Search

Background: Direct surgery is an important option to treat vertebral artery (VA) stenosis. Method: A patient with symptomatic stenosis at the origin of the right VA underwent transposition of the right VA to the common carotid artery (CCA). Using the sternocleidomastoid sparing approach, the VA was anastomosed to the posterior wall of the CCA by twisting the CCA to expose its posterior wall to face the operative field. Conclusion: This approach, consisting of securing the proximal VA and then following it to its distal end, not only preserves the sternocleidomastoid muscle but also protects the sympathetic chains and thoracic duct. [ABSTRACT FROM AUTHOR]

Background: The worldwide vaccination response to COVID-19 has been associated with rare thrombotic complications, including the case of postvaccination splanchnic venous thrombosis we report here. Case presentation: An 80-year-old Japanese male with abdominal pain presented to our hospital six days after receiving a dose of the COVID-19 messenger ribonucleic acid vaccine. Abdominal computed tomography showed localized edema of the small intestine, increased density of the surrounding adipose tissue, and a thrombus in the superior mesenteric vein. Conservative inpatient treatment with unfractionated heparin relieved the thrombosis, and the patient is currently receiving oral apixaban as an outpatient. Conclusion: Reported cases of thrombosis after COVID-19 vaccination typically have been associated with viral vector vaccines, with few reports of thrombosis induced by mRNA vaccines. The potential for venous thrombosis should be explored when patients present with abdominal pain soon after COVID-19 vaccination. [ABSTRACT FROM AUTHOR]

Background: Young baseball players with medial elbow injuries are known to have high forearm flexor-pronator muscle elasticity; however, the causal relationship between forearm muscle elasticity and the occurrence of medial elbow injuries remains unclear. Purpose/Hypothesis: The purpose of this study was to determine whether the forearm flexor-pronator muscle elasticity is a risk factor for medial elbow injury in young baseball players. It was hypothesized that high flexor carpi ulnaris (FCU) elasticity would be a risk factor for medial elbow injuries. Study Design: Cohort study; Level of evidence, 2. Methods: Young baseball players (aged 9-12 years) with no history of elbow injuries underwent examination during which the strain ratios (SRs) of the pronator teres, flexor digitorum superficialis, and FCU muscles were measured using ultrasound strain elastography as an index of elasticity. Additionally, the participants completed a questionnaire assessing age, height, weight, months of experience as a baseball player, position in baseball, number of training days per week, number of throws per day, and elbow pain during throwing; then the range of motion of the shoulder and hip internal/external rotation were measured. One year after the baseline measurements, the occurrence of new medial elbow injuries was evaluated. Multivariate logistic regression analysis was subsequently conducted to determine risk factors for medial elbow injuries. Cutoff points for significant SR values obtained from the multivariate logistic regression analysis were calculated using the receiver operating characteristic curve. Results: Of the 314 players, 76 (24.2%) were diagnosed with medial elbow injury. Multivariate logistic regression analysis showed that a 0.1 increase in the SR of the FCU muscle (odds ratio [OR], 1.211; 95% CI, 1.116-1.314) and number of throws per day (OR, 1.012; 95% CI, 1.001-1.022) were significantly associated with medial elbow injuries. Receiver operating characteristic curve analyses revealed that the optimal cutoff for the SR of the FCU muscle was 0.920 (area under the curve, 0.694; sensitivity, 75.0%; specificity, 56.7%). Conclusion: Increased FCU elasticity is a risk factor for medial elbow injury. Evaluation of the FCU elasticity may be useful in identifying young baseball players at high risk of medial elbow injuries and may facilitate prevention of medial elbow injury. As shown by the results of multivariate logistic regression analysis, FCU elasticity itself may be useful in identifying young baseball players at high risk of elbow injuries. However, we believe that other factors, such as the number of pitches per day, need to be considered to improve its accuracy. [ABSTRACT FROM AUTHOR]

Objective: A U-shaped relationship between energy cost of walking (Cw) and walking speed indicates that there is a specific speed minimizing the Cw, called economical speed (ES). It is mostly slower in older adults than young adults; however, effects of leg length on the ES have been ignored. We investigated effects of aging and exercise habituation on the normalized ES by leg length (ESnormalized). We quantified time delay of stride length and step frequency in sedentary young (SY), active young (AY), and active elderly (AE) adults in response to sinusoidal gait speed change at 30-s and 180-s periods with an amplitude of ± 0.56 m･s− 1. Results: The ES was significantly slower in the following sequence: AE, SY, and AY, whereas ESnormalized was slower in the AE than in other young groups, with no difference between AY and SY. AE and SY showed greater step variabilities at the 180-s period, whereas AY showed relatively smaller step variabilities at both periods. Collectively, the ESnormalized slowed due to aging, not due to exercise habituation. When optimizing the appropriate SL-SF combination for sinusoidal speed changes, young and elderly adults may adopt different strategies. Exercise habituation may reduce step variabilities in young adults. [ABSTRACT FROM AUTHOR]

In this paper, we present a damage identification method for small damages based on topology optimization and Lasso regularization. In particular, this work extends the applicability of the previously developed damage identification method using frequency response functions and topology optimization, by conducting rigorous parametric studies in terms of damping, measurement noise, and damage size. It is shown that the presented method successfully identifies small damaged regions with a reasonable accuracy. To evaluate the effectiveness of the proposed method, we applied the method to identify the damages in cantilevered plates that are subject to static or dynamic loads. The method succeeded in detecting the locations and shapes of damages more accurately than the method without Lasso regularization. Furthermore, in most cases we have considered, spurious damages generated during the optimization were successfully suppressed. [ABSTRACT FROM AUTHOR]

