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Development of coastal areas in Japan for various land uses since the 1960s has contributed to industrial upgrades and improved the efficiency of transportation networks. However, there are concerns about the vulnerability of developments on alluvial plains and reclaimed lands to geological events, like ground subsidence due to liquefaction during large earthquakes. Realistic assessment of earthquake and tsunami hazards and evaluation of possible countermeasures require accurate estimation of the amount of subsidence that can be expected from liquefaction at coastal and riverside sites supporting various structures. In this study, to evaluate the amount a river embankment structure might be expected to settle as a result of strong motion from an assumed Nankai Trough great earthquake, we conducted a numerical simulation using the soil–water coupled finite deformation analysis code GEOASIA. We then investigated the effect of the estimated embankment subsidence on tsunami inundation, which was simulated by using nonlinear shallow-water equations and a grid spacing as fine as 3.3 m. The influence of urban structures on the inundated area was taken into account by using a structure-embedded elevation model (SEM). The results showed that subsidence of river embankments and the collapse of parapet walls on top of them would increase both the depth and area of inundation caused by a tsunami triggered by a Nankai Trough scenario earthquake. Our findings underscore the importance of evaluating not only earthquake resistance but also vulnerability of coastal and riverside structures to strong motion in tsunami hazard analyses. Furthermore, the importance of tsunami inundation analysis using a SEM for predicting the behavior of tsunami flotsam in urban areas was demonstrated. [ABSTRACT FROM AUTHOR]

The southern Kuril Trench is one of the most seismically active regions in the world. In this study, marine surveys and observations were performed to construct fault models for possible outer-rise earthquakes. Seismic and seafloor bathymetric surveys indicated that the dip angle of the outer-rise fault was approximately 50°–80°, with a strike that was slightly oblique to the axis of the Kuril Trench. The maximum fault length was estimated to be ~ 260 km. Based on these findings, we proposed 17 fault models, with moment magnitudes ranging from 7.2 to 8.4. To numerically simulate tsunami, we solved two-dimensional dispersive wave and three-dimensional Euler equations using the outer-rise fault models. The results of both simulations yielded identical predictions for tsunami with short-wavelength components, resulting in significant dispersive deformations in the open ocean. We also found that tsunami generated by outer-rise earthquakes were affected by refraction and diffraction because of the source location beyond the trench axis. These findings can improve future predictions of tsunami hazards. [ABSTRACT FROM AUTHOR]

Objectives: To examine real‐world characteristics, journey, and outcomes among patients with locoregional, nonmetastatic renal cell carcinoma (RCC). Methods: A retrospective analysis of medical records from the ConcertAI Oncology Dataset was performed on adults in the United States with newly diagnosed nonmetastatic RCC between January 2012–December 2017 who received surgical treatment, and were followed until August 2021. Patients were stratified based on the risk of recurrence after nephrectomy. Recurrence rate and survival outcomes were assessed. Results: The cohort (n = 439) had a median age of 64 years, 66.1% were male, and 76.5% had clear‐cell histology. The median follow‐up time from nephrectomy was 39.3 months overall, 41.0 months for intermediate‐high‐risk patients (n = 377; 85.9%) and 24.1 months for high‐risk patients (n = 62; 14.1%). For intermediate‐high‐ and high‐risk patients, respectively, 68.4% and 56.5% had ≥1 medical oncologist visit after nephrectomy. Of 260 patients with documentation of postoperative imaging assessments, 72% were ordered by medical oncologists, and the median time from initial nephrectomy to the first scan was 110 days (intermediate‐high‐risk) and 51 days (high‐risk). Provider‐documented recurrence occurred in 223 (50.8%) patients, of whom 41.7% had ≥1 medical oncologist visit before the recurrence. Three‐year disease‐free survival (DFS), and overall survival rates were 49.4% and 80.8% (all patients): 27.7% and 64.7% (high‐risk); and 52.9% and 83.3% (intermediate‐high‐risk). Conclusions: Our study reports low DFS after nephrectomy for patients with intermediate‐high‐ and high‐risk RCC. Subsequent approval and use of new and newly approved adjuvant therapeutic options could potentially delay or prevent recurrence. [ABSTRACT FROM AUTHOR]

PURPOSE: Treatment of non–muscle-invasive bladder cancer (NMIBC) is guided by risk stratification using clinical and pathologic criteria. This study aimed to develop a natural language processing (NLP) model for identifying patients with high-risk NMIBC retrospectively from unstructured electronic medical records (EMRs) and to apply the model to describe patient and tumor characteristics. METHODS: We used three independent EMR-derived data sets including adult patients with a bladder cancer diagnosis in 2011-2020 for NLP model development and training (n = 140), validation (n = 697), and application for the retrospective cohort analysis (n = 4,402). Deep learning methods were used to train NLP recognition of medical chart terminology to identify seven high-risk NMIBC criteria; model performance was assessed using the F1 score, weighted across features. An algorithm was then used to classify each patient as high-risk NMIBC (yes/no). Manually reviewed records served as the gold standard. RESULTS: The F1 scores after model training were >0.7 for all but one uncommon feature (prostatic urethral involvement). The highest area under the receiver operating curves (AUC) was observed for Ta (0.897) and T1 (0.897); the lowest AUC was for carcinoma in situ (CIS; 0.617). For high-risk NMIBC classification, positive predictive value was 79.4%, negative predictive value was 93.2%, and false-positive rate was 8.9%. Sensitivity and specificity were 83.7% and 91.1%, respectively. Of 748 patients manually confirmed as having high-risk NMIBC, 196 (26%) had CIS (of whom 19% also had T1 and 23% also had Ta disease); 552 tumors (74%) had no associated CIS. CONCLUSION: The NLP model, combined with a rule-based algorithm, identified high-risk NMIBC with good performance and will enable future work to study real-world treatment patterns and clinical outcomes for high-risk NMIBC. [ABSTRACT FROM AUTHOR]

