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The ACUTE HF score is a simple risk score that predicts the prognosis of patients with acute heart failure (HF) using clinical and echocardiographic parameters. As this score was developed for a small European population, we aimed to validate this score in an external population.This retrospective observational cohort analysis included patients hospitalized with acute HF during 2015-2019. Of 744 patients, 703 patients with available ACUTE HF scores were analyzed (75 ± 13 years; 61% male; left ventricular ejection fraction [LVEF] 49 ± 17%). Approximately one-third (34.4%) of the patients had reduced LVEF (40%), and 51.4% exhibited preserved LVEF (≥50%). During a median follow-up of 452 days, primary and secondary outcomes were observed in 110 and 204 patients, respectively. The ACUTE HF score successfully stratified patients for primary (all-cause mortality) and secondary endpoints (a composite of all-cause mortality and heart failure rehospitalization) in Kaplan-Meier analyses (log-rank test, P 0.001). Multivariable Cox proportional hazards models showed that the score was significantly independently associated with both primary and secondary endpoints after adjusted by covariates (P 0.001).We validated the risk prediction ability of ACUTE HF score in an Asian population. This score may be applicable in clinical practice.

The purpose of this study was to investigate axial load resistance of the tibia depending on the thickness of tibial tuberosity osteotomy in medial open-wedge distal tuberosity proximal tibial osteotomy (OWDTO). The hypothesis is that a thin tibial tuberosity osteotomy shows high axial load resistance of the tibia.The OWDTO model was constructed from imitation bones of the tibia. Distal tibial tuberosity osteotomy was performed with thicknesses of 7, 14, and 21 mm (n = 5 for each group). Cyclic axial-load fatigue tests were performed to investigate the strain at five measurement points on the OWDTO model. An axial-load failure test was also performed to investigate the maximum strain for failure.The 7-mm OWDTO model showed a significantly lower stain range than the 14-mm model at the middle part of the lateral hinge (P = 0.0263, mean difference: -852.6 με), posterior part (P = 0.0465, mean difference: -1040.0 με), posterior tibial cortex (P 0.0001, mean difference: -583.4 με), and plate (P = 0.0029, mean difference: -121.6 με). There were no significant differences in the strain at the tibial tuberosity between the groups. The axial load for complete failure was significantly higher in the 7-mm model than in the 21-mm model (P = 0.0010, mean difference: 2577.0 N). The failure points were at the lateral hinges.Thinner distal tibial tuberosity osteotomy is more resistant to axial load and may be recommended for the prevention of tibial and lateral hinge fractures after OWDTO.

Purpose: The effect of the posterior tibial slope (PTS) in cruciate-retaining total knee arthroplasty (CR-TKA) on clinical outcomes remains unclear. We aimed to investigate 1) the effect of alteration of the PTS on clinical outcomes, including patient satisfaction and joint awareness, and 2) the relationship between the patient-reported outcomes, the PTS, and compartment loading. Methods: Based on the alteration of the PTS after CR-TKA, 39 and 16 patients were stratified into increased and decreased PTS groups, respectively. Clinical evaluation was performed by the Knee Society Score (KSS) 2011 and the Forgotten Joint Score-12 (FJS-12). Compartment loading was intraoperatively assessed. Results: KSS 2011 (symptoms, satisfaction, and total score) was significantly higher (p = 0.018, 0.023, and 0.040, respectively), and FJS (“climbing stairs?”) was significantly lower (p = 0.025) in the increased PTS group compared with the decreased PTS group. The decrease in both medial and lateral compartment loading of Δ45°, Δ90°, and Δfull was significantly greater in the increased PTS group than in the decreased PTS group (p < 0.01 for both comparisons). Medial compartment loading of Δ45°, Δ90°, and Δfull significantly correlated with KSS 2011 for “symptom” (r = -0.4042, -0.4164, and -0.4010, respectively; p = 0.0267, 0.0246, and 0.0311, respectively). ΔPTS significantly correlated with medial compartment loading differentials of Δ45°, Δ90°, and ΔFull (r = -0.3288, -0.3792, and -0.4424, respectively; p = 0.0358, 0.01558, and 0.0043, respectively). Conclusion: Patients with increased PTS showed better symptoms and higher patient satisfaction compared with those with decreased PTS following CR-TKA, possibly due to a greater decrease in compartment loading during knee flexion.