Context: Baseball pitching is a coordinated movement involving the spine. A previous study indicated that increased thoracic kyphosis angle in a standing position was a risk factor for medial elbow injuries in youth baseball players. However, spinal alignments in single-leg standing and their relationships with medial elbow injuries, scapular alignment, or hip joint range of motion are unclear. Objective: To examine the difference in spinal alignment between standing and single-leg standing positions in youth baseball players and analyze their relationship with elbow injuries, scapular alignment, or hip joint range of motion. Design: Cross-sectional study. Setting: University laboratory. Participants: There were 51 youth baseball players with medial epicondylar fragmentation (medial elbow injury group) and 102 healthy youth baseball players (control group). Main Outcome Measures: Thoracic kyphosis, lumbar lordosis, and trunk inclination angles during standing and single-leg standing, forward scapular posture, and hip joint range of motion. Results: In the single-leg standing position, the thoracic kyphosis and backward trunk inclination angles were significantly higher in the medial elbow injury group than in the control group (P =.016 and P =.046, respectively). In the standing position, no significant difference was observed between both groups. The thoracic kyphosis angle in single-leg standing was positively correlated with the bilateral forward scapular posture in the medial elbow injury (P =.008 and P <.001 on the throwing and nonthrowing sides, respectively) and control (P =.010 and P =.032 on the throwing and nonthrowing sides, respectively) groups. Conclusions: High thoracic kyphosis and backward trunk inclination angles are characteristics during single-leg standing in youth baseball players with medial elbow injuries. Spinal alignment measurement in single-leg standing may be useful for identifying youth baseball players who are at risk for sustaining medial elbow injury. [ABSTRACT FROM AUTHOR]

The recurrence of non-metastatic renal cell carcinoma (RCC) may occur early or late after surgery. This study aimed to develop a recurrence prediction machine learning model based on quantitative nuclear morphologic features of clear cell RCC (ccRCC). We investigated 131 ccRCC patients who underwent nephrectomy (T1-3N0M0). Forty had recurrence within 5 years and 22 between 5 and 10 years; thirty-seven were recurrence-free during 5–10 years and 32 were for more than 10 years. We extracted nuclear features from regions of interest (ROIs) using a digital pathology technique and used them to train 5- and 10-year Support Vector Machine models for recurrence prediction. The models predicted recurrence at 5/10 years after surgery with accuracies of 86.4%/74.1% for each ROI and 100%/100% for each case, respectively. By combining the two models, the accuracy of the recurrence prediction within 5 years was 100%. However, recurrence between 5 and 10 years was correctly predicted for only 5 of the 12 test cases. The machine learning models showed good accuracy for recurrence prediction within 5 years after surgery and may be useful for the design of follow-up protocols and patient selection for adjuvant therapy. [ABSTRACT FROM AUTHOR]

Despite remarkable recent progress in developing anti-cancer agents, outcomes of patients with solid tumors remain unsatisfactory. In general, anti-cancer drugs are systemically administered through peripheral veins and delivered throughout the body. The major problem with systemic chemotherapy is insufficient uptake of intravenous (IV) drugs by targeted tumor tissue. Although dose escalation and treatment intensification have been attempted in order to increase regional concentrations of anti-tumor drugs, these approaches have produced only marginal benefits in terms of patient outcomes, while often damaging healthy organs. To overcome this problem, local administration of anti-cancer agents can yield markedly higher drug concentrations in tumor tissue with less systemic toxicity. This strategy is most commonly used for liver and brain tumors, as well as pleural or peritoneal malignancies. Although the concept is theoretically reasonable, survival benefits are still limited. This review summarizes clinical results and problems and discusses future directions of regional cancer therapy with local administration of chemotherapeutants. [ABSTRACT FROM AUTHOR]

TJs maintain the epithelial barrier by regulating paracellular permeability. Since TJs are under dynamically fluctuating intercellular tension, cells must continuously survey and repair any damage. However, the underlying mechanisms allowing cells to sense TJ damage and repair the barrier are not yet fully understood. Here, we showed that proteinases play an important role in the maintenance of the epithelial barrier. At TJ break sites, EpCAM–claudin-7 complexes on the basolateral membrane become accessible to apical membrane-anchored serine proteinases (MASPs) and the MASPs cleave EpCAM. Biochemical data and imaging analysis suggest that claudin-7 released from EpCAM contributes to the rapid repair of damaged TJs. Knockout (KO) of MASPs drastically reduced barrier function and live-imaging of TJ permeability showed that MASPs-KO cells exhibited increased size, duration, and frequency of leaks. Together, our results reveal a novel mechanism of TJ maintenance through the localized proteolysis of EpCAM at TJ leaks, and provide a better understanding of the dynamic regulation of epithelial permeability. [ABSTRACT FROM AUTHOR]

