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Ono M, Takahashi K, Hara H, Gao C, Wang R, Kappetein P, Mohr F, Mack M, Holmes D, Morice M, Davierwala P, Head S, Onuma Y, Thuijs D, Serruys P. Ten-year all-cause death in elderly patients undergoing percutaneous coronary intervention or coronary artery bypass grafting: a prespecified subgroup analysis of the SYNTAX Extended Survival study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Coronary artery disease is the leading cause of death among elderly men and women worldwide. The aging society worldwide will lead to increasing numbers of elderly patients with multivessel coronary artery disease. Although age is recognized as one of the most important factors in a decision-making for revascularization of multivessel coronary artery disease, the very long-term outcomes in patients undergoing revascularization by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) is still unclear.
Objectives
The aim of the present study was to investigate the association between revascularization strategies and 10-year outcomes in elderly patients.
Methods
The SYNTAX Extended Survival (SYNTAXES) study (NCT 03417050) is an investigator-driven extension of follow-up of a multicentre, randomised controlled trial done in 85 hospitals across 18 North American and European countries, enrolling 1,800 patients with de novo three-vessel disease (3VD) and/or left main coronary artery disease (LMCAD) randomized to revascularization strategy with CABG versus PCI in the SYNTAX trial. Patients were divided into two groups according to the prespecified threshold of 70 years old; elderly patients (>70 years) and non-elderly patients (≤70 years). The primary endpoint of this study was all-cause death at 10 years.
Results
Out of 1,800 patients, 575 patients (31.9%) were classified as elderly (>70 years). The mean age ± standard deviation (SD) of the elderly patients and the non-elderly patients was 75.8±3.6 years and 60.1±7.4 years, respectively. Of note, elderly patients were more frequently female than non-elderly patients (33.6% vs. 17.1%, p<0.001). As expected, the elderly patients had higher prevalence of chronic kidney disease (43.4% vs. 7.9%, p<0.001), had higher anatomical SYNTAX score (30.2±11.8 vs 28.0±11.2 p<0.001) when compared to those of the non-elderly patients.
Up to 10 years, all-cause death occurred in 42.7% and 18.9% in the elderly and non-elderly patients, respectively (Log-rank p<0.001). The cubic spline curve showed an exponentially increase in all-cause death at 10 years according to the increase of age both in the PCI arm and the CABG arm. At 10 years, there was no significant difference in the risk of all-cause death between CABG vs. PCI either in elderly patients (41.5% vs. 44.0%; Log-rank p=0.53) or non-elderly patients (16.6% vs. 21.1%; Log-rank p=0.051).
Conclusion
CABG and PCI were equipoise in terms of risk of all-cause death at 10 years in patients with de novo 3VD and/or LMCAD irrespective of their age when stratified according to the prespecified threshold of 70 years old.
Kaplan-Meier curves
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): German Foundation of Heart Research
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Asano T, Ono M, Saito A, Kanie T, Takaoka T, Komiyama N. Twenty-year trends in clinical outcome of randomized controlled trial for coronary intervention: systematic review and meta-regression analysis of 46 randomized controlled trials. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Aim
The technology of percutaneous coronary intervention (PCI) has been developed after the advent of coronary stent. However, the impact of the technological development on clinical outcomes is still unclear, whereas a remarkable improvement of clinical outcomes after PCI has not been observed in the trials comparing to medical therapy or coronary bypass graft. The current analysis aims to investigate trends in clinical outcomes after PCI after the emargence of coronary stent, using the randomized controlled trials (RCTs) comparing coronary stents.
