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Afterimages of snow particles in blowing snow may cause lower visibility of the human eye compared to images captured by a digital video camera. However, the impact of the afterimage of snow particles on the visibility of the human eye in blowing snow has not been investigated quantitatively. Here we examined visibility taking the effect of afterimages of snow particles on the human eye into consideration. By considering the duration range of afterimages, and changing the windspeed while the snow density remains constant, our numerical model of visibility for the visual duration range of 0.12 to 0.04 s could accurately explain the visibility of the human eye previously observed in blowing snow.

Peritoneal dialysis (PD) is an important alternative treatment for end-stage renal disease. Continuous exposure to non-physiological fluids during PD is associated with pathological responses, such as sustained microinflammation, leading to tissue fibrosis and angiogenesis. However, the effect of PD fluid on submesothelial cells has not yet been investigated in detail.We investigated the association between macrophages and the expression of matrix metalloproteinase-12 (MMP-12), an elastin proteinase secreted by macrophages, in the peritoneal tissue of rats undergoing continuous PD.Morphological data revealed that the submesothelial layer of the peritoneum in PD model rats was markedly thickened, with fibrosis and angiogenesis. In the fibrillization area, elastin was disorganized and fragmented, and macrophages accumulated, which tended to have M2 characteristics. The expression of MMP-12 was enhanced by continuous exposure to PD fluid, suggesting that MMP-12 expression may be involved in PD fluid-induced peritoneal damage.The results of this study may lead to a better understanding of the mechanisms underlying fibrosis in PD.

Background: Cerebral microbleeds (CMBs) detected on susceptibility-weighted imaging (SWI) are associated with cerebral small vessel disease. Chronic kidney disease and microalbuminuria have been associated with the presence of CMBs in stroke patients. Urinary immunoglobulin G (IgG) is measured to document glomerular injury; however, the relationship between urinary IgG and CMBs is unknown. Methods: We retrospectively enrolled consecutive patients who had been admitted with transient ischemic attack (TIA) or ischemic stroke and identified those who had undergone SWI and a spot urine test. The location of CMBs was classified on magnetic resonance imaging as strictly lobar, deep/infratentorial (D/I), or mixed areas. We analyzed the association between urinary IgG and the presence and location of CMBs. Results: We included 298 patients (86 female, median age 70 years, median eGFR 65.8 mL/min/1.73 m2). Positive urinary IgG and CMB results were found in 58 (19%) and 160 patients (54%), respectively. Urinary IgG positivity was significantly associated with CMBs compared with non-CMBs (28% vs. 9%, p < 0.001), and with D/I or mixed CMBs compared with non-D/I or mixed CMBs (34% vs. 10%, p < 0.001). Multivariate analysis revealed that urinary IgG and hypertension positivity were strongly associated with D/I or mixed CMBs (OR 3.479, 95% CI: 1.776–6.818, p < 0.001; OR 3.415, 95% CI: 1.863–6.258, p < 0.001). Conclusions: Urinary IgG was associated with the prevalence of D/I or mixed location CMBs in TIA or ischemic stroke patients. Our findings provide new insights into the association between urinary IgG and the distribution of CMBs.

