Effectiveness of Partially Hydrolyzed Guar Gum on Cognitive Function and Sleep Efficiency in Healthy Elderly Subjects in a Randomized, Double-Blind, Placebo-Controlled, and Parallel-Group Study

The consumption of functional foods in a daily diet is a promising approach for the maintenance of cognitive health. The present study examines the effects of water-soluble prebiotic dietary-fiber, partially hydrolyzed guar gum (PHGG), on cognitive function and mental health in healthy elderly individuals. Participants consumed either 5 g/day of PHGG or a placebo daily for 12 weeks in this randomized, double-blind, placebo-controlled, and parallel-group study. An assessment of cognitive functions, sleep quality, and subjective mood evaluations was performed at baseline and after 8 and 12 weeks of either PHGG or placebo intake. The visual memory scores in cognitive function tests and sleepiness on rising scores related to sleep quality were significantly improved in the PHGG group compared to the placebo group. No significant differences were observed in mood parameters between the groups. Vigor-activity scores were significantly improved, while the scores for Confusion-Bewilderment decreased significantly in the PHGG group when compared to the baseline. In summary, supplementation with PHGG was effective in improving cognitive functions, particularly visual memory, as well as enhancing sleep quality and vitality in healthy elderly individuals (UMIN000049070).

Association of child-specific and household material deprivation with depression among elementary and middle school students in Japan

PURPOSE

This study aimed to investigate the association between child-specific and household material deprivation with depression among elementary and middle school students in Japan.

METHODS

We used cross-sectional data from 10,505 and 10,008 students for fifth-grade elementary school students (G5) and second-grade middle school students (G8), respectively, and their caregivers. The data were collected from August to September 2016 in 4 municipalities of Tokyo and from July to November 2017 in 23 municipalities of Hiroshima prefecture. Caregivers completed questionnaires including household income and material deprivation, and children completed child-specific material deprivation and depression status using the Japanese version of the Birleson depression self-rating scale for children (DSRS-C). To explore the associations, logistic regression was used after conducting multiple imputation for the missing data.

RESULTS

14.2% of G5 students and 23.6% of G8 students had DSRS-C scores of more than or equal to 16, denoting the risk of depression. We found that household equivalent income was not associated with childhood depression in both G5 and G8 students when adjusted for material deprivations. While at least one item of household material deprivation was significantly associated with depression in G8 students (OR = 1.19, CI = 1.00, 1.41), but not in G5 children. Child-specific material deprivation of more than 5 items was significantly associated with depression in both age groups (G5: OR = 1.53, CI = 1.25, 1.88; G8: OR = 1.45, CI = 1.22, 1.73).

CONCLUSION

Future research on child mental health needs to consider children's perspectives, especially material deprivation in young children.

Hesperetin-7-O-glucoside/β-cyclodextrin Inclusion Complex Induces Acute Vasodilator Effect to Inhibit the Cold Sensation Response during Localized Cold-Stimulate Stress in Healthy Human Subjects: A Randomized, Double-Blind, Crossover, and Placebo-Controlled Study

Hesperetin, a citrus flavonoid, exerts vasodilation and is expected to improve endothelial function and alleviate cold sensation by activating nervous system thermal transduction pathways. In this randomized, double-blind, crossover, and placebo-controlled study, the purpose was to assess the effect of an orally administered highly bioavailable soluble inclusion complex of hesperetine-7-O-glucoside with β-cyclodextrin (HEPT7G/βCD; SunActive® HES/HCD) on cold sensation response during localized cold-stimulated stress in healthy humans. A significant (p ≤ 0.05) dose-dependent increase in skin cutaneous blood flow following relatively small doses of HEPT7G/βCD inclusion complex ingestion was confirmed, which led to a relatively effective recovery of peripheral skin temperature. The time delay of an increase in blood flow during rewarming varied significantly between low- and high-dose HEPT7G/βCD inclusion complex consumption (e.g., 150 mg and 300 mg contain 19.5 mg and 39 mg of HEPT7G, respectively). In conclusion, the substantial alteration in peripheral skin blood flow observed during local cooling stress compared to placebo suggested that deconjugated hesperetin metabolites may have a distinct capacity for thermoregulatory control of human skin blood flow to maintain a constant body temperature during cold stress exposure via cutaneous vasodilation and vasoconstriction systems.

Effects of partially hydrolyzed guar gums of different molecular weights on a human intestinal in vitro fermentation model

Partially hydrolyzed guar gums (PHGGs) are prebiotic soluble dietary fibers. High molecular-weight PHGGs have rapid fermentation and high short-chain fatty acid (SCFA) productivity rates, compared to low molecular-weight PHGGs. Therefore, low molecular-weight PHGGs may have less pronounced prebiotic effects than high molecular-weight PHGGs. However, the effects of PHGGs of different molecular weights on the human intestinal microbiota, as well as their fermentation ability and prebiotic effects, have not been investigated. The aim of this study was to evaluate the effects of two PHGGs of different molecular weights, Sunfiber-R (SF-R; 20 kDa) and Sunfiber-V (SF-V; 5 kDa), on human colonic microbiota and SCFA production. A human intestinal in vitro fermentation model was operated by fecal samples with and without the PHGGs. The addition of 0.2% SF-R or SF-V increased the relative abundance of Bacteroides spp., especially that of Bacteroides uniformis. This increase corresponded to a significant (p = 0.030) and non-significant (p = 0.073) increase in propionate production in response to SF-R and SF-V addition, respectively. Both fibers increased the relative abundance of Faecalibacterium and stimulated an increase in the abundance of unclassified Lachnospiraceae and Bifidobacterium. In conclusion, the low molecular-weight PHGG exerted prebiotic effects on human colonic microbiota to increase SCFA production and bacteria that are beneficial to human health in a manner similar to that of the high molecular-weight forms of PHGG.

Partially hydrolyzed guar gum is associated with improvement in gut health, sleep, and motivation among healthy subjects

Partially hydrolyzed guar gum dietary fiber is well recognized for a number of health benefits. In the present study, we aim to investigate the effects of partially hydrolyzed guar gum on constipation, intestinal microbiota as well as mental health in healthy subjects. In the randomized, parallel, double-blind, and placebo-controlled study the enrolled healthy men and women volunteers took either 3 g/day (T3) or 5 g/day (T5) of dietary fiber intakes for eight consecutive weeks compared to placebo (T0). The fecal characteristics, fecal microbiota, defecation characteristics, and quality of life (QOL) questionnaire were investigated. The results revealed a significant suppression in fecal potent harmful mucolytic bacteria in the T3 and T5 groups compared to the T0 group. The defecation frequency, excretory feeling, and scores of sleep and motivation questionnaire were also improved in the dietary fiber intake groups, showing a significant difference in the T5 group compared to the T0 group. In summary, the consumption of partially hydrolyzed guar gum dietary fiber is found effective in suppressing the potent harmful mucolytic bacteria that could be associated with the improvement of constipation-related symptoms including mental health in terms of sleep and motivation among the healthy subjects.

