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Introduction: Although active vitamin D (VD) has been used both preoperatively and postoperatively to prevent hypocalcemia risk in patients undergoing total thyroidectomy, the role of 1,25-dihydroxyvitamin D (1,25(OH)2D) has not been examined. This study comprehensively investigated the effects of 1,25(OH)2D on calcium (Ca) concentrations after total thyroidectomy. Methods: Serum Ca, parathyroid hormone (PTH), and 1,25(OH)2D levels were measured in 82 patients with thyroid disease before and after surgery. Results: Serum Ca, PTH, and 1,25(OH)2D levels decreased significantly on the morning of the first postoperative day. Notably, the decrease in 1,25(OH)2D concentration was significantly lower than that of PTH concentration (10.5 ± 33.4% vs. 52.1 ± 30.1%, p<0.0001), with 28% of patients showing increases in 1,25 (OH)2D. The only factor predicting a postoperative 1,25(OH)2D decrease was a high preoperative 1,25(OH)2D concentration. Postoperative 1,25(OH)2D concentrations, as well as the magnitude and rate of decrease from preoperative levels, showed strong positive correlations with preoperative 1,25 (OH)2D concentrations (p<0.0001 for all three variables) but not with PTH concentrations. These findings suggest that 1,25(OH)2D concentrations after thyroidectomy were more strongly dependent on preoperative concentrations than on the effect of PTH decrease and were relatively preserved, possibly preventing sudden severe postoperative hypocalcemia. A high 1,25(OH)2D level was the most important preoperative factor for hypocalcemia (<2 mmol/L; p<0.05) on the first postoperative day; however, only PTH decrease was statistically significant (p<0.001) when intraoperative factors were added. In the PTH >10 pg/mL group, the decrease in 1,25(OH)2D levels was significantly associated with postoperative hypocalcemia (p<0.05). Similarly, in the PTH levels >15 pg/mL group, a decrease in 1,25(OH)2D concentration was a significant factor, and the amount of PTH decrease was no longer significant. Conclusion: 1,25(OH)2D plays an important role in preventing sudden, severe hypocalcemia due to decreased PTH levels after total thyroidectomy, whereas high preoperative 1,25(OH)2D levels are a significant risk factor for postoperative hypocalcemia. Optimizing preoperative protocols to adjust Ca, PTH, and 1,25 (OH)2D levels to improve the management of patients undergoing total thyroidectomy and to prevent extreme intraoperative PTH decreases may reduce the risk of hypocalcemia. [ABSTRACT FROM AUTHOR]

Introduction: Although active vitamin D (VD) has been used both preoperative^ and postoperatively to prevent hypocalcemia risk in patients undergoing total thyroidectomy, the role of 1,25-dihydroxyvitamin D (1,25(OH)2D) has not been examined. This study comprehensively investigated the effects of 1,25(OH)2D on calcium (Ca) concentrations after total thyroidectomy. Methods: Serum Ca, parathyroid hormone (PTH), and 1,25(OH)2D levels were measured in 82 patients with thyroid disease before and after surgery. Results: Serum Ca, PTH, and 1,25(OH)2D levels decreased significantly on the morning of the first postoperative day. Notably, the decrease in 1,25(OH)2D concentration was significantly lower than that of PTH concentration (10.5 ± 33.4% vs. 52.1 ± 30.1%, p<0.0001), with 28% of patients showing increases in 1,25 (OH)2D. The only factor predicting a postoperative 1,25(OH)2D decrease was a high preoperative 1,25(OH)2D concentration. Postoperative 1,25(OH) 2D concentrations, as well as the magnitude and rate of decrease from preoperative levels, showed strong positive correlations with preoperative 1,25 (OH)2D concentrations (p<0.0001 for all three variables) but not with PTH concentrations. These findings suggest that 1,25(OH)2D concentrations after thyroidectomy were more strongly dependent on preoperative concentrations than on the effect of PTH decrease and were relatively preserved, possibly preventing sudden severe postoperative hypocalcemia. A high 1,25(OH)2D level was the most important preoperative factor for hypocalcemia (<2 mmol/L; p<0.05) on the first postoperative day; however, only PTH decrease was statistically significant (p<0.001) when intraoperative factors were added. In the PTH >10 pg/mL group, the decrease in 1,25(OH)2D levels was significantly associated with postoperative hypocalcemia (p<0.05). Similarly, in the PTH levels >15 pg/mL group, a decrease in 1,25(OH)2D concentration was a significant factor, and the amount of PTH decrease was no longer significant. Conclusion: 1,25(OH)2D plays an important role in preventing sudden, severe hypocalcemia due to decreased PTH levels after total thyroidectomy, whereas high preoperative 1,25(OH)2D levels are a significant risk factor for postoperative hypocalcemia. Optimizing preoperative protocols to adjust Ca, PTH, and 1,25 (OH)2D levels to improve the management of patients undergoing total thyroidectomy and to prevent extreme intraoperative PTH decreases may reduce the risk of hypocalcemia. [ABSTRACT FROM AUTHOR]

