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The optimal administration of inotrope after cardiac surgery is unknown. This study aimed to investigate the impact of postoperative inotrope on clinical outcomes in adult elective cardiac surgery patients. Data from the Blood Pressure and Relative Optimal Target after Heart Surgery in Epidemiologic Registry study were analyzed, employing propensity score considering the hospital of admission. The primary outcome was the length of hospital stay evaluated using quantile regression. Secondary outcomes were kidney injury progression, renal replacement therapy, atrial fibrillation, mortality, mechanical ventilation duration, and length of intensive care unit (ICU) stay. Among 870 patients from 14 ICUs in Japan, 535 received inotropes within 24 h of ICU admission, with usage rates ranging from 40 to 100% among facilities. After propensity score matching, 218 patients were included in each group. The inotrope group had a significantly longer hospital stay compared to the control group (16 days vs. 14 days; median difference 1.78 [95% confidence interval [CI] 0.31–3.24]; p = 0.018). However, no significant differences were observed in the secondary outcomes, except for mechanical ventilation duration. The results of the sensitivity analysis using a mixed-effects quantile regression analysis considering the hospital of admission for length of hospital stay in the original cohort were consistent with the results of the propensity analyses (median difference in days, 2.35 [95% CI, 0.35–4.36]; p = 0.022). The use of inotropes within 24 h of ICU admission in adult elective cardiac surgery patients was associated with an extended hospitalization period of approximately 2 days, without offering any prognostic benefit. Clinical trial registration: UMIN-CTR, https://www.umin.ac.jp/ctr/index-j.htm, UMIN000037074. [ABSTRACT FROM AUTHOR]

Dupuytren's contracture, a superficial dermal fibrosis, causes flexion contracture of the affected finger, impairing hand function. Specific single-nucleotide polymorphisms within genes in the Wnt signalling pathway are associated with the disease. However, the precise role of Wnt signalling dysregulation in the onset and progression of Dupuytren's contracture remains unclear. Here, using a fibrosis mouse model and clinical samples of human Dupuytren's contractures, we demonstrate that the activation of Wnt/β-catenin signalling in Tppp3-positive cells in the dermis of the paw is associated with the development of fibrosis. Fibrosis development and progression via Wnt/β-catenin signalling are closely related to stromal cell–macrophage interactions, and Wnt/β-catenin signalling activation in Tppp3-positive stromal cells causes M2 macrophage infiltration via chemokine Cxcl14, resulting in the formation of a TGF-β-expressing fibrotic niche. Inhibition of Cxcl14 mitigates fibrosis by decreasing macrophage infiltration. These findings suggest that Cxcl14-mediated stromal cell–macrophage interaction is a promising therapeutic target for Wnt/β-catenin-induced fibrosis. Wnt/β-catenin signalling activation in the dermis cause fibrosis by cell-autonomous program and by a non-cell-autonomous program mediated by TGF-β niche formation based on Cxcl14-mediated interactions between stromal cells and M2 macrophages. [ABSTRACT FROM AUTHOR]

Biomimetic actuators are critical components of bionics research and have found applications in the fields of biomedical devices, soft robotics, and smart biosensors. This paper reports the first study of nanoassembly topology‐dependent actuation and shape memory programming in biomimetic 4D printing. Multi‐responsive flower‐like block copolymer nanoassemblies (vesicles) are utilized as photocurable printing materials for digital light processing (DLP) 4D printing. The flower‐like nanoassemblies enhance thermal stability, attributed to their surface loop structures on the shell surfaces. Actuators prepared from these nanoassemblies display topology‐dependent bending in response to pH and temperature‐programmable shape memory properties. Biomimetic octopus‐like soft actuators are programmed with multiple actuation patterns, large bending angles (≈500°), excellent weight‐to‐lift ratios (≈60), and moderate response time (≈5 min). Thus, nanoassembly topology‐dependent and shape‐programmable intelligent materials are successfully developed for biomimetic 4D printing. [ABSTRACT FROM AUTHOR]

Observational studies suggest that abnormal glucose metabolism and insulin resistance contribute to colorectal cancer; however, the causal association remains unknown, particularly in Asian populations. A two-sample Mendelian randomisation analysis was performed to determine the causal association between genetic variants associated with elevated fasting glucose, haemoglobin A1c (HbA1c), and fasting C-peptide and colorectal cancer risk. In the single nucleotide polymorphism (SNP)-exposure analysis, we meta-analysed study-level genome-wide associations of fasting glucose (~ 17,289 individuals), HbA1c (~ 52,802 individuals), and fasting C-peptide (1,666 individuals) levels from the Japanese Consortium of Genetic Epidemiology studies. The odds ratios of colorectal cancer were 1.01 (95% confidence interval [CI], 0.99–1.04, P = 0.34) for fasting glucose (per 1 mg/dL increment), 1.02 (95% CI, 0.60–1.73, P = 0.95) for HbA1c (per 1% increment), and 1.47 (95% CI, 0.97–2.24, P = 0.06) for fasting C-peptide (per 1 log increment). Sensitivity analyses, including Mendelian randomisation-Egger and weighted-median approaches, revealed no significant association between glycaemic characteristics and colorectal cancer (P > 0.20). In this study, genetically predicted glycaemic characteristics were not significantly related to colorectal cancer risk. The potential association between insulin resistance and colorectal cancer should be validated in further studies. [ABSTRACT FROM AUTHOR]

The association between vitamin D and total and colorectal cancer risk was inconsistent in observational studies. We conducted Mendelian randomization approach in which the effect of confounding might be reduced. 110 single nucleotide polymorphisms (SNPs) associated with 25-hydroxyvitamin D concentrations were systematically selected according to the "GWAS Catalog" from all ethnic populations. For the SNP-vitamin D concentration association, 3978 individuals from two Japanese cohorts were included. Regarding SNP-total and colorectal cancer association, 4543 cancer cases and 14,224 controls and 7936 colorectal cancer cases and 38,042 controls, respectively were included from the Japanese Consortium of Genetic Epidemiology and other studies in Japan. There was no significant association between the genetically predicted plasma 25-hydroxyvitamin D concentration and total or colorectal cancer in any of the MR analyses. Odds ratios per doubling in vitamin D concentration were 0.83 (95% confidence interval [CI] 0.63–1.09) for total cancer and 1.00 (95% CI 0.80–1.24) for colorectal cancer in inverse variance weighted method, 0.83 (95% CI 0.57–1.19) for total cancer and 1.01 (95% CI 0.75–1.37) for colorectal cancer in MR-Egger method. Consistent with previous MR analyses among European ancestries, there was no significant association identified between 25-hydroxyvitamin D levels and total or colorectal cancer among Asians. [ABSTRACT FROM AUTHOR]

Background and study aims: The diagnostic ability of endoscopists to determine invasion depth of early gastric cancer is not favorable. We designed an artificial intelligence (AI) classifier for differentiating intramucosal and submucosal gastric cancers and examined it to establish a diagnostic method based on cooperation between AI and endoscopists. Patients and methods: We prepared 500 training images using cases of mainly depressed-type early gastric cancer from 250 intramucosal cancers and 250 submucosal cancers. We also prepared 200 test images each of 100 cancers from another institution. We designed an AI classifier to differentiate between intramucosal and submucosal cancers by deep learning. We examined the performance of the AI classifier and the majority vote of the endoscopists as high confidence and low confidence diagnostic probability, respectively, and cooperatively combined them to establish a diagnostic method providing high accuracy. Results: Internal evaluation of the training images showed that accuracy, sensitivity, specificity, and F1 measure by the AI classifier were 77%, 76%, 78%, and 0.768, and those of the majority vote of the endoscopists were 72.6%, 53.6%, 91.6%, and 0.662, respectively. A diagnostic method based on cooperation between AI and the endoscopists showed that the respective values were 78.0%, 76.0%, 80.0%, and 0.776 for the test images. The value of F1 measure was especially higher than those by AI or the endoscopists alone. Conclusions: Cooperation between AI and endoscopists improved the diagnostic ability to determine invasion depth of early gastric cancer. [ABSTRACT FROM AUTHOR]