Occludin, tricellulin, and marvelD3 belong to the tight junction (TJ)‐associated MARVEL protein family. Occludin and tricellulin jointly contribute to TJ strand branching point formation and epithelial barrier maintenance. However, whether marvelD3 has the same function remains unclear. Furthermore, the roles of the carboxy‐terminal cytoplasmic tail, which is conserved in occludin and tricellulin, on the regulation of TJ strand morphology have not yet been explored in epithelial cells. We established tricellulin/occludin/marveld3 triple‐gene knockout (tKO) MDCK II cells and evaluated the roles of marvelD3 in the TJ strand structure and barrier function using MDCK II cells and a mathematical model. The complexity of TJ strand networks and paracellular barrier did not change in tKO cells compared to that in tricellulin/occludin double‐gene knockout (dKO) cells. Exogenous marvelD3 expression in dKO cells did not increase the complexity of TJ strand networks and epithelial barrier tightness. The expression of the carboxy‐terminal truncation mutant of tricellulin restored the barrier function in the dKO cells, whereas occludin lacking the carboxy‐terminal cytoplasmic tail was not expressed on the plasma membrane. These data suggest that marvelD3 does not affect the morphology of TJ strands and barrier function in MDCK II cells and that the carboxy‐terminal cytoplasmic tail of tricellulin is dispensable for barrier improvement. [ABSTRACT FROM AUTHOR]

This study examined the changes in the medial elbow joint space width and forearm flexor strength due to repetitive pitching and analysed the relationships among these factors. Thirty-one collegiate baseball players pitched seven sets of 15 pitches each. The medial elbow joint space width, grip strength, and forearm flexor strengths were measured before pitching and after each set. These parameters were compared at baseline and after pitching for each set. Additionally, the relationships between changes in the medial elbow joint space and forearm flexor strength were examined for each set. The medial elbow joint space width significantly increased after four sets compared to baseline values. Compared to baseline values, grip strength decreased significantly after one set, wrist flexion and radial deviation after six, and ulnar deviation after five. However, changes in the medial joint space compared to baseline values after each set were not significantly correlated with changes in forearm flexor strength variables. Therefore, repetitive pitching causes an increase in elbow valgus laxity and a decrease in forearm flexor strength. However, the decrease in forearm muscle strength does not explain the increase in elbow valgus laxity. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to investigate the influence of the trunk position during the single-leg landing on the knee angle and muscle activity. Forty healthy university students (20 men and 20 women) performed right single-leg landings from a 40 cm-high platform with the trunk in neutral, flexion, extension, and right and left lateral flexion. Knee flexion and valgus angles were determined by two-dimensional video analysis, and rectus femoris (RF) and biceps femoris (BF) muscle activities were assessed. The knee flexion angle was significantly higher in the trunk-flexion position than in the other trunk positions. The knee valgus angle was significantly lower in the trunk-neutral and trunk-flexion positions than in the trunk-extension, trunk-right-lateral-flexion, and trunk-left-lateral flexion positions. Muscle activity of the RF was significantly lower in the trunk-flexion position than in the trunk-extension position and that of the BF was significantly higher in the trunk-flexion position than in the trunk-neutral, trunk-extension, and trunk-right-lateral-flexion positions. Single (right)-leg landing with the trunk in flexion may confer a low risk of anterior cruciate ligament injury compared to that with the trunk in extension or right lateral flexion. [ABSTRACT FROM AUTHOR]

Simple Summary: For advanced cancer, surgery may not be possible at the site of lymph node metastasis, such as para-aortic lymph node metastasis. Systemic administration of anticancer drugs has been performed in these cases, but treatment results are still inadequate. This study investigated the efficiency of drug delivery to intra-abdominal lymph nodes by administering an anticancer drug retrogradely to lymphatic vessels in order to deliver the drug directly to the metastatic lymph nodes. Thoracic duct infusion resulted in the same concentration of paclitaxel in abdominal lymph nodes as via systemic administration, but the serum concentration was lower. The results show that thoracic infusion may achieve higher paclitaxel doses than systemic administration. Infusion of anti-cancer drugs into the thoracic duct may yield clinical benefits for patients with extensive lymphatic metastases in abdominal malignancies. Gastrointestinal cancer with massive nodal metastases is a lethal disease. In this study, using a porcine model, we infused the anti-cancer drug Paclitaxel (PTX) into thoracic ducts to examine the efficiency of drug delivery to intra-abdominal lymph nodes. We established a technical method to catheterize the thoracic duct in the necks of pigs. We then compared the pharmacokinetics of PTX administered intrathoracically with those of systemic (intravenous) infusion. Serum, liver, and spleen concentrations of PTX were significantly lower following thoracic duct (IT) infusion than after intravenous (IV) administration approximately 1–8 h post-infusion. However, PTX levels in abdominal lymph nodes were maintained at relatively high levels up to 24 h after IT infusion compared to after IV infusion. Concentrations of PTX in urine were much higher after IT administration than after IV administration. After IT infusion, the same concentration of PTX was obtained in abdominal lymph nodes, but the serum concentration was lower than after systemic infusion. Therefore, IT infusion may be able to achieve higher PTX doses than IV infusion. IT delivery of anti-cancer drugs into the thoracic duct may yield clinical benefits for patients with extensive lymphatic metastases in abdominal malignancies. [ABSTRACT FROM AUTHOR]

For a 2-connected graph G , the relative length of G , denoted by diff (G) , is the difference between the orders of a longest path and a longest cycle in G. This parameter is used as a measure to estimate how close a given graph is to a hamiltonian graph. Let σ k (G) be the least value of the sums of degrees of vertices in independent sets of cardinality k. In 2008, Paulusma and Yoshimoto proved that a 2-connected triangle-free graph G of order n with σ 4 (G) ≥ n + 2 satisfies diff (G) ≤ 1 unless G is isomorphic to one exceptional graph G 0. In this paper, we extend their result and prove that for an integer s with 2 3 (n + 4) < s ≤ n + 2 , a 2-connected triangle-free graph of order n with σ 4 (G) ≥ s satisfies diff (G) ≤ n + 3 − s unless s = σ 4 (G) = n + 2 and G = G 0. [ABSTRACT FROM AUTHOR]

