ObjectiveThe chronic kidney disease (CKD) is widely diagnosed on the basis of albuminuria and the glomerular filtration rate. A more precise diagnosis of CKD, however, requires the assessment of other factors. Urinary adiponectin recently attracted attention for CKD assessment, but evaluation is difficult due to the very low concentration of urinary adiponectin in normal subjects.Research design and methodsWe developed an ultrasensitive ELISA coupled with thionicotinamide-adenine dinucleotide cycling to detect trace amounts of proteins, which allows us to measure urinary adiponectin at the subattomole level. We measured urinary adiponectin levels in 59 patients with diabetes mellitus (DM) and 24 subjects without DM (normal) to test our hypothesis that urinary adiponectin levels increase with progression of CKD due to DM.ResultsThe urinary adiponectin levels were 14.88±3.16 (ng/mg creatinine, mean±SEM) for patients with DM, and 3.06±0.33 (ng/mg creatinine) for normal subjects. The threshold between them was 4.0 ng/mg creatinine. The urinary adiponectin levels increased with an increase in the CKD risk. Furthermore, urinary adiponectin mainly formed a medium-molecular weight multimer (a hexamer) in patients with DM, whereas it formed only a low-molecular weight multimer (a trimer) in normal subjects. That is, the increase in urinary adiponectin in patients with DM led to the emergence of a medium-molecular weight form in urine.ConclusionsOur new assay showed that urinary adiponectin could be a new diagnostic index for CKD. This assay is a non-invasive test using only urine, thus reducing the patient burden.

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Objectives This study investigated the relationship between oral high-risk HPV (HR HPV) infection and sexual behavior in Japanese medical professionals. Materials and methods We collected oral specimens and a self-administered questionnaire from 234 men and 171 women. Results The oral HR HPV infection prevalence was 4.7% (95% confidence interval [CI]: 3.0-7.2]) overall, 7.3% (95% CI: 4.6-11.3) for men, and 1.2% (95% CI: 0.3-4.2) for women. The number of sex partners had a significant influence on this prevalence, with variation by type of sexual behavior. The prevalence of oral HR HPV infection was significantly higher (p < 0.0001) among those with more than 20 lifetime overall sex partners (23.8%, 95% CI: 13.5-38.5) or oral sex partners (25.0%, 95% CI: 14.2-40.2). In terms of the number of vaginal sex partners, the prevalence was approximately the same for those with 6-10 (8.3%, 95% CI: 3.9-17.0), 11-20 (11.1%, 95% CI: 5.2-22.2), or more than 20 (11.5%, 95% CI: 4.0-29.0) partners (p = 0.0043). Furthermore, dividing the number of vaginal and oral sex partners into four categories (both>5, only vaginal>5, only oral>5, and both≤5), the infection prevalence was significantly higher when both vaginal and oral sex partners were more than five (12.5%, 95% CI: 7.7-19.6). The prevalence was also higher for those who had more oral than vaginal partners, compared with other groups (13.5%, 95% CI: 6.7-25.3). Conclusions and clinical relevance Oral HR HPV infection in Japan seems to be influenced by sexual behavior, and preventive health efforts such as vaccination and health education should be implemented.

The pulley-type heat-engine using a shape memory alloy (SMA), which is consisted of pulleys and a coil or a liner shaped SMA element, is one of the representative SMA heat-engines for recovering low-temperature exhaust heat energy. However, the output-power of pulley-type SMA engines tends to reduce due to the cooling insufficiency of the SMA element because the main cooling method of this engine is air cooling. Furthermore, the reduction in size of the mechanism of this engine is incompatible with augmentation of the power output. For improvement of the cooling efficiency and output power, we propose the use of a tape-shaped SMA element and invented a new cooling system contained in the pulley. By using this system, the mechanism of pulley-type SMA heat-engine can be made compact and temperature stability of the SMA elements during operation is achieved. Results of the experiment show the peak output power to be approximately equal regardless of the presence/absence of operation of the cooling system. However, the output power of the engine without cooling decreases to less than half of the maximum power due to overheating during operating. On the other hand, the decrement of engine output during operation is suppressed by approximately 10 %, by the operation of cooling system. Furthermore, the optimal inter-shaft distance of pulleys is shortened by the cooling system. This tendency is caused by the transformation ability improvement of the SMA element due to the improvement in cooling efficiency.Key words: shape memory alloy, pulley-type heat-engine using shape memory alloy, cooling system INTRODUCTIONThe recovery method of low-temperature exhaust heat energy (less than 373 K) is not well-established because the energy conversion efficiency of the low-temperature exhaust is less than 10 %.Ti-Ni based shape memory alloys (SMA) are well known as functional materials which show shape recovery and superelastic characteristics [1][2][3][4] . Since Ti-Ni based SMA work by heating from heat sources less than 373 K and show a large recovery force (approximately 10 6 J/m 3 ) [5] , SMA are capable of being applied as the driving element for a heat-engine for energy recovery from low-temperature thermal energy.In previous research, several SMA heat-engines have been produced and researched. One of the representative SMA heat-engine is a pulley-type SMA engine [6,7] as shown in Fig.1. The SMA element of this engine is wire rods memorized to straight liner or coil shape, and made into a hoop by welding. When the SMA is put in hot water, the SMA element recovers to linear shape and produces a recovery force. The tangential component of the recovery force rotates pulleys (generates torque) by the friction with the pulley, and the SMA element moves to the opposite pulley. Here the SMA element is cooled in the air and deformed again by the generating power of other part (heated part) of SMA element. Since these actuations are performed consecutively, this mechanism