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Background: Osteoporosis and osteopenia are more frequent in patients who have received kidney transplants than in healthy individuals. Although osteoporosis and sarcopenia are closely related, only few studies have considered them in the post-transplantation period. We aimed to investigate the relationship between lower bone mineral density and skeletal muscle in kidney transplant recipients. Methods: We included 371 patients in the maintenance phase of kidney transplantation (> 6 months after transplantation) followed-up at our institution from January to December 2019. The primary endpoint was the association between bone mineral density and skeletal muscle mass index. As secondary endpoints, in addition to skeletal muscle mass index, we investigated other factors associated with low bone mineral density, including kidney function and 25-hydroxy vitamin D (25(OH)D) concentration. Considering the possibility that factors affecting bone mineral density differ between men and women, we explored these factors separately for both sexes. Results: Of the 371 participants, 243 (65.4%) were men. The median age and time after transplantation were 52 and 14 years, respectively. Univariate analysis showed that age, female sex, time since transplantation, cystatin C-based estimated glomerular filtration rate (eGFRcysC), 25(OH)D, and skeletal muscle mass index were associated with bone mineral density. Multivariate analysis showed associations of bone mineral density with eGFRcysC, 25(OH)D, and skeletal muscle mass index. Multivariate analysis by sex showed significant associations with eGFRcysC, hemoglobin, and skeletal muscle mass index in men and with age, eGFRcysC, albumin, and skeletal muscle mass index in women. Bone mineral density was not associated with history of dialysis prior to transplantation or time since transplantation. Conclusions: In kidney transplant recipients, an independent association between lower bone mineral density and skeletal muscle mass index was observed in both sexes. Graphical abstract:

Black cohosh extracts improved overall menopausal symptoms, hot flashes, vaginal atrophy, and somatic symptoms compared to placebo. Combined black cohosh and other herbal medicine did not provide superior benefits.

BackgroundModerate-to-severe cancer related fatigue occurs in 45% of patients with cancer and interferes with many aspects of quality of life. Although physical exercise has level 1 evidence for improvement of cancer related fatigue, it has a relatively high behavioural demand compared with other non-pharmacological interventions. The aim of this updated meta-analysis was to address the efficacy of light therapy in improving cancer related fatigue in patients with cancer.MethodsWe included randomised controlled trials investigating the efficacy of bright white light (BWL) therapy in ameliorating cancer related fatigue in patients with cancer. This meta-analysis was conducted using a random-effects model. The target outcomes were changes in cancer related fatigue associated with BWL or dim red light (DRL).ResultsThere were 9 articles with 231 participants included. The main results revealed that daily morning BWL for 30 min was associated with significantly better improvement in fatigue severity compared with DRL (k=5, Hedges’ g=−0.414, 95% CI −0.740 to −0.087, p=0.013). The subgroup without psychiatric comorbidities (k=4, Hedges’ g=−0.479, 95% CI −0.801 to −0.156, p=0.004) was associated with significantly better improvement in fatigue severity with BWL than with DRL. In contrary, BWL was not associated with significantly different changes in depression severity or quality of life compared with DRL. Finally, BWL was associated with similar acceptability (ie, dropout rate) and safety profile (ie, any discomfort) as those of DRL.ConclusionsThis meta-analysis provides an updated evidence on the rationale for application of BWL in ameliorating cancer related fatigue in patients with different types of cancer.Trial registration numberINPLASY202140090.

BackgroundA strategy for maintaining and/or improving cardiorespiratory fitness (CRF) in the growing population of cancer survivors is of major clinical importance, especially in the COVID-19 era. The effect of unsupervised high-intensity interval training (HIIT) on increasing CRF in breast cancer survivors is unknown.PurposeThe purpose of this study was to determine whether the newly developed habit-B programme, which involves home-based smartphone-supported HIIT using body weight exercises, improves CRF in early-stage breast cancer survivors.MethodsThis single-centre, 12-week, parallel-group, single-blind, randomised controlled trial involved 50 women with stage I–IIa breast cancer, aged 20–59 years, who had completed initial treatment except for hormone therapy. Participants were randomised to either the exercise or control group. The primary outcome was the 12-week change in peak oxygen uptake [Formula]. Other outcomes included muscle strength, 6 min walk test, resting heart rate, physical activity, fatigue, safety and quality of life.ResultsThe change in [Formula] and leg strength increased significantly in the exercise group compared with the control group (p<0.01). Changes in other outcomes were not significantly different between the groups.ConclusionA home-based HIIT intervention can lead to improve CRF and muscle strength in early-stage breast cancer survivors.

