Efficacy and safety of once-yearly zoledronic acid in Japanese patients with primary osteoporosis: two-year results from a randomized placebo-controlled double-blind study (ZOledroNate treatment in Efficacy to osteoporosis; ZONE study)

In a 2-year randomized, placebo-controlled study of 665 Japanese patients with primary osteoporosis, once-yearly administration of zoledronic acid (5 mg) reduced the risk of new morphometric vertebral fractures.

INTRODUCTION

The purpose of this study was to determine the efficacy and safety of once-yearly intravenous infusion of ZOL in Japanese patients with primary osteoporosis.

METHODS

This was a two-year multicenter, randomized, placebo-controlled, double-blind, parallel-group comparative study (ZONE Study). Subjects were 665 Japanese patients between the ages of 65 and 89 years who had prevalent vertebral fracture. Subjects were randomly assigned to receive once-yearly intravenous infusion of 5 mg of ZOL or placebo at baseline and 12 months.

RESULTS

The 2-year incidence of new morphometric vertebral fracture was 3.0 % (10/330 subjects) in the ZOL group and 8.9 % (29/327) in the placebo group (p = 0.0016). The 24-month cumulative incidence of new morphometric vertebral fracture was 3.3 % in the ZOL group versus 9.7 % in the placebo group (log-rank test: p = 0.0029; hazard ratio: 0.35; 95 % confidence interval: 0.17-0.72). The cumulative incidence of any clinical fracture, clinical vertebral fracture, and non-vertebral fracture was significantly reduced in the ZOL group by 54, 70, and 45 %, respectively, compared to the placebo group. At 24 months, ZOL administration increased bone mineral density in the lumbar spine, femoral neck, and total hip (t test: p < 0.0001). No new adverse events or osteonecrosis of the jaw were observed in this study.

CONCLUSIONS

Once-yearly administration of ZOL 5 mg to Japanese patients with primary osteoporosis reduced the risk of new morphometric vertebral fractures and was found to be safe.

Choline and betaine ameliorate liver lipid accumulation induced by vitamin B6 deficiency in rats

We investigated the efficacy of supplementing the diet with choline or betaine in ameliorating lipid accumulation induced by vitamin B₆ (B₆) deficiency in rat liver. Male Wistar rats were fed a control, B₆-deficient, choline-supplemented (2, 4, or 6 g choline bitartrate/kg diet) B₆-deficient diet or betaine-supplemented (1, 2, or 4 g betaine anhydrous/kg diet) B₆-deficient diet for 35 d; all diets contained 9 g L-methionine (Met)/kg diet. Choline or betaine supplementation attenuated liver lipid deposition and restored plasma lipid profiles to control levels. These treatments restored the disruptions in Met metabolism and the phosphatidylcholine (PC)/phosphatidylethanolamine (PE) ratio induced by B₆ deficiency in liver microsomes. These results suggest that choline and betaine ameliorated liver lipid accumulation induced by B₆ deficiency via recovery of Met metabolism and very low-density lipoprotein secretion by restoring the supply of PC derived from PE.

Vertical distribution of sediment phosphorus in Lake Hachirogata related to the effect of land reclamation on phosphorus accumulation

The focus of this work is the change in sediment properties and chemical characteristics that occur after land reclamation projects. The results indicate a higher sedimentation rate in Lake Hachirogata after reclamation, with the rate increasing with proximity to the agricultural zone. In the west-side water samples, higher levels of dissolved total nitrogen and dissolved total phosphorus (DTP) were found in both surface and bottom waters. The increase in P (39-80%) was generally greater than that for N (12-16%), regarding the nutrient supply from reclaimed farmland in the western part of the lake. In the eastern part of the lake, the pore-water Cl^- profile showed a decreasing vertical gradient in the sediment core. This indicates desalination of the lake water after construction of a sluice gate in 1961. In the western sediment-core sample, a uniform Cl^- profile indicates the mixing of lake water and pore water after reclamation. Considering the sedimentation of P in the last 100 years, there is a trend of increasing accumulation of P and P-activities after the reclamation project. This appears to be an impact from change in the lake environment as a result of increased agricultural nutrients, desalination, and residence. A large amount of mobile phosphorus (42-72% of TP in the western core sample) trapped in sediment increases the risk of phosphorus release and intensification of algal blooms. High sediment phosphorus and phosphorus mobility should be considered a source of pollution in the coastal environment.

