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3. Lipotoxic stress alters the membrane lipid profile of extracellular vesicles released by Huh-7 hepatocarcinoma cells

Author

Sandra Buratta, Y. Shimanaka, E. Costanzi, S. Ni, L. Urbanelli, N. Kono, F. Morena, K. Sagini, S. Giovagnoli, R. Romani, M. Gargaro, H. Arai, and C. Emiliani

Subjects
Medicine, Science
Abstract

Abstract Extracellular vesicles (EVs) are well-known mediators in intercellular communication playing pivotal roles in promoting liver inflammation and fibrosis, events associated to hepatic lipotoxicity caused by saturated free fatty acid overloading. However, despite the importance of lipids in EV membrane architecture which, in turn, affects EV biophysical and biological properties, little is known about the lipid asset of EVs released under these conditions. Here, we analyzed phospholipid profile alterations of EVs released by hepatocarcinoma Huh-7 cells under increased membrane lipid saturation induced by supplementation with saturated fatty acid palmitate or Δ9 desaturase inhibition, using oleate, a nontoxic monounsaturated fatty acid, as control. As an increase of membrane lipid saturation induces endoplasmic reticulum (ER) stress, we also analyzed phospholipid rearrangements in EVs released by Huh-7 cells treated with thapsigargin, a conventional ER stress inducer. Results demonstrate that lipotoxic and/or ER stress conditions induced rearrangements not only into cell membrane phospholipids but also into the released EVs. Thus, cell membrane saturation level and/or ER stress are crucial to determine which lipids are discarded via EVs and EV lipid cargos might be useful to discriminate hepatic lipid overloading and ER stress.

Published
2021
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6. Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry

Author

Jitendra PS. Sawhney, Veerappa A. Kothiwale, Vikas Bisne, Rajashekhar Durgaprasad, Praveen Jadhav, Manoj Chopda, Velam Vanajakshamma, Ramdhan Meena, Govindan Vijayaraghavan, Kamaldeep Chawla, Jagan Allu, Karen S. Pieper, A. John Camm, Ajay K. Kakkar, Jean-Pierre Bassand, David A. Fitzmaurice, Samuel Z. Goldhaber, Shinya Goto, Sylvia Haas, Werner Hacke, Lorenzo G. Mantovani, Frank Misselwitz, Alexander G.G. Turpie, Martin van Eickels, Freek W.A. Verheugt, Gloria Kayani, Keith A.A. Fox, Bernard J. Gersh, Hector Lucas Luciardi, Harry Gibbs, Marianne Brodmann, Frank Cools, Antonio Carlos Pereira Barretto, Stuart J. Connolly, Alex Spyropoulos, John Eikelboom, Ramon Corbalan, Dayi Hu, Petr Jansky, Jørn Dalsgaard Nielsen, Hany Ragy, Pekka Raatikainen, Jean-Yves Le Heuzey, Harald Darius, Matyas Keltai, Sanjay Kakkar, Jitendra Pal Singh Sawhney, Giancarlo Agnelli, Giuseppe Ambrosio, Yukihiro Koretsune, Carlos Jerjes Sánchez Díaz, Hugo Ten Cate, Dan Atar, Janina Stepinska, Elizaveta Panchenko, Toon Wei Lim, Barry Jacobson, Seil Oh, Xavier Viñolas, Marten Rosenqvist, Jan Steffel, Pantep Angchaisuksiri, Ali Oto, Alex Parkhomenko, Wael Al Mahmeed, David Fitzmaurice, D.Y. Hu, K.N. Chen, Y.S. Zhao, H.Q. Zhang, J.Z. Chen, S.P. Cao, D.W. Wang, Y.J. Yang, W.H. Li, Y.H. Yin, G.Z. Tao, P. Yang, Y.M. Chen, S.H. He, Ying Wang, Yong Wang, G.S. Fu, X. Li, T.G. Wu, X.S. Cheng, X.W. Yan, R.P. Zhao, M.S. Chen, L.G. Xiong, P. Chen, Y. Jiao, Y. Guo, L. Xue, F.Z. Wang, H. Li, Z.M. Yang, C.L. Bai, J. Chen, J.Y. Chen, X. Chen, S. Feng, Q.H. Fu, X.J. Gao, W.N. Guo, R.H. He, X.A. He, X.S. Hu, X.F. Huang, B. Li, J. Li, L. Li, Y.H. Li, T.T. Liu, W.L. Liu, Y.Y. Liu, Z.C. Lu, X.L. Luo, T.Y. Ma, J.Q. Peng, X. Sheng, X.J. Shi, Y.H. Sun, G. Tian, K. Wang, L. Wang, R.N. Wu, Q. Xie, R.Y. Xu, J.S. Yang, L.L. Yang, Q. Yang, Y. Ye, H.Y. Yu, J.H. Yu, T. Yu, H. Zhai, Q. Zhan, G.S. Zhang, Q. Zhang, R. Zhang, Y. Zhang, W.Y. Zheng, B. Zhou, Z.H. Zhou, X.Y. Zhu, S. Kakkar, J.P.S. Sawhney, P. Jadhav, R. Durgaprasad, A.G. Ravi Shankar, R.K. Rajput, K. Bhargava, R. Sarma, A. Srinivas, D. Roy, U.M. Nagamalesh, M. Chopda, R. Kishore, G. Kulkarni, P. Chandwani, R.A. Pothiwala, M. Padinhare Purayil, S. Shah, K. Chawla, V.A. Kothiwale, B. Raghuraman, G. Vijayaraghavan, V.M. Vijan, G. Bantwal, V. Bisne, A. Khan, J.B. Gupta, S. Kumar, D. Jain, S. Abraham, D. Adak, A. Barai, H. Begum, P. Bhattacharjee, M. Dargude, D. Davies, B. Deshpande, P. Dhakrao, V. Dhyani, S. Duhan, M. Earath, A. Ganatra, S. Giradkar, V. Jain, R. Karthikeyan, L. Kasala, S. Kaur, S. Krishnappa, A. Lawande, B. Lokesh, N. Madarkar, R. Meena, P. More, D. Naik, K. Prashanth, M. Rao, N.M. Rao, N. Sadhu, D. Shah, M. Sharma, P. Shiva, S. Singhal, S. Suresh, V. Vanajakshamma, S.G. Panse, Y. Koretsune, S. Kanamori, K. Yamamoto, K. Kumagai, Y. Katsuda, K. Sadamatsu, F. Toyota, Y. Mizuno, I. Misumi, H. Noguchi, S. Ando, T. Suetsugu, M. Minamoto, Hiroshi Oda, K. Shiraishi, S. Adachi, K. Chiba, H. Norita, M. Tsuruta, T. Koyanagi, H. Ando, T. Higashi, K. Okada, S. Azakami, S. Komaki, K. Kumeda, T. Murayama, J. Matsumura, Y. Oba, R. Sonoda, K. Goto, K. Minoda, Y. Haraguchi, H. Suefuji, H. Miyagi, H. Kato, Tadashi Nakamura, Tsugihiro Nakamura, H. Nandate, R. Zaitsu, Yoshihisa Fujiura, A. Yoshimura, H. Numata, J. Ogawa, H. Tatematsu, Y. Kamogawa, K. Murakami, Y. Wakasa, M. Yamasawa, H. Maekawa, S. Abe, H. Kihara, S. Tsunoda, Katsumi Saito, Kazuyuki Saito, T. Fudo, K. Obunai, H. Tachibana, I. Oba, T. Kuwahata, S. Higa, M. Gushiken, T. Eto, H. Yoshida, D. Ikeda, Yoshitake Fujiura, M. Ishizawa, M. Nakatsuka, K. Murata, C. Ogurusu, M. Shimoyama, M. Akutsu, I. Takamura, F. Hoshino, N. Yokota, T. Iwao, K. Tsuchida, M. Takeuchi, Y. Hatori, Y. Kitami, Yoichi Nakamura, R. Oyama, M. Ageta, Hiroyuki Oda, Y. Go, K. Mishima, T. Unoki, S. Morii, Yuhei Shiga, H. Sumi, T. Nagatomo, K. Sanno, K. Fujisawa, Y. Atsuchi, T. Nagoshi, T. Seto, T. Tabuchi, M. Kameko, K. Nii, K. Oshiro, H. Takezawa, S. Nagano, N. Miyamoto, M. Iwaki, Yuichiro Nakamura, M. Fujii, M. Okawa, Masahiko Abe, Masatake Abe, Mitsunori Abe, T. Saito, T. Mito, K. Nagao, J. Minami, T. Mita, I. Sakuma, T. Taguchi, S. Marusaki, H. Doi, M. Tanaka, T. Fujito, M. Matsuta, T. Kusumoto, S. Kakinoki, K. Ashida, N. Yoshizawa, J. Agata, O. Arasaki, M. Manita, M. Ikemura, S. Fukuoka, H. Murakami, S. Matsukawa, Y. Hata, T. Taniguchi, T. Ko, H. Kubo, M. Imamaki, M. Akiyama, M. Inagaki, H. Odakura, T. Ueda, Y. Katsube, A. Nakata, H. Watanabe, M. Techigawara, M. Igarashi, K. Taga, T. Kimura, S. Tomimoto, M. Shibuya, M. Nakano, K. Ito, T. Seo, S. Hiramitsu, H. Hosokawa, M. Hoshiai, M. Hibino, K. Miyagawa, Hajime Horie, N. Sugishita, Yukio Shiga, A. Soma, K. Neya, Tetsuro Yoshida, Tomoki Yoshida, M. Mizuguchi, M. Ishiguro, T. Minagawa, M. Wada, H. Mukawa, F. Okuda, S. Nagasaka, Y. Abe, Sen Adachi, Susumu Adachi, T. Adachi, K. Akahane, T. Amano, K. Aoki, T. Aoyama, H. Arai, S. Arima, T. Arino, H. Asano, T. Asano, J. Azuma, T. Baba, T. Betsuyaku, H. Chibana, H. Date, J. Doiuchi, Y. Emura, M. Endo, Y. Fujii, R. Fujiki, A. Fujisawa, Y. Fujisawa, T. Fukuda, T. Fukui, N. Furukawa, T. Furukawa, W. Furumoto, T. Goto, M. Hamaoka, N. Hanazono, K. Hasegawa, T. Hatsuno, Y. Hayashi, K. Higuchi, K. Hirasawa, H. Hirayama, M. Hirose, S. Hirota, M. Honda, Hideki Horie, T. Ido, O. Iiji, H. Ikeda, K. Ikeda, K. Ikeoka, M. Imaizumi, H. Inaba, T. Inoue, F. Iseki, A. Ishihara, N. Ishioka, N. Ito, T. Iwase, H. Kakuda, J. Kamata, H. Kanai, H. Kanda, M. Kaneko, H. Kano, T. Kasai, T. Kato, Y. Kato, Y. Kawada, K. Kawai, K. Kawakami, S. Kawakami, T. Kawamoto, S. Kawano, J. Kim, T. Kira, H. Kitazawa, H. Kitazumi, T. Kito, T. Kobayashi, T. Koeda, J. Kojima, H. Komatsu, I. Komatsu, Y. Koshibu, T. Kotani, T. Kozuka, Y. Kumai, T. Kumazaki, I. Maeda, K. Maeda, Y. Maruyama, S. Matsui, K. Matsushita, Y. Matsuura, K. Mineoi, H. Mitsuhashi, N. Miura, S. Miyaguchi, S. Miyajima, H. Miyamoto, A. Miyashita, S. Miyata, I. Mizuguchi, A. Mizuno, T. Mori, O. Moriai, K. Morishita, O. Murai, Sho Nagai, Shunichi Nagai, E. Nagata, H. Nagata, A. Nakagomi, S. Nakahara, M. Nakamura, R. Nakamura, N. Nakanishi, T. Nakayama, R. Nakazato, T. Nanke, J. Nariyama, Y. Niijima, H. Niinuma, Y. Nishida, Y. Nishihata, K. Nishino, H. Nishioka, K. Nishizawa, I. Niwa, K. Nomura, S. Nomura, M. Nozoe, T. Ogawa, N. Ohara, M. Okada, K. Okamoto, H. Okita, M. Okuyama, H. Ono, T. Ono, Y. Onuki Pearce, S. Oriso, A. Ota, E. Otaki, Y. Saito, H. Sakai, N. Sakamoto, Y. Sakamoto, Y. Samejima, Y. Sasagawa, H. Sasaguri, A. Sasaki, T. Sasaki, Kazuki Sato, Kiyoharu Sato, M. Sawano, S. Seki, Y. Sekine, Y. Seta, K. Sezaki, N. Shibata, Y. Shiina, H. Shimono, Y. Shimoyama, T. Shindo, H. Shinohara, R. Shinohe, T. Shinozuka, T. Shirai, T. Shiraiwa, Y. Shozawa, T. Suga, C. Sugimoto, Kazuo Suzuki, Keita Suzuki, Shu Suzuki, Shunji Suzuki, Susumu Suzuki, Y. Suzuki, M. Tada, A. Taguchi, T. Takagi, Y. Takagi, K. Takahashi, S. Takahashi, H. Takai, C. Takanaka, S. Take, H. Takeda, K. Takei, K. Takenaka, T. Tana, G. Tanabe, K. Taya, H. Teragawa, S. Tohyo, S. Toru, Y. Tsuchiya, T. Tsuji, K. Tsuzaki, H. Uchiyama, O. Ueda, Y. Ueyama, N. Wakaki, T. Wakiyama, T. Washizuka, M. Watanabe, T. Yamada, T. Yamagishi, H. Yamaguchi, Kenichi Yamamoto, Kentaro Yamamoto, Kunihiko Yamamoto, T. Yamamoto, M. Yamaura, M. Yamazoe, K. Yasui, Y. Yokoyama, K. Yoshida, T.W. Lim, C.K. Ching, C.G. Foo, J.H. Chow, D.D. Chen, F.R. Jaufeerally, Y.M. Lee, G. Lim, W.T. Lim, S. Thng, S.Y. Yap, C. Yeo, S. Oh, H.N. Pak, J.-B. Kim, J.H. Kim, S.-W. Jang, D.H. Kim, D.R. Ryu, S.W. Park, D.-K. Kim, D.J. Choi, Y.S. Oh, M.-C. Cho, S.-H. Kim, H.-K. Jeon, D.-G. Shin, J.S. Park, H.K. Park, S.-J. Han, J.H. Sung, J.-G. Cho, G.-B. Nam, Y.K. On, H.E. Lim, J.J. Kwak, T.-J. Cha, T.J. Hong, S.H. Park, J.H. Yoon, N.-H. Kim, K.-S. Kim, B.C. Jung, G.-S. Hwang, C.-J. Kim, D.B. Kim, J.J. Ahn, H.J. An, H. Bae, A.L. Baek, W.J. Chi, E.A. Choi, E.H. Choi, H.K. Choi, H.S. Choi, S. Han, E.S. Heo, K.O. Her, S.W. Hwang, E.M. Jang, H.-S. Jang, S. Jang, H.-G. Jeon, S.R. Jeon, Y.R. Jeon, H.K. Jeong, I.-A. Jung, Hyeon Jeong Kim, Hyun Ju Kim, Ji Seon Kim, Jung Sook Kim, J.A. Kim, K.T. Kim, M.S. Kim, Sang Hee Kim, Sang Hyun Kim, Y.-I. Kim, C.S. Lee, E.H. Lee, G.H. Lee, H.Y. Lee, H.-Y. Lee, K.H. Lee, K.R. Lee, M.S. Lee, M.-Y. Lee, R.W. Lee, S.E. Lee, S.H. Lee, S. Lee, W.Y. Lee, I.K. Noh, A.R. Park, B.R. Park, H.N. Park, J.H. Park, M. Park, Y. Park, S.