Aims/Introduction: Among colorectal cancer (CRC) patients, pre‐existing diabetes is suggested to influence poor prognosis, but the impact on adjuvant chemotherapy implementation is largely unknown. We aimed to compare the implementation rate of adjuvant chemotherapy between CRC patients with and without pre‐existing diabetes in a retrospective cohort study. Materials and Methods: Colorectal cancer diagnosis information was obtained from the hospital‐based cancer registry of patients with stage III CRC who underwent curative surgery in 2013 in Japan (n = 6,344). Health claims data were used to identify diabetes and chemotherapy. We examined the association between diabetes and the implementation rate of adjuvant chemotherapy using a generalized linear model adjusted for age, sex, updated Charlson Comorbidity Index, hospital type and prefecture. Furthermore, we applied a mediation analysis to examine the extent to which postoperative complications mediated the association. Results: Of the 6,344 patients, 1,266 (20.0%) had diabetes. The mean ages were 68.2 and 71.3 years for patients without and with diabetes, respectively. Compared with those without diabetes, patients with diabetes were less likely to receive adjuvant chemotherapy (crude rate 58.9 and 49.8%; adjusted percentage point difference 4.6; 95% confidence interval 1.7–7.5). The difference was evident for patients aged <80 years, and larger for platinum‐containing regimens than others. Mediation analysis showed that postoperative complications explained 9.1% of the inverse association between diabetes and adjuvant chemotherapy implementation. Conclusions: We observed that patients with stage III CRC and diabetes are less likely to receive adjuvant chemotherapy than those without diabetes, and postoperative complications might partially account for the association. [ABSTRACT FROM AUTHOR]

Background: A dose-response and nonlinear association between fruit and vegetable intake and mortality has been reported in Europe and the United States, but little is known about this association in Asia.Objectives: This study aimed to evaluate the association of fruit and vegetable intake with all-cause, cancer, cardiovascular, and respiratory disease mortality in a Japanese cohort.Methods: In the Japan Public Health Center-based prospective study, we included 94,658 participants (mean age: 56.4; 46.0% male) without cancer and cardiovascular disease at baseline. Information on fruit and vegetable intake was collected using a validated FFQ. The Cox proportional hazard model was used to estimate HRs and 95% CIs of each quintile of fruit and vegetable intake, separately, in relation to all-cause and cause-specific mortality using the first quintile as a reference. Nonlinear associations were evaluated using a likelihood ratio test, comparing a linear model with a restricted cubic spline model.Results: During a median of 20.9 follow-up years (IQR: 19.6-23.8 y), 23,687 all-cause deaths were documented. After adjusting for age, sex, and potential confounding factors, fruit and vegetable intake was nonlinearly and significantly associated with lower all-cause mortality, with the fourth and fifth quintiles having comparable HRs (fruit: fourth quintile HR: 0.91; 95% CI: 0.87, 0.95 and fifth quintile HR: 0.92; 95% CI: 0.88, 0.96; P-nonlinearity < 0.001; vegetable: fourth quintile HR: 0.92; 95% CI: 0.88, 0.97 and fifth quintile HR: 0.93; 95% CI: 0.89, 0.98; P-nonlinearity = 0.002). Fruit intake was significantly associated with lower cardiovascular mortality (HR in the fifth quintile: 0.91; 95% CI: 0.83, 0.99; P-nonlinearity = 0.01).Conclusions: In the Japanese population, higher intake of fruits and vegetables was nonlinearly associated with decreased all-cause mortality. These findings may contribute to the establishment of dietary recommendations for enhancing life expectancy in Asia. [ABSTRACT FROM AUTHOR]

Aims: Workplace demands, support, and relationships differ according to employment status (e.g., employment that is full-time, part-time, or self-employed) and may lead to unequal opportunities to keep diabetic appointments. We investigated the association between employment status and outpatient diabetic appointment non-attendance among working-age adults with type 2 diabetes. Methods: This was a secondary analysis of a cluster-randomized trial (the Japan diabetes outcome intervention trial 2 large-scale trial). The analysis included 2010 trial participants (40–65 years old) with type 2 diabetes who were regularly followed by primary care physicians (PCPs). The outcome measure was the first non-attendance (defined as a failure to visit a PCP within 2 months of the original appointment) during the one-year follow-up. The association between baseline employment status and non-attendance was examined using Cox proportional hazard model in men and women. Results: During the 1279 and 789 person-year follow-up periods, 90 men and 34 women, respectively, experienced their first appointment non-attendance. Among men, self-employed participants had a higher risk of non-attendance compared with full-time employees (adjusted HR, 1.84; 95% CI, 1.15, 2.95). The trial intervention (attendance promotion) was associated with a significantly reduced risk of non-attendance among self-employed participants (HR, 0.51; 95% CI, 0.26, 0.99). Among women, a significant association between employment status and non-attendance was not observed. Conclusions: Self-employed men with type 2 diabetes had a twofold increased risk of non-attendance than did full-time employees. Our study suggests that self-employed men with type 2 diabetes should be targeted for interventions promoting appointment adherence. [ABSTRACT FROM AUTHOR]

Background: It is often challenging to determine which variables need to be included in the g-computation algorithm under the time-varying setting. Conditioning on instrumental variables (IVs) is known to introduce greater bias when there is unmeasured confounding in the point-treatment settings, and this is also true for near-IVs which are weakly associated with the outcome not through the treatment. However, it is unknown whether adjusting for (near-)IVs amplifies bias in the g-computation algorithm estimators for time-varying treatments compared to the estimators ignoring such variables. We thus aimed to compare the magnitude of bias by adjusting for (near-)IVs across their different relationships with treatments in the time-varying settings.Methods: After showing a case study of the association between the receipt of industry payments and physicians' opioid prescribing rate in the US, we demonstrated Monte Carlo simulation to investigate the extent to which the bias due to unmeasured confounders is amplified by adjusting for (near-)IV across several g-computation algorithms.Results: In our simulation study, adjusting for a perfect IV of time-varying treatments in the g-computation algorithm increased bias due to unmeasured confounding, particularly when the IV had a strong relationship with the treatment. We also found the increase in bias even adjusting for near-IV when such variable had a very weak association with unmeasured confounders between the treatment and the outcome compared to its association with the time-varying treatments. Instead, this bias amplifying feature was not observed (i.e., bias due to unmeasured confounders decreased) by adjusting for near-IV when it had a stronger association with the unmeasured confounders (≥0.1 correlation coefficient in our multivariate normal setting).Conclusion: It would be recommended to avoid adjusting for perfect IV in the g-computation algorithm to obtain a less biased estimate of the time-varying treatment effect. On the other hand, it may be recommended to include near-IV in the algorithm unless their association with unmeasured confounders is very weak. These findings would help researchers to consider the magnitude of bias when adjusting for (near-)IVs and select variables in the g-computation algorithm for the time-varying setting when they are aware of the presence of unmeasured confounding. [ABSTRACT FROM AUTHOR]