Quadratic Fermi node in a 3D strongly correlated semimetal

Strong spin–orbit coupling fosters exotic electronic states such as topological insulators and superconductors, but the combination of strong spin–orbit and strong electron–electron interactions is just beginning to be understood. Central to this emerging area are the 5d transition metal iridium oxides. Here, in the pyrochlore iridate Pr₂Ir₂O₇, we identify a non-trivial state with a single-point Fermi node protected by cubic and time-reversal symmetries, using a combination of angle-resolved photoemission spectroscopy and first-principles calculations. Owing to its quadratic dispersion, the unique coincidence of four degenerate states at the Fermi energy, and strong Coulomb interactions, non-Fermi liquid behaviour is predicted, for which we observe some evidence. Our discovery implies that Pr₂Ir₂O₇ is a parent state that can be manipulated to produce other strongly correlated topological phases, such as topological Mott insulator, Weyl semimetal, and quantum spin and anomalous Hall states.

5d transition metal iridates provide a platform to study the combined effects of strong spin orbit coupling and strong electronic correlations. Here, the authors find a quadratic band touching in the band structure of Pr₂Ir₂O₇, suggesting it may be tuned to form various strongly correlated topological phases.

Development of an implantable wireless ECoG 128ch recording device for clinical brain machine interface

Brain Machine Interface (BMI) is a system that assumes user's intention by analyzing user's brain activities and control devices with the assumed intention. It is considered as one of prospective tools to enhance paralyzed patients' quality of life. In our group, we especially focus on ECoG (electro-corti-gram)-BMI, which requires surgery to place electrodes on the cortex. We try to implant all the devices within the patient's head and abdomen and to transmit the data and power wirelessly. Our device consists of 5 parts: (1) High-density multi-electrodes with a 3D shaped sheet fitting to the individual brain surface to effectively record the ECoG signals; (2) A small circuit board with two integrated circuit chips functioning 128 [ch] analogue amplifiers and A/D converters for ECoG signals; (3) A Wifi data communication & control circuit with the target PC; (4) A non-contact power supply transmitting electrical power minimum 400[mW] to the device 20[mm] away. We developed those devices, integrated them, and, investigated the performance.

Simulation model of a lever-propelled wheelchair

Wheelchair efficiency depends significantly on the individual adjustment of the wheelchair propulsion interface. Wheelchair prescription involves reconfiguring the wheelchair to optimize it for specific user characteristics. Wheelchair tuning procedure is a complicated task that is performed usually by experienced rehabilitation engineers. In this study, we report initial results from the development of a musculoskeletal model of the wheelchair lever propulsion. Such a model could be used for the development of new advanced wheelchair approaches that allow wheelchair designers and practitioners to explore virtually, on a computer, the effects of the intended settings of the lever-propulsion interface. To investigate the lever-propulsion process, we carried out wheelchair lever propulsion experiments where joint angle, lever angle and three-directional forces and moments applied to the lever were recorded during the execution of defined propulsion motions. Kinematic and dynamic features of lever propulsion motions were extracted from the recorded data to be used for the model development. Five healthy male adults took part in these initial experiments. The analysis of the collected kinematic and dynamic motion parameters showed that lever propulsion is realized by a cyclical three-dimensional motion of upper extremities and that joint torque for propulsion is maintained within a certain range. The synthesized propulsion model was verified by computer simulation where the measured lever-angles were compared with the angles generated by the developed model simulation. Joint torque amplitudes were used to impose the torque limitation to the model joints. The results evidenced that the developed model can simulate successfully basic lever propulsion tasks such as pushing and pulling the lever.

Cytomegalovirus-induced small intestinal bleeding complicated with cutaneous vasculitis: a case report

Abstract A 17-year-old woman who was being treated with prednisolone for cutaneous vasculitis developed recurrent massive melena and abdominal pain. An emergency resection was performed because of uncontrollable melena, revealing many small intestinal ulcers with cytomegalic inclusion bodies, which were found by immunopathological staining. However, the cytomegalovirus (CMV) antigenemia (CMV-Ag) assay and the IgM antibody titer for CMV were negative on admission. This case indicates that a high state of alertness for CMV infection in immunocompromised patients with gastrointestinal bleeding is required even if the CMV-Ag assay and IgM antibody are both negative.