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Chronic kidney disease-associated pruritus (CKD-aP) is very common and sometimes refractory to treatment in hemodialysis patients. In a trial conducted in Japan, nalfurafine, effectively reduced itching of treatment-resistant CKD-aP. Our present bridging study aimed to evaluate the efficacy and safety of nalfurafine in Chinese cohort with refractory CKD-aP. In this phase III, multicenter bridging study conducted at 22 sites in China, 141 Chinese cases with refractory CKD-aP were randomly (2:2:1) assigned to receive 5 μg, 2.5 μg of nalfurafine or a placebo orally for 14 days in a double-blind manner. The primary end point was the mean decrease in the mean visual analogue scale (VAS) from baseline. A total of 141 patients were included. The primary endpoint analysis based on full analysis set (FAS), the difference of mean VAS decrease between 5 μg nalfurafine and placebo group was 11.37 mm (p =.041); the difference of mean VAS decrease between 2.5 μg and placebo group was 8.81 mm (p =.110). Both differences were greater than 4.13 mm, which met its predefined success criterion of at least 50% efficacy of the key Japanese clinical trial. The per protocol set (PPS) analysis got similar results. The incidence of adverse drug reactions (ADRs) was 49.1% in 5μg, 38.6% in 2.5 μg and 33.3% in placebo group. The most common ADR was insomnia, seen in 21 of the 114 nalfurafine patients. Oral nalfurafine effectively reduced itching with few significant ADRs in Chinese hemodialysis patients with refractory pruritus. [ABSTRACT FROM AUTHOR]

It has been more than 30 years since Hikami Y and Shiraishi N (1988) Rain–wind-induced vibrations of cable-stayed bridges. Journal of Wind Engineering and Industrial Aerodynamics 29: 409–418 first reported the rain–wind-induced vibration (RWIV) of stay cables in the construction stage of Meikonishi Bridge, Japan. After that, considerable research efforts have been devoted to understanding the RWIV of stay cables, and the role of the upper rivulet has been gradually realized and studied. This study presents a selective review on recent progress of RWIV and its controversial excitation mechanism. The available knowledge and up-to-date understanding of this complex fluid-structure interaction are presented in some detail. The formation, dynamics of water rivulet, and its role in affecting the near-wall boundary layer properties and in the excitation scenario of RWIV are of particular interest in this study. Finally, some limitations of previous studies are concluded, with some perspective suggestions for further study of excitation mechanism of RWIV. [ABSTRACT FROM AUTHOR]