Missing responses are common when Asian patients complete the Forgotten Joint Score-12 (FJS-12), which is widely used to evaluate total hip arthroplasty (THA). We aimed to provide orthopaedic researchers with a solution for handling missing values in such patient-reported outcome measures (PROMs).Patients who had undergone primary THA between 1998 and 2016 (n = 1,021) were investigated in 2020. The FJS-12 and 9 other PROMs, including questions related to Asian lifestyle activities, were administered. Risk factors for missing FJS-12 items were investigated. Partial respondents were matched with complete respondents; then, in each pair, the items not completed by the partial respondent were deleted from the responses of the complete respondent. Predictive mean matching (PMM) was performed in an attempt to recover the deleted items, using 65 sets of imputation models. After the missing values had been imputed, we explored patient characteristics that affected the FJS-12, using data from all complete and partial respondents.A total of 652 patients responded to the survey (393 complete and 193 partial respondents). Partial respondents were older, more often female, and less active. Older respondents were more likely to skip items involving the bed, while those who reported a better ability to sit in the seiza style (traditional Japanese floor sitting) were more likely to skip items about chair sitting. The imputed FJS-12 value exhibited excellent reliability (intraclass correlation coefficient for agreement with the true scores, 0.985). FJS-12 values of complete respondents were significantly higher than those of respondents with 4 to 11 missing items (51.6 versus 32.8, p0.001). Older age was associated with higher FJS-12 values, which was revealed only via analysis of the multiply imputed data sets (p0.001).Analysis of only complete FJS-12 responses after THA resulted in a nonresponse bias, preferentially excluding older, female, and less active individuals and those with a traditional floor living style. Multiple imputation could provide a solution to scoring and analyzing PROMs with missing responses by permitting the inclusion of partial respondents.Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Objective S-1 and modified FOLFIRINOX (mFFX) were often used as the second-line chemotherapies after failure of gemcitabine plus nab-paclitaxel (GnP) in unresectable pancreatic cancer (UPC) until nanoliposomal irinotecan plus 5-fluorouracil/leucovorin therapy was approved as an alternative in Japan in 2020. However, the clinical outcomes of S-1 and mFFX after GnP have scarcely been reported. Therefore, we retrospectively studied them. Methods We extracted the clinical data of 86 patients with UPC who received second-line chemotherapy after GnP between 2015 and 2020. Among the patients who had a good organ functions and no massive ascites, 41 patients treated with S-1 and 21 treated with mFFX were enrolled. Results Compared to S-1, mFFX tended to be used for younger patients with a good general condition (median age, 63 vs. 71 years, p0.01; and performance status 0, 67% vs. 37%, p0.05). The median progression-free and overall survival were similar between the S-1 (3.7 and 7.2 months, respectively) and mFFX (3.3 and 7.4 months, respectively) groups. The response rate in patients with measurable lesions was 4% (n=1/23) in the S-1 group and 17% (n=2/12) in the mFFX group. The incidence of grade 3 or 4 adverse events was 20% in the S-1 group and 57% (neutrophil count decreased in 43%) in the mFFX group (p0.01). Conclusion S-1 and mFFX were both acceptable second-line chemotherapies after GnP therapy for UPC, although attention should be paid to myelosuppression during mFFX treatment. Further studies involving nanoliposomal irinotecan plus 5-fluorouracil/leucovorin therapy are necessary to facilitate the selection of the optimal regimen for each patient.

This study aimed to (1) set a reference value for anterior center edge angle (ACEA) for preoperative planning of periacetabular osteotomy (PAO), (2) investigate the effects of pelvic rotation and inclination from false profile (FP) radiographs on the measured ACEA, and (3) determine the “appropriate range of positioning” for FP radiograph. This single-centered, retrospective study analyzed 61 patients (61 hips) who underwent PAO from April 2018 and May 2021. ACEA was measured in each digitally reconstructed radiography (DRR) image of the FP radiograph reconstructed in different degrees of pelvic rotation. Detailed simulations were performed to determine the “appropriate range of positioning” (0.67

Purpose No report has clarified the frequency and interacting factors affecting sleep disturbance among Asian patients at midterm after total knee arthroplasty (TKA). This study aimed to evaluate the frequency of sleep disturbance at midterm after TKA in a Japanese cohort and to identify intervening factors for sleep. We hypothesized that residual knee pain and decreased physical activity negatively interact with sleep quality after TKA.Methods A total of 209 Japanese participants (average age: 77.1 ± 8.3 years; postoperative follow-up period: 4.5 ± 1.9 years) who underwent primary TKA for knee osteoarthritis were included in this study. Sleep quality, satisfaction, pain, physical activity, joint awareness, and mental condition were evaluated using the Pittsburgh Sleep Quality Index (PSQI), Knee Society Score (KSS) 2011, Forgotten Joint Score (FJS)-12, and 12-Item Short-Form Health Survey (SF-12) Mental Component Summary (MCS). Multivariate analysis was performed to determine the influencing factors on PSQI.Results The scores for the PSQI, satisfaction with pain level while lying in bed, pain during level walking, functional activity category in the KSS 2011, awareness of the artificial joint in bed at night in the FJS-12, and SF-12 MCS were 6.7 ± 3.0, 5.8 ± 1.8, 1.6 ± 2.3, 62 ± 22, 1.5 ± 1.4, and 56 ± 9.3 on average, respectively. Sleep disturbance (PSQI ≥ 5.5) occurred in 54% of the Japanese participants. Multivariate analysis revealed that high activity was a significant interacting factor for sleep quality improvement (p Conclusion Decreased physical activity, not residual knee pain, negatively interacted with sleep quality. The sleep disturbance rate was high during the middle postoperative period after TKA in the Japanese cohort, suggesting that interventions that promote daytime exercises may be effective.