Influence of iron supplementation on fatigue, mood states and sweating profiles of healthy non-anemic athletes during a training exercise: A double-blind, randomized, placebo-controlled, parallel-group study

Iron is specifically important to athletes, and attention has grown to the association between sports performance and iron regulation in the daily diets of athletes. The study presents new insights into stress, mood states, fatigue, and sweating behavior among the non-anemic athletes with sweating exercise habits who consumed a routine low dose (3.6 mg/day) of iron supplementation. In this double-blind, randomized, placebo-controlled, parallel-group study, both non-anemic male (N = 51) and female (N = 42) athletes were supplemented either with a known highly bioavailable iron formulation (SunActive® Fe) or placebo during the follow-up training exercise period over four weeks at their respective designated clinical sites. The effect of oral iron consumption was examined on fatigue, stress profiles, as well as the quality of life using the profile of mood state (POMS) test or a visual analog scale (VAS) questionnaire, followed by an exercise and well-being related fatigue-sweat. Also, their monotonic association with stress biomarkers (salivary α-amylase, salivary cortisol, and salivary immunoglobulin A) were determined using spearman's rank correlation coefficient test. Repeated measure multivariate analysis of variance (group by time) revealed that the total mood disturbance (TMD) score was significantly lower (P = 0.016; F = 6.26) between placebo and iron supplementation groups over the four weeks study period among female athletes. Also, a significant reduction in tired feeling/exhaustion after the exercise (P = 0.05; F = 4.07) between the placebo and iron intake groups was noticed. A significant within-group reduction (P ≤ 0.05) was noticed in the degree of sweat among both male and female athletes after 2 and 4 weeks of iron supplementation, while athletes of the placebo intake group experienced a non-significant within-group reduction in the degree of sweat. Overall, the result indicates routine use of low dose (3.6 mg/day) iron supplementation is beneficial for non-anemic endurance athletes to improve stress, mood states, subjective fatigue, and sweating conditions.

Structural Investigation of Hesperetin-7-O-Glucoside Inclusion Complex with β-Cyclodextrin: A Spectroscopic Assessment

Flavonoids are biologically active natural products of great interest for their potential applications in functional foods and pharmaceuticals. A hesperetin-7-O-glucoside inclusion complex with β-cyclodextrin (HEPT7G/βCD; SunActive^® HCD) was formulated via the controlled enzymatic hydrolysis of hesperidin with naringinase enzyme. The conversion rate was nearly 98%, estimated using high-performance liquid chromatography analysis. The objective of this study was to investigate the stability, solubility, and spectroscopic features of the HEPT7G/βCD inclusion complex using Fourier-transform infrared (FTIR), Raman, ultraviolet–visible absorption (UV–vis), ¹H- and ¹³C- nuclear magnetic resonance (NMR), differential scanning calorimetry (DSC), liquid chromatography/mass spectroscopy (LC–MS), scanning electron microscopy (SEM), and powdered X-ray diffraction (PXRD) spectroscopic techniques including zeta potential, Job’s plot, and phase solubility measurements. The effects of complexation on the profiles of supramolecular interactions in analytic features, especially the chemical shifts of β-CD protons in the presence of the HEPT7G moiety, were evaluated. The stoichiometric ratio, stability, and solubility constants (binding affinity) describe the extent of complexation of a soluble complex in 1:1 stoichiometry that exhibits a greater affinity and fits better into the β-CD inner cavity. The NMR spectroscopy results identified two different configurations of the HEPT7G moiety and revealed that the HEPT7G/βCD inclusion complex has both –2S and –2R stereoisomers of hesperetin-7-O-glucoside possibly in the –2S/–2R epimeric ratio of 1/1.43 (i.e., –2S: 41.1% and –2R: 58.9%). The study indicated that encapsulation of the HEPT7G moiety in β-CD is complete inclusion, wherein both ends of HEPT7G are included in the β-CD inner hydrophobic cavity. The results showed that the water solubility and thermal stability of HEPT7G were apparently increased in the inclusion complex with β-CD. This could potentially lead to increased bioavailability of HEPT7G and enhanced health benefits of this flavonoid.

Monocaprin Enhances Bioavailability of Fucoxanthin in Diabetic/Obese KK-Ay Mice

Fucoxanthin is a marine carotenoid found in brown seaweeds and several microalgae. It has been reported that fucoxanthin has health benefits such as anti-obesity and anti-diabetic effects. To facilitate fucoxanthin applications in the food industry, it is important to improve its low bioavailability. We attempted the combined feeding of fucoxanthin-containing seaweed oil (SO) and monocaprin in a powder diet and analyzed the fucoxanthin metabolite contents in the liver, small intestine and serum of diabetic/obese KK-Ay mice. After 4 weeks of feeding with the experimental diets, the serum fucoxanthinol concentrations of the mice fed 0.2% SO and 0.5% monocaprin were higher than those of the 0.2% SO-fed mice. Furthermore, fucoxanthinol accumulation in the liver and small intestine tended to increase in a combination diet of 0.2% SO and 0.125–0.5% monocaprin compared with a diet of 0.2% SO alone, although amarouciaxanthin A accumulation was not different among the 0.2% SO-fed groups. These results suggest that a combination of monocaprin with fucoxanthin-containing SO is an effective treatment for improving the bioavailability of fucoxanthin.

Abstract 5953: Modulation of the gut microenvironment by water-soluble dietary fiber alleviates cancer-induced muscle wasting in mice

Cancer cachexia and the associated skeletal muscle wasting are considered poor prognostic factors, although effective treatment has not yet been established. Recent studies have indicated that the pathogenesis of skeletal muscle loss in age-related sarcopenia may involve dysbiosis of the gut microbiota and the accompanying chronic inflammation or altered metabolism, the so-called ‘gut-muscle axis’. However, limited evidence is available on the relationship between cancer-related sarcopenia and the gut environment. Dietary fiber, a non-digestible nutrient including polysaccharides which modulate composition and activity of the gut microbiota, are now noticed for its beneficial effects. In this study, we evaluated the possible effects of modifying the gut microenvironment with partially hydrolyzed guar gum (PHGG), a soluble dietary fiber, on cancer-related muscle wasting and its mechanism using a colon-26 murine cachexia model. Compared to a fiber-free (FF) diet, PHGG contained fiber-rich (FR) diet attenuated body weight and skeletal muscle loss in cachectic mice by suppressing the elevation of the major muscle-specific ubiquitin ligases Atrogin-1 and MuRF1, as well as the autophagy markers LC3 and Bnip3. Although tight junction markers were partially reduced in both FR and FF diet-fed cachectic mice, the abundance of Bifidobacterium, Akkermansia, and unclassified S24-7 family increased by FR diet, contributing to the significant retention of the colonic mucus layer. The reinforcement of the gut barrier function resulted in the controlled entry of pathogens into the host system and reduced circulating levels of lipopolysaccharide-binding protein (LBP) and IL-6, which in turn led to the suppression of proteolysis by downregulating the ubiquitin-proteasome system and autophagy pathway. Moreover, cecal short chain fatty acid (SCFA) levels were relatively low in cachectic mice, although the reduction was mitigated when PHGG supplementation was given. To explore the effects of SCFAs on skeletal muscle mass, we used a well-established in vitro myotube culture model. Exposure of C2C12 myotubes to LPS induced a significant decrease in the diameter, but was reversed on administering a cocktail of SCFAs by suppressing the elevation of Atrogin-1, and upregulating the expression of PGC1α and Tfam, markers of mitochondrial biogenesis. Taken together, our findings suggest that dietary fiber may have the potential to alleviate skeletal muscle loss in cancer cachexia, providing new insights for developing effective strategies in the future.

Citation Format: Tomoki Sakakida, Takeshi Ishikawa, Toshifumi Doi, Ryuichi Morita, Yasuko Hirai, Katsura Mizushima, Yasuki Higashimura, Ken Inoue, Tetsuya Okayama, Kazuhiko Uchiyama, Tomohisa Takagi, Aya Abe, Ryo Inoue, Yoshito Itoh, Yuji Naito. Modulation of the gut microenvironment by water-soluble dietary fiber alleviates cancer-induced muscle wasting in mice [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5953.

Recognition of pathogen-derived sphingolipids in Arabidopsis

In plants, many invading microbial pathogens are recognized by cell-surface pattern recognition receptors, which induce defense responses. Here, we show that the ceramide Phytophthora infestans-ceramide D (Pi-Cer D) from the plant pathogenic oomycete P. infestans triggers defense responses in Arabidopsis. Pi-Cer D is cleaved by an Arabidopsis apoplastic ceramidase, NEUTRAL CERAMIDASE 2 (NCER2), and the resulting 9-methyl-branched sphingoid base is recognized by a plasma membrane lectin receptor-like kinase, RESISTANT TO DFPM-INHIBITION OF ABSCISIC ACID SIGNALING 2 (RDA2). 9-Methyl-branched sphingoid base is specific to microbes and induces plant immune responses by physically interacting with RDA2. Loss of RDA2 or NCER2 function compromised Arabidopsis resistance against an oomycete pathogen. Thus, we elucidated the recognition mechanisms of pathogen-derived lipid molecules in plants.