Iodine-containing formulations have been widely used to treat iodine deficiency and as antiseptics. Lecithin-bound iodine (LBI) has been approved to treat allergic diseases in Japan; however, its underlying mechanism remains unknown. In this study, we show that LBI ameliorated disease symptoms in an ovalbumin (OVA)-induced allergic rhinitis mouse model. LBI suppressed OVA-specific IgE production by attenuating germinal center (GC) reaction in the draining lymph nodes. The antiallergic effect of LBI is most likely attributed to increased serum iodine levels but not thyroid hormone levels. In vitro treatment of activated B cells with potassium iodide induced ferroptosis by increasing intracellular reactive oxygen species (ROS) and ferrous iron in a concentration-dependent manner. Accordingly, LBI diets increased ROS levels in GC B cells of the draining lymph nodes. This study suggests that iodine directly promotes ferroptosis in activated B cells and attenuates GC reactions, leading to the alleviation of allergic symptoms.

Mibyou has been defined in traditional oriental medicine as a certain physiological condition whereby an individual is not ill but not healthy; it is also often referred to as a sub-healthy condition. In a society focused on longevity, “Mibyou-care” becomes of primary importance for healthy lifespan expenditure. Functional foods can play crucial roles in Mibyou-care; thus, the search for novel resources of functional food is an important and attractive research field. Mushrooms are the target of such studies because of their wide variety of biological functions, such as immune modulation and anti-obesity and anticancer activities, in addition to their nutritional importance. Basidiomycetes-X (BDM-X; Shirayukidake in Japanese) is a mushroom which has several attractive beneficial health functions. A metabolome analysis revealed more than 470 components of both nutritional and functional interest in BDM-X. Further isolation and purification studies on its components using radical scavenging activity and UV absorbance identified ergosterol, (10E,12Z)-octadeca-10,12-dienoic acid (CLA), 2,3-dihydro-3,5-dihydroxy-6-methyl-4H-pyran-4-one (DDMP), formyl pyrrole analogues (FPA), including 4-[2-foemyl-5-(hydroxymethyl)-1H-pyrrole-1-yl] butanamide (FPAII), adenosine and uridine as major components. Biological activities attributed to these components were related to the observed biological functions of BDM-X, which suggest that this novel mushroom is a useful resource for Mibyou-care functional foods and medicines.

Renal dysfunction includes glomerular dysfunction (GD) and tubular dysfunction (TD); however, there is limited information regarding the prevalence, coexistence, and prognostic relevance of TD and GD among patients with acute heart failure (AHF).Methods and Results:This study reviewed 489 patients with AHF who had undergone testing at the time of their admission to identify GD (estimated glomerular filtration rate60 mL/min/1.73 mAs a significant proportion of patients with AHF had isolated TD and an increased risk of mortality, patients with AHF should be screened for TD even if they do not have GD.

This paper investigates the influence of adding an upper body to a bipedal robot on its stable walking behavior. The robot’s parts are mutually interconnected through an actuator network system. Therefore, the movement pattern of the upper body depends on the type of interactions created with other limbs. Throughout the experiments, various interactions among the different body parts were tested. The results showed that a robot with a motionless upper body exhibited unstable walking behavior. However, once the same upper body was involved and interacted properly, with other body parts, its movement significantly helped to stabilize the behavior of the robot.

Background Although population studies have implicated emotional burden in asthma severity, the underlying genetic risk factors are not completely understood. We aimed to evaluate the genetic influence of a functional single-nucleotide polymorphism (SNP) in the stress-related μ-opioid receptor gene (OPRM1; A118G SNP, rs1799971) on asthma severity. Methods We initially assessed disease severity in asthmatic outpatients carrying A118G. Using an ovalbumin-induced experimental asthma rodent model harboring the functionally equivalent SNP, we investigated the mechanism by which this SNP influences the allergic immune response. Results Among 292 outpatients, 168 underwent airway hyperresponsiveness (AHR) to methacholine testing. Compared with patients carrying the AA and AG genotypes, those carrying the GG genotype exhibited enhanced AHR. The stress levels were presumed to be moderate among patients and were comparable among genotypes. Compared with Oprm1 AA mice, GG mice demonstrated aggravated asthma-related features and increased pulmonary interleukin-4+CD4+ effector and effector memory T cells under everyday life stress conditions. Intraperitoneal naloxone methiodide injection reduced effector CD4+ T cell elevation associated with increased eosinophil numbers in bronchoalveolar lavage fluid of GG mice to the levels in AA mice, suggesting that elevated Th2 cell generation in the bronchial lymph node (BLN) of GG mice induces enhanced eosinophilic inflammation. Conclusions Without forced stress exposure, patients with asthma carrying the OPRM1 GG genotype exhibit enhanced AHR, attributable to enhanced Th2 cell differentiation in the regional lymph node. Further research is necessary to elucidate the role of the OPRM1 A118G genotype in the Th2 cell differentiation pathway in the BLN.

