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We evaluated the relationship between penile curvature and testosterone in Peyronie's disease patients treated in Japan.Data were obtained from 109 patients with Peyronie's disease treated with surgery at our hospital between April 2004 and December 2019. Penile deformity assessment was based on findings of a rigid erection induced by intracavernosal injection. Low total testosterone level was defined as300 ng/dl. Patients were divided into two groups according to curvature severity (I,60°; II ≥60°), then clinical factors including total testosterone were compared. Uni- and multivariate logistic regression analyses were performed to identify factors predicting severe penile deformity (≥60°).For all patients, mean total testosterone was 469 ng/dl and median curvature was 50°, with a significant inverse correlation found between curvature and testosterone level (p 0.0001). Group I and II patients numbered 55 and 54, respectively. Mean total testosterone for Group II was 397 ng/dl, significantly lower than Group I (539 ng/dl). Median curvature in 15 patients with a low testosterone level was 80°, significantly higher than those with a normal testosterone range (50°). Univariable and multivariable logistic regression analysis indicated total testosterone, follicle stimulating hormone, and C-reactive protein as significant factors correlated with severe penile deformity, among which total testosterone was most relevant.The present findings confirmed that penile deformity severity is correlated with testosterone level in Japanese males with Peyronie's disease.

Introduction. A metastatic testicular tumor is uncommon. We report here a case of testicular metastasis associated with recurrent colorectal cancer. Case Presentation. A 75-year-old male was presented with right scrotum pain one year after undergoing a right hemicolectomy combined with resection of the small intestine and omentum for ascending colon cancer (pT4N0M0). Magnetic resonance imaging of the pelvis showed a 7.3 × 5.4 × 4.5 cm mass consisting of a cystic solid tumor. A right inguinal orchiectomy was performed and right testicular pain improved after surgery. Pathology results showed that the tumor was a metastatic adenocarcinoma. The patient subsequently died two months later due to progression of the colon cancer. Conclusion. Although colorectal cancer metastasis to the testis is very uncommon, it should be kept in mind in clinical situations, especially for older males with a testicular mass or discomfort.

Peyronie's disease (PD) is a benign condition caused by plaque formation on the tunica albuginea of the penis. It is associated with penile pain, curvature, and shortening, and contributes to erectile dysfunction, which worsens patient quality of life. In recent years, understanding of the detailed mechanisms and risk factors involved in development of PD has been increasing. In this review, the pathological mechanisms and several closely related signaling pathways, including TGF-β, WNT/β-catenin, Hedgehog, YAP/TAZ, MAPK, ROCK, and PI3K/AKT, are described. Findings regarding cross-talk among these pathways are then discussed to elucidate the complicated cascade behind tunica albuginea fibrosis. Finally, various risk factors including genetic involved in the development of PD are presented and their association with the disease summarized. The purpose of this review is to provide better understanding regarding involvement of risk factors in the molecular mechanisms associated with PD pathogenesis, as well as provide insight into disease prevention and novel therapeutic interventions.

Accurate diagnosis of colorectal premalignant polyps, including adenomas, is vital in clinical practice.To investigate the diagnostic yields of novel findings of brown slits for adenomas.Patients who underwent colonoscopy at the Toyoshima Endoscopy Clinic were enrolled. Polyps sized ≥ 5 mm suspected of adenomas or clinically significant serrated polyps were included in the study. We defined the surface structures of colorectal polyps, which were brown curves inside and along the tubular glands identified using a combination of a new X1 system (Olympus Corporation) and a conventional magnifying colonoscope with non-staining narrow band imaging (NBI), as brown slits. The brown slits corresponded to slit-like lumens on endocytoscopy and histological crypt openings of an adenoma. We evaluated the diagnostic performance of brown slits for adenoma.A total of 108 Lesions from 62 patients were eligible. The average age was 60.4 years and 41.9% were male. The mean polyp size was 7.45 ± 2.83 mm. Fifty-seven lesions were positive for brown slits. Histopathological diagnosis comprised 59 low-grade tubular adenomas, 16 sessile serrated lesions, and 33 hyperplastic polyps. Among 59 adenomas, 56 (94.9%) were positive for brown slits. Among 16 sessile serrated lesions, 0 (0%) was positive for brown slits. Among 33 hyperplastic polyps, 1 (3.0%) was positive for brown slits. The sensitivity, specificity, and accuracy of brown slits for adenoma were 94.9%, 98.0%, and 96.3%, respectively. The positive predictive value and negative predictive value of brown slits for adenoma were also excellent for 98.2%, and 94.1%, respectively.Brown slits on conventional magnifying endoscopy with non-staining NBI using the X1 system were useful for diagnosing colorectal adenoma. The new endoscopy system could be examined using new standards.

We investigated whether aspartate transaminase (AST)-to-alanine aminotransferase (ALT) ratio and its change during the course of treatment in castration-resistant prostate cancer (CRPC) patients is associated with tumor condition and lethality. Clinical data from 130 CRPC patients were retrospectively evaluated. AST/ALT ratios at the time of prostate cancer (PC) diagnosis, androgen deprivation therapy (ADT), CRPC diagnosis, and the final follow-up examination after CRPC treatment were calculated for each. The prognostic capabilities of the AST/ALT ratio for overall survival (OS) were analyzed by the Kaplan-Meier method and Cox hazard models. The median AST/ALT ratio at the PC diagnosis was 1.517 and the optimal value predicting lethality defined by the receiver operating curve was 1.467. The AST/ALT ratio decreased once during ADT and then elevated in a stepwise manner with cancer progression. The median AST/ALT ratio at the PC diagnosis in surviving patients was 1.423, which did not change longitudinally, whereas that of in deceased patient was significantly higher (1.620) and further elevated after CRPC diagnosis. Kaplan-Meier curves indicated significantly worse OS in patients with the AST/ALT ratio ≥ 1.467, which was confirmed by multivariate analysis. We identified the AST/ALT ratio as a prognostic biomarker for CRPC that changed longitudinally reflecting tumor progression.

