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Most gastric neuroendocrine tumors (NETs) develop from enterochromaffin-like (ECL) cells. ECL-cell NETs are classically categorized into three types according to their etiology. A 50-year-old woman presented with submucosal tumor-like lesions in the stomach, which were identified via esophagogastroduodenoscopy. Although esophagogastroduodenoscopy and pathological findings of biopsy specimens showed an absence of mucosal atrophy in the body of the stomach, sticky, adherent, dense mucus was observed. All lesions were diagnosed as ECL-cell NETs based on histological examination findings; however, ECL-cell NETs did not apply to any of the classic types I-III categorization based on laboratory, computed tomography, and 24-h intragastric pH monitoring test findings. Endoscopic submucosal dissection of the tumor was performed. Pathological findings of the excised specimen indicated that parietal cell hyperplasia with a protrusion, dilated fundic glands, and endocrine cell hyperplasia in the background mucosa, and parietal cells were not immunostained for the α-subunits of H

Programming artificially a sequence of organic-metal oxide multilayers (superlattices) by using atomic layered depositions (ALD) is a fascinating and challenging issue in material chemistry. However, the complex chemical reactions between ALD precursors and organic layer surfaces have limited their applications for various material combinations. Here we demonstrate the impact of interfacial molecular compatibility on the formation of organic-metal oxide superlattices using ALD. The effects of both organic and inorganic compositions on the metal oxide layer formation processes onto self-assembled monolayers (SAM) were examined by using scanning transmission electron microscopy (STEM), in-situ quartz crystal microbalance (QCM) measurements, and Fourier-transformed infrared spectroscopy (FT-IR). These series of experiments reveal that the terminal group of organic SAM molecules must satisfy two conflicting requirements, the first of which is to promptly react with ALD precursors and the second is not to bind strongly to the bottom metal oxide layers to avoid undesired SAM conformations. OH-terminated phosphate aliphatic molecules, which we have synthesized, were identified as one of the best candidates for such a purpose. Molecular compatibility between metal oxide precursors and the -OHs must be properly considered to form superlattices. In addition, it is also important to form densely packed and all-trans-like SAMs to maximize the surface density of reactive -OHs on the SAMs. Based on these design strategies for organic-metal oxide superlattices, we have successfully fabricated various superlattices composed of metal oxides (Al-, Hf-, Mg-, Sn-, Ti-, Zr oxides) and their multilayered structures.

With the development of laser technology in the 1960s, a technique was developed to inject intradermal vaccines immediately after irradiating the skin with laser light to elicit an adjuvant effect, referred to as “laser adjuvant.” We have been investigating the mechanism of laser adjuvant in influenza mouse models using noninvasive continuous-wave (CW) near-infrared (NIR) light mainly at a wavelength of 1064 nm, and have shown that the production of reactive-oxygen-species (ROS) in the skin and mast cells in the skin tissue plays an important role in the laser adjuvant effect. The new wavelength of 1270 nm NIR light is characterized by its ability to elicit the same vaccine adjuvant effect as other wavelengths at a lower energy, and may be suitable for clinical applications. In this study, we investigated the physiological activity of CW1270 nm NIR light in mast cells, its biological activity on mouse skin, and the durability of the vaccine adjuvant effect in influenza vaccine mouse models. We show that irradiation of mast cells with 1270 nm NIR light produced ROS and ATP, and irradiation of isolated mitochondria also produced ATP. In mouse skin, the relative expression levels of chemokine mRNAs, such as Ccl2 and Ccl20, were increased by irradiation with 1270 and 1064 nm NIR light at minimum safe irradiance. However, the relative expression of Nfkb1 was increased at 1064 nm, but not at 1270 nm. Serum anti-influenza IgG antibody titers increased early after immunization with 1064 nm, whereas with 1270 nm, there was not only an early response of antibody production but also persistence of antibody titers over the medium- to long-term. Thus, to our knowledge, we show for the first time that 1270 nm NIR light induces ROS and ATP production in mitochondria as photoreceptors, initiating a cascade of laser adjuvant effects for intradermal vaccines. Additionally, we demonstrate that there are wavelength-specific variations in the mechanisms and effects of laser adjuvants. In conclusion, CW1270 nm NIR light is expected to be clinically applicable as a novel laser adjuvant that is equivalent or superior to 1064 nm NIR light, because it can be operated at low energy and has a wavelength-specific adjuvant effect with medium- to long-lasting antibody titer.

This study classifies fetal inflammatory response syndrome (FIRS) based on the presence or absence of maternal-fetal inflammation in the placenta and clarifies the association of FIRS with neonatal morbidities. Women (330) who delivered at gestational ages of 22w0d-33w6d were enrolled and grouped into four based on FIRS and maternal/fetal inflammatory response (MIR/FIR) statuses: Group A: without FIRS and MIR/FIR (reference group); Group B: MIR/FIR alone; Group C: FIRS and MIR/FIR; and Group D: FIRS without MIR/FIR. The associations between bronchopulmonary dysplasia (BPD), adverse neonatal outcomes, extremely low gestational age and Groups B, C, and D were investigated after adjustment for potential confounders. Among patients with FIRS, 29% were in Group D. The risk of BPD was increased in Groups C (adjusted odds ratio (aOR): 3.36; 95% confidence interval (CI): 1.14–9.89) and D (aOR: 4.17; 95% CI: 1.03–16.9), as was the risk of adverse neonatal outcomes (Group C: aOR: 7.17; 95% CI: 2.56–20.1; Group D: aOR: 6.84; 95% CI: 1.85–25.2). The risk of extremely low gestational age was increased in Group D (aOR: 3.85; 95% CI: 1.56–9.52). Therefore, FIRS without MIR/FIR is not rare and may be associated with neonatal morbidities more than FIRS and MIR/FIR.