Methods and results
We performed a systematic review of RCTs investigating coronary stents in non-specific population (excluding the trials particularly enrolling diabetic or myocardial infarction etc.) conducted between 1996 and 2015 (publication between 1997 and 2019) with independent clinical event adjudication. The random-effect meta-regression analysis including 90 arms with 94,831 patients in 46 RCTs was performed investigating the 20-year trends in clinical outcomes such as death, cardiac death, myocardial infarction, target lesion revascularization (TLR) and stent thrombosis at one and five years after the index procedure. The sensitivity analysis was performed by limiting to 20 all comer trials. In the meta-regression analysis, we did not observe significant change in the incidences of cardiac death and myocardial infarction after PCI over 20 years (P values for cardiac death: 0.666 at one year, 0.256 at five years and P values for myocardial infarction: 0.121 at one year, 0.376 at five years; R2 for cardiac death: <0.01 at one year and five years and R2 for myocardial infarction: <0.01 at one year and five years), whereas the incidences of clinically indicated TLR (P value <0.001, R2 = 0.40 at one year, P value = 0.002, R2 = 0.22 at five years) and stent thrombosis were decreased steeply in the first decade and slightly in the second decade (P value = 0.040, R2 = 0.09 at one year; P value = 0.017, R2 = 0.17 at five year). The sencitivity analysis limiting all-comer population revealed the consistent results.
Conclusion
The development of PCI had an impact on the 20-year trends in TLR and ST, despite there were no trends in the cardiac death and myocardial infarction.
Trends in the incidence of the outcomes
Funding Acknowledgement
Type of funding source: None
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Zawierucha K, Porazinska DL, Ficetola GF, Ambrosini R, Baccolo G, Buda J, Ceballos JL, Devetter M, Dial R, Franzetti A, Fuglewicz U, Gielly L, Łokas E, Janko K, Novotna Jaromerska T, Kościński A, Kozłowska A, Ono M, Parnikoza I, Pittino F, Poniecka E, Sommers P, Schmidt SK, Shain D, Sikorska S, Uetake J, Takeuchi N. A hole in the nematosphere: tardigrades and rotifers dominate the cryoconite hole environment, whereas nematodes are missing. J Zool (1987) 2020. [DOI: 10.1111/jzo.12832] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Ono M, Raman R. Active Radiative Liquid Lithium Divertor for Handling Transient High Heat Flux Events. JOURNAL OF FUSION ENERGY 2020. [DOI: 10.1007/s10894-020-00253-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tamura K, Takahashi S, Mukohara T, Tanioka M, Yasojima H, Ono M, Naito Y, Shimoi T, Otani Y, Kobayashi K, Kogawa T, Suzuki T, Takase T, Matsunaga R, Masuda N. 346P Phase I study of the liposomal formulation of eribulin (E7389-LF): Results from the HER2-negative breast cancer expansion. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Ono M, Oh A, Ota M, Miyaguchi Y, Ueda H, Kinai E. PRO12 Investigation of Consistency of Haemophilia a Care in JAPAN: A Claims-Based Cohort Study. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ono M, Onuma Y, Serruys PW, Wykrzykowska JJ. Will coronary artery bypass grafting remain a standard of care for elderly patients with multivessel disease in the contemporary era? Neth Heart J 2020; 28:457-459. [PMID: 32737679 PMCID: PMC7431478 DOI: 10.1007/s12471-020-01477-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Ishiyama D, Makino E, Nakamura Y, Uchida M, Shimizu H, Ono M, Horikita T. Perinatal rib fractures in 18 calves delivered from Holstein dams. Vet Anim Sci 2020; 10:100134. [PMID: 32775764 PMCID: PMC7399173 DOI: 10.1016/j.vas.2020.100134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/04/2020] [Accepted: 07/18/2020] [Indexed: 11/29/2022] Open
Abstract
We diagnosed rib fractures by palpation, computed tomography, and thoracic necropsy. For 163 symptomatic calves delivered from Holstein-Friesian dams on farms in Japan, 11.0% (18) showed rib fractures by palpation. Four of five calves that were scanned or necropsied presented with pneumonia despite not having tracheal stenosis. Rib fractures decreased sale prices at a livestock market and longevity.
