Functional Limitations and Perceived Neighborhood Walkability Among Urban Dwelling Older Adults

Older adults with functional limitations (FLs) often experience obstacles to walking. Although health promotion programs targeting physical activity are available in lower-income areas, few studies have compared the walking experiences of older adults who have FLs with those who do not in the community. The purpose of this cross-sectional survey was to compare perceptions of neighborhood walkability among older adults living in lower-income communities with and without FLs. Participants (N = 132) were recruited in 2018 at regional health clinics in Flint, Michigan. To be eligible, participants had to be 65 years of age or older, report no cognitive decline, and be Flint residents. Of the 132 participants, the mean age was 69.74 (SD = 4.97). The majority were female (66%); African American (77%); single, divorced, or widowed (72%); educated below the General Education Development level (57%), and had a FL (67%). Older adults with FLs were significantly (p < 0.05) less likely than those without to visit many places within walking distance, to have well-lit neighborhoods at night, and to reside in neighborhoods where sidewalks were separated from the road and traffic. Multiple regression analyses revealed that having a FL was associated with poorer neighborhood perceptions of mixed-land-use (b = −0.19, p < 0.05) and more walking hazards (b = −0.26, p < 0.05). Findings suggest that a FL is associated with perceptions of walkability. It is essential to develop disability-friendly support systems and accommodations to encourage walking in lower-income communities.

Grade 1 Endometrioid Carcinoma With an Area of Serous Carcinoma Less than 5% Is More Aggressive than Stage IA Pure-type Grade 1 Endometrioid Carcinoma

BACKGROUND/AIM

In 2020, the percentages were removed from the World Health Organization's criteria for mixed carcinoma. The aim was to examine the clinical significance of an area of serous carcinoma (SC) <5%.

PATIENTS AND METHODS

Our study included 236 patients with the 2009 International Federation of Obstetrics and Gynecology (FIGO) stage IA grade 1 endometrioid carcinoma (EG1) from multiple hospitals. EG1 patients with an area of SC <5% and those with pure-type EG1 were retrospectively compared.

RESULTS

In the multivariate analysis for recurrence, an area of SC <5% was an independent risk factor [hazard ratio (HR)=101.51, p<0.01]. In the multivariate analysis for progression-free survival, an area of SC <5% was identified as a negative prognostic factor (HR=62.43, p<0.01).

CONCLUSION

EG1 with an area of SC <5% may be more aggressive than pure-type EG1 at FIGO stage IA.

Association of patient quality of life with the degree of agreement in the perceptions of patient disability within the stroke patient-rehabilitation therapist dyad: a cross-sectional study in postdischarge rehabilitation setting

OBJECTIVES

The purpose of study was to explore the association between patient physical and psychological quality of life (QOL) with the degree of agreement in perceptions of patient disability within the stroke patient-rehabilitation therapist dyad.

DESIGN

Cross-sectional dyadic study with a tablet-based structured questionnaire.

SETTING

Rehabilitation, nursing and long-term care facilities that provide rehabilitation services in the Kanagawa prefecture, Japan.

PARTICIPANTS

The 81 dyads of a male patient with stroke living at home and the rehabilitation therapist in charge of the eligible patient were recruited from March 2019 to February 2020.

METHOD

Patient physical and psychological QOL was measured using the WHOQOL BREF. Perceptions of patient disability were measured using the 12-item WHO Disability Assessment Schedule V.2.0 (DAS). DAS scores of patients and therapists were classified into two (high and low) and three (high, medium, low) categories, respectively, and six patterns of agreement about patient function were created and used in the analysis. Generalised estimating equations were used to examine multivariable associations between WHOQOL scores in patients and the degree of agreement within dyads adjusting for other covariates and clustering effects.

RESULTS

Among 81 enrolled dyads, 48 (59.3%) were classified into one of four disagreement groups (low medium, low high, high medium, high low). When the patient appraised himself as having mild disability, the degree of patient-therapist disagreement was negatively associated with patient's physical and psychological QOL. When the patient appraised himself as having severe disability, his physical and/or psychological QOL was poorer, regardless of the degree of agreement.