Background and aim Lipopolysaccharide (LPS) preconditioning drastically augments bactericidal activity but reduces the host inflammatory response. Therefore, it may be beneficial to prevent postoperative infectious complications and mitigate host damage by surgical stress. Considering its clinical application, how LPS preconditioning influences the antitumor effect in the liver is an important issue. We then investigated the effect of LPS preconditioning on antitumor activity against Colon26 tumor cells in mice. Methods Lipopolysaccharide preconditioning was induced in mice by the intraperitoneal injection of 5 μg/kg LPS for three consecutive days. Intraportal inoculation of Colon26 cells, which express luminescent protein called Nano-lantern, was performed to evaluate the effect of LPS preconditioning on tumor liver metastasis. The antitumor activities of cytotoxic liver lymphocytes, especially natural killer (NK) cells and natural killer T (NKT) cells, against Colon26 cells were also examined in LPS preconditioned mice. Results Lipopolysaccharide preconditioning remarkably prevented liver metastasis of Colon26 cells, as observed by IVIS imaging system, and prolonged survival after tumor inoculation. LPS preconditioning increased the proportions and number of liver NK cells and NKT cells and augmented their intracellular perforin and granzyme B expression, while reducing their intracellular expression of IFN-γ. An in vitro antitumor cytotoxicity assay revealed that LPS preconditioning significantly augmented antitumor cytotoxicities of the liver NK cells and NKT cells, especially NKT cells, against Colon26 cells. Conclusions Lipopolysaccharide preconditioning potently augmented antitumor cytotoxicity of liver NK cells and NKT cells, thereby improving mouse survival after intraportal inoculation of Colon26 tumor cells. It may be useful for perioperative care in oncological patients.

This study aimed to identify the recurrence rate of genetic generalized epilepsy (GGE) and risk factors for recurrence after antiseizure medication (ASM) withdrawal in adolescent patients.We retrospectively reviewed medical records of patients with GGE who were included in the registry at the Department of Child Neurology, National Hospital Organization Nishiniigata Chuo Hospital from 2000 through 2020. The eligibility criteria were as follows: onset of epileptic seizures at15 years of age, treatment with an ASM, and attempted treatment withdrawal at 10-19 years of age. The rates of seizure recurrence after drug withdrawal were evaluated. Moreover, several variables were evaluated as predictors of recurrence.In total, 77 patients with GGE (21, 13, and 43 patients with juvenile myoclonic epilepsy [JME], juvenile absence epilepsy [JAE], and epilepsy with generalized tonic-clonic seizures alone [EGTCSA], respectively) were included in this study. Recurrence was detected in 68% of patients with GGE (86%, 31%, and 70% of patients with JME, JAE, and EGTCSA, respectively). Recurrence rates for patients who developed epilepsy at ≥13 years of age, those who started dose reduction at ≥16 years of age, those who exhibited a seizure-free period of36 months before withdrawal, and those who chose to discontinue treatment at their own discretion were significantly higher than those for their counterparts. Multivariate analysis revealed that initiation of dose reduction at ≥16 years of age was associated with increased recurrence risk. Meanwhile, a diagnosis of JAE was associated with decreased recurrence risk. All patients with JAE were treated with valproic acid.Antiseizure medication withdrawal at ≥16 years of age and a diagnosis other than JAE may be independent risk factors for seizure recurrence after drug withdrawal in adolescent patients.

Severe intra-amniotic inflammation, even with a negative bacterial culture, can lead to premature labor. We report a 43-year-old multiparous woman with severe intra-amniotic inflammation and cervical insufficiency at 23 weeks and 5 days of gestation. Continuous transabdominal amnioinfusion was started 2 days after the diagnosis. The amniotic fluid interleukin-6 level normalized after 2 days of treatment. She underwent Shirodkar cervical cerclage on day 7. Despite termination of amnioinfusion and catheter removal on day 16, the pregnancy was maintained without any subsequent treatment. At 33 weeks and 5 days of gestation, an intrauterine Ureaplasma parvum infection and the onset of contractions led to repeat cesarean delivery. The birth weight was 2292 g, and the Apgar scores were 8/8. Both mother and infant had good outcomes. Continuous transabdominal amnioinfusion may have eliminated factors causing intra-amniotic inflammation, thereby prolonging the pregnancy and improving the infant's prognosis.

Background/aimsThe aim of our study was to investigate the associations between driving self-regulation and glaucoma severity, and between driving self-regulation and glaucomatous visual field (VF) defect patterns.MethodsIn 247 patients with primary open-angle glaucoma included in this prospective observational study, a battery of ophthalmic examination was performed, including visual acuity (VA) and VF. Integrated binocular VF was constructed and mean of total deviation (mTD) values in four sectors was calculated (mTDsup-peri, mTDsup-centre, mTDinf-peri and mTDinf-centre). In addition, all participants answered seven questions regarding their avoidance in driving. (1) at night, (2) in rain, (3) in fog, (4) on freeways, (5) lane changing, (6) at high speed and (7) close to the car in front. The associations between these driving behaviours and 10 variables (age, gender, best VA, worst VA, the four sectorial average TD values, years holding a driver’s licence and distance driven per week) were analysed using the generalised linear model with binomial distribution, followed by the model section method using the corrected Akaike information criterion.ResultsAs a result of the model selection, it was suggested that deterioration of mTDsup-peri was associated with (1) avoiding driving at night and (2) avoiding driving in rain. On the other hand, mTDsup-centre was related to (3) avoiding driving in fog.ConclusionDamage in visual function was related with driving behaviours in patients with glaucoma.

Malaria remains a grave concern for humans, as effective medical countermeasures for Plasmodium infection have yet to be developed. Phagocytic clearance of parasitized red blood cells (pRBCs) by macrophages is an important front-line innate host defense against Plasmodium infection. We previously showed that repeated injections of low-dose lipopolysaccharide (LPS) prior to bacterial infection, called LPS preconditioning, strongly augmented phagocytic/bactericidal activity in murine macrophages. However, whether LPS preconditioning prevents murine Plasmodium infection is unclear. We investigated the protective effects of LPS preconditioning against lethal murine Plasmodium infection, focusing on CD11b(high) F4/80(low) liver macrophages, which are increased by LPS preconditioning. Mice were subjected to LPS preconditioning by intraperitoneal injections of low-dose LPS for 3 consecutive days, and 24 h later, they were intravenously infected with pRBCs of Plasmodium yoelii 17XL. LPS preconditioning markedly increased the murine survival and reduced parasitemia, while it did not reduce tumor necrosis factor (TNF) secretions, only delaying the peak of plasma gamma interferon (IFN-γ) after Plasmodium infection in mice. An in vitro phagocytic clearance assay of pRBCs showed that the CD11b(high) F4/80(low) liver macrophages, but not spleen macrophages, in the LPS-preconditioned mice had significantly augmented phagocytic activity against pRBCs. The adoptive transfer of CD11b(high) F4/80(low) liver macrophages from LPS-preconditioned mice to control mice significantly improved survival after Plasmodium infection. We conclude that LPS preconditioning stimulated CD11b(high) F4/80(low) liver macrophages to augment the phagocytic clearance of pRBCs, which may play a central role in resistance against Plasmodium infection.