Partially Hydrolyzed Guar Gum Suppresses the Development of Sarcopenic Obesity

Partially hydrolyzed guar gum (PHGG) is a soluble dietary fiber derived through controlled enzymatic hydrolysis of guar gum, a highly viscous galactomannan derived from the seeds of Cyamopsis tetragonoloba. Here, we examined the therapeutic potential of dietary supplementation with PHGG against sarcopenic obesity using Db/Db mice. Db/Db mice fed a normal diet alone or a fiber-free diet, or supplemented with a diet containing PHGG (5%), were examined. PHGG increased grip strength and the weight of skeletal muscles. PHGG increased the short-chain fatty acids (SCFAs) concentration in feces and sera. Concerning innate immunity, PHGG decreased the ratio of inflammatory cells, while increasing the ratio of anti-inflammatory cells in the small intestine. The present study demonstrated the preventive effect of PHGG on sarcopenic obesity. Changes in nutrient absorption might be involved through the promotion of an anti-inflammatory shift of innate immunity in the intestine accompanied by an increase in SCFA production by PHGG.

Water-soluble dietary fiber alleviates cancer-induced muscle wasting through changes in gut microenvironment in mice

Cancer cachexia and the associated skeletal muscle wasting are considered poor prognostic factors, although effective treatment has not yet been established. Recent studies have indicated that the pathogenesis of skeletal muscle loss may involve dysbiosis of the gut microbiota and the accompanying chronic inflammation or altered metabolism. In this study, we evaluated the possible effects of modifying the gut microenvironment with partially hydrolyzed guar gum (PHGG), a soluble dietary fiber, on cancer‐related muscle wasting and its mechanism using a colon‐26 murine cachexia model. Compared with a fiber‐free (FF) diet, PHGG contained fiber‐rich (FR) diet–attenuated skeletal muscle loss in cachectic mice by suppressing the elevation of the major muscle‐specific ubiquitin ligases Atrogin‐1 and MuRF1, as well as the autophagy markers LC3 and Bnip3. Although tight‐junction markers were partially reduced in both FR and FF diet–fed cachectic mice, the abundance of Bifidobacterium, Akkermansia, and unclassified S24‐7 family increased by FR diet, contributing to the retention of the colonic mucus layer. The reinforcement of the gut barrier function resulted in the controlled entry of pathogens into the host system and reduced circulating levels of lipopolysaccharide‐binding protein (LBP) and IL‐6, which in turn led to the suppression of proteolysis by downregulating the ubiquitin‐proteasome system and autophagy pathway. These results suggest that dietary fiber may have the potential to alleviate skeletal muscle loss in cancer cachexia, providing new insights for developing effective strategies in the future.

DNA/RNA heteroduplex oligonucleotide technology for regulating lymphocytes in vivo

Manipulating lymphocyte functions with gene silencing approaches is promising for treating autoimmunity, inflammation, and cancer. Although oligonucleotide therapy has been proven to be successful in treating several conditions, efficient in vivo delivery of oligonucleotide to lymphocyte populations remains a challenge. Here, we demonstrate that intravenous injection of a heteroduplex oligonucleotide (HDO), comprised of an antisense oligonucleotide (ASO) and its complementary RNA conjugated to α-tocopherol, silences lymphocyte endogenous gene expression with higher potency, efficacy, and longer retention time than ASOs. Importantly, reduction of Itga4 by HDO ameliorates symptoms in both adoptive transfer and active experimental autoimmune encephalomyelitis models. Our findings reveal the advantages of HDO with enhanced gene knockdown effect and different delivery mechanisms compared with ASO. Thus, regulation of lymphocyte functions by HDO is a potential therapeutic option for immune-mediated diseases.

How Organic Waste Improves Bitumen’s Characteristics

The organic fraction derived from the differentiated collection of urban waste is mainly composed of fatty acids, medium molecular weight hydrocarbons and cellulose. This peculiar composition gave us insight into the possible use of organic waste to improve bitumen’s characteristics (possible antioxidant, regenerating and/ or viscosifying additive for road pavements). The issue of the disposal of organic waste is a global one and it’s constantly of increasing concern. This study looks to alleviate this problem by finding ways for this waste fraction to be utilized for the greater good- in this case, as an additive for bitumen binder in road pavements. The present study is focused on the use of waste as it is and waste treated by the FENTON process (treatment with ferrous sulphate and hydrogen peroxide solution). Dynamic Shear Rheology (DSR) and aging tests (Rolling Thin Film Oven Test, RTFOT) showed that two of the additives tested in this study proved effective: one can be utilised as a viscosifying agent and the other can be us ed as a filler.

Tumor microenvironment in triple-negative breast cancer: the correlation of tumor-associated macrophages and tumor-infiltrating lymphocytes

Purpose

Immune cells such as cytotoxic T cells, helper T cells, B cells or tumor-associated macrophages (TAMs) contribute to the anti-tumor response or pro-tumorigenic effect in triple negative breast cancer (TNBC). The interrelation of TAMs, T and B tumor-infiltrating lymphocytes (TILs) in TNBC has not been fully elucidated.

Methods

We evaluated the association of tumor-associated macrophages, T and B TILs in TNBC.

Results

TNBCs with a high CD68+, CD163+ TAMs and low CD4+, CD8+, CD20+ TILs had a significantly shorter relapse-free survival (RFS) and overall survival (OS) than those with low CD68+, CD163+ TAMs and high CD4+, CD8+, CD20+ TILs. TNBCs with high CD68+ TAMs/low CD8+ TILs showed a significantly shorter RFS and OS and a significantly poorer prognosis than those with high CD68+ TAMs/high CD8+ TILs, low CD68+ TAMs/high CD8+ TILs, and low CD68+/low CD8+. TNBCs with high CD163+ TAMs/low CD8+, low CD20 + TILs showed a significantly shorter RFS and OS and a significantly poorer prognosis than those with high CD163+ TAMs/high CD8+ TILs and high CD163+ TAMs /high CD20+ TILs.

Conclusions

Our study suggests that TAMs further create an optimal tumor microenvironment (TME) for growth and invasion of cancer cells when evasion of immunoreactions due to T and B TILs occurs. In TNBCs, all these events combine to affect prognosis. The process of TME is highly complex in TNBCs and for an improved understanding, larger validation studies are necessary to confirm these findings.

[The association between grandparental poverty and grandchildren's health]

Objective　This study aimed to examine whether there is any remaining association between grandparental poverty and grandchildren's body mass index (BMI) and depression, after controlling for parental poverty and other parental characteristics.Methods　Data used in this study were gathered through the Child Living Standard Survey (Kodomo no Seikatsu Jittai Chosa) conducted by the Tokyo Metropolitan government in 2016. The survey questionnaires were mailed to all children in grades five, eight, and eleven who lived in four districts of Tokyo. Data for grades five and eight were used for analysis. First, the children were divided into four groups according to their grandparents' and mothers' poverty status, and their BMI and depression were compared. Then, structural equation modeling was used to fit a model where grandparental poverty was associated with parental poverty and parental BMI and depression, and they, in turn are associated with grandchildren's BMI and depression, as well as directly associated with them. BMI and Birleson Child Depression Scale (DSRS-C) were used for grandchildren, and BMI and K6 depression scale were used for parents.Results　Children whose grandparents were poor but parents were not poor had a higher depression index than those who were not poor at all. However, the result did not hold for BMI. The goodness of fit of the SEM model was CFI=0.907, RMSEA=0.036 for BMI; CFI=0.810, RMSEA=0.037 for depression. The findings indicated that grandparental poverty was associated with grandchildren's BMI only through parental BMI, whereas for depression, grandparental poverty was associated with parental poverty and parental depression, which in turn were associated with grandchildren's depression. Furthermore, an association was found between grandparental poverty and grandchildren's depression even after controlling for parental poverty and parental depression.Conclusion　Grandparental poverty is associated with grandchildren's depression through means other than parental poverty and parental depression. To combat this, it is necessary to not only adopt the "3-generation approach" which focuses on child and parent's current conditions, but also to implement policy to assist children when they become parents in the future. As for BMI, effective policies should be put into place to combat parents' and children's current weight problems.