Introduction: Metastatic urothelial carcinoma (mUC) has poor prognosis. A high unmet need exists for novel treatment for those who are unfit for platinumbased chemotherapy. Methods: We aimed to describe real-world temporal changes in patient characteristics and 1L treatment selection for mUC patients in the United States following the approval of anti-PD-1/L1 treatments. This study was a retrospective, observational study using anonymized and structured oncology electronic medical record (EMR) data from IQVIA and the US Oncology Network iKnowMed (USON). Results: After approval of 1L anti-PD-1/L1 treatment for mUC, there is a marked increase in the use of 1L anti-PD-1/L1 monotherapies, accompanied by a proportional decrease in 1L platinum-based treatments and non-guidelinebased therapy; particularly among the elderly (> 75 years) and those with poor ECOG performance status (ECOG PS 2+). Discussion: Anti-PD-1/L1 monotherapies fulfill the prior unmet need of frail mUC patients who are ineligible for platinum-based therapies. [ABSTRACT FROM AUTHOR]

We present a novel method for coastal tsunami prediction utilizing a denoising autoencoder (DAE) model, one of the deep learning algorithms. Our study focuses on the Tohoku coast, Japan, where dense offshore bottom pressure gauges (OBPGs), called S-net, are installed. To train the model, we generated 800 hypothetical tsunami scenarios by employing stochastic earthquake models (M7.0–8.8). We used synthetic tsunami waveforms at 44 OBPGs as input and the waveforms at four coastal tide gauges as output. Subsequently, we evaluated the model's performance using 200 additional hypothetical and two real tsunami events: the 2016 Fukushima earthquake and 2022 Tonga volcanic tsunamis. Our DAE model demonstrated high accuracy in predicting coastal tsunami waveforms for hypothetical events, achieving an impressive quality index of approximately 90%. Furthermore, it accurately forecasted the maximum amplitude of the 2016 Fukushima tsunami, achieving a quality index of 91.4% at 15 min after the earthquake. However, the prediction of coastal waveforms for the 2022 Tonga volcanic tsunami was not satisfactory. We also assessed the impact of the forecast time window and found that it had limited effects on forecast accuracy. This suggests that our method is suitable for providing rapid forecasts soon after an earthquake occurs. Our research is the first application of an artificial neural network to tsunami prediction using real observations. In the future, we will use more tsunami scenarios for model training to enhance its robustness for different types of tsunamis. [ABSTRACT FROM AUTHOR]

A Markov-based cost-effectiveness model was developed to project long-term effectiveness and costs among patients who undergo nephrectomy for renal cell carcinoma and receive either adjuvant pembrolizumab, adjuvant sunitinib, or routine surveillance alone (no adjuvant treatment). Over a lifetime horizon, pembrolizumab was estimated to prolong quality-adjusted life expectancy and be cost-effective relative to both comparator treatment strategies. Introduction: Pembrolizumab was recently approved as an adjuvant treatment of renal cell carcinoma (RCC), based on prolonged disease-free survival compared to placebo in the phase III KEYNOTE-564 trial. The objective of this study was to evaluate the cost-effectiveness of pembrolizumab as monotherapy in the adjuvant treatment of RCC post-nephrectomy, from a US health sector perspective. Patients and Methods: A Markov model with 4 health states (disease-free, locoregional recurrence, distant metastases, and death) was developed to compare the cost and effectiveness of pembrolizumab versus routine surveillance or sunitinib. Transition probabilities were estimated using patient-level KEYNOTE-564 data (cutoff: June 14, 2021), a retrospective study, and published literature. Costs of adjuvant and subsequent treatments, adverse events, disease management, and terminal care were estimated in 2022 US$. Utilities were based on EQ-5D-5L data collected in KEYNOTE-564. Outcomes included costs, life-years (LYs), and quality-adjusted LYs (QALYs). Robustness was assessed through one-way and probabilistic sensitivity analyses. Results: Total cost per patient was $549,353 for pembrolizumab, $505,094 for routine surveillance, and $602,065 for sunitinib. Over a lifetime, pembrolizumab provided gains of 0.96 QALYs (1.00 LYs) compared to routine surveillance, yielding an incremental cost-effectiveness ratio of $46,327/QALY. Pembrolizumab dominated sunitinib with 0.89 QALYs (0.91 LYs) gained while saving costs. At a $150,000/QALY threshold, pembrolizumab was cost-effective versus both routine surveillance and sunitinib in 84.2% of probabilistic simulations. Conclusion: Pembrolizumab is projected to be cost-effective as an adjuvant RCC treatment versus routine surveillance or sunitinib based on a typical willingness-to-pay threshold. [ABSTRACT FROM AUTHOR]

In this study, the effects of critical depth of cut and wheel wear were investigated to realize efficient precision grinding of CVD-SiC by ductile mode grinding at low cost. To compare the results under experimental conditions, Vickers indentation tests and grinding experiments were conducted. As a result of the Vickers indentation test at an applied load of 0.015 N, the minimum indentation load in this study, the indentation depth was 1.3 μm, and cracks were observed at the corners of the indentation isotropically. Additionally, the pile-up was observed around the indentation, suggesting that plastic deformation due to shear flow was relatively large. Grinding experiments were conducted using grinding wheels with different grain sizes. All the grinding conditions in this study resulted in a surface with a mixture of brittle and ductile modes. The proportion of ductile modes was larger, and the surface roughness Ra was smaller when a grindstone with a smaller grain size was used. Additionally, the effect of wear was investigated. As wear progressed, the number of protruding grains decreased, resulting in a smaller surface roughness. These results indicate that the amount of protruding abrasive grains must be controlled to achieve stable ductile mode grinding. [ABSTRACT FROM AUTHOR]