Background: Although childhood undervaccination among single mother families is a concern for child healthcare, their association is still under debate. This study aimed to investigate the association between maternal marital status and the risk of childhood undervaccination and determine the mediating effect of household income.Methods: We utilised prospective birth cohort from the Japan Environment and Children's Study (JECS). Of 104,062 foetal records (children) from 97,413 mothers, 82,462 that included mothers recruited between 2011 and 2014, were analysed. Childhood undervaccination was defined as not having been vaccinated with at least one routine vaccine. A log-binomial regression analysis was used to estimate the risk ratio (RR) for the association between maternal marital status and the risk of childhood undervaccination. A causal mediation analysis was further performed to investigate the proportion of the association mediated by household income.Results: Among 82,462 children, 3188 and 79,274 had unmarried and married mothers, respectively. Childhood undervaccination was observed in 1053 (33.0%) and 16,901 (21.3%) children of unmarried and married mothers, respectively. Maternal marital status was associated with a higher risk of childhood undervaccination (adjusted risk ratio [aRR], 1.34; 95% confidence interval [CI], 1.27 to 1.41). Compared with married and older mothers, both unmarried and older (aRR, 1.54; 95% CI, 1.35 to 1.77) and unmarried and younger (aRR, 1.66; 95% CI, 1.54 to 1.79) mothers were associated with a higher risk of childhood undervaccination. The causal mediation analysis showed that the proportion mediated by household income was 10.5% (95% CI, 9.9 to 11.0%).Conclusions: This nationwide, prospective, large-scale birth cohort study found that a household with a single mother was associated with an increased risk of childhood undervaccination, and 10% of this association was explained by household income. These findings underscore the importance of improving the social environment among single mother families, including not only poverty but also working conditions. [ABSTRACT FROM AUTHOR]

Summary: Introduction: The COVID‐19 pandemic posed tremendous challenges for children. However, the long‐term effects of the pandemic on various aspects of physical health at a national level remain unclear. Methods: In this retrospective cohort study, we analysed data from nationwide health checkup records amongst children aged 7–15 years. The dataset comprised 3 544 146 records from 393 794 individuals who graduated from junior high school during fiscal years 2007 to 2022. Difference‐in‐differences (DID) analyses with multiple time periods were used to examine the impact of COVID‐19 on physical health outcomes. Results: Compared with the pre‐pandemic period, the COVID‐19 pandemic was associated with excess increases in obesity for boys and girls, persisting over the 3 years (+0.42%; [95% CI, 0.23–0.61]). Also, it was associated with excess increases in underweight (+0.28% [0.25–0.32]) and poor visual acuity amongst boys in the 3rd year (+1.80% [1.30–2.30]). There were excess reductions in dental caries (−1.48% [−2.01 to −0.95]), glucosuria (−0.55 [−0.88 to −0.23]) and hematuria (−0.43% [−0.73 to −0.13]) during the 3rd year of the pandemic. Conclusions: These findings underscore the multifaceted impact of the pandemic on various health indicators for school‐aged children. This information could be valuable for public health policy and paediatric healthcare planning in the post‐pandemic era. [ABSTRACT FROM AUTHOR]

Temperature dependences of NMR spectra have been observed for 23Na and 27Al in the metallic phase of Na–K form low silica X (LSX) zeolite loaded with potassium, where the condition of saturation is achieved with a loading level of 9.0 atoms per supercage and the paramagnetic moment contributes to the magnetism of the system beyond simple isolated spin. Two separated peaks have been recognized for 23Na, where the shift values show a quite linear relationship with susceptibility, and the so-called K–χ plot works quite well to give values of 0.32 kOe μB−1 and 0.40 kOe μB−1 for hyperfine coupling constants. Although no separated peak is seen in the 27Al NMR spectrum, the spectral centroid deviates to the positive side. The shoulder of the spectrum scales to susceptibility and the K–χ plot also works well to give a value of 0.15 kOe μB−1 for the hyperfine coupling constant. The orbital of potassium-originated electrons confined in the cage of LSX is understood as seeping out over the framework of zeolite, which is wider than that of the sodium-originated case. [ABSTRACT FROM AUTHOR]

Aims/Introduction: The aim of the current study was to prospectively evaluate the association between passive smoking from a spouse and the risk of diabetes among never‐smoking Japanese women. Passive smoking at a workplace (or public facilities) was assessed as a secondary measure. Materials and Methods: In the Japan Public Health Center‐based Prospective Study (baseline 1990 or 1993), we followed 25,391 never‐smoking women aged 40–69 years and without diabetes. Passive smoking was defined as having a husband who was a self‐reported smoker, and the exposure at a workplace (or public facilities) was self‐reported by women. The development of diabetes was identified in questionnaires administered at the 5‐year and 10‐year surveys. A pooled logistic regression model was used to assess the association between passive smoking and the development of diabetes with adjustment for age and possible confounders. Results: Compared with women whose husbands had never smoked, women whose husband smoked ≥40 cigarettes/day had significantly higher odds of developing diabetes in an age‐adjusted model, but the association was attenuated in a multivariable model (odds ratio 1.34, 95% confidence interval 0.96–1.87). There was a dose–response trend between the number of cigarettes smoked by a husband and the odds of developing diabetes (P = 0.02). Women reporting daily passive smoking at a workplace (or public facilities) had higher odds of developing diabetes than women reporting no such exposure (odds ratio 1.23, 95% confidence interval 0.995–1.53). Conclusions: Our results indicated a higher risk of diabetes among never‐smoking Japanese women with higher exposure to passive smoking from a spouse. [ABSTRACT FROM AUTHOR]

Cancer patients with diabetes experience a poorer prognosis, yet the population burden of this multimorbidity remains unknown. This study aimed to estimate the latest incidence and prevalence of cancer with diabetes mellitus in Japan. We used projection of cancer incidence and latest survival data from population‐based cancer registries. The incidence of cancer associated with diabetes was estimated separately for patients with pre‐existing diabetes and those without diabetes, and used to estimate the 5‐year cancer prevalence for those with and without diabetes. The prevalence of pre‐existing diabetes in cancer patients at any cancer site was estimated to be 20.7% (647,160 men and women). Among cancer sites, diabetes prevalence was high in patients with liver and pancreatic cancers in both sexes. In conclusion, our study shows a large burden of diabetes in cancer patients in Japan, which warrants further attention by health practitioners and policy‐makers. [ABSTRACT FROM AUTHOR]

Keywords: Diabetes; Diagnosis; Guideline; Treatment EN Diabetes Diagnosis Guideline Treatment 1020 1076 57 07/27/20 20200701 NES 200701 PREFACE Objectives of the current guideline for the management of diabetes The current guideline represents the 6th edition of the "Japanese Clinical Practice Guideline for Diabetes" which has been revised every three years since its first appearance in 2004 to promote evidence-based, rational, efficient and consistent clinical practice in diabetes. b Intensive insulin therapy has been shown to be effective in preventing the onset of macroangiopathy in type 2 diabetes 9,31,32. 7 DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT FOR THE SELF-MANAGEMENT OF DIABETES B [CQ7-1] Are organized support and education for the self-management of diabetes useful for the management of diabetes? MNT for elderly patients with diabetes B [VIII-CQ-1] Is MNT as effective for elderly patients with diabetes as for non-elderly patients? Glycemic control and cancer risk in patients with diabetes The "Report of the Committee on Diabetes and Cancer II" addressed this issue and examined the impact of glycemic control on the subsequent risk of cancer in patients with diabetes[443], demonstrating that there is no high-quality evidence available, at present, to clarify the association between glycemic control and cancer risk in patients with diabetes. Management and prognosis of patients with cancer and diabetes It is reported that patients with cancer and diabetes are associated with poorer short-term and long-term life prognosis than patients with cancer without diabetes[[446]]. [Extracted from the article]