Short DNA/RNA heteroduplex oligonucleotide interacting proteins are key regulators of target gene silencing

Antisense oligonucleotide (ASO)-based therapy is one of the next-generation therapy, especially targeting neurological disorders. Many cases of ASO-dependent gene expression suppression have been reported. Recently, we developed a tocopherol conjugated DNA/RNA heteroduplex oligonucleotide (Toc-HDO) as a new type of drug. Toc-HDO is more potent, stable, and efficiently taken up by the target tissues compared to the parental ASO. However, the detailed mechanisms of Toc-HDO, including its binding proteins, are unknown. Here, we developed native gel shift assays with fluorescence-labeled nucleic acids samples extracted from mice livers. These assays revealed two Toc-HDO binding proteins, annexin A5 (ANXA5) and carbonic anhydrase 8 (CA8). Later, we identified two more proteins, apurinic/apyrimidinic endodeoxyribonuclease 1 (APEX1) and flap structure-specific endonuclease 1 (FEN1) by data mining. shRNA knockdown studies demonstrated that all four proteins regulated Toc-HDO activity in Hepa1-6, mouse hepatocellular cells. In vitro binding assays and fluorescence polarization assays with purified recombinant proteins characterized the identified proteins and pull-down assays with cell lysates demonstrated the protein binding to the Toc-HDO and ASO in a biological environment. Taken together, our findings provide a brand new molecular biological insight as well as future directions for HDO-based disease therapy.

Cumulative incidence of femoral localized periosteal thickening (beaking) preceding atypical femoral fractures in patients with rheumatoid arthritis

The incidence of localized periosteal thickening (LPT, also termed beaking) of the lateral cortex that often precedes an atypical femoral fracture (AFF) was not high in patients with rheumatoid arthritis (RA) but incomplete AFFs developed in two patients. Higher-dose prednisolone was a significant risk factor for LPT in patients with RA.

INTRODUCTION

Atypical femoral fractures (AFFs) are stress fractures; bisphosphonate (BP) use is a major risk factor for the development of such fractures. Localized periosteal thickening (LPT, also termed beaking) of the lateral cortex often precedes a complete or incomplete AFF. We evaluated the incidence of latent LPT in patients with rheumatoid arthritis (RA), to evaluate LPT progression, and to define LPT risk factors.

METHODS

A total of 254 patients with RA were included; all underwent annual X-ray evaluation, dual-energy X-ray absorptiometry, and analyses of serum and bone metabolic markers for 2-3 years. LPT of the lateral cortex was sought in femoral X-rays.

RESULTS

The incidence of LPT was 2.4% (6/254). Among patients on both BP and prednisolone (PSL) at enrollment, the incidence was 2.3% (3/131). Two femurs of two patients with LPT developed incomplete AFFs; LPT was extensive and associated with endosteal thickening. One patient had been on BP and PSL and microscopic polyangiitis was comorbidity. The other was on a selective estrogen receptor modulator and PSL. A daily PSL dose >5 mg (OR 11.4; 95%CI 2.15-60.2; p = 0.004) and higher-dose methotrexate (OR 1.22; 95%CI 1.01-1.49; p = 0.043) were significant risk factors for LPT.

CONCLUSIONS

The incidence of latent LPT was not high (2.4%) but incomplete AFFs developed in two RA patients. Higher-dose PSL because of a comorbid disease requiring glucocorticoid treatment other than RA or refractory RA were risk factors for LPT; X-ray screening for latent LPT would usefully prevent complete AFFs.

Mothers' nonstandard work schedules and adolescent obesity: a population-based cross-sectional study in the Tokyo metropolitan area

Background

Many wage earners in developed countries have irregular shift patterns and work evenings, nights, and weekends. Some studies have demonstrated that the nonstandard work schedules of parents have adverse effects on their children’s weight, specifically leading to or worsening obesity. However, no such study has been conducted in adolescents of high school age. This study examined the association between mothers’ nonstandard work schedules and adolescent obesity.

Methods

A cross-sectional study of adolescents aged 16–17 years (n = 1743) used paired matches of self-administered questionnaires for adolescents and their mothers from Tokyo, Japan. Obesity was defined by International Obesity Task Force cut-offs. Nonstandard work schedules were defined as working early mornings, nights, overnights, or weekends. Chi-square tests were conducted to examine the association between the mothers’ work schedules and their adolescent children’s poor lifestyles, overall and stratified by income levels. Then, logistic regression analyses were conducted to examine the association between mothers’ work schedules and obesity of their adolescent children, overall and stratified by income levels.

Results

Overall, 6.5% of adolescents had obesity. The prevalence of obesity was higher among adolescents from low-middle income groups (8.2%) than that among those from high-income groups (5.9%). No clear patterns were found between mothers’ work schedules and adolescents’ poor lifestyles when stratified by income levels. Mothers’ nonstandard work schedules were significantly associated with adolescent obesity (odds ratio [OR]: 1.56, 95% confidence interval [CI]: 1.02–2.40). However, this association was not significant after adjustment for confounders. After stratification by income levels, mothers’ nonstandard work schedules significantly associated with their children’s obesity (OR: 2.93, 95% CI: 1.45–5.92) only in high-income groups. This association remained after adjustment of the adolescents’ lifestyles and their mothers’ working hours.

Conclusions

Our results suggest that mothers’ nonstandard work schedules have adverse effects on adolescent obesity only in high-income families. Low-middle income families experienced higher levels of adolescent obesity, regardless of the mothers’ work schedules. Policy makers should consider mothers’ work schedules as a factor in preventing adolescent obesity.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10279-w.

Nutrient adequacy of Japanese schoolchildren on days with and without a school lunch by household income

Background

Evidence for whether the nutrient intakes of Japanese schoolchildren differ according to household income is sparse.

Objective

We investigated the role of school lunches for nutrient adequacy among Japanese primary school children using dietary reference intakes in a cross-sectional survey.

Design

Participants were 10- to 11-year-old (5th grade) children from 19 public primary schools in four prefectures of East Japan, and 836 children were analyzed. The participants completed 24-h dietary records with photographs of their meals for 4 consecutive days, composed of 2 days with and 2 days without a school lunch. −Children’s household income was obtained from questionnaires that were completed by the participants’ guardians and divided into the following three categories: low (0.2236–2.2361 million yen; n = 319), middle (2.3333–2.8868 million yen; n = 194), and high (3.1305–6.3640 million yen; n = 323). Logistic regression analyses were used to estimate the odds ratios for whether participants had poor nutrient intakes, with adjustment for confounders.

Results

On days without a school lunch, the prevalence of nutrient shortages was significantly higher compared with those on days with a school lunch for most macro- and micronutrients among all three levels of household income. Children from low-income households had higher rates of nutrient shortages for vitamin B₆, pantothenic acid, K, Mg, P, Fe, and Zn than those from middle-income households on days without a school lunch (P = 0.004, 0.001, 0.001, 0.006, 0.037, <0.001, and 0.015, respectively), but those differences were not significant on days with a school lunch.

Conclusion

The findings suggest that school lunches are important for achieving adequate nutrient intakes in schoolchildren and reduce disparities of adequate nutrient intake by household income levels.