Powerful relativistic jets in active galactic nuclei (AGN) are believed to be originated from the accretion of material onto the supermassive black hole (SMBH)1. The nearby radio galaxy M87 is one of the best examples of this phenomenon, and the recent detection of a black-hole shadow with the Event Horizon Telescope provided compelling evidence for this paradigm2. However, whether the central SMBH in M87 has a spin or not, a fundamental parameter of a BH along with the mass, remains unconstrained by observations since the appearance of the photon ring is rather insensitive to the spin2-4. A clue to this challenge is to trace the long-term evolution of the innermost jet base where the central BH and accretion disk tightly regulate its flow dynamics. Here we report an extensive analysis of the morphological evolution of the M87 jet nozzle based on 170 high-resolution radio images spanning more than two decades. The ensemble of the data reveals a periodic (a period of 11 years) variation of the jet direction with a peak-to-peak amplitude of ~10 deg on the sky. A successful fit of a precession model to the data as well as general-relativistic magnetohydrodynamic simulations strongly supports the presence of a spinning BH in M87, inducing a Lense-Thirring precession of a misaligned accretion disk by the frame-dragging effect5. Our results suggest that jet precession with a spinning BH can commonly exist in other more distant AGN but had evaded detection due to the small magnitude and long period of position angle variation.

DNAX-associated protein 12 kDa size (DAP12) is a dominant immunoreceptor tyrosine-based activation motif (ITAM)-signaling adaptor that activates costimulatory signals essential for osteoclastogenesis. Although several DAP12-associated receptors (DARs) have been identified in osteoclasts, including triggering receptor expressed on myeloid cells 2 (TREM-2), C-type lectin member 5A (CLEC5A), and sialic acid-binding Ig-like lectin (Siglec)-15, their precise role in the development of osteoclasts and bone remodeling remain poorly understood. In this study, mice deficient in Trem-2, Clec5a, Siglec-15 were generated. In addition, mice double deficient in these DAR genes and FcεRI gamma chain (FcR)γ, an alternative ITAM adaptor to DAP12, were generated. Bone mass analysis was conducted on all mice. Notably, Siglec-15 deficient mice and Siglec-15/FcRγ double deficient mice exhibited mild and severe osteopetrosis respectively. In contrast, other DAR deficient mice showed normal bone phenotype. Likewise, osteoclasts from Siglec-15 deficient mice failed to form an actin ring, suggesting that Siglec-15 promotes bone resorption principally by modulating the cytoskeletal organization of osteoclasts. Our results further demonstrated that Siglec-15 may be involved in macrophage colony-stimulating factor (M-CSF) signaling; therefore, mediating cytoskeletal organization of osteoclasts via promoting activation of the Ras-associated protein-1 (RAP1)/Ras-related C3 botulinum toxin substrate 1 (RAC1) pathway, which is an essential component of the canonical osteoclast cytoskeletal organization complex. Furthermore, biochemical analysis revealed that Sigelc-15 activates M-CSF-induced Rac1 pathway through formation of a complex with p130CAS and CrkII, leading to cytoskeletal remodeling of osteoclasts. Our data provide genetic and biochemical evidence that Siglec-15 facilitates M-CSF-induced cytoskeletal remodeling of the osteoclasts.

Aims: Are nurses adapting to the mechanized nursing practice environment? Is it possible for nurses to collaborate with technology to provide care to patients? The aim of the study is to investigate what nurses feel about using technology in nursing practice. Background: Preventing patients from falling is one of the nursing tasks that can be helped by using technology, such as sensors. However, little is known about how nurses experience and feel the use of technological beds for monitoring functionality within clinical nursing practice. Especially it is indicated that alarm fatigue makes nurses and patients fatigued and induces a dissonance between nurses and technology. Objective: To clarify the experiences of nurses in clinical practice following the introduction of a bed with monitoring and fall prevention technology (technology bed). Methods: We interviewed 12 nurses working at a hospital about their nursing practice experiences with the technology bed. Results: The content of the interview was classified into three categories: ‘providing a safe environment’, ‘limitation of entry into machine care scenes’, and ‘nurses’ dilemmas’; with eight themes describing nursing practice: (1) strategies of fall prevention, (2) decrease in nurses’ burden, (3) not good at using technology (all tools must be easy to use), (4) inefficiency such as over-engineering, (5) patients feel annoyed by frequent visits from nurses, (6) limitations of utilization from a nursing perspective, (7) nurse resistance to equipment introduction and (8) ethical issues. Conclusion: Although technology beds could effectively prevent falls, many nurses face an ethical dilemma in using these beds. It would be important for nurses to recognize the role of technology, embrace it, and raise awareness of collaborating with technology to eliminate a dissonance between technology and nurses.

The authors have requested that this preprint be removed from Research Square.