Cranial rib fractures during dystocia and the ensuing callus formations in calves often cause tracheal stenosis. Rib fractures may affect the lung since ribs tend to fracture above the costochondral junction during delivery. Considering that calving assistance rates for dystocia are high, calves with fractured ribs may develop respiratory disease which results in economic loss. The objective of this study was to elucidate the contribution of rib fractures to economic loss through respiratory disease in calves. Of 163 sick calves delivered from Holstein-Friesian dams included in this study, a total of 18 rib fractured calves was found, giving an incidence of rib fracture in sick calves of 11.0%. There were significant differences in incidence by the rib involved, indicating the 2nd to 7th ribs tend to break. Many of the rib fractured calves showed dyspnea and pyrexia. In this study, four of five scanned or necropsied calves had pneumonia lesions despite the fact that these four calves did not have tracheal stenosis. Rib fractured calves sold at below market value with a median difference from average sale price of minus 64,861 yen. Survival analysis indicated an overall association between rib fracture and time to death. In this study, we demonstrated that rib fractures happened most frequently in the 2nd to 7th ribs, and these cases tended to cause pneumonia, which decreased sale prices and longevity. Farmers should work to reduce risks and rates of dystocia so as to lessen economic loss and poor welfare in calves due to rib fractures.
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Itoda Y, Kinoshita O, Yamauchi H, Shimada S, Ando M, Kimura M, Komae H, Hoshino Y, Inoue T, Tsuji M, Ono M. Efficacy of the Tricuspid Valve Intervention at the Time of Ventricular Assist Device Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Higuchi T, Yoshimura M, Oka S, Tanaka K, Naito T, Yuhara S, Warabi E, Mizuno S, Ono M, Takahashi S, Tohma S, Tsuchiya N, Furukawa H. Modulation of methotrexate-induced intestinal mucosal injury by dietary factors. Hum Exp Toxicol 2019; 39:500-513. [PMID: 31876189 DOI: 10.1177/0960327119896605] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Methotrexate (MTX)-induced intestinal mucosal injury in animals has been studied to understand how MTX can cause gastrointestinal disorders, but the pathogenesis of gastrointestinal disorders is still uncertain. We have attempted to reveal how dietary factors influence intestinal toxicity due to MTX. Mice were fed normal chow (NC) or a high-fat high-sucrose diet (HFHSD) before oral administration of MTX. While MTX significantly decreased the survival rates of mice fed HFHSD, the intestinal epithelial injury was detected. MTX excretion in the feces of mice fed HFHSD was reduced. Change of diets between NC and HFHSD influences the survival. The survival rates of the mice fed a high-sucrose diet or control diet were higher than those fed HFHSD. Higher survival rates were observed in mice fed a high-fat high-sucrose diet modified (HFHSD-M) in which casein was replaced by soybean-derived proteins. The survival rates of mice treated with vancomycin were lower than those administered neomycin. Microbiome and metabolome analyses on feces suggest a similarity of the intestinal environments of mice fed NC and HFHSD-M. HFHSD may modify MTX-induced toxicity in intestinal epithelia on account of an altered MTX distribution as a result of change in the intestinal environment.
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Idei H, Onchi T, Kariya T, Tsujimura T, Kubo S, Kobayashi S, Sakaguchi M, Imai T, Hasegawa M, Nakamura K, Mishra K, Fukuyama M, Yunoki M, Kojima S, Watanabe O, Kuroda K, Hanada K, Nagashima Y, Ejiri A, Matsumoto N, Ono M, Higashijima A, Nagata T, Shimabukoro S, Takase Y, Fukuyama A, Murakami S. 28-GHz ECHCD system with beam focusing launcher on the QUEST spherical tokamak. FUSION ENGINEERING AND DESIGN 2019. [DOI: 10.1016/j.fusengdes.2019.02.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Itoda Y, Kimura M, Kinoshita O, Yamauchi H, Nawata K, Ono M. Total Replacement of Implantable Left Ventricular Assist Device for Pump Pocket/Device Infection. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Hata H, Toda K, Saiki Y, Ono M, Shiose A, Yoshioka D, Sawa Y. Impact of Concomitant Valve Surgery at the Time of HeartMate II Implantation; Japanese Multicenter Study. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abe T, Ito Y, Fukada I, Shibayama T, Ono M, Kobayashi T, Kobayashi K, Takahashi S, Horii R, Akiyama F, Iwase T, Ueno T, Ohno S. Abstract P4-08-29: Lymphatic invasion is an independent risk factor in patients with small node-negative luminal breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-08-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
[Background]
In patients with node-negative (N0), hormone receptor-positive, human epidermal growth factor receptor (HER2) -negative (luminal) breast cancer, the impact of lymphatic invasion (ly) on the prognosis remains to be clarified.