Recent developments in conversational technologies have attracted researchers to study their applications in recommending items through conversations. It is considered that physical robots, rather than virtual ones, are effective in situations in which robots talk about items near participants. However, in real situations, robots may be required to recommend items that are present but invisible in the scene of the communication. In this study, we conducted a field experiment in a shopping mall to investigate the effects of robot embodiment on recommendation tasks. The robots recommended a dish after talking to participants about their food preferences. We developed a conversational recommendation system and implemented it using physical and virtual robots. The field experiment was conducted in a shopping mall; the visitors were encouraged to participate. The experiment lasted a total of 99 hours (9 hours per day for 11 days) inside and in front of a food court. Although no significant difference in the behavioral aspect was confirmed, the results obtained from 272 conversations suggested that having physical bodies enhanced the satisfaction and agreement with the robots' recommendations.

In a static Lucas tree economy, we propose a model that the representative agent is sensitive to regret, that is, the agent is affected by not only the actual outcome but also value-differences between actual and foregone consequences. Our model generalizes the classical simple regret model pioneered by Bell (1982) and Loomes and Sugden (1982), and makes it possible to derive the equilibrium asset price and to see when the regret effect decreases the price. To verify that our model predicts sufficient decreases of the equilibrium price to explain the empirically high risk premium, we analyze the data of U.S. stock market and GDP growth rates during 1871–2018. The numerical calculation indicates that the estimated equilibrium price is small enough to explain the equity premium puzzle.

Robots are required to be significantly compliant and versatile to work in unstructured environments. In a number of studies, robots have positively exploited the environments during interactions and completed tasks from a morphological viewpoint. Modular robots can help realize real-world adaptive robots. Researchers have been investigating the actuation, coupling, and communication mechanisms among these robots to realize versatility. However, the diverse force transmission among modules needs to be further studied to achieve the adaptive whole-body dynamics of a robot. In this study, we fabricated a modular robot and proposed the realization of force transmission on this robot, by constructing fluid transferable network systems on the actuation modules. By exploiting the physical property variations of the modular robot, our experimental results prove that the robot’s motion can be changed by switching the connection pattern of the system.

In this paper, we present an electrically driven childlike android named ibuki equipped with a wheeled mobility unit that enables it to move in a real environment. Since the unit includes a vertical oscillation mechanism, the android can replicate the movements of the human center of mass and can express human-like upper-body movements even when moving by wheels. Moreover, providing 46 degrees of freedom enables it to perform various human-like physical expressions. The development of ibuki, as well as the implementation and testing of several functions, is described. Finally, we discuss the potential advantages and future research direction of a childlike mobile android.

Food allergy is a type I allergic reaction induced by mast cells and is mainly activated by allergen-specific immunoglobulin (Ig)E. Spi-B is an E26-transformation-specific (Ets) family transcription factor essential for the differentiation and functional maturation of several immune cell subsets, including mast cells. However, the possible involvement of Spi-B in food allergy remains unclear. In this study, we found that Spi-B-deficient mice were highly susceptible to food allergy to ovalbumin (OVA), as indicated by the exacerbation of diarrhea and elevation of serum IgE levels. These pathological changes were associated with enhanced mast cell infiltration into the intestinal lamina propria. Activation of mast cells in the intestinal mucosa was observed in Spib−/− mice, even under physiological conditions. Accordingly, Spi-B deficiency increased the translocation of fluorescently labeled dextran from the lumen to the serum, suggesting increased intestinal permeability in Spib−/− mice. Moreover, Spib−/− mice showed defects in oral tolerance induction to OVA. These data illustrate that Spi-B suppresses the development of food allergies by controlling the activation of intestinal mast cells and by inducing immune tolerance to food allergens.

The seismic isolation mechanism of the core-suspended isolation (CSI) system comprises a double layer of inclined rubber bearings installed on top of a reinforced core structure. A multilevel structure is then suspended from a hat truss or umbrella girder constructed on the seismic isolation mechanism. The first building to use the CSI system was the Safety and Security Center in Tokyo, Japan, whose structural health monitoring system has detected and recorded 231 earthquake motions since 2006, including the 2011 Tohoku Pacific Earthquake (2011-TPE). The present study estimates the dynamic characteristics of this CSI-equipped building in earthquakes, and the effects of the CSI system are revealed via the observed earthquake records. The temporal changes of the fundamental period and damping factor are estimated from the 2011-TPE; the fundamental period increases with the deformation of the isolation level, whereas the fundamental damping factor is only related weakly to that deformation. The 231 observed earthquake records reveal that the CSI system performs seismic isolation by reducing the response acceleration of the suspended structure by roughly a half for peak ground accelerations exceeding 30 cm/s2. Daily microtremor observations are used to diagnose earthquake damage; the fundamental frequencies in each direction remain almost constant and were not changed by the 2011-TPE.