Background Partition cells are cholinergic interneurons located in lamina VII of the spinal cord. Some partition cells are the source of the cholinergic boutons, known as C-terminals or C-boutons, that modulate the activity of spinal motor neurons. Therefore, partition cells might play an important role in motor control. Previous studies categorized partition cells into three groups (medial, intermediate, and lateral partition cells) according to their distance from the central canal. However, the morphological characteristics of the three groups remain obscure. Methods To analyze the morphology of partition cells, we developed an efficient technique for visualization of specific neurons at single-cell level in particular positions using adenovirus vectors and Cre/lox mediated recombination. Cre/lox conditional vectors were injected into the spinal cord of choline acetyltransferase-Cre transgenic mice, and partition cells labeled by green fluorescent protein were reconstructed from histological serial sections at the single-cell level. Results This technique allowed for the visualization of partition cells at high resolution and revealed that partition cells had various patterns of dendrite orientations and fields. Most of the visualized partition cells had more than 60% of their dendrites located in layer VII of the spinal cord. Partition cells had dendrites extending into various Rexed’s layers (V, VI, VII, VIII, IX, and X), but none of the cells had dendrites extending dorsal to layer IV. The dendrites of partition cells terminated both ipsilaterally and bilaterally. We also found that C-terminals on motor neurons may be derived from the middle/outer group of partition cells. Conclusions Our results indicated that partition cells have various morphological features of the dendritic pattern and may receive differential inputs. Our results suggested that C-terminals originate not only from medial but also from intermediate/lateral cholinergic partition cells. The present study suggests that intermediate/lateral partition cells modulate activities of motor neurons through C-terminal synapses.

Aim The optimal antibiotic regimen for preterm premature rupture of membrane (pPROM) is still unclear. This study aimed to determine the effects of ampicillin-sulbactam (SBT/ABPC) and azithromycin (AZM) on the incidence of bronchopulmonary dysplasia (BPD). Methods This retrospective study included women with singleton gestations and a diagnosis of pPROM between 22 and 27 weeks of gestation. In patients presenting with a high risk of intra-amniotic infection between January 2011 and May 2013, piperacillin or cefmetazole + clindamycin (regimen 1 group; n = 11) was administered, whereas SBT/ABPC and AZM (regimen 2 group; n = 11) were administered in patients presenting a similar risk between June 2013 and May 2016. Results The incidence of moderate or severe infant BPD in the regimen 2 group was significantly lower than that in the regimen 1 group, even when adjusted for gestational age at the time of rupture of membrane, with an odds ratio (95% confidence interval) of 0.02 (1.8 × 10-5 -0.33). The incidence of BPD and total days on mechanical ventilation were significantly lower in the regimen 2 group than in the regimen 1 group. No significant differences were seen in other morbidities. Conclusion In patients with pPROM between 22 and 27 weeks of gestation, the administration of SBT/ABPC and AZM may improve the perinatal outcomes.

Malaria remains a grave concern for humans, as effective medical countermeasures for malaria infection have yet to be developed. Phagocytic clearance of parasitized red blood cells (pRBCs) by macrophages is an important front-line innate host defense against malaria infection. We previously showed that repeated injections of low-dose lipopolysaccharide (LPS) prior to bacterial infection, called LPS preconditioning, strongly augmented phagocytic/bactericidal activity in murine macrophages. However, how LPS preconditioning prevents murine malaria infection is unclear. We investigated the protective effects of LPS preconditioning against lethal murine malaria infection, focusing on CD11bhigh F4/80low liver macrophages, which are increased by LPS preconditioning. Mice were subjected to LPS preconditioning by intraperitoneal injections of low-dose LPS for 3 consecutive days, and 24 h later, they were intravenously infected with pRBCs of Plasmodium yoelii 17XL. LPS preconditioning markedly increased the murine survival and reduced parasitemia, while it did not reduce TNF secretions, only delaying the peak of plasma IFN-γ after malaria infection in mice. An in vitro phagocytic clearance assay of pRBCs showed that the CD11bhigh F4/80low liver macrophages of the LPS-preconditioned mice had significantly augmented phagocytic activity against pRBCs. The adoptive transfer of CD11bhigh F4/80low liver macrophages from LPS-preconditioned mice to control mice significantly improved the survival after malaria infection. We conclude that LPS preconditioning stimulated CD11bhigh F4/80low liver macrophages to augment the phagocytic clearance of pRBCs, which may play a central role in resistance against malaria infection. LPS preconditioning may be an effective tool for preventing malaria infection.