Epithelial tissues cover the surfaces and lumens of the internal organs of multicellular animals and crucially contribute to internal environment homeostasis by delineating distinct compartments within the body. This vital role is known as epithelial barrier function. Epithelial cells are arranged like cobblestones and intricately bind together to form an epithelial sheet that upholds this barrier function. Central to the restriction of solute and fluid diffusion through intercellular spaces are occluding junctions, tight junctions in vertebrates and septate junctions in invertebrates. As part of epithelial tissues, cells undergo constant renewal, with older cells being replaced by new ones. Simultaneously, the epithelial tissue undergoes relative rearrangement, elongating, and shifting directionally as a whole. The movement or shape changes within the epithelial sheet necessitate significant deformation and reconnection of occluding junctions. Recent advancements have shed light on the intricate mechanisms through which epithelial cells sustain their barrier function in dynamic environments. This review aims to introduce these noteworthy findings and discuss some of the questions that remain unanswered. • Epithelial barrier function is maintained even in highly dynamic environments. • Barrier maintenance is achieved through the rearrangement of occluding junctions. • The rearrangement process and its associated molecular mechanisms are discussed. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess the efficiency of artificial intelligence (AI) in the detection of visceral pleural invasion (VPI) of lung cancer using high-resolution computed tomography (HRCT) images, which is challenging for experts because of its significance in T-classification and lymph node metastasis prediction.This retrospective analysis was conducted on preoperative HRCT images of 472 patients with stage I non-small cell lung cancer (NSCLC), focusing on lesions adjacent to the pleura to predict VPI. YOLOv4.0 was utilized for tumor localization, and EfficientNetv2 was applied for VPI prediction with HRCT images meticulously annotated for AI model training and validation.Of the 472 lung cancer cases (500 CT images) studied, the AI algorithm successfully identified tumors, with YOLOv4.0 accurately localizing tumors in 98% of the test images. In the EfficientNet v2-M analysis, the receiver operating characteristic curve exhibited an area under the curve of 0.78. It demonstrated powerful diagnostic performance with a sensitivity, specificity, and precision of 76.4% in VPI prediction.AI is a promising tool for improving the diagnostic accuracy of VPI for NSCLC. Furthermore, incorporating AI into the diagnostic workflow is advocated because of its potential to improve the accuracy of preoperative diagnosis and patient outcomes in NSCLC.Methods: This study aimed to assess the efficiency of artificial intelligence (AI) in the detection of visceral pleural invasion (VPI) of lung cancer using high-resolution computed tomography (HRCT) images, which is challenging for experts because of its significance in T-classification and lymph node metastasis prediction.This retrospective analysis was conducted on preoperative HRCT images of 472 patients with stage I non-small cell lung cancer (NSCLC), focusing on lesions adjacent to the pleura to predict VPI. YOLOv4.0 was utilized for tumor localization, and EfficientNetv2 was applied for VPI prediction with HRCT images meticulously annotated for AI model training and validation.Of the 472 lung cancer cases (500 CT images) studied, the AI algorithm successfully identified tumors, with YOLOv4.0 accurately localizing tumors in 98% of the test images. In the EfficientNet v2-M analysis, the receiver operating characteristic curve exhibited an area under the curve of 0.78. It demonstrated powerful diagnostic performance with a sensitivity, specificity, and precision of 76.4% in VPI prediction.AI is a promising tool for improving the diagnostic accuracy of VPI for NSCLC. Furthermore, incorporating AI into the diagnostic workflow is advocated because of its potential to improve the accuracy of preoperative diagnosis and patient outcomes in NSCLC.Results: This study aimed to assess the efficiency of artificial intelligence (AI) in the detection of visceral pleural invasion (VPI) of lung cancer using high-resolution computed tomography (HRCT) images, which is challenging for experts because of its significance in T-classification and lymph node metastasis prediction.This retrospective analysis was conducted on preoperative HRCT images of 472 patients with stage I non-small cell lung cancer (NSCLC), focusing on lesions adjacent to the pleura to predict VPI. YOLOv4.0 was utilized for tumor localization, and EfficientNetv2 was applied for VPI prediction with HRCT images meticulously annotated for AI model training and validation.Of the 472 lung cancer cases (500 CT images) studied, the AI algorithm successfully identified tumors, with YOLOv4.0 accurately localizing tumors in 98% of the test images. In the EfficientNet v2-M analysis, the receiver operating characteristic curve exhibited an area under the curve of 0.78. It demonstrated powerful diagnostic performance with a sensitivity, specificity, and precision of 76.4% in VPI prediction.AI is a promising tool for improving the diagnostic accuracy of VPI for NSCLC. Furthermore, incorporating AI into the diagnostic workflow is advocated because of its potential to improve the accuracy of preoperative diagnosis and patient outcomes in NSCLC.Conclusion: This study aimed to assess the efficiency of artificial intelligence (AI) in the detection of visceral pleural invasion (VPI) of lung cancer using high-resolution computed tomography (HRCT) images, which is challenging for experts because of its significance in T-classification and lymph node metastasis prediction.This retrospective analysis was conducted on preoperative HRCT images of 472 patients with stage I non-small cell lung cancer (NSCLC), focusing on lesions adjacent to the pleura to predict VPI. YOLOv4.0 was utilized for tumor localization, and EfficientNetv2 was applied for VPI prediction with HRCT images meticulously annotated for AI model training and validation.Of the 472 lung cancer cases (500 CT images) studied, the AI algorithm successfully identified tumors, with YOLOv4.0 accurately localizing tumors in 98% of the test images. In the EfficientNet v2-M analysis, the receiver operating characteristic curve exhibited an area under the curve of 0.78. It demonstrated powerful diagnostic performance with a sensitivity, specificity, and precision of 76.4% in VPI prediction.AI is a promising tool for improving the diagnostic accuracy of VPI for NSCLC. Furthermore, incorporating AI into the diagnostic workflow is advocated because of its potential to improve the accuracy of preoperative diagnosis and patient outcomes in NSCLC.Graphical abstract: This study aimed to assess the efficiency of artificial intelligence (AI) in the detection of visceral pleural invasion (VPI) of lung cancer using high-resolution computed tomography (HRCT) images, which is challenging for experts because of its significance in T-classification and lymph node metastasis prediction.This retrospective analysis was conducted on preoperative HRCT images of 472 patients with stage I non-small cell lung cancer (NSCLC), focusing on lesions adjacent to the pleura to predict VPI. YOLOv4.0 was utilized for tumor localization, and EfficientNetv2 was applied for VPI prediction with HRCT images meticulously annotated for AI model training and validation.Of the 472 lung cancer cases (500 CT images) studied, the AI algorithm successfully identified tumors, with YOLOv4.0 accurately localizing tumors in 98% of the test images. In the EfficientNet v2-M analysis, the receiver operating characteristic curve exhibited an area under the curve of 0.78. It demonstrated powerful diagnostic performance with a sensitivity, specificity, and precision of 76.4% in VPI prediction.AI is a promising tool for improving the diagnostic accuracy of VPI for NSCLC. Furthermore, incorporating AI into the diagnostic workflow is advocated because of its potential to improve the accuracy of preoperative diagnosis and patient outcomes in NSCLC. [ABSTRACT FROM AUTHOR]