A timely determination of the risk of post‐traumatic stress disorder (PTSD) is a prerequisite for efficient service delivery and prevention. We provide a risk estimate tool allowing a calculation of individuals’ PTSD likelihood from early predictors. Members of the International Consortium to Predict PTSD (ICPP) shared individual participants’ item‐level data from ten longitudinal studies of civilian trauma survivors admitted to acute care centers in six countries. Eligible participants (N=2,473) completed an initial clinical assessment within 60 days of trauma exposure, and at least one follow‐up assessment 4‐15 months later. The Clinician‐Administered PTSD Scale for DSM‐IV (CAPS) evaluated PTSD symptom severity and diagnostic status at each assessment. Participants’ education, prior lifetime trauma exposure, marital status and socio‐economic status were assessed and harmonized across studies. The study's main outcome was the likelihood of a follow‐up PTSD given early predictors. The prevalence of follow‐up PTSD was 11.8% (9.2% for male participants and 16.4% for females). A logistic model using early PTSD symptom severity (initial CAPS total score) as a predictor produced remarkably accurate estimates of follow‐up PTSD (predicted vs. raw probabilities: r=0.976). Adding respondents’ female gender, lower education, and exposure to prior interpersonal trauma to the model yielded higher PTSD likelihood estimates, with similar model accuracy (predicted vs. raw probabilities: r=0.941). The current model could be adjusted for other traumatic circumstances and accommodate risk factors not captured by the ICPP (e.g., biological, social). In line with their use in general medicine, risk estimate models can inform clinical choices in psychiatry. It is hoped that quantifying individuals’ PTSD risk will be a first step towards systematic prevention of the disorder.

Objectives: Although safe approaches for improving depression in pregnancy are required and the efficacy of omega-3 polyunsaturated fatty acids (PUFAs) has been suggested, the amount of supplemental omega-3 PUFAs has varied among previous studies and adequate amount might be different among countries. The aim of this pilot study is to explore the feasibility of using 1800 mg of omega-3 PUFAs supplementation for our future double-blind, placebo-control trial, and to clarify the clinical difference and the similarity between two sites of Japan and Taiwan.Methods: Pregnant women between 12 and 24 weeks’ gestation with depressive symptoms were recruited. Participants were supplemented daily with omega-3 PUFAs capsules containing 1206 mg eicosapentaenoic acid and 609 mg docosahexaenoic acid for 12 weeks. The primary outcome was change in total score on the 17-item Hamilton Rating Scale for Depression (HAMD) at 12 weeks after supplementation.Results: Eight pregnant women in Japan and five in Taiwan participated in the study. A substantial proportion of pregnant women reported high consumption of omega-3 supplements and dietary fish were excluded in Taiwan rather than in Japan sites. The decrease in HAMD score from baseline to 12 weeks after the start of the intervention was significantly larger in Japanese participants than in Taiwanese participants (Wilcoxon rank sum test; P = 0.045).Discussion: The improvement of depressive symptoms was smaller at the Taiwan site than at the Japan site. Differences in psychopathology of recruited participants identified by self-rating scales might affect the degree of population heterogeneity and the treatment efficacy. A randomized-controlled trial is needed to confirm these findings.Trial Registration: ClinicalTrials.gov Identifier: NCT01948596.