The effects of the ambient temperature and relative humidity on crack propagation behavior during wheel scribing were investigated. A chamber was built to allow dynamic observation of crack propagation behavior in a controlled atmosphere. A developed miniature scriber was installed in the chamber, and the crack propagation behavior was observed from lateral and back sides during wheel scribing under various atmospheric conditions. As a result, the median crack propagation rate increased with relative humidity. We speculated that this was caused by the stress corrosion of glass. Although stress corrosion is considered to be more reactive at higher temperatures, the results of scribing at different temperatures showed that higher temperatures did not necessarily increase median crack propagation. This is due to the formation of lateral cracks before the median cracks have fully propagated. These results suggest that the interaction between multiple cracks should be considered when discussing the effects of temperature and humidity in wheel scribing. [ABSTRACT FROM AUTHOR]

We examined whether it is possible to estimate the tsunami source model of the 2011 Tohoku-Oki earthquake from a comparison of numerical simulations of tsunami propagation and sediment transport, the measured trace heights, and the sediment thickness of tsunami deposits. Twelve models with different subfault numbers were prepared based on a reference model inferred from tsunami waveform inversion. The reference model with 55 subfaults considering rupture propagation and the model with instantaneous slip successfully reproduced both the tsunami trace heights and sediment thickness distribution of tsunami deposits in the Idagawa Lowland and Sendai Plain. Other models with the same moment magnitude but fewer subfaults could not reproduce the observed trace heights, and the reproducibility of sediment thickness distribution strongly depended on the slip distribution. Models with increased slip amounts and moment magnitude could reproduce the trace heights; however, the simulated sediment thickness was underestimated for the Idagawa Lowland while overestimated for the Sendai Plain. Our results indicate that the combination of trace heights, sediment thickness of tsunami deposits, and numerical simulations of tsunami propagation and sediment transport can be used to estimate historical earthquakes and tsunamis. Efforts should be made to increase the number of subfaults for the study of historical events, although the obtained solutions may not be unique because of fewer trace heights or tsunami deposit data. [ABSTRACT FROM AUTHOR]

The island of Sulawesi, Indonesia, is located in a complex and tectonically active region, and has experienced tsunamis in the past. One of the major earthquake and tsunami events was the 23 February 1969 event that struck the Majene region in western Sulawesi Island. Interpretation of the historical accounts revealed that the Mw 7.0 earthquake generated strong intensity up to VIII on the Modified Mercalli Intensity scale. The earthquake was followed by an unusually high tsunami of 4 m that rapidly decayed within 25 km from the highest observation site. Hypocentre and earthquake mechanism analyses confirmed that it was an inland earthquake with a thrust mechanism. Ground motion modelling is able to reproduce the earthquake intensity but earthquake scenarios are unable to reconstruct the tsunami observations. A plausible solution to explain the tsunami report is from a combined scenario of an earthquake and a submarine mass failure of 0.5 km 3 . [ABSTRACT FROM AUTHOR]

High‐frequency (HF) radar monitors the sea surface current velocity and provides information for tsunami early warning. SeaSondeR, an HF ocean radar system in the eastern Tsugaru Strait, Japan, measured the tsunami‐induced current velocity during the 2022 Tonga volcanic tsunami. As an air‐coupled tsunami, the generating mechanism was complex, making it difficult to predict coastal tsunamis using traditional early warning methods. We adopted the tsunami data assimilation (DA) approach, which reconstructs the tsunami wavefield using offshore data and does not require source information, to forecast the coastal tsunami waveforms. Observations from the HF radar and offshore bottom pressure gauges (OBPGs) were used as the input for tsunami DA. The assimilation process started at 09:00 (UTC, hereafter) and forecasts were made at 14:00 and 15:00. The surface current velocity recorded by the HF radar reached the maximum (∼0.25 m/s) at 13:00, which corresponded to a negative phase of ∼2 cm sea level variation observed by OBPGs. We compared the forecasted waveforms with the observed waveforms at Hakodate and Shimokita tide gauges. The assimilation results obtained using HF radar showed a better performance in tsunami forecasting than those using OBPG in this case study. At 14:00, the forecasting accuracy indices were 91% and 67% for the next 2 and 6 hr, respectively. At 15:00, it was 63% and 70% for the next 2 and 6 hr, respectively. We suggest that HF radar could be a good supplement to OBPG for tsunami early warning purposes. Plain Language Summary: On 15 January 2022, the eruption of the Hunga Tonga–Hunga Ha'apai volcano generated a tsunami that arrived in Japan. The tsunami was detected by a high‐frequency (HF) ocean radar system in the eastern Tsugaru Strait. The HF radar recorded the velocity of tsunami‐induced sea surface currents. We used these velocity data to forecast the tsunami waveforms at coastal tide gauge stations. The forecast method, called tsunami data assimilation, does not require tsunami source information but accurately forecasts the coastal tsunami waveforms. We demonstrate that the HF radar data can be successfully applied to tsunami early warning systems. Key Points: High‐frequency (HF) radar observed surface current velocity in the eastern Tsugaru Strait during the 2022 Tonga volcanic tsunamiHF radar observations were used for data assimilation to forecast tsunami waveforms at coastal tide gaugesThe assimilation results using HF radar had an accuracy of over 63% for Hakodate and Shimokita tide gauges [ABSTRACT FROM AUTHOR]

Ceftriaxone is a third‐generation cephalosporin commonly used to treat infection. However, encephalopathy is an emerging adverse effect of ceftriaxone infusion. These patients present with various symptoms, including those of neurotoxicity, that typically resolve 1 week after discontinuation of ceftriaxone. We experienced two cases of ceftriaxone‐induced encephalopathy that were successfully treated by rapid removal of ceftriaxone by hemoperfusion. [ABSTRACT FROM AUTHOR]