This study sought to determine whether lower extremity muscle size, power and strength could be a determinant of whole-body maximal aerobic performance in athletes. 20 male and 19 female young athletes (18 ± 4 years) from various sporting disciplines participated in this study. All athletes performed a continuous ramp-incremental cycling to exhaustion for the determination of peak oxygen uptake (V˙O2peak : the highest V˙O2 over a 15-s period) and maximal power output (MPO: power output corresponding to V˙O2peak). Axial scanning of the right leg was performed with magnetic resonance imaging, and anatomical cross-sectional areas (CSAs) of quadriceps femoris (QF) and hamstring muscles at 50% of thigh length were measured. Moreover, bilateral leg extension power and unilateral isometric knee extension and flexion torque were determined. All variables were normalised to body mass, and six independent variables (V˙O2peak , CSAs of thigh muscles, leg extension power and knee extension and flexion torque) were entered into a forward stepwise multiple regression model with MPO being dependent variable for males and females separately. In the males, V˙O2peak was chosen as the single predictor of MPO explaining 78% of the variance. In the females, MPO was attributed to, in the order of importance, V˙O2peak (p < 0.001) and the CSA of QF (p = 0.011) accounting for 84% of the variance. This study suggests that while oxygen transport capacity is the main determinant of MPO regardless of sex, thigh muscle size also has a role in whole-body maximal aerobic performance in female athletes. [ABSTRACT FROM AUTHOR]

Although voluntary muscle contraction modulates spinal reflex excitability of contracted muscles and other muscles located at other segments within a limb (i.e., intra-limb modulation), to what extent corticospinal pathways are involved in intra-limb modulation of spinal reflex circuits remains unknown. The purpose of the present study was to identify differences in the involvement of corticospinal pathways in intra-limb modulation of spinal reflex circuits among lower-limb muscles during voluntary contractions. Ten young males performed isometric plantar-flexion, dorsi-flexion, knee extension, and knee flexion at 10% of each maximal torque. Electromyographic activity was recorded from soleus, tibialis anterior, vastus lateralis, and biceps femoris muscles. Motor evoked potentials and posterior root-muscle reflexes during rest and isometric contractions were elicited from the lower-limb muscles using transcranial magnetic stimulation and transcutaneous spinal cord stimulation, respectively. Motor evoked potential and posterior root-muscle reflex amplitudes of soleus during knee extension were significantly increased compared to rest. The motor evoked potential amplitude of biceps femoris during dorsi-flexion was significantly increased, whereas the posterior root-muscle reflex amplitude of biceps femoris during dorsi-flexion was significantly decreased compared to rest. These results suggest that corticospinal and spinal reflex excitabilities of soleus are facilitated during knee extension, whereas intra-limb modulation of biceps femoris during dorsi-flexion appeared to be inverse between corticospinal and spinal reflex circuits. [ABSTRACT FROM AUTHOR]

