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Underwater acoustic positioning system (UAPS) is used to know the positions of underwater robots and underwater structures. In ultra-short baseline (USBL) acoustic positioning systems, the three-dimensional position is determined by measuring the time difference of arrival (TDOA). In this paper, we investigate the acoustic positioning system targeting multiple sound sources and propose a simultaneous multi-point measurement method using time division and code division multiplexing (TD-CDM). TD-CDM provides higher position accuracy than code division multiplexing (CDM) and has a much shorter positioning time than time division and multiplexing (TDM). The effectiveness of TD-CDM has been proven by the results of the water tank experiment and simulation.

This prospective phase I trial aimed to determine the recommended dose of 3-day total marrow and lymphoid irradiation (TMLI) for a myeloablative conditioning regimen by increasing the dose per fraction. The primary end-point of this single-institution dose escalation study was the recommended TMLI dose based on the frequency of dose-limiting toxicity (DLT) ≤100 days posthematopoietic stem cell transplantation (HSCT); a 3 + 3 design was used to evaluate the safety of TMLI. Three dose levels of TMLI (14/16/18 Gy in six fractions over 3 days) were set. The treatment protocol began at 14 Gy. Dose-limiting toxicities were defined as grade 3 or 4 nonhematological toxicities. Nine patients, with a median age of 42 years (range, 35-48), eight with acute lymphoblastic leukemia and one with chronic myeloblastic leukemia, received TMLI followed by unrelated bone marrow transplant. The median follow-up period after HSCT was 575 days (range, 253-1037). Three patients were enrolled for each dose level. No patient showed DLT within 100 days of HSCT. The recommended dose of 3-day TMLI was 18 Gy in six fractions. All patients achieved neutrophil engraftment at a median of 19 days (range, 14-25). One-year overall and disease-free survival rates were 83.3% and 57.1%, respectively. Three patients experienced relapse, and no nonrelapse mortality was documented during the observation period. One patient died due to disease relapse 306 days post-HSCT. The recommended dose of 3-day TMLI was 18 Gy in six fractions. The efficacy evaluation of this regimen is currently being planned in a phase II study.

Intensity-modulated radiation therapy (IMRT) helps achieve good radiation dose conformity and precise dose evaluation. We conducted a single-centre prospective study to assess the safety and feasibility of total body irradiation with IMRT (IMRT-TBI) using helical tomotherapy in allogeneic haematopoietic stem cell transplantation (allo-HSCT).Thirty-nine adult patients with haematological malignancy (acute lymphoblastic leukaemia [The mean doses for the lungs and kidneys were 7.50 and 9.11 Gy, respectively. The mean maximum dose for the lens (right/left) was 5.75/5.87 Gy. The 2-year overall survival (OS), disease-free survival (DFS), cumulative incidence of relapse (CIR) and non-relapse mortality (NRM) were 69, 64, 18 and 18%, respectively. Thirty-six patients developed early adverse events (AEs) (including four patients with Grade 3/4 toxicities), most of which were reversible oral mucositis and may partially have been related to IMRT-TBI. However, the incidence of toxicity was comparable to conventional TBI-based conditioning transplantation. None of the patients developed primary graft failure, or Grade III-IV acute graft-versus-host disease (GVHD). In late complications, chronic kidney disease was observed in six patients, a lower incidence compared to conventional TBI-based conditioning transplantation. No radiation pneumonitis or cataracts were observed in any of the patients.IMRT-TBI is safe and feasible for haematological malignancies with acceptable clinical outcomes.KEY MESSAGESIMRT-TBI-helical tomotherapy aids in accurate dose calculation and conformity.It could be used without any considerable increase in the rate of TBI-related AEs.Allo-HSCT with IMRT-TBI may be an alternative to conventional TBI for clinical use.

Sarcopenia is a prognostic factor for cancer. Because creatinine is formed from creatine phosphate in muscle tissue, urinary creatinine excretion (UCE) serves as an index of muscle volume. However, as of yet, there are no studies assessing the clinical impact of UCE or weight- adjusted urinary creatinine excretion (WA-UCE) on allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. We analyzed the association between pre-transplant WA-UCE and transplant outcomes among 164 adult patients with acute myeloid leukemia in complete remission who underwent their first allo-HSCT at our center. The patients were classified into a high (

This study presents a new neural network model for recognizing manual works using body-worn accelerometers in industrial settings, named Lightweight Ordered-work Segmentation Network (LOS-Net). In industrial domains, a human worker typically repetitively performs a set of predefined processes, with each process consisting of a sequence of activities in a predefined order. State-of-the-art activity recognition models, such as encoder-decoder models, have numerous trainable parameters, making their training difficult in industrial domains because of the consequent substantial cost for preparing a large amount of labeled data. In contrast, the LOS-Net is designed to be trained on a limited amount of training data. Specifically, the decoder in the LOS-Net has few trainable parameters and is designed to capture only the necessary information for precise recognition of ordered works. These are (i) the boundary information between consecutive activities, because a transition in the performed activities is generally associated with the trend change of the sensor data collected during the manual works and (ii) long-term context regarding the ordered works, e.g., information about the previous and next activity, which is useful for recognizing the current activity. This information is obtained by introducing a module that can collect it at distant time steps using few trainable parameters. Moreover, the LOS-Net can refine the activity estimation by the decoder by incorporating prior knowledge regarding the order of activities. We demonstrate the effectiveness of the LOS-Net using sensor data collected from workers in actual factories and a logistics center, and show that it can achieve state-of-the-art performance.