Because of its proximity and the large size of its black hole, M87 is one of the best targets for studying the launching mechanism of active galactic nucleus jets. Currently, magnetic fields are considered to be an essential factor in the launching and accelerating of the jet. However, current observational estimates of the magnetic field strength of the M87 jet are limited to the innermost part of the jet or to HST-1. No attempt has yet been made to measure the magnetic field strength in between. We aim to infer the magnetic field strength of the M87 jet out to a distance of several thousand $r_s$ by tracking the distance-dependent changes in the synchrotron spectrum of the jet from high-resolution very long baseline interferometry observations. In order to obtain high-quality spectral index maps, quasi-simultaneous observations at 22 and 43 GHz were conducted using the KVN and VERA Array (KaVA) and the VLBA. We compared the spectral index distributions obtained from the observations with a model and placed limits on the magnetic field strengths as a function of distance. The overall spectral morphology is broadly consistent over the course of these observations. The observed synchrotron spectrum rapidly steepens from $\alpha_{22-43 GHz}$ ~ -0.7 at ~ 2 mas to $\alpha_{22-43 GHz}$ ~ -2.5 at ~ 6 mas. A spectral index model in which nonthermal electron injections inside the jet decrease with distance can adequately reproduce the observed trend. This suggests the magnetic field strength of the jet at a distance of 2 - 10 mas (~ 900 $r_s$ - ~ 4500 $r_s$ in the deprojected distance) has a range of $B=(0.3 - 1.0 G)(z/2 mas)^{-0.73}$. Extrapolating to the EHT scale yields consistent results, suggesting that the majority of the magnetic flux of the jet near the black hole is preserved out to ~ 4500 $r_s$ without significant dissipation., Comment: 16 pages, 9 figures. Accepted for publication in Astronomy & Astrophysics

KOSENs not only try to increase students’ engineering abilities and literacy, which is the ability to use knowledge and skills, but also their competency, which we consider is the ability to apply knowledge and skills to any problem that might arise outside the walls of school. So the present study analyzes the relationship between a teacher’s evaluation of students’ self-assessment by “Daifuku-cho,” which is used for teacher-and-student interaction in PE class, and their competency improvement using PROG test scores. The result confirmed that students’ daily self-reflection and teachers’ feedback on them are important, and the outcome of their daily self-reflection can quantitatively show the growth in their competency. In particular, we report that the interaction between students and their teacher through the use of “Daifuku-cho” enhanced their learning and also that by comparing what the students wrote in “Daifukucho,” their grades and the results of PROG test, we suggest that the better students reflected themselves using “Daifuku-cho,” the more their competency developed.

The efficacy and renal safety of low-dose/high-frequency (LDHF) dosing and high-dose/low-frequency (HDLF) dosing of bisphosphonates (BPs) are comparable in patients with normal kidney function but might be different in patients with late-stage chronic kidney disease (CKD). This study aimed to compare the efficacy and renal safety of two different dosage regimens of a BP, alendronate (ALN), in stage 4 CKD using a rat model. Male, 10-week-old Sprague-Dawley rats were subjected to either 5/6 nephrectomy or sham surgery. The animals received subcutaneous administration of vehicle (daily) or ALN in LDHF dosage regimen (LDHF-ALN: 0.05 mg/kg/day) or HDLF dosage regimen (HDLF-ALN: 0.70 mg/kg/2 weeks). Medications commenced at 20 weeks of age and continued for 10 weeks. Micro-computed tomography, histological analysis, infrared spectroscopic imaging, and serum and urine assays were performed to examine the efficacy and renal safety of the ALN regimens. Both LDHF-ALN and HDLF-ALN increased bone mass, improved micro-structure, and enhanced mechanical properties, without causing further renal impairment in CKD rats. Histologically, however, HDLF-ALN more efficiently suppressed bone turnover, leading to more mineralized trabecular bone, than LDHF-ALN in CKD rats, whereas such differences between LDHF-ALN and HDLF-ALN were not observed in sham rats. Both LDHF-ALN and HDLF-ALN showed therapeutic effects on high bone turnover osteoporosis in CKD stage 4 rats without causing further renal impairment. However, as HDLF-ALN more efficiently suppressed bone turnover than LDHF-ALN in late-stage CKD, HDLF-ALN might be more appropriate than LDHF-ALN for fracture prevention in high bone turnover osteoporosis patients with late-stage CKD.

Bisphosphonates (BPs) have been shown to reduce the incidence of vertebral fractures during the first year or two of glucocorticoid (GC) treatments and are therefore recommended as a first-line treatment for GC-induced osteoporosis (GIO). However, there are theoretical concerns about the long-term use of BPs in low-turnover osteoporosis caused by chronic GC therapy.We analyzed the trabecular microarchitecture, bone metabolism, and material strength of iliac crest bone biopsy samples from 10 female patients with rheumatoid arthritis who received an average of 6.7 years of BP therapy for GIO (GIOBP group), compared with those of 10 age- and bone mineral density (BMD)-matched non-rheumatoid arthritis postmenopausal women (reference group).Patients in the GIOBP group had a significantly greater fracture severity index, as calculated from the number and the extent of vertebral fractures compared with the reference patients. Micro-computed tomography analysis showed that the degree of mineralization and trabecular microarchitecture were significantly lower in the GIOBP group than in the reference patients. Patients in the GIOBP group exhibited lower bone contact stiffness, determined by micro-indentation testing, than in the reference group. The contact stiffness of the bone was negatively correlated with the fracture severity index and the daily prednisolone dosage. Immunohistochemistry and serum bone turnover markers showed decreased osteoclastic activity, impaired mineralization, and an increased fraction of empty lacunae in the GIOBP group.Our findings indicate that patients receiving long-term BP for GIO are still at high risk for fragility fractures because of poor bone quality.