Graphene has been investigated as a transparent conductive film for use in a variety of devices, and in recent years it has shown promise for use in millimeter-wave devices as 5G technology. In this study, we applied single-layer (SL), triple-layer (3L), and p-type doped 3L graphene to coplanar waveguide (CPW) transmission lines of practical sizes and obtained transmission characteristics from 1 to 50 GHz, which covered the 5G band. Furthermore, an equivalent circuit model of the CPW used in the measurements was constructed, and simulations were performed, which showed good agreement with the measured results. The results validated the transmission properties of the graphene and the contact impedance with electrodes and the graphene in CPW circuits. In addition, by comparing the transmission loss of various types of graphene, the parameters for improving the transmission characteristics were clarified.

Magnetic resonance imaging (MRI)-detected lesions are often category 2 or 3 lesions on initial ultrasound examination. In addition, in the case of new non-mass lesions detected on MRI, one would expect to find lesions with ductal dilatation with minimal secretory accumulation, single short lesions with ductal dilatation, cyst-like lesions less than 5 mm in size, mammary gland-like lesions less than 8 mm in size, and very indistinct lesions. Detection is expected to be even more difficult. Currently, there are no clear uniform criteria for the indication of second-look ultrasonography (US) for MRI-detected lesions, so it is not possible to make a general comparison, but recent studies have indicated that the ratio of mass to non-mass MRI-detected lesions is 7:3. And it has been pointed out that the percentage of malignancy is about 30% for each. Before about 2012, the US detection rate was about 70%, and MRI-guided biopsies of undetected lesions showed a small percentage of malignant lesions. Therefore, some observers believe that lesions not detected on US should be followed up, while others believe that MRI-guided biopsy should be performed. Recently, however, the use of surrounding anatomical structures as landmarks for second-look US has increased the detection rate to as high as 87–99%, and the percentage of malignancy remains the same. In addition, recent surveillance of high-risk breast cancer requires careful management of MRI-detected lesions. In this review, we will discuss the literature on MRI-detected lesions and describe ultrasound techniques to accurately detect small lesions and reliably reveal pale lesions based on their structural differences from their surroundings.

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Paneth cells are antimicrobial peptide-secreting epithelial cells located at the bottom of the intestinal crypts of Lieberkühn. Crypts begin to form around day 7 of postnatal mice (P7), and Paneth cells usually appear within the first 2 weeks. Paneth cell dysfunction has been reported to correlate with Crohn’s disease-like inflammation, showing narrow crypts or loss of crypt architecture in mice. The morphology of dysfunctional Paneth cells is similar to that of a Paneth/goblet intermediate cell. However, it remains unclear whether the formation of the crypt is related to the maturation of Paneth cells. In this study, we investigated the histological changes in the mouse ileum postnatally and assessed the effect of the methyltransferase inhibitor on epithelium development using organoid culture. The morphological and functional maturation of Paneth cells occurred in the first 2 weeks and was accompanied by histone H3 lysine 27 (H3K27) trimethylation. Inhibition of H3K27 trimethylation suppressed crypt formation and Paneth cell maturation on organoids derived from ileum of early second postnatal mouse. Overall, our data show that post-transcriptional modification of histones, particularly H3K27 trimethylation, leads to the structural and functional maturation of Paneth cells during postnatal development.

Differentiation protocols are used for induced pluripotent stem cells (iPSCs) in in vitro disease modeling and clinical applications. Transplantation of endothelial cells (ECs) is an important treatment strategy for ischemic diseases. For example, in vitro generated ECs can be used to provide the vascular plexus to regenerate organs such as the liver. Here, we demonstrate that the E-twenty-six (ETS) transcription factor ETV2 alone can directly convert iPSCs into vascular endothelial cells (iPS-ETV2-ECs) with an efficiency of over 90% within 5 d. Although the stable overexpression of ETV2 induced the expression of multiple key factors for endothelial development, the induced ECs were less mature. Furthermore, doxycycline-inducible transient ETV2 expression could upregulate the expression of von Willebrand factor (vWF) in iPS-ETV2-ECs, leading to a mature phenotype. The findings of this study on generation of mature iPS-ETV2-ECs provide further insights into the exploration of cell reprogramming from iPSCs. Here, we provide a new protocol for differentiation of iPSCs, thus providing a new source of ECs for in vitro disease modeling and clinical applications.