-Y. Seo, J. Shim, J.H. Sim, Y.M. Sohn, W.S. Son, Y.S. Son, H.J. Song, H.K. Wi, J.J. Woo, S. Ye, K.H. Yim, K.M. Yoo, E.J. Yoon, S.Y. Yun, P. Angchaisuksiri, S. Chawanadelert, P. Mongkolwongroj, K. Kanokphatcharakun, S. Cheewatanakornkul, T. Laksomya, S. Pattanaprichakul, T. Chantrarat, S. Rungaramsin, S. Silaruks, W. Wongcharoen, K. Siriwattana, K. Likittanasombat, P. Katekangplu, W. Boonyapisit, D. Cholsaringkarl, B. Chatlaong, P. Chattranukulchai, Y. Santanakorn, P. Hutayanon, P. Khunrong, T. Bunyapipat, S. Jai-Aue, P. Kaewsuwanna, P. Bamungpong, S. Gunaparn, S. Hongsuppinyo, R. Inphontan, R. Khattaroek, K. Khunkong, U. Kitmapawanont, C. Kongsin, B. Naratreekoon, S. Ninwaranon, J. Phangyota, A. Phrommintikul, P. Phunpinyosak, K. Pongmorakot, S. Poomiphol, N. Pornnimitthum, S. Pumprueg, S. Ratchasikaew, K. Sanit, K. Sawanyawisuth, B. Silaruks, R. Sirichai, A. Sriwichian, W. Suebjaksing, P. Sukklad, T. Suttana, A. Tangsirira, O. Thangpet, W. Tiyanon, Y. Vorasettakarnkij, T. Wisaratapong, W. Wongtheptien, A. Wutthimanop, S. Yawila, A. Oto, A. Altun, I. Ozdogru, K. Ozdemir, O. Yilmaz, A. Aydinlar, M.B. Yilmaz, E. Yeter, Z. Ongen, M. Cayli, H. Pekdemir, M. Ozdemir, M. Sucu, T. Sayin, M. Demir, H. Yorgun, M. Ersanli, E. Okuyan, D. Aras, H. Abdelrahman, O. Aktas, D. Alpay, F. Aras, M.F. Bireciklioglu, S. Budeyri, M. Buyukpapuc, S. Caliskan, M. Esen, M.A. Felekoglu, D. Genc, B. Ikitimur, E.B. Karaayvaz, S. Kılıç Karataş, S. Okutucu, E. Ozcelik, A. Quisi, H. Sag, L. Sahiner, B.Y. Sayin, T. Seker, D. Uzun Alkan, E. Yildirim, R. Yildirim, F. Yilmaz, V. Yuksekdag, H.L. Luciardi, N. Vensentini, A.C. Ingaramo, G.A. Sambadaro, V. Fernandez Caputi, S.G. Berman, P. Dragotto, A.J. Kleiban, N. Centurion, G. Giacomi, R.A. Ahuad Guerrero, D. Conde, G. Zapata, L.A. Di Paola, J.L. Ramos, R.D. Dran, J. Egido, A.A. Fernandez, M.J. Fosco, S. Sassone, V.A. Sinisi, L.R. Cartasegna, M.A. Berli, O.A. Gomez Vilamajo, F. Ferroni, E.D. Alaguibe, A. Alvarez D'Amelio, C. Arabetti, L. Arias, J.A. Belardi, L. Bergesio, F. Berli, M. Berli, S. Borchowiec, C. Buzzetti, R. Cabrini, V. Campisi, A.L. Cappi, R. Carrizo, F. Colombo Berra, J.P. Costabel, O.J.A. Costamagna, A.A. Damonte, I.N. De Urquiza, F. Diez, M.F. Edén, M. Fanuele, F. Fernandez Voena, M. Foa Torres, C. Funosas, M.P. Giacomi, C.H. Gimenez, E.P. Gurfinkel, M. de L.M. Had, V. Hansen, A.D. Hrabar, M. Ingratta, A. Lopez, G. Maehara, L. Maffei, A. Martinelli, C. Martinelli, J. Matkovich, B. Mautner, A. Meirino, R. Munguia, A. Navarro, V. Novas, G. Perez Prados, J. Pontoriero, R.N. Potito, C. Ricotti, M.A. Rodriguez, F. Rolandi, M.E. Said Palladino, M. Salinger, L.S. Sanziani, P.O. Schygiel, A. Sossich, J.F. Tinto, L. Tonelli, A.L. Tufare, M. Vallejo, M.E. Yunis, M. Zillo, F.J. Zurbrigk, A.C.P. Barretto, D.C. Sobral Filho, J. Jaber, D. Armaganijan, J. Faria Neto, A. Steffens, W. Kunz Sebba Barroso de Souza, J.D. de Souza Neto, J.M. Ribeiro, M. Silveira Teixeira, P.R. Ferreira Rossi, L. Pires, D. Moreira, J.C. Moura Jorge, A. Menezes Lorga Filho, L.C. Bodanese, M. Westerlund Montera, C.H. Del Carlo, T. Da Rocha Rodrigues, F.A. Alves da Costa, A. Lopes, R. Lopes, G.R. Araújo, E.R. Fernandes Manenti, J.F. Kerr Saraiva, J.C. Ferreira Braga, A. Negri, L. Souto, C. Moncada, D. Bertolim Precoma, F. Roquette, G. Reis, R.A. Ramos Filho, E. Lanna Figueiredo, R. Vieira Botelho, C. Munhoz da Fontoura Tavares, C.R. Costantini Frack, J. Abdalla Saad, H.C. Finimundi, C. Pisani, D. Chemello, M. Pereira Martins, C.C. Broilo França, F. Alban, G.B. Aranha Rosito, J.B. de Moura Xavier Moraes Junior, R.T. Tumelero, L. Nigro Maia, R. Simões de Almeida, N.C. do Carmo Borges, L.G. Gomes Ferreira, P. Agliardi, J. Alves de Oliveira Gomes, V. Araujo, M. Arruda Nakazone, T. Barbosa, S. Barroso, E. Belisario Falchetto, H. Bellotti Lopes, M.A. Benez Teixeira Lemos, G. Biazus, L. Borges Queiroz, F.E. Camazzola, M. Caporale, S. Cardoso Boscato, F. Chieza, M.O. Chokr, R. Clemente Mingireanov, N. Codonho Góes, C. Correa, M. Costa, C. Costantini Ortiz, L.S. da Silva, F. da Silva Paulitsch, J.A. da Silveira, E. Daros, G.R. de Araújo, M.I. Del Monaco, C. Dias, M.A. Dias, A.P. Drummond Wainstein, P. Ely Pizzato, D.C. Esteves, P. Fabri, T. Félix Lorenzato Fonseca, E. Fernandes, C. Fonseca, C.R. Frack Costantini, R. Franchin Ferraz, F. Freire, P. Gottardo, D. Guanaes, S. Guizzardi, E. Hettwer Magedanz, F. Igansi, F. Jannuzzi, G. Junior, D. Komar, E.G. Lino, D. Lopes, O. Lourenço da Silva Júnior, E. Lustosa, A.P. Macagnan, M.C. Marinho, M. Mazzoni, G. Melo, L. Mortari, O.M.C.C. Mouco, C. Nanzer Vital, C. Ormundo, S. Oss Emmer, E. Palmegiani, R. Pavani, L. Pereira, V.L. Pereira, R. Perreira, S. Poletti, S.C. Quaia Fortunato, C. Queirantes, N. Ramos Pereira, R.L. Rech, S. Ribeiro, A. Rodrigues, H. Roesch, T. Ruaro Reichert, D. Santos, I. Santos, M. Santos, M.V. Seroqui, S. Silva, L. Soares, L. Spolaor, C. Stoll, N. Toazza Duda, L. Trama, B. Unterkircher, M.V. Valois, T. Vargas, T. Viana, C. Vicente, L. Vidal Armaganijan, R. Vieira Homem, L.G. Vieira Torres, L. Vila Boas, F. Villaça Guimarães Filho, R. Corbalan, G. Eggers, C. Bugueño Gutiérrez, G. Arriagada, S. Potthoff Cardenas, B.A.J. Stockins Fernandez, C. Conejeros, C. Houzvic, P. Marin Cuevas, H. Montecinos, A. Forero, F. Lanas, M. Larico Gómez, G. Charme Vilches, C. Rey, C. Astudillo, J. Aguilar, Y. Campisto, C. Lara, E. Molina, J. Munoz Oyarzon, V. Olguin, M. Vergara, C. Villan, C.J. Sánchez Díaz, J. Illescas Diaz, R. Leal Cantú, M.G. Ramos Zavala, R. Cabrera Jardines, N. Espinola Zavaleta, S. Villarreal Umaña, E. López Rosas, G. Llamas Esperón, G. Pozas, E. Cardona Muñoz, N. Matadamas Hernández, A. Leyva Rendón, N. García Hernández, M. de los Ríos Ibarra, L. Virgen Carrillo, D. López Villezca, C. Hernández Herrera, J.J. López Prieto, R. Gaona Rodríguez, E. Villeda Espinosa, D. Flores Martínez, J. Velasco Barcena, R. Yong, I. Rodríguez Briones, J.L. Leiva Pons, H. Álvarez López, R. Olvera Ruiz, C. Díaz de la Vega, C. Cantú Brito, E. Chuquiure Valenzuela, R. Reyes-Sanchez, A. Bazzoni Ruiz, O. Nandayapa Flores, M. Benavides Gonzalez, R. Arriaga Nava, J.D. Morales Cerda, O. Fierro Fierro, P. Fajardo Campos, T.A.A. Alfaro, S. Altamirano Bellorin, R. Avena, M. Chavarria, I. Espinosa, F. Flores Silva, R.H. Garcia Nava, K. Godoy, E.J. Gonzalez Felix, C.L. Gonzalez Garcia, L.G. Gonzalez Salas, P. Guajardo, S. Hernandez Gonzalez, T. Izquierdo, M.C. Mancilla Ortiz, D. Martinez Vasquez, N. Mendoza, J. Morales, N. Nikitina, S. Ochoa Aybar, A. Ortiz, P. Padilla Macias, F. Perez, J.A. Perez Sanchez, S. Piña Toledano, M. Ramos Gonzalez, C. Rivera Ramos, V. Roa Castro, G. Romero Cardona, M. Ruiz Cornejo, A. Salinas, G. Santana, P. Sida Perez, A.C. Tovar Castaneda, R. Trujillo Cortes, M. Brodmann, K. Lenz, H. Drexel, J. Foechterle, C. Hagn, A. Podczeck-Schweighofer, K. Huber, M. Winkler, B. Schneeweiß, A. Gegenhuber, W. Lang, S. Eichinger-Hasenauer, P. Kaserer, J. Sykora, H. Rasch, M. Pichler, E. Schaflinger, B. Strohmer, R. Breier, K.-M. Ebner, L. Eischer, F. Freihoff, A. Lischka-Lindner, T. Mark, A. Mirtl, A. Said, C. Stöcklöcker, B. Vogel, A. Vonbank, C. Wöhrer, D. Zanolin, F. Cools, G. Paparella, P. Vandergoten, J.-L. Parqué, L. 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Domenech Borras, A. Elorriaga Madariaga, A. Espallargas, M. Fernandez, E. Fernandez Escobar, E. Fernandez Mas, A. Ferrer, J. Fosch, M. Garcia Bermudez, V. Garcia Millan, M. Gavira Saenz, C. Gines Garcia, C. Gomez, Y. Gomez Perez, A. Gonzales Segovia, P. Gonzalez, L. Grigorian, A. Guerrero Molina, M. del C. Gutierrez del Val, B. Herrero Maeso, E. Hevia Rodriguez, A. Iglesias Garcia, M.J. Jimenez Fernandez, B. Jimeno Besa, P. Juan Salvadores, M.B. Lage Bouzamayor, I. Lasuncion, L.E. Lezcano Gort, M. Llobet Molina, M. Lopez, A. Manzanal Rey, J. Mara Guerra, S. Marcus, A. Martin Vila, M. Martinez Mena, P. Mazon, F. Mendez Zurita, G. Millán, M. Molina, P. Montero Alia, D. Montes, M. Moure Gonzalez, R.B. Munoz Munoz, A. Negrete Palma, H.N. Orellana Figueroa, V.M. Ortega, C. Ortiz Cortes, D. Otero Tomera, N. Palomo Merchan, I. Pareja Ibar, E. Pena Garcia, M. Pereda Armayor, M. Perez Carasa, I. Prieto, V. Quintern, R. Renom, L.M. Rincon Diaz, V. Rios, L. Riquelme Sola, R. Rivera, X. Robiro Robiro, M. Roca, C. Roca Saumell, C. Rodrigo, E. Rodriguez, M. Rodriguez Garcia, S. Saez Jimenez, P. Sanchez Calderon, L. Sanchez Mendez, S. Sanchez Parra, C. Santolaya, M.R. Senan Sanz, A. Seoane Blanco, E. Serralvo, N. Sierra, C. Simon Valero, J. Sorribes Lopez, M. Teixido Fontanillas, M. Terns Riera, G. Tobajas, C. Torres, J. Torres Marques, M. Ubeda Pastor, M. Rosenqvist, A. Wirdby, J. Linden, K. Henriksson, M. Elmersson, A. Egilsson, U. Börjesson, G. Svärd, B. Liu, A. Lindh, L.-B. Olsson, M. Gustavsson, Lars Andersson, Lisbeth Andersson, L. Benson, C. Bothin, A. Hajimirsadeghi, K. Kadir, M. Ericsson, A. Ohlsson, H. Lindvall, P. Svensson, K. Thorne, H. Handel, P. Platonov, B. Eriksson, I. Timberg, K. Romberg, M. Crisby, J.