Purpose To evaluate fear of falling using the Fall Efficacy Scale-International (FES-I) in glaucoma patients and investigate its association with glaucomatous visual field loss. Methods This study included 273 patients (160 men and 113 women, average age 64.2 years) with primary open-angle glaucoma. Participants were requested to answer the FES-I questionnaire, translated into Japanese, in a face-to-face interview. The relationship between total FES-I score and the following variables was analyzed using multivariable linear regression: age, sex, better and worse best corrected visual acuity, total deviation (TD) in four visual field areas, body mass index (BMI), minutes walked per day, history of diabetes mellitus, history of systemic hypertension, number of previous falls. Results Univariate analysis suggested that total FES-I score increased with age and in woman, whereas other variables were not significantly associated with total FES-I score. However, age (coefficient, 0.23; standard error [SE], 0.04; P < 0.001), sex (coefficient, 1.79 for women; SE, 0.84; P = 0.034), mean TD in the inferior central area (coefficient, 0.92; SE, 0.22; P

Three Schiff-base-type nickel(II) complexes (1a–3a) and the corresponding noninnocent-type complexes (1b–3b) were synthesized, and the equilibria between these valence isomers were observed in tetrahydrofuran (THF) at room temperature. The electronic state of the noninnocent-type nickel complex was also confirmed by isolation of the one-electron-reduced species. The catalytic ability for the photogeneration of hydrogen from water was examined about 1a–3a and 1b–3b in the presence of a photosensitizer and a sacrificial electron donor. Then, a Schiff-base-type complex with chlorine atoms (2a) and a noninnocent-type complex with methyl groups (3b) on the pendant phenyl rings being present as the minor species in THF exhibited high activity of over 400 turnover numbers. The dynamic light scattering and transmission electron microscopy measurements suggested the formation of NiSx-like aggregate species under photocatalytic conditions. The electrocatalytic activities of the nickel complexes for hydrogen product...

Stereotactic body radiation therapy (SBRT) involves the delivery of substantially larger doses over fewer fractions than conventional therapy. Therefore, SBRT treatments will strongly benefit patients using vivo patient dose verification, because the impact of the fraction is large. For in vivo measurements, a commercially available quality assurance (QA) system is the COMPASS system (IBA Dosimetry, Germany). For measurements, the system uses a new transmission detector (Dolphin, IBA Dosimetry). In this study, we evaluated the method for in vivo 3D dose reconstruction for SBRT using this new transmission detector. We confirmed the accuracy of COMPASS with Dolphin for SBRT using multi leaf collimator (MLC) test patterns and clinical SBRT cases. We compared the results between the COMPASS, the treatment planning system, the Kodak EDR2 film, and the Monte Carlo (MC) calculations. MLC test patterns were set up to investigate various aspects of dose reconstruction for SBRT: (a) simple open fields (2 × 2–10 × 10 cm2), (b) a square wave chart pattern, and (c) the MLC position detectability test in which the MLCs were changed slightly. In clinical cases, we carried out 6 and 8 static IMRT beams for SBRT in the lung and liver. For MLC test patterns, the differences between COMPASS and MC were around 3%. The COMPASS with the dolphin system showed sufficient resolution in SBRT. For clinical cases, COMPASS can detect small changes for the dose profile and dose–volume histogram. COMPASS also showed good agreement with MC. We can confirm the feasibility of SBRT QA using the COMPASS system with Dolphin. This method was successfully operated using the new transmission detector and verified by measurements and MC.

AIM Given the scarcity of relevant reports, this study aimed to elucidate whether pregnancy can be prolonged by maintaining the amniotic fluid volume with continuous transabdominal amnioinfusion (TA) for patients with mid-trimester preterm premature rupture of membranes (PPROM) and oligoamnios. METHODS We retrospectively examined patients who were managed during hospitalization at our department after developing PPROM between week 22 day 0 and week 25 day 6 of gestation and subsequent oligoamnios (amniotic fluid index [AFI]

We investigated the dynamic positioning accuracy of Agility (Elekta) for volumetric modulated arc therapy (VMAT). The accuracy of the multileaf collimator (MLC) leaf position during VMAT was evaluated using three different tests: (1) a dynamic multileaf collimator (DMLC) output test with various leaf speeds, and gantry angles; (2) a slit-fence test with and without gantry rotation; and (3) a complicated VMAT plans test with dose distributions compared with measurements using gamma analysis. The DMLC output was within 1.5 % under all test conditions. The agreement between the static and VMAT in the slit-fence test was within 0.5 mm. The pass rate of each complicated VMAT test plan was more than 93.9 % ± 0.36 for gamma analysis. We confirmed the dynamic positioning accuracy of Agility, which during VMAT delivery is within VMAT tolerances. The fastest MLC was found to have the potential to offer clinical advantages, such as high-quality rapid VMAT.

Background The aim of this study, which included a baseline cross-sectional study and a 3-year follow-up prospective study, was to investigate the association between glaucomatous visual field damage and driving cessation in subjects with primary open-angle glaucoma (POAG). Methods A total of 211 POAG subjects divided into 3 groups according to POAG severity (mild, moderate, or severe) in the better eye were enrolled along with 148 control subjects; subjects were asked about changes in their driving status. In the 3-year follow-up study, 185 of the POAG subjects and 80 of the controls annually reported their driving status. Adjusted odds ratios and 95% confidence intervals for the prevalence and incidence of driving cessation were estimated with a multiple logistic regression model. Results In the original cross-sectional study, 11/148 (7%) members of the control group reported having given up driving over the previous 5 years; the corresponding figures for the mild POAG, moderate POAG, and severe POAG groups were 9/173 (5%), 0/22 (0%), and 5/16 (31%), respectively (p = 0.001, Fisher’s exact test), with severe POAG found to be associated with driving cessation after adjustment for age, gender, systemic hypertension, and diabetes mellitus (odds ratio 11.52 [95% CI 2.87-46.35], ref. control, p = 0.001). In the follow-up study, the proportions of subjects who ceased driving were 1/80 (1.3%) in the control group, 8/152 (5.3%) in the mild POAG group, 5/22 (22.7%) in the moderate POAG group, and 2/11 (18.2%) in the severe POAG group (p = 0.001, Fisher’s exact test). Moderate POAG and severe POAG in the better eye were found to be associated with driving cessation after adjustment for age, gender, systemic hypertension, and diabetes mellitus (moderate POAG in the better eye: odds ratio 37.7 [95% CI 3.7-383.8], ref. control, p = 0.002, and severe POAG in the better eye: odds ratio 52.8 [95% CI 3.5-797.0], ref. control, p = 0.004). Conclusion Moderate and Severe POAG in the better eye is associated with driving cessation.