A 56-year-old postmenopausal woman with out-of-hospital cardiac arrest caused by acute myocardial infraction was successfully resuscitated by intensive treatments and recovered without any neurological disability. She was diagnosed as having familial hypercholesterolemia (FH) based on a markedly elevated low-density lipoprotein cholesterol (LDL-C) level and family history of premature coronary artery disease. Genetic testing in her family members showed that a variant of the proprotein convertase subtilisin/kexin type 9 (PCSK9) gene (c.2004C＞A, p.S668R), which had been previously reported as having uncertain significance, was associated with FH, indicating that the variant is a potential candidate for the FH phenotype. Next-generation sequencing analysis for the proband also showed that there was a heterozygous mutation of the ATP-binding cassette sub-family G member 5 (ABCG5) gene (c.1166G＞A, R389H), which has been reported to increase LDL-C level and the risk of cardiovascular disease. She was also diagnosed as having type 1 CD36 deficiency based on a lack of myocardial uptake of 123 I-labeled 15-(p-iodophenyl)-3-R,S-methyl-pentadecanoic acid in scintigraphy and the absence of CD36 antigen in both monocytes and platelets in flow cytometry. She had a homozygous mutation of the CD36 gene (c.1126-5_1127delTTTAGAT), which occurs in a canonical splice site (acceptor) and is predicted to disrupt or distort the normal gene product. To our knowledge, this is the first report of a heterozygous FH phenotype caused by possibly oligogenic variants of the PCSK9 and ABCG5 genes complicated with type I CD36 deficiency caused by a novel homozygous mutation. Both FH phenotype and CD36 deficiency might have caused extensive atherosclerosis, leading to acute myocardial infarction in the present case.

The 11th International Symposium on Adaptive Motion of Animals and Machines. Kobe University, Japan. 2023-06-06/09. Adaptive Motion of Animals and Machines Organizing Committee., Poster Session P79

TAFRO syndrome is a rare systemic inflammatory disorder that is characterized by thrombocytopenia, anasarca, fever, reticulin fibrosis, and organomegaly. Progressive renal involvement is frequently observed in patients with TAFRO syndrome, and the renal histological findings remain limited. A 52-year-old man with thymoma that was detected by chest computed tomography was admitted to our hospital because of dyspnea and abdominal distension. He had a rapid reappearance of pleural and abdominal effusion following repeated puncture with inflammation and kidney involvement on admission. Renal histology showed glomerular lesions denoting diffuse endocapillary proliferative glomerulonephritis, without any crescentic glomeruli, which was diagnosed as thrombotic microangiopathy (TMA)-like glomerulopathy. Together with histological findings of thymoma and progressively emergent thrombocytopenia, the patient was diagnosed with TAFRO syndrome. Corticosteroid and tocilizumab administration ameliorated the renal insufficiency and his clinical condition relevant to TAFRO syndrome, but there was a rapid concomitant appearance of massive proteinuria. A second renal biopsy revealed membranoproliferative glomerulonephritis (MPGN)-like glomerulopathy with de novo sclerosing and crescentic glomeruli development. Patients with TAFRO syndrome show glomerular lesions that are consistent with TMA- or MPGN-like lesions, but their clinical data are similar between the two glomerulopathies. It remains controversial whether the two are a histopathological continuum or distinct diseases. This case shows that glomerular lesions had TMA-like glomerulopathy in the acute stage of TAFRO syndrome, while the histopathology pattern favors MPGN in the chronic stage, as confirmed by repeated renal biopsies. TAFRO syndrome disease activity may not always correspond to that of glomerulopathy that is associated with TAFRO syndrome.