Postmenopausal women have an increased risk of developing metabolic diseases, such as osteoporosis, obesity, and diabetes. Thus, chemoprophylaxis for postmenopausal symptoms through the daily diet is critical. Vanillic acid (VA) is a phenolic compound found in the herbal medicine "Toki" (Angelica acutiloba) and the mycelium of the shiitake mushroom Lentinula edodes. VA has no affinity for estrogen receptors and may offer preventive effects against these diseases. Here, we demonstrate the metabolic effects of VA in ovariectomized mice. Ten-week-old ovariectomized mice were fed a VA-containing diet (100 mg/kg body weight/day) for 10 weeks. Dietary VA significantly prevented femoral bone mineral density loss and also reduced the increases in glucose levels and white adipose tissue weights compared with those in the control group. Furthermore, uterine enlargement was not observed because of these beneficial effects. Our findings suggest that VA has the potential to mitigate postmenopausal symptoms in ovariectomized mice without estrogenic action. [ABSTRACT FROM AUTHOR]

The air compression of a high-speed train entering a tunnel results in micro-pressure waves (MPWs), which can cause environmental problems. To mitigate MPWs, tunnel hoods with discrete windows are installed at the tunnel entrances. By properly adjusting the window conditions, the efficiency of the tunnel hood in mitigating MPWs can be enhanced. Per Japanese convention, window conditions are optimized by changing the opening/closing pattern in the longitudinal direction (pattern optimization). The optimization pattern of the windows is fundamentally different if there is a change in the train speed, train nose length, the relative position between the train and the windows, or the train nose shape. Therefore, for extremely long tunnel hoods, the optimal state of the windows is almost impossible to detect numerically or experimentally using pattern optimization. In this study, we realized a rapid and simple optimization of the windows of the tunnel hood (i.e., area optimization) for mitigation of MPWs by field measurements. The result demonstrated that the area optimization considerably helps in mitigating the MPWs, despite the simplicity of the procedures. [ABSTRACT FROM AUTHOR]

Copyright of Romanian Journal of Internal Medicine is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Although the clinicopathological significance of serum p53 antibodies (s-p53-Abs) in esophageal cancer have been evaluated previously, previous reports only analyzed around 100–200 patients. This study was a multi-institutional study promoted by the Japan Esophageal Society to evaluate the clinical significance of preoperative s-p53-Ab status and antibody titers in 1487 esophageal cancer patients without neoadjuvant therapy. Methods: A total of 1487 patients with esophageal squamous cell carcinoma surgically treated between 2008 and 2016 in 15 hospitals in Japan were enrolled. The cut-off value to classify the patients into s-p53-Ab positive and negative groups was 1.30 U/ml. A receiver operating characteristic curve was constructed to assess the s-p53-Abs cut-off levels to differentiate poor prognosis among the s-p53-Ab positive group. Univariate and multivariate analyses were used to evaluate the clinicopathological and prognostic significance of s-p53-Ab status and titers. Results: Although s-p53-Ab status was significantly associated with tumor depth (P = 0.002), nodal status (P = 0.027), and pathological stage (P = 0.002). The s-p53-Ab positive status was not significantly associated with poor overall survival (P = 0.699). Using 9.82 U/ml as a cut-off, the high s-p53-Ab titer group showed a significantly worse overall survival than the low s-p53-Ab titer group (P = 0.038). However, the difference was not significant in the multivariate analysis. Conclusion: The presence of s-p53-Abs was associated with tumor progression. Although high s-p53-Ab titers more than 9.82 U/ml, might be associated with poor prognosis for patients with esophageal squamous cell carcinoma, it was not an independent risk factor. [ABSTRACT FROM AUTHOR]