Researchers have developed tsunami inundation models based on nonlinear shallow water equations to estimate tsunami propagation and inundation. However, their empirical results are not in perfect agreement with those of other research institutes, even though the same governing equations are used. Therefore, we quantitatively evaluated the variability of tsunami simulations in this study. Several research institutes have conducted tsunami simulations under the same input conditions using tsunami inundation models adopted for tsunami hazard assessment, resulting in a certain degree of variability among them. By examining the spatial and temporal differences in various physical quantities, we identified the characteristic topography where the variability between tsunami simulations increases. A novel method for calculating statistics from the area integrals of physical quantities was proposed to demonstrate the variability in the overall simulation results. In addition, the effects of different setting parameters and computational environments on the simulation results of a single model were evaluated. The findings of this study are expected to not only serve as a basis to verify the reliability of source codes employed by users of the tsunami inundation model, but also contribute useful technical information to advance probabilistic tsunami hazard assessment in the future. [ABSTRACT FROM AUTHOR]

The ocean floor network system for earthquakes and tsunamis is one of the effective tools for the early detection of large earthquakes on plate boundaries and the tsunamis they generate. The Dense Oceanfloor Network system for Earthquakes and Tsunamis (DONET) was installed in the first rupture areas of the 1944 Tonankai and 1946 Nankai earthquakes. The DONET around the Nankai Trough, a site of huge earthquakes that have caused severe damage, has the potential to detect the genesis of a tsunami. We developed a real-time tsunami prediction system for local communities that takes advantage of the features of DONET, and we have already made it available to several local governments and a commercial company. The outputs of the prediction are the tsunami arrival time, its height, its inundation area, and inundation depth. The system makes real-time monitoring of tsunamis possible. The system should be conceptually applicable to the Nankai Trough area, which has characteristics consistent with the assumptions the system makes about tsunami propagation, crustal activities, and coastal communities. Here, we describe the conceptual basis of the system, the features used to ensure the accuracy of predictions, and the policies used to develop and implement them. [ABSTRACT FROM AUTHOR]

Tsunami-related fires may occur in the inundation area during a huge tsunami disaster, and woody debris produced by the tsunami can cause the fires to spread. To establish a practical method for evaluating tsunami-related fire predictions, we previously developed a method for evaluating the tsunami debris thickness distribution that uses tsunami computation results and static parameters for tsunami numerical analysis. We then used this evaluation method to successfully reproduce the tsunami debris accumulation trend. We then developed an empirical building fragility function that relates the production of debris not only to inundation depth but also to the topographic gradient and the proportion of robust buildings. Using these empirical evaluation models, along with conventional tsunami numerical analysis data, we carried out a practical tsunami debris prediction for Owase City, Mie Prefecture, a potential disaster area for a Nankai Trough mega-earthquake. This prediction analysis method can reveal hazards which go undetected by a conventional tsunami inundation analysis. These results indicate that it is insufficient to characterize the tsunami hazard by inundation area and inundation depth alone when predicting the hazard of a huge tsunami; moreover, more practically, it is necessary to predict the hazard based on the effect of tsunami debris. [ABSTRACT FROM AUTHOR]

We estimated the time difference between the 1854 CE Ansei–Tokai and Ansei–Nankai earthquakes from tidal records of two tide gauge stations (San Francisco and San Diego) on the west coast of North America. The first signals of the Ansei–Tokai tsunami were apparent, whereas those of the Ansei–Nankai tsunami were obscured by the later waves of the Ansei–Tokai tsunami. Waveforms of the Ansei–Nankai tsunami simulated with nonlinear dispersive wave theory by assuming an origin time of 07:00 GMT on 24 December arrived earlier than in the observations. The normalized root mean square and the misfit between the simulated and observed waveforms of the Ansei–Nankai tsunami showed a time difference between them of approximately 0.4 h. This finding suggests that the actual origin time of the Ansei–Nankai tsunami was approximately 07:24 GMT on 24 December. A previous study estimated the origin time of the Ansei–Tokai tsunami to be about 00:30 GMT on 23 December. Thus, we concluded that the time difference between the 1854 CE Ansei–Tokai and Ansei–Nankai tsunamis was 30.9 h. Despite the significant difference in the time resolution between the seasonal timekeeping system used in Japan in 1854 and waveform digitization, our result is roughly in agreement with historical descriptions of the tsunamis, suggesting that such information can be effectively used to determine the origin times of historical earthquakes. [ABSTRACT FROM AUTHOR]

Although tsunamis are dispersive water waves, hazard maps for earthquake-generated tsunamis neglect dispersive effects because the spatial dimensions of tsunamis are much greater than the water depth, and dispersive effects are generally small. Furthermore, calculations that include non-dispersive effects tend to predict higher tsunamis than ones that include dispersive effects. Although non-dispersive models may overestimate the tsunami height, this conservative approach is acceptable in disaster management, where the goal is to save lives and protect property. However, we demonstrate that offshore frequency dispersion amplifies tsunamis caused by outer-rise earthquakes, which displace the ocean bottom downward in a narrow area, generating a dispersive short-wavelength and pulling-dominant (water withdrawn) tsunami. We compared observational evidence and calculations of tsunami for a 1933 Mw 8.3 outer-rise earthquake along the Japan Trench. Dispersive (Boussinesq) calculations predicted significant frequency dispersion in the 1933 tsunami. The dispersive tsunami deformation offshore produced tsunami inundation heights that were about 10% larger than those predicted by non-dispersive (long-wave) calculations. The dispersive tsunami calculations simulated the observed tsunami inundation heights better than did the non-dispersive tsunami calculations. Contrary to conventional practice, we conclude that dispersive calculations are essential when preparing deterministic hazard maps for outer-rise tsunamis. [ABSTRACT FROM AUTHOR]

The detailed understanding of tsunami hazard risk using numerical simulations requires a numerical model that can accurately predict tsunami inundation phenomena on land. In such models, the structural effects are indirectly considered using the variation of bottom roughness as a proxy for the differences in building densities. Only a few studies have conducted intermodel tests to investigate tsunami inundation in complex coastal urban cities. During the tsunami analysis hackathon held in September 2020, eight research groups met to have a detailed discussion on the current urban inundation problems. In this study, we conducted an intermodel comparison of the numerical tsunami models, using the data from physical experiments that were performed on a detailed urban model. Our objective was to investigate the necessary conditions of an accurate numerical model based that can ensure high reproducibility and practicality. It was confirmed that the accuracy of topographic data is an important parameter for tsunami inundation simulations in complex urban areas. Based on the computational cost and accuracy, we suggest that a resolution of 1 cm of topographic data is a sufficient condition for tsunami inundation simulations on 1/250 scale model. [ABSTRACT FROM AUTHOR]