CONCLUSIONS

Disagreement in the perception of disability within patient-rehabilitation therapist dyad could be associated with patient's poor QOL, especially when the patient perceives himself as having mild disability. Reaching an agreement about patient disability is needed in the delivery of rehabilitation care for patients with stroke living at home to improve their QOL.

Change in hepatitis C virus positivity among needle-stick injury source patients: a 10-year experience in a Japanese tertiary hospital

Background

As a blood-borne pathogen, hepatitis C virus (HCV) has long been a major threat associated with needle-stick injuries (NSIs) mainly because no vaccine is available for HCV. Following an NSI, we usually test the source patient for HCV antibody (HCV-Ab). Since HCV-Ab positivity does not necessarily indicate current infection, HCV RNA is further examined in patients positive for HCV-Ab. Direct-acting antivirals (DAAs) have enabled us to treat most HCV-infected patients; therefore, we speculate that the rate of HCV RNA positivity among HCV-Ab-positive patients decreased after the emergence of DAAs. This cross-sectional study was performed to investigate the change in the actual HCV RNA positivity rate in source patients before and after the interferon (IFN)-free DAA era.

Methods

This was a cross-sectional study of NSI source patients at a tertiary academic hospital in Japan from 2009 to 2019. IFN-free DAA regimens were first introduced in Japan in 2014. Accordingly, we compared HCV status of NSI source patients that occurred between 2009 and 2014 (the era before IFN-free DAAs) with those that occurred between 2015 and 2019 (the era of IFN-free DAAs) in a tertiary care hospital in Japan.

Results

In total, 1435 NSIs occurred, and 150 HCV-Ab-positive patients were analyzed. The proportion of HCV RNA-positive patients significantly changed from 2009 through 2019 (p = 0.005, Cochran–Armitage test). Between 2009 and 2014, 102 source patients were HCV-Ab-positive, 78 of whom were also positive for HCV RNA (76.5%; 95%CI, 67.4–83.6%). Between 2015 and 2019, 48 patients were HCV-Ab-positive, 23 of whom were also positive for HCV RNA (47.9%; 95%CI, 34.5–61.7%; p = 0.0007 compared with 2009–2014). In the era of IFN-free DAAs, 9 of 23 HCV RNA-negative patients (39.1%) and 2 of 22 HCV RNA-positive patients (9.1%) were treated with an IFN-free combination of DAAs (p = 0.0351). Regarding the departments where NSIs occurred, HCV RNA-negative patients were predominant in departments not related to liver diseases in the era of IFN-free DAAs (p = 0.0078, compared with 2009–2014).

Conclusions

Actual HCV RNA positivity in source patients of NSIs decreased after the emergence of IFN-free DAAs. IFN-free DAAs might have contributed to this reduction, and HCV RNA-negative patients were predominant in departments not related to liver diseases in the era of IFN-free DAAs.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-021-06117-4.

Significance of mesothelin and CA125 expression in endometrial carcinoma: a retrospective analysis

Background

This study aimed to investigate the association between clinicopathologic factors, mesothelin, and cancer antigen (CA) 125 in endometrial carcinoma.

Methods

Between 1989 and 2017, patients with endometrial carcinoma who underwent total hysterectomy and bilateral salpingo-oophorectomy at our hospital were identified. The association between either or both immunochemical expression of mesothelin and CA125 and clinicopathological features were retrospectively examined.

Results

Among 485 patients, 171 were positive for mesothelin, 368 were positive for CA125, and 167 were positive for mesothelin and CA125. The expression of mesothelin and CA125 was positively correlated (p < 0.01). More patients with mesothelin expression showed myometrial invasion of more than 50% (p = 0.028) and positive lymphovascular invasion (p = 0.027). Similarly, more patients with co-expression of mesothelin and CA125 had myometrial invasion of more than 50% (p = 0.016) and positive lymphovascular invasion (p = 0.02). Patients with mesothelin expression and co-expression of mesothelin and CA125 demonstrated worse progression-free survival (PFS) and overall survival (OS). In the multivariate analysis, mesothelin expression and co-expression were poor prognostic factors for PFS (mesothelin expression: hazard ratio [HR] = 2.14, p < 0.01; co-expression: HR = 2.19, p < 0.01) and OS (mesothelin expression: HR = 2.18, p < 0.01; co-expression: HR = 2.22, p < 0.01).