One‐pot synthesis of methacrylic and acrylic polymers from benzylic alcohols (R−OH) used as initiating moieties was developed. R−OH was converted to alkyl iodide (R−I), and the generated R−I was used as an initiator without purification or isolation in the subsequent reversible complexation mediated polymerization (RCMP), leading to one‐pot RCMP from R−OH. As a useful application, this technique was exploited for one‐pot polymer‐grafting from lignin that is the second most abundant renewable carbon‐source on earth and bears benzylic alcohols. The direct initiation from lignin eliminates tedious initiator attachment and purification, offering a facile access to polymer‐grafted lignin. The obtained polymer‐grafted lignin was utilized to form an efficient UV‐absorbing film with high transparency in visible region. One‐pot RCMP may serve as a practical method to obtain value‐added functional lignin‐polymer composites. [ABSTRACT FROM AUTHOR]

One‐pot synthesis of methacrylic and acrylic polymers from benzylic alcohols (R−OH) used as initiating moieties was developed. R−OH was converted to alkyl iodide (R−I), and the generated R−I was used as an initiator without purification or isolation in the subsequent reversible complexation mediated polymerization (RCMP), leading to one‐pot RCMP from R−OH. As a useful application, this technique was exploited for one‐pot polymer‐grafting from lignin that is the second most abundant renewable carbon‐source on earth and bears benzylic alcohols. The direct initiation from lignin eliminates tedious initiator attachment and purification, offering a facile access to polymer‐grafted lignin. The obtained polymer‐grafted lignin was utilized to form an efficient UV‐absorbing film with high transparency in visible region. One‐pot RCMP may serve as a practical method to obtain value‐added functional lignin‐polymer composites. [ABSTRACT FROM AUTHOR]

We sought to estimate the exact causes of death, mortality rate and life expectancy of diabetes patients by analyzing death records in a diabetes specialist clinic in Japan. Of the 6,140 participants included in our analysis, the average age was 58.1 years and 77% were men. A total of 261 deaths were recorded during the total follow‐up period of 24,079 total person‐years. The leading causes of death were cancer, heart diseases and cerebrovascular diseases. Using a life table prepared from the mortality rates estimated with the exponential distribution model, a life expectancy at 40 years was 39.2 years (95% confidence interval 37.9–40.2 years) for men and 43.6 years (95% confidence interval 41.8–45.3 years) for women. Although the present results must be interpreted with caution, compared with populations with diabetes surveyed during similar periods by the Japan Diabetes Society, our diabetes patients had similar ranking of the causes of death. [ABSTRACT FROM AUTHOR]

Abstract: Background: Sex hormones are implicated in the development of diabetes. However, whether genetic variations in sex hormone pathways (SHPs) contribute to the risk of type 2 diabetes mellitus (T2DM) remains to be determined. This study investigated associations between genetic variations in all candidate genes in SHPs and T2DM risk among a cohort of women participating in the Women’s Health Initiative (WHI). Methods: Single nucleotide polymorphisms (SNPs) located within 30 kb upstream and downstream of SHP genes were comprehensively examined in 8180 African American, 3498 Hispanic American, and 3147 European American women in the WHI. In addition, whether significant SNPs would be replicated in independent populations was examined. Results: After adjusting for age, region, and ancestry estimates and correcting for multiple testing, seven SNPs were significantly associated with the risk of T2DM among Hispanic American women were identified in the progesterone receptor (PGR) gene, with rs948516 showing the greatest significance (odds ratio 0.67; 95% confidence interval 0.57–0.78; P = 8.8 × 10−7; false discovery rate, Q = 7.8 × 10−4). These findings were not replicated in other ethnic groups in the WHI or in sex‐combined analyses in replication studies. Conclusion: Significant signals were identified implicating the PGR gene in T2DM development in Hispanic American women in the WHI, which are consistent with genome‐wide association studies findings linking PGR to glucose homeostasis. Nevertheless, the PGR SNPs–T2DM association was not statistically significant in other ethnic populations. Further studies, especially sex‐specific analyses, are needed to confirm the findings and clarify the role of SHPs in T2DM. [ABSTRACT FROM AUTHOR]

Aims/Introduction: To investigate whether the COVID‐19 pandemic affected behavioral changes and glycemic control in patients with diabetes and to conduct a survey of telemedicine during the pandemic. Materials and Methods: In this retrospective study, a total of 2,348 patients were included from 15 medical facilities. Patients were surveyed about their lifestyle changes and attitudes toward telemedicine. Hemoglobin A1c (HbA1c) levels were compared among before (from June 1 to August 31, 2019) and in the first (from June 1 to August 31, 2020) and in the second (from June 1 to August 31, 2021) year of the pandemic. A survey of physician attitudes toward telemedicine was also conducted. Results: The HbA1c levels were comparable between 2019 (7.27 ± 0.97%), 2020 (7.28 ± 0.92%), and 2021 (7.25 ± 0.94%) without statistical difference between each of those 3 years. Prescriptions for diabetes medications increased during the period. The frequency of eating out was drastically reduced (51.7% in 2019; 30.1% in 2020), and physical activity decreased during the pandemic (48.1% in 2019; 41.4% in 2020; 43.3% in 2021). Both patients and physicians cited increased convenience and reduced risk of infection as their expectations for telemedicine, while the lack of physician–patient interaction and the impossibility of consultation and examination were cited as sources of concern. Conclusions: Our data suggest that glycemic control did not deteriorate during the COVID‐19 pandemic with appropriate intensification of diabetes treatment in patients with diabetes who continued to attend specialized diabetes care facilities, and that patients and physicians shared the same expectations and concerns about telemedicine. [ABSTRACT FROM AUTHOR]

Aims: To clarify the associations between plasma adiponectin levels and ADIPOQ variants with type 2 diabetes incidence in a general Japanese population.Methods: We conducted a case-control study nested within the Japan Public Health Center-based Prospective Study. We measured plasma adiponectin levels and genotyped +45T>G (rs2241766) and +276G>T (rs1501299) in the ADIPOQ gene among 417 incident diabetes cases and 1197 control subjects matched by age, sex, and area.Results: After potential confounding factor adjustment, the multivariable-adjusted diabetes odds ratios (ORs) were 0.59 (95% confidence interval [CI]: 0.51-0.68) and 0.68 (95% CI: 0.60-0.78) per 1 standard deviation increment in the log-transformed levels of total- and high-molecular-weight (HMW) adiponectin levels, respectively. However, the ADIPOQ variants were not significantly associated with plasma adiponectin levels (for total adiponectin, +45 P=0.15 and +276 P=0.08) and diabetes risk (+45 P=0.70 and +276 P=0.72) under the additive genetic model.Conclusions: Our prospective findings suggest that both total and HMW adiponectin levels are strongly and inversely associated with diabetes risk after adjustment for potential confounding factors; however, the ADIPOQ variants +45 and +276 are not associated with adiponectin levels and diabetes risk in the general Japanese population. [ABSTRACT FROM AUTHOR]

The reaction mechanism of living radical polymerization using organic catalysts, a reversible complexation mediated polymerization (RCMP), was studied using both theoretical calculations and experiments. The studied catalysts are tetramethylguanidine (TMG), triethylamine (TEA), and thiophene. Methyl 2-iodoisobutyrate (MMA-I) was used as the low-molar-mass model of the dormant species (alkyl iodide) of poly(methyl methacrylate) iodide (PMMA-I). For the reaction of MMA-I with TEA to generate MMA• and •I-TEA radicals (activation process), the Gibbs activation free energy for the inner-sphere electron transfer mechanism was calculated to be 39.7 kcal mol-1, while the observed one was 25.1 kcal mol-1. This difference of the energies suggests that the present RCMP proceeds via the outer-sphere electron transfer mechanism, i.e., single-electron transfer (SET) reaction from TEA to MMA-I to generate MMA• and •I-TEA radicals. The mechanism of the deactivation process of MMA• to generate MMA-I was also theoretically studied. For the studied three catalysts, the theoretical results reasonably elucidated the experimentally observed polymerization behaviors. [ABSTRACT FROM AUTHOR]

