Diabetes is a complex and heterogeneous disease, making the prediction of the risks of diabetic complications challenging. Novel adult-onset diabetes subgroups have been studied using cluster analysis, but its application in East Asians remains unclear. We conducted a retrospective cohort study to elucidate the clinical utility of cluster-based subgroup analysis in the Japanese population. Cluster analysis based on anti-glutamate decarboxylase antibody (GAD antibody) levels, age at diagnosis, body mass index (BMI), hemoglobin A1c (A1c), and homeostatic model assessment 2 estimates of β-cell function and insulin resistance was performed in 1520 diabetic patients. The risk of developing diabetic complications was analyzed using Kaplan–Meier analysis and the Cox proportional hazards model. By cluster analysis, we identified five distinct subgroups of adult-onset diabetes in the Japanese population. The risk of diabetic complications varied greatly among the clusters. Patients with severe autoimmune diabetes or severe insulin deficiency diabetes were at an increased risk of diabetic retinopathy, and those with severe insulin resistant diabetes (SIRD) had the highest risk of developing diabetic kidney disease (DKD). After adjusting for uncorrectable and correctable risk factors, SIRD was found to be an independent risk factor for DKD. In conclusion, we identified five subgroups of adult-onset diabetes and the risk factors for diabetic complications in the Japanese population. This new classification system can be effective in predicting the risk of diabetic complications and for providing optimal treatment.

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The concentrations of hydroxyl groups located inside and on the surface oxide films of a commercially pure titanium, cp-Ti, a type 316L austenitic stainless steel, SS, and a cobalt-chromium-molybdenum alloy, Co-Cr-Mo, were evaluated using X-ray photoelectron spectroscopy, XPS, and a zinc-complex substitution technique. As a result, the concentrations of the hydroxyl groups detected by the zinc-complex substitution technique, defined as active hydroxyl groups, were much larger than those detected by other conventional techniques. The concentration of the active hydroxyl groups on Co-Cr-Mo was significantly larger than those on cp-Ti and SS. Poly(ethylene glycol), PEG, is a biofunctional molecule that inhibits the adsorption of proteins. The immobilization of PEG to metal surfaces by electrodeposition or immersion is an important technique to biofunctionalize the metals. The amounts of the PEG layer immobilized on the metals were governed by the concentrations of the active hydroxyl groups on each surface oxide in the case of electrodeposition; it was governed by the relative permittivity of the surface oxide in the case of immersion. The estimation of active hydroxyl groups on the surface oxide film with the zinc-complex substitution technique is useful for the elucidation of reactions between metal substrates and immobilized molecules.

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Pseudomonas cannabina pv. alisalensis (Pcal), which causes bacterial blight disease of Brassicaceae, is an economically important pathogen worldwide. To identify Pcal genes involved in pathogenesis, we conducted a screen for 1,040 individual Pcal KB211 Tn5 mutants with reduced virulence on cabbage plants using a dip-inoculation method. We isolated 53 reduced virulence mutants and identified several potential virulence factors involved in Pcal virulence mechanisms such as the type III secretion system, membrane transporters, transcription factors, and amino acid metabolism. Importantly, Pcal is pathogenic on a range of monocotyledonous and dicotyledonous plants. Therefore, we also carried out the inoculation test on oat plants, which are cultivated after cabbage cultivation as green manure crops. Interestingly among the 53 mutants, 31 mutants also exhibited reduced virulence on oat seedlings, indicating that Pcal optimizes its virulence factors for pathogenicity on different host plants. Our results highlight the importance of revealing the virulence factors for each plant host-bacterial interaction, and will provide new insights into Pcal virulence mechanisms.

The in vitro short-term platelet adhesion on various metals, as accelerated by the addition of Ca(2+), was evaluated in this study. Metals used for medical devices [an austenitic stainless steel, a cobalt (Co)-chromium (Cr)-molybdenum (Mo) alloy, a titanium (Ti)-6 aluminum (Al)-4 vanadium (V) alloy, a Ti-6Al-7 niobium (Nb) alloy, a Tinickel (Ni) alloy, and commercially pure Ti] were immersed into a platelet-rich plasma solution for 5 or 20 min, and platelet adhesion and aggregation on the surfaces were observed using a scanning electron microscope. The platelet adhesion level on each metal after 5 min of immersion in a platelet-rich plasma solution was the smallest in this order: stainless steel

Diabetes mellitus is a risk factor for mild cognitive impairment (MCI) and dementia. However, how the clinical characteristics of MCI patients with type 2 diabetes mellitus are linked to sarcopenia and/or its criteria remain to be elucidated. Japanese patients with type 2 diabetes mellitus were categorized into the MCI group for MoCA-J (the Japanese version of the Montreal cognitive assessment) score <26, and into the non-MCI group for MoCA-J ≥26. Sarcopenia was defined by a low skeletal mass index along with low muscle strength (handgrip strength) or low physical performance (walking speed <1.0 m/s). Univariate and multivariate-adjusted odds ratio models were used to determine the independent contributors for MoCA-J <26. Among 438 participants, 221 (50.5%) and 217 (49.5%) comprised the non-MCI and MCI groups, respectively. In the MCI group, age (61 ± 12 vs. 71 ± 10 years, p < 0.01) and duration of diabetes mellitus (14 ± 9 vs. 17 ± 9 years, p < 0.01) were higher than those in the non-MCI group. Patients in the MCI group exhibited lower hand grip strength, walking speed, and skeletal mass index, but higher prevalence of sarcopenia. Only walking speed (rather than muscle loss or muscle weakness) was found to be an independent determinant of MCI after adjusting for multiple factors, such as age, gender, body mass index (BMI), duration of diabetes mellitus, hypertension, dyslipidemia, smoking, drinking, estimated glomerular filtration rate (eGFR), HbA1c, and history of coronary heart diseases and stroke. In subgroup analysis, a group consisting of male patients aged ≥65 years, with BMI <25, showed a significant OR for walking speed. This study showed that slow walking speed is a sole determinant criterion of sarcopenia of MCI in patients with type 2 diabetes mellitus. It was suggested that walking speed is an important factor in the prediction and prevention of MCI development in patients with diabetes mellitus.

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