Our previous study has shown that matrix metalloproteinase 9 (MMP-9) plays a central role in the early induction of neuropathic pain (Kawasaki et al., 2008). However, clinical trials to inhibit MMP-9 have failed due to toxicity and lack of specificity of small molecule inhibitors. By using functional selection, we developed a monoclonal antibody (mAb) that reduced chemotherapy-induced mechanical pain (Lopez et al., 2019). In this study, we tested the effects of the MMP-9 mAb in mouse models of diabetes-induced peripheral neuropathy (DPN) induced by Streptozotocin (STZ). MMP-9 mAb was administrated intrathecally (IT) or intravenously (IV). Mechanical and cold pain was assessed and conditioned place preference (CPP) test was also performed. Whole cell patch-clamp recordings were made from the spinal dorsal horn neurons of STZ-treated mice to examine the effects of MMP-9 and mAb on synaptic transmission. Pharmacokinetics of injected MMP-9 mAb was assessed using ELISA kit. The results showed that either IT or IV injection of MMP-9 mAb significantly reduced mechanical allodynia. We also observed CPP in mice treated with MMP-9 antibody indicating the effectiveness of the mAb in reducing spontaneous pain. Furthermore, MMP-9 mAb effectively reduced diabetic neuropathic pain in a genetic model of DPN in db/db mice. MMP-9 treatment in spinal cord slices enhanced spontaneous excitatory postsynaptic currents in dorsal horn neurons, whereas the mAb treatment reduced EPSCs in neurons of diabetic animals. Our findings suggest that MMP-9 monoclonal antibody is effective in alleviating diabetic neuropathic pain in mice via both peripheral and central actions. DoD grant W81XWH2110756 to X.G and R.R.J.

AbstractObjectiveThis study aimed to evaluate factors associated with post-traumatic stress disorder (PTSD) symptoms and burnout 4years after the Great East Japan Earthquake among medical rescue workers in Disaster Medical Assistance Teams (DMATs).MethodsWe examined participants’ background characteristics, prior health condition, rescue work experiences, and the Peritraumatic Distress Inventory (PDI) score at 1 month after the earthquake. Current psychological condition was assessed by the Impact of Event Scale-Revised and Maslach Burnout Inventory administered 4 years after the earthquake. By applying univariate and multivariate linear regression analyses, we assessed the relative value of the PDI and other baseline variables for PTSD symptoms and burnout at 4 years after the earthquake.ResultsWe obtained baseline data from 254 participants during April 2 to 22, 2011. Of the 254 participants, 188 (74.0%) completed the follow-up assessment. PDI score 1 month after the earthquake was associated with symptoms of PTSD (β=0.35, P<.01) and burnout (β=0.21, P<.01). Stress before deployment was a related factor for burnout 4 years after the earthquake in these medical rescue workers (β=2.61, P<.04).ConclusionsIt seems important for DMAT headquarters to establish a routine system for assessing the PDI of medical rescue workers after deployment and screen those workers who have high stress prior to deployment (Disaster Med Public Health Preparedness. 2016;10:848–853)

Although attention has been paid to post‐traumatic stress disorder (PTSD) among health care professionals after disasters, the impact of traumatic events on their work has not been elucidated. The aim of this study was to examine whether disaster‐related distress, resilience, and post‐traumatic growth (PTG) affect work engagement among health care professionals who had been deployed to the areas affected by the Great East Japan Earthquake that occurred on March 11, 2011. We recruited disaster medical assistance team members who were engaged in rescue activities after the earthquake. The short version of the Resilience Scale (RS‐14) and Peritraumatic Distress Inventory (PDI) were administered one month after the earthquake, and the short form of Posttraumatic Growth Inventory (SF‐PTGI) and Utrecht Work Engagement Scale (UWES) were administered four years after the earthquake. Work engagement is composed of vigor, dedication, and absorption. Regression analyses were used to examine the relationship of UWES with RS‐14, PDI, and SF‐PTGI. We obtained baseline data of 254 participants in April 2011, and 191 (75.2%) completed the follow‐up assessment between December 2014 and March 2015. The results showed that RS‐14 predicted vigor, dedication, and absorption; in addition, SF‐PTGI was positively related with these three parameters (p<0.01 for all). Resilience at baseline and PTG after rescue activities may increase work engagement among health care professionals after disasters. These findings could be useful for establishing a support system after rescue activities during a largescale disaster and for managing work‐related stress among health care professionals.