Background: Entamoeba histolytica (E. histolytica) is rarely identified as a cause of amebic pericarditis. We report a case of amebic pericarditis complicated by cardiac tamponade, in which the diagnosis was missed initially and was made retrospectively by polymerase chain reaction (PCR) testing of a stored sample of pericardial fluid. Furthermore, we performed a systematic review of the literature on amebic pericarditis.Case Presentation: A 71-year-old Japanese man who had a history of sexual intercourse with several commercial sex workers 4 months previously, presented to our hospital with left chest pain and cough. He was admitted on suspicion of pericarditis. On hospital day 7, he developed cardiac tamponade requiring urgent pericardiocentesis. The patient's symptoms temporarily improved, but 1 month later, he returned with fever and abdominal pain, and multiple liver lesions were found in the right lobe. Polymerase chain reaction of the aspiration fluid of the liver lesion and pericardial and pleural fluid stored from the previous hospitalization were all positive for E. histolytica. Together with the positive serum antibody for E. histolytica, a diagnosis of amebic pericarditis was made. Notably, the diagnosis was missed initially and was made retrospectively by performing PCR testing. The patient improved with metronidazole 750 mg thrice daily for 14 days, followed by paromomycin 500 mg thrice daily for 10 days.Conclusions: This case suggests that, although only 122 cases of amebic pericarditis have been reported, clinicians should be aware of E. histolytica as a potential causative pathogen. The polymerase chain reaction method was used to detect E. histolytica in the pericardial effusion and was found to be useful for the diagnosis of amebic pericarditis in addition to the positive results for the serum antibody testing for E. histolytica. Because of the high mortality associated with delayed treatment, prompt diagnosis should be made. [ABSTRACT FROM AUTHOR]

For a graph G, define σ 2 (G) by σ 2 (G) = min { d G (x) + d G (y) : x , y ∈ V (G) , x ≠ y , x y ∉ E (G) } . If G is a bipartite graph with partite sets X and Y, we also define σ 1 , 1 (G) by σ 1 , 1 (G) = min { d G (x) + d G (y) : x ∈ X , y ∈ Y , x y ∉ E (G) } . Ore's theorem states that a graph of order n ≥ 3 with σ 2 (G) ≥ n contains a hamiltonian cycle and the Moon–Moser theorem states that a balanced bipartite graph G of order 2 n ≥ 4 with σ 1 , 1 (G) ≥ n + 1 contains a hamiltonian cycle. In Chen et al. (Discrete Math 343:Article No. 111663, 2020), we studied the relationship between Ore's theorem and the Moon–Moser theorem, and proved that the refinement of the Moon–Moser theorem given by Ferrara et al. (Discrete Math 312:459–461, 2012) implies Ore's theorem for graphs of even order. In this paper, we extend the above study to the graphs of odd order. Since no graphs of odd order contain a spanning balanced bipartite subgraph, the Moon–Moser theorem does not work in this case. We instead introduce its counterpart for the graphs in which the orders of the partite sets differ by 1, proved in Matsubara et al. (Discrete Math 340:87–95, 2017). We refine this result and prove that this refinement implies Ore's theorem. [ABSTRACT FROM AUTHOR]

A dominating set X in a graph G is secure if for each u ∈ V (G) − X , there exists a neighbor x of u in X such that (X − { x }) ∪ { u } is a dominating set. The secure domination number of G is the order of a smallest secure dominating set and denoted by γ s (G). Let β (G) be the independence number of G. In this note, we remark that every C 5 -free G satisfies γ s (G) ≤ β (G). This inequality unifies and extends several known results. [ABSTRACT FROM AUTHOR]

This paper proposes a robust damage identification method using noisy frequency response functions (FRFs) and topology optimization. We formulate the damage identification problem as an inverse problem of generating the damage topology of the structure from measured dynamic responses of the structure to given external dynamic loading. The method is based on the minimization of the objective function representing errors between measured FRFs of the structure obtained by experimental modal analysis, and those obtained by harmonic response analysis using finite element analysis. In the minimization process, material distribution, or the topology of the structure is varied and the optimal damage topology is identified as regions with no material assigned as a result of the minimization using the solid isotropic material with penalization (SIMP). In order to overcome the problems caused by the ill-posedness of the inverse problem, it is proposed that the least absolute shrinkage and selection operator (Lasso) regularization, or the penalization to the L1 norm of the design variable be applied to the original objective function. By applying Lasso regularization, the method is expected not only to eliminate spurious damaged regions but also to minimize the effect of measurement noises. This paper first presents the mathematical background and its numerical implementation of the proposed methodology. The method is then applied to the identification of a damage of cantilevered plates. The FRFs were experimentally obtained and the proposed method is applied. It is shown that the method successfully identifies the damage. • A damage identification method for elastic structures has been proposed. • Damage identification is formulated as a minimization problem. • Differences in frequency response functions are minimized by topology optimization. • Penalizing L1 norm of the design variables can suppress the spurious damaged areas. [ABSTRACT FROM AUTHOR]

Purpose: Electromyostimulation (EMS) induces a short-term change in muscle metabolism, and EMS training induces long-term improvements of muscle atrophy and function. However, the effects of EMS training on intramuscular fat in older adults are still poorly known. The purpose of this study was to examine whether the intramuscular fat index and biochemical parameters change with EMS training of the quadriceps femoris muscles in older adults. Methods: Nineteen non-obese older men and women performed EMS training of the quadriceps femoris for 12 weeks (3 times/week; single session for 30 min). The intramuscular fat content index was estimated by echo intensity of the vastus lateralis and rectus femoris muscles on ultrasonography, and muscle thickness was also measured. Muscle strength was assessed as the maximal voluntary contraction during isometric knee extension. Echo intensity, muscle thickness, and muscle strength were measured before and after EMS training. A rested/fasting blood samples were collected before and after EMS training for measuring plasma glucose, insulin, free fatty acid, triglyceride, and interleukin-6 concentrations. To examine the acute effect of a single-EMS session on biochemical parameters, blood samples were taken before and after the EMS session. Results: EMS training did not significantly change echo intensity in muscles, muscle thickness, muscle strength, or biochemical parameters. Regarding the acute effect on blood lipid concentrations, a single-EMS session increased free fatty acid and glucose concentrations. Conclusion: EMS sessions had an acute effect of increasing free fatty acid and glucose concentrations, but EMS training intervention did not improve intramuscular fat content. [ABSTRACT FROM AUTHOR]