Conclusions

Mesothelin expression and co-expression might be associated with tumor aggressiveness and poor prognosis in patients with endometrial carcinoma. Persons with mesothelin-expressing endometrial cancers present a particularly high medical unmet need.

Examination of the Antimicrobial Peptide Myticalin A6 Active Site

In 2017, Leoni et al. reported myticalins as novel cationic linear antimicrobial peptides obtained from marine mussels. The authors focused on myticalin A6 (29 amino acids), which has a relatively short chain length among myticalins and contains a repeating X-proline(Pro)-arginine (Arg) sequence in its structure. We investigated the antimicrobial activity of myticalin A6 against Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus (S. aureus). Fragment derivatives of myticalin A6 were synthesized, and the site required for expression of antimicrobial activity was examined. To investigate the structure-antimicrobial activity relationship of myticalin A6, short-chain derivatives and partially substituted derivatives were synthesized, and the antimicrobial activity was measured. Furthermore, some cyclized derivatives were synthesized and examined for antimicrobial activity. Circular dichroism (CD) spectroscopy of myticalin A6 and its derivatives was carried out to evaluate the secondary structure. Myticalin A6 exhibited an antimicrobial activity of 1.9 µM against S. aureus. Myticalin A6 (3-23)-OH (21 amino acids) exhibited an antimicrobial activity of 2.4 µM against S. aureus, suggesting that the X-Pro-Arg repeat sequence is important for antimicrobial activity. Derivatives with different CD measurement results from myticalin A6 (3-23)-OH exhibited decreased activity. The myticalin A6 (3-23)-OH derivative in which all Arg residues were replaced with lysine (Lys) residues exhibited reduced antimicrobial activity against S. aureus. We succeeded in synthesizing cyclic derivatives using 9-fluorenylmethoxycarbonyl (Fmoc)-aspartic acid (Asp)(Wang resin)-[2-phenylisopropyl ester (OPis)], but the yield of derivatives with 21 amino acids was decreased. The myticalin derivatives synthesized in this study did not exhibit any enhancement in antimicrobial activity due to cyclization.

Diagnostic efficacy of ascites cell block for ovarian clear cell carcinoma

BACKGROUND

Ascites cytology is important for determining the stage and treatment methods for ovarian clear cell carcinoma (CCC) as defined by the 2014 International Federation of Obstetrics and Gynecology classification.

METHODS

Patients with CCC who underwent surgery at our hospital between January 2012 and December 2019 and who received cytodiagnosis of their ascites using Papanicolaou (Pap) and May-Grünwald-Giemsa (MGG) staining, and cell block methods were identified. The cell block technique was performed using hematoxylin-eosin (H&E) staining and immunohistochemical staining for hepatocyte nuclear factor-1β (HNF-1β), estrogen receptor (ER), progesterone receptor (PR), and Wilms tumor-1 (WT-1). Cancer cells of CCC were defined as tumor cells that were positive for HNF-1β and negative for ER, PR, and WT-1. The diagnostic accuracy of ascites cytology using Pap and MGG staining and cell block methods was examined.

RESULTS

Based on cytological data, our study included 17 patients: seven (41.1%) with malignant (MAL) ascites, eight (47.1%) with negative for malignancy (NFM), and two (11.8%) with atypia of undetermined significance (AUS) because of a few atypical cells based on Pap and MGG staining. Malignant cells diagnosed by cell blocks were detected in 7/7 patients with MAL ascites based on PAP and MGG staining, 2/8 (25.0%) patients with NFM, and 1/2 (50%) patients with AUS.

CONCLUSION

These findings show that the cell block method combined with the immunohistochemical investigation may be useful for increasing the diagnostic accuracy of malignant cells in CCC.