[Methods]
Among 3,158 patients with primary breast cancers who underwent surgery in our institute from January 2007 to December 2009, we analyzed 1027 N0 luminal invasive breast cancers without preoperative systemic therapy. The luminal breast cancer was defined as hormone receptor-positive (ER of ≥ 10% or PgR of ≥ 10%) and HER2-negative (immunohistochemistry: 0, 1+ or FISH: ratio < 2.0) cancer in the postoperative pathological specimen. ly was defined as positive when cancer cell nests were detected within the lymph duct in the whole specimen. N0 was confirmed pathologically by the sentinel lymph node biopsy in all the patients. The Fisher's exact test was used for comparison between different categories. The distant recurrence rate (DRR) was analyzed using the Kaplan-Meier method and the log-rank test. For multivariate analysis, Cox's regression analysis was performed.
[Results]
The median follow-up period was 103.8 months (range: 5.6-128.8). Recurrence with distant metastasis occurred in 26 patients (2.5%). There were 5 (0.7%) deaths related to breast cancer. ly was detected in 240 patients (23.4%). In the ly-positive group, the tumor size was larger (p = 0.007), and the nuclear grade (NG) was higher (p < 0.001) than in the ly-negative group. Postoperative endocrine therapy (p < 0.001) and postoperative chemotherapy (p < 0.001) were more frequently employed for patients with ly-positive tumor. The univariate analysis showed that ly positivity (p < 0.001), large tumor size (p < 0.001), high NG (p < 0.001), PgR negativity (p = 0.002) and the history of adjuvant chemotherapy (p < 0.001) were associated with high DRR. In the multivariate analysis, large tumor size (p = 0.007) and PgR negativity (p = 0.015) remained significant. Although positive ly had a risk ratio of 2.2, it was not an independent risk factor.When restricted to T1 tumor (n = 899), the aforementioned factors still showed prognostic value in the univariate analysis, among which ly positivity (p = 0.004)remained significant together with PgR negativity (p = 0.047)in themultivariate analysis.The 8-year DRR was very favorable (0.8%) in patients with ly-negative T1N0 tumor while it was modest (6.6%) in patients with ly-positive T1N0 tumor (p < 0.001). Only 1.3% of the patients had received adjuvant chemotherapy in the ly-negative group while 27% of the patients had in the ly-positive group.
[Conclusion]
Lymphatic invasion was associated with higher DRR although it was not independent in the multivariate analysis among patients with N0 luminal breast cancer. When restricted to patients with T1N0 luminal breast cancer, the presence of ly was independently associated with higher risk of distant recurrence. It suggests that the assessment of ly is clinically more relevant when considering treatment options for small luminal breast cancer.
Citation Format: Abe T, Ito Y, Fukada I, Shibayama T, Ono M, Kobayashi T, Kobayashi K, Takahashi S, Horii R, Akiyama F, Iwase T, Ueno T, Ohno S. Lymphatic invasion is an independent risk factor in patients with small node-negative luminal breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-08-29.
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Ono M, Schneider S, Junghaenel DU, Stone AA. What Affects the Completion of Ecological Momentary Assessments in Chronic Pain Research? An Individual Patient Data Meta-Analysis. J Med Internet Res 2019; 21:e11398. [PMID: 30720437 PMCID: PMC6379815 DOI: 10.2196/11398] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/21/2018] [Accepted: 10/26/2018] [Indexed: 11/13/2022] Open
Abstract
Background Ecological momentary assessment (EMA) involves repeated sampling of people’s current experiences in real time in their natural environments, which offers a granular perspective on patients’ experience of pain and other symptoms. However, EMA can be burdensome to patients, and its benefits depend upon patients’ engagement in the assessments. Objective The goal of this study was to investigate factors affecting EMA-completion rates among patients with chronic pain. Methods This individual patient data meta-analysis was based on 12 EMA datasets that examined patients with chronic noncancer-related pain (n=701). The EMA-completion rates were calculated on a daily basis for each patient. Multilevel models were used to test the following predictors of completion rates at different levels: within-patient factors (days into the study and daily pain level), between-patient factors (age, sex, pain diagnosis, and average pain level per person), and between-study EMA design factors (study duration, sampling density, and survey length). Results Across datasets, an EMA-completion rate of 85% was observed. The strongest results were found for the between-patient factor age: Younger respondents reported lower completion rates than older respondents (P=.002). One within-patient factor, study day, was associated with completion rates (P<.001): over the course of the studies, the completion rates declined. The two abovementioned factors interacted with each other (P=.02) in that younger participants showed a more rapid decline in EMA completion over time. In addition, none of the other hypothesized factors including gender, chronic pain diagnoses, pain intensity levels, or measures of study burden showed any significant effects. Conclusion Many factors thought to influence the EMA-completion rates in chronic pain studies were not confirmed. However, future EMA research in chronic pain should note that study length and young age can impact the quality of the momentary data and devise strategies to maximize completion rates across different age groups and study days.