-E. Karlsson, S.A. Jensen, A. Andersson, L. Malmqvist, B. Martinsson, F. Bernsten, J. Engdahl, J. Thulin, A. Hot-Bjelac, P. Stalby, H. Aaröe, E. Ahbeck, H. Ahlmark, F. Al-Khalili, G. Bonkowski, S. Dzeletovic, A.-B. Ekstrand, G.-B. Eriksson, K. Floren, C. Grässjö, S. Hahn, P. Jaensson, B. Jansson, J.-H. Jansson, R.-M. Kangert, A. Koch, D. Kusiak, A. Lettenström, A. Lindberg, C.-J. Lindholm, A. Mannermyr, K. Mansson, M. Millborg, C. Nilsson, A.-M. Ohlin, A. Olofsson, A. Osberg, A. Pedersen, K. Risbecker, K. Rosenberg, J. Samuelsson, M. Shayesteh, K. Skoglund, M. Stjernberg, C. Thorsen, J. Steffel, J.H. Beer, J. Debrunner, D. Amstutz, J. Bruegger, G. Elise, A. Grau, A. Guinand, I. Henriette, E. Saga, S. Winnik, A. Parkhomenko, I. Rudyk, V. Tseluyko, O. Karpenko, S. Zhurba, I. Kraiz, I. Kupnovytska, N. Serediuk, Y. Mostovoy, O. Ushakov, O. Koval, I. Kovalskyi, Y. Svyshchenko, O. Sychov, M. Stanislavchuk, O. Kraydashenko, A. Yagensky, S. Tykhonova, I. Fushtey, R. Belegai, G. Berko, L. Burdeuna, O. Chabanna, I. Daniuk, A. Ivanov, E. Kamenska, P. Kaplan, O. Khyzhnyak, S. Kizim, O. Matova, O. Medentseva, V. Mochonyi, M. Mospan, V. Nemtsova, T. Ovdiienko, O. Palamarchuk, M. Pavelko, R. Petrovskyy, D. Plevak, O. Proshak, S. Pyvovar, L. Rasputina, O. Romanenko, O. Romanova, A. Sapatyi, O. Shumakov, R. Stets, L. Todoriuk, V. Varenov, D. Fitzmaurice, N. Chauhan, D. Goodwin, P. Saunders, R. Evans, J. Leese, P.S. Jhittay, A. Ross, M.S. Kainth, G. Pickavance, J. McDonnell, A. Williams, T. Gooding, H. Wagner, S. Suryani, A. Singal, S. Sircar, R. Bilas, P. Hutchinson, A. Wakeman, M. Stokes, N. Paul, M. Aziz, C. Ramesh, P. Wilson, S. Franklin, S. Fairhead, J. Thompson, V. St Joseph, G. Taylor, D. Tragen, D. Seamark, C. Paul, M. Richardson, A. Jefferies, H. Sharp, H. Jones, C. Giles, M. Page, O. Oginni, J. Aldegather, S. Wetherwell, W. Lumb, P. Evans, F. Scouller, N. Macey, Y. Stipp, R. West, S. Thurston, P. Wadeson, J. Matthews, P. Pandya, A. Gallagher, T. Railton, B. Sinha, D. Russell, J.A. Davies, P. Ainsworth, C.P. Jones, P. Weeks, J. Eden, D. Kernick, W. Murdoch, L. Lumley, R.P. Patel, S.W. Wong, M. Saigol, K. Ladha, K. Douglas, D.F. Cumberlidge, C. Bradshaw, G. Van Zon, K.P. Jones, M.J. Thomas, E. Watson, B. Sarai, N. Ahmad, W. Willcock, J. Cairns, S. Sathananthan, N. de Kare-Silver, A. Gilliland, E. Strieder, A. Howitt, B. Vishwanathan, N. Bird, D. Gray, M. Clark, J. Bisatt, J. Litchfield, E. Fisher, T. Fooks, A.R. Kelsall, E. Alborough, J. Wakeling, M. Parfitt, K. Milne, S. Rogers, R. Priyadharshan, J.L. Oliver, E. Davies, S. Abushal, M. Jacobs, C. Hutton, N.I. Walls, R. Thompson, C. Chigbo, S.M.A. Zaidi, M. Howard, K.C. Butter, S. Barrow, H. Little, I.U. Haq, L. Gibbons, S. Glencross, A.J. McLeod, K. Poland, C. Mulholland, A. Warke, P. Conn, G. Burns, R.N. Smith, S. Lowe, R. Kamath, H.S. Dau, J. Webster, I. Hodgins, S. Vercoe, P.C. Roome, H. Pinnock, J.R.A. Patel, A. Ali, N. Hart, R. Davies, E. Stuart, C.A. Neden, M. Danielsen, R. Heath, P. Sharma, S. Galloway, C. Hawkins, R. Oliver, M. Aylward, S. Mannion, M. Braddick, D. Edwards, A.C. Rothwell, A. Sabir, F. Choudhary, S. Khalaque, A. Wilson, S. Peters, W. Coulson, N. Roberts, A. Heer, S. Coates, B. Ward, D. Jackson, S. Walton, D. Shepherd, M. Sterry, T. Wong, M. Boon, R. Bunney, R. Haria-Shah, R.T. Baron, S. Davies, T. Schatzberger, N. Hargreaves, T. Stephenson, H. Choi, R. Batson, L. Lucraft, T. Myhill, S. Estifano, D. Geatch, J. Wilkinson, R. Veale, K. Forshaw, T. Davies, K. Zaman, P. Vinson, C. Liley, M. Bandrapalli, P. McGinty, R. Wastling, P. McEleny, A. Beattie, P. Cooke, M. Wong, J. Gunasegaram, M. Pugsley, S. Ahmad, C. A'Court, J. Ayers, J. Bennett, S. Cartwright, S. Dobson, C. Dooldeniya, A. Flynn, R. Fox, J. Goram, A. Halpin, A. Hay, P. Jacobs, L. Jeffers, L. Lomax, I. Munro, R. Muvva, M. Nadaph, K. Powell, S. Randfield, D. Redpath, R. Reed, M. Rickenbach, G. Rogers, P.B. Saunders, C. Seamark, J. Shewring, P. Simmons, H. Simper, H. Stoddart, A. Sword, N. Thomas, A. Thomson, H. Gibbs, A. Blenkhorn, B. Singh, W. Van Gaal, W. Abhayaratna, R. Lehman, P. Roberts-Thomson, J. Kilian, D. Coulshed, A. Catanchin, D. Colquhoun, H. Kiat, D. Eccleston, J. French, L. Zimmett, B. Ayres, T. Phan, P. Blombery, D. Crimmins, D. O'Donnell, A. Choi, P. Astridge, M. Arstall, N. Jepson, M. Binnekamp, A. Lee, J. Rogers, G. Starmer, P. Carroll, J. Faunt, A. Aggarwala, L. Barry, C. Batta, R. Beveridge, A. Black, M. Bonner, J. Boys, E. Buckley, M. Campo, L. Carlton, A. Connelly, B. Conway, D. Cresp, H. Dimitri, S. Dixon, M. Dolman, M. Duroux, M. Eskandari, R. Eslick, A. Ferreira-Jardim, T. Fetahovic, D. Fitzpatrick, R. Geraghty, J. Gibbs, T. Grabek, M.H. Modi, K. Hayes, M.P. Hegde, L. Hesketh, B. Hoffmann, B. Jacobson, K. Johnson, C. Juergens, I. Kassam, V. Lawlor, M. Lehman, S. Lehman, D. Leung, S. Mackay, M. MacKenzie, C. McCarthy, C. McIntosh, L. McKeon, H. Morrison, C. Mussap, J.-D. Myers, V. Nagalingam, G. Oldfield, V. O'May, J. Palmer, L. Parsons, K. Patching, T. Patching, V. Paul, M. Plotz, S. Preston, H. Rashad, M. Ratcliffe, S. Raynes, J. Rose, L. Sanders, M. Seremetkoska, H. Setio, S. Shone, P. Shrestha, C. Singh, C. Singleton, N. Stoyanov, S. Sutcliffe, K. Swaraj, J. Tarrant, S. Thompson, I.M. Tsay, M. Vorster, A. Waldman, L. Wallis, E. Wilford, K. Wong, S.J. Connolly, A. Spyropoulos, J. Eikelboom, R. Luton, M. Gupta, A.S. Pandey, S. Cheung, R. Leader, P. Beaudry, F. Ayala-Paredes, J. Berlingieri, J. Heath, G. Poirier, M. Du Preez, R. Nadeau, G. Dresser, R. Dhillon, T. Hruczkowski, B. Schweitzer, B. Coutu, P. Angaran, P. MacDonald, S. Vizel, S. Fikry, R. Parkash, A. Lavoie, J. Cha, B. Ramjattan, J. Bonet, K. Ahmad, L. Aro, T. Aves, K. Beaudry, C. Bergeron, J. Bigcanoe, N. Bignell, L. Breakwell, E. Burke, L. Carroll, B. Clarke, T. Cleveland, S. Daheb, P. Dehghani, I. Denis, Z. Djaidani, P. Dorian, S. Douglass, J. Dunnigan, A. Ewert, D. Farquhar, A. Fearon, L. Ferleyko, D. Fournier, B. Fox, M.-C. Grenier, W. Gulliver, K. Haveman, C. Hines, K. Hines, A.M. Jackson, C. Jean, G. Jethoo, R. Kahlon, S. Kelly, R. Kim, V. Korley, J. Kornder, L. Kwan, J. Largy, C. Lewis, S. Lewis, I. Mangat, R. Moor, J. Navratil, I. Neas, J. Otis, R. Otis, M. Pandey, F. Petrie, A. Pinter, M. Raines, P. Roberts, M. Robinson, G. Sas, S. Schulman, L. Snell, S. Spearson, J. Stevenson, T. Trahey, S. Wong, D. Wright, H. Ragy, A. Abd El-Aziz, S.K. Abou Seif, M.G. El Din, S. El Etriby, A. Elbahry, A. El-Etreby, M. Elkhadem, A. Katta, T. Khairy, A. Mowafy, M. Nawar, A. Ohanissian, A. Reda, M. Reda, H. Salem, N. Sami, S. Samir, M. Setiha, M. Sobhy, A. Soliman, N. Taha, M. Tawfik, E. Zaatout, D. Kettles, J. Bayat, H. Siebert, A. Horak, Y. Kelfkens, R. Garda, T. Pillay, M. Guerra, L. van Zyl, H. Theron, A. Murray, R. Louw, D. Greyling, P. Mntla, V. Ueckermann, R. Loghdey, S. Ismail, F. Ahmed, J. Engelbrecht, A. Ramdass, S. Maharajh, W. Oosthuysen, G. Angel, C. Bester, M. Booysen, C. Boshoff, C. Cannon, S. Cassimjee, C. Chami, G. Conway, A. Davids, L. de Meyer, G. Du Plessis, T. Ellis, L. Henley, M. Karsten, E. Loyd, J. Marks, L. Mavhusa, M. Mostert, A. Page, L. Rikhotso, M. Salie, J. Sasto, F. Shaik, A. Skein, L. Smith, G. Tarr, T. Tau, F. van Zyl, W. Al Mahmeed, G. Yousef, A. Agrawal, M. Nathani, M. Ibrahim, E.M. Esheiba, R. Singh, A. Naguib, M. Abu-Mahfouz, M. Al Omairi, A. Al Naeemi, R. Maruthanayagam, N. Bazargani, A. Wassef, R. Gupta, M. Khan, B. Subbaraman, A. Abdul, A. Al Mulla, S. El Bardisy, P. Haridas, S. Jadhav, K. Magdaluyo, M. Makdad, I. Maqsood, R. Mohamed, N. Sharma, R. Sharma, M. Thanzeel, S.Z. Goldhaber, R. Canosa, P. Rama, E. Blumberg, J. Garcia, P. Mullen, V. Wilson, A. Quick, K. Ferrick, W.M. Kutayli, M. Cox, M. Franco, S. Falkowski, R. Mendelson, M. Williams, S. Miller, S. Beach, A. Alfieri, T. Gutowski, I. Haque, R. Reddy, W. Ahmed, P. Delafontaine, D. Diercks, D. Theodoro, K. Remmel, M. Alberts, R. Ison, H. Noveck, P. Duffy, S. Pitta, D. Nishijima, C. Treasure, N. Asafu-Adjaye, K. Ball, M. Bartlett, M. Bentley, S. Bowers, A. Brown, A. Browne, J. Cameron-Watts, M. Canova, D. Cassidy, K. Cervellione, S. Congal, J. DePauw, A. Dickerson, M. Eley, L. Evans, S. Felpel, K. Ferdinand, D. Fielder, P. Gentry, A. Haideri, F. Hakimi, T. Harbour, E. Hartranft, B. Hawkins, M. Headlee, L. Henson, C. Herrick, T. Hicks, S. Jasinski, A. Jones, L. Jones, P. Jones, S. Karl, M. Keeling, J. Kerr, P. Knowles, J. Langdon, M. Lay, J.A. Lee, T. Lincoln, E. Malone, A. Merliss, D. Merritt, J. Minardo, B. Mooso, C. Orosco, V. Palumbo, M. Parker, T. Parrott, S. Paserchia, G. Pearl, J. Peterson, N. Pickelsimer, T. Purcell, J. Raynor, S. Raziano, C. Richard, T. Richardson, C. Robertson, A. Sage, T. Sanghera, P. Shaw, J. Shoemaker, K. Smith, B. Stephanie, A. Thatcher, H. Theobald, N. Thompson, L. Treasure, T. Tripti, C. Verdi, and V. Worthy