Background The aim of the study is to investigate risk factors for future falls in subject with primary open angle glaucoma (POAG). Methods All participants answered the following question at their baseline ophthalmic examination: Have you had any falls in the last year? (Yes/No). All study participants answered the same question every 12 months for 3 years. The means of total deviation values in the whole, superior peripheral, superior central, inferior central, and inferior peripheral visual fields (VF) were calculated. The relationship between these mean VF measurements, and various clinical factors against patients’ future falls was analyzed using multiple linear regression. Results Two-hundred ninety four POAG patients answered the baseline and follow-up fall questionnaires over a period of three years. Among 294 subjects, 69 patients experienced a fall during the three-year follow-up. History of falls at baseline (coefficient = 1.22), history of fear of falling at baseline (0.53), best corrected visual acuity in the worse eye (7.37), prevalence of diabetes mellitus (0.60), prevalence of systemic hypertension (0.53) were selected in the optimal model. Conclusions Visual acuity in the worse eye, history of falls, fear of falling, diabetes mellitus, and systemic hypertension are risk factors for falling in subjects with POAG. Electronic supplementary material The online version of this article (10.1186/s12886-017-0613-1) contains supplementary material, which is available to authorized users.

PURPOSE: To confirm that subjects with primary open-angle glaucoma (POAG) who avoid driving in high-risk situations are less likely to be involved in motor vehicle collisions (MVCs) than those who do not. METHODS: This study evaluated 252 consecutive Japanese aged between 40 and 85 years with POAG. All participants were requested to answer a questionnaire on their driving habits, including self-restriction in driving at night, in rain, in fog, on freeways, and lane changing, and history of MVCs. Those who reported restricting their driving in one or more ways constituted the self-restriction group, and those who reported no self-restriction made up the no-restriction group. The prevalence of MVCs and the crash rate (number of MVCs/10,000 km driven) were compared between the two groups. The association between prevalence of MVCs and the number of driving self-restrictions was also evaluated. RESULTS: The association between driving self-restriction and MVCs was observed among the male subjects, not among the female subjects. Among the male subjects, the prevalence of MVCs was significantly higher in the no-restriction group than in the self-restriction group (no-restriction group, 33/107 = 30.8%; self-restriction group, 9/66 = 13.6%, p = 0.01). The crash rate was also significantly higher in the no-restriction group (no-restriction group, 1.4 ± 0.8; self-restriction group, 0.4 ± 0.3, average ± SE, p = 0.01). No restriction was significantly associated with MVCs (multivariable-adjusted odds ratios, 2.43 [95% confidence interval, 1.03 to 5.73]). The number of driving self-restrictions was also associated with MVCs (multivariable-adjusted odds ratios, 0.41 [95% confidence interval, 0.18 to 0.99], per one increment of self-restriction). CONCLUSIONS: Driving self-restriction may be associated with a reduced prevalence of MVCs in men with POAG. Language: en

In this study, we evaluated the performance of a three‐dimensional (3D) dose verification system, COMPASS version 3, which has a dedicated beam models and dose calculation engine. It was possible to reconstruct the 3D dose distributions in patient anatomy based on the measured fluence using the MatriXX 2D array. The COMPASS system was compared with Monte Carlo simulation (MC), glass rod dosimeter (GRD), and 3DVH, using an anthropomorphic phantom for intensity‐modulated radiation therapy (IMRT) dose verification in clinical neck cases. The GRD measurements agreed with the MC within 5% at most measurement points. In addition, most points for COMPASS and 3DVH also agreed with the MC within 5%. The COMPASS system showed better results than 3DVH for dose profiles due to individual adjustments, such as beam modeling for each linac. Regarding the dose‐volume histograms, there were no large differences between MC, analytical anisotropic algorithm (AAA) in Eclipse treatment planning system (TPS), 3DVH, and the COMPASS system. However, AAA underestimated the dose to the clinical target volume and Rt‐Parotid slightly. This is because AAA has some problems with dose calculation accuracy. Our results indicated that the COMPASS system offers highly accurate 3D dose calculation for clinical IMRT quality assurance. Also, the COMPASS system will be useful as a commissioning tool in routine clinical practice for TPS. PACS number: 87.55.Qr, 87.56.Fc, 87.61.Bj

Three Schiff-base-type nickel(II) complexes (1a-3a) and the corresponding noninnocent-type complexes (1b-3b) were synthesized, and the equilibria between these valence isomers were observed in tetrahydrofuran (THF) at room temperature. The electronic state of the noninnocent-type nickel complex was also confirmed by isolation of the one-electron-reduced species. The catalytic ability for the photogeneration of hydrogen from water was examined about 1a-3a and 1b-3b in the presence of a photosensitizer and a sacrificial electron donor. Then, a Schiff-base-type complex with chlorine atoms (2a) and a noninnocent-type complex with methyl groups (3b) on the pendant phenyl rings being present as the minor species in THF exhibited high activity of over 400 turnover numbers. The dynamic light scattering and transmission electron microscopy measurements suggested the formation of NiS

In this study, we evaluated the dosimetric performance of the three-dimensional (3D) dose verification system, COMPASS version 3 (IBA Dosimetry, GmbH, Germany). The COMPASS has the function of a dedicated beam modeling and dose calculation. It is able to reconstruct 3D dose distributions on patient CT images, using the incident fluence from a linear accelerator measured with the MatriXX 2D array (IBA Dosimetry). The dose profiles measured with various multi-leaf collimator (MLC) test patterns for the COMPASS were checked by comparison with those of EDR2 (Eastman Kodak, Rochester, NY) films and Monte Carlo (MC) simulations. The COMPASS was also used for dose verification in clinical intensity-modulated radiation therapy (IMRT) plans for head and neck cases. The dose distributions were compared with those measured by 3DVH (Sun Nuclear, Melbourne, FL) and MC. In addition, the quality assurance (QA) times among the COMPASS, 3DVH, and EDR2 were compared. For MLC test patterns, the COMPASS dose profiles agreed within 3 % with those of EDR2 films and MC simulations. The physical resolution of the COMPASS detectors was lower than that of film, but the dose resolution for MLC patterns was comparable to that of film. In clinical plans, the dose-volume-histograms were equal for all systems. The average QA times of the COMPASS, 3DVH, and EDR2 film were 40.1, 59.4, and 121.4 min, respectively. The COMPASS system provides fast and reliable 3D dose verification for clinical IMRT QA. The COMPASS QA process does not require phantom plans. Therefore, it allows a simple QA workflow.