Proposal of novel potent inhibitors against androgen receptor based on ab initio molecular orbital calculations

The androgen receptor (AR), a family of nuclear receptor proteins, stimulates the transcription of androgen-responsive genes. As its abnormal activation can cause the progression of prostate cancer, numerous types of ligands for AR have been developed as promising antagonists for the treatment of prostate cancer. We previously investigated the specific interactions between AR and nine types of existing non-steroidal ligands, using molecular simulations based on molecular mechanics and ab initio fragment molecular orbital methods. The results were confirmed to be comparable to the binding affinities of these ligands observed in experiments. We here propose novel ligands as potent inhibitors against AR and investigate their binding properties to AR, using the same molecular simulations. The results indicate that the most promising ligand binds stronger to AR than the existing non-steroidal ligands, and that our proposed ligand binds strongly to a mutant-type AR, which has drug resistance to the existing non-steroidal ligands.

Functional Limitations and Barriers to Care Influence the Likelihood of Adherence to Mammography Guideline

Objective: In this study, we examined the influence of having a functional limitation (FL) on the likelihood of adherence to mammography guidelines, as well as the potential moderating role of barriers to care on this relationship. Methods: Women aged 50-75 years from the 2017 National Health Interview Survey were assessed for FL and barriers to care as predictors mammography screening prevalence using weighted logistic regression. Results: Of 5627 women, most were without FLs (56%), Caucasian (81%), with at least a high school education (62%), married (63%), had a usual source of care (97%), and reported barriers to care (9%). Compared to women without FLs, those with FLs were less likely to adhere to mammography guidelines in the past year. Endorsement of the items, Could not get through on the phone, Not open when you could go, and No transportation negatively moderated this association (adjusted odds ratio (AOR) = 0.60, 95% Cl [0.59, 0.60], AOR = 0.54, 95% Cl [0.54, 0.55], and AOR = 0.32, 95% [0.31, 0.33], respectively). Conclusions: Improving the ability of women with FLs to schedule appointments that will suit their functional needs within universal design guidelines may improve compliance.

Clear cell borderline tumor without fibromatous component: Pathological and literature review and report of two cases

The aim of the present study was to examine the clinical outcome of ovarian clear cell borderline tumor (CCBT) through pathological review for cases with clear cell carcinoma (CCC) and CCBT between 1984 and 2015 who received surgery at the National Defense Medical College Hospital using 2020 World Health Organization (WHO) criteria. In addition to the definition of CCBT in 2020 WHO criteria, clear cell with atypia of the glandular epithelium without fibromatous component was added to the diagnostic criteria of CCBT. Two cases with CCBT were identified through review in the current study. There were no cases that changed from the initial CCBT diagnosis that were included in the current study. Case 1 was a 43-year-old woman who received total hysterectomy, bilateral salpingo-oophorectomy and partial omentectomy. Pathologically, cysts were lined by cuboidal, hobnail and clear cells with eosinophilic cytoplasm and moderate nuclear atypia without the fibromatous component. These cells were adjacent to atypical endometriosis and non-atypical endometriosis, and the patient was diagnosed with CCBT. She exhibited no evidence of the disease for 37 months following surgery. Case 2 was a 42-year-old woman who received left salpingo-oophorectomy, partial omentectomy and pelvic lymphadenectomy. The tumor exhibited a cyst (80 mm) and nodular component. Pathologically, the tumor cells were lined by hobnail cells with mild atypia and eosinophilic cytoplasm without the fibromatous component. This patient was diagnosed with CCBT and exhibited no evidence of disease for 20 months following surgery. CCBT without fibromatous component is a rare and non-aggressive histological subtype. Additionally, regardless of fibromatous component, CCBT was able to be diagnosed.

Ovarian Seromucinous Borderline Tumors Are Histologically Different from Mucinous Borderline Tumors

AIM

To examine the clinicopathological features of ovarian seromucinous borderline tumors (SMBTs) and compare them with those of mucinous borderline/atypical proliferative mucinous tumors (MB/APMTs).

PATIENTS AND METHODS

Patients with SMBT between 2014 and 2018 and those with MB/APMT between 1988 and 2018 who underwent surgery at our Institution were identified. Pathological review was conducted using the 2014 World Health Organization criteria. Clinical features were compared retrospectively between SMBT and MB/APMT.