Background Bisphosphonates (BPs) have been shown to reduce the incidence of vertebral fractures during the first year or two of glucocorticoid (GC) treatments and are therefore recommended as a first-line treatment for the prevention and treatment of GC-induced osteoporosis (GIO). However, there are theoretical concerns about the long-term use of BPs in low-turnover osteoporosis caused by chronic GC therapy. Methods We analyzed the trabecular microarchitecture, bone metabolism, and material strength of bone biopsy samples from the iliac crest of female patients with rheumatoid arthritis (RA) receiving an average of 6.7 years of BP therapy for GIO (GIOBP group, n = 10), compared with those of age- and bone mineral density (BMD)-matched non-RA postmenopausal women with no history of anti-osteoporosis medication use (reference group, n=10). Results Patients in the GIOBP group had a significantly greater fracture severity index, as calculated by the sum of the Genant visual semiquantitative grading scores of vertebral fractures (T4-L5) compared with the reference patients. Micro-computed tomography analysis showed that the degree of mineralization and trabecular microarchitecture were significantly lower in the GIOBP group than in the BMD-matched reference patients. Patients in the GIOBP group exhibited lower bone contact stiffness, determined by micro-indentation testing, than in the reference group. The contact stiffness of the bone was negatively correlated with the fracture severity index and the daily prednisolone dosage. Immunohistochemistry and serum bone turnover markers showed decreased osteoclastic activity, impaired mineralization, and an increased fraction of empty lacunae in the GIOBP group. Conclusions Our findings indicate that patients with RA receiving long-term BP for GIO are still at high risk for fragility fractures because of poor bone quality.

A Global Positioning System (GPS) is widely used as a method of outdoor localization. However, indoor localization system is required because the GPS signals are disturbed indoors. Although the fingerprinting method is a simple and inexpensive method of indoor localization, it is affected by environmental factors such as multipath effects. This paper proposes a Convolutional Neural Networks (CNN)-based localization model that consists of pooling layers for Wi-Fi fingerprinting indoor localization. These pooling layers of CNN can extract features of RSSI that contribute to the localization. Experimental results show that the proposed model reduces MAE about 16%. Furthermore, the coefficient of determination improves by 0.5 compared to the fingerprinting method.

Breast cancer is one of the most prevalent malignancies in women, and approximately 75-80% of patients with advanced breast cancer develop bone metastasis. Expression of the cancer-associated carbohydrate antigen sialyl-Tn (STn) in breast cancer is associated with a poor prognosis; however, involvement of STn in the development of metastatic bone lesions remains unclear. We investigated whether STn expression on breast cancer cells influences intraosseous tumor growth and bone response in mice models of skeletal colonization. STn-positive (STn+) breast cancer cells were generated by stable transfection of an expression vector encoding ST6GaLNAc I into the breast cancer cell line MDA-MB-231. Parental MDA-MB-231 cells not expressing STn antigen were used as STn-negative (STn-) breast cancer cells. Contrary to expectations, STn expression attenuated the development of destructive bone lesions in the in vivo mice models. An in vitro study demonstrated that STn expression impaired adhesion of MDA-MB-231cells to bone marrow stromal cells. This finding in vitro was also confirmed by another breast cancer cell line MCF-7. Cell adhesion to fibronectin and type I collagen was also impaired in STn+ MDA-MB-231 cells compared to that in STn- MDA-MB-231 cells, suggesting integrin dysfunction. Given that the integrin β1 subunit is the main carrier of the STn epitope, it is likely that changes in glycan structure impaired the adhesive capacity of β1 integrin in the bone environment, leading to attenuation of tumor cell engraftment. In conclusion, breast cancer cells expressing STn antigen had less capacity for skeletal colonization, possibly due to impaired adhesive capability.

We examined whether a tool for determining Johnsen scores automatically using artificial intelligence (AI) could be used in place of traditional Johnsen scoring to support pathologists’ evaluations. Average precision, precision, and recall were assessed by the Google Cloud AutoML Vision platform. We obtained testicular tissues for 275 patients and were able to use haematoxylin and eosin (H&E)-stained glass microscope slides from 264 patients. In addition, we cut out of parts of the histopathology images (5.0 × 5.0 cm) for expansion of Johnsen’s characteristic areas with seminiferous tubules. We defined four labels: Johnsen score 1–3, 4–5, 6–7, and 8–10 to distinguish Johnsen scores in clinical practice. All images were uploaded to the Google Cloud AutoML Vision platform. We obtained a dataset of 7155 images at magnification 400× and a dataset of 9822 expansion images for the 5.0 × 5.0 cm cutouts. For the 400× magnification image dataset, the average precision (positive predictive value) of the algorithm was 82.6%, precision was 80.31%, and recall was 60.96%. For the expansion image dataset (5.0 × 5.0 cm), the average precision was 99.5%, precision was 96.29%, and recall was 96.23%. This is the first report of an AI-based algorithm for predicting Johnsen scores.

Osteomyelitis is characterized by progressive inflammatory bone destruction accompanied by severe pain and disability. However, with the exception of antibiotic therapies, there is no established therapy to protect the bone from infectious osteolysis. The anti-receptor activator of nuclear factor-kB ligand (RANKL) monoclonal antibody (anti-RANKL Ab) is a potential drug based on its proven effectiveness in preventing joint bone erosion in rheumatoid arthritis; however, the efficacy and adverse effects of anti-RANKL Ab in osteomyelitis remain to be investigated. In this study, we investigated the effects of anti-mouse RANKL Ab on acute osteomyelitis and compared them with those of zoledronic acid (ZA) using a murine model. Mice were inoculated with bioluminescent Staphylococcus aureus (Xen 29) on their left femur and then treated with ZA, anti-RANKL Ab, or phosphate-buffered saline as control. A 21-day longitudinal observational study using microcomputed tomography showed that both anti-RANKL Ab and ZA had an osteoprotective effect against infectious osteolysis. However, it was also demonstrated through bioluminescence imaging that ZA delayed the spontaneous reduction of bacterial load and through histology that it increased the amount of necrotic bone, while anti-RANKL Ab did not. Findings from histopathological and in vitro studies suggest that an intense inflammatory response around the necrotic bone could induce osteoclasts in a RANKL-independent manner, leading to the removal of necrotic bone, even after administration of the anti-RANKL Ab therapy. Collectively, anti-RANKL Ab may exert an osteoprotective effect without hampering the removal of the necrotic bone, which serves as a nidus for infection in osteomyelitis.