This research develops a conversational robot that stimulates users’ dialogue satisfaction and motivation in non-task-oriented dialogues that include opinion and/or preference exchanges. One way to improve user satisfaction and motivation is by demonstrating the robot’s ability to understand user opinions. In this paper, we explore a method that efficiently obtains the concept of user preferences: likes and dislikes. The concept is acquired by complementing a small amount of user preference data observed in dialogues. As a method for efficient collection, we propose a dialogue strategy that creates utterances with the largest expected complementation. Our experimental results with a female-type android robot suggest that the proposed strategy efficiently obtained user preferences and enhanced dialogue satisfaction. In addition, the strength of user motivation (i.e., long-term willingness to communicate with the android) is only positively correlated with the android’s willingness to understand. Our results not only show the effectiveness of our proposed strategy but also suggest a design theory for dialogue robots to stimulate dialogue motivation, although the current results are derived only from a female-type android.

Humans can express their emotions with not only facial expressions or gestures but also whole-body motion, even while walking, which are essential for our interpersonal relationships and our interaction with others. Communication with people is also considered an important task for robots, however emotional expressions by wheeled mobile humanoid robots when moving has not been well studied. In this paper, we implemented emotional human-like gait-induced upper body motion in a mobile android ibuki. We hypothesize that the gait-induced upper body motion with vertical oscillation enhances the human perception of a mobile robot’s emotional expressions. ibuki is a mobile robot, which has a vertical oscillation mechanism, which enables the robot to move its body with a human gait-induced upper body motion. We ran two experiments in which participants watched videos of ibuki moving in a room expressing different emotions - anger, happiness, and sadness–, before answering how they perceived the emotion and their respective confidence level in their answer. Our results show that for motions with vertical oscillation, recognition rates were: 56.0 % for anger, 77.7 % for happiness, and 97.0 % for sadness. We also found that the recognition rate and confidence level of motions expressing happiness with vertical oscillation were higher. Our results play an important role in opening up avenues for more natural ways of interaction between humans and robots. For example, by approaching humans closer while expressing emotions, a robot can naturally provide an opportunity to get started conversation with them.

Hypertrophic scars and keloids tend to cause serious functional and cosmetic impediments to patients. As these scars are not life threatening, many patients do not seek proper treatment. Thus, educating physicians and patients regarding these scars is important. The authors aimed to develop an algorithm for a scar screening system and compare the accuracy of the system with that of physicians. This algorithm was designed to involve health care providers and patients.Digital images were obtained from Google Images (Google LLC, Mountain View, Calif.), open access repositories, and patients in the authors' hospital. After preprocessing, 3768 images were uploaded to the Google Cloud AutoML Vision platform and labeled with one of the four diagnoses: immature scars, mature scars, hypertrophic scars, and keloid. A consensus label for each image was compared with the label provided by physicians.For all diagnoses, the average precision (positive predictive value) of the algorithm was 80.7 percent, the average recall (sensitivity) was 71 percent, and the area under the curve was 0.846. The algorithm afforded 77 correct diagnoses with an accuracy of 77 percent. Conversely, the average physician accuracy was 68.7 percent. The Cohen kappa coefficient of the algorithm was 0.69, while that of the physicians was 0.59.The authors developed a computer vision algorithm that can diagnose four scar types using automated machine learning. Future iterations of this algorithm, with more comprehensive accuracy, can be embedded in telehealth and digital imaging platforms used by patients and primary doctors. The scar screening system with machine learning may be a valuable support tool for physicians and patients.Diagnostic, II.

This study aimed to retrospectively investigate (1) the reproducibility of gap measurements by manual stress using the Z-shaped retractor depending on the surgeon's experience with this maneuver and (2) the consistency of the gap distraction force produced by manual stress throughout the range of motion (ROM) in the robotic-assisted total knee arthroplasty (TKA). It was hypothesized that the joint gap produced by manual stress is not reproducible depending on the surgeon's experience, and the distraction force applied by manual stress throughout the ROM is not constant.Medial and lateral joint gaps were obtained throughout the ROM by manual stress or a tensioner by two surgeons with different levels of experience in robotic-assisted TKA. The association between the differences in gap measurement by the two surgeons and the preoperative radiographic parameters, including the hip-knee-ankle (HKA) angle and absolute and relative varus/valgus laxities were analyzed.The experienced surgeon produced significantly greater gaps than the inexperienced surgeon from 0° to 100° flexion, with a mean difference of 0.35 ± 0.12 mm in the medial gap (p 0.0001), and from 10° to 120° flexion with a mean difference of 0.57 ± 0.13 mm in the lateral gap (p 0.0001). The tensioner produced a significantly greater medial gap from 70° to 110° flexion with a mean difference of 0.32 ± 0.01 mm in the medial gap (p 0.0001) and from 0° to 110° flexion with a mean difference of 1.12 ± 0.26 mm in the lateral gap (p 0.0001). The differences in gap distance by manual stress between experienced and inexperienced surgeons were moderately correlated with the HKA angle in the lateral gap (r = 0.40, p = 0.01). The gap differences due to manual stress and a tensioner showed moderate negative correlation with the HKA angle in the medial gap (r = - 0.50, p = 0.001) and weak negative correlation with the absolute valgus laxity in the lateral gap (r = - 0.35, p = 0.03).The joint distraction force by manual stress may differ depending on the surgeon's experience and tended to be smaller in deep flexion; therefore, the flexion gap may be underestimated. Surgeons should determine implant positioning considering gap balance by manual stress, taking into account these characteristics of the manual stress maneuver.Level III, retrospective cohort study.

