Shiga University

Adropin is a 43-amino acid peptide that is highly conserved among mammals. First identified in the mouse liver in 2008, adropin is broadly expressed throughout the body and has been implicated in various pathological conditions, including obesity, altered food intake, insulin resistance, glucose intolerance, and other disorders related to energy metabolism. However, its precise physiological role remains unclear. In this study, we developed a specific competitive enzyme-linked immunosorbent assay (ELISA) for adropin using an in-house generated anti-adropin polyclonal antibody. We then examined plasma adropin levels in mice under different energy metabolic conditions: fed a normal diet, subjected to short-term fasting, and fed a long-term high-fat diet. In addition, we assessed hepatic and hypothalamic expression of Enho mRNA, which encodes adropin. We observed a wide range of plasma adropin levels, spanning from those in normal healthy mice on a high-fat diet to preclinical and obese diabetic mice. Both plasma adropin concentrations and hepatic Enho mRNA expression increased in response to feeding and high-fat diet intake. Multiple regression analysis revealed a significant negative correlation between plasma adropin and plasma glucagon concentrations. These findings suggest that adropin secretion is modulated by the peripheral hormone glucagon and may contribute to the maintenance of energy metabolic homeostasis. In conclusion, the ELISA developed in this study provides a useful and reliable tool for investigating the mechanisms underlying energy metabolism.

While severe traumatic brain injury (TBI) faces an increased risk of venous thromboembolism (VTE), pharmacological VTE prophylaxis might be significantly delayed because of concerns for TBI progression. We aimed to assess practice variations in the rate and timing of VTE prophylaxis for adolescent patients with severe TBI between different trauma center types.

This retrospective cohort study using the American College of Surgeon Trauma Quality Improvement Program database (2017–2021) included patients aged 14 to 18 years with severe TBI. Trauma centers were classified as follows: adult trauma center (ATC), mixed trauma center (MTC), and pediatric trauma center (PTC). We developed a multilevel mixed-effect Poisson regression model to assess the association between trauma center type and the rate and timing of VTE prophylaxis. Effect sizes for fixed effects were reported as adjusted incidence rate ratio (aIRR) with 95% confidence interval (CI). Secondary outcomes included the incidence of VTE and late neurosurgical interventions (>72 hours).

Of 7,238 eligible patients, pharmacological VTE prophylaxis was performed in 63.1% at ATC, 59.0% at MTC, and 28.5% at PTC. The median time to the initial prophylaxis was 4 days at ATC, 4 days at MTC, and 6 days at PTC (p < 0.001). In the regression model, treatment at MTC and PTC was associated with decreased likelihood of VTE prophylaxis (aIRR, 0.89 [95% CI, 0.80–0.97] and aIRR, 0.39 [95% CI, 0.32–0.47]) compared with ATC. Treatment at PTC was associated with higher odds of VTE events (odds ratio, 2.04; 95% CI, 1.16–3.60), while there was no significant difference in the rate of late neurosurgical interventions between ATC and PTC (odds ratio, 1.18; 95% CI, 0.68–2.05).

We observed significant practice variations in the use of pharmacological VTE prophylaxis for adolescent patients with severe TBI between ATC, MTC, and PTC. Further research is warranted to investigate potential drivers of these variations and develop standardized protocols.

Therapeutic/Care management; Level III.

The objective of this study was to understand the descriptive epidemiology of childhood tuberculosis (TB) in Japan under the 2013 Bacillus Calmette-Guérin (BCG) immunization program modification. The median percentage of annual vaccination coverage for infants aged <13 months was 97.0 % during follow-up (2007-2022). The age at which most infants received their vaccinations was 3 months before 2013 and 5 months after 2013. During follow-up, the number of childhood TB notifications and annual incidence declined by approximately 60 % and 40 %, respectively. A multivariate-adjusted model analysis was performed by birth year to determine the association between childhood TB and the 2013 BCG immunization program modification. However, childhood TB was associated with age and BCG vaccination history but not with the 2013 BCG immunization program modification. This study represents a valuable resource for future research, elucidating the efficacy of BCG as well as the impact of BCG policies.