Electrocardiographic evaluation of depolarization and repolarization abnormalities in breast cancer patients with HER2-inhibitor related cardiac dysfunction

Background

The arrhythmic substrates of the myocardium such as depolarization and repolarization abnormalities are thought to reflect cardiac dysfunction prior to the morphologic left ventricular dysfunction. Activation time (AT), recovery time (RT) and T wave peek-end interval dispersion (Tpe-dispersion) are useful indicators of the arrhythmic substrate. We examined the appearance of depolarization and repolarization abnormalities in patients with cancer therapeutics-related cardiac dysfunction (CTRCD) using AT, RT and Tpe-dispersion.

Methods

We conducted a standardized case-control study of CTRCD with 40 patients who developed breast cancer and treated with trastuzumab (13 cases and 27 controls). We assessed the relation between electrocardiographic indexes, including AT, RT and corrected Tpe-dispersion, and CTRCD. QT intervals were measured by Fridericia method, and QT observer 3 software were used for the measurement of all electrocardiographic indexes.

Results

LVEF in case and control group were 45.7±8% and 69.2±6%, respectively. AT in aVR lead was significantly higher in case group compared with control (28.8±7ms vs 22.8±5ms, P=0.02). corrected Tpe-dispersion tended to be higher in case group than that of control group (43.2±19ms vs 31.9±10ms, P=0.06). QT dispersion and RT dispersion were not different between case and control group.

Conclusions

Our study demonstrated that AT in aVR may predict cardiac dysfunction in breast cancer patients with HER2-inhibitor related cardiac dysfunction. More detailed studies using other modalities which can detect depolarization and repolarization abnormalities, including ventricular late potentials and T wave alternans, are needed.

Funding Acknowledgement

Type of funding source: None

Characterizing the gut microbiota in females with infertility and preliminary results of a water-soluble dietary fiber intervention study

Despite the advances in assisted reproductive technology, approximately 8-12% of the individuals worldwide who are willing to conceive are unable to do so. Fertility depends on a receptive state of the endometrium and hormonal adaptations as well as the immune system. Local and systemic immunities are greatly influenced by the microbiota. The aim of the present study was to compare the gut microbiota in female patients with that in infertility with fertile control subjects and to evaluate the effect of prebiotic partially hydrolyzed guar gum supplementation on gut dysbiosis and the outcome of pregnancy in patients treated with assisted reproductive technology. Dietary fiber can reconstitute the host intestinal microbiota and modify the immune function; however, clinical data regarding the effect of dietary fiber treatment on the success of assisted reproductive technology is lacking. To investigate the gut microbiota in fertile and infertile females, we conducted 16S metagenomic analysis of fecal samples. In total 18 fertile female subjects and 18 patients with infertility matched by age were recruited, and fecal samples were obtained to analyze the gut microbiome using 16S rRNA V3-V4 sequencing. The unweighted and weighted principal coordinate analyses showed a trend indicating microbial structural differences in β-diversity between these two groups. The abundance of the phylum Verrucomicrobia was higher in patients with infertility. At the genus level, a decrease in the abundance of the genera Stenotrophomonas, Streptococcus, and Roseburia and an increase in the abundance of the genera Unclassified [Barnesiellaceae] and Phascolarctobacterium was observed in patients with infertility. Twelve patients agreed to receive the combined therapy comprising embryo transfer by assisted reproductive technology and oral supplementation with partially hydrolyzed guar gum. The success of pregnancy by this combined therapy was 58.3% (7/12), and the failure was 41.7% (5/12). Predictive factors for pregnancy before treatment were characterized by a decrease in the abundance of Paraprevotella and Blautia and an increase in the abundance of Bifidobacterium. Predictive factors for pregnancy before treatment were characterized by a decrease in the abundance of Paraprevotella and Blautia and an increase tendency in the abundance of Bifidobacterium. In conclusion, the present study showed differences in the abundance of gut microbiota between fertile and infertile groups; moreover, partially hydrolyzed guar gum supplementation helped improve gut dysbiosis and the success of pregnancy in females with infertility.

Epigallocatechin-3-gallate (EGCG) attenuates non-alcoholic fatty liver disease via modulating the interaction between gut microbiota and bile acids

The spectrum of non-alcoholic fatty liver disease (NAFLD) ranges from simple hepatic steatosis commonly associated with obesity, to non-alcoholic steatohepatitis, which can progress to fibrosis, cirrhosis and hepatocellular carcinoma. Recent reports have indicated the crucial role of gut microbiota and their metabolites in the progression of NAFLD. In the present review, we demonstrated the influence of oral administration of (-)-epigallocatechin-3-gallate (EGCG) on the gut microbiota, serum bile acid profile, and gene expression in the liver in mice fed a high-fat diet (HFD). EGCG significantly inhibited the increase in histological fatty deposit and triglyceride accumulation in the liver induced by HFD, and improved intestinal dysbiosis. One of important findings is that the abundance of Proteobacteria and Defferibacteres phylums increased markedly in the HFD group, and this increase was significantly suppressed in the EGCG group. Interestingly, taurine-conjugated cholic acid (TCA) increased in the HFD group, like the mirror image against a marked decrease in the cholic acid (CA) value, and this increase was markedly inhibited in the EGCG group. TCA is not a simple serum biomarker for liver injury but TCA may be a causal factor to disturb lipid metabolism. The distribution of correlation coefficients by Heatmap analysis showed that the abundance of Akkermansia and Parabacteroides genus showed a positive correlation with CA and a negative correlation with TCA, and significantly increased in the EGCG group as compared with the HFD group. In addition, nutrigenomics approaches demonstrated that sirtuin signaling, EIF2 pathway and circadian clock are involved in the anti-steatotic effects of EGCG. In the present paper, we summarized recent update data of EGCG function focusing on intestinal microbiota and their interaction with host cells.

SAT0047 RISK FACTORS FOR THE POSTOPERATIVE DELAYED WOUND HEALING IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH A BIOLOGICAL AGENT

Background:

It has been suggested that perioperative use of biological disease-modifying anti-rheumatic drugs (bDMARDs) in rheumatoid arthritis (RA) patients carries risks for the surgical-site infection and the delayed wound healing (DWH); however, the risk of DWH with perioperative use of bDMARDs has not reached a general consensus.

Objectives:

This retrospective study aimed to investigate the risk factors associated with DWH after orthopedic surgery in RA patients treated with bDMARDs.

Methods:

We reviewed medical records of 277 orthopedic procedures for 188 RA patients treated with bDMARDs between from 2014 to 2017 in Niigata Rheumatic Center. As preoperative nutritional status assessment, we evaluated body mass index (BMI), prognostic nutritional index (PNI), and CONtrolling NUTritional status (CONUT). In addition, we evaluated DAS28-CRP, DAS28-ESR, face scale for pain, global health (GH), and Health Assessment Questionnaire-Disability Index (HAQ-DI) to assess the disease activity. Univariate and multivariate logistic regression analyses were performed to evaluate the risk factor for DWH.

Results:

The major characteristics of the patients in 277 procedures were mean age of 63.2 years old and mean disease duration of 18.2 years. Surgical site were hand and wrist (145 procedures), foot and ankle (76), hip and knee (31), elbow and shoulder (24), and spine (1). Seventy-four patients were treated with tocilizumab, 62 with etanercept, 55 with golimumab, 49 with abatacept, 16 with infliximab, 15 with adalimumab, and 6 with certolizumab. According to nutritional assessment in PNI and CONUT, 63% (n=175) and 47% (n=130) were normal nourished patients, respectively.

In 277 procedures, DWH were identified in 24 patients (8.6%). The following variables were significant in the univariate analyses: disease duration (OR 1.053; 95% CI 1.010–1.099; p=0.016), foot and ankle surgery (OR 7.091; 95% CI 2.130–23.603; p=0.001), tocilizumab (OR 0.286; 95% CI 0.093–0.881; p=0.029) (Table 1). These variables were entered into a multivariate model, and it was revealed that pre-operative use of tocilizumab (OR 0.265; 95% CI 0.074–0.953; p=0.042) and procedures in the foot and ankle (OR 6.915; 95% CI 1.914–24.976; p=0.003) were associated with an increased risk of DWH (Table 1).