Developmental dysplasia of the hip (DDH) is characterized by anatomical abnormalities of the hip joint, ranging from mild acetabular dysplasia to hip subluxation and eventually dislocation. The mechanism underlying the cartilage degeneration of the hip joints exposed to reduced dynamic loads due to hip dislocation remains unknown. We established a rodent hip dislocation (disarticulation; DA) model of DDH (DA-DDH rats and mice) by swaddling. Expression levels of periostin (Postn) and catabolic factors, such as interleukin-6 (IL-6) and matrix metalloproteinase 3 (Mmp3), increased and those of chondrogenic markers decreased in the acetabular cartilage of the DA-DDH models. Postn inducedIL-6andMmp3expression in chondrocytes through integrin αVβ3, focal adhesion kinase, Src, and nuclear factor-κB (NF-κB) signaling. The microgravity environment created by a random positioning machine induced Postn expression in chondrocytes through signal transducer and activator of transcription 3 (STAT3) signaling. IL-6 stimulated Postn expression via STAT3 signaling. Furthermore, cartilage degeneration was suppressed in the acetabulum ofPostn−/−DA-DDH mice compared with that in the acetabulum of wild type DA-DDH mice. In summary, reduced dynamic loads due to hip dislocation induced acetabular cartilage degeneration via IL-6 and MMP3 through STAT3/periostin/NF-κB signaling in the rodent DA-DDH models.

Objectives We investigated whether the locomotive syndrome (LS) severity affects future fragility fractures in osteoporosis patients. Methods In this retrospective cohort study, 315 women with osteoporosis (mean follow-up period, 2.8 years) were reviewed, of whom 244 were included in the analysis. At baseline, we obtained medical information, bone mineral density of the lumbar spine and femoral neck, and sagittal vertical axis. Additionally, LS risk was assessed using the two-step test, stand-up test, and 25-question geriatric locomotive function scale scores. The LS risk test results were used to classify LS severity, which was rated on a 4-point scale from stage 0 (robust) to 3 (worsening). Cox proportional hazards regression analysis was used to determine the association of the severity with future fragility fracture. Results Fragility fractures occurred in 37 of 315 participants (11.8%). This study showed that sagittal vertical axis (hazard ratio = 1.014; 95% confidence interval, 1.005–1.023; p value = 0.003) and LS severity (hazard ratio =1.748; 95% confidence interval, 1.133–2.699; p = 0.012) were independent risk factors for incidence of fragility fracture. Conclusions This study revealed the LS severity to predicted fragility fractures. We suggested that the progression of LS associated with osteoporosis increases the fracture risk.

Modelling the cognitive process is a challenging task. Contextual conditions and the scope of the options are critical factors that influence human decisions. We propose and formulate an attention-based network to model the various choices made by humans based on the various factors that predict the possible option in each scope. To evaluate our proposed method, we conducted a user choice experiment in which a user chose an option from among limited choices. Our results showed that our model successfully extracted the hidden context on the attention layer and even outperformed the chance level in terms of prediction accuracy.

Infectious colitis is one of the most common health issues worldwide. Microfold (M) cells actively transport luminal antigens to gut-associated lymphoid tissue to induce IgA responses; however, it remains unknown whether M cells contribute to the induction of cellular immune responses. Here we report that M cell-dependent antigen transport plays a critical role in the induction of Th1, Th17, and Th22 responses against gut commensals in the steady state. The establishment of commensal-specific cellular immunity was a prerequisite for preventing bacterial dissemination during enteropathogenic Citrobacter rodentium infection. Therefore, M cell-null mice developed severe colitis with increased bacterial dissemination. This abnormality was associated with mucosal barrier dysfunction. These observations suggest that antigen transport by M cells may help maintain gut immune homeostasis by eliciting antigen-specific cellular immune responses.