To present reference values, clinically significant changes (CSC), and prediction equations of lower-limb muscle strength (LMS) and physical performance (PP) in community-dwelling older adults in a rural area. Quadriceps muscle and toe grip strength were measured as LMS. Maximal gait speed, Timed-Up and Go test, one-legged stand test, and four-square step test were measured as PP. Overall and age-specific reference values for both sexes were presented. CSC was calculated using a distribution-based approach. We conducted multivariate regression analyses to make prediction equations for each variable. The prediction error was checked using 10-fold cross-validation. Three-hundred ninety-two participants (male, n = 116; female, n = 276) were included. LMS was maintained with age, while PS declined linearly. The prediction equations were significant, but the prediction error was high. Reference values and CSC help evaluate the deterioration of LMS and PP and the effectiveness of an intervention on these outcomes. [ABSTRACT FROM AUTHOR]

Fibroblasts constitute a ubiquitous mesenchymal cell type and produce the extracellular matrix (ECM) of connective tissue, thereby providing the structural basis of various organs. Fibroblasts display differential transcriptional patterns unique to the organ of their origin and they can be activated by common stimuli such as transforming growth factor-β (TGF-β) and platelet-derived growth factor (PDGF) signaling. Cancer-associated fibroblasts (CAFs) reside in the cancer tissue and contribute to cancer progression by influencing cancer cell growth, invasion, angiogenesis and tumor immunity. CAFs impact on the tumor microenvironment by remodeling the ECM and secreting soluble factors such as chemokines and growth factors. Differential expression patterns of molecular markers suggest heterogeneous features of CAFs in terms of their function, pathogenic role and cellular origin. Recent studies elucidated the bimodal action of CAFs on cancer progression and suggest a subgroup of CAFs with tumor-suppressive effects. This review attempts to describe cellular features of colorectal CAFs with an emphasis on their heterogeneity and functional diversity. [ABSTRACT FROM AUTHOR]

The natural history of ruptured basilar artery dissecting aneurysms (BADAs) remains unclear compared to that of ruptured vertebral artery dissecting aneurysms (VADAs). In this study, we investigated the natural history and optimal management of ruptured BADAs. We identified 17 patients with ruptured BADA among 4586 patients with aneurysmal subarachnoid hemorrhage (SAH) treated in seven participating hospitals. A scoping literature review was undertaken to investigate prognostic factors. Six patients among the profiled patients (35.3%) died, all with poor SAH grades (World Federation of Neurological Societies Grade IV and V). Rebleeding after admission was observed in three patients (17.6%) with poor SAH grades. Aggressive treatment and conservative management were initiated in seven and ten patients, respectively. Patients with good SAH grades had significantly higher favorable treatment outcomes than those with poor grades (83.3% vs. 9.1%, P = 0.005). Moreover, based on a scoping review of 158 cases with ruptured BADA, including the patients from our series, approximately 90% of patients with good SAH grades had favorable outcomes. A good SAH grade and no rebleeding after admission were favorable prognostic factors (P < 0.0001 and P = 0.002, respectively). The rebleeding rates were 20.2%, 13.3%, and 6.3% for dilated, pearl and string, and stenotic lesions, respectively. We concluded that the natural history of isolated ruptured BADAs may be better than that of VADAs. Although definitive treatment, if possible, is undoubtedly important, conservative management with careful radiological follow-up for morphological changes might be a viable option for patients in good clinical condition and with non-dilated lesions. [ABSTRACT FROM AUTHOR]

Background: The treatment strategies for colorectal cancer (CRC) must ensure a radical cure of cancer and prevent over/under treatment. Biopsy specimens used for the definitive diagnosis of T1 CRC were analyzed using artificial intelligence (AI) to construct a risk index for lymph node metastasis. Methods: A total of 146 T1 CRC cases were analyzed. The specimens for analysis were mainly biopsy specimens, and in the absence of biopsy specimens, the mucosal layer of the surgical specimens was analyzed. The pathology slides for each case were digitally imaged, and the morphological features of cancer cell nuclei were extracted from the tissue images. First, statistical methods were used to analyze how well these features could predict lymph node metastasis risk. A lymph node metastasis risk model using AI was created based on these morphological features, and accuracy in test cases was verified. Results: Each developed model could predict lymph node metastasis risk with a > 90% accuracy in each region of interest of the training cases. Lymph node metastasis risk was predicted with 81.8–86.3% accuracy for randomly validated cases, using a learning model with biopsy data. Moreover, no case with lymph node metastasis or lymph node risk was judged to have no risk using the same model. Conclusions: AI models suggest an association between biopsy specimens and lymph node metastases in T1 CRC and may contribute to increased accuracy of preoperative diagnosis. [ABSTRACT FROM AUTHOR]