Conclusion:

As previous study on tocilizumab described, the current retrospective study suggested that pre-operative use of tocilizumab and procedures in the foot and ankle were risk factors for DWH. Pre-operative disease activity and nutritional status were not independent risk factors for an increase in the prevalence of DWH.

References:

[1] Momohara S, Hashimoto J, Tsuboi H et al. Analysis of perioperative clinical features and complications after orthopaedic surgery in rheumatoid arthritis patients treated with tocilizumab in a real-world setting: Results from the multicentre tocilizumab in perioperative period (TOPP) study. Modern rheumatology. 2013, 23: 440-9.

Disclosure of Interests:

Shunji Okita: None declared, Hajime Ishikawa: None declared, Asami Abe: None declared, Satoshi Ito Speakers bureau: Abbvie,Eisai, Akira Murasawa: None declared, Keiichiro Nishida Grant/research support from: K. Nishida has received scholarship donation from CHUGAI PHARMACEUTICAL Co., Eisai Co., Mitsubishi Tanabe Pharma and AbbVie GK., Speakers bureau: K. Nishida has received speaking fees from CHUGAI PHARMACEUTICAL Co., Eli Lilly, Janssen Pharmaceutical K.K., Eisai Co. and AYUMI Pharmaceutical Corporation., Toshifumi Ozaki: None declared

AB0297 THE LONG-TERM OBSERVATION OF PATIENTS WITH RHEUMATOID ARTHRITIS WHO ACHIEVED A BIO-FREE CONDITION WITH ADALIMUMAB

Background:

Biological disease-modifying antirheumatic drugs (bDMARDs) caused a paradigm shift in the treatment of rheumatoid arthritis (RA). However, their high cost is a burden for patients and the national medical economy.

Objectives:

To analyze the long-term outcomes of patients with RA who achieved a bio-free condition (BF) with adalimumab (ADA).

Methods:

We followed 25 patients (male 6, female 19) who discontinued ADA with clinical remission (CR), and one female with a low disease activity (LDA), over 19.4 ±7.8 months of ADA treatment1). At the introduction of ADA, the average age was 51.2 ± 11.9 years old, and the average disease duration was 45.1 ± 48.4 months. The disease activity measured by disease activity score based on C-reactive protein (DAS28-CRP) was defined as follows: CR, <2.3; LDA, 2.3 - 2.7; moderate DA, 2.7 -4.1; and high DA, > 4.1, since the DAS28-CRP tends to be lower than the DAS28-based on the erythrocyte sedimentation rate in Japanese patients2).

Results:

We lost one patient with a transfer to another hospital. Four patients re-started ADA due to flare (DAS28-CRP>2.7) but achieved CR (in BF) again with the intensification of the treatment (dose increase or initiation of prednisolone [PSL] and/or conventional synthetic [cs] DMARDs such as tacrolimus or iguratimode). The DAS28-CRP significantly decreased from 3.45 ± 1.32 at base line (BL) to 1.55 ± 0.41 (p<0.0001) at BF. It remained 1.59 ± 0.59 (n=25) at 24 months after BF, 1.56 ± 0.39 (n= 20) at 48 months, 1.8 ± 0.7 (n=11) at 60 months. At the last observation, every patient remained in CR up to 84 months (n=2, Figure 1). The modified health assessment questionnaire score significantly decreased from 0.42 ± 0.46 (BL, n=19) to 0.02 ± 0.05 (p<0.002) at BF. It remained 0.03 ± 0.07 (n=19) at 24 months and 0.06 ± 0.14 (n=14) at 48 months, 0.04 ± 0.08 at 60 months (n=9). The PSL dose (mg/day) decreased from 3.2 ± 3.3 (BL) to 2.2 ± 2.8 at BF and 2.04 ± 2.13 (n=25) at 24 months, 1.73 ± 1.9 (n=20) at 48 months, and 1.6 ± 2.3 (n=11) at 60 months, but there were no significant changes. The methotrexate (MTX) dose (mg/week) increased from 10.1 ± 2.9 (BL) to 10.6 ± 2.6 (p< 0.78) at BF, 10.4 ± 3.3 (n=25) at 24 months, 10.7 ± 3.4 (n=20) at 48 months, 10.4 ± 3.1 at 60 months (not significant). The number of csDMARDs significantly increased from 0.8 ± 0.6 (BL) to 1.3 ± 0.9 (p<0.001, at BF), 2.56 ± 0.94 (n=25) at 24 months, 1.6 ± 1.01 (n=20) at 48 mnths, and 1.6 ± 2.3 at 60 months (n=11, Figure 2).

Conclusion:

BF can be sustained with an adequate dose of MTX and combination of csDMARDs.

References:

[1]Ito S, et al. An analysis of the biological disease-modifying antirheumatic drug-free condition of adalimumab-treated rheumatoid arthritis patients. Intern Med 58: 511-519, 2019

[2]Inoue E, et al. Comparison of Disease Activity Score (DAS)28-erythrocyte sedimentation rate and DAS28- C-reactive protein threshold values. Ann Rheum Dis. 66:407-409, 2007.

Disclosure of Interests:

Satoshi Ito Speakers bureau: Abbvie,Eisai, Shunsuke sakai: None declared, Yoichi Kurosawa: None declared, Daisuke Kobayashi: None declared, Ryo Okabayashi: None declared, Asami Abe: None declared, Hiroshi Otani: None declared, Kiyoshi Nakazono: None declared, Akira Murasawa: None declared, Ichiei Narita: None declared, Hajime Ishikawa: None declared

SAT0147 EFFICACY AND SAFETY OF IGURATIMOD AS FIRST-LINE DISEASE-MODIFYING ANTIRHEUMATIC DRUG THERAPY FOR PATIENTS WITH RHEUMATOID ARTHRITIS

Background:

Although methotrexate is the anchor drug, it took some days to check contraindications, such as interstitial pneumonia, hepatitis B virus infection, and latent tuberculosis infection. Therefore, we sometimes start rheumatoid arthritis (RA) treatment with other disease-modifying antirheumatic drug (DMARD) in daily clinical setting. Iguratimod (IGU) is a newly developed DMARD approved in Japan in September 2012, and the efficacy of IGU for DMARD naïve patients has not been thoroughly evaluated.

Objectives:

The aim of this prospective single-center study was to demonstrate the efficacy and safety of IGU when used as a first-line daily DMARD for patients with RA in a clinical setting.

Methods:

Enrolled patients included those diagnosed with RA according to the 2010 American College of Rheumatology/European League against Rheumatism (ACR/EULAR) classification criteria who took IGU as a first-line DMARD at Niigata Rheumatic Center between April 2016 and December 2018 (IGU group). There were no constraints regarding the addition or withdrawal of other DMARDs. Details of the patients’ background, clinical parameters, and laboratory findings were obtained, including C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), matrix metalloprotease-3 (MMP-3), rheumatoid factor (RF), Disease Activity Score for 28-joint counts based on the erythrocyte sedimentation rate (DAS28-4[ESR]), Clinical Disease Activity Index (CDAI), and Health Assessment Questionnaire Disability Index (HAQ-DI). The efficacy of IGU was evaluated at week 24. The IGU group’s data were then compared with 64 patients who took salazosulfapyridine or bucillamine as first-line DMARD in our hospital (other DMARD group). The data were expressed as median values. Comparisons between the parameters were performed using nonparametric method.