This paper presents a three dimensional localization method for underwater acoustic positioning systems. In typical ultra-short baseline (USBL) acoustic positioning systems, the three dimensional position is localized by using multiple time difference of arrivals (TDOAs). Since the TDOA accuracy is less than the other sensor data, we focus on a localization method with the minimum number of TDOA. We propose a method of transmitting depth data by pulse position modulation (PPM), where the target position is localized by a single TDOA, a distance, and a depth. The proposed method shows a higher positional accuracy than the conventional method with two TDOAs. The effectiveness of the proposed method has been demonstrated in the evaluation of simulation and experiment.

Context Parathyroidectomy (PTx) and cinacalcet are both effective treatments for secondary hyperparathyroidism in hemodialysis patients, but limited data exist comparing the long-term outcomes of these interventions. Objective We aimed to compare the risk of mortality among hemodialysis patients who underwent PTx and those who started treatment with cinacalcet. Methods In this prospective cohort study, comprising patients from the Japanese Society for Dialysis Therapy Renal Data Registry, patients who had intact parathyroid hormone (PTH) levels ≥ 300 pg/mL in late 2007 and underwent PTx or started treatment with cinacalcet in 2008 to 2009 were matched by propensity score at 1:3. PTx and cinacalcet were compared for all-cause mortality within 6 years. Results Among eligible patients, 894 patients who underwent PTx were matched with 2682 patients who started treatment with cinacalcet. The median baseline intact PTH levels were 588 pg/mL and 566 pg/mL in the PTx and cinacalcet groups, respectively. PTx resulted in greater reductions in intact PTH, calcium, and phosphorus levels compared with cinacalcet. During the 6-year follow-up period, 201 patients (22.5%) in the PTx group and 736 patients (27.4%) in the cinacalcet group died. PTx was associated with a lower risk of mortality compared with cinacalcet (hazard ratio, 0.78 [95% CI, 0.67-0.91]; P = 0.002). This association was more pronounced in patients with intact PTH levels ≥ 500 pg/mL and in patients with serum calcium levels ≥ 10.0 mg/dL (both P for interaction Conclusion PTx compared with cinacalcet is associated with a lower risk of mortality, particularly among patients with severe secondary hyperparathyroidism.

Chimeric antigen receptor (CAR) T-cell therapy has revolutionized the approach to patients with relapsed or refractory diffuse large B-cell lymphoma (r/r DLBCL). This study retrospectively analyzed patients treated with commercially available tisagenlecleucel at our hospital and evaluated its safety and effectiveness. Of the 21 patients evaluated, any grade and grade ≥3 cytokine release syndrome (CRS) occurred in 85.7% and 9.5% of the patients, respectively. A total of 66.7% received tocilizumab and 28.6% received glucocorticoids for the treatment of CRS. The complete response (CR) rate at 3 months was 61.9% (95% confidence interval [CI] 38.4-81.9). After a median follow-up of 6.3 months following CAR-T infusion, the progression-free survival (PFS) and overall survival rates at 6 months were 53.1% (95%CI 28.3-72.7) and 69.2% (95%CI 43.7-84.9), respectively. Severe cytopenia and hypogammaglobulinemia occurred frequently following CAR-T infusion. Eight patients (38.1%) had comorbidities that would have made them ineligible for leukapheresis in the JULIET trial. However, the presence of comorbidities at the time of leukapheresis had no significant effect on the rates of CR, PFS, and adverse events. Tisagenlecleucel for r/r DLBCL in the real-world setting showed high efficacy and manageable safety profile comparable with the pivotal trial.

Fludarabine with intravenous busulfan (6.4 mg/kg; FB2) and fludarabine with intermediate-dose melphalan (140 mg/m2; FM140) are the most widely used reduced-intensity conditioning (RIC) regimens for allogeneic hematopoietic stem cell transplantation. FM140 generally has a lower relapse rate and higher non-relapse mortality (NRM), resulting in overall survival (OS) comparable to that seen with FB2. To evaluate the effect of reducing the melphalan dose, we retrospectively compared transplant outcomes in 156 patients who received FB2 (n = 103) or FM80 (n = 53) at our center (median age: 63 years; range 27–72 years). All patients received 4-Gy total body irradiation. Three-year OS, the cumulative incidence of relapse, and NRM were comparable between groups (FB2 vs. FM80, 58% vs. 47%, p = 0.24; 30% vs. 36%, p = 0.57; 17% vs. 21%, p = 0.44, respectively). There was no significant difference in the cumulative incidence of graft-versus-host disease (GVHD) at day 100, chronic GVHD at 3 years, or the 3-year GVHD-free/relapse-free survival rate. In the high-risk disease group, patients receiving FM80 tended to have lower 3-year OS (FB2 vs. FM80, 48% vs. 17%, p = 0.06). In summary, transplant outcomes following FB2 or FM80 were comparable except in patients with high-risk disease.