Threats of cyber attacks are rampant all over the world. The threats are getting stronger year by year. In 2015, the National Institute of Technology (KOSEN) launched the KOSEN Security Educational Community (K-SEC) and started cyber security training for KOSEN students. This project has two main purposes that one is outstanding cyber security human resource development which objects for improving quality and other one is fostering many KOSEN students who have systematically acquired security knowledge which objects for quantitative expansion. As part of K-SEC, research of cyber security human resource development education has been promoted. A new project ”Highly Advanced Cybersecurity for KOSEN (HACK) ” has been launched within K-SEC to accelerate the achievement of the two main purposes since 2019. HACK is a project based on the simple idea of strengthening KOSEN technical staff in order to foster strong students who have acquired practical cyber security skills. The plan is a three-year plan. HACK has three main objectives which are improving faculties ’ and technical staffs’ skills, the development excellent teaching materials based on the skills and to create both skills and human resources network. The success of HACK is important to contribute not only to security education but also to the examination of KOSEN or engineering education centered on practical education. In this paper, we will evaluate the effectiveness and legal theory of cyber security practice education for faculty and technical staff who participate the IT course in the first year. In addition, we will verify the effect of improving the skills of each faculty member in the off-season until the start of the second year. Furthermore, we will also consider whether the cyber security skills of the entire technical college have improved in the fiscal year. This year, we are proceeding with the project for the second year. In the second year, based on the results of the first year, we will evaluate, consider and examine for the improvement of the educational content toward the third year, which is the completion year. The evaluation includes the validity of the schedule. We also achieved a certain level of success in the development of teaching materials. This project is in good condition for the continuation of the plan and consideration of new items for the next year and after next year. In this paper, we report on the process of building this sustainable and effective cybersecurity education methodology suitable for KOSEN faculty and staff, and thus for students.

Background: Johnsen scores are commonly used for scoring testicular biopsy, and are needed for testicular sperm extraction (TESE). However, pathologists need much experience to make histopathological evaluations of testes. Therefore, we considered that a tool for determining Johnsen scores automatically using AI could be used in place of traditional Johnsen scoring to support pathologists’ evaluations. Methods: 275 patients with obstructive or non-obstructive azoospermia who underwent testicular sperm extraction (TESE) were included in this study. We obtained testicular tissues for the 275 patients and were able to make 264 haematoxylin and eosin (H&E)-stained glass microscope slides. Slides were examined under an optical microscope (X400). In addition, we cut out of parts of the histopathology images of (5·0 X 5·0 cm) for expansion of Johnsen’s characteristic areas with seminiferous tubules. We defined four labels: Johnsen score 1-3, 4-5, 6-7, and 8-10 to distinguish Johnsen scores in clinical practice. All images were uploaded to the Google Cloud AutoML vision platform. We obtained a dataset of 7155 images at magnification X400 and a dataset of 9822 expansion images for the 5·0 X 5·0 cm cutouts. Performance of the algorithm was assessed by average precision (positive predictive value), precision, and recall. Findings: For the X400 magnification image dataset, the average precision (positive predictive value) of the algorithm was 82·6%, precision was 80·31%, and recall was 60·96%. For the expansion image dataset (5·0 X 5·0 cm), the average precision of the algorithm was 99·5%, precision was 96·29%, and recall was 96·23%. Interpretation: This is the first report of an AI-based algorithm for predicting Johnsen scores. It was created through an automated deep learning approach needing no coding experience. Funding: Grant-in-Aid for Scientific Research (C) from the Japan Society for the Promotion of Science Declaration of Interests: All authors have no competing interests to declare. Ethics Approval Statement: The study was approved by the Research Ethics Committee of the Omori Hospital, School of Medicine, Toho University (approval No. M20103).