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Stanner C, Horndasch M, Vitanova K, Ono M, Strbad M, Heßling G, Lange R, Cleuziou J. Pacemaker Implantation in the First Year of Life: A Midterm Analysis. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Yamazaki H, Delgado-Aparicio LF, Groebner R, Grierson B, Hill K, Pablant N, Stratton B, Efthimion P, Ejiri A, Takase Y, Ono M. A computational tool for simulation and design of tangential multi-energy soft x-ray pin-hole cameras for tokamak plasmas. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2018; 89:10G120. [PMID: 30399783 DOI: 10.1063/1.5038788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 07/12/2018] [Indexed: 06/08/2023]
Abstract
A new tool has been developed to calculate the spectral, spatial, and temporal responses of multi-energy soft x-ray (ME-SXR) pinhole cameras for arbitrary plasma densities (n e,D), temperature (T e), and impurity densities (n Z). ME-SXR imaging provides a unique opportunity for obtaining important plasma properties (e.g., T e, n Z, and Z eff) by measuring both continuum and line emission in multiple energy ranges. This technique employs a pixelated x-ray detector in which the lower energy threshold for photon detection can be adjusted independently. Simulations assuming a tangential geometry and DIII-D-like plasmas (e.g., n e,0 ≈ 8 × 1019 m-3 and T e,0 ≈ 2.8 keV) for various impurity (e.g., C, O, Ar, Ni, and Mo) density profiles have been performed. The computed brightnesses range from few 102 counts pixel-1 ms-1 depending on the cut-off energy thresholds, while the maximum allowable count rate is 104 counts pixel-1 ms-1. The typical spatial resolution in the mid-plane is ≈0.5 cm with a photon-energy resolution of 500 eV at a 500 Hz frame rate.
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Oguri T, Nakano K, Fukuda N, Kawaguchi K, Urasaki T, Nishizawa M, Yunokawa M, Ono M, Taira S, Tomomatsu J, Toshiyasu T, Mitani H, Takahashi S. The retrospective analysis of nephrotoxicity for cisplatin dose of CRT compared 100 mg/m2 to 80 mg/m2 for head and neck cancer (HNC) patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Delgado-Aparicio LF, Wallace J, Yamazaki H, VanMeter P, Reusch L, Nornberg M, Almagari A, Maddox J, Luethi B, Rissi M, Donath T, Den Hartog D, Sarff J, Weix P, Goetz J, Pablant N, Hill K, Stratton B, Efthimion P, Takase Y, Ejiri A, Ono M. Simulation, design, and first test of a multi-energy soft x-ray (SXR) pinhole camera in the Madison Symmetric Torus (MST). THE REVIEW OF SCIENTIFIC INSTRUMENTS 2018; 89:10G116. [PMID: 30399822 DOI: 10.1063/1.5038798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 06/20/2018] [Indexed: 06/08/2023]
Abstract
A multi-energy soft x-ray pinhole camera has been designed and built for the Madison Symmetric Torus reversed field pinch to aid the study of particle and thermal-transport, as well as MHD stability physics. This novel imaging diagnostic technique combines the best features from both pulse-height-analysis and multi-foil methods employing a PILATUS3 x-ray detector in which the lower energy threshold for photon detection can be adjusted independently on each pixel. Further improvements implemented on the new cooled systems allow a maximum count rate of 10 MHz per pixel and sensitivity to the strong Al and Ar emission between 1.5 and 4 keV. The local x-ray emissivity will be measured in multiple energy ranges simultaneously, from which it is possible to infer 1D and 2D simultaneous profile measurements of core electron temperature and impurity density profiles with no a priori assumptions of plasma profiles, magnetic field reconstruction constraints, high-density limitations, or need of shot-to-shot reproducibility. The expected time and space resolutions will be 2 ms and <1 cm, respectively.