Introduction In Japan, dialyzers are classified based on β2-microglobulin clearance. Type I dialyzers are classified as low-flux dialyzers ( Methods In this nationwide prospective cohort study, we analyzed Japanese Society for Dialysis Therapy Renal Data Registry data collected at the end of 2008 and 2011. We enrolled 242,467 patients on maintenance hemodialysis and divided them into five groups by dialyzer type. We assessed the associations of each dialyzer type with 3-year all-cause mortality using Cox proportional hazards models and performed propensity score matching analysis, adjusting for potential confounders. Results By the end of 2011, 53,172 (21.9%) prevalent dialysis patients had died. Mortality significantly decreased according to dialyzer type. Hazard ratios (HRs) were significantly higher for type I, II and III compared with type IV (reference) after adjustment for basic factors and further adjustment for dialysis-related factors. HR was significantly higher for type I, but significantly lower for type V, after further adjustment for nutrition- and inflammation-related factors. These significant findings were also evident after propensity score matching. Conclusions Hemodialysis using super high-flux dialyzers might reduce mortality. Randomized controlled trials are warranted to clarify whether these type V dialyzers can improve prognosis.

A 60-year-old woman with myelodysplastic syndrome/myeloproliferative neoplasm-unclassifiable underwent unrelated bone marrow transplantation from a human leukocyte antigen (HLA) 8/8 allele-matched male donor. Neutrophil engraftment was achieved on day 29. Fluorescence in situ hybridization of sex chromosomes demonstrated complete donor chimerism. The red blood cell and platelet transfusion dependence continued, and the neutrophil count decreased gradually. Despite prolonged administration of broad-spectrum antibiotics for febrile neutropenia, blood cultures on days 46 and 58 returned positive for Stenotrophomonas maltophilia (SM). Contrast-enhanced computed tomography revealed multiple nodules of septic emboli in the lungs and kidneys, suggesting a disseminated SM infection. Antibiotic therapy was conducted based on antimicrobial susceptibility testing. However, the blood cell count failed to normalize and a secondary graft failure was diagnosed. A HLA-haploidentical peripheral-blood stem-cell transplantation from the patient's son was performed on day 134 after the initial transplantation. Neutrophil engraftment was achieved on day 11. Red blood cells and platelets were also engrafted. After the resolution of the SM bacteremia, the patient was discharged on day 63. The prognosis of the SM bacteremia with neutropenia is poor. Antibiotic treatment based on antimicrobial susceptibility testing and a second transplant from an HLA-haploidentical donor likely contributed to the successful outcome in this patient.

Late-onset noninfectious pulmonary complications (LONIPC) are a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). However, the clinical impact of lung function deterioration itself in long-term adult survivors of HSCT remains to be fully investigated. This retrospective, longitudinal study aimed to investigate pulmonary function following HSCT in terms of its change and the clinical significance of its decline. We examined 167 patients who survived for at least 2 years without relapse. The median follow-up period was 10.3 years. A linear mixed-effects model showed that the slope of pulmonary function tests values, including percent vital capacity (%VC), percent forced expiratory volume in one second (%FEV1), and FEV1/forced VC ratio (FEV1%), decreased over time. The cumulative incidence of newly obstructive and restrictive lung function impairment (LFI) at 10 years was 15.7% and 19.5%, respectively. Restrictive LFI was a significant, independent risk factor for overall survival (hazard ratio 7.11, P = 0.007) and non-relapse mortality (hazard ratio 12.19, P = 0.003). Our data demonstrated that lung function declined over time after HSCT and that the decline itself had a significant impact on survival regardless of LONIPC.

A 22-year-old man with a history of mediastinal germ cell tumor, which was diagnosed at age 20 and remained disease-free after chemotherapy, was diagnosed with acute myeloid leukemia (AML) M2 in January 2020. Karyotype analysis of bone marrow (BM) specimen at diagnosis detected 47,XXY, inv (16) in all cells. Following induction treatment, he achieved complete remission with a remarkable decrease in the minimal residual disease marker. Although considered related to therapy, the AML had a prognostically favorable karyotype, and the initial treatment response was very good. He had no human leukocyte antigen-matched sibling donor candidate. Thus, allogeneic hematopoietic stem cell transplantation was not scheduled at the first complete remission. After three cycles of consolidation therapy, he remained disease-free for over one year. Karyotype analysis of BM during remission revealed that all analyzed cells harbored 47,XXY, and Klinefelter syndrome (KS) was diagnosed. Although the patient experienced an adjustment disorder on KS diagnosis, he had overcome the difficulty with the assistance of psycho-oncologists, clinical psychologists, and genetic counselors. Herein, we report this rare case of KS that manifested after AML diagnosis following mediastinal germ cell tumor treatment.

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients are at high risk of developing invasive pneumococcal disease (IPD) with substantial morbidity and mortality. Pneumococcal polysaccharide vaccine (PPSV23) and pneumococcal conjugate vaccine (PCV13) are the primary prevention strategy. The difference between the Japanese and international guidelines is limited except when to start PCV13. However, Japanese data regarding the incidence of IPD after allo-HSCT that include vaccination status are limited. Therefore, we aimed to study the clinical characteristics of patients with IPD following allo-HSCT, focusing on unvaccinated patients. We retrospectively reviewed allo-HSCT recipients between April 2005 and December 2018 at Komagome Hospital. Among 1,091 recipients, 11 (1008/100,000 recipients) developed 13 episodes of IPD. The median period from the first allo-HSCT to the first IPD episode was 686 days (10-3040 days). Ten patients developed IPD before vaccination, and seven of these unvaccinated patients with late-onset IPD were ineligible for vaccination based on domestic guidelines. Although appropriate treatments resulted in a good short-term prognosis, most episodes of IPD developed in unvaccinated allo-HSCT recipients. Our data support the promotion of better adherence to the current guidelines and the importance of pneumococcal vaccination even years after allo-HSCT to protect against late-onset IPD.