Full list of authors: Cho, Ilje; Zhao, Guang-Yao; Kawashima, Tomohisa; Kino, Motoki; Akiyama, Kazunori; Johnson, Michael D.; Issaoun, Sara; Moriyama, Kotaro; Cheng, Xiaopeng; Algaba, Juan-Carlos; Jung, Taehyun; Sohn, Bong Won; Krichbaum, Thomas P.; Wielgus, Maciek; Hada, Kazuhiro; Lu, Ru-Sen; Cui, Yuzhu; Sawada-Satoh, Satoko; Shen, Zhiqiang; Park, Jongho; Jiang, Wu; Ro, Hyunwook; Yi, Kunwoo; Wajima, Kiyoaki; Lee, Jee Won; Hodgson, Jeffrey; Tazaki, Fumie; Honma, Mareki; Niinuma, Kotaro; Trippe, Sascha; An, Tao; Zhang, Yingkang; Lee, Jeong Ae; Oh, Se-Jin; Byun, Do-Young; Lee, Sang-Sung; Kim, Jae-Young; Oh, Junghwan; Koyama, Shoko; Asada, Keiichi; Wang, Xuezheng; Cui, Lang; Hagiwara, Yoshiaki; Nakamura, Masanori; Takamura, Mieko; Hirota, Tomoya; Sugiyama, Koichiro; Kawaguchi, Noriyuki; Kobayashi, Hideyuki; Oyama, Tomoaki; Yonekura, Yoshinori; Kim, Jongsoo; Hwang, Ju-Yeon; Jung, Dong-Kyu; Kim, Hyo-Ryoung; Kim, Jeong-Sook; Oh, Chung-Sik; Roh, Duk-Gyoo; Yeom, Jae-Hwan; Xia, Bo; Zhong, Weiye; Li, Bin; Zhao, Rongbing; Wang, Jinqing; Liu, Qinghui; Chen, Zhong.--This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited., Sagittarius A* (Sgr A*), the Galactic Center supermassive black hole (SMBH), is one of the best targets in which to resolve the innermost region of an SMBH with very long baseline interferometry (VLBI). In this study, we have carried out observations toward Sgr A* at 1.349 cm (22.223 GHz) and 6.950 mm (43.135 GHz) with the East Asian VLBI Network, as a part of the multiwavelength campaign of the Event Horizon Telescope (EHT) in 2017 April. To mitigate scattering effects, the physically motivated scattering kernel model from Psaltis et al. (2018) and the scattering parameters from Johnson et al. (2018) have been applied. As a result, a single, symmetric Gaussian model well describes the intrinsic structure of Sgr A* at both wavelengths. From closure amplitudes, the major-axis sizes are ∼704 ± 102 μas (axial ratio ∼${1.19}_{-0.19}^{+0.24}$) and ∼300 ± 25 μas (axial ratio ∼1.28 ± 0.2) at 1.349 cm and 6.95 mm, respectively. Together with a quasi-simultaneous observation at 3.5 mm (86 GHz) by Issaoun et al. (2019), we show that the intrinsic size scales with observing wavelength as a power law, with an index ∼1.2 ± 0.2. Our results also provide estimates of the size and compact flux density at 1.3 mm, which can be incorporated into the analysis of the EHT observations. In terms of the origin of radio emission, we have compared the intrinsic structures with the accretion flow scenario, especially the radiatively inefficient accretion flow based on the Keplerian shell model. With this, we show that a nonthermal electron population is necessary to reproduce the source sizes. © 2022. The Author(s). Published by the American Astronomical Society., I.C. and J.P. are supported by the National Research Foundation of Korea (NRF) via a Global PhD Fellowship grant (NRF-2015H1A2A1033752 and NRF-2014H1A2A1018695, respectively). I.C. acknowledges financial support by the Spanish Ministerio de Economía y Competitividad (grants PID2019-108995GB-C21) and the Junta de Andalucía (grant P18-FR-1769). G.-Y.Z. and T.J. are supported by the Korea Research Fellowship Program through the NRF (NRF-2015H1D3A1066561). I.C. and G.-Y.Z. acknowledge financial support from the State Agency for Research of the Spanish MCIU through the "Center of Excellence Severo Ochoa" award to the Instituto de Astrofísica de Andalucía (SEV-2017-0709). K.A. is supported by the National Science Foundation (NSF) through grants AST-1440254, AST-1614868, and AST-2034306. This work is partially supported by JSPS KAKENHI grant Nos. JP18K03656 (M.K.), JP18H03721 (K.N., M.K., K.H.), JP18K13594 (T.K.), JP18KK0090 (K.H.), JP19H01943 (K.H.), JP21H01137 (K.H., M.K.), and the Mitsubishi Foundation grant No. 201911019 (K.H.). J.-C.A. acknowledges support from the Malaysian Fundamental Research grant Scheme (FRGS) FRGS/1/2019/STG02 /UM/02/6. M.D.J. acknowledges support from the National Science Foundation (AST-1716536, AST-1935980) and the Gordon and Betty Moore Foundation (GBMF-5278). X.-P.C. and B.-W.S. are supported by Brain Pool Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science and ICT (2019H1D3A1A01102564). R.-S.L. is supported by the Max Planck Partner Group of the MPG and the CAS and acknowledges the support by the Key Program of the National Natural Science Foundation of China (grant No. 11933007) and Research Program of Fundamental and Frontier Sciences, CAS (grant No. ZDBS-LY-SLH011). J.P. acknowledges financial support through the EACOA Fellowship awarded by the East Asia Core Observatories Association, which consists of the Academia Sinica Institute of Astronomy and Astrophysics, the National Astronomical Observatory of Japan, Center for Astronomical Mega-Science, Chinese Academy of Sciences, and the Korea Astronomy and Space Science Institute. S.T. acknowledges financial support from the NRF via Basic Research grant 2019R1F1A1059721. This work was also supported in part by MEXT SPIRE, MEXT as "Priority Issue on post-K computer" (Elucidation of the Fundamental Laws and Evolution of the Universe) and as "Program for Promoting Researches on the Supercomputer Fugaku" (High-energy astrophysical phenomena in black holes and supernovae). J.S.K. (grant Nos. 2016R1A5A1013277 and 2020R1A2C1007219) and J.O. (grant No. 2021R1A6A3A01086420) has been supported by the Basic Science Research Program through the NRF funded by the Ministry of Education.

Background Pneumoperitoneum to maintain a constant gas flow to assist various surgeries is known to cause severe bradycardia and has been linked to heart failure;; however, a recent study demonstrated that it is not linked to poorer surgical outcomes; accordingly, it does not require routine preventive measures. Thus, whether there is a link between sudden bradycardia development and surgical procedures is controversial. We report the case of severe bradycardia that occurred along with a complete atrioventricular block (CAVB) during peritoneum creation in robot-assisted radical prostatectomy (RARP). Case presentation A 72-year-old man presented at our hospital with prostate cancer and underwent RARP. After pneumoperitoneum, severe bradycardia and CAVB were observed; thus, the surgery was extended by inserting a temporary pacemaker (TPM). Conclusion Because of the difficulty in performing emergency procedures in robot-assisted surgeries, the current case is reported to provide an awareness that surgeons should be cautious of the possible complication of bradycardia and CAVB during such operations, and thus should take steps necessary for managing induction of such conditions.