In diverse situations, humans produce natural and adaptable bipedal locomotion by cooperatively manipulating the interactions among the different parts of their bodies and the environment. Therefore, to realize a robot with adaptable behavior, it should be enabled to adjust its morphology accordingly in response to environmental changes. From this perspective, this study introduces the development of a bipedal robot with adaptive morphology. By implementing an actuator network system (ANS), the robot is able to manipulate the physical characteristics of its legs and the way they interact with each other. Two experiments have been conducted: main and supplementary experiments. The main experiment examined how effective is adjusting the robot’s morphology on changing the robot’s behavior. The experiment was conducted on different ground materials and under different connection patterns between the robot’s legs. During the experiment, the robot’s behavior was evaluated in reference to four aspects: walking style, stability, speed, and moving direction. The supplementary experiment took the results of the main experiment and used it to improve the robot’s behavior during locomotion. The robot was enabled to automatically switch between the different connection patterns of the ANS, which in turn changed the interaction between the robot’s legs and generated a more suitable dynamics for the surrounding environment.

Fibrosis is the most important pathological feature in predicting development of Hepatocellular carcinoma (HCC). However, the incidence rate of HCC in patients with non-alcoholic fatty liver disease (NAFLD) is relatively low. We evaluated phenotypic histological features to differentiate HCC from non-HCC in patients with non-tumor lesions of cirrhotic livers.Seventeen patients with NAFLD who underwent liver transplantation were enrolled. FibroNest was used to quantify histological phenotypes of non-tumor fibrosis lesions. Quantification included collagen content and structure traits, fiber morphometric traits, and fibrosis architecture traits. Each trait was described by up to seven quantitative fibrosis traits (qFTs). Among the qFTs measured in each specimen, those that described most of the variability between consecutive groups were automatically detected and combined into a normalized Phenotypic Composite Fibrosis Score (Ph-CFS). We trained FibroNest to identify the principal traits that differentiate HCC from non-HCC.HCC was found in 8 cases and non-HCC in 9 cases. The Ph-CFS significantly differentiated HCC from non-HCC (4.6 vs. 5.9, p 0.05). Individual qFTs for morphometric features including collagen fiber length, width, perimeter, and area denoted significant differences between HCC and non-HCC. The Ph-CFS could be used to distinguish HCC (Ph-FCS 5.0) from non-HCC (Ph-FCS ≥ 5.0) with 75% sensitivity and 100% specificity.In patients who underwent liver transplantation, fibrotic histological phenotypes in non-tumor lesions appeared to be different between HCC and non-HCC. Phenotypic analysis of collagen in non-tumor lesions might be an effective and automated method to distinguish HCC from non-HCC on histopathology imaging.

Pyrrole-2-carboxaldehyde (Py-2-C) derivatives have been isolated from many natural sources, including fungi, plants (roots, leaves, and seeds), and microorganisms. The well-known diabetes molecular marker, pyrraline, which is produced after sequential reactions in vivo, has a Py-2-C skeleton. Py-2-Cs can be chemically produced by the strong acid-catalyzed condensation of glucose and amino acid derivatives in vitro. These observations indicate the importance of the Py-2-C skeleton in vivo and suggest that molecules containing this skeleton have various biological functions. In this review, we have summarized Py-2-C derivatives based on their origins. We also discuss the structural characteristics, natural sources, and physiological activities of isolated compounds containing the Py-2-C group.

Adjuvant chemotherapy is commonly indicated in lung cancer patients undergoing surgical therapy because tumor recurrence is frequent. A biomarker that can predict tumor recurrence in the postoperative period is currently unavailable. CXCR4 receptor and its ligand CXCL12 play important roles in metastasis. This study investigated the value of tumor CXCL12 expression to predict prognosis and indicate adjuvant chemotherapy in non-small cell lung cancer patients. This study enrolled 82 non-small cell lung cancer patients. The expression of CXCL12 was evaluated by immunohistochemistry. The degree of CXCL12 expression was assessed using the Allred score system. Among all subjects, the progression-free survival and overall survival were significantly prolonged in cancer patients with low tumor expression of CXCL12 compared to patients with high tumor expression. Multivariate analysis showed that the increased level of CXCL12 is a significant predictor of progression-free survival and overall survival in NSCLC patients. Among subjects with high tumor CXCL12 expression, progression-free survival and overall survival were significantly improved in patients treated with adjuvant chemotherapy compared to untreated patients. These results suggest the potential value of tumor CXCL12 expression as a marker to predict prognosis and to indicate adjuvant chemotherapy after surgical tumor resection in non-small cell lung cancer patients.