Although a substantial number of patients return to dialysis after kidney transplant failure, it remains controversial whether transplant-failure patients have a higher mortality risk than transplant-naive patients on dialysis who have never undergone kidney transplantation. We compared outcomes of transplant-failure and transplant-naive patients on hemodialysis. Data from the Japanese National Dialysis Registry (2012–2013) were analyzed, including 220,438 prevalent hemodialysis patients. Multivariable Cox models were used to compare all-cause, cardiovascular, and infection-related mortality during 1-year follow-up between transplant-failure and transplant-naive patients. Multiple imputation and propensity score matching were utilized as sensitivity analyses. During 209,377 patient-years of follow-up, 18,648 all-cause deaths (8.5% of all patients), 7700 cardiovascular deaths (41% of all-cause deaths), and 3806 infection-related deaths (20% of all-cause deaths) were observed. Adjusted hazard ratios [95% confidence intervals] for all-cause, cardiovascular, and infection-related deaths among transplant-failure patients were 0.81 [0.59–1.11], 0.54 [0.30–0.98], and 1.54 [0.92–2.59], respectively. Sensitivity analyses using multiple imputation and propensity score matching yielded similar results. This Japanese cohort study suggested that a cardiovascular mortality risk of transplant-failure patients could be significantly lower than that of transplant-naive patients, while there might be a trend toward a higher infection-related mortality risk in transplant-failure patients. However, this retrospective, single-country study can introduce an immortal time bias in transplant-failure patients, and limit the external validity. Further prospective studies are warranted to improve the comparability of outcomes between transplant-failure and transplant-naive patients, and to examine worldwide the generalizability of the potential cardiovascular benefit of kidney transplantation even after returning to dialysis.

Facial attractiveness has been reported to be influenced by visual features such as facial shape and the colour and texture of the skin. However, no empirical studies have examined the effects of facial skin radiance on facial attractiveness. The present study investigated whether types of skin reflection (i.e. radiant, oily and shiny, and matte) and the position of the reflection on the face influence facial attractiveness and other affective impressions.A total of 160 female participants (1) estimated the ages and (2) evaluated attractiveness and other impressions of unfamiliar female faces in a total of seven skin reflection conditions. These conditions incorporated three types of reflection (i.e. radiant, oily and shiny, and matte) and three positions of the reflection on the face (i.e. entire facial skin, only cheeks, and only T-zone).The facial images of radiance on entire faces were rated as appearing younger than the facial images of oily shine on entire faces and the matte faces. Attractiveness ratings and other positive impressions increased in the order of the matte (ranked lowest), the oily shine on entire face, and the radiance on entire face (ranked highest) conditions. The reflection position also influenced facial attractiveness: attractiveness ratings and other positive impressions were higher in the radiance on entire face condition than in the radiant cheeks and the radiant T-zone conditions. Interestingly, the radiant cheek faces were rated more radiant and healthier but less feminine and less bright than the radiant T-zone faces.These results suggest that facial radiance enhances facial attractiveness and conveys a wide variety of positive impressions on the observer. The magnitude of the effects of cheek radiance and T-zone radiance differs across various affective impressions. Nevertheless, the results demonstrate that cheek and the T-zone radiance both contribute to higher attractiveness and other positive impressions of the radiance on entire faces. We believe that our findings can contribute as a guide to the enhancement of positive facial impressions by means of skin radiance, thereby leading to a better understanding of the value of skincare and base makeup.Selon certaines études, l’attractivité du visage viendrait de caractéristiques visuelles telles que la forme du visage ainsi que la couleur et la texture de la peau. Cependant, aucune étude empirique n’a examiné les effets de l’éclat de la peau sur l’attractivité du visage. La présente étude s’est intéressée aux divers types de reflets de la peau (par exemple une peau lumineuse, une peau grasse et luisante ou une peau mate) et à leur position sur le visage, et a cherché à savoir s’ils influençaient l’attractivité du visage et d’autres impressions d’ordre affectif. MÉTHODES: Au total, 160 participantes 1) ont estimé l’âge et 2) ont évalué l’attractivité et d’autres impressions de visages féminins inconnus sur sept types de reflets de la peau au total. Ces états comprenaient trois types de reflets (lumineux, gras et mat) et trois positions des reflets sur le visage (toute la peau du visage, joues uniquement et partie yeux-nez [« zone T »] uniquement). RÉSULTATS: Les photos de visages caractérisées par un éclat sur tout le visage ont été considérées comme étant plus jeunes que celles dont la peau était grasse-luisante sur l’ensemble du visage et que les visages à peau mate. Les notes attribuées pour l’attractivité et les autres impressions positives augmentent dans l’ordre suivant : peau mate (note la plus basse), peau grasse-luisante sur tout le visage et luminosité sur tout le visage (note la plus haute). La position du reflet a elle aussi joué un rôle sur les notes attribuées à l’attractivité des visages, et les autres impressions positives ont obtenu des scores plus élevés pour une luminosité de tout le visage que pour des joues lumineuses et une zone T lumineuse. Il est intéressant de noter que les visages aux joues lumineuses ont été jugés plus lumineux et plus sains, mais moins féminins et moins éclatants que les visages présentant une zone T lumineuse.Ces résultats suggèrent que l’éclat du visage améliore l’attractivité du visage et communique toutes sortes d’impressions positives à l’observateur. L’ampleur des effets de l’éclat sur les joues et sur la zone T diffère selon les différentes impressions d’ordre affectif. Néanmoins, les résultats démontrent que la luminosité des joues et de la zone T contribue à rendre le visage plus séduisant ainsi qu’à d’autres impressions positives suscitées par la luminosité de l’ensemble du visage. Nous sommes convaincus que nos résultats peuvent servir à guider la façon de renforcer l’impression positive produite par un visage en faisant ressortir la luminosité de la peau, et amener ainsi à mieux comprendre la valeur des soins de la peau et des bases de maquillage.