RESULTS

In total, 11 (12.9%) patients with SMBT and 74 (87.1%) patients with MB/APMT were included in our study. The diagnosis of six patients with SMBT and 73 patients with MB/APMT was not revised on review. SMBT was diagnosed at a younger age (p=0.04), was of smaller size (p<0.01) and bilateral (p=0.03), coexisted with endometriosis (p<0.01), and more frequently recurred than MB/APMT (p=0.04).

CONCLUSION

SMBT might be more aggressive than MB/APMT.

A New Model to Improve the Prediction of Prognosis of Endometrial Carcinoma by Combining Traditional Classification With the Presence of Tumor-infiltrating Lymphocytes

BACKGROUND/AIM

We aimed to predict the prognosis of endometrial carcinoma by combining traditional histological classification with the status of tumor-infiltrating lymphocytes (TILs).

PATIENTS AND METHODS

All patients with endometrial carcinoma, treated at our hospital, were classified into four categories-Category I: Type I positive for TILs; category II: type I negative for TILs; category III: type II positive for TILs; and category IV: type II negative for TILs. Prognoses were compared across all the categories. Positivity for TILs was defined as a continuously formed thick zone of TILs at the invasive front.

RESULTS

Multivariate analyses of progression-free and overall survival indicated that category classification was an independent prognostic factor, with hazard ratios of 3.127, 3.483, and 8.459 for progression-free survival, and 3.444, 4.374, and 11.058 for OS for patients in categories II, III, and IV, respectively.

CONCLUSION

Combining traditional histological classification with TIL status might better predict prognosis of endometrial carcinoma.

Newly Diagnosed Patients with Inflammatory Bowel Disease: The Relationship Between Perceived Psychological Support, Health-Related Quality of Life, and Disease Activity

Background: Newly diagnosed patients with inflammatory bowel disease (IBD) encounter many physical, mental, and social uncertainties. In other chronic diseases, patients having access to disease-specific information and psychological support adhere better to medical regimens. Currently, there is a paucity of data on how newly diagnosed patients with IBD interact with their medical providers. Methods: Patients diagnosed with IBD within 5 years completed a series of questionnaires related to heath-related quality of life (HRQoL), disease activity, health education resources, medical provider relationship, and psychological support. Results: A total of 89 patients were included in the study. IBD activity correlated with disease-specific quality of life (r=-0.69, p<0.0001). Patient satisfaction with gastroenterologist interaction correlated with HRQoL (r=0.33, p=0.04) and disease activity for Crohn's disease (CD) patients (Harvey Bradshaw Index, r=-0.52, p<0.001). Eleven percent of recently diagnosed patients reported receiving educational or psychological support as part of their treatment program, whereas 42% of patients believed that they would benefit from having these types of support incorporated in their treatment protocol. Discussion: In patients with newly diagnosed CD, the patients' perceived relationship with their medical provider was closely related to both HRQoL and disease activity. More attention to education, support, and the doctor-patient relationship at diagnosis could result in better patient outcomes.

Expressions of conventional vitellogenin and vitellogenin-like A in worker brains are associated with a nursing task in a ponerine ant

In eusocial insect colonies, non-reproductive workers often perform different tasks. Tasks of an individual worker are shifted depending on various factors, e.g., age and colony demography. Although a vitellogenin (Vg) gene play regulatory roles in both reproductive and non-reproductive division of labours in a honeybee, it has been shown that the insect Vg underwent multiple gene duplications and sub-functionalisation, especially in apical ant lineages. The regulatory roles of duplicated Vgs were suggested to change evolutionarily among ants, whereas such roles in phylogenetically basal ants remain unclear. Here, we examined the expression patterns of conventional Vg (CVg), Vg-like A, Vg-like B and Vg-like C, as well as Vg receptor, during the task shift in an age-dependent manner and under experimental manipulation of colony demography in a primitive ant Diacamma sp. Expressions of CVg and Vg-like A in a brain were associated with a nursing task. It is suggested that associations of brain expressions of these Vgs with worker tasks were acquired in the basal ant lineage, and that such Vg functions could have sub-functionalised in the derived ant lineage.