Subjects
Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background: The Global Anticoagulant Registry in the FIELD–Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. Methods and results: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012–2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P

Published
2018
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11. Abstracts from Hydrocephalus 2016

Author

A. Adam, J. Robison, J. Lu, R. Jose, N. Badran, T. Vivas-Buitrago, D. Rigamonti, A. Sattar, O. Omoush, M. Hammad, M. Dawood, M. Maghaslah, T. Belcher, K. Carson, J. Hoffberger, I. Jusué Torres, S. Foley, S. Yasar, Q. A. Thai, J. Wemmer, P. Klinge, L. Al-Mutawa, H. Al-Ghamdi, K. A. Carson, M. Asgari, D. de Zélicourt, V. Kurtcuoglu, S. Garnotel, S. Salmon, O. Balédent, A. Lokossou, G. Page, L. Balardy, Z. Czosnyka, P. Payoux, E. A. Schmidt, M. Zitoun, M. A. Sevestre, N. Alperin, I. Baudracco, C. Craven, S. Matloob, S. Thompson, P. Haylock Vize, L. Thorne, L. D. Watkins, A. K. Toma, Karl Bechter, A. C. Pong, L. Jugé, L. E. Bilston, S. Cheng, W. Bradley, F. Hakim, J. F. Ramón, M. F. Cárdenas, J. S. Davidson, C. García, D. González, S. Bermúdez, N. Useche, J. A. Mejía, P. Mayorga, F. Cruz, C. Martinez, M. C. Matiz, M. Vallejo, K. Ghotme, H. A. Soto, D. Riveros, A. Buitrago, M. Mora, L. Murcia, S. Bermudez, D. Cohen, D. Dasgupta, C. Curtis, L. Domínguez, A. J. Remolina, M. A. Grijalba, K. J. Whitehouse, R. J. Edwards, A. Eleftheriou, F. Lundin, K. N. Fountas, E. Z. Kapsalaki, H. F. Smisson, J. S. Robinson, M. J. Fritsch, W. Arouk, M. Garzon, M. Kang, K. Sandhu, D. Baghawatti, K. Aquilina, G. James, D. Thompson, M. Gehlen, M. Schmid Daners, A. Eklund, J. Malm, D. Gomez, M. Guerra, M. Jara, M. Flores, K. Vío, I. Moreno, S. Rodríguez, E. Ortega, E. M. Rodríguez, J. P. McAllister, M. M. Guerra, D. M. Morales, D. Sival, A. Jimenez, D. D. Limbrick, M. Ishikawa, S. Yamada, K. Yamamoto, A. Junkkari, A. Häyrinen, T. Rauramaa, H. Sintonen, O. Nerg, A. M. Koivisto, R. P. Roine, H. Viinamäki, H. Soininen, A. Luikku, J. E. Jääskeläinen, V. Leinonen, U. Kehler, O. Lilja-Lund, K. Kockum, E. M. Larsson, K. Riklund, L. Söderström, P. Hellström, K. Laurell, M. Kojoukhova, A. Sutela, R. Vanninen, K. I. Vanha, M. Timonen, J. Rummukainen, V. Korhonen, S. Helisalmi, E. Solje, A. M. Remes, J. Huovinen, J. Paananen, M. Hiltunen, M. Kurki, B. Martin, F. Loth, M. Luciano, A. J. Luikku, A. Hall, S. K. Herukka, J. Mattila, J. Lötjönen, I. Alafuzoff, I. Jurjević, M. Miyajima, M. Nakajima, H. Murai, T. Shin, D. Kawaguchi, C. Akiba, I. Ogino, K. Karagiozov, H Arai, R. C. Reis, M. J. Teixeira, C. G. Valêncio, D. da Vigua, L. Almeida-Lopes, M. W. Mancini, F. C. G. Pinto, R. H. Maykot, G. Calia, J. Tornai, S. S. S. Silvestre, G. Mendes, V. Sousa, B. Bezerra, P. Dutra, P. Modesto, M. F. Oliveira, C. E. Petitto, H. Pulhorn, A. Chandran, C. McMahon, A. S. Rao, M. Jumaly, D. Solomon, A. Moghekar, N. Relkin, M. Hamilton, H. Katzen, M. Williams, T. Bach, S. Zuspan, R. Holubkov, A. Rigamonti, G. Clemens, P. Sharkey, A. Sanyal, E. Sankey, K. Rigamonti, S. Naqvi, A. Hung, E. Schmidt, F. Ory-Magne, P. Gantet, A. Guenego, A. C. Januel, P. Tall, N. Fabre, L. Mahieu, C. Cognard, L. Gray, J. A. Buttner-Ennever, K. Takagi, K Onouchi, S. D. Thompson, L. D. Thorne, H. M. Tully, T. L. Wenger, W. A. Kukull, D. Doherty, W. B. Dobyns, D. Moran, S. Vakili, M. A. Patel, B. Elder, C. R. Goodwin, J. A. Crawford, M. V. Pletnikov, J. Xu, A. Blitz, D. A. Herzka, H. Guerrero-Cazares, A. Quiñones-Hinojosa, S. Mori, P. Saavedra, H. Treviño, K. Maitani, W. C. Ziai, V. Eslami, S. Nekoovaght-Tak, R. Dlugash, G. Yenokyan, N. McBee, and D. F. Hanley

Subjects
Neurology. Diseases of the nervous system, RC346-429
Published
2017
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12. Usefulness of simultaneous isolation of the coronary sinus and the left atrial inferior wall for persistent atrial fibrillation refractory to box isolation

Author

Y Yamauchi, Y Sagawa, K Murata, H Arai, A Oda, and A Suzuki

Subjects
Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract

Funding Acknowledgements Type of funding sources: None. Background In patients who are refractory to box isolation (BoxI) and have atrial fibrillation (AF) substrate in left atrial inferior wall (LAIW), LAIW isolation is effective, but the procedure is highly difficult because the connection between LAIW and coronary sinus (CS) is dense. In this study, we report four cases of persistent AF in which simultaneous isolation of LAIW and CS was so effective. Methods and Results Case 1 is a 76-year-old female with persistent AF who had undergone BoxI and failed mitral isthmus block (MIB) creation. However, AF and atrial tachycardia (AT) persisted. In the 4th session, chemical ablation of Marshall vein was performed, and AF/AT was terminated, and MIB was created. Thereafter, multiple ATs were still inducible by rapid atrial pacing. Because AT substrate seemed to be confined to LAIW, we attempted to isolate LAIW by performing linear ablation between the right inferior pulmonary vein (RIPV) and posteroseptal mitral annulus (MA) near CS ostium, and linear ablation parallel to CS along posterior MA. However, LAIW isolation could not be achieved. Finally, CS ostial ablation from right atrium (RA) succeeded in simultaneous isolation of LAIW and CS. CS burst pacing could induce AT confined to LAIW and CS although RA maintained sinus rhythm (SR). Rapid RA pacing could not induce AT/AF. Case 2 is a 78-year-old female with persistent AF who completed BoxI and MIB creation. Raid RA pacing induced AF. Because cycle length of LAIW was apparently shorter than RA, we attempted to isolate LAIW. Firstly, we performed linear ablation from RIPV ostium to posterior MA. During linear ablation, AF converted to AT, and finally RA returned to SR while AT was still sustained within LAIW and CS. This tachycardia was a reentrant tachycardia circling LAIW and CS. After this AT returned to SR by linear ablation within LAIW, LAIW and CS were not isolated during SR. CS ostial ablation from RA succeeded in simultaneous LAIW and CS isolation. Case 3 is a 74-year-old female with persistent AF refractory to BoxI. Although non-pulmonary vein (non-PV) trigger was documented in LAIW, the precise origin of non-PV trigger could not be identified due to infrequency. Case 4 is a 64-year-old male with persistent AF refractory to BoxI. He had undergone catheter ablation three times. Fractionation map showed that AF substrate was likely located in LAIW. Therefore, we attempted to isolate LAIW in Case 3 and 4. We performed MI ablation, linear ablation between RIPV ostium and posteroseptal MA, and CS ostial ablation from RA, which succeeded in simultaneous isolation of LAIW and CS in both cases. AF has never recurred in Case 1 and 2. SR could be maintained with antiarrhythmics in Case 3 and 4. Conclusions In patients with persistent AF refractory to BoxI, if LAIW has AF/AT substrate or non-PV triggers, simultaneous isolation of LAIW and CS may be a new therapeutic strategy. Simultaneous isolation of LAIW and CS requires ablation at CSos from RA.

Published
2023

16. Study Protocol of a Comprehensive Activity Promotion

Author

H. Shimada, S. Lee, K. Harada, S. Bae, K. Makino, I. Chiba, O. Katayama, and H. Arai

Subjects
Research Design, geriatric medicine, protocols and guidelines, Humans, Dementia, Smartphone, Neuropsychological Tests, preventive medicine, Exercise, Aged, Randomized Controlled Trials as Topic, Original Research
Abstract

Background Several technical devices are available to monitor and promote changes in behavior toward higher activity. In particular, smartphones are becoming the primary platform for recognizing human activity. However, the effects of behavior change techniques that promote physical, cognitive, and social activities on incident dementia in older adults remain unknown. Objectives This randomized controlled trial aims to examine the effects of behavior change techniques on the prevention of dementia among community-dwelling older adults using a smartphone as a behavior change tool. Design A randomized controlled trial. Setting Community in Japan. Participants The study cohort comprises 3,498 individuals, aged ≥60 years, randomized into two groups: the smartphone group (n = 1,749) and the control group (n = 1,749). Intervention. The smartphone group will be asked to use smartphone applications for at least 30 minutes daily to self-manage and improve their physical, cognitive, and social activities. The smartphone group will perform 60-minute group walking sessions using application-linked Nordic walking poles with cognitive stimulation twice a week during the intervention period. The walking poles are a dual-task exercise tool that works with a smartphone to perform cognitive tasks while walking, and the poles are equipped with switches to answer questions for simple calculation and memory tasks. The smartphone and control groups will receive lectures about general health that will be provided during the baseline and follow-up assessments. Measurements Incident dementia will be detected using cognitive tests (at baseline, after 15 months, and after 30 months) and by preparing diagnostic monthly reports based on data from the Japanese Health Insurance System. Participants without dementia at baseline who will be diagnosed with dementia over the 30-month follow-up period will be considered to have incident dementia. Conclusions This study has the potential to provide the first evidence of the effectiveness of information communication technology and Internet of Things in incident dementia. If our trial results show a delayed dementia onset for self-determination interventions, the study protocol will provide a cost-effective and safe method for maintaining healthy cognitive aging.