Cyclophosphamide (CY)-induced cardiotoxicity involves rare lethal complications. We previously reported the cardiac events of 811 allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients; 12 out of 811 recipients (1.5%) developed fatal heart failure. The mortality rate was also very high (91.6%, 11/12). CY dose (200 mg/kg or more) was reported as the independent risk factor. The main disease in patients treated with 200 mg/kg or more of CY was severe aplastic anemia (AA). Therefore, we reduced the dose of CY during conditioning for AA (from 200 to 100 mg/kg), and then we analyzed the clinical features of 294 patients who received a total dose of at least 100 mg/kg of CY. We also compared the clinical features between the current study and our previous study. The proportion of patients treated with at least 200 mg/kg of CY was reduced from 4.2% to 0%. However, CY-induced heart failure occurred in four of the 294 patients (1.4%), which was similar to the finding reported in our previous study (1.5%). Two of these four patients received a post-transplant CY (PTCy) regimen (CY 100 mg/kg). All four patients were treated in the cardiac intensive care unit (C-ICU), and two patients survived. In summary, even the CY dose of 120 mg/kg or less would cause cardiotoxicity. We should also carefully monitor patients treated with PTCy, considering the possibility of CY-induced cardiotoxicity. Early diagnosis and ICU management have contributed to improved outcomes.

Variants of the t (8;21) (q22;q22) involving chromosome 8, 21, and other chromosomes account for about 3% of all t (8;21) (q22;q22) in patients with acute myeloid leukemia (AML). However, the prognosis of AML with variant t (8;21) remains unknown due to the scarcity of reported cases. Herein we report a case of AML with t (6;21;8) (p23;q22;q22). Fluorescence in situ hybridization confirmed a RUNX1-RUNX1T1 fusion signal on the derivative chromosome 8. This is the first report on a variant of t (8;21) involving the breakpoint 6p23. After induction chemotherapy, our patient achieved complete remission and has been stable for four years.

The relationships among body mass index (BMI), diabetes, age, and all-cause mortality in hemodialysis patients remain unclear. We examined BMI-stratified relationships between diabetes, age, and the risk of long-term mortality in incident hemodialysis patients.This is a cohort study. Data were obtained from the national dialysis registry in Japan 2007 that included 35,415 incident hemodialysis patients and 6,061 patients aged ≥20 years with BMI data. Patients were divided into 6 categories according to baseline BMI (low:18.5, normal: 18.5-25, Obesity: ≥25) and the presence or absence of diabetes. The primary outcome was all-cause mortality during a 5-year follow-up. Hazard ratios were estimated using Cox's model for the relationships among diabetes, BMI categories, and all-cause mortality, and adjusted for potential confounders. Patients with a normal BMI and non-diabetic were the reference category. We also examined the effects of age on these relationships.A total of 6,061 patients, including 3,239 with diabetes, were enrolled. During the follow-up, 31.0% and 30.7% of all and diabetic patients, respectively, died. Cox's regression analysis showed that low BMI, but not obesity, was independently associated with an increased risk of all-cause death in patients with and without diabetes. When patients were divided into 2 groups-younger and older than 60 years-the risk of mortality in both groups was increased in low BMI with diabetes.Among Japanese incident hemodialysis patients, low BMI increases the risk of all-cause mortality. The markedly high mortality rate in diabetic patients with low BMI regardless of age warrants attention.

An EDF-sigma laser for a strain sensor is devised using a double-pass cascaded-chirped LPG with a polarization compensation effect. In the experiment, the stable measurements and sensor operations with suppression of polarization-induced fluctuations are demonstrated.

Background: The use of exchange devices for peritoneal dialysis (PD) fluids is a common practice in Japan. Evidence on the effectiveness of exchange devices in preventing PD-related peritonitis is scarce. We evaluated the association between the use of exchange devices for PD fluids and peritonitis incidence. Methods: We retrospectively enrolled 3845 patients, aged ≥20 years, receiving PD for ≥3 months, with available data on the exchange procedure for PD fluids and peritonitis incidence that was obtained from the Japan Renal Data Registry, a nationwide annual survey. The patients were grouped according to whether the manual or device PD fluid exchange method was used. The onset of peritonitis was defined as a leukocyte count of >100/µL (neutrophils ≥50%) in PD effluents. We applied quasi-Poisson regression analyses to estimate the incidence rate ratio (IRR). Age, sex, PD vintage, body mass index, automated PD use, residual kidney function, comorbidities, haemoglobin and serum albumin were adjusted as potential confounders. Results: Older age, automated PD use, diabetes as comorbidity and lower haemoglobin levels were associated with the use of exchange devices for PD fluids. Patients using devices for PD fluid exchange (69.2%) had an increased risk of peritonitis of 37% (IRR: 1.37, 95% confidence interval (CI): 1.07–1.75) and 28% (IRR: 1.28, 95% CI: 1.00–1.63) in the crude and multivariate adjustment models, respectively. Conclusions: The use of exchange devices for PD fluids and peritonitis incidence showed no favourable association. There may remain possible residual confounding by indication.