Applicability of ultrasonography for detection of marginal sinus placenta previa

This study aimed to examine whether marginal sinus placenta previa, defined as when the marginal sinus just reaches the internal cervical os and placental parenchyma might be >2 cm from the internal cervical os, can be diagnosed using ultrasonography (US). We identified the placenta previa cases that underwent both US and magnetic resonance imaging (MRI) between April 2010 and December 2018 at our institution. The diagnostic discrepancies for marginal sinus placenta previa between US and MRI were examined retrospectively. Of the 183 cases of placenta previa, 28 (15.3%) cases were diagnosed as marginal sinus placenta previa using MRI. Among them, 18 cases (64.3%) could also be diagnosed using US. The sensitivity and specificity of the diagnosis of marginal sinus placenta previa using US were 64.3% and 92.9%, respectively. A change in US diagnosis occurred in 10 (35.7%) cases, all of which were diagnosed with low-lying placenta previa or marginal placenta previa and did not develop any serious miserable obstetrical outcomes. In conclusion, the diagnostic accuracy of US for detecting marginal sinus placenta previa was not significant. MRI examination may be required to accurately categorize the types of placenta previa.

Development of novel polyglycerol fatty acid ester-based nanoparticles for the dermal delivery of tocopherol acetate

The aim of this study was to develop and evaluate novel polyglycerol fatty acid ester (PGFE)-based nanoparticles (NPs) for the dermal delivery of tocopherol acetate (TA). TA-loaded PGFE-based NPs (PGFE-NPs) were prepared by mixing PGFE, soya phosphatidylcholine, dimyristoylphosphatidylglycerol, and TA with film using the film rehydration and extrusion method. The prepared formulations were analyzed by dynamic light scattering, small-angle X-ray diffraction and polarization microscopy. An in vitro skin accumulation test was performed with TA under occlusive and non-occlusive applications, using Yucatan micropig skin. The size range of the TA-loaded liposome and PGFE-NPs was 107-128 nm, and they were encapsulated in 1.6-2.3 mg/mL TA. All PGFE-NP formulations were negatively charged and stable for 2 weeks. Under occlusive applications, all formulations induced small amounts of TA accumulation in the epidermis but not in the dermis. However, under non-occlusive applications, some of PGFE-NP formulations enhanced TA accumulation in the epidermis. Furthermore, only the polyglycerol 4-laurate (PG4L)-based formulation induced dermal TA accumulation with the change in the formulation from a vesicular to bilayer stacked structure following water evaporation under non-occlusive applications. These results indicated that the novel TA-loaded PG4L formulation enabled the dermal delivery of TA in non-occlusive applications.

Dyadic Agreement in the Perceptions of Patient Disability Between the Stroke Patient and Rehabilitation Therapist

Research supports that an agreement about the consequences of the illness within related parties is critical for optimal patient outcomes. This study aimed to explore the association between patient QOL and the degree of agreement in the perceptions of patient disability within the stroke patient-rehabilitation therapist dyad. A cross-sectional study was conducted in Japan from March 2019 to February 2020. A total of 81 dyads consisting of a male stroke patient living at home and the therapist in charge of the eligible patient participated. Patient QOL was measured using the WHOQOL BREF. Perceptions of patient disability were measured using the 12-item WHO Disability Assessment Schedule 2.0 (DAS). DAS scores of patients and therapists were classified into two (high, low) and three (high, medium, low) categories, respectively, and six patterns of agreement on patient ability were created to use in the analysis. Generalized estimating equations were used to examine multivariable associations between the degree of agreement within dyad and WHOQOL scores in patients. Results suggested that when the patient appraised himself as having a low disability, the degree of patient-therapist disagreement was negatively associated with patient QOL. When the patient appraised himself as having a high disability, his QOL was lower, regardless of the degree of agreement. Disagreements in the perception of disability between patients and therapists can worsen patient QOL, especially when the patient perceives himself as having a low disability.