Very Long Baseline Interferometry (VLBI) astrometry using the phase-referencing technique remains an open issue for the quantitative characterization of the observing conditions to achieve a feasible parallax precision of 10 micro-arcseconds (μas). To address this issue, we evaluated the astrometric performance of the VLBI Exploration of Radio Astrometry (VERA) through the parallax measurements of five distant star-forming regions under good observing conditions of close separations (${0{^{\circ}_{.}}5}$–${1{_{.}^{\circ}}3}$) and high elevations (≥50°). Their parallaxes measured 89–200 μas, corresponding to distances of 5–11 kpc with an error of 11–20 μas. Furthermore, we investigated the contributions to the position error budget and concluded that the tropospheric residual contribution is the dominant error source. We also confirmed that the astrometric error propagation strongly depends on the term $\Delta \sec Z$, which stands for the difference between $\sec Z$ of the target and its reference source, where Z is the zenith angle during the observations. We found that for a source pair with a $\Delta \sec Z$ less than 0.01 (for example, a set of a close separation of $\le {{0{^{\circ}_{.}}5}}$ and a high elevation of ≥50°), we can achieve the parallax precision of 10 μas using a typical monitoring program comprising 10 observing epochs over a span of two years.

OBJECTIVES To develop a novel simple quantitative scoring model for predicting stone-free status after a flexible ureteroscopy lithotripsy procedure by standardizing the complexity of ureteral stone characteristics. METHODS We retrospectively reviewed 586 patients with renal or ureteral stones who underwent flexible ureteroscopy lithotripsy at Abiko Toho Hospital, Chiba, Japan, from 2015 to 2018. Multivariate regression was applied to examine the relationship between preoperative descriptors and stone-free status, and a nomogram was developed using significant predictors. Next, the individual components of the nomogram were assigned points to form a simple scoring system. The predictive performance of this new scoring system was compared with the STONE score at optimal cut-off values using receiver operating characteristic curve and area under the curve analyses. RESULTS Multivariate logistic regression findings showed that factors associated with stone-free status were length, Hounsfield unit and stone location. A nomogram prediction model was developed with an area under the curve value of 0.845, then consequently used to develop a new simple score system termed the T.O.HO. score consisting of three stone characteristics: (T)allness (1-5 points), (O)ccupied lesion (1-3 points) and (HO)unsfield units evaluation (1-3 points). The T.O.HO. score was significantly higher in stone remaining (7.66) than stone-free (5.27; P

We present the first astrometry catalog from the Japanese VLBI (very long baseline interferometer) project VERA (VLBI Exploration of Radio Astrometry). We have compiled all the astrometry results from VERA, providing accurate trigonometric annual parallax and proper motion measurements. In total, 99 maser sources are listed in the VERA catalog. Among them, 21 maser sources are newly reported while the rest of 78 sources are referred to previously published results or those in preparation for forthcoming papers. The accuracy in the VERA astrometry are revisited and compared with those from the other VLBI astrometry projects such as BeSSeL (The Bar and Spiral Structure Legacy) Survey and GOBELINS (the Gould's Belt Distances Survey) with the VLBA (Very Long Baseline Array). We have confirmed that most of the astrometry results are consistent with each other, and the largest error sources are due to source structure of the maser features and their rapid variation, along with the systematic calibration errors and different analysis methods. Combined with the BeSSeL results, we estimate the up-to-date fundamental Galactic parameter of $R_{0}=7.92\pm0.16_{\rm{stat.}}\pm0.3_{\rm{sys.}}$~kpc and $\Omega_{\odot}=30.17\pm0.27_{\rm{stat.}}\pm0.3_{\rm{sys.}}$~km~s$^{-1}$~kpc$^{-1}$, where $R_{0}$ and $\Omega_{\odot}$ are the distance from the Sun to the Galactic center and the Sun's angular velocity of the Galactic circular rotation, respectively., Comment: 35 pages, 7 figures, accepted for publication in the Publications of the Astronomical Society of Japan

The power monitoring system is used to manage the operation status of home appliances. The power sensor driven without a battery using the energy harvesting is developed. The power monitoring system handled in this paper uses the developed home appliance power sensor. However, the power monitoring system does not take measures against hardware failures of gateway. Therefore, home appliances are unable to be monitored when failures occur in the gateway. We propose a method of redundancy. Our proposed method is achieved by communication in which the power sensor does not distinguish the gateway and alive confirmation messages between gateways. We implemented and experimented with the proposed method. We confirmed that failover is executed when a failure occurs. The downtime was a minimum of 69 s, a maximum of 108 s, an average of 92 s.

In deep neural networks, which have been gaining attention in recent years, the features of input images are expressed in a middle layer. Using the information on this feature layer, high performance can be demonstrated in the image recognition field. In the present study, we achieve image recognition, without using convolutional neural networks or sparse coding, through an image feature extraction function obtained when identity mapping learning is applied to sandglass-style feed-forward neural networks. In sports form analysis, for example, a state trajectory is mapped in a low-dimensional feature space based on a consecutive series of actions. Here, we discuss ideas related to image analysis by applying the above method.

Measuring the flow of people and utilizing them is a technology that is required in various fields such as economics, marketing, search for lost or lame people and psychological behavior analysis. Recently, research using image processing or Doppler radar has been conducted for measurement the flow of people. However, it is unable to use for follow-up survey on how to move from a point because it is difficult to identify a person in any of the studies. On the other hand, in Japan, according to the Ministry of Internal Affairs and Communications, the ownership rate of smartphones exceeds 75% in all households. With the spread of smartphones in recent years, many people have smartphones. Therefore, we propose a method for measuring the flow of people using information from smartphones because if it is possible to collect information from smartphones, it is possible to realize a more detailed measurement the flow of people as to what kind of action each person takes. When the experiment by the prototype was done, it could measure to some extent such as time which there are many people or few.