In 2018, the US Food and Drug Administration (FDA) limited the indication for immune checkpoint inhibitors (ICI) in metastatic bladder cancer to patients with programmed cell death protein ligand-1 (PD-L1)–positive tumors. The impact of the label change on survival outcomes remains unknown. We conducted a controlled interrupted time series analysis using a nationwide electronic health record–derived oncology dataset. We used Cox regression to compare mortality in the post- vs prelabel change periods among affected (initiators of ICI or carboplatin-based chemotherapy) vs unaffected (initiators of cisplatin-based chemotherapy) patients. The use of ICI, carboplatin, and cisplatin was similar pre- and postlabel change, but PD-L1 testing increased postlabel change. In adjusted models, survival did not differ after the FDA label change policy compared with prior to the label change in any of the groups. The FDA label restriction on immunotherapy was associated with increased PD-L1 testing but not with changes in treatment patterns or mortality among patients with metastatic bladder cancer. [ABSTRACT FROM AUTHOR]

The recycling ratio of construction sludge in Japan has gradually increased over the past 20 years. However, the increase in this ratio has become marginal. One of the main reasons for the stagnation is the alkalinity of the recycled sludge after treatment, as alkaline construction sludge can impact the environment owing to factors such as alkali leaching. Therefore, this study explored whether the neutralization of alkaline construction sludge can be accelerated with a controlled CO 2 concentration during the production of recycled soils at recycling plants. A CO 2 incubator was introduced in the laboratory to accelerate the neutralization of the alkaline sludge to investigate the effects of the initial water content and the layer thickness of the sludge on the neutralization process. The effects of the degree of CO 2 concentration on the process were also examined, as were the contributions of other factors to the neutralization rate. First, the mixture conditions were explored to simulate alkaline construction sludge having a wide range of pH values (hydrogen-ion exponent) to investigate the effects of the initial pH on the neutralization rate. The results revealed that the neutralization rate of simulated alkaline sludge subjected to atmospheric curing was affected by the initial pH. Sludge with high alkalinity, such as a pH of 11 or 12, cannot fall below the upper limit of the pH regulated by the water pollution prevention act even after a dozen days. Consequently, sample surveys were conducted to capture the variation in the pH of actual construction sludge at several intermediate treatment facilities. The sample surveys showed that the pH of the sludge samples, which were in an either solid or semi-solid state, fell in the range of 6.9–13.0, with the samples having a pH of around 11 being dominant. Therefore, CO 2 curing using a CO 2 incubator was implemented in the laboratory on alkaline sludge that simulated the characteristics observed in the sample surveys. The laboratory test results revealed that, at a constant sludge height, a higher CO 2 concentration increased the neutralization rate of the alkaline sludge. However, the contribution of the CO 2 concentration to the acceleration of the neutralization decreased with a reduction in the initial water content. The test results also suggested that the contribution of the initial water content to the acceleration of the neutralization was more dominant than that of the sludge height for the present experimental conditions. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the feasibility of a combination therapy of photodynamic therapy (PDT) and airway stent placement using a transparent silicone stent (gold studded stent [GSS]). Laser irradiation (664 nm, continuous wave) was performed through the GSS using a straight and cylindrical fiber 1.0 cm away from a power meter. There are two types of GSS: the TD type for the trachea and the BD type for the bronchus. Laser outputs were set to 150 mW, 180 mW, 210 mW, 240 mW, 270 mW, and 300 mW. The laser powers passing through the both types of GSS were measured three times for each outputs and the averages were calculated. Based on the results, animal experiment was performed using two female pigs. Under general anesthesia, a GSS (BD type) was inserted into trachea of pigs, and PDT using NPe6 as a photosensitizer was performed by 100 J/cm2 laser irradiation on parts of the trachea with and without a GSS. Immediately after and 1 week after PDT, pig tracheas were harvested and histological analysis was performed. Histological analysis of areas with or without the stent showed edematous changes between the cartilage and submucosal layer immediately after PDT, and necrotic changes 1 week later. The effectiveness of NPe6-PDT for pigs' trachea covered by the stent was same as trachea without the stent. The use of a GSS may enable PDT to be effective even in the area covered by the stent. [ABSTRACT FROM AUTHOR]