Neighborhood Walkability Among Older Adults With and Without Physical Disabilities

Older adults with physical disabilities (PDs) often experience obstacles to walking locally. Although health promotion programs targeting physical activity are available in lower income, few studies have compared the walking experiences of older adults in these communities who have PDs with those who do not. The purpose of this study was to compare perceptions of neighborhood walkability among adults living in lower income communities with and without PDs. Participants (N=132) were recruited in 2018 at a regional health clinic in Flint, MI. To be eligible, participants had to be over 65 years old and Flint residents. A subsample (N=12) were then followed up with in 2019/2020. We defined PDs as having difficulty performing one or more activities of daily living. Descriptive statistics and analysis of covariance (ANCOVA) were performed. Of the 132 participants, the mean age in 2018 was 69.75 (SD=5.00). The majority were female (68%); African American (80%); single, divorced, or widowed (80%); and educated below GED level (84%). Older adults with PDs were less likely than those without to visit stores within walking distance and walk in their neighborhoods, and more likely to complain about a lot of traffic along the street. Analysis of the longitudinal data show that older adults who had PDs at time 1 were more likely at time 2 to 1) state that their neighborhoods were unsafe; and 2) perceive their neighborhoods more negatively. Findings suggest it is essential to develop disability-friendly support systems and accommodations to encourage walking in lower income communities.

Gastrointestinal and metabolic function in the MPTP-treated macaque model of Parkinson's disease

Background

Gastrointestinal (GI) and metabolic function are frequently altered in Parkinson's disease (PD). Although enteric nervous system anatomopathological alterations have previously been reported in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) monkey model of PD, the resulting gastric emptying and intestinal permeability functional parameters are unknown. The current exploratory study was, thus, designed to investigate these GI functional factors and insulin resistance in the MPTP-treated monkey.

Methods

Eight rhesus macaque monkeys (4 controls and 4 MPTP-treated) received the oral acetaminophen absorption test to measure gastric emptying, the oral FITC-dextran absorption test to investigate intestinal permeability, and the intravenous glucose tolerance test to assess insulin resistance. Constipation was evaluated using the Bristol stool scale.

Results

None of the tests, acetaminophen absorption, FITC-dextran absorption or glucose tolerance, showed a difference between control and MPTP-treated monkeys. MPTP-treated monkeys did present signs of transit acceleration.

Conclusion

While the MPTP monkey model reliably displays motor and certain non-motor symptoms of PD, the current study did not demonstrate the GI symptoms associated with PD.

Progress in international collaboration on EXFOR library

The EXFOR library has served as the unique repository of experimental cross section and other nuclear reaction data for 50 years. The Nuclear Reaction Data Centres (NRDC) have compiled data sets from more than 22000 experimental works for the EXFOR library. Our collaboration and effort on improvement of EXFOR coverage are described in this paper, as well as tools for digitization of numerical data from graph images developed by us for EXFOR compilation.

Placenta previa may acquire invasive nature by factors associated with epithelial-mesenchymal transition and matrix metalloproteinases

AIM

To investigate the differences in epithelial-mesenchymal transition (EMT)- and matrix metalloproteinases (MMP)-related factors among placenta previa with and without placenta accreta spectrum (PAS) (n = 69), and normal placenta (n = 51).

METHODS

The women diagnosed with placenta previa with or without PAS, and normal placentas, who delivered at our institution between 2006 and 2016, were enrolled. The difference of EMT-related factors' expression by immunochemical analysis in chorionic villi and decidual cells between the normal placenta and placenta previa with or without PAS were evaluated.

RESULTS

In chorionic villi of placenta previa with and without PAS, E-cadherin expression decreased, while that of ZEB1, SNAIL2 and MMP-9 increased than that in normal placenta. In decidual cells of placenta previa with and without PAS, expression of vimentin, ZEB1 and MMP-9 increased than that in normal placenta. In placenta previa with and without PAS, there was strong co-expression of ZEB1 and vimentin in chorionic villi, of ZEB1 and MMP-2 or MMP-9 in decidual cells, and of SNAIL2 and vimentin or MMP-9 in both chorionic villi and decidual cell. Vimentin expression in both chorionic villi and decidual cells was higher in placenta previa with PAS (n = 18) than in placenta previa without PAS (n = 51). MMP-2 expression in decidual cells was higher in placenta previa with PAS than in placenta previa without PAS.