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Bending D, Ono M. From stability to dynamics: understanding molecular mechanisms of regulatory T cells through Foxp3 transcriptional dynamics. Clin Exp Immunol 2018; 197:14-23. [PMID: 30076771 PMCID: PMC6591142 DOI: 10.1111/cei.13194] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2018] [Indexed: 12/30/2022] Open
Abstract
Studies on regulatory T cells (Treg) have focused on thymic Treg as a stable lineage of immunosuppressive T cells, the differentiation of which is controlled by the transcription factor forkhead box protein 3 (Foxp3). This lineage perspective, however, may constrain hypotheses regarding the role of Foxp3 and Tregin vivo, particularly in clinical settings and immunotherapy development. In this review, we synthesize a new perspective on the role of Foxp3 as a dynamically expressed gene, and thereby revisit the molecular mechanisms for the transcriptional regulation of Foxp3. In particular, we introduce a recent advancement in the study of Foxp3‐mediated T cell regulation through the development of the Timer of cell kinetics and activity (Tocky) system, and show that the investigation of Foxp3 transcriptional dynamics can reveal temporal changes in the differentiation and function of Tregin vivo. We highlight the role of Foxp3 as a gene downstream of T cell receptor (TCR) signalling and show that temporally persistent TCR signals initiate Foxp3 transcription in self‐reactive thymocytes. In addition, we feature the autoregulatory transcriptional circuit for the Foxp3 gene as a mechanism for consolidating Treg differentiation and activating their suppressive functions. Furthermore, we explore the potential mechanisms behind the dynamic regulation of epigenetic modifications and chromatin architecture for Foxp3 transcription. Lastly, we discuss the clinical relevance of temporal changes in the differentiation and activation of Treg.
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Hori D, Katz NM, Fine DM, Ono M, Barodka VM, Lester LC, Yenokyan G, Hogue CW. Defining oliguria during cardiopulmonary bypass and its relationship with cardiac surgery-associated acute kidney injury. Br J Anaesth 2018; 117:733-740. [PMID: 27956671 DOI: 10.1093/bja/aew340] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND While urine flow rate ≤0.5 ml kg-1 h-1 is believed to define oliguria during cardiopulmonary bypass (CPB), it is unclear whether this definition identifies risk for acute kidney injury (AKI) . The purpose of this retrospective study was to evaluate if urine flow rate during CPB is associated with AKI. METHODS Urine flow rate was calculated in 503 patients during CPB. AKI in the first 48 h after surgery was defined by the Kidney Disease: Improving Global Outcomes classification. Adjusted risk factors associated with AKI and urine flow rate were assessed. RESULTS Patients with AKI [n=149 (29.5%)] had lower urine flow rate than those without AKI (P<0.001). The relationship between urine flow and AKI risk was non-linear, with an inflection point at 1.5 ml kg-1 h-1 Among patients with urine flow <1.5 ml kg-1 h-1, every 0.5 ml kg-1 h-1 higher urine flow reduced the adjusted risk of AKI by 26% (95% CI 13-37; P<0.001). Urine flow rate during CPB was independently associated with the risk for AKI. Age up to 80 years and preoperative diuretic use were inversely associated with urine flow rate; mean arterial pressure on CPB (when <87 mmHg) and CPB flow were positively associated with urine flow rate. CONCLUSIONS Urine flow rate during CPB <1.5 ml kg-1 h-1 identifies patients at risk for cardiac surgery-associated AKI. Careful monitoring of urine flow rate and optimizing mean arterial pressure and CPB flow might be a means to ensure renal perfusion during CPB. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov NCT00769691 and NCT00981474.