Copyright of Ecos de Economía is the property of Universidad EAFIT and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: This study evaluated the cost-effectiveness of replacing standard intravenous therapy (taxane) with oral S-1 therapy for first-line metastatic breast cancer treatment.Methods: This cost-effectiveness analysis was based on data from a randomized phase III trial (SELECT BC). As cost-effectiveness was a secondary endpoint of the SELECT BC trial, some of the randomized patients participated in an EQ-5D survey (N = 391) and health economic survey (N = 146). The EQ-5D responses, claims, and prescription data were collected for as long as possible until death. The expected quality-adjusted life years (QALY) obtained from each treatment were calculated using patient-level EQ-5D data, and the expected cost was calculated using patient-level claim data. The analysis was performed from the perspective of public healthcare payers.Results: The estimated EQ-5D least-square means and 95% CI up to 48 months were 0.764 (95% CI, 0.741-0.782) and 0.742 (95% CI, 0.720-0.764) in the S-1 and taxane arms, respectively. The expected QALY was 2.11 for the S-1 arm and 2.04 for the taxane arm, with expected costs of JPY 5.13 million (USD 46,600) and JPY 5.56 million (USD 50,500), respectively. These results show that S-1 is cost-saving. According to probabilistic sensitivity analysis, S-1 was dominant with a probability of 63%. When the willingness to pay (WTP) value was JPY 5 million (USD 45,500) per QALY, the probability of being cost-effective was 92%.Conclusions: Our results show that the introduction of oral S-1 therapy for metastatic breast cancer is highly likely to be cost-effective.Trial Registration: UMIN CTR C000000416 . Registered on May 10, 2006. [ABSTRACT FROM AUTHOR]

When ultrashort laser pulses are focused inside a glass at a high repetition rate, structural changes occur because of the heat accumulation from the train of laser pulses. This report describes phase measurement of the structural changes induced inside glass by phase-shifting digital holographic microscopy. Two-dimensional phase distribution across the structural change for static exposure is retrieved. By focusing femtosecond laser pulses at the interface between two glass substrates, melted materials can directly weld glass plates. Quantitative phase measurement of welded glass substrates revealed that the refractive index decreased in the laser-irradiated zone. [ABSTRACT FROM AUTHOR]

We have investigated the relation between the softening of elastic constants and martensitic transformation in Fe3Pt, which exhibits various kinds of martensitic transformation depending on its long-range order parameter S. The martensite phases of the examined alloys are BCT (S = 0.57), FCT1 (S = 0.75, c/a < 1) and FCT2 (S = 0.88, c/a > 1). The elastic constants C' and C44 of these alloys decrease almost linearly with decreasing temperature. Although the temperature coefficient of C' decreases as S increases, C' at the transformation temperature is the smallest in the alloy with S = 0.75, which transforms to FCT1. This result implies that softening is most strongly related to the formation of the FCT1 martensite with tetragonality c/a < 1 among the three martensites. [ABSTRACT FROM AUTHOR]

A Fe-31.2Pd (at.%) alloy exhibits a weak first-order martensitic transformation from a cubic structure to a tetragonal structure near 230 K. This transformation is associated with significant softening of elastic constant C'. Because of the softening, the alloy shows a large elastic strain of more than 6% in the [001] direction. In addition, the alloy has a critical point and shows a high elastocaloric effect in a wide temperature range for both the parent and the martensite phases. [ABSTRACT FROM AUTHOR]