Background: The open-label, randomized, active-controlled KEYNOTE-045 study (NCT02256436) showed that second-line pembrolizumab significantly improved overall survival (OS) of patients with advanced/metastatic urothelial cancer (UC) that progressed after first-line platinum-containing chemotherapy, compared with standard chemotherapy (paclitaxel, docetaxel, or vinflunine). Pembrolizumab is approved for patients with bladder cancer in Japan. Patients and methods: Analysis was performed in the subgroup of Japanese patients enrolled in the KEYNOTE-045 study. Coprimary end points were OS and progression-free survival (PFS). Objective response rate (ORR) and safety were secondary end points. Results: Fifty-two Japanese patients (pembrolizumab, n = 30; chemotherapy, n = 22) were followed up for a median of 26.1 months. Patients who received pembrolizumab compared with chemotherapy had a 19% lower risk for death (hazard ratio [HR] 0.81, 95% CI 0.44–1.50); after adjusting for baseline covariates, the HR for OS was 0.61 (95% CI 0.32–1.15). The 24-month OS rate was higher with pembrolizumab (26.9% vs 14.3%). PFS was 2.0 and 4.9 months for pembrolizumab and chemotherapy, respectively (HR 1.71, 95% CI 0.95–3.08). ORR was similar for pembrolizumab and chemotherapy (20.0% vs 18.2%); durability of response was higher with pembrolizumab: 67% and 33% of patients, respectively, maintained a response for > 12 months. Treatment-related adverse events, including grade 3–5 events, occurred less frequently with pembrolizumab. Conclusions: Pembrolizumab provided durable antitumor activity in patients with locally advanced/metastatic UC that progressed after platinum-containing chemotherapy in the overall population and in the Japanese subgroup; safety profile was consistent with that previously observed for pembrolizumab. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate epidermal growth factor receptor (EGFR) mutations as a prognostic factor for postoperative patients with positive EGFR mutations treated with postoperative platinum-based adjuvant chemotherapy (PBAC), and whether two common EGFR mutations exhibit different responses to PBAC. A total of 110 patients who underwent complete surgical resection were enrolled, and overall survival (OS) and disease-free survival (DFS) were investigated based on EGFR mutation status and PBAC. The 3 year OS rate in patient groups were as follows: Patients with EGFR mutations (MT) undergoing PBAC, 89.3%; MT patients without PBAC, 83.3%; wild-type (WT) patients with PBAC, 82.3%; and WT patients without PBAC, 62.2%. Statistically significant differences were observed between WT patients based on PBAC (P=0.026). No statistically significant differences were observed between MT patients with PBAC and MT patients without PBAC. On the basis of mutation subtypes, the 3 year OS rate of patient groups were as follows: Patients with in-frame deletions in exon19 (19 del) with PBAC, 92.3%; patients with 19 del without PBAC, 85.7%; patients with the point mutation L858R inexon21 (21L858R) with PBAC, 86.7%; and patients with 21L858R without PBAC, 81.5%; the respective 3-year DFS rates were 53.8, 14.3, 40.2 and 26.9%. Statistically significant differences were observed in the DFS rates in 19 del patients, which was dependent on PBAC (P=0.040). EGFR mutation-positive patients exhibited a decreased benefit from PBAC for increasing in survival rate compared with WT patients. It may be necessary to consider postoperative strategies based on EGFR mutations and their subtype in the future. [ABSTRACT FROM AUTHOR]

Carbon black (CB) particles were employed as a reinforcing filler in carboxyl‐terminated butadiene acrylonitrile rubber (CTBN)/epoxy resin (diglycidyl ether of bisphenol‐A (DGEBA))/aromatic diamine (diamino diphenyl methane (DDM)) network polymer blends. The strength, modulus, and ability to absorb impact energy of the resulting composites were evaluated. The aim of this work was to determine the effects of interfacial interactions between components, and processing conditions (especially temperature) on mechanical properties. The application of high temperatures during the kneading process resulted in strong interfacial interactions between the CB particles and the CTBN. The formation of strong bonds at the CB/CTBN interfaces during kneading was the key factor in obtaining high strength and high impact energy absorbance. The composites also exhibited good adhesive strength during both shear and peel stress tests. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Diabetes mellitus is a progressive disease with cardiovascular complications. This study evaluated the effects of liraglutide, a glucagon‐like peptide‐1 analogue and the dipeptidyl peptidase 4 inhibitors sitagliptin and linagliptin on cardiac function in type 2 diabetes patients with renal impairment. Materials and Methods: A total of 139 patients who were referred because of suboptimal glycaemic control were randomly assigned to liraglutide 0.9 mg/d (n = 45), sitagliptin 50 mg/d, (n = 49) or linagliptin 5 mg/d (n = 45) at enrolment and were evaluated. Blood glucose, glycosylated haemoglobin and serum creatinine were assayed every 3 months for 48 months. Echocardiography was performed every 12 months for 48 months. Results: Compared with baseline, fasting glucose, postprandial glucose, and systolic and diastolic pressure, but not estimated glomerular filtration rate, significantly decreased in all three groups. Albuminuria decreased from 24 to 48 months with liraglutide, but only from 24 to 30 months with sitagliptin and linagliptin. Diastolic function, assessed by E/e′ or left atrial dimension improved only with liraglutide. Conclusions: Liraglutide was effective for glucose and blood pressure control, reduced albuminuria and improved diastolic function. Diastolic function was not improved by sitagliptin and linagliptin. [ABSTRACT FROM AUTHOR]

Following the 2011 Tohoku earthquake, coastal forests dissipated the energy of the tsunami and trapped flotsam. Although studies have shown how trees dissipate flow energy and are damaged in the process, the factors determining the trapping of flotsam by lines of trees or their capacity to do so have not been quantitatively examined. Quantitative evaluation of these factors may lead to tree-based strategies for suppressing the secondary damage caused by tsunami flotsam. To increase the ability of trees to mitigate damage, their physical limitations need to be identified. Field surveys revealed that integrated clusters of flotsam were caught by trees even if individual floating objects were smaller than the distance between the trees. Hydraulic experiments revealed relations between physical factors and the capture of flotsam. From these relations, we derived a simple formula for evaluating the trapping capacity of lines of trees. The estimates from our model were consistent with the actual results of the 2011 tsunami in Tagajo city, Miyagi prefecture, where trees did not topple under the forces applied by trapped flotsam. [ABSTRACT FROM AUTHOR]

We report a case of metachronous multiple lung adenocarcinoma at the cut-end, diagnosed 4 years after sublobar resection for adenocarcinoma in situ (AIS), on the basis of discordance of epidermal growth factor receptor ( EGFR) mutation status between the first and second tumor. The patient was an 81-year-old Japanese man, whose chest computer tomography (CT) scan showed mixed ground-glass opacity in the right upper lobe of the lung. Wedge resection was performed and a diagnosis of AIS, non-mucinous (18 × 14 mm), with a margin of 6 mm, was made. A tumor at the cut-end was seen on a CT scan 4 years later, and abnormal uptake was identified by fluorine-18 fluorodeoxyglucose-positron emission tomography. Right upper lobectomy and lymph node dissection were performed and the tumor was diagnosed as invasive adenocarcinoma, acinar predominant. Discordance of EGFR mutation status between the first tumor, harboring exon 19 deletion, and the second tumor, having an L858R point mutation in exon 21, revealed that the second tumor was metachronous multiple lung cancer. This case demonstrates the necessity of comparing EGFR mutation status between the first tumor and the second tumor at the cut-end. [ABSTRACT FROM AUTHOR]