Background: Glycated hemoglobin (HbA1c) and glycated albumin (GA) are frequently used as glycemic control markers. However, these markers are influenced by alterations in hemoglobin and albumin metabolism. Thus, conditions such as anemia, chronic renal failure, hypersplenism, chronic liver diseases, hyperthyroidism, hypoalbuminemia, and pregnancy need to be considered when interpreting HbA1c or GA values. Using data from patients with normal albumin and hemoglobin metabolism, we previously established a linear regression equation describing the GA value versus the HbA1c value to calculate an extrapolated HbA1c (eHbA1c) value for the accurate evaluation of glycemic control. In this study, we investigated the difference between the measured HbA1c and the eHbA1c values for patients with various conditions. Methods: Data sets for a total of 2461 occasions were obtained from 731 patients whose HbA1c and GA values were simultaneously measured. We excluded patients with missing data or changeable HbA1c levels, and patients who had received transfusions or steroids within the previous 3 months. Finally, we included 44 patients with chronic renal failure (CRF), 10 patients who were undergoing hemodialysis (HD), 7 patients with hematological malignancies and a hemoglobin level of less than 10 g/dL (HM), and 12 patients with chronic liver diseases (CLD). Results: In all the groups, the eHbA1c values were significantly higher than the measured HbA1c values. The median difference was 0.75 % (95 % CI 0.40-1.10 %, P for the difference is <0.001) in the CRF group, 0.80 % (95 % CI 0.30-1.65 %, P for the difference is 0.041) in the HD group, 0.90 % (95 % CI 0.90-1.30 %, P for the difference is 0.028) in the HM group, and 0.85 % (95 % CI 0.40-1.50 %, P for the difference is 0.009) in the CLD group. Conclusions: We found that the measured HbA1c values were lower than the eHbA1c values in each of the groups. [ABSTRACT FROM AUTHOR]

Molecularly imprinted polymers (MIPs) are tailor-made biomimetic receptors obtained by polymerization in the presence of molecular templates. They contain binding sites for target molecules with affinities and specificities on a par with those of antibodies, hormone receptors or enzymes. Mainly synthesized via radical polymerization of vinyl monomers, MIPs have also recently taken advantage of the introduction of modern methods of controlled/living radical polymerization (CRPs). In this paper, we report for the first time the use for MIP synthesis of a recently developed CRP method based on an iodide-transfer polymerization with a reversible activation mechanism, referred to as Reversible chain-Transfer Catalysed Polymerization (RTCP). Using S-propranolol as model template, we show that this technique is a convenient method for the synthesis of MIPs, both in the format of bulk polymers and nanoparticles, yielding polymers with reactive chain ends for an easy surface functionalization. [ABSTRACT FROM AUTHOR]

Aims/Introduction To provide age- and sex-specific trends, age-standardized trends, and projections of diabetes prevalence through the year 2030 in the Japanese adult population. Materials and Methods In the present meta-regression analysis, we included 161,087 adults from six studies and nine national health surveys carried out between 1988 and 2011 in Japan. We assessed the prevalence of diabetes using a recorded history of diabetes or, for the population of individuals without known diabetes, either a glycated hemoglobin level of ≥6.5% (48 mmol/mol) or the 1999 World Health Organization criteria (i.e., a fasting plasma glucose level of ≥126 mg/ dL and/or 2-h glucose level of ≥200 mg/ dL in the 75-g oral glucose tolerance test). Results For both sexes, prevalence appeared to remain unchanged over the years in all age categories except for men aged 70 years or older, in whom a significant increase in prevalence with time was observed. Age-standardized diabetes prevalence estimates based on the Japanese population of the corresponding year showed marked increasing trends: diabetes prevalence was 6.1% among women (95% confidence interval [ CI] 5.5-6.7), 9.9% (95% CI 9.2-10.6) among men, and 7.9% (95% CI 7.5-8.4) among the total population in 2010, and was expected to rise by 2030 to 6.7% (95% CI 5.2-9.2), 13.1% (95% CI 10.9-16.7) and 9.8% (95% CI 8.5-12.0), respectively. In contrast, the age-standardized diabetes prevalence using a fixed population appeared to remain unchanged. Conclusions This large-scale meta-regression analysis shows that a substantial increase in diabetes prevalence is expected in Japan during the next few decades, mainly as a result of the aging of the adult population. [ABSTRACT FROM AUTHOR]

This chapter reviews surface-initiated living radical polymerizations via iodine transfer polymerization (ITP), organotellurium-mediated radical polymerization (TERP), and reversible chain-transfer catalyzed polymerization (RTCP) using organic catalysts. The successful application of these polymerizations made it possible to graft various polymers with well-defined structures onto flat substrates and nanoparticles. Living radical polymerizations, including ITP, TERP, and RTCP, also lead to a striking increase in the graft density. Because of their unique advantages as synthetic tools, ITP, TERP, and RTCP can be used to expand the scope of controlled surface modification. [ABSTRACT FROM AUTHOR]

Objective: We aimed to examine factors associated with untreated diabetes in a nationally representative sample of the Japanese population. Research Design and Methods: We pooled data from the Japanese National Health and Nutrition Survey from 2005 to 2009 (n = 20,496). Individuals aged 20 years and older were included in the analysis. We classified participants as having diabetes if they had HbA1c levels ≥6.5% (≥48 mmol/mol). People with diabetes who self-reported that they were not currently receiving diabetic treatment were considered to be untreated. We conducted a multinomial logistic regression analysis to determine factors associated with untreated diabetes relative to non-diabetic individuals. Results: Of 20,496 participants who were included in the analysis, untreated diabetes was present in 748 (3.6%). Among participants with untreated diabetes, 48.3% were previously diagnosed with diabetes, and 46.5% had HbA1c levels ≥7.0% (≥53 mmol/mol). Participants with untreated diabetes were significantly more likely than non-diabetic participants to be male, older, and currently smoking, have lower HDL cholesterol levels and higher BMI, non-HDL cholesterol levels, and systolic blood pressure. Conclusions: A substantial proportion of people in Japan with untreated diabetes have poor glycemic control. Targeting relevant factors for untreated diabetes in screening programs may be effective to enhance the treatment and control of diabetes. [ABSTRACT FROM AUTHOR]

Aims/Introduction Recently, the prevalence of lifestyle-related disease has increased, and its associated medical costs have become considerable. Although walking is thought to prevent lifestyle-related disease, few studies have evaluated its effect on medical costs in Japanese subjects. We aimed at evaluating the effect of walking on medical costs by simulation mainly focusing on diabetes in the Japanese population. Materials and Methods A Markov model focusing on diabetes was constructed. As complications of diabetes, 'dialysis', 'ischemic heart disease' and 'stroke' were included. The model has four states: 'non-diabetes', 'diabetes', 'dialysis' and 'dead', and 'ischemic heart disease' and 'stroke' were included as events that occurred in each state. The effect of walking was included as changing the rate of transition and incident rates of events. Results After 10 years, the numbers of subjects with diabetes were 4.3 and 7.3% lower for daily increase of 3,000 and 5,000 steps, respectively. The numbers of cases of ischemic heart disease and stroke also decreased. Lower medical costs were also seen according to the daily increase in steps. In 10 years, the total medical costs were 5.2 and 8.4% lower for 3,000 and 5,000 steps increase, respectively. The cost reduction associated with a daily increase of 3,000 steps walked was calculated as ¥0.00146 for each step. Conclusions Walking is one of the most common and accessible forms of exercises. The present results suggested that walking reduced the medical costs associated with lifestyle-related disease, which will have a large impact on health policy. [ABSTRACT FROM AUTHOR]