Background: Japan still has the highest ratio of beds devoted to psychiatric patients in the world. In 2011, in order to reduce re-hospitalization of patients who became disconnected from regular contact with outpatient medical services, the Japanese Ministry established the Japanese Outreach Model Project (JOMP). In this study, we will explicate the JOMP project protocol and investigate the rate and length of hospital admission, impairments of social function and problematic behavior at the follow-up period (6- and 12-month) and time of services provided by JOMP. Method: This longitudinal retrospective study used survey data collected from 32 outreach teams of 21 prefectures in Japan during September 2011 to July 2013. The outcome variables were assessed at baseline, 6-month and 12-month as to whether or not participants had been admitted to the hospital. Data from 162 participants with mental illness who had difficulties in maintaining contact with mental health services were analyzed. Repeated measures analysis of variance provided a significant effect of the intervention over time. Results: The rate of hospital admission of JOMP participants was 24.1% at 6-months and 27.2% at the 12-month follow-up. The average length of hospital-stay at baseline and 12-months was 38.7 days (SD 84.7). Compared with the baseline, the average score of the Global Assessment Functioning and the Social Behavioral Schedule were significantly improved after the 6-month and 12-month follow-up. The activity log showed that among the most often delivered JOMP services were to “prevent exacerbation of somatic symptoms” and “care for families”. Conclusion: These results suggest that JOMP has a strong potential to both reduce readmission rates and the length of hospital stay compared with the Japanese regular outpatient care by public insurance, and improve social function and problematic behavior. The JOMP teams provided long-term support for families. As of April 2014 JOMP was included in the National Health Insurance program in a limited way therefore an evaluation of JOMP team fidelity on readmissions must be examined. [ABSTRACT FROM AUTHOR]

An Fe3Pt alloy with degree of order 0.75 exhibits a second-order-like martensitic transformation from a cubic structure to a tetragonal one at about 90 K; its tetragonality c/a changes nearly continuously from 1 to 0.945 on cooling from 90K to 14 K. We have investigated the change in lattice parameters in a single crystal of the Fe3Pt alloy at 93K under compressive stresses, σ, applied in the [001] direction by neutron diffraction. The tetragonality c/a has decreased continuously from 1 to 0.907 with an increase in |σ| up to |σ|=280MPa; the corresponding lattice strain in the [001] direction, due to the continuous structure change, increases from 0% to 6.1%. When the stress of 300MPa is reached, c/a has changed abruptly from 0.907 to 0.789 due to a first-order martensitic transformation. [ABSTRACT FROM AUTHOR]

In this paper, shift multiplex recording of phase data pages on a volume polarization-sensitive medium by retardagraphy is demonstrated. The origin of shift selectivity in volume retardagraphy is explained. In the experiment, four-valued phase data pages are used. Then, a coding method is proposed to correct a reconstructed phase pattern. The recorded phase data pages are reconstructed using the feature of the coding method. By comparing the reconstructed phase data pages with recording phase data pages, symbol error rates of less than 11% are achieved. From the experimental result, it is verified that volume retardagraphy is applicable to optical memory. [ABSTRACT FROM AUTHOR]

In this paper, the long-run causality between financial development, financial crisis and globalization--trade and financial openness--in India is investigated through the co-integration techniques of the VARX and ARDL methods. The main finding is that although the single impact of either trade or financial openness is uncertain, the simultaneous opening of the two sectors contributes to financial development. Another finding is that the growing presence of international trade is relevant to the occurrence of financial crisis. Policymakers, especially those of developing countries, need to recognize these effects of trade and financial openness in designing development plans. [ABSTRACT FROM AUTHOR]

Background: In economic evaluation, cost per quality-adjusted life year (QALY) is generally used as an indicator for cost-effectiveness. Although JPY 5 million to 6 million (USD 60, 000 to 75,000) per QALY is frequently referred to as a threshold in Japan, do all QALYs have the same monetary value? Methods: To examine the relationship between severity of health status and monetary value of a QALY, we obtained willingness to pay (WTP) values for one additional QALY in eight patterns of health states. We randomly sampled approximately 2,400 respondents from an online panel. To avoid misunderstanding, we randomly allocated respondents to one of 16 questionnaires, with 250 responses expected for each pattern. After respondents were asked whether they wanted to purchase the treatment, double-bounded dichotomous choice method was used to obtain WTP values. Results: The results clearly show that the WTP per QALY is higher for worse health states than for better health states. The slope was about JPY -1 million per 0.1 utility score increase. The mean and median WTP values per QALY for 16 health states were JPY 5 million, consistent with our previous survey. For respondents who wanted to purchase the treatment, WTP values were significantly correlated with household income. Conclusion: This survey shows that QALY based on the EQ-5D does not necessarily have the same monetary value. The WTP per QALY should range from JPY 2 million (USD 20,000) to JPY 8 million (USD 80,000), corresponding to the severity of health states. [ABSTRACT FROM AUTHOR]