Psychiatry is at an important juncture, with the current pharmacologically focused model having achieved modest benefits in addressing the burden of poor mental health worldwide. Although the determinants of mental health are complex, the emerging and compelling evidence for nutrition as a crucial factor in the high prevalence and incidence of mental disorders suggests that diet is as important to psychiatry as it is to cardiology, endocrinology, and gastroenterology. Evidence is steadily growing for the relation between dietary quality (and potential nutritional deficiencies) and mental health, and for the select use of nutrient-based supplements to address deficiencies, or as monotherapies or augmentation therapies. We present a viewpoint from an international collaboration of academics (members of the International Society for Nutritional Psychiatry Research), in which we provide a context and overview of the current evidence in this emerging field of research, and discuss the future direction. We advocate recognition of diet and nutrition as central determinants of both physical and mental health.

Incidence proportion of post-traumatic stress disorder (PTSD) after motor vehicle accidents (MVA) vary considerably across countries, and whether heart rate (HR) and respiratory rate (RR) immediately after MVA predict subsequent PTSD remains controversial. This study examined the incidence proportion of PTSD at 6 months after MVA in Japan, and the predictors of PTSD in MVA survivors.

Abstract

Summary We investigated the adverse effects of adjuvant chemotherapy on the hippocampus in Japanese breast cancer survivors with (n=44) and without (n=31) adjuvant chemotherapy. There were no significant differences in hippocampal volume (magnetic resonance imaging) or additionally in memory function (Wechsler Memory Scale-Revised) between the two groups.

The authors’ aim was to identify the determinants of intrusive recollections related to receiving a cancer diagnosis in women after cancer treatment. A consecutive series of breast cancer patients at 3–15 months after surgery, consisting of subjects with (N = 63) and without (N = 92) intrusive recollections was examined. Logistic regression analysis revealed that neuroticism, precancer intrusive recollections, and the number of cancer patients in relatives by marriage were final significant determinants, and receiving radiotherapy was an associated factor. These results suggest that biopsychosocial factors contribute to intrusive recollections and have clinical implications for the use of these characteristics in screening and early intervention.

Intrusive thoughts are one of the re-experiencing symptoms in posttraumatic stress disorder, and have been suggested as a predictor for the continuous presence of psychological distress in cancer survivors. The aim of this preliminary study was to examine the possibility of using cancer-related intrusive thoughts (CITs) as an indicator of psychological distress and adjustment after breast surgery. A consecutive series of ambulatory breast cancer survivors at 3 or more years after surgery were given the Structured Clinical Interview for DSM-IV (SCID) and self-report questionnaires, including Profile Of Mood States (POMS), Impact of Event Scale (IES) and Mental Adjustment to Cancer (MAC) scale, to measure psychological distress and/or adjustment. The SCID identified a history of CITs in 34 (46%) of the 74 participants. No significant differences were found in the POMS and IES psychological distress scores between subjects with and without a history of CITs. Subjects with a history of CITs showed significantly higher levels of anxious preoccupation, one of the MAC subscale scores. The association continued to be significant after controlling for potential confounders such as social support, depression, avoidance, arousal, and neuroticism. The results indicated that CITs might be useful for indicating poor psychological adjustment, but not distress, in patients at 3 or more years after breast surgery.