Objectives The mechanism underlying neuropathic pain (NP) in osteoarthritis (OA) of the knee is not completely understood. This study aimed to investigate whether possible NP in patients with knee OA undergoing knee surgery is associated with specific radiological findings. Methods This study included 197 patients who underwent knee surgery for symptomatic knee OA. Clinical evaluation was performed using the Central Sensitization Inventory (CSI), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and PainDETECT questionnaire. Radiological evaluation was performed using the hip-knee-ankle (HKA) angle, posterior tibial slope (PTS), varus and valgus laxities, and magnetic resonance imaging OA Knee Score (MOAKS). Radiological findings were compared between patients with possible and unlikely NP. Logistic regression analysis was performed to identify the predictive factors for NP. Results There were 163 and 34 patients with unlikely NP and with possible NP, respectively. The percentage of patients with CSI score ≥ 40 was significantly higher in the possible NP group than in the unlikely NP group (17.6% vs. 6.1%). Patients with possible NP had worse WOMAC scores than patients with unlikely NP. There were no significant positive associations between the possible NP and radiological findings in knee OA. Regression analysis showed no predictive factors for possible NP. Conclusions Possible NP is not associated with specific radiological findings in knee OA. Patients with possible NP may mediate CS and experience more severe symptoms, including decreased knee function and lower quality of life, than patients with unlikely NP.

Although the joint gap distance and compartment loading of the knee are different parameters for obtaining balanced knees in patients with total knee arthroplasty (TKA), the extent to which a balanced knee is achieved in patients with mechanically aligned TKA (MA-TKA) is unclear. This study aimed to investigate the anatomical factors that affect the ligament balancing in MA-TKA according to a gap balancing technique by measured resection technique.The relationship between compartment loading, gap distance, and lower limb alignment was analysed in forty-three patients who underwent navigation-assisted MA-TKA with the minimum soft-tissue release. Radiographic parameters included hip-knee-ankle (HKA) angle, femorotibial angle, mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle, posterior tibial slope, varus and valgus joint line convergence angle, femoral valgus angle, femoral shaft curve, and tibial shaft curve (TSC).The postoperative HKA angle was 0.4±1.5°, with one coronal alignment outlier (2.3%). The gap distance showed four unbalanced knees for extension (9.3%) and flexion (9.3%), whereas the compartment loading identified 17 unbalanced knees (39.5%) at extension, 8 (18.6%) at 45° flexion, 7 (16.2%) at 90° flexion, and 10 (23.2%) at full flexion in MA-TKA. Mediolateral differentials of compartment loading correlated with femoral valgus angle (0°, 45°, and 90° flexion), mLDFA (45° and 90° flexion), and TSC (45° and 90° flexion). Femoral valgus angle and TSC were risk factors of the mediolateral differentials of compartment loading.Extra-articular factors of femoral valgus angle, mLDFA, and TSC were associated with the mediolateral imbalance of compartmental loading, suggesting there is a limit to obtaining balanced knees in MA-TKA due to these unadjustable extra-articular factors.IV, therapeutic case series.

This study aimed to examine whether it is advantageous in robotic-assisted TKA (RA-TKA) compared with conventional TKA throughout a 14 postoperative days (PODs). A total of 113 knees (100 patients) were reviewed and divided into the control group (55 knees) and the RA-TKA group (58 knees). We assessed postoperative pain intensity using a visual analogue scale at rest (rVAS) and during movement (mVAS), evaluated lower extremity functional recovery through quadriceps muscle strength and knee range of motion (ROM), preoperatively and on PODs 3, 7, 10, and 14. We also assessed the rescue analgesia intake and postoperative implant coronal alignment. The mean rVAS and mVAS scores did not differ significantly between the two groups. Muscle strength recovery was significantly faster in the RA-TKA group than in the control group on every PODs. ROM recovery was better in the RA-TKA group than in the control group on POD 10. The amount of postoperative analgesia was significantly lower in the RA-TKA group than in the control group. Attainment of a β angle

Synchronization between humans is often observed in our daily lives, for example in breathing, in hand clapping in crowds, and in walking. It has been reported that pedestrian gait synchronization maximizes walking flow efficiency. As increasingly more mobile robots are being developed for practical use, it is important to consider how robots may impact pedestrian flows. While there is research on synchronization phenomena between humans and robots, gait synchronization between humans and robots has yet to be studied, particularly synchronization occurring with wheeled humanoid robots while moving. In this paper, we investigated the gait phase synchronization between humans and a wheeled mobile humanoid robot, which moved its upper body in three distinct types of motion patterns: (1) no-motion, (2) arm-swinging (as is common for typical mobile humanoids), and (3) arms-swinging in addition to periodic vertical-oscillation similar to the human upper body movement while walking. Rayleigh test was performed on the distribution of the obtained gait phase differences under each condition and a significant distributional bias was confirmed when participants were walking with the robot that performed both arm-swinging and vertical-oscillation of the upper body. These results suggest that humans can spontaneously synchronize their gaits with wheeled robots that utilize upper body oscillating. These findings can be important for the design of robot-integrated urban transportation systems, such as train stations and airports, where both humans and robots are mobile and a highly efficient flow is required.