We study the Iwasawa $lambda $-invariant of the cyclotomic $mathbb {Z}_2$-extension of $mathbb {Q}(sqrt {p} )$ for an odd prime number $p$ which satisfies $pequiv 1pmod {16}$ relating it to units having certain properties. We give an upper bound of $lambda $ and show $lambda =0$ in certain cases. We also give new numerical examples of $lambda =0$. [ABSTRACT FROM AUTHOR]

Abstract   Background Several randomized controlled trials have confirmed the usefulness of trastuzumab as an adjuvant therapy for HER2-overexpressed breast cancer patients; however, the costs for 1-year treatment are high. Therefore, we performed an economic analysis regarding the efficient distribution of medical resources. Methods To analyze the cost-effectiveness for a 1-year adjuvant trastuzumab treatment group compared with the observation group, we constructed a Markov model adopting a 3% per year discount rate for costs and outcomes. The time horizon was 50 years. The perspective was that of health-care payers, as only direct medical costs were calculated. The outcome was measured as life-year gained (LYG) from 2-year follow-up HERA trial data. Results The ICER of the standard setting (5 years efficacy and 50–60 kg patient weight) was JPY 2,600,000 (€17,000) per LYG. The calculation results of other weight class ICER were JPY 2,200,000 (€15,000) and JPY 3,300,000 (€22,000) per LYG for the patients, respectively, who weighed less than 50 kg, and 60–75 kg. In the sensitivity analysis, the period of trastuzumab efficacy was the most influential parameter for the result of cost-effectiveness. However, even if the trastuzumab efficacy were to continue for only 2 years, at least, which is a conservative setting judging from the joint analysis (NSABP B-31 and NCCTG N9831 trials), the ICER remains acceptable for any weight class. Conclusion These results suggest that the 1-year adjuvant trastuzumab treatment is cost-effective. Both clinical and economic benefits were superior for the 1-year adjuvant trastuzumab treatment group compared with the observation group. [ABSTRACT FROM AUTHOR]

We construct certain algebraic integers $\alpha_n$ as special values of two variable theta functions in the ray class field of a certain quartic field modulo $2^n$, and study a property of prime ideals which appear in $\alpha_n$ in connection to the relationships between cyclotomic units and exponential functions and between elliptic units and elliptic theta functions. [ABSTRACT FROM AUTHOR]

We have studied the temperature dependencies of elastic-like deformation and the elastocaloric effect in an L12-type Fe3Pt alloy with degree of order S  =  0.75, which exhibits a weak first-order martensitic transformation (MT) near 85 K (TM). The stress–strain curve under a compressive stress applied in the [0 0 1] direction shows a small stage in the vicinity of TM due to the stress-induced MT. The transformation strain is 0.17% at TM; it decreases linearly as temperature decreases and disappears at 130 K. Thereseems to be a critical point of the MT in the stress–temperature phase diagram at (20 MPa, 130 K). The latent heat of the MT is estimated to be 0.52 J mol−1 from the Clausius–Clapeyron equation. The adiabatic temperature change ΔTadi caused by the latent heat is 0.04 K at 90 K. In contrast, experimentally obtained ΔT is approximately 1 K at 90 K when the applied stress is 100 MPa. The main contribution to ΔT is the temperature dependence of elastic strain caused by softening; the Young’s modulus at 288 K is 55 GPa and it decreases linearly with a slope of 0.28 GPa K−1 as temperature decreases. [ABSTRACT FROM AUTHOR]