ABSTRACTBackground: Posttraumatic stress disorder (PTSD) symptoms are known to occur after acute coronary syndrome (ACS). Peritraumatic distress has been indicated as a risk factor for PTSD and can be measured by the Peritraumatic Distress Inventory (PDI). However, no studies have yet measured peritraumatic distress after ACS using the PDI to predict PTSD.Objectives: This prospective cohort study examined the impact of peritraumatic distress on PTSD symptoms at 6 months after ACS.Methods: We used the PDI to assess peritraumatic distress in patients treated for ACS at a teaching hospital in Tokyo within 7 days after percutaneous coronary intervention. They were followed up over the next 6 months and were assessed for PTSD symptoms at 6 months using the Impact of Event Scale-Revised. The association between peritraumatic distress and PTSD symptoms was examined by multiple linear regression analysis.Results: The study enrolled 101 ACS patients, and 97 completed the follow-up assessment. PDI total score was an independent predictor of PTSD symptoms after adjustment for potential covariates (beta = 0.38; p< 0.01).Limitations: The results were obtained from a single teaching hospital and assessment of PTSD symptoms was questionnaire based.Conclusion: We provide the first evidence that PDI score can predict the development of PTSD symptoms in ACS patients. Assessing peritraumatic distress after ACS with the PDI may be useful for initiating early intervention against PTSD symptoms.

ABSTRACTBackground: Understanding the development of post-traumatic stress disorder (PTSD) is a precondition for efficient risk assessment and prevention planning. Studies to date have been site and sample specific. Towards developing generalizable models of PTSD development and prediction, the International Consortium to Predict PTSD (ICPP) compiled data from 13 longitudinal, acute-care based PTSD studies performed in six different countries.Objective: The objectives of this study were to describe the ICPP’s approach to data pooling and harmonization, and present cross-study descriptive results informing the longitudinal course of PTSD after acute trauma.Methods: Item-level data from 13 longitudinal studies of adult civilian trauma survivors were collected. Constructs (e.g. PTSD, depression), measures (questions or scales), and time variables (days from trauma) were identified and harmonized, and those with inconsistent coding (e.g. education, lifetime trauma exposure) were recoded. Administered in 11 studies, the Clinician Administered PTSD Scale (CAPS) emerged as the main measure of PTSD diagnosis and severity.Results: The pooled data set included 6254 subjects (39.9% female). Studies’ average retention rate was 87.0% (range 49.1–93.5%). Participants’ baseline assessments took place within 2 months of trauma exposure. Follow-up durations ranged from 188 to 1110 days. Reflecting studies’ inclusion criteria, the prevalence of baseline PTSD differed significantly between studies (range 3.1–61.6%), and similar differences were observed in subsequent assessments (4.3–38.2% and 3.8–27.0% for second and third assessments, respectively).Conclusion: Pooling data from independently collected studies requires careful curation of individual data sets for extracting and optimizing informative commonalities. However, it is an important step towards developing robust and generalizable prediction models for PTSD and can exceed findings of single studies. The large differences in prevalence of PTSD longitudinally cautions against using any individual study to infer trauma outcome. The multiplicity of instruments used in individual studies emphasizes the need for common data elements in future studies.

For Abstract see ChemInform Abstract in Full Text.

For Abstract see ChemInform Abstract in Full Text.

A high-speed and high-output-voltage edge-illuminated refracting-facet photodiode (RFPD) has been developed by employing a thin absorption layer. In the RFPD, the incident light parallel to the up-side surface is refracted at an inwardly angled facet and penetrates at a small angle in the absorption layer. The absorption length is thus effectively longer, resulting in high responsivity even at a thin absorption layer. In addition, since this RFPD uses a p-metal as a reflector, the absorption length is doubled. The light penetration at a small angle in the absorption layer also reduces the carrier density, and thinning the absorption layer effectively suppresses the influence of field modulation due to space charges. The fabricated RFPD has a responsivity as high as 0.69 A/W for 1.55 µm light even with an absorption layer as thin as 0.43 µm, a maximum 3 dB bandwidth of 66 GHz, and a high output peak voltage of over 2.5 V.