Background: Dialyzers are classified as low-flux, high-flux, and protein-leaking membrane dialyzers internationally and as types I, II, III, IV, and V based on β2-microglobulin clearance rate in Japan. Type I dialyzers correspond to low-flux membrane dialyzers, types II and III to high-flux membrane dialyzers, and types IV and V to protein-leaking membrane dialyzers. Here we aimed to clarify the association of dialyzer type with mortality.Methods: This nationwide retrospective cohort study analyzed data from the Japanese Society for Dialysis Therapy Renal Data Registry from 2010 to 2013. We enrolled 238,321 patients on hemodialysis who were divided into low-flux, high-flux, and protein-leaking groups in the international classification and into type I to V groups in the Japanese classification. We assessed the associations of each group with 3-year all-cause mortality using Cox proportional hazards models and performed propensity score matching analysis.Results: By the end of 2013, 55,308 prevalent dialysis patients (23.2%) had died. In the international classification subgroup analysis, the hazard ratio (95% confidence interval) was significantly higher in the low-flux group [1.12 (1.03–1.22), P = 0.009] and significantly lower in the protein-leaking group [0.95 (0.92–0.98), P = 0.006] compared with the high-flux group after adjustment for all confounders. In the Japanese classification subgroup analysis, the hazard ratios were significantly higher for types I [1.10 (1.02–1.19), P = 0.015] and II [1.10 (1.02–1.39), P = 0.014] but significantly lower for type V [0.91 (0.88–0.94), P < 0.0001] compared with type IV after adjustment for all confounders. These significant findings persisted after propensity score matching under both classifications.Conclusions: Hemodialysis using protein-leaking dialyzers might reduce mortality rates. Furthermore, type V dialyzers are superior to type IV dialyzers in hemodialysis patients.

Abstract According to the annual survey of the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) conducted at the end of 2018, a total of 339,841 patients were receiving dialysis (hereinafter, dialysis patients) in Japan. This survey included an investigation of individual test results for hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibody (HCV-Ab), HCV-RNA, and serum alanine aminotransferase (ALT) (glutamic pyruvic transaminase [GPT]). The survey revealed that among dialysis patients in Japan, the prevalence of HBsAg positivity was 1.38% and the prevalence of HCV-Ab positivity was 4.7% at the end of 2018, both of which were markedly lower than the corresponding rates documented in 2007 (9.8% and 4.7%, respectively). The proportion of HCV-RNA-positive patients among all HCV-Ab-positive patients was 37.5%, which was also markedly lower than the percentage recorded in 2007 (64.0%). The prevalence of HBsAg positivity tended to increase as the dialysis vintage increased. The prevalence of HCV-Ab positivity was also not correlated with the dialysis vintage during the first 30 years of dialysis; however, it tended to increase as the dialysis vintage increased beyond the 30th year. Trial registration University hospital Medical Information Network (UMIN) Clinical Trials Registry, UMIN000018641. The JRDR was approved by the ethics committee of the JSDT (approval number 1-3) and was registered on August 8, 2015 (accessed June 2, 2020).

This paper presents an unsupervised method for recognizing assembly work done by factory workers by using wearable sensor data. Such assembly work is a common part of line production systems and typically involves the factory workers performing a repetitive work process made up of a sequence of manual operations, such as setting a board on a workbench and screwing parts onto the board. This study aims to recognize the starting and ending times for individual operations in such work processes through analysis of sensor data collected from the workers along with analysis of the process instructions that detail and describe the flow of operations for each work process. We propose a particle-filter-based factory activity recognition method that leverages (i) trend changes in the sensor data detected by a nonparametric Bayesian hidden Markov model, (ii) semantic similarities between operations discovered in the process instructions, (iii) sensor-data similarities between consecutive repetitions of individual operations, and (iv) frequent sensor-data patterns (motifs) discovered in the overall assembly work processes. We evaluated the proposed method using sensor data from six workers collected in actual factories, achieving a recognition accuracy of 80% (macro-averaged F-measure).

Background Despite the widespread use of erythropoietin-stimulating agents (ESAs) to treat anemia in patients undergoing hemodialysis, the relative mortality risks associated with use of different types of ESAs are unknown. Methods To compare the mortality risk associated with use of short-acting ESAs versus long-acting ESAs, we conducted a nationwide cohort study of 194,698 hemodialysis patients in Japan who received either a short-acting (epoetin α / β or epoetin κ ) or a long-acting (darbepoetin or epoetin β pegol) ESA. Study outcomes were 2-year all-cause and cause-specific mortality. In addition to Cox proportional hazards models, we performed an instrumental variable analysis in which facility-level long-acting ESA prescription rates were taken as the instrumental variable. Results During the 2-year follow-up period, 31,557 deaths occurred. In a multivariable Cox model, long-acting ESA users had a 13% higher rate of deaths compared with short-acting ESA users, a significant difference ( P Conclusions Among patients undergoing hemodialysis, use of long-acting ESAs might be associated with a higher risk of death than use of short-acting ESAs.

