinity suggest appearances of nonlinear optical effects near the focal point and ionization of metallic elements with low ionization potential and are discussed in relation to results of bubble visualization, gas composition analysis, and pressure measurement in gaseous products.
This study presents the first experimental evidence of direct H
2
production from seawater without harmful gas emissions (
e.g.
, CO
2
, Cl
2
), which uses multiphoton ionization water splitting with a femtosecond pulse laser.
Disposable masks are widely used, particularly in medicine to prevent the spread of infections, as they afford hygiene and convenience. Recently, sensor‐integrated masks are explored for monitoring ...human voice and respiration. However, masks equipped with acoustic/respiration sensors containing nano/microfiber mats cannot be used as readily as conventional disposable masks because of their high material and manufacturing costs. To address these issues, in this article, a self‐power‐generating mask‐type acoustic/respiration sensor (MTAS) incorporated with electrospun atactic poly(styrene) (aPS) microfiber‐nonwoven mats is proposed. aPS is integral to the MTAS fabrication strategy as it is inexpensive and amenable to the one‐step production of charged electrospun microfiber mats. When subjected to acoustic waves, the MTAS generates a voltage corresponding to the sound pressure and frequency owing to its ferroelectric properties. Furthermore, when a tablet is connected to the mask worn by a subject who is vocalizing, the uttered words are converted into text on the tablet. Additionally, the MTAS worn by a person can output a voltage in response to breathing. Overall, the devised mask can pioneer the development of systems that can link voice and breathing in virtual spaces, enable real‐time translation of speech, and monitor respiratory diseases.
In this article, a self‐power‐generating mask‐type acoustic/respiration sensor based on a conventional disposable mask embedded with positively/negatively electrospun microfiber mats is reported on. The mask‐type sensor outputs voltage in response to the voice and respiration of the mask‐wearing person. Additionally, when the mask is connected to a conventional tablet, the tablet identifies the words spoken by the mask‐wearing person.
Despite the introduction of plasmapheresis and immunoglobulin therapy, many patients with Guillain-Barré syndrome still have an incomplete recovery. Evidence from pathogenesis studies suggests the ...involvement of complement-mediated peripheral nerve damage. We aimed to investigate the safety and efficacy of eculizumab, a humanised monoclonal antibody against the complement protein C5, in patients with severe Guillain-Barré syndrome.
This study was a 24 week, multicentre, double-blind, placebo-controlled, randomised phase 2 trial done at 13 hospitals in Japan. Eligible patients with Guillain-Barré syndrome were aged 18 years or older and could not walk independently (Guillain-Barré syndrome functional grade 3–5). Patients were randomly assigned (2:1) to receive 4 weeks of intravenous immunoglobulin plus either eculizumab (900 mg) or placebo; randomisation was done via a computer-generated process and web response system with minimisation for functional grade and age. The study had a parallel non-comparative single-arm outcome measure. The primary outcomes were efficacy (the proportion of patients with restored ability to walk independently functional grade ≤2 at week 4) in the eculizumab group and safety in the full analysis set. For the efficacy endpoint, we predefined a response rate threshold of the lower 90% CI boundary exceeding 50%. This trial is registered with ClinicalTrials.gov, number, NCT02493725.
Between Aug 10, 2015, and April 21, 2016, 34 patients were assigned to receive either eculizumab (n=23) or placebo (n=11). At week 4, the proportion of the patients able to walk independently (functional grade ≤2) was 61% (90% CI 42–78; n=14) in the eculizumab group, and 45% (20–73; n=5) in the placebo group. Adverse events occurred in all 34 patients. Three patients had serious adverse events: two in the eculizumab group (anaphylaxis in one patient and intracranial haemorrhage and abscess in another patient) and one in the placebo group (depression). The possibility that anaphylaxis and intracranial abscess were related to eculizumab could not be excluded. No deaths or meningococcal infections occurred.
The primary outcome measure did not reach the predefined response rate. However, because this is a small study without statistical comparison with the placebo group, the efficacy and safety of eculizumab could be investigated in larger, randomised controlled trials.
The Japan Agency for Medical Research and Development, Ministry of Health, Labor and Welfare, and Alexion Pharmaceuticals.
The prevalence of allergic diseases has increased all over the world during the last two decades. Dietary change is considered to be one of the environmental factors that cause this increase and ...worsen allergic symptoms. If this is the case, an appropriate intake of foods or beverages with anti-allergic activities is expected to prevent the onset of allergic diseases and ameliorate allergic symptoms. Flavonoids, ubiquitously present in vegetables, fruits or teas possess anti-allergic activities. Flavonoids inhibit histamine release, synthesis of IL-4 and IL-13 and CD40 ligand expression by basophils. Analyses of structure-activity relationships of 45 flavones, flavonols and their related compounds showed that luteolin, ayanin, apigenin and fisetin were the strongest inhibitors of IL-4 production with an IC50 value of 2–5μM and determined a fundamental structure for the inhibitory activity. The inhibitory activity of flavonoids on IL-4 and CD40 ligand expression was possibly mediated through their inhibitory action on activation of nuclear factors of activated T cells and AP-1. Administration of flavonoids into atopic dermatitis-prone mice showed a preventative and ameliorative effect. Recent epidemiological studies reported that a low incidence of asthma was significantly observed in a population with a high intake of flavonoids. Thus, this evidence will be helpful for the development of low molecular compounds for allergic diseases and it is expected that a dietary menu including an appropriate intake of flavonoids may provide a form of complementary and alternative medicine and a preventative strategy for allergic diseases. Clinical studies to verify these points are now in progress.