The dose-response curve for cholecystokinin (CCK), which was obtained from the responses of the isolated guinea-pig gall bladder induced by sulfated CCK octapeptides (CCK8) in the presence of atropine, was shifted in parallel to the right by three benzodiazepines, chlordiazepoxide (CZP), diazepam (DZP) and medazepam (MZP). The pA2values of CZP and DZP were 5.06 ± 0.19 and 6.34 ± 0.17, respectively. The benzodiazepines caused no parallel shift of the dose-response curves for acetylcholine, histamine and bradykinin, but depressed their maximum response. Atropine reversible CCK-induced contraction of the isolated rat stomach fundus was slightly inhibited by 10−5M of DZP. Higher concentration of DZP caused atropine reversible contraction of the fundus. Atropine insensitive contraction of the fundal muscle induced by serotonin was hardly inhibited by DZP. These results indicate that antagonism between CCK and benzodiazepines is specific and competitive and the response mediated by the CCK receptor (G) of muscle cell membrane is more sensitively antagonized by benzodiazepines than that mediated by neural receptor (N). Benzodiazepines seem to act as a partial agonist on neural CCK receptor.

InP/InGaAs heterojunction bipolar transistors with a 550-Å-thick base and 3000-Å-thick collector layers are fabricated to study the electron velocity overshoot effect in collector depletion layers. The intrinsic delay time evaluated at room temperature measurement remains almost constant at 0.7-0.8 ps in the investigated base/collector bias range of 0 to 1.1 V at a collector current density of 1×105A/cm2. According to Monte Carlo simulation results, such bias-independent behavior is associated with the sufficiently large overshoot effect caused at high collector biases, where the overshoot velocity is enhanced by the high electric field.

Effect of crystalline defects on minority carrier lifetime in silicon is investigated with regard to oxygen concentration and annealing conditions. Various defects have been introduced during two-step annealing in wafers sliced from several positions in Czoch-ralski silicon ingot. For each wafer, lifetime was measured by the photo-conductive decay method. Defects were analyzed by transmission electron microscopy. Lifetime and defect generation show plain dependence on both crystal position (oxygen concentration) and annealing conditions. Lifetime is found to be inversely proportional to the cube root of stacking fault volume density. Contributions from microdefects other than stacking faults were found.

Novel hexagonal emitters are proposed for heterostructure bipolar transistors (HBTs) with a base-metal-overlaid emitter-base self-alignment structure to reduce parasitic effects. Two different layer structures for InP/InGaAs double-heterostructure bipolar transistors (DHBTs) that can more fully utilize the inherent potential of the materials are used to enhance unity current gain cutoff frequency, fT, and maximum oscillation frequency, fmax . On a wafer with a 180-nm-thick collector, a transistor with a 20-µ m2hexagonal emitter electrode shows an fTof 230 GHz and an fmax of 147 GHz, while with a 4-µ m2hexagonal emitter electrode the corresponding values are 225 GHz and 241 GHz. fmax of 300 GHz is achieved for a transistor with a 4-µ m2emitter electrode and a 330-nm-thick collector. Transistor operation is analyzed using a simple but appropriate small-signal equivalent circuit model of a transistor that includes internal and external base/collector capacitances and yields good estimates of the measured scattering (s-) parameters. Even in these InP-based (D)HBTs, the internal collector capacitance increases with collector current density due to the Kirk effect which degrades performance. In thin-collector (D)HBTs, the increase in the internal collector capacitance is suppressed, which increases the collector current density at which the transistor can operate normally, and fTis increased by both transit time reduction and high-collector-current operation.

A compositionally-graded InxGa1-xAs base is experimentally shown to improve electron transport properties in abrupt-emitter InP/InGaAs heterojunction bipolar transistors (HBTs). The built-in field in the base of 6 kV/cm enables a more than 50% improvement in current gains, compared to a uniform-base structure. The peak current-gain cutoff frequency fTfor the graded-base HBT is 143 GHz versus 121 GHz for the uniform-base HBT. It is also shown that the graded-base structure is effective in suppressing the space charge in the vicinity of the base-collector junction. The built-in field in the base accelerates low-speed energy-relaxed electrons and thereby increases the velocity of electrons injected into the collector. The minimized base widening effect, combined with low base resistance, yields a maximum oscillation frequency fmaxover 200 GHz even at a collector bias voltage VCEas low as 1 V.