Published
2022

22. Impact of Frailty on Dietary Habits among Community-Dwelling Older Persons during the COVID-19 Pandemic in Japan

Author

Shosuke Satake, H. Arai, and K. Kinoshita

Subjects
Male, social isolation, Disease, Logistic regression, self-isolation, Japan, Weight loss, Pandemic, Medicine, Humans, Social isolation, Geriatric Assessment, Pandemics, Original Research, Aged, 80 and over, Frailty, business.industry, SARS-CoV-2, COVID-19, General Medicine, Odds ratio, Feeding Behavior, Frail elderly, Confidence interval, Social relation, aged, Cross-Sectional Studies, nutrition, Female, Independent Living, medicine.symptom, business, Demography
Abstract

Background: The coronavirus disease (COVID-19) pandemic has resulted in reduced physical activity and social interaction. These restrictions may have affected the food intake habits of frail older people more than non-frail older people. Objectives: To investigate the association between frailty and change in dietary habit during the pandemic. Design: Cross-sectional mail survey Setting: Community-based Participants: The study questionnaire was mailed to 4,436 older residents of Higashiura, Aich Japan, who were aged ≥75 years and who did not need care as of April 1, 2020. Of these, 2,738 participants provided complete answers to the questionnaires (75–96 years old, 49.3% males). Measurements: The participants’ frailty status and changes in food consumption during social isolation were assessed. Frailty status was assessed using the five-item frailty screening index (i.e., weight loss, low physical function, low physical activity, cognition, and exhaustion). Any participant who reported an increase or a decrease in ≥1 of the 12 food categories was defined as having change in dietary habit. Using multivariate logistic regression analysis, the odds ratios (ORs) and 95% confidence intervals (CIs) of frailty for changes in diet were estimated by adjusting for age, sex, BMI, and living alone. In each of the 12 food categories, the proportion of participants with increased and decreased food intake was compared between the groups. Results: Among the participants, 470 (17.2%) were frail, and 1,097 (40.1%) experienced a change in dietary habit under social restriction. The adjusted OR (95% CI) of the frail group for a change in dietary habit was 2.01 (1.63–2.47, p

Published
2021

23. Rivaroxaban Monotherapy in Patients With Atrial Fibrillation After Coronary Stenting

Author

Tetsuya Matoba, Satoshi Yasuda, Koichi Kaikita, Masaharu Akao, Junya Ako, Masato Nakamura, Katsumi Miyauchi, Nobuhisa Hagiwara, Kazuo Kimura, Atsushi Hirayama, Kunihiko Matsui, Hisao Ogawa, Yukihiro Koretsune, Takafumi Hiro, Tetsuya Sumiyoshi, Kazumi Kimura, Yoichiro Hashimoto, Teruyuki Hirano, Hiroyuki Daida, Yasushi Okada, Tsutomu Yamazaki, A. Nakamura, E. Tamiya, T. Yamamoto, S. Suetake, T. Noguchi, S. Nakamura, A. Matsumura, J. Kojima, S. Suwa, H. Yamaguchi, K. Kaikita, T. Yasu, A. Nakajima, T. Yamada, H. Arai, Y. Hata, T. Sakanashi, H. Tateishi, T. Nakayama, Y. Nozaki, M. Akao, Y. Okumura, M. Tokue, N. Kuroki, Y. Maruyama, T. Matoba, N. Hagiwara, H. Suzuki, Y. Nishida, M. Ajioka, K. Yumoto, S. Shimizu, T. Aoyama, H. Shimomura, T. Takeda, K. Oshiro, N. Sugishita, Y. Shibata, T. Otonari, H. Kihara, H. Ogawa, A. Ohno, M. Hazama, M. Shimizu, K. Tsukahara, S. Haruta, T. Wakeyama, T. Haruna, M. Ito, K. Fujii, N. Atsuchi, M. Sata, K. Kimura, N. Hasebe, Y. Kobayasi, K. Ohsato, K. Hironaga, Y. Naganuma, K. Anzaki, K. Oiwa, S. Okazaki, Y. Nakagawa, K. Tokuhiro, K. Tanaka, T. Momose, Y. Fukushima, R. Kametani, K. Kawamitsu, Y. Saito, S. Akashi, K. Kumagai, K. Eshima, T. Tobaru, T. Seo, K. Okuhara, K. Kozuma, Y. Ikari, T. Takahashi, I. Michishita, H. Fujikura, S. Momomura, Y. Yamamoto, K. Otomo, T. Matsubara, H. Tashiro, T. Inoue, M. Ishihara, I. Shiojima, E. Tachibana, J. Ako, K. Sumii, N. Yamamoto, N. Ohmura, T. Nakamura, Y. Morita, N. Takahashi, K. Watanabe, H. Fujinaga, M. Maruyama, T. Oka, T. Shirayama, T. Amano, K. Fukui, K. Ando, S. Oshima, S. Kagiyama, H. Teragawa, M. Yuge, S. Ono, T. Koga, K. Fujiu, M. Kuwabara, Y. Ohya, Y. Yumoto, N. Kuji, M. Ikemura, K. Kario, K. Chatani, K. Sato, H. Miyagi, M. Murakami, K. Saito, M. Hoshiga, S. Sato, N. Kubo, Y. Sakamoto, K. Ashida, H. Sakamoto, S. Murasaki, H. Uehara, T. Akasaka, Y. Ooba, S. Nakahara, Y. Hanaoka, T. Nishimiya, R. Tsunoda, Y. Onuma, S. Higuchi, A. Tani, A. Wada, M. Kato, H. Obata, Y. Higuchi, T. Endo, R. Katou, T. Matsunaga, T. Matsuoka, H. Noguchi, M. Usui, T. Hayashi, Y. Otsuji, T. Osaki, H. Zaizen, H. Yoshihara, K. Kadota, T. Hirose, T. Miyazawa, A. Mori, M. Takano, W. Shimizu, M. Wake, S. Oriso, M. Yoshiyama, S. Kakinoki, T. Nishioka, T. Ozaki, K. Nomoto, K. Seki, K. Kawai, Y. Ozaki, S. Miura, M. Kawasaki, R. Funada, K. Dote, T. Nagano, S. Okamoto, T. Kubo, Y. Murozono, T. Owada, T. Doke, T. Matsumura, M. Horiuchi, A. Takaishi, M. Yamamoto, H. Nakashima, M. Munemasa, Y. Sakata, N. Inoue, T. Ota, Y. Hamano, N. Abe, T. Tsubokura, M. Goto, I. Kubota, M. Yano, K. Umetani, T. Date, H. Morimoto, T. Noda, S. Goto, K. Hibi, A. Nakano, S. Hiramitsu, Y. Kihara, M. Sugi, N. Shiba, D. Izumi, T. Sato, S. Tayama, T. Matsui, A. Suzuki, K. Ajiki, M. Oishi, M. Kiryu, T. Ko, H. Ando, S. Miyazaki, T. Kinugawa, H. Otake, H. Kitaoka, Y. Hirata, S. Honda, M. Manita, Y. Ishii, H. Oka, Y. Nanba, M. Nishino, T. Sakamoto, T. Saito, H. Sakai, M. Ichikawa, S. Namiuchi, K. Inoue, N. Komiyama, Y. Akashi, Y. Nakamura, T. Komaru, T. Hosokawa, T. Chikamori, H. Tanaka, O. Arasaki, K. Aonuma, Y. Wakasa, T. Yoshizawa, T. Sugano, N. Yokota, A. Kakutani, T. Suzuki, Y. Abe, T. Kataoka, H. Okayama, H. Yokoi, K. Chin, K. Hasegawa, H. Tomita, H. Honzyo, H. Kawai, K. Yamamoto, Y. Morino, S. Tsujiyama, S. Hamasaki, Y. Niijima, Y. Mizuno, A. Maki, K. Tanabe, T. Murohara, S. Naomi, M. Arikawa, T. Kato, N. Matsumoto, T. Minamino, H. Sairenji, N. Miyamoto, H. Ito, Y. Matsuura, S. Hata, Y. Nakatsu, T. Onodera, M. Yoshimura, H. Amano, E. Tokutake, M. Kasao, M. Moriguchi, M. Tsuji, H. Yamamoto, Y. Yanbe, T. Iwasawa, M. Suzuki, and H. Mori

Subjects
Rivaroxaban, medicine.medical_specialty, business.industry, Unstable angina, medicine.medical_treatment, Percutaneous coronary intervention, Atrial fibrillation, medicine.disease, Thrombosis, Coronary artery disease, Internal medicine, medicine, Cardiology, cardiovascular diseases, Myocardial infarction, Cardiology and Cardiovascular Medicine, business, Stroke, medicine.drug
Abstract

Objectives The aim of this AFIRE (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease) trial subgroup analysis was to examine rivaroxaban monotherapy benefits and their relation to the time between stenting and enrollment among patients after coronary stenting. Background Of 2,215 patients with atrial fibrillation and stable coronary artery disease in the AFIRE trial, rivaroxaban monotherapy was noninferior to rivaroxaban plus antiplatelet therapy (combination therapy) in terms of efficacy and superior for safety endpoints. However, thrombotic risk after antiplatelet therapy cessation remained a concern among 1,444 patients who had undergone coronary stenting >1 year before enrollment. Methods The benefits of rivaroxaban monotherapy in coronary stenting subgroups were assessed for efficacy (a composite of stroke, systemic embolism, myocardial infarction, unstable angina requiring revascularization, or death of any cause), safety (major bleeding defined according to International Society on Thrombosis and Haemostasis criteria), ischemic endpoints, net adverse clinical event, and time between stenting and enrollment. Results Efficacy and safety endpoints for monotherapy were superior to combination therapy, with HRs of 0.70 for efficacy (95% CI: 0.50-0.98; P = 0.036) and 0.55 for safety (95% CI: 0.33-0.92; P = 0.019). For ischemic endpoints, the HR was 0.82 (95% CI: 0.58-1.15; P = 0.240). The HR became smaller with longer time between stenting and enrollment (efficacy, P for interaction = 0.158; safety, P = 0.097). Conclusions In patients with atrial fibrillation after coronary stenting, the benefits of rivaroxaban monotherapy for efficacy and safety endpoints were consistent with those in the whole AFIRE trial population. The benefits became apparent with longer time between stenting and enrollment. (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease Study [AFIRE]; UMIN000016612 , NCT02642419 )

Published
2021

24. Physical Frailty and Hemoglobin-to-Red Cell Distribution Width Ratio in Japanese Older Outpatients

Author

K. Kinoshita, S. Satake, K. Murotani, M. Takemura, Y. Matsui, and H. Arai

Subjects
Erythrocyte Indices, Hemoglobins, Frailty, Japan, Frail Elderly, Outpatients, Humans, General Medicine, Biomarkers, Aged
Abstract

The Frailty screening should be widely performed; however, simple and inexpensive biomarkers are missing. Biomarkers that can be routinely assessed in many patients are desirable. Recently, the hemoglobin-to-red cell distribution width ratio (Hb/RDW, HRR) has been suggested as a new prognostic marker and has been reported to be associated with inflammation, one of the factors contributing to frailty. Therefore, we aimed to address the role of HRR in frailty among 557 older outpatients (aged 65-96 years). Frailty was assessed using the Japanese version of the Cardiovascular Health Study criteria, and HRR was calculated from clinical records. Participants were classified into five groups based on a sex-stratified quintile of HRR (Q1-Q5). Of the participants, 20.3% were frail. Using multiple logistic regression models with the Q5 group as a reference, after adjusting for sex, age, body mass index, polypharmacy, pre-orthopedic surgery, and the use of iron medications, the multivariable-adjusted odds ratios (95% confidence intervals) of the Q4 to Q1 groups were 0.92 (0.58-1.47), 1.04 (0.67-1.61), 1.29 (0.84-1.96), and 1.85 (1.22-2.82), respectively, indicating that a lower HRR was significantly associated with frailty. The robustness of these results was also shown in the multiple imputation analysis. The results suggest that HRR measurement may be one of the indicators to identify frail older adults in routine practice.