We have newly developed the mutual-capacitive touch screen using double layered metal mesh electrodes with separated floating electrodes in borders between X- and Y-directional electrodes. We have defined the effect of the floating electrode with an electric field simulation and improved the sensitivity and the response time of the touch screen by separating the floating electrode into several small patterns.

Corrosion resistant microfluidic devices with Ti-lined structure were fabricated for hydrothermal synthesis of high purity metal oxide nanoparticles under high-temperature and high-pressure condition. Pr-doped Ca 0.6 Sr 0.4 TiO 3 red phosphor nanoparticles without contaminations were continuously and safely synthesized using the devices at 673 K and 30 MPa within short residence time of 20 ms in spite of corrosive environment. The nanoparticles having an average particle size of 10 nm and a perovskite structure showed a strong red emission peak around 613 nm.

In this work, a continuous hydrothermal synthesis method in supercritical water was applied to environmentally benign production of Ca1−xSrxTiO3 (x = 0.0–1.0) solid-solution nanoparticles as key materials in conducting, electric, magnetic, and photocatalytic fields. A T-type micromixer (330 μm id) was introduced for rapid heating of stating solutions of Ca(NO3)2, Sr(NO3)2, and TiO2 sol using turbulent flow mixing with preheated NaOH aqueous solution and also for exact control of reaction temperature. At 673 K and 30 MPa for 5.0 s mean residence time, Ca1−xSrxTiO3 solid-solution nanoparticles having crystallite diameters of around 20 nm with monomodal diameter distributions were obtained without byproducts and production of CaTiO3 and SrTiO3 separately over the whole composition range. Effects of NaOH molality, Ca and Sr compositions in the starting solutions, and mean residence time on the reaction were examined. The results showed that TiO2 sol dissolution and Ca1−xSrxTiO3 precipitation were almost finished within 0.25 s mean residence time, and after that Ostwald ripening proceeded.

PURPOSE We predict the likelihood of a future motor vehicle collision (MVC) from visual function data, attitudes to driving, and past MVC history using the penalized support vector machine (pSVM) in subjects with primary open-angle glaucoma (POAG). METHODS Patients with POAG were screened prospectively for eligibility and 185 were analyzed in this study. Self-reported MVCs of all participants were recorded for 3 years from the baseline using a survey questionnaire every 12 months. A binocular integrated visual field (IVF) was calculated for each patient by merging a patient's monocular Humphrey Field Analyzer (HFA) visual fields (VFs). The IVF was divided into six regions, based on eccentricity and the right or left hemifield, and the average of the total deviation (TD) values in each of these six areas was calculated. Then, the future MVCs were predicted using various variables, including age, sex, 63 variables of 52 TD values, mean of the TD values, visual acuities (VAs), six sector average TDs with (predpenSVM_all) and without (predpenSVM_basic) the attitudes in driving, and also past MVC history, using the pSVM method, applying the leave-one-out cross validation. RESULTS The relationship between predpenSVM_basic and the future MVC approached significance (odds ratio = 1.15, [0.99-1.29], P = 0.064, logistic regression). A significant relationship was observed between predpenSVM_all and the future MVC (odds ratio = 1.21, P = 0.0015). CONCLUSIONS It was useful to predict future MVCs in patients with POAG using visual function metrics, patients' attitudes to driving, and past MVC history, using the pSVM. TRANSLATIONAL RELEVANCE Careful consideration is needed when predicting future MVCs in POAG patients using visual function, and without driving attitude and MVC history.

159 Background: The incidence of upper-third early gastric cancer (EGC) has been increasing in East Asia. Although total gastrectomy (TG) has been a standard treatment for upper-third EGC, proximal gastrectomy (PG) or distal gastrectomy (DG) can be indicated for some selected patients. Theoretically, the more we preserve stomach volume, the better postoperative quality of life will be. However, this issue is not fully investigated. The aim of this study was to clarify the most suitable procedure for upper-third EGC. Methods: This study included 187 patients who underwent TG (n = 20), PG (n = 138), or DG (n = 29) for cT1N0 upper-third gastric cancer between 2009 and August 2017. Surgical outcomes, including bodyweight change one year after the surgery, were retrospectively compared among surgical procedures. DG was generally selected if the distance between the esophagogastric junction (EGJ) and proximal margin of the tumor was more than 20 mm. PG was chosen if at least the distal half of the stomach could be preserved. Otherwise, TG was performed. Results: Background characteristics and proportion of laparoscopic approach were not different among the groups. The duration of surgery was not significantly different, but intraoperative blood losswas significantly less in DG than PG (19 vs. 39 g, p = 0.02). The incidence of Clavien-Dindo classification grade IIIa or more anastomosis-related complications was less frequent in DG (3.4%) than in PG (15.9%, p = 0.13) or TG (10%, p = 0.56), although the differences were not statistically significant. Albumin and hemoglobin levels one year after surgery were not significantly different among the groups. Bodyweight loss one year after surgery was less in DG (11.1%) than in PG (14.6%, p = 0.03) or TG (16.6%, p < 0.01). Conclusions: DG was a safe procedure with less bodyweight loss, and thus preservation of the EGJ should be considered for all patients with tumors at least 2 cm apart from the EGJ. If the distance between EGJ and tumor is less than 2 cm, PG or TG will be indicated. However, surgical outcomes between PG and TG in this study were not different, and therefore, further investigations including long term quality of life are necessary.