We report on a rare case of thoracoscopic surgery for a patient with an aberrant pulmonary artery of the inferior lobar branch (A7) in the right lower lobe. A 69-year-old woman presented with a chief complaint of an abnormal shadow on chest radiography. Computed tomography (CT) revealed a 14-mm solid nodule in the right lower lobe. The patient was diagnosed with lung cancer by bronchoscopic biopsy, and a surgery was planned. Preoperative thin-slice CT and three-dimensional CT showed an aberrant A7 branching from the right main pulmonary artery. The right lower lobe and lymph node dissection was performed safely under a video view. Preoperative evaluation of this anomaly is important for a safe surgery.

Introduction Platelet-rich plasma (PRP) therapy is used to treat pathological conditions such as degenerative inflammatory diseases including osteoarthritis (OA) by enhancing tissue repair and promoting anti-inflammatory effects. Although PRP therapy for patients with knee OA improved pain and functional scores, the association of clinical outcomes and quality of PRP including cell composition and concentration is unclear. Methods Therefore, this study analyzed blood cell counts, including the immature platelet fraction (IPF), in peripheral blood and PRP of 144 patients with knee OA who underwent PRP therapy. The mean leukocyte and platelet concentrations in whole blood and PRP were analyzed using an XN-1000 automated hematology analyzer. Visual analogue scale (VAS) scores and knee injury and osteoarthritis outcome scores (KOOS) before and 1 month after a single PRP injection were also determined. Results Higher platelet and lower leukocyte concentration rates were observed in PRP compared with whole blood. The platelet concentration in whole blood was negatively correlated with VAS improvement. The percentage of IPF (IPF%) in whole blood was positively correlated with VAS improvement and KOOS (pain) improvement, whereas the IPF% in PRP tended to correlate with VAS improvement. Furthermore, multivariate logistic regression demonstrated the high IPF% in whole blood was significantly associated with VAS improvement. The low percentage of neutrophil (neutrophil%) in PRP was significantly associated with the VAS improvement and KOOS (ADL) improvement. Conclusions Therefore, PRP efficacy for OA might depend on the patient's biological status., Highlights • High percentage of IPF (IPF%) in whole blood was significantly associated with VAS improvement. • Low neutrophil% in PRP was significantly associated with VAS improvement and KOOS (ADL) improvement. • The PRP efficacy for knee OA might depend on the patient's biological status.

A novel tunable Erbium-doped fiber ring laser (EDFRL) with a cascaded-chirped long-period fiber grating (C-CLPG) as a wavelength selection filter is proposed from the viewpoint of the sensor use, in which a variable optical attenuator (VOA) is employed as an intracavity loss modulator to change the oscillation wavelength region so that the resultant tuning wavelength range is widened. In the demonstrative experiment for temperature measurements, oscillation over the wavelength range of 12.85 nm (1557.62~1570.47 nm), which is more than three times range of the previously presented laser and is equivalent to 64 °C in terms of temperature change, was achieved, while a single-wavelength oscillation was maintained. In addition, a practical technique for realizing a temperature measurement by combining with the VOA control is also discussed.

Facial attraction has a great influence on our daily social interactions. Previous studies have mainly focused on the attraction from facial shape and expression. We recently found that faces with radiant skin appear to be more attractive than those with oily-shiny or matte skin. In the present study, we conducted functional magnetic resonance imaging (fMRI) and psychological experiments to determine the human brain activity that reflects facial attractiveness modulated by these skin reflection types. In the fMRI experiment, female subjects were shown successive images of unfamiliar female faces with matte, oily-shiny, or radiant skin. The subjects compared each face with the immediately preceding face in terms of attractiveness, age, and skin reflection, all based on the skin. The medial part of the orbitofrontal cortex (mOFC) was significantly more active when comparing attractiveness than when comparing skin reflection, suggesting that the mOFC is involved in processing facial attractiveness from skin reflection. In the psychological experiment, attractiveness rating was highest for radiant skin, followed by oily-shiny, and then matte skin. Comparison of the results of these experiments showed that mOFC activation level increased with attractiveness rating. These results suggest that the activation level of the mOFC reflects facial attractiveness from skin reflection.

In mammals, hyperactivation is essential for sperm fertilization with oocytes in vivo. Two types of hyperactivation "full-type and nonfull-type patterns" can be observed in the spermatozoa from boars, bulls, and mice. We have a hypothesis that the full-type hyperactivation is a physiological (in vivo) pattern and are elucidating its molecular bases. The aims of this study were to detect calmodulin in boar sperm flagella by Western blotting and indirect immunofluorescence and to investigate effects of extracellular Ca

A novel laser strain sensor based on a sigma-cavity configuration is developed, in which a double-pass cascaded-chirped long period fiber grating with a Faraday rotator mirror is employed in the sigma-branch as a strain-sensitive wavelength filter. © 2021 The Author(s)

In this paper we have investigated optical frequency-shift sensitivities of the transmittance channeled spectra of cascaded-chirped long period fiber gratings (C-CLPGs) to the applied strain and temperature change from the viewpoint of the sensor use. In the experiment, several kinds of C-CLPGs have been fabricated by changing the cascaded distance between CLPGs and the strain- or temperature-induced spectral shifts for three different order of the cladding modes are measured simultaneously by use of a cross-correlation technique which provides highly precise determination of the spectral shift. As a result, it is confirmed that the frequency-shift sensitivities of the C-CLPGs to the strain and temperature are larger with the higher order of cladding mode, while the dependences for the temperature sensitivity is much less than that for the strain. In addition, the dependences for the cascaded distance are also investigated.