Published
2022

25. How to perform effective cryoballooon ablation of left atrial roof: considerations after experiences of more than 1000 cases

Author

T Shigeta, Y Yamauchi, A Oda, K Sudo, H Arai, Y Sagawa, K Okishige, M Goya, and T Sasano

Subjects
Cardiology and Cardiovascular Medicine
Abstract

Introduction Although pulmonary vein isolation is the cornerstone of atrial fibrillation (AF) ablation, concomitant cryoballoon ablation of left atrial (LA) roof has been expected to improve clinical outcomes after ablation. We demonstrate characteristics and efficacy of cryoballoon ablation of LA roof through our experiences from a large volume of procedures. Methods We had performed cryoballoon ablation of LA roof in 1036 procedures including 202 redo procedures in AF patients since June 2016. Among these procedures, we analyzed 834 patients (309 paroxysmal AF) who had undergone de novo ablation for AF. We confirmed whether the complete conduction block of LA roof line was obtained after the ablation. Results LA roof line block was obtained in 767 patients (92.0%) without touch up ablation with a radiofrequency catheter (Group A). LA diameter (LAD) was significantly smaller (43.6±6.6mm vs 47.4±7.5mm, p Conclusion LA roof line block could be obtained by solely cryoballoon with a reasonable success rate, especially in those with smaller LAD and lower BMI. To obtaine LA roof line block, cryoballoon ablation with the guiding catheter located in LSPV is preferable. LA roof line block without touch up ablation brings better clinical outcomes in those who underwent cryoballoon ablation of LA roof. Funding Acknowledgement Type of funding sources: None.

Published
2022

27. Cryoballoon ablation of left atrial roof with a novel cryoballoon system

Author

T Shigeta, Y Yamauchi, A Oda, K Sudo, H Arai, Y Sagawa, K Okishige, M Goya, and T Sasano

Subjects
Cardiology and Cardiovascular Medicine
Abstract

Introduction A novel cryoballoon system (POLARx) has emerged and its efficacy regarding pulmonary vein isolation (PVI) has been already investigated. On the other hand, cryoballoon ablation of left atrial (LA) roof has been performed using a conventional cryoballoon system (Arctic Front Advance Pro [AFA-Pro]) in addition to PVI. However, cryoballoon ablation of LA roof with POLARx has not been investigated yet. Methods We performed cryoballoon ablation of LA roof with POLARx in 22 patients after we achieved PVI. After the cryoballoon ablation, complete conduction block at LA roof and isolation of all PVs were confirmed by creating an activation map during high right atrium pacing. If they could not be obtained with solely a cryoballoon, touch up ablation with radiofrequency ablation was permitted. The procedural data during ablation with POLARx was compared with those during ablation with AFA-Pro we had performed in a historical cohort of patients (n=46). Results Complete conduction block at LA roof without touch up ablation could be obtained in all the patients in POLARx group and 44 (95.7%) patients in AFA-Pro group. Total procedure time was almost similar in both groups (164.2±35.4 min for POLARx vs 180.3±35.4 min for AFA-Pro, p=0.10). During LA roof line ablation, nadir balloon temperature was significantly lower in POLARx group (right side: −53.6±4.4°C for POLARx vs −45.6±4.6°C for AFA-Pro, p Conclusion Complete conduction block at LA roof could be obtained after cryoballoon ablation with POLARx, in the same way as AFA-Pro. Lower nadir balloon temperature could be expected in shorter freezing time during LA roof line ablation in using POLARx compared with AFA-Pro. Funding Acknowledgement Type of funding sources: None.

Published
2022

29. The Japan-Multimodal Intervention Trial for Prevention of Dementia (J-MINT): The Study Protocol for an 18-Month, Multicenter, Randomized, Controlled Trial

Author

T. Sugimoto, T. Sakurai, H. Akatsu, T. Doi, Y. Fujiwara, A. Hirakawa, F. Kinoshita, M. Kuzuya, S. Lee, K. Matsuo, M. Michikawa, S. Ogawa, R. Otsuka, K. Sato, H. Shimada, H. Suzuki, H. Takechi, S. Takeda, H. Umegaki, S. Wakayama, and H. Arai

Subjects
Male, medicine.medical_specialty, Activities of daily living, Psychological intervention, Cognitive decline, Neuropsychological Tests, Prevention of dementia, law.invention, multidomain intervention, cognitive training, Cognition, Japan, Randomized controlled trial, Risk Factors, law, physical exercise, Activities of Daily Living, medicine, Humans, Dementia, Cognitive Dysfunction, Exercise, Geriatric Assessment, Aged, Original Research, Aged, 80 and over, medicine.diagnostic_test, business.industry, Neuropsychological test, medicine.disease, Cognitive training, Nutrition Assessment, nutrition, Physical therapy, Female, business
Abstract

Background/Objectives The Japan-multimodal intervention trial for prevention of dementia (J-MINT) is intended to verify the effectiveness of multi-domain interventions and to clarify the mechanism of cognitive improvement and deterioration by carrying out assessment of dementia-related biomarkers, omics analysis and brain imaging analysis among older adults at high risk of dementia. Moreover, the J-MINT trial collaborates with partnering private enterprises in the implementation of relevant interventional measures. This manuscript describes the study protocol. Design/Setting Eighteen-month, multi-centered, randomized controlled trial. Participants We plan to recruit 500 older adults aged 65–85 years with mild cognitive impairment. Subjects will be centrally randomized into intervention and control groups at a 1:1 allocation ratio using the dynamic allocation method with all subjects stratified by age, sex, and cognition. Intervention The multi-domain intervention program includes: (1) management of vascular risk factors; (2) group-based physical exercise and self-monitoring of physical activity; (3) nutritional counseling; and (4) cognitive training. Health-related information will be provided to the control group every two months. Measurements The primary and secondary outcomes will be assessed at baseline, 6-, 12-, and 18-month follow-up. The primary outcome is the change from baseline to 18 months in a global composite score combining several neuropsychological domains. Secondary outcomes include: cognitive change in each neuropsychological test, incident dementia, changes in blood and dementia-related biomarkers, changes in geriatric assessment including activities of daily living, frailty status and neuroimaging, and number of medications taken. Conclusions This trial that enlist the support of private enterprises will lead to the creation of new services for dementia prevention as well as to verify the effectiveness of multi-domain interventions for dementia prevention. Electronic Supplementary Material Supplementary material is available for this article at 10.14283/jpad.2021.29 and is accessible for authorized users.

Published
2021

34. Tolvaptan reduces the required amount of albumin infusion in patients with decompensated cirrhosis with uncontrolled ascites : a multicenter retrospective propensity score-matched cohort study

Author

T Ueno, Toshio Uraoka, Hitoshi Takagi, M Namikawa, H. Suzuki, D Takizawa, Yuichi Yamazaki, H Arai, A. Naganuma, Ken Sato, Yutaka Suzuki, Satoru Kakizaki, T Hatanaka, T. Hoshino, and Hiroki Tojima

Subjects
Liver Cirrhosis, Male, medicine.medical_specialty, Cirrhosis, Serum albumin, Tolvaptan, Gastroenterology, Cohort Studies, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Albumins, Internal medicine, Ascites, medicine, Paracentesis, Humans, Propensity Score, Aged, Retrospective Studies, Creatinine, biology, medicine.diagnostic_test, business.industry, Liver Neoplasms, Albumin, Middle Aged, medicine.disease, chemistry, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, biology.protein, 030211 gastroenterology & hepatology, medicine.symptom, business, medicine.drug
Abstract

Background : The aim of this retrospective study was to determine whether tolvaptan treatment reduces the amount of albumin administered, volume of ascites removed, and frequency of paracentesis procedures in patients with decompensated cirrhosis with uncontrolled ascites with conventional diuretics. Patients and methods : The control (C) group included patients treated with conventional diuretics. The tolvaptan (T) group included patients treated with both tolvaptan and conventional diuretics. Both groups were matched according to baseline parameters. The amount of albumin administered, volume of ascites removed, and frequency of paracentesis within 30 days of onset of uncontrolled ascites were compared between the two groups. Results : After matching, 74 patients (C=37, T=37) were included. Baseline parameters (C vs. T group) were as follows : age, 69.5 ± 9.3 vs. 70.4 ± 11.0 years (p = 0.702) ; males, 24 (64.9%) vs. 25 (67.6%) (p = 0.999) ; patients with hepatocellular carcinoma, 17 (45.9%) vs. 18 (48.6%) (p = 0.999) ; serum albumin levels at treatment initiation, 2.76 ± 0.48 vs. 2.73 ± 0.49 g/dL (p = 0.773), and serum creatinine levels at treatment initiation, 1.18 ± 1.23 vs. 1.09 ± 0.48 g/dL (p = 0.679). In the C vs. T groups, respectively, mean amount of albumin administered was 51.0 ± 31.4 vs. 33.4 ± 29.8 g/month (p = 0.016) ; mean volume of ascites removed was 2,905 ± 4,921 vs. 1,824 ± 3,185 mL/month (p = 0.266) ; and mean frequency of paracentesis was 0.92 ± 1.46 vs. 0.89 ± 1.45 procedures (p = 0.937). Conclusions : Tolvaptan reduced the use of albumin infusion in patients with decompensated cirrhosis and was effective and acceptable for uncontrolled ascites.

Published
2021

36. Analysis of soil aggregates contaminated by 137Cs via particle size classification and X-ray diffraction

Author

H. Arai and K. Ishii

Subjects
General Earth and Planetary Sciences, General Environmental Science
Abstract

We subjected 137Cs-contaminated soil to stirring and particle classification to reduce the contaminated soil volume. 137Cs activity as a function of particle diameter changed drastically as the weight ratio of soil/water varied; 85% of all 137Cs was adsorbed to particles of minimum diameter after stirring. Soil argillites (smectites, vermiculites, and illites) adsorbed 137Cs. We used X-ray diffraction (XRD) analysis to measure the soil contents; the 137Cs distribution as a function of soil particle diameter mirrored the smectite levels revealed by the XRD peak intensities. Thus, smectic was the main absorbent of 137Cs.