Results:

Forty-three patients (15 males, 28 females) received IGU as a first-line DMARD for RA. The age was 69.0 years and the duration of disease was 2.0 months. Twenty patients received prednisolone (PSL) concomitantly at a median dose of 5.0 mg/day. At 24 weeks medications were utilized in patients as follows: IGU in 36 (83.7 %), methotrexate in 18 (41.2%), PSL in 17 (39.5%), BUC in 10 (23.2 %), and biological DMARD in 7 (15.2 %) patients. Although 7 patients discontinued taking IGU due to liver enzyme elevation (n=4), nausea (n=1), creatinine elevation (n=1), and skin rash (n=1) during the 24-week period, serious adverse events requiring hospitalization were not observed. Clinical parameters that improved from baseline after 24 weeks of treatment included: ESR from 42.0 mm/h to 16.0 mm/h with p < 0.001; CRP from 0.70 mg/dL to 0.10 mg/dL with p< 0.001; MMP-3 from 136 ng/mL to 91.5 ng/mL with a p value of 0.11; RF went from 18.0 IU/mL to 8.00 IU/mL with p < 0.001; DAS28(4)-ESR dropped from 5.13 to 2.73 with p< 0.001; CDAI dropped from 20.0 to 5.00 with p< 0.001, and HAQ-DI decreased from 0.55 to 0.00 with p< 0.001. Patients who achieved a good or moderate response based on EULAR response at 24 weeks, included 90.7% in the IGU group versus 70.5% in the other DMARD group (Fisher`s exact test, p=0.046). The retention rate of the IGU group was 81.4 %, roughly equivalent to the 81.2% retention rate in the other DMARD group (Log-rank test, p=0.733).

Conclusion:

Our study indicates IGU is safe and effective for DMARD naïve RA patients. Starting treatment with IGU might be a new and effective strategy for RA patients without previous use of a DMARD.

Disclosure of Interests:

Daisuke Kobayashi: None declared, Eriko Hasegawa: None declared, Yoko Wada: None declared, Satoshi Ito Speakers bureau: Abbvie,Eisai, Asami Abe: None declared, Kiyoshi Nakazono: None declared, Akira Murasawa: None declared, Ichiei Narita: None declared, Hajime Ishikawa: None declared

P93 The usefulness of dual cardiac autonomic nervous modulation assessment for prediction of mortality in patients with relatively preserved left ventricular ejection fraction

Background

Recent guidelines have stated that reduced left ventricular ejection fraction (LVEF) is the gold standard marker for identifying patients at risk for cardiac mortality. Although reduced LVEF identifies patients at an increased risk of cardiac arrest, sudden cardiac deaths (SCDs) occur considerably more often in patients with relatively preserved LVEF. Current guidelines on SCDs risk stratification do not adequately cover this general population pool. Heart rate variability (HRV) and heart rate turbulence (HRT) are non-invasive electrocardiography (ECG)-based techniques capable of providing relevant information on the cardiac autonomic nervous modulation. Although a large body of evidence about autonomic nervous modulation markers has been reported, the usefulness of HRV and HRT parameters for risk stratification in such patients with relatively preserved LVEF has not yet been elucidated.

Purpose

This study aimed to evaluate HRV and HRT parameters for predicting cardiac mortality in patients with structural heart disease (SHD), including ischemic heart disease, dilated cardiomyopathy and valvular heart disease, who have mid-range left ventricular dysfunction (LVD).

Methods

We prospectively enrolled 229 patients (187 men, age 63 ± 13 years) with SHD who have mid-range LVD (LVEF &gt; 40%). HRV and HRT parameters based on 24-hour ambulatory ECG recordings (Fukuda Denshi Co., Ltd., Tokyo, Japan) were evaluated as follows; SDNN, triangular index, high and low frequency HRV, turbulence onset and slope. The primary endpoint was all-cause mortality. Univariate and multivariate Cox regression analysis were used to assess the association between these cardiac autonomic nervous modulation and mortality.

Results

During a mean follow-up of 21 ± 11 months, all-cause mortality was seen in 11 (4.8%) patients. Univariate Cox regression analysis showed that reduced SDNN (&lt;50ms), reduced triangular index (&lt;20ms) and HRT category 2 were significantly associated with the primary endpoint (P &lt; 0.05). When HRT category 2 combined with reduced SDNN, Multivariate Cox regression analysis revealed that this combination more strongly associates with the primary endpoint (hazard ratio =7.91, 95%CI, 1.82-34.2; P = 0.006).

Conclusion

Dual cardiac autonomic nervous modulation assessment which combined HRT and HRV could be a superior technique to predict mortality in patients with relatively preserved LVEF.

Association between parents' work hours and nutrient inadequacy in Japanese schoolchildren on weekdays and weekends

OBJECTIVES

Evidence is sparse concerning whether the nutrient intake in schoolchildren differs according to parents' work hours. The aim of this study was to investigate the relationship between parents' work hours and nutrient inadequacy among Japanese primary schoolchildren using dietary reference intakes on days with and without a school lunch.

METHODS

Participants included 10- to 11-y-old children in grade 5 from 19 public primary schools in four prefectures of east Japan. Data for 699 children were analyzed. Participants completed 24-h dietary records with photographs of their meals for 4 d consecutively, which included of 2 d of weekdays and 2 d of weekends. Their mothers' and fathers' work hours were obtained from questionnaires that were completed by the participants' guardians. Logistic regression analyses were used to estimate the odds ratios for whether participants had poor nutrient intake, with adjustment for confounders.

RESULTS

Children whose mothers worked ≥40 h/wk had significantly higher rates of nutrient shortages for vitamins A, E, K, and B₆, pantothenic acid, potassium, magnesium, and iron (P = 0.007, 0.003, 0.007, 0.023, 0.021, 0.045, 0.004, and 0.009, respectively) than those in the 0 h/wk group. These differences were not significant based on fathers' working hours, with the exception of vitamin A (≥40 versus 0-39 h/wk, P = 0.032). Additionally, nutrient shortages for children were more pronounced on weekdays than on weekends.

CONCLUSIONS

This evidence revealed the necessity to improve nutrition intake in children whose mothers work more than statutory working hours, which would enable children to have adequate nutrient intake, especially on weekdays.

A theoretical model to estimate inactivation effects of OH radicals on marine Vibrio sp. in bubble-shock interaction

A theoretical model for estimating inactivation effects on marine Vibrio sp. is developed from the viewpoint of the chemical action of the OH radicals induced by interaction of bubbles with shock waves. It consists of a biological probability model for cell viability and a bubble dynamic model for its collapsing motion due to the shock pressures. The biological probability model is built by defining a sterilized space of the OH radicals. To determine the radius of the sterilized space, the Herring equation is solved in the bubble dynamic model in consideration of the effect of the heat conductivity and mass transportation. Furthermore, the pressure waveform of incident shock wave used in the model is obtained with the pressure measurement. On the other hand, a bio-experiment of marine Vibrio sp. is carried out using a high-voltage power supply in a cylindrical water chamber. Finally, the viability ratio of marine bacteria estimated by the theoretical model is examined under the experimental conditions of this study. In addition, we also discuss the influence of bubble initial size for predicting the inactivation effects.

Development of a read-across workflow for skin irritation and corrosion predictions

We developed a read-across workflow using the OECD QSAR Toolbox for the prediction of skin irritation and corrosion. In the workflow, we gathered analogues using an improved profiler for skin irritation and corrosion to define valid categories. In addition, we refined categories by removing chemicals based on melting points and structural features. Finally, prediction results were obtained using our self-determined rule for read-across. In this rule, we decided the number of analogues from which the read-across is performed, analogue selection criteria (i.e. high similarity vs. near log P_ow) and prediction rule (i.e. majority vs. unanimity). We created a program for the optimization of read-across workflows. We applied this program to 313 chemicals in the training set and sought the optimized workflows among >1000 possible choices of profilers and ways of subcategorization and data gap filling. Use of the optimized workflows provided highly accurate, unbiased, user-independent and reproducible read-across predictions. The prediction results obtained from read-across workflows can be used for the selection of in vitro test methods or as part of the weight-of-evidence approaches in the Integrated Approach on Testing and Assessment for skin irritation and corrosion. Moreover, these results can be used for screening purposes and/or preliminary hazard assessment.