Loop-mediated isothermal amplification (LAMP) is an innovative molecular technique requiring only a heating device and isothermal conditions to amplify a specific target gene. The results of current microscopic diagnostic tools for pneumocystis pneumonia are not sufficiently consistent for detecting infection with a low-density of Pneumocystis jirovecii. Although polymerase chain reaction (PCR) is highly sensitive, it is not suitable for resource-limited facilities. LAMP is a potential diagnostic replacement for PCR in such settings but a critical disadvantage of DNA extraction was still remained. Therefore, we employed the Procedure for Ultra Rapid Extraction (PURE) kit, which uses a porous material, to isolate the DNA from clinical samples in a simple way in combination with previously reported LAMP procedure for diagnosing PCP. The detection limit of the PURE-LAMP method applied to artificial bronchoalveolar lavage fluid samples was 100 copies/tube, even with the use of massive blood-contaminated solutions. In addition, we concluded the diagnostic procedure within 1 h without the need for additional equipment. PURE-LAMP coupled with suitable primers for specific pathogens has good potential for diagnosing various infectious diseases.

We have developed a new high performance projected capacitive touch screen which has double layered metal mesh electrodes. By using high conductive metal electrodes and optimizing the mesh design, high sensitive 15-inch diagonal self capacitance touch screen and 8-inch diagonal mutual capacitance touch screen, both of which are optically bonded to LCD modules, have been developed.

We previously reported a simple method for the preparation of size-controlled spherical silver nanoparticles (Ag NPs) generated by autoclaving a mixture of silver-containing glass powder and glucose. The particle size is regulated by the glucose concentration, with concentrations of 0.25, 1.0 and 4.0 wt% glucose providing small (3.48 ± 1.83 nm in diameter), medium (6.53 ± 1.78 nm) and large (12.9 ± 2.5 nm) particles, respectively. In this study, Ag NP/chitosan composites were synthesized by mixing each of these three Ag NP suspensions with a 75% deacetylated (DAc) chitosan suspension (pH 5.0) at room temperature. The Ag NPs were homogeneously dispersed and stably embedded in the chitosan matrices. The Ag NP/chitosan composites were obtained as yellow or brown flocs. It was estimated that approximately 60, 120 and 360 μg of the small, medium and large Ag NPs, respectively, were maximally embedded in 1 mg of chitosan. The bactericidal and anti-fungal activities of the Ag NP/chitosan composites increased as the amount of Ag NPs in the chitosan matrix increased. Furthermore, smaller Ag NPs (per weight) in the chitosan composites provided higher bactericidal and anti-fungal activities.

A simple method for the preparation of size-controlled spherical silver nanoparticles (Ag NPs) was reported for their generation by autoclaving a mixture of silver-containing glass powder and glucose. The particle size is regulated by the glucose concentration, with concentrations of 0.25, 1.0, and 4.0 wt% glucose providing small (3.48±1.83 nm in diameter), medium (6.53±1.78 nm), and large (12.9±2.5 nm) particles, respectively. In this study, Ag NP/chitin composites were synthesized by mixing each of these three Ag NP suspensions with a μg of the small, medium, and large Ag NPs, respectively, were estimated to maximally adsorb onto 1 mg of chitin. The bactericidal and antifungal activities of the Ag NP/chitin composites increased as the amount of Ag NPs in the chitin increased. Furthermore, smaller Ag NPs (per weight) in the chitin composites provided higher bactericidal and anti-fungal activities.

Our purpose in this study was to evaluate the accuracy of a new multi-planar dose measurement method. The multi-planar dose distributions were reconstructed at each depth by convolution of EPID fluence and dose kernels with the use of EPIDose software (SunNuclear). The EPIDose was compared with EPID, MapCHECK (SunNuclear), EDR2 (Kodak), and Monte Carlo-calculated dose profiles. The EPIDose profiles were almost in agreement with Monte Carlo-calculated dose profiles and MapCHECK for test plans. The dose profiles were in good agreement with EDR2 at the penumbra region. For dose distributions, EPIDose, EDR2, and MapCHECK agreed with that of the treatment-planning system at each depth in the gamma analysis. In comparisons of clinical IMRT plans, EPIDose had almost the same accuracy as MapCHECK and EDR2. Because EPIDose has a wide dynamic range and high resolution, it is a useful tool for the complicated IMRT verification. Furthermore, EPIDose can also evaluate the absolute dose.

The lack of MHC molecules on red blood cells (RBCs) has led to questions regarding the immunological function of CD8(+) T cells against malarial blood-stage (MBS). However, several recent reports contradicting with this concept have suggested that they play an important role in the course of MBS infection. The present study generated genetically engineered murine malaria, Plasmodium yoelii, which expresses a well-defined Trypanosoma cruzi-derived, H-2K(b)-restricted CD8(+) T cell epitope, ANYNFTLV. Prime/boost vaccination by the use of recombinant adenovirus and recombinant modified vaccinia virus Ankara (MVA), which induced an enhanced number of ANYNFTLV-specific CD8(+) T cells, failed to prevent a pathological outcome to occur upon ANYNFTLV-expressing murine MBS infection. This outcome did not change even with the combination of passive transfer of an appreciable number of in vitro-expanded ANYNFTLV-specific CD8(+) T cells. In contrast, the pre-infection of mice with T. cruzi, which intrinsically bears the same CD8(+) T cell epitope significantly improved the survival of ANYNFTLV-expressing malaria-infected mice but not that of control malaria-infected ones. This protective effect was abrogated by the use of a CD8(+) T cell-depleting monoclonal antibody. Although the protective effect was observed only in certain situations, the actively induced antigen-specific CD8(+) T cells could ameliorate the pathologies caused by the MBS. This is the first study to implicate that the active induction of antigen-specific CD8(+) T cells should be included in the development of a vaccine against MBS.

SUMMARY Precise estimation of the capacity for right-turn traffic (comparable to left-turn traffic in the USA) is of great importance to determine signal phasing schemes at signalized intersections in Japan, where the left-hand driving rule is valid. However, in most signal timing procedures across the world, the lost time of right-turn traffic is simply determined by the duration of intergreen intervals and thus lacks considerations of various signal phasing and driver behavior. Meanwhile, sneakers per cycle are usually applied to account for the number of drivers completing right turns during the effective red portion of the clearance-and-change intervals. As a result, an initial cycle length must be hypothesized in order to assess the total number of sneakers within the analysis period. Consequently, a time-consuming iterative calculation process often becomes necessary. Therefore, the present study aims to develop a new lost time estimation method for right-turn traffic to overcome the aforementioned drawbacks. Lost times of right-turn traffic under three conventional phasing plans are theoretically formulated on the basis of a time–space diagram and shock-wave theory. The new method is validated using field data, with case studies of its application in the signal timing procedure. Results indicated that the proposed method is capable of offering more accurate estimation than conventional approaches, which leads to shorter cycle length and simplifies signal timing process by eliminating an iterative check to determine the number of sneakers. Copyright © 2012 John Wiley & Sons, Ltd.