Solitary pulmonary capillary hemangioma ( SPCH) is a rare benign lung tumor that must be distinguished from small and early lung cancers. Here, we report a case of SPCH for which we performed frozen section diagnosis. The patient was a 55-year-old Japanese woman. Five years before the operation, mixed ground-glass opacity was detected by computed tomography in the left posterior basal segment of the lower lobe ( S10). Because the interior tumor density of the ground-glass opacity increased slightly, video-assisted thoracic surgery wedge resection was performed. Frozen section diagnosis revealed a benign tumor without proliferation of atypical epithelial cells. The tumor had narrow alveolar lumens, thickened alveolar septa and a clear boundary separating it from normal lung tissue. The proliferated lumens varied in size and were lined with single layers of flat cells. After the operation, immunohistochemical staining of a paraffin section revealed that the thickened alveolar septa resulted from the proliferation of capillary vessels, the flat cells of which were positive for CD31 and CD34 and negative for podoplanin; the tumor was diagnosed as SPCH. Here, we discuss the pathological features of SPCH on frozen sections with reference to this case and review previous related reports. [ABSTRACT FROM AUTHOR]

A large amount of buildings was damaged or destroyed by the 2011 Great East Japan tsunami. Numerous field surveys were conducted in order to collect the tsunami inundation extents and building damage data in the affected areas. Therefore, this event provides us with one of the most complete data set among tsunami events in history. In this study, fragility functions are derived using data provided by the Ministry of Land, Infrastructure and Transportation of Japan, with more than 250,000 structures surveyed. The set of data has details on damage level, structural material, number of stories per building and location (town). This information is crucial to the understanding of the causes of building damage, as differences in structural characteristics and building location can be taken into account in the damage probability analysis. Using least squares regression, different sets of fragility curves are derived to demonstrate the influence of structural material, number of stories and coastal topography on building damage levels. The results show a better resistant performance of reinforced concrete and steel buildings over wood or masonry buildings. Also, buildings taller than two stories were confirmed to be much stronger than the buildings of one or two stories. The damage characteristic due to the coastal topography based on limited number of data in town locations is also shortly discussed here. At the same tsunami inundation depth, buildings along the Sanriku ria coast were much greater damaged than buildings from the plain coast in Sendai. The difference in damage states can be explained by the faster flow velocities in the ria coast at the same inundation depth. These findings are key to support better future building damage assessments, land use management and disaster planning. [ABSTRACT FROM AUTHOR]

More than half of persons living with HIV infection in the United States (U.S.) will be >50 years of age by 2020, including postmenopausal women. We conducted a systematic literature review about the effects of (1) HIV infection on age at menopause and (2) menopause on antiretroviral therapy (ART) response, in order to inform optimal treatment strategies for menopausal women living with HIV infection. We used the Ovid Medline database from 1980 to 2012. We included studies that focused on HIV-infected persons, included postmenopausal women, and reported outcome data for either age at menopause or response to ART across menopause. We identified six original research articles for age at menopause and five for response to ART across menopause. Our review revealed that current data were conflicting and inconclusive; more rigorous studies are needed. Disentangling the effects of menopause requires well-designed studies with adequate numbers of HIV-infected and HIV-uninfected women, especially disproportionately affected women of color. Future studies should follow women from premenopause through menopause, use both surveys and laboratory measurements for menopause diagnoses, and control for confounders related to normal aging processes, in order to inform optimal clinical management for menopausal women living with HIV. [ABSTRACT FROM AUTHOR]

On March 11th, 2011, the Pacific coast of Japan was hit by a tsunami generated by the largest earthquake (M9.0) in the history of the country and causing a wide range of devastating damage. Using preliminary reported data from many sources, some topics such as tsunami fatality ratio and tsunami fragility curves for structural damage are discussed and compared with other countries. This paper aims to discuss the damage characteristics of this tsunami as well as its mechanism, as observed through field surveys conducted over the 4 months following the tsunami. The field survey covers 13 areas in the Miyagi prefecture from Kesennuma city in the northernmost region to Yamamoto town in the southernmost region. The arrival time of the first tsunami along the coastal areas in the Miyagi prefecture was confirmed by stopped clocks found during the survey. The damage mechanism of coastal structures such as breakwaters, seawalls, tsunami gates, and evacuation buildings was investigated and discussed. Damage characteristics for each area, i.e., urban areas, port, coastal structures, fisheries, and agricultural areas, were also summarized. The conclusions drawn from the data analysis suggest that experience and education (soft countermeasures) are important to reduce the loss of life, as shown for example in the Sanriku area. The field surveys indicate that wood and reinforced-concrete (RC) structures should be balanced to survive both earthquake and tsunami forces, and the structural design for buildings should be reconsidered after the example in Onagawa town. In addition, coastal structures for tsunami countermeasures (hard countermeasures) should be more properly designed for survival instead of becoming floating debris upon being overturned by a tsunami. The combination of both hard and soft measures is especially necessary for optimizing the outcomes following a great disaster. These recommendations should be taken into consideration in the reconstruction efforts for better tsunami countermeasures in the future. [ABSTRACT FROM AUTHOR]