Background and Purpose: Blood viscosity (BV) is associated with blood stagnation leading to thrombosis. Some polyunsaturated fatty acids (PUFAs) are said to have an antithrombotic effect. First, we aimed to determine the association between BV and the presence of the susceptivity vessel sign (SVS) in patients with cardioembolism (CE) due to atrial fibrillation (AF). Second, we aimed to reveal the association between BV and PUFAs levels. Methods: Consecutive patients with ischemic stroke who met the following inclusion criteria were included: 1) patients with CE, defined by TOAST classification, secondary to AF; 2) onset to door time within 24 h; 3) availability of MRI, including susceptibility-weighted images, obtained at our hospital before IV rt-PA and/or MT; and 4) availability of PUFAs measurements on the day of or the day after the hospital visit. Hematocrit-derived BV at high shear rate (300 sec -1 ) was calculated using the following formula: BV = 1.4175+ 5.878*Ht - 12.98*Ht 2 + 31.964*Ht 3 (Ht = Hematocrit/100). First, we assessed whether BV could be associated with the presence of SVS. Second, we evaluated whether some PUFAs (dihomo-γ-linolenic acid [DGLA], arachidonic acid, eicosapentaenoic acid, docosahexaenoic acid) levels could be the factors associated with BV. Results: We screened 1,720 consecutive ischemic stroke patients and included 137 patients (95 [69%] male, median age 73 years). Of 137, SVS was observed in 83 (61%) patients. In multivariable logistic regression analysis, BV was independently associated with the presence of SVS (odds ratio [OR] 0.391, 95% confidence interval [CI] 0.18-0.86, p = 0.02, Figure). Multiple linear regression analysis revealed a significant positive association between DGLA levels and BV (unstandardized coefficient 0.01, 95% confidence interval 0.01 to 0.02, p < 0.01). Conclusions: Lower BV might be related to the presence of SVS with CE due to AF and DGLA level might be positively associated with BV.

Background and Purpose: Ischemic stroke developed while bathing (ISB) occasionally causes fatal accident. Factors associated with ISB remain unclear. We aimed to estimate the clinical characteristics of ISB, especially the subtype of stroke and the association between cerebral small vessel disease (CSVD) markers. Methods: Consecutive patients with ischemic stroke ≤48 h from onset who underwent MRI during the hospitalization were included. We divided patients into ISB and non-ISB group to analyze differences in clinical characteristics, especially the stroke subtype based on TOAST classification and the association between CSVD markers. The CSVD markers were evaluated by MRI and defined as old lacunes, white matter hyperintensities scale (separately scored by periventricular hyperintensity [PVH] and deep and subcortical white matter hyperintensity), the number of cerebral microbleeds (CMBs) categorized as lobar, deep, and infratentorial lesions, and the scale of enlarged perivascular space in the basal ganglia and centrum semiovale. Results: We screened 2,112 consecutive patients with ischemic stroke including 1,517 patients (1,070 [71%] male, median age 69 years). Of these patients, 52 (3%) were included in ISB group. In univariable analysis, ISB group showed higher frequency of large-artery atherosclerosis ( p = 0.004), lower frequency of cardioembolism ( p = 0.008), smaller number of cerebral microbleeds in deep lesions ( p = 0.025) and lower grade of PVH ( p = 0.023). ISB group showed a lower NIHSS score on admission ( p = 0.002). However, there was no difference in mRS score at 3 months from the onset. In the multivariable analysis (Figure), large-artery atherosclerosis (OR 2.46, 95% CI 1.21-5.01, p = 0.013) and CMBs in deep lesions (OR 0.75, 95% CI 0.58-0.98, p = 0.038) showed independently associated with ISB. Conclusions: ISB showed higher frequency of large-artery atherosclerosis, however, had a less association with the presence of CMBs in deep lesions.

The purpose of the present study was to compare learners' movement variability while maintaining balance and the ability to recover balance using the kinesthetic-experiential learning (KEL) method of implicit learning and the model-mastery learning (MML) method of explicit learning. The participants were 29 healthy university students. They were randomly divided into two groups (KEL and MML). They were required to balance both knees on an exercise ball. The balancing time and the ability to recover their balance were measured using motion capture. Results indicated that balancing time was significantly improved for both learning methods. Regarding the learners' movements while maintaining balance, they maintained balance while moving in the KEL method, whereas they maintained balance by keeping the entire body stationary in the MML method. Concerning the ability to recover, the KEL method improved the balance recovery ability more effectively than the MML method. Therefore, we concluded that using the KEL method at the initial stage of learning improves learners' balance recovery ability and increases movement variability.