Importance of absorbable surgical sutures for the prevention of stitch abscess after surgery in patients with oral squamous cell carcinoma

Background

To elucidate the significance of absorbable surgical sutures in the occurrence of stitch abscess after surgery in patients with oral squamous cell carcinoma (SCC).

Material and Methods

The subjects were 251 patients who underwent excision and/or reconstruction and/or neck dissection for oral SCC using absorbable surgical sutures. Detection rates and characteristics of patients with stitch abscess were retrospectively evaluated by comparing between our present and previous data.

Results

There was only one stitch abscess among the 251 patients. A significant difference in the incidence of stitch abscess was found between the present data and our previous data. Of course, no significant correlations were found between the occurrence of stitch abscess using absorbable surgical sutures and the various factors seen in our previous analysis.

Conclusions

A complete switch of surgical sutures from silk to absorbable surgical sutures is needed for surgery in patients with oral SCC.

Key words:Stitch abscess, oral cancer, occurrence, absorbable surgical sutures, silk suture.

Socioeconomic disparities in psychological distress in a nationally representative sample of Japanese adolescents: A time trend study

OBJECTIVE

Socioeconomic status as a determinant of mental health problems has received scant attention in Japan, which has long been considered an egalitarian society. This study examined the association between socioeconomic status and psychological distress and its trends over 6 years among Japanese adolescents.

METHODS

We used data from a nationally representative sample of 9491 adolescents aged 12-18 years who participated in three repeated cross-sectional surveys between 2007 and 2013. The K6 scale was used to assess psychological distress. Socioeconomic status indicators included household income, parental education, parental working status and household structure.

RESULTS

Psychological distress prevalence decreased significantly from 2007 (10.7%) to 2013 (7.6%). However, the socioeconomic status patterns of psychological distress were consistent through the study period. Adolescents living in both lower (odds ratio = 1.61; 95% confidence interval = [1.27, 2.05]) and higher income households (odds ratio = 1.30; 95% confidence interval = [1.03, 1.62]) were more likely to report psychological distress than their middle-income counterparts. Adolescents with low household income were more likely to feel stress from interpersonal relationships and less likely to have help-seeking behaviors, while those with high household income were more likely to feel stress about school achievement. Psychological distress was also associated with parental poor education and single parenthood.

CONCLUSIONS

Socioeconomic status disparities in adolescent psychological distress were evident and consistent during the 6-year period. There is a unique U-shaped relationship between household income and psychological distress among adolescents in Japan, unlike those from other countries. However, the underlying mechanisms may differ by income status. Future prevention efforts should consider socioeconomic status as a determinant of adolescent mental health problems.

100 FACTORS AFFECTING PREGNANCY RATES IN THE TRANSFER OF IN VITRO-PRODUCED JAPANESE BLACK CATTLE EMBRYOS

Despite the rapid expansion of in vitro embryo production (IVP) technology for genetic improvement in the cattle industry in the last decades, pregnancy rates by the transfer of IVP embryos are still lower than those derived from in vivo-produced embryos. The objective of this study was to analyse factors affecting pregnancy rates after the transfer of IVP Japanese Black cattle embryos under farm conditions. Holstein heifers (n = 4,475) and cows (n = 8,541) were selected as recipients. Most cows (80%) were managed in tie-stall barns and most heifers (80%) were managed in pens. Embryo transfers were performed for 9 years, from 2004 to 2012. The embryos were produced from oocytes derived from a local abattoir and semen from 14 proven bulls by the Livestock Improvement Association of Japan (Hamano and Kuwayama 1993 Theriogelogy 39, 703–712). The fresh IVP embryos (quality; IETS code 1) that reached the blastocyst stage after 7 to 8 days (insemination = Day 0) were transported by an airplane (2 h) and subsequently by a car (1.5 h). Embryos were non-surgically transferred to each recipient on Day 7 to 9 of their natural oestrous cycle on farms. Pregnancy was diagnosed on Day 40 to 60 after oestrus. Pregnancy results were statistically analysed using the GLM procedures of SAS. The following variables were included in the model: recipient parity (0, 1, 2, or 3), day (7, 8, or 9) of the oestrous cycle at the time of embryo transfer, oestrus behaviour (increased activity observed by farmers), presence of mucus at oestrus, presence of blood after oestrus, and year (1, 2, 3, 4, 5, 6, 7, 8, or 9) and season (April–June as spring, July–September as summer, October–December as fall, or January–March as winter) of embryo transfer. The Bonferroni correction was used to counteract the problem of multiple comparisons. Heifers had significantly higher pregnancy rates than cows (51.0% v. 37.9%, respectively; P < 0.01), and first parity cows had higher pregnancy rates than third parity cows (42.9% v. 35.7%, respectively; P < 0.01). Pregnancy rates were significantly higher in recipients that received an embryo transfer on Day 8 of their oestrous cycle, than on Day 7 (46.6% v. 42.4%, respectively; P < 0.01). Recipients without oestrus behaviour had higher pregnancy rates than those with oestrus behaviour (46.3% v. 43.4%, respectively; P < 0.01). The presence of mucus and/or blood after oestrus and the season of transfer were not found to significantly affect pregnancy rates. The results of this study indicated that performing IVP embryo transfers on Day 8 of a recipient’s oestrous cycle will improve the pregnancy rate, season does not have an effect on pregnancy rate, and the detection of oestrus by monitoring increased activity is not always reliable and instead should be determined by multiple symptoms on farm conditions.

Irreversible inactivation of glutathione S-transferase-π by a low concentration of naphthoquinones

π-Class glutathione S-transferase (GST-π) was very potently inactivated by oxidants such as H2O2, xanthine-xanthine oxidase and naphthoquinones. Thiols and glutathione analogs including dithiothreitol, reduced gluta-thione, cysteine, cysteamine, S-methyl-SG, S-hexyl-SG and S-decyl-SG protected GST-π from the inactivation, but a substrate analog (2,4-dinitrophenol), superoxide dismutase and catalase did not, suggesting that the cysteinyl residue(s) in/nearby the glutathione binding site (G-site) may be oxidatively modified by these oxidants. Many reductants and radical scavengers including butylated hydoxytoluene, α-tocopherol, ascorbate, uric acid, mannitol, tyrosine, tryptophan, histidine, quercitrin and bilirubin had no effect on the inactivation. GST-π pretreated with cystamine was reactivated very efficiently by 50 mM DTT following incubation with 1,2-naphthoquinone, whereas cystamine-untreated GST-π was not reactivated.

Associations between Japanese schoolchildren's involvement in at-home meal preparation, their food intakes, and cooking skills

BACKGROUND/OBJECTIVES

This study aimed to examine the association of Japanese schoolchildren's involvement in at-home meal preparation with food intake and cooking skill.

SUBJECTS/METHODS

We included 1,207 fifth-grade children aged 10-11 years and one parent of each child. A cross-sectional survey was used to collect data on involvement in at-home meal preparation. Correspondence analysis was used to classify involvement in at-home meal preparation into three groups: food-related activities (cooking only or with other activities such as shopping, table-setting, clean up, and dishwashing), non-food-related activities (table-setting and/or clean up), and no (helping) activities. Food intake was assessed using a food frequency questionnaire. Logistic regression models were used to examine involvement in at-home meal preparation associations.

RESULTS

The sample consisted of 1,207 fifth-grade children. Vegetable intake was lower in the no (helping) activities group than the food-related activities group (95% CI; boys: 1.2, 5.1, girls: 2.0, 8.9). Fewer children in the non-food-related activities group reported they were able to make a portion of their meals compared with the food-related activities group (95% CI; boys: 1.6, 3.5; girls: 1.5, 3.2).

CONCLUSIONS

Children in the food-related activities group showed more favorable food intake and cooking skills than children in the no (helping) activities or non-food-related activities group.