At 14:46 JST on March 11, 2011 a magnitude 9.0 earthquake (2011 Tohoku Earthquake and Tsunami) occurred off the Pacific Coast of Miyagi Prefecture. This study investigated the extensive changes in beach morphology due to the earthquake and tsunami along the 15 km Northern Sendai Coast using remotely sensed data. The remote sensing analysis on the beach topography and coastal forest demonstrated the following notable characteristics of beach morphological change: erosion of the northern barrier at the mouths of the Nanakitagawa and Natorigawa Rivers; erosion at an old river channel; scour landward of the seawalls in the longshore direction; erosion and deposition in beach areas with detached breakwaters; and deposition in coastal forest areas. Linkage of the deposition in the forest areas with the damage type of coastal forests was observed. The impact of the earthquake and tsunami on the beach morphology was serious; roughly 60% of the study area was degraded by 0.2-0.5 m in elevation mainly due to land subsidence, and a total of 0.4 km2 of beach area was eroded mainly due to erosion of the northern barrier at the mouths of the Nanakitagawa and Natorigawa Rivers. This study explores the geographical changes brought on by a tremendous earthquake and tsunami, which will help to elucidate the mechanisms of coastal forest destruction, beach erosion, and their interaction during tsunami events. [ABSTRACT FROM AUTHOR]

Japan was hit by the tsunami generated by the greatest earthquake in the history of Japan. The authors conducted the post-tsunami field survey in Miyagi prefecture immediately after the event to measure the inundation depth and investigate damaged buildings. Most of the buildings surveyed were wooden houses and could be classified into 4 damage levels. The primary data of inundation depth and damage levels obtained from the field survey were used to create the tsunami fragility curves, which described the degree of structural damage as a function of the hydrodynamic characteristics of tsunami inundation. The developed fragility curves show that damage with more than a 50% chance of occurring is classified as minor damage, moderate damage, major damage and complete damage when the tsunami inundation depth is between 2.5-3.0 m, 3.0-4.0 m and 4.0-4.5 m and greater than 4.5 m, respectively. By comparing the developed tsunami fragility curves, wooden houses in the studied area have higher structural performance than those obtained from historical events in other areas. The new curves suggest that wooden houses will be severely damaged if the inundation depth is greater than 3 m and collapse if the depth is greater than 4 m while wooden houses from historical data can resist only 1-2 m. Moreover, wooden walls in Japan reduce the overall failure of a structural member because a wooden wall is easier to destroy (compared to brick walls in Thailand and Indonesia) and allows the tsunami to pass through, which reduces the pressure at the attacking front of the tsunami. The fragility curves are very important for the loss estimation and reconstruction plans of the city; they are also crucial for reducing the disaster damage from a future tsunami. [ABSTRACT FROM AUTHOR]

A 47-year-old man with optimally controlled type-2 diabetes mellitus and chronic hepatitis B was admitted to a local hospital because of a 1-week history of cough and high-grade fever. He was diagnosed with Pneumocystis pneumonia (PCP) and Klebsiella pneumonia from a chest radiograph and sputum. Simultaneously, he was found to have HIV infection with a CD4 count of 76/μl. Despite alteration of treatment secondary to the development of allergic reaction to trimethoprim-sulfamethoxazole (TMP-SMX), the patient was able to complete a 3-week therapy for PCP after being switched to pentamidine isetionate. After the treatment of PCP, he was referred to our hospital for the initiation of anti-HIV therapy. He presented with recurrent high-grade fever of a few days' duration prior to his initial visit, which subsequently led to his admission. Chest computed tomography (CT) showed the enlargement of a previously identified infiltrate in the left upper lung field, and the sputum culture upon admission was positive for Gram-positive branching rods; the organism was later identified as Nocardia exalbida. Due to his allergy to sulfonamide, the patient was treated with imipenem (IMP) and amikacin (AMK) given intravenously for 17 days, followed by garenoxacin (GRNX) taken orally for 6 months, without any adverse effects. The chest infiltrate resolved completely, and he remains stable without relapse 8 months after the completion of the therapy. Pulmonary nocardiosis should be considered as a differential diagnosis of recurring pneumonia in immunocompromised patients, especially in HIV-infected individuals. Oral administration of GRNX following IMP and AMK can be used as an alternative to TMP-SMX therapy in cases of pulmonary nocardiosis caused by N. exalbida. [ABSTRACT FROM AUTHOR]

Background: The rapid aging of the population in Japan has been accompanied by an increased rate of surgery for lung cancer among elderly patients. It is thus an urgent priority to map out a treatment strategy for elderly patients with primary lung cancer. Although surgical resection remains standard treatment for early stage non-small-cell lung cancer (NSCLC), it is now essential to confirm the status of epidermal growth factor receptor (EGFR) gene mutations when planning treatment strategies. Furthermore, several studies have reported that EGFR mutations are an independent prognostic marker in NSCLC. However, the relations between age group and the molecular and pathological characteristics of NSCLC remain unclear. We studied the status of EGFR mutations in elderly patients with NSCLC and examined the relations of EGFR mutations to clinicopathological factors and outcomes according to age group.Methods: A total of 388 consecutive patients with NSCLC who underwent complete tumor resection in our hospital from 2006 through 2008 were studied retrospectively. Formalin-fixed, paraffin-embedded tissue sections were used to isolate DNA from carcinoma lesions. Mutational analyses of EGFR gene exons 19, 20, and 21 and KRAS gene exons 12 and 13 were performed by loop-hybrid mobility shift assay, a highly sensitive polymerase chain reaction-based method.Results: EGFR mutations were detected in 185 (47.7%) and KRAS mutations were detected in 33 (8.5%) of the 388 patients. EGFR mutations were found in a significantly higher proportion of patients younger than 80 years (younger group; 178/359, 49.6%) than in patients 80 years or older (older group; 7/29, 24.1%) (P = 0.008). In contrast, KRAS mutations were more common in the older group (6/29, 20.7%) than in the younger group (27/359, 7.5%) (P = 0.014). The older group showed a trend toward a higher rate of 5-year overall survival among elderly patients with EGFR mutations (100%) than among those with wild-type EGFR (66.2%), but the difference was not significant.Conclusions: Our results suggest that the EGFR status of patients with NSCLC differs between patients 80 years or older and those younger than 80 years. EGFR mutation status might be a prognostic marker in elderly patients with completely resected NSCLC. [ABSTRACT FROM AUTHOR]