In kinematically aligned total knee arthroplasty (TKA), it is necessary to infer the pre-arthritic constitutional medial proximal tibial angle (MPTA) in advanced osteoarthritis (OA) of the knee with bone loss. The aim of this study was to investigate whether MPTA at the posterior tibial plateau represents the pre-arthritic constitutional MPTA in anterior cruciate ligament (ACL)-intact, advanced OA knees. It was hypothesized that MPTA at the posterior tibial plateau represents the pre-arthritic constitutional MPTA of ACL-intact, advanced knee OA.One hundred varus, anterior cruciate ligament (ACL)-intact, advanced OA knees were analysed. The hip-knee-ankle (HKA) angle and MPTA were assessed on computed radiography (CR) and MPTAs at the anterior, middle, and posterior part of the tibial plateau were assessed on computed tomography (CT) images. The association between these parameters was also analysed.CR images showed an HKA angle of 172.4 ± 4.1° and MPTA of 84.3 ± 2.5°. CT images showed different MPTAs in the three regions, ranging from 83.9 ± 2.4° to 85.9 ± 2.8°. The middle MPTA was the lowest at 83.9 ± 2.4°. HKA angle correlated with the middle MPTA (r = 0.3355, 95% confidence interval [CI] 0.1489-0.4991, p = 0.0006) and ΔMPTA (Middle-Posterior) (r = 0.5128, 95% CI 0.3518-0.6443, p 0.0001).The MPTA at the posterior tibial plateau represents the pre-arthritic constitutional MPTA in ACL-intact, advanced OA knees.III, retrospective cohort study.

We investigated whether multiple food allergies could be safely prevented by simultaneously administering very small amounts of multiple foods.Infants 3-4 months old with atopic dermatitis from 14 primary care pediatric clinics in Japan were enrolled in this randomized, placebo-controlled trial. The infants were administered either mixed allergenic food powder (MP) containing egg, milk, wheat, soybean, buckwheat, and peanuts, or placebo powder (PP). The amount of powder was increased in a stepwise manner on weeks 2 and 4, and continued until week 12. The occurrence of food allergy episodes after powder intervention was assessed at 18 months old. This trial was registered with the University Hospital Medical Information Network Clinical Trials Registry (number UMIN000027837).A total of 163 participants were randomly allocated to either the MP group (n = 83) or the PP group (n = 80). The incidence of food allergy episodes by 18 months was significantly different between the MP and PP groups (7/83 vs. 19/80, respectively; risk ratio 0.301 [95% CI 0.116-0.784]; P = 0.0066). Egg allergies were reduced in the MP group. In addition, food allergy episodes from any of the other five foods were significantly reduced, although the reductions in those due to individual foods were not significant.Gradually increasing the intake of very small amounts of multiple foods in early infancy can safely reduce the incidence of egg allergies. Other foods may also suppress food allergies, but no definitive conclusions could be reached.

The function of the anterior cruciate ligament (ACL) in osteoarthritis (OA) of the knee remains to be elucidated. The purpose of this study is to evaluate histological changes of the ACL in end-stage knee OA and to clarify the relationship between histological changes in the ACL and knee function.The hypothesis in this study was that ACL degeneration in knee OA is associated with decreased knee function.Eighty-two ACL specimens from 65 patients who underwent primary total knee arthroplasty (TKA) were investigated. The correlation between histological changes of the ACL (myxoid changes, chondroid metaplasia, total collagen degeneration, microcyst formation, vascular proliferation, and inflammatory cell infiltration) and knee function (range of motion, anterior tibial translation test, knee extension muscle strength, one-leg standing time, and functional reach test) were investigated. Age, body mass index, joint space narrowing, osteophyte formation, lower extremity alignment, and knee medial/lateral instability were also evaluated.Myxoid change in the ACLs was significantly negatively correlated with one-leg standing time. Chondroid metaplasia was not correlated with knee function. Collagen degeneration in the ACL was significantly negatively correlated with knee flexion angle and one-leg standing time. In addition, a negative correlation between microcyst formation and knee flexion angle was noted. Osteophyte formation, particularly lateral femoral intercondylar osteophytes, was correlated with myxoid changes. The other parameters did not correlate with ACL histological changes.Myxoid changes in the ACL were shown to correlate with knee function. The osteophyte score, particularly as related to lateral femoral intercondylar osteophytes, correlated with the severity of myxoid changes in the ACL in knee OA. Precise ACL evaluation should be included in the indications for ACL-retaining surgeries because ACL degeneration may be related to decreased knee function after surgery.IV, Diagnostic case series.

Some of the most serious threats to network security involve malware. One common way to detect malware-infected machines in a network is by monitoring communications based on blacklists. However, such detection is problematic because (1) no blacklist is completely reliable, and (2) blacklists do not provide the sufficient evidence to allow administrators to determine the validity and accuracy of the detection results. In this paper, we propose a malicious DNS query clustering approach for blacklist-based detection. Unlike conventional classification, our cause-based classification can efficiently analyze malware communications, allowing infected machines in the network to be addressed swiftly.