Published
2020

38. The Design and Rationale of a Phase 2b, Randomized, Double-Blinded, and Placebo-Controlled Trial to Evaluate the Safety and Efficacy of Lomecel-B in Older Adults with Frailty

Author

K. Yousefi, K.N. Ramdas, J.G. Ruiz, J. Walston, H. Arai, E. Volpi, A.B. Newman, C. Wang, B. Hitchinson, L. McClain-Moss, L. Diaz, G.A. Green, J.M. Hare, and A.A. Oliva

Subjects
Treatment Outcome, Double-Blind Method, Frailty, SARS-CoV-2, COVID-19, Humans, General Medicine, Biomarkers, Aged
Abstract

Background: Frailty in older adults is a rapidly growing unmet medical need. It is an aging-related syndrome characterized by physical decline leading to higher risk of adverse health outcomes. OBJECTIVES: To evaluate the efficacy of Lomecel-B, an allogeneic medicinal signaling cell (MSC) formulation, in older adults with frailty. DESIGN: This multicenter, randomized, parallel-arm, double-blinded, and placebo-controlled phase 2b trial is designed to evaluate dose-range effects of Lomecel-B for frailty on physical functioning, patient-reported outcomes (PROs), frailty status, and biomarkers. SETTING: Eight enrolling clinical research centers, including the Miami Veterans Affairs Medical Center. PARTICIPANTS: Target enrollment is 150 subjects aged 70-85 years of any race, ethnicity, or gender. Enrollment criteria include a Clinical Frailty Score of 5 (“mild”) or 6 (“moderate”), a 6MWT of 200-400 m, and serum tumor necrosis factor-alpha (TNF-α) ≥2.5 pg/mL. INTERVENTION: A single intravenous infusion of Lomecel-B (25, 50, 100, or 200 million cells) or placebo (N=30/arm). Patients are followed for 365 days for safety, and the efficacy assessments performed at 90, 180, and 270 days. MEASUREMENTS: The primary endpoint is change in 6MWT in the Lomecel-B-treated arms versus placebo at 180 days post-infusion. Secondary and exploratory endpoints include change in: 6MWT and other physical function measures at all time points; PROs; frailty status; cognitive status; and an inflammatory biomarkers panel. A pre-specified sub-study examines vascular/endothelial biomarkers. Safety is evaluated throughout the trial. RESULTS: The trial is conducted under a Food and Drug Administration Investigational New Drug (IND), with Institutional Review Board approval, and monitoring by an NIH-appointed independent Data Safety Monitoring Board. CONCLUSION: This clinical trial investigates the use of a regenerative medicine strategy for frailty in older adults. The results will further the understanding of the potential for Lomecel-B in the geriatric condition of frailty.

Published
2022

40. Specific activity and vermiculite content of soils of various particle sizes contaminated by the Fukushima Daiichi nuclear power plant accident

Author

K. Ishii and H. Arai

Subjects
General Earth and Planetary Sciences, General Environmental Science
Abstract

Soil polluted by the Fukushima Daiichi nuclear power plant accident was collected and reduced in volume. We explored whether clay particles adsorbed radioactive cesium. Soil was sampled in a highly contaminated zone 16 km northwest of the power plant; soil particles 0.15–200 [Formula: see text]m in diameter were obtained by sieving and centrifugation, and specific activity was analyzed using a high-powered Ge detector. Vermiculite contents were quantified by X-ray diffraction. For soil particles[Formula: see text]m in diameter, the specific activity was constant, at about 381 kBq/kg, which is close to the 350 kBq/kg reported previously. For particles 10–200 [Formula: see text]m in diameter, the specific activity decreased by approximately the square root of the surface/entire volume ratio. The vermiculite content was identical for all soil particles [Formula: see text]2.5 [Formula: see text]m in diameter, but decreased in particles 2.5–200 [Formula: see text]m in diameter. Thus, the specific activity and vermiculite content were approximately proportionate. Vermiculite adhered to soil particles [Formula: see text]10 [Formula: see text]m in diameter, and radioactive cesium was uniformly distributed within the vermiculite.

Published
2020

41. Low Amino Acid Score of Breakfast is Associated with the Incidence of Cognitive Impairment in Older Japanese Adults: A Community-Based Longitudinal Study

Author

Takada Michihiro, H. Jinzu, A. Imaizumi, Yukiko Nishita, Hiroshi Shimokata, Kaori Kinoshita, H. Arai, Chikako Tange, Masafumi Kuzuya, Masako Tsukamoto-Yasui, Makiko Tomida, and Rei Otsuka

Subjects
Male, Meal, medicine.medical_specialty, Longitudinal study, business.industry, Incidence (epidemiology), Incidence, digestive, oral, and skin physiology, Odds ratio, Logistic regression, Confidence interval, Japan, Internal medicine, medicine, Humans, Cognitive Dysfunction, Female, Longitudinal Studies, Amino Acids, business, Body mass index, Protein quality, Aged, Breakfast
Abstract

Background: The protein digestibility-corrected amino acid score (PDCAAS) represents the degree of utilizable dietary protein, namely the protein quality. The PDCAAS of a diet is required to be evaluated on a meal-by-meal basis, as food digestion and absorption occur with each meal intake. Although a positive association between protein intake and cognitive function has been reported, no study has investigated the association between PDCAAS of a diet and cognitive function. Objectives: To investigate the relationship between PDCAAS of a diet and cognitive impairment in older adults. Design: Longitudinal epidemiological study Setting: Community-based setting Participants: We analyzed 541 community-dwellers who participated in both baseline and follow-up survey. They were 60–83 years of age without cognitive impairment at baseline. Measurements: Cognitive impairment was defined as a Mini-Mental State Examination (MMSE) score ≤27. Individual PDCAASs were calculated for each of three regular meals from the 3-day dietary records at baseline. Participants were classified into two groups according to the sex-specific tertiles (T1–T3) of the PDCAAS for each meal (i.e., T1 as the low score group and T2–T3 as the medium and high score group). The dependent variable was cognitive impairment observed after 4 years, and the explanatory variables were the PDCAAS groups for each meal (the medium and high group as the reference) and covariates (sex, age, body mass index, education, depressive symptoms, medical history, protein intake at each meal, and the MMSE score at baseline). Multivariable logistic regression analysis was performed to evaluate the low PDCAAS group for cognitive impairment after 4 years. Results: A significant association was observed only between a low PDCAAS of breakfast and the incidence of cognitive impairment (the adjusted odds ratios [95% confidence intervals] of low PDCAAS for cognitive impairment for breakfast, lunch, and dinner were 1.58 [1.00–2.50], 0.85 [0.54–1.34], and 1.08 [0.71–1.65], respectively). Conclusion: A lower PDCAAS of breakfast, i.e., a diet with poor quality of protein, was associated with the incidence of cognitive impairment in older adults of the community.

Published
2022

42. Altered vitamin E status in Niemann-Pick type C disease

Author

L. Ulatowski, R. Parker, C. Davidson, N. Yanjanin, T.J. Kelley, D. Corey, J. Atkinson, F. Porter, H. Arai, S.U. Walkley, and D. Manor

Subjects
nutrition, oxidized lipids, Niemann-Pick disease, Biochemistry, QD415-436
Abstract

Vitamin E (α-tocopherol) is the major lipid-soluble antioxidant in many species. Niemann-Pick type C (NPC) disease is a lysosomal storage disorder caused by mutations in the NPC1 or NPC2 gene, which regulates lipid transport through the endocytic pathway. NPC disease is characterized by massive intracellular accumulation of unesterified cholesterol and other lipids in lysosomal vesicles. We examined the roles that NPC1/2 proteins play in the intracellular trafficking of tocopherol. Reduction of NPC1 or NPC2 expression or function in cultured cells caused a marked lysosomal accumulation of vitamin E in cultured cells. In vivo, tocopherol significantly accumulated in murine Npc1-null and Npc2-null livers, Npc2-null cerebella, and Npc1-null cerebral cortices. Plasma tocopherol levels were within the normal range in Npc1-null and Npc2-null mice, and in plasma samples from human NPC patients. The binding affinity of tocopherol to the purified sterol-binding domain of NPC1 and to purified NPC2 was significantly weaker than that of cholesterol (measurements kindly performed by R. Infante, University of Texas Southwestern Medical Center, Dallas, TX). Taken together, our observations indicate that functionality of NPC1/2 proteins is necessary for proper bioavailability of vitamin E and that the NPC pathology might involve tissue-specific perturbations of vitamin E status.

Published
2011
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43. Channel Capacity Enhancement by Pattern Controlled Handset Antenna

Author

J. Ohno and H. Arai

Subjects
eywords MIMO, inverted-F shaped antenna, channel capacity, correlation coefficient, MEG., Electrical engineering. Electronics. Nuclear engineering, TK1-9971
Abstract

This paper presents a radiation pattern controlled antenna for handset terminals to reduce the correlation coefficient between antennas and enhance the channel capacity in MIMO applications. A pair of small inverted-F shaped antennas combined by a phase shifter provides a single port with controlled pattern. To enhance the channel capacity, the phase difference for the IFA array is optimized using the evaluation parameter of reception level, correlation coefficient and mean effective gain of the proposed array geometry. The channel capacity enhancement is verified by assuming Croneker scattering under Nakagami-Rice propagation model.

Published
2009

47. Relationship between Serum Fatty Acids and Components of Physical Frailty in Community-Dwelling Japanese Older Adults

Author

K, Kinoshita, R, Otsuka, C, Tange, Y, Nishita, M, Tomida, F, Ando, H, Shimokata, and H, Arai

Subjects
Cross-Sectional Studies, Frailty, Japan, Frail Elderly, Fatty Acids, Humans, Independent Living, Aged
Abstract

Polyunsaturated fatty acids help maintain insulin sensitivity, mitochondrial function, and anti-inflammation. It is well known that deterioration in these areas can cause frailty. However, little is known about the differences in serum polyunsaturated fatty acid levels among frailty components. We investigated the cross-sectional relationship between frailty and serum fatty acids in 1,033 community-dwelling older adults aged 60-88 years. Polyunsaturated fatty acid concentrations were measured from fasting blood samples. The modified phenotype criteria defined frailty. Polyunsaturated fatty acid levels were compared among each component using general linear modeling after controlling for sex, age, body mass index, smoking status, household income, and medical history. Lower polyunsaturated fatty acid levels were associated with the modified frailty criteria, including shrinking and weakness (p0.05). Our findings suggest that serum polyunsaturated fatty acid levels differ depending on the frailty status of older adults.

Published
2021

50. Cognitive diagnosis models for estimation of misconceptions analyzing multiple-choice data

Author

Koken Ozaki, Noriko H. Arai, and Shingo Sugawara

Subjects
Computer science, business.industry, Applied Mathematics, Knowledge state, Experimental and Cognitive Psychology, Statistical model, computer.software_genre, Clinical Psychology, Possession (linguistics), Binary data, Cognitive diagnosis, Artificial intelligence, business, computer, Analysis, Natural language processing, Test data, Multiple choice
Abstract

Incorrect options for multiple-choice questions are often intentionally included so that they may be selected by an examinee who possesses a misconception. Determining whether an examinee possess a misconception is useful for educational purposes. In the present paper, two statistical models that can estimate examinees’ possession of misconceptions by analyzing multiple-choice data, which are unscored data were developed. By converting multiple-choice data to binary data, which are scored data ($$1=$$ correct, $$0=$$ incorrect), the Bug-DINO model can estimate examinees’ possession of misconceptions. However, converting multiple-choice data to binary data causes a loss in information, because which incorrect option an examinee chooses is important information for an examinee’s knowledge state. The three models (two developed models and the Bug-DINO model) are compared in a simulation study, and the developed models are applied to the Reading Skill Test data.

Published
2019

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