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Young JK, Bergman DL, Ono M. Bad dog: feral and free-roaming dogs as agents of conflict. Anim Conserv 2018. [DOI: 10.1111/acv.12438] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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May M, Junghaenel DU, Ono M, Stone AA, Schneider S. Ecological Momentary Assessment Methodology in Chronic Pain Research: A Systematic Review. THE JOURNAL OF PAIN 2018; 19:699-716. [PMID: 29371113 PMCID: PMC6026050 DOI: 10.1016/j.jpain.2018.01.006] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 12/22/2017] [Accepted: 01/03/2018] [Indexed: 01/11/2023]
Abstract
Self-reported pain intensity assessments are central to chronic pain research. Ecological momentary assessment (EMA) methodologies are uniquely positioned to collect these data, and are indeed being used in the field. However, EMA protocols are complex, and many decisions are necessary in the design of EMA research studies. A systematic literature review identified 105 articles drawing from 62 quantitative EMA research projects examining pain intensity in adult chronic pain patients. Study characteristics were tabulated to summarize and describe the use of EMA, with an emphasis placed on various dimensions of decision-making involved in executing EMA methodologies. Most identified studies considered within-person relationships between pain and other variables, and a few examined interventions on chronic pain. There was a trend toward the use of smartphones as EMA data collection devices more recently, and completion rates were not reported in nearly one third of studies. Pain intensity items varied widely with respect to number of scale points, anchor labels, and length of reporting period; most used numeric rating scales. Recommendations are provided for reporting to improve reproducibility, comparability, and interpretation of results, and for opportunities to clarify the importance of design decisions. PERSPECTIVE Studies that use EMA methodologies to assess pain intensity are heterogeneous. Aspects of protocol design, including data input modality and pain item construction, have the potential to influence the data collected. Thorough reporting on design features and completion rates therefore facilitates reproducibility, comparability, and interpretation of study results.
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Schneider S, Junghaenel DU, Ono M, Stone AA. Temporal dynamics of pain: an application of regime-switching models to ecological momentary assessments in patients with rheumatic diseases. Pain 2018; 159:1346-1358. [PMID: 29557930 PMCID: PMC6008214 DOI: 10.1097/j.pain.0000000000001215] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Advances in pain measurement using ecological momentary assessments offer novel opportunities for understanding the temporal dynamics of pain. This study examined whether regime-switching models, which capture processes characterized by recurrent shifts between different states, provide clinically relevant information for characterizing individuals based on their temporal pain patterns. Patients with rheumatic diseases (N = 116) provided 7 to 8 momentary pain ratings per day for 2 weekly periods, separated by 3 months. Regime-switching models extracted measures of Average pain (mean level over time), Amplitude (magnitude of shifts in pain levels), Persistence (average duration of pain states), and Dominance (relative duration of higher vs lower pain states) for each patient and assessment period. After controlling for Average pain, the Persistence of pain states uniquely predicted emotional functioning measures, whereas the Dominance of higher pain uniquely predicted physical functioning and pain interference. Longitudinal analyses of changes over the 3 months largely replicated cross-sectional results. Furthermore, patients' retrospective judgments of their pain were uniquely predicted by Amplitude and Dominance of higher pain states, and global impressions of change over the 3 months were predicted by changes on Dominance, controlling for Average pain levels. The results suggest that regime-switching models can usefully capture temporal dynamics of pain and can contribute to an improved measurement of patients' pain intensity.
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Ida K, Kobayashi T, Ono M, Evans TE, McKee GR, Austin ME. Hysteresis Relation between Turbulence and Temperature Modulation during the Heat Pulse Propagation into a Magnetic Island in DIII-D. PHYSICAL REVIEW LETTERS 2018; 120:245001. [PMID: 29956950 DOI: 10.1103/physrevlett.120.245001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/10/2018] [Indexed: 06/08/2023]
Abstract
The hysteresis relation between turbulence and temperature modulation during the heat pulse propagation into a magnetic island is studied for the first time in toroidal plasmas. Lissajous curves of the density fluctuation (n[over ˜]/n) and the electron temperature (T_{e}) modulation show that the (n[over ˜]/n) propagation is faster than the heat pulse propagation near the O point of the magnetic island. This faster n[over ˜]/n propagation is experimental evidence of the turbulence spreading from the X point to the O point of the magnetic island.
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