A new method of producing carbon-centered radicals was discovered through the reaction of an alkyl iodide (R-I) with organic salts to reversibly generate the corresponding alkyl radical (R•). Via this new reaction, the organic salts were used as new and highly efficient organic catalysts in living radical polymerization. The catalysts included common and inexpensive compounds such as tetrabutylammonium iodide and methyltributylphosphonium iodide. Notably, the catalysts were highly reactive. They enabled the synthesis of high-molecular-weight polymers (up to Mn = 140?000) and the control of acrylate polymerization, which had been difficult with other organic catalysts. The organic salt catalysts were highly versatile, reacting with methacrylate, acrylate, styrene, acrylonitrile, and functional methacrylate monomers. Well-defined block copolymers were also prepared by using this method. A kinetic study quantitatively confirmed the high reactivity of these catalysts. Attractive features of this system include its low cost, its ease of operation, and its ability to access a wide range of polymer designs. [ABSTRACT FROM AUTHOR]

A growing body of evidence from observational studies and meta-analyses of the data suggest that diabetes mellitus is associated with an increased risk of cancer. Meta-analyses have shown that diabetes increases the risks of total cancer, and of site-specific cancers of the breast, endometrium, bladder, liver, colorectum and pancreas, and that it decreases the risk of prostate cancer. Insulin resistance and secondary hyperinsulinemia is the most frequently proposed hypothesis, and hyperglycemia itself might promote carcinogenesis. In addition to several facets of lifestyle including obesity, smoking and lack of exercise, treatment for diabetes might affect the risk of cancer. For instance, metformin, an insulin sensitizer, reportedly has a potential anticancer effect. In light of the exploding global epidemic of diabetes, even a modest increase in the cancer risk will translate into a substantial socioeconomic burden. The current insights underscore the need for clinical attention and better-designed studies of the complex interactions between diabetes and cancer. [ABSTRACT FROM AUTHOR]

Photoinduced reversible complexation mediated polymerization(photo-RCMP) was developed as a new photoinduced living radical polymerization(LRP). It consisted of an alkyl iodide as a dormant species and anamine as a catalyst, using visible light at 350–600 nm. Theamine catalysts include such common compounds as tributylamine. Mechanistically,the polymerization is induced by the photolysis of the dormant speciesand dormant species/catalyst complex, which frequently occurs as themain activation process. The polymer molecular weight and its distribution(Mw/Mn= 1.1–1.4)were well controlled in the polymerizations of methyl methacrylateand some functional methacrylates up to fairly high conversions inmany cases. Perfectly no polymerization took place without photoirradiation,meaning that the system is an ideal photo “on”–“off”switchable system. The polymerization rate was also finely tunableby the external irradiation power. Attractive features of photo-RCMPinclude the uses of inexpensive compounds and visible light, goodpolydispersity control, good tolerance to functional groups, and fineresponse to external photoirradiation. [ABSTRACT FROM AUTHOR]

Objective: Low-carbohydrate diets and their combination with high-protein diets have been gaining widespread popularity to control weight. In addition to weight loss, they may have favorable short-term effects on the risk factors of cardiovascular disease (CVD). Our objective was to elucidate their long-term effects on mortality and CVD incidence. Data sources: MED LINE, EMBASE, ISI Web of Science, Cochrane Library, and ClinicalTrials.gov for relevant articles published as of September 2012. Cohort studies of at least one year's follow-up period were included. Review methods: Identified articles were systematically reviewed and those with pertinent data were selected for meta-analysis. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) for all-cause mortality, CVD mortality and CVD incidence were calculated using the random-effects model with inverse-variance weighting. Results: We included 17 studies for a systematic review, followed by a meta-analysis using pertinent data. Of the 272,216 people in 4 cohort studies using the low-carbohydrate score, 15,981 (5.9%) cases of death from all-cause were reported. The risk of all-cause mortality among those with high low-carbohydrate score was significantly elevated: the pooled RR (95% CI) was 1.31 (1.07-1.59). A total of 3,214(1.3%) cases of CVD death among 249,272 subjects in 3 cohort studies and 5,081 (2.3%) incident CVD cases among 220,691 people in different 4 cohort studies were reported. The risks of CVD mortality and incidence were not statistically increased: the pooled RRs (95% CIs) were 1.10 (0.98-1.24) and 0.98 (0.78-1.24), respectively. Analyses using low-carbohydrate/high-protein score yielded similar results. Conclusion: Low-carbohydrate diets were associated with a significantly higher risk of all-cause mortality and they were not significantly associated with a risk of CVD mortality and incidence. However, this analysis is based on limited observational studies and large-scale trials on the complex interactions between low-carbohydrate diets and long-term outcomes are needed. [ABSTRACT FROM AUTHOR]

Background: A growing body of evidence has suggested that metformin potentially reduces the risk of cancer. Our objective was to enhance the precision of estimates of the effect of metformin on the risk of any-site and site-specific cancers in patients with diabetes. Methods/Principal Findings: We performed a search of MEDLINE, EMBASE, ISI Web of Science, Cochrane Library, and ClinicalTrials.gov for pertinent articles published as of October 12, 2011, and included them in a systematic review and meta-analysis. We calculated pooled risk ratios (RRs) for overall cancer mortality and cancer incidence. Of the 21,195 diabetic patients reported in 6 studies (4 cohort studies, 2 RCTs), 991 (4.5%) cases of death from cancer were reported. A total of 11,117 (5.3%) cases of incident cancer at any site were reported among 210,892 patients in 10 studies (2 RCTs, 6 cohort studies, 2 case-control studies). The risks of cancer among metformin users were significantly lower than those among nonmetformin users: the pooled RRs (95% confidence interval) were 0.66 (0.49-0.88) for cancer mortality, 0.67 (0.53-0.85) for allcancer incidence, 0.68 (0.53-0.88) for colorectal cancer (n = 6), 0.20 (0.07-0.59) for hepatocellular cancer (n = 4), 0.67 (0.45-0.99) for lung cancer (n = 3). Conclusion/Significance: The use of metformin in diabetic patients was associated with significantly lower risks of cancer mortality and incidence. However, this analysis is mainly based on observational studies and our findings underscore the more need for long-term RCTs to confirm this potential benefit for individuals with diabetes. [ABSTRACT FROM AUTHOR]

Polymer brushes of water-soluble polymers, poly(2-hydroxyethyl acrylate) (PHEA) and poly(poly(oxyethyleneglycol)methylether acrylate) (PPEGA), were synthesized on a silicon wafer and a silica particle by applying photo-induced organotellurium-mediated radical polymerization to surface-initiated graft polymerization. High graft densities were obtained, corresponding to reduced graft densities of about 0.32 and 0.42 for the PHEA and PPEGA brushes, respectively. These values were high enough to be categorized in the regime of 'concentrated' polymer brushes (CPBs). Atomic force microscopic (AFM) study revealed that the CPB of PPEGA was allowed to be highly swollen in water but the CPB of PHEA did not. This means that water is reasonably good for PPEGA but not for PHEA. The AFM microtribological study between swollen brushes revealed two lubrication regimes, namely, boundary- and hydrodynamic-lubrication regimes, with different shear-velocity dependencies. Reflecting insufficient quality of water as a solvent, the CPB of PHEA showed adhesive interaction and thereby a higher frictional coefficient μ in the boundary lubrication. More interestingly, super lubrication was achieved for the CPB of PPEGA with a μ value in the order of 10−4 in water and in 0.1 M aqueous NaCl solution (without the help of electrostatic repulsion). Super lubrication was concluded to be a characteristic feature of the CPB, even in an aqueous system. © 2011 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem, 2011 [ABSTRACT FROM AUTHOR]