We present a multipoint vibration sensing system using fiber Fabry-Perot interferometers consisting of low-reflective fiber Bragg gratings (FBG-FPI) and a current-modulated laser diode. The lasing wavelength of a laser diode can be modulated by changing the injection current. Therefore, high-speed current modulation makes possible to achieve high-speed wavelength sweep exceeding 100 kHz. Using a current modulated laser diode as the source for interrogation of FBG-FPI sensor array, high-speed multipoint vibration measurement can be realized.

In mammals, hyperactivation is essential for sperm fertilization with oocytes in vivo. Two types of hyperactivation "full-type and nonfull-type patterns" can be observed in the spermatozoa from boars, bulls, and mice. We have a hypothesis that the full-type hyperactivation is a physiological (in vivo) pattern and are elucidating its molecular bases. The aims of this study were to detect calmodulin in boar sperm flagella by Western blotting and indirect immunofluorescence and to investigate effects of extracellular Ca2+ and calmodulin antagonists "W-7 and W-5 (W-5; a less potent antagonist)" on the occurrence of full-type hyperactivation in boar spermatozoa. Calmodulin was specifically detected as the 17-kDa antigen in the flagella and postacrosomal region of the heads. Full-type hyperactivation could be induced effectively in the samples incubated with 3.42 mM CaCl2 for 120-180 min, and it was significantly reduced in the concentration-dependent manners of W-7 and W-5. Suppressing effects of W-7 on the full-type hyperactivation were stronger than those of W-5. These observations indicate that flagellar calmodulin is involved in the occurrence of extracellular Ca2+ -dependent full-type hyperactivation in boar spermatozoa. This is the first indication of the intracellular Ca2+ -sensing molecule which can function in the full-type hyperactivation.

Vacuolar myelopathy (VM) is known to be a neurological complication in patients with acquired immunodeficiency syndrome (AIDS). In autopsy-based studies, VM was reported in approximately 20-50% of patients with AIDS. It manifests in various says, mainly presenting as a painless spastic paraparesis with a sensory ataxia. We present a rare case of VM after bone marrow transplantation (BMT) in a patient without AIDS. A 50-year-old man developed weakness in the lower legs, leg muscle atrophy, and difficulty in walking 86 days after BMT. The patient died from septic shock on day 309. The autopsy revealed intralamellar vacuolation in the spinal white matter, which was compatible with VM.

Background The expected remaining lifetime of dialysis patients in Japan was only reported in 2003 and has not been reported thereafter. From 2003 to the present, several new therapeutic agents have been introduced. These events may have improved outcomes for dialysis patients. Thus, expected remaining lifetime of dialysis patients in Japan was newly calculated in 2015. Methods The Japanese Society for Dialysis Therapy Renal Data Registry database was used for analyses. From this database, the following three indexes were compiled: the number of surviving dialysis patients (198,125 males and 111,962 females) at the end of 2014 and the number of surviving (179,649 males and 101,758 females) and dead (18,044 males and 111,417 females) patients at the end of 2015. Based on these values, expected remaining lifetime at 1-year increment was calculated using the life table method. Results Excerpts of the calculated expected remaining lifetimes of patients aged 60 years were as follows: 11.9 years for males and 14.1 years for females. These expected remaining lifetimes were 1.1 to 1.2 times as compared with those in 2003. Meanwhile, expected remaining lifetime of diabetic patients was 10.8 years for males and 12.5 years for females and that of nondiabetic patients was 13.0 years for males and 15.0 years for females. Conclusion Expected remaining lifetime of dialysis patients in Japan in 2015 was 10–20% longer than that in 2003. These results suggest that advances in dialysis technologies during this 12-year period improved the survival rate of dialysis patients.

The annual survey questionnaires of the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) were sent to 4458 dialysis facilities at the end of 2018; 4402 facilities (98.7%) responded to the facility questionnaire, and 4222 facilities (94.7%) responded to the patient questionnaire. This paper reports the results obtained in regard to several issues: dialysis fluid quality, prescription of hemodialysis and hemodiafiltration, current status of peritoneal dialysis, and glycemic indices and treatment of diabetic patients.

We have investigated optical frequency-shift sensitivity of the transmittance channeled spectrum of cascaded-chirped long period fiber gratings (C-CLPGs) to an applied strain from the viewpoint of the sensor use. In the experiment, eight different kinds of C-CLPGs have been fabricated by changing the cascaded distance for two types of CLPGs and the strain-induced spectral shifts are measured by use of a cross-correlation technique which provides highly precise determination of the spectral shift. As a result, it is confirmed that the higher frequency-shift sensitivities of the C-CLPGs to the strain obtain with the higher order of cladding mode.

A novel tunable and switchable Erbium-doped fiber ring laser (EDFRL) is constructed from the viewpoint of sensor applications. The laser consists of a cascaded-chirped long period fiber grating (C-CLPG) and a variable optical attenuator (VOA). The oscillation wavelength is used for sensing a measurand. As a result, wavelength range selecting over about 1557.57 ~ 1570.68 nm with the tuning range within ~5.6 nm is demonstrated, and the sensitivity of ~ −0.22 nm/°C is recorded.