CONCLUSION

This study revealed that EMT- and MMP-associated factors may be related to placenta previa with and without PAS. Furthermore, placenta previa without PAS may acquire invasive nature.

The use of magnetic resonance imaging to predict placenta previa with placenta accreta spectrum

INTRODUCTION

Massive hemorrhage due to placenta previa with placenta accreta spectrum is associated with high maternal mortality and morbidity. Therefore, accurate prediction of placenta previa with placenta accreta spectrum is essential; magnetic resonance imaging (MRI) is a useful tool for this purpose. This study investigated novel predictors of anterior and posterior placenta previa with placenta accreta spectrum using MRI.

MATERIAL AND METHODS

This was a retrospective study at a tertiary obstetrics hospital in Japan. The singleton patients with placenta previa who were scanned with MRI prenatally and had a cesarean section at our institution between 2007 and 2018 were included. The prediction of anterior and posterior placenta previa with placenta accreta spectrum was evaluated using four MRI findings: heterogeneous signals in the placenta, dark T2-weighted intraplacental bands, myometrial thinning or interruption, and focal uterine bulging. The prediction of posterior placenta previa with placenta accreta spectrum was performed using the quantification of cervical varicosities, which were defined as the ratio of the distance between the minimum distance from the most dorsal cervical varicosities (a) to the deciduous and amniotic placenta (b) on a sagittal image.

RESULTS

Among 202 patients, 14 (6.9%) patients were pathologically diagnosed as having placenta accreta spectrum. Further, 38 (18.8%) patients had anterior placenta previa and 164 (81.2%) patients had posterior placenta previa. When anterior placenta previa with placenta accreta spectrum was predicted using at least one of the four MRI findings, the sensitivity and specificity of the anterior placenta previa with placenta accreta spectrum were 87.5% and 86.7%, respectively. In contrast, the sensitivity and specificity of posterior placenta previa with placenta accreta spectrum were 42.9% and 96.2%, respectively. But when the A/B ratio was set at 0.20, the sensitivity and specificity of the prediction for posterior placenta previa with placenta accreta spectrum using cervical varicosities were 100.0% and 89.2%, respectively.

CONCLUSIONS

The findings of MRI to predict the anterior placenta previa with placenta accreta spectrum were different from posterior placenta previa. The cervical varicosities may be useful in predicting posterior placenta previa with placenta accreta spectrum.

In vitro affinity optimization of an anti-BDNF monoclonal antibody translates to improved potency in targeting chronic pain states in vivo

The role of brain-derived neurotrophic factor (BDNF) signaling in chronic pain has been well documented. Given the important central role of BDNF in long term plasticity and memory, we sought to engineer a high affinity, peripherally-restricted monoclonal antibody against BDNF to modulate pain. BDNF shares 100% sequence homology across human and rodents; thus, we selected chickens as an alternative immune host for initial antibody generation. Here, we describe the affinity optimization of complementarity-determining region-grafted, chicken-derived R3bH01, an anti-BDNF antibody specifically blocking the TrkB receptor interaction. Antibody optimization led to the identification of B30, which has a > 300-fold improvement in affinity based on BIAcore, an 800-fold improvement in potency in a cell-based pERK assay and demonstrates exquisite selectivity over related neurotrophins. Affinity improvements measured in vitro translated to in vivo pharmacological activity, with B30 demonstrating a 30-fold improvement in potency over parental R3bH01 in a peripheral nerve injury model. We further demonstrate that peripheral BDNF plays a role in maintaining the plasticity of sensory neurons following nerve damage, with B30 reversing neuron hyperexcitability associated with heat and mechanical stimuli in a dose-dependent fashion. In summary, our data demonstrate that effective sequestration of BDNF via a high affinity neutralizing antibody has potential utility in modulating the pathophysiological mechanisms that drive chronic pain states.