OBJECTIVE--Coffee consumption has been inversely associated with type 2 diabetes risk, but its mechanisms are largely unknown. We aimed to examine whether plasma levels of sex hormones and sex hormone-binding globulin (SHBG) may account for the inverse association between coffee consumption and type 2 diabetes risk. RESEARCH DESIGN AND METHODS--We conducted a case-control study nested in the prospective Women's Health Study (WHS). During a median follow-up of 10 years, 359 postmenopausal women with newly diagnosed type 2 diabetes were matched with 359 control subjects by age, race, duration of follow-up, and time of blood draw. RESULTS--Caffeinated coffee was positively associated with SHBG but not with sex hormones. Multivariable-adjusted geometric mean levels of SHBG were 26.6 nmol/l among women consuming ≥4 cups/day of caffeinated coffee and 23.0 nmol/l among nondrinkers (P for trend = 0.01). In contrast, neither decaffeinated coffee nor tea was associated with SHBG or sex hormones. The multivariable-adjusted odds ratio (OR) of type 2 diabetes for women consuming ≥4 cups/day of caffeinated coffee compared with nondrinkers was 0.47 (95% CI 0.23- 0.94; P for trend = 0.047). The association was largely attenuated after further adjusting for SHBG (OR 0.71 [95% CI 0.31-1.61]; P for trend = 0.47). In addition, carriers of rs6259 minor allele and noncarriers of rs6257 minor allele of SHBG gene consuming ≥2 cups/day of caffeinated coffee had lower risk of type 2 diabetes in directions corresponding to their associated SHBG. CONCLUSIONS--Our findings suggest that SHBG may account for the inverse association between coffee consumption and type 2 diabetes risk among postmenopausal women. Diabetes 60: 269-275, 2011 [ABSTRACT FROM AUTHOR]

The major stratospheric sudden warming (SSW) event of January 2009 is analyzed using the Japan Meteorological Agency (JMA) Climate Data Assimilation System (JCDAS). This SSW event is characterized by the extraordinary predominance of the planetary-scale wave of zonal wavenumber 2 (wave 2). The total amount of the upward Eliassen–Palm (EP) flux for wave 2 was the strongest since the winter of 1978/79. It is found that the remarkable development of the upper troposphere ridge over Alaska played important roles in the SSW in January 2009. During the first development stage, the ridge excited wave packets upward as well as eastward over around Alaska. The eastward-propagating packets intensified a trough over eastern Siberia, which led to the development of the planetary wave over eastern Siberia during the second development stage. The results of this study indicate that the pronounced wave-2 pattern observed in the stratosphere was brought about by accumulative effects of rather localized propagation of wave packets from the troposphere during the course of this SSW event rather than by the ubiquitous propagation of planetary-scale disturbances in the troposphere. The features of the SSW in January 2009 are quite similar to those during the major stratospheric warming event in February 1989: both SSWs are characterized by the predominance of wave 2, the remarkable development of the upper troposphere ridge over around Alaska, and positive SSTs in the eastern part of the North Pacific corresponding to a La Niña condition. [ABSTRACT FROM AUTHOR]

Abstract: This article introduces the new family of living radical polymerizations with germanium (Ge), tin (Sn), phosphorus (P), and nitrogen (N) catalysts which we recently developed. The polymerizations are based on a new reversible activation mechanism, Reversible chain Transfer (RT) catalysis. Low-polydispersity polymers are obtained in the homopolymerizations and random and block copolymerizations of styrene, methyl methacrylate, and functional methacrylates. The background, performance, and kinetic features of the polymerizations are described. Attractive features of the catalysts include their high reactivity, low toxicity (Ge, P, and N), low cost (P and N), and ease of handling (robustness). [Copyright &y& Elsevier]

We present a scheme of surface-sensitive nuclear magnetic resonance in optically pumped semiconductors, where an NMR signal from a part of the surface of a bulk compound semiconductor is detected apart from the bulk signal. It utilizes optically oriented nuclei with a long spin-lattice relaxation time as a polarization reservoir for the second (target) nuclei to be detected. It provides a basis for the nuclear spin polarizer [IEEE Trans. Appl. Supercond. 14:1635, ], which is a polarization reservoir at the surface of the optically pumped semiconductor that polarizes nuclear spins in a target material in contact through the nanostructured interfaces. [ABSTRACT FROM AUTHOR]

Background: An inappropriately low frequency of healthcare utilization has been reported to be associated with poor control of chronic diseases, accelerating healthcare disparities. However, the evidence is limited regarding the association between no healthcare utilization and mortality.Objectives: To examine whether individuals without healthcare utilization have the increased risks of mortality among the US general population.Design: Prospective cohort study PARTICIPANTS: Adults aged ≥ 20 years (n = 39,067) in the National Health and Nutrition Examination Survey (NHANES)1999-2014 linked to national mortality data through December 2015.Main Measures: The exposure was the number of visits to healthcare providers during the past year (healthcare utilization): none, 1-3 times (referent), 4-9 times, or ≥ 10 times. Cox hazard regression models were employed to estimate the adjusted hazard ratios (aHR) of all-cause, cardiovascular, and cancer mortality adjusting for socio-demographic characteristics and comorbidities.Key Results: During a median follow-up of 7.4 years, participants without visit over the past year showed higher risks of all-cause mortality (aHR [95% CI] = 1.16 [1.04-1.30]) and cardiovascular mortality (aHR [95% CI] = 1.62 [1.28-2.05]) than those who visited the office 1-3 times. We found no evidence of the association between no visit and cancer mortality. The association between no providers' office visit and all-cause mortality was stronger among males (aHR [95% CI] = 1.22 [1.06-1.40]) than females (aHR [95% CI] = 0.97 [0.79-1.19]; p-for-interaction = 0.01) and among uninsured individuals (aHR [95% CI] = 1.22 [0.98-1.51]) than insured individuals (aHR [95% CI] = 1.09 [0.95-1.25]; p-for-interaction = 0.04).Conclusion: No providers' office visit over a year was associated with increased risks of all-cause and cardiovascular mortality. Further investigations are warranted to identify the underlying reasons for the elevated mortality risks due to no healthcare utilization. [ABSTRACT FROM AUTHOR]

Background Preexisting diabetes may contribute to the indication for adjuvant chemotherapy among patients with colorectal cancer (CRC); however, the association between diabetes and its implementation is largely unknown. Methods We analyzed the hospital-based cancer registry and health claims data of patients with stage III CRC who received curative surgery in 2013 in Japan (n = 6,344). Chemotherapy and diabetes was identified based on procedure, prescription, and diabetes codes in claims data. We examined the association between diabetes and implementation rate of adjuvant chemotherapy using the generalized linear model adjusted for age, sex, and updated Charlson Comorbidity Index, hospital type, and prefecture. We further applied a mediation analysis to examine the extent to which postoperative complications mediated the association. Results Of these, 1,236 (19.5%) had diabetes. Compared with those without diabetes, patients with diabetes were less likely to receive adjuvant chemotherapy (crude rate: 58.9% and 49.8%; adjusted percentage point difference: 4.7% [95% confidence limits: 1.7, 7.5]). Mediation analysis indicated that postoperative complications explained 9.4% of the association between diabetes and adjuvant chemotherapy implementation. Conclusions Our findings suggest that patients with stage III CRC and diabetes are less likely to receive adjuvant chemotherapy than those without diabetes, and postoperative complications may partially account for the association. Key messages Concomitant diabetes might negatively impact the implementation rate of adjuvant chemotherapy in patients with stage III CRC. [ABSTRACT FROM AUTHOR]