In this study, we developed a one-step method for fabricating hydrophobic surfaces on copper (Cu) substrates. Cuprous oxide (Cu
O) with low free energy was successfully formed after low-fluence laser ...direct irradiation. The formation of Cu
O enhanced the hydrophobicity of the Cu substrate surface, and the contact angle linearly increased with the proportion of Cu
O. The Cu
O fabricated by low-fluence laser treatment showed the same crystal plane orientation as the pristine Cu substrate, implying an epitaxial growth of Cu
O on a Cu substrate.
Takayasu arteritis (TAK) and giant cell arteritis (GCA) are two major variants of large vessel vasculitis, and age is a major factor in their differential diagnosis. We sought to determine whether ...the two diseases exist on the same spectrum. We compared the serum levels of multiple cytokines and chemokines in 25 patients with TAK, 20 patients with GCA, and sex- and age-matched healthy donors for either condition (HD-TAK and HD-GCA). To evaluate the effects of age on the levels of cytokines and chemokines, we performed multiple logistic regression analysis using the least absolute shrinkage and selection operator (LASSO) method. The levels of IL-1RA, IL-10, GM-CSF, G-CSF, FGF-2, eotaxin, and IP-10 were significantly different between TAK and GCA, but no differences were found in the levels of IL-6, IL-12(p40), IL-17, IFN-γ, and TNF-α. Significant differences in the levels of IL-1RA, IL-10, GM-CSF, eotaxin, and IP-10 were observed between the HD-TAK and HD-GCA groups. Multiple logistic regression analysis demonstrated that only FGF-2 and IP-10 could significantly distinguish the diseases when added to age. Multiple logistic analysis using factors selected by the LASSO method revealed that FGF-2 was the only significant factor to distinguish the diseases when added to age. Among numerous cytokines and chemokines analyzed, only FGF-2 could be used together with age at diagnosis to differentiate TAK and GCA. Our results suggested the importance of considering the effects of age on serum cytokines.
Among patients with hyperphosphatemia undergoing dialysis, it is unclear whether non-calcium-based phosphate binders are more effective than calcium-based binders for reducing cardiovascular events.
...To determine whether lanthanum carbonate reduces cardiovascular events compared with calcium carbonate in patients with hyperphosphatemia at risk of vascular calcification undergoing hemodialysis.
Open-label, randomized, parallel-group clinical trial with blinded end point adjudication performed in 2374 patients with chronic kidney disease from 273 hemodialysis facilities in Japan. Eligible patients had hyperphosphatemia and 1 or more risk factors for vascular calcification (ie, ≥65 years, postmenopausal, diabetes). Enrollment occurred from November 2011 to July 2014; follow-up ended June 2018.
Patients were randomized to receive either lanthanum carbonate (n = 1154) or calcium carbonate (n = 1155) and titrated to achieve serum phosphate levels of between 3.5 mg/dL and 6.0 mg/dL.
The primary outcome was a composite cardiovascular event (cardiovascular death, nonfatal myocardial infarction or stroke, unstable angina, transient ischemic attack, or hospitalization for heart failure or ventricular arrhythmia). Secondary outcomes included overall survival, secondary hyperparathyroidism-free survival, hip fracture-free survival, and adverse events.
Among 2309 randomized patients (median age, 69 years; 40.5% women), 1851 (80.2%) completed the trial. After a median follow-up of 3.16 years, cardiovascular events occurred in 147 of 1063 patients in the lanthanum calcium group and 134 of 1072 patients in the calcium carbonate group (incidence rate, 4.80 vs 4.30 per 100 person-years; difference 0.50 per 100 person-years 95% CI, -0.57 to 1.56; hazard ratio HR, 1.11 95%, CI, 0.88 to 1.41, P = .37). There were no significant differences in all-cause death (difference, 0.43 per 100 person-years 95% CI, -0.63 to 1.49; HR, 1.10 95% CI, 0.88 to 1.37; P = .42) or hip fracture (difference, 0.10 per 100 person-years 95% CI, -0.26 to 0.47; HR, 1.21 95% CI, 0.62 to 2.35; P = .58). The lanthanum carbonate group had an increased risk of cardiovascular death (difference, 0.61 per 100 person-years 95% CI, 0.02 to 1.21; HR, 1.51 95% CI, 1.01 to 2.27; P = .045) and secondary hyperparathyroidism (difference, 1.34 95% CI, 0.49 to 2.19; HR, 1.62 95% CI, 1.19 to 2.20; P = .002). Adverse events occurred in 282 (25.7%) in the lanthanum carbonate group and 259 (23.4%) in the calcium carbonate groups.