Although multiple mechanisms associated with Peyronie's disease (PD) have been proposed, details regarding etiologic factors, especially genetic, remain unclear. We examined the relationship of the ABO blood type system, known as a genetic factor associated with susceptibility to a number of diseases, with PD in Japanese males.We compared 202 Japanese PD patients treated with surgery at our hospital between March 2004 and December 2019 with 846 randomly selected non-PD male patients who underwent urological surgery during the same period regarding distribution of ABO blood types. In addition, we assessed the risk of PD according to blood type group among all study participants using odds ratio (OR) and 95% confidence interval (CI) calculations.The distribution of individual blood types in the control group was nearly the same as that in the general Japanese population. In contrast, O, A, B, and AB blood types were noted in 37.6%, 36.1%, 14.9% and 11.4%, respectively, of the PD patients, which was significantly different from the control group, where blood type O was found in 29.1% and B in 23.2% (p0.05). Our results showed that as compared with patients with blood group B, those with another blood type were more likely to develop PD, among which type O had a significantly increased OR of 2.018 (CI, 1.271-3.205).These are the first reported results showing that ABO blood type may be associated with risk of PD, though further investigations are needed.

Cross-dimerization of a conjugated diene with a substituted alkene catalyzed by in situ reduction of an air-stable Ru(II) catalyst precursor has been achieved. Reaction of 2,3-dimethylbutadiene with styrene is catalyzed by [Ru(acac)2(η4-1,5-COD)] (2a) (5 mol %) with BuLi (10 mol %) at 50 °C for 6 h in hexane, giving the cross-dimers in 99% yield ((E)-4,5-dimethyl-1-phenylhexa-1,4-diene (3a)/(E)-4,5-dimethyl-1-phenylhexa-2,4-diene (3b)/isomers = 84/9/7). Because neither 2a nor BuLi separately catalyzes the cross-dimerization and reduction of 2a with BuLi in the presence of naphthalene produces [Ru(η6-naphthalene)(η4-1,5-COD)] (1a), the active species in this catalysis is considered to be a Ru(0) compound. Interestingly, this in situ reduction method of Ru(II) using BuLi can be applied to the cross-dimerization using an ester such as methyl acrylate. Alternatively, an air-stable Ru(II) complex having a labile arene ligand such as [RuCl2(η6-anisole)]2 (5c) (5 mol %) with Na2CO3 (40 mol %) in the presence of ...

In this proceeding paper, we introduce the recent results of Galactic maser astrometry by mainly focusing on those obtained with Japanese VLBI array VERA. So far we have obtained parallaxes for 86 sources including preliminary results, and combination with the data obtained with VLBA/BeSSeL provides astrometric results for 159 sources. With these most updated results we conduct preliminary determinations of Galactic fundamental parameters, obtaining R0 = 8.16 ± 0.26 kpc and Θ0 = 237 ± 8 km/s. We also derive the rotation curve of the Milky Way Galaxy and confirm the previous results that the rotation curve is fairly flat between 5 kpc and 16 kpc, while a remarkable deviation is seen toward the Galactic center region. In addition to the results on the Galactic structure, we also present brief overviews on other science topics related to masers conducted with VERA, and also discuss the future prospect of the project.

In deep neural networks, which have been gaining attention in recent years, the features of input images are expressed in a middle layer. Using the information on this feature layer, high performance can be demonstrated in the image recognition field. In the present study, we achieve image recognition, without using convolutional neural networks or sparse coding, through an image feature extraction function obtained when identity mapping learning is applied to sandglass-style feed-forward neural networks. In sports form analysis, for example, a state trajectory is mapped in a low-dimensional feature space based on a consecutive series of actions. Here, we discuss ideas related to image analysis by applying the above method.

A continuous survey of students’ Generic Skills (GSs) has been conducted since academic year of 2014 at National Institute of Technology, Sendai College (Sendai KOSEN). Five years have passed since the survey started, and the survey from students’ admission to their graduation at Sendai KOSEN has been completed. Our students’ growth characteristics of GSs in the educational curriculum at Sendai KOSEN became evident from this five-year continuous survey.. Based on the survey results, we propose a “students’ voluntary growth system of GSs.” Using this proposed method, students can be expected to enter a cycle of improving their own generic skills voluntarily and effectively.

The azoospermia factor (AZF) region is important for spermatogenesis, and deletions within these regions are a common cause of oligozoospermia and azoospermia. Although several studies have reported this cause, the present research, to the best of our knowledge, is the first large-scale study assessing this factor in Japan. In this study, 1030 male patients with infertility who were examined for Y chromosome microdeletion using the polymerase chain reaction-reverse sequence-specific oligonucleotide (PCR-rSSO) method, a newly developed method for Y chromosome microdeletion screening, were included. The study enrolled 250 patients with severe oligospermia and 717 patients with azoospermia. Among the 1030 patients, 4, 4, 10, and 52 had AZFa, AZFb, AZFb+c, and AZFc deletions, respectively. The sperm recovery rate (SRR) of microdissection testicular sperm extraction in patients with AZFc deletions was significantly higher than that in those without AZF deletions (60.0% vs 28.7%, P = 0.04). In patients with gr/gr deletion, SRR was 18.7%, which was lower than that in those without gr/gr deletion, but was not statistically significant. In conclusion, our study showed that the frequency of Y chromosome microdeletion in male patients in Japan was similar to that reported in patients from other countries, and SRR was higher in patients with AZFc deletion.