A novel class of living radical polymerizations with germanium, tin, and phosphorus catalysts were developed. The polymerizations are based on a new reversible activation mechanism, Reversible chain Transfer (RT) catalysis. Low-polydispersity (Mw/Mn≈ 1.1-1.3) polystyrene, poly(methyl methacrylate), poly(glycidyl methacrylate), and poly(2-hydroxyethyl methacrylate) with predicted molecular weight were obtained with fairly high conversion in a fairly short time. The pseudo-first-order activation rate constant kact for the styrene/Gel4 (catalyst) system was large enough, even with a small amount of Gel4, explaining why the system provides low-polydispersity polymers from an early stage of polymerization. The retardation in the polymerization rate observed for the styrene/Gel4 system was kinetically proven to be mainly due to the cross-termination between the propagating radical with Gel3. Attractive features of the germanium, tin, and phosphorus catalysts include their high reactivity hence small amounts (1-10 mM) being required under relatively mild conditions (at 60-100 °C), high solubility in organic media without ligands, insensitivity to air hence sample preparation being allowed in the air, and minor color and smell. The germanium and phosphorus catalysts may also be attractive for their low toxicity. The phosphorus catalysts may also be attractive for their low cost. [ABSTRACT FROM AUTHOR]

We have been developing a nuclear hyperpolarization and polarization transfer system for semiconductors. It enables successive transfers of polarization (angular momentum) from photons to nuclear spins via photo-excited electrons in semiconductors using laser, microwave and multi-channel radio-frequency fields, resulting in the nuclear hyperpolarization in a target material. A part of the system has been completed and successfully applied to the hyperpolarization and polarization transfer experiments in InP and GaAs. The current status of the system is presented together with some preliminary data. [ABSTRACT FROM AUTHOR]

We describe an optical-pumping double-resonance NMR system equipped with a single-coil double-tuning (XY) probe with an optical fiber attachment working in a helium-gas flow cryostat. The system enables simultaneous control of an infrared light and two radio-frequency fields irradiated to a sample, so that solid-state NMR techniques such as spin locking, decoupling, and cross polarization can be invoked under the optical-pumping condition. A nuclear hyperpolarization transfer experiment in optically pumped InP:Fe is presented. [ABSTRACT FROM AUTHOR]

Abstract: The degenerative (exchange) chain transfer constant C ex was determined for the dithioacetate-mediated living radical block and random copolymerizations of styrene (St) and methyl methacrylate (MMA) at 40°C. The addition of the polystyrene (PSt) radical to a polymer–dithioacetate adduct (P–X) to form the intermediate radical (PSt–(X )–P) was (about twice) faster than that of the poly(methyl methacrylate) (PMMA) radical to form the intermediate radical PMMA–(X )–P. The fragmentation (release) of the PMMA radical from the PSt–(X )–PMMA intermediate formed at the initiating stage of block copolymerization was much (about 100 times) faster than the release of the PSt radical, explaining why the block copolymerization of MMA from a PSt–dithiocarbonate adduct is not so satisfactory as that of St from a PMMA–dithiocarbonate adduct. In the random copolymerization, there was implicit penultimate unit effect on the exchange chain transfer process, which appeared in the addition process but not in the fragmentation process. [Copyright &y& Elsevier]

We have been developing an optical pumping nuclear spin polarizer (OPNSP) to enhance nuclear magnetic resonance (NMR) signals from small amount of nano- and biological materials. In this scheme, a semiconductor and a target (nano- or biological) material are in close contact with each other, and high nuclear spin polarization in the semiconductor created by the optical pumping method is transferred to the nuclei in the target material by a cross-polarization at the interfaces and a spin diffusion inside the target material. As a result, high nuclear spin polarization is realized in the target material. In this paper, we present profiles of the nuclear spin polarization in the target material of the OPNSP calculated for the multilayered and multi-columnar configurations, from which suitable designs of the OPNSP to achieve high nuclear polarization in the target materials are discussed. [ABSTRACT FROM AUTHOR]

This review covers fundamental kinetic features of living radical polymerization (LRP). Theories on polymerization rate Rp and polydispersity index (PDI) and experimental investigations into individual LRP systems are summarized. The presence of bimolecular termination, which is unavoidable in LRP as well as in conventional radical polymerization, provides LRP with the characteristic time dependence of radical concentrations and hence Rp and PDI, depending on experimental conditions, such as the presence or absence of conventional initiation. Despite the presence of termination (and initiation, in some cases), the product from LRP can have a low polydispersity, provided that the number of terminated chains is small compared to the number of potentially active, i.e. living, chains. On the premise that an activation–deactivation quasi-equilibrium holds, a large rate constant of activation, kact, is another fundamental requisite for low polydispersities. The kinetic parameters related to reversible activation reactions are tabulated. Treated in this review are nitroxide-mediated polymerization, atom transfer radical polymerization, iodide-mediated polymerization, reversible addition–fragmentation chain transfer polymerization, and organotellurium-mediated radical polymerization. [Copyright &y& Elsevier]

A core (305 cm long) taken from Lake Siling in central Tibet is subdivided on the basis of carbonate composition into a dolomite zone (275–255 cm depth), a dolomite–aragonite zone (255–245 cm depth), an aragonite zone (245–147.5 cm depth) and a hydromagnesite–aragonite zone (147.5–30 cm depth). Most core samples contain clay minerals, quartz and low-Mg calcite. Six samples on terraces near the lakeshore consist of hydromagnesite with heavy O and C stable isotopic ratios and low density. The hydromagnesite–aragonite zone is characterized by a strong correlation among δ18O (−4.9–2.3‰), δ13C (5.5–8.0‰) and particle density (2.40–2.68 g/cm3). This occurs when carbonates from the underlying aragonite zone, characterized by lighter O and C isotopic ratios and high density, are plotted against terrace samples of hydromagnesite. The correlation in the hydromagnesite–aragonite zone is attributed to the mixing of hydromagnesite with the aragonite zone sediments in varying proportions. When compared with available 14C TAMS ages, it appears that hydromagnesite was added to bottom sediments at about 5000 years bp. At that time, the lake began to shrink and formed lacustrine terraces because evaporation dominated over precipitation around the lake. The depositional rate of the hydromagnesite–aragonite zone (0.6 mm/year) was about six times faster than that of the aragonite zone (0.1 mm/year) due to formation of hydromagnesite within an arid climate. The plausible sources of four carbonate minerals are as follows: (1) aragonite is an inorganic carbonate from the lake water, (2) hydromagnesite is an evaporitic carbonate on terraces, (3) dolomite is a diagenetic carbonate and (4) low-Mg calcite is a detrital carbonate. [Copyright &y& Elsevier]

We have developed an optical pumping NMR system for semiconductors as an effective nuclear spin polarizer for a solid-state NMR quantum computer. The system was successfully applied to enhance 31P nuclear spin polarization in InP doped with Fe, and the enhancement of the 31P NMR signal by more than two orders of magnitude was achieved. We also observed the strong dependences of the enhancement on the helicity and the photon energy of incident light. The most effective enhancement was achieved with the helicity σ+ and photon energy smaller than the bandgap by 10∼15 meV. [Copyright &y& Elsevier]