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Objective: The clinical practice guideline for primary aldosteronism (PA) places a high value on confirmatory tests to sparing patients with false‐positive results in case detection from undergoing adrenal venous sampling (AVS). However, it is unclear whether multiple types of confirmatory tests are more useful than a single type. To evaluate whether the machine‐learned combination of two confirmatory tests is more useful in predicting subtypes of PA than each test alone. Design: A retrospective cross‐sectional study in referral centres. Patients: This study included 615 patients with PA randomly assigned to the training and test data sets. The participants underwent saline infusion test (SIT) and captopril challenge test (CCT) and were subtyped by AVS (unilateral, n = 99; bilateral, n = 516). Measurements: The area under the curve (AUC) and clinical usefulness using decision curve analysis for the subtype prediction in the test data set. Results: The AUCs for the combination of SIT and CCT, SIT alone and CCT alone were 0.850, 0.813 and 0.786, respectively, with no significant differences between them. The AUC for the baseline clinical characteristics alone was 0.872, whereas the AUCs for these combined with SIT, combined with CCT and combined with both SIT and CCT were 0.868, 0.854 and 0.855, respectively, with no significant improvement in AUC. The additional clinical usefulness of the second confirmatory test was unremarkable on decision curve analysis. Conclusions: Our data suggest that patients with positive case detection undergo one confirmatory test to determine the indication for AVS. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effects of an intensity display type accelerometer on diabetic patients' physical activity. Methods: This was a two‐arm, non‐randomized controlled study. Both groups received information about the recommendation of 150 min/week moderate‐to‐vigorous physical activity (MVPA). The intervention group used an intensity display type accelerometer to monitor their physical activity intensity for 10 days at baseline and 3 months later. We compared intervention and control groups after 3 and 6 months. Primary outcomes were MVPA and number of steps over 7 days. Secondary outcomes were glycosylated hemoglobin (HbA1c), body mass index, and self‐management. Results: Of 62 participants, 30 and 32 were included in the intervention and control groups, respectively. Mean age in each group was 59.7 ± 10.8 and 58.8 ± 10.2 years, and mean HbA1c was 6.9 ± 0.9% and 6.9 ± 0.8%, respectively. There were no significant differences between the intervention and control groups at either time point, and no outcomes showed significant changes. In a subgroup analysis by physical activity intensity, MVPA of active individuals in the control group significantly decreased at 6 months from baseline. MVPA and number of steps among inactive individuals in the intervention group significantly increased at 6 months from baseline. Self‐management of the intervention group showed a trend toward improvement, but HbA1c and body mass index showed no significant change. Conclusions: Monitoring physical activity intensity led to increased MVPA of inactive patients and maintained MVPA of active patients with diabetes mellitus. This straightforward intervention could be applied in clinical practice. [ABSTRACT FROM AUTHOR]

In pheochromocytoma/paraganglioma, nontumorous high 18F‐fluorodeoxyglucose accumulations are observed in both beige and brown adipose tissues. Recognizing this feature of 18F‐fluorodeoxyglucose accumulation can help physicians make precise diagnoses and help them avoid the pitfalls of a false‐positive 18F‐fluorodeoxyglucose positron emission tomography result, preventing unnecessary interventions. [ABSTRACT FROM AUTHOR]

Smad2 is a critical mediator of TGF-β signals that are known to play an important role in a wide range of biological processes in various cell types. Its role in the development of the CNS, however, is largely unknown. Mice lacking Smad2 in the CNS (Smad2-CNS-KO) were generated by a Cre-loxP approach. These mice exhibited behavioral abnormalities in motor coordination from an early postnatal stage and mortality at approximately 3 weeks of age, suggestive of severe cerebellar dysfunction. Gross observation of Smad2-CNS-KO cerebella demonstrated aberrant foliations in lobule IX and X. Further analyses revealed increased apoptotic cell death, delayed migration and maturation of granule cells, and retardation of dendritic arborization of Purkinje cells. These findings indicate that Smad2 plays a key role in cerebellar development and motor function control. [ABSTRACT FROM AUTHOR]

Abstract: In this paper, the synthesis and solid-state structures of β-alkyl-substituted dipyrrolyldiketone BF2 complexes are discussed; these complexes can function as π-conjugated acyclic anion receptors (“molecular flippers”) and are potential building subunits of anion-responsive π-conjugated oligomers or polymers. Modes of the solid-state assemblies in these complexes determined by performing single-crystal X-ray analysis are found to depend on the lengths of the alkyl chains at the β-positions. A β-methyl-substituted receptor has a highly planar structure, which efficiently forms stacking assemblies in the core π-plane in the solid state, while a β-ethyl-substituted receptor shows no stacking assemblies due to the presence of bulky ethyl moieties, which form only dimeric structures by hydrogen bonding. β-Alkyl-substituted anion receptors can be used not only as monomer units of stimuli-responsive polymeric macromolecules but also as components of solid-state electronic materials. [Copyright &y& Elsevier]

Polycystic ovary syndrome (PCOS) frequently exhibits hyperinsulinemia due to insulin resistance, but there are many unknown aspects of this disease. This report presents the case of a 31-year-old woman with PCOS and type B insulin resistance syndrome (TBIRS). The patient had repeated hyperglycemia and hypoglycemia, and prominent hyperinsulinemia. The insulin receptor antibody was positive, leading to a diagnosis of TBIRS. She also had amenorrhea during the previous 3 months, high blood testosterone levels, and enlarged polycystic ovaries, leading to a diagnosis of PCOS at the same time. The patient was treated with glucocorticoid for TBIRS. The insulin receptor antibody eliminated at 8 weeks after initiation of glucocorticoid treatment, and the blood glucose levels and hyperinsulinemia improved at 9 weeks. Then, the enlargement of both ovaries diminished at 32 weeks, and the menstruation had normalized since 36 weeks. The blood testosterone level normalized at 41 weeks. To the best of our knowledge, this is the first report to demonstrate that enlarged polycystic ovaries and a menstrual disorder in TBIRS improved after glucocorticoid treatment. It is possible that elimination of insulin receptor antibodies by glucocorticoid treatment attenuated insulin resistance and subsequently improved PCOS in TBIRS.