Among patients undergoing hemodialysis with hyperphosphatemia and at least 1 vascular calcification risk factor, treatment of hyperphosphatemia with lanthanum carbonate compared with calcium carbonate did not result in a significant difference in composite cardiovascular events. However, the event rate was low, and the findings may not apply to patients at higher risk.
ClinicalTrials.gov Identifier: NCT01578200; UMIN Clinical Trial Registry Identifier: UMIN000006815.
Background
Cause-and-effect associations between sevelamer hydrochloride (HCl) and mortality have yet to be clarified. The effects of sevelamer HCl on mortality, lipid abnormality and arterial ...stiffness were examined in patients with chronic kidney disease stage 5D.
Methods
The effects of sevelamer HCl were studied by a single-center cohort study that was conducted from January 1, 2005 to December 31, 2008 (
n
= 483). By the end of the study, 172 patients (Sevelamer group) had succeeded in continuing sevelamer HCl for >6 months (median 37 months), and 300 patients (Control group) had received calcium carbonate (
n
= 264) or no phosphate binder (
n
= 36). The mortality and other outcomes were compared between these two groups after matching by a propensity score calculated using age, gender, diabetes prevalence, and dialysis vintage.
Results
All-cause hazard ratio (HR) 0.4,
P
= 0.02 and cardiovascular (CV)-cause HR 0.29,
P
= 0.03 cumulative mortality were significantly lower in the matched Sevelamer group than in the matched Control group. The matched Sevelamer group showed increased high-density lipoprotein cholesterol (
P
= 0.003) and no change in pulse wave velocity (PWV) and ankle-brachial index (ABI), whereas the matched Control group showed increased serum low-density lipoprotein (LDL) cholesterol (
P
= 0.003), increased PWV (
P
= 0.03), and decreased ABI (
P
= 0.0009). Change in serum LDL cholesterol level correlated inversely with sevelamer HCl dosage (
P
= 0.02).
Conclusions
Reduced mortality in patients with sevelamer HCl may, at least in part, be explained by an improvement in dyslipidemia and arterial stiffness by sevelamer HCl.
The shallow-seafloor Wakamiko hydrothermal field in Kagoshima Bay, Japan, has been characterized by high ammonium contents (~17 mM) in the discharge fluid. The sediment layer covering the field also ...contained a high concentration of ammonium in the pore fluids. The fluid chemistry suggests that the high concentration was attributed to whether mixing with hydrothermal fluid or the mineralization of organic matter. The occurrence of sediments such as smectite, illite and mica has been reported, and is associated with hydrothermal activity. Those 2:1 clay minerals can fold ammonium as mineral nitrogen (MN) in their interlayers. Extracted clay fractions from the sediment core samples obtained from the field were mainly composed of smectite. It contained a small amount of MN and its δ15N values reflected that of pore fluid ammonium in the case of a high ammonium (>4 mM) environment. On the other hand, δ15N values of MN in the low ammonium (≤4 mM) environment were similar to those of the associated adsorbed organic nitrogen. The high ammonium environment associated with hydrothermal activity is expected to enhance formation of ammonium-bearing clay minerals, and then the δ15N value of MN fixed in the clay minerals is possibly preserved a signal of pore fluid ammonium.
Variants in the galactosidase alpha (GLA) gene cause Fabry disease (FD), an X-linked lysosomal storage disorder caused by α-galactosidase A (α-GAL) deficiency. Recently, disease-modifying therapies ...have been developed, and simple diagnostic biomarkers for FD are required to initiate these therapies in the early stages of the disease. Detection of urinary mulberry bodies and cells (MBs/MCs) is beneficial for diagnosing FD. However, few studies have evaluated the diagnostic accuracy of urinary MBs/MCs in FD. Herein, we retrospectively evaluated the diagnostic ability of urinary MBs/MCs for FD.
We analyzed the medical records of 189 consecutive patients (125 males and 64 females) who underwent MBs/MCs testing. Out of these, two female patients had already been diagnosed with FD at the time of testing, and the remaining 187 patients were suspected of having FD and underwent both GLA gene sequencing and/or α-GalA enzymatic testing.
Genetic testing did not confirm the diagnosis in 50 females (26.5%); hence, they were excluded from the evaluation. Two patients were previously diagnosed with FD, and sixteen were newly diagnosed. Among these 18 patients, 15, including two who had already developed HCM at diagnosis, remained undiagnosed until targeted genetic screening of at-risk family members of patients with FD was performed. The accuracy of urinary MBs/MCs testing exhibited a sensitivity of 0.944, specificity of 1, positive predictive value of 1, and negative predictive value of 0.992.
MBs/MCs testing is highly accurate in diagnosing FD and should be considered during the initial evaluation prior to genetic testing, particularly in female patients.
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