Purpose: This study investigated the possibility of using cylindrical ionization chambers for percent depth-dose (PDD) measurements in high-energy clinical electron beams. Methods: The cavity correction factor, P{sub cav}, for cylindrical chambers with various diameters was calculated as a function of depth from the surface to R{sub 50}, in the energy range of 6-18 MeV electrons with the EGSnrc C ++ -based user-code CAVITY. The results were compared with those for IBA NACP-02 and PTW Roos parallel-plate ionization chambers. The effective point of measurement (EPOM) for the cylindrical chamber and the parallel-plate chamber was positioned according to the IAEA TRS-398 code of practice. The overall correction factor, P{sub Q}, and the percent depth-ionization (PDI) curve for a PTW30013 Farmer-type chamber were also compared with those of NACP-02 and Roos chambers. Results: The P{sub cav} values at depths between the surface and R{sub 50} for cylindrical chambers were all lower than those with parallel-plate chambers. However, the variation in depth for cylindrical chambers equal to or less than 4 mm in diameter was equivalent to or smaller than that for parallel-plate chambers. The P{sub Q} values for the PTW30013 chamber mainly depended on P{sub cav}, and for parallel-plate chambers depended on themore » wall correction factor, P{sub wall}, rather than P{sub cav}. P{sub Q} at depths from the surface to R{sub 50} for the PTW30013 chamber was consequently a lower value than that with parallel-plate chambers. However, the variation in depth was equivalent to that of parallel-plate chambers at electron energies equal to or greater than 9 MeV. The shift to match calculated PDI curves for the PTW30013 chamber and water (perturbation free) varied from 0.65 to 0 mm between 6 and 18 MeV beams. Similarly, the shifts for NACP-02 and Roos chambers were 0.5-0.6 mm and 0.2-0.3 mm, respectively, and were nearly independent of electron energy. Conclusions: Calculated PDI curves for PTW30013, NACP-02, and Roos chambers agreed well with that of water by using the optimal EPOM. Therefore, the possibility of using cylindrical ionization chambers can be expected for PDD measurements in clinical electron beams.« less

We report a patient with congenital Chagas disease in Japan. This report reemphasizes the role of neglected and emerging tropical diseases in the era of globalization. It also indicates the need for increased vigilance for detecting Chagas disease in non-disease-endemic countries.

The completion of the Plasmodium (malaria) life cycle in the mosquito requires the parasite to traverse first the midgut and later the salivary gland epithelium. We have identified a putative kinase-related protein (PKRP) that is predicted to be an atypical protein kinase, which is conserved across many species of Plasmodium . The pkrp gene encodes a RNA of about 5300 nucleotides that is expressed as a 90 kDa protein in sporozoites. Targeted disruption of the pkrp gene in Plasmodium berghei , a rodent model of malaria, compromises the ability of parasites to infect different tissues within the mosquito host. Early infection of mosquito midgut is reduced by 58–71%, midgut oocyst production is reduced by 50–90% and those sporozoites that are produced are defective in their ability to invade mosquito salivary glands. Midgut sporozoites are not morphologically different from wild-type parasites by electron microscopy. Some sporozoites that emerged from oocysts were attached to the salivary glands but most were found circulating in the mosquito hemocoel. Our findings indicate that a signalling pathway involving PbPKRP regulates the level of Plasmodium infection in the mosquito midgut and salivary glands.

The solubilities of CO 2 and the liquid densities in a Bronsted acid–base ionic liquid, [DMFH][Tf 2 N], composed of N , N -dimethylformamide (DMF) and bis(trifluoromethanesulfonyl)amide (HTf 2 N) have been investigated at high pressures and at different temperatures. The results were compared with those in DMF and a typical 1-butyl-3-methylimidazolium analogue with the same anion, [BMIM][Tf 2 N]. The mole fraction scaled solubilities of CO 2 in the three liquids showed a slight increase in the following order, DMF 2 N] 2 N], whereas more remarkable difference was observed in the volume scaled concentrations of CO 2 , [BMIM][Tf 2 N] 2 N] « DMF, mainly due to the bulkiness of liquid entities.

The aim of the study was to evaluate the perturbation correction factors at a reference depth for cylindrical ionization chambers in high-energy electron beams by means of the EGSnrc Monte Carlo user code cavity. The cylindrical chambers used in this study were the Farmer-type of PTW30010, PTW30011, PTW30012, and PTW30013 models. We calculated the wall correction factor, P (wall), the cavity or electron fluence correction factor, P (cav), the stem correction factor, P (stem), the central electrode correction factor, P (cel), and the overall perturbation correction factor, P (Q), for each chamber. The calculated P (cav) values were higher by from 2 to 1% than those recommended by the IAEA-TRS-398 code of practice, in an energy range of 6-18 MeV. The P (wall) values almost agreed with the analytical calculation performed with IAEA-TRS-398. The P (cel) values agreed with those of Ma and Nahum, performed with IAEA-TRS-398. The P (stem) values were approximately 0.995 on average and were independent of the electron beam energy. P (stem) needs to be considered in future dosimetry protocols. The P (Q) values were higher from 1 to 2% than those of IAEA-TRS-398 in an energy range of 6-18 MeV.

Volumetric properties of carbon dioxide + ethanol mixtures at 313.15 K were measured, using the vibrating-tube Anton Paar DMA 512P density meter. In the present experiments, no analytical instrument was required. The saturated pressures of carbon dioxide + ethanol mixtures at 313.15 K were measured by the synthetic method. The experimental data obtained were correlated with the density equation, the Soave−Redlich−Kwong (SRK) equation of state, and the pseudocubic equation of state.