Background: Fecal immunochemical testing (FIT) is widely used for colorectal cancer screening, its only indication. Its effect on clinical decision-making beyond screening is unknown. We studied the use of FIT in emergency and inpatient settings and its impact on patient care.Methods: Using electronic medical records, we reviewed all non-ambulatory FITs performed from November 2017 to October 2019 at a tertiary care community hospital. We collected data on demographics, indications, gastroenterology consultations, and endoscopic procedures. Multivariate logistic regression was performed to determine the effect of FIT on gastroenterology consultation and endoscopy.Results: We identified 550 patients with at least 1 FIT test. Only 3 FITs (0.5%) were performed for colorectal cancer screening. FITs were primarily ordered from the emergency department (45.3%) or inpatient hospital floor (42.2%). Anemia (44.0%), followed by gastrointestinal bleeding (40.9%), were the most common indications. FIT was positive in 253 patients (46.0%), and gastroenterology consultation was obtained for 47.4% (n = 120), compared with 14.5% (n = 43) of the 297 FIT-negative patients (odds ratio 3.28; 95% confidence interval, 2.23-4.82, P < .0001). A potential bleeding source was identified in 80% of patients with reported or witnessed overt gastrointestinal bleeding, a similar proportion (80.7%; P = .92) to patients who were FIT positive with overt gastrointestinal bleeding. Multivariate analysis showed that melena, hematemesis, and a positive FIT were associated with gastroenterology consultation (all P < .05), while only melena (odds ratio 3.34; 95% confidence interval, 1.48-7.54) was associated with endoscopy.Conclusions: Nearly all emergency department and inpatient FIT use was inappropriate. FIT resulted in more gastroenterology consultation but was not independently associated with inpatient endoscopy. [ABSTRACT FROM AUTHOR]

Introduction: The traditional Japanese herbal medicine hochuekkito (TJ-41) has been reported to ameliorate systemic inflammation and malnutrition in patients with chronic obstructive pulmonary disease (COPD). TJ-41 has also been known to have preventive effects against influenza virus infection. However, its role in the acute exacerbation of COPD (AECOPD) remains to be elucidated. Our previous study established a murine model of viral infection-associated AECOPD that was induced by intratracheal administration of porcine pancreatic elastase (PPE) and polyinosinic-polycytidylic acid [poly(I:C)]. Here, we used this model and investigated the effects of TJ-41 in AECOPD. Methods: Specific pathogen-free C57BL/6J mice were used. A COPD model was induced by treating mice intratracheally with PPE on day 0. To generate the murine model of AECOPD, poly(I:C) was administered intratracheally following PPE treatment on days 22–24. Mice were sacrificed and analyzed on day 25. Mice were fed a diet containing 2% TJ-41 or a control diet. Results: Daily oral intake of TJ-41 significantly decreased the numbers of neutrophils and lymphocytes in the bronchoalveolar lavage fluid (BALF), which was accompanied by decreased transcripts of CXC chemokines involved in neutrophil migration, viz., Cxcl1 and Cxcl2, in whole lung homogenates and reduced Cxcl2 concentration in BALF. Conclusion: This study demonstrates the anti-inflammatory effects of TJ-41 in a mouse model of AECOPD, suggesting the effectiveness of TJ-41 for the management of COPD. Clinical investigations evaluating the therapeutic efficacy of TJ-41 in AECOPD would be meaningful. [ABSTRACT FROM AUTHOR]

The spleen is a key source of circulating and tumor-infiltrating immune cells. However, the effect of splenectomy on tumor growth remains unclear. At 3 weeks after splenectomy, we subcutaneously injected LuM1 cells into BALB/c mice and evaluated the growth of primary tumors and lung metastases at 4 weeks after tumor inoculation. In addition, we examined the phenotypes of immune cells in peripheral blood by using flow cytometry and in tumor tissue by using multiplex immunohistochemistry. The growth of primary tumors was reduced in splenectomized mice compared with the sham-operated group. Conversely, splenectomized mice had more lung metastases. Splenectomized mice had fewer CD11b+cells, especially monocytic MDSCs (CD11b+Gr-1neg-lowLy6chigh), and NK cells (CD49b+CD335+). The proportion of NK cells was inversely correlated with the number of lung metastases. In splenectomized mice, the density of CD3+ and granzyme B+ CD8+ T cells was increased, with fewer M2-type macrophages in primary tumors, but NK cells were decreased markedly in lung. Splenectomy concurrently enhances T cell-mediated acquired immunity by reducing the number of monocytic MDSCs and suppresses innate immunity by decreasing the number of NK cells. Splenectomy has opposite effects on primary and metastatic lesions through differential regulation on these two immune systems. [ABSTRACT FROM AUTHOR]

Background: Recently, intestinal bacteria have attracted attention as factors affecting the prognosis of patients with cancer. However, the intestinal microbiome is composed of several hundred types of bacteria, necessitating the development of an analytical method that can allow the use of this information as a highly accurate biomarker. In this study, we investigated whether the preoperative intestinal bacterial profile in patients with esophageal cancer who underwent surgery after preoperative chemotherapy could be used as a biomarker of postoperative recurrence of esophageal cancer. Methods: We determined the gut microbiome of the patients using 16S rRNA metagenome sequencing, followed by statistical analysis. Simultaneously, we performed a machine learning analysis using a random forest model with hyperparameter tuning and compared the data obtained. Results: Statistical and machine learning analyses revealed two common bacterial genera, Butyricimonas and Actinomyces, which were abundant in cases with recurrent esophageal cancer. Butyricimonas primarily produces butyrate, whereas Actinomyces are oral bacteria whose function in the gut is unknown. Conclusion: Our results indicate that Butyricimonas spp. may be a biomarker of postoperative recurrence of esophageal cancer. Although the extent of the involvement of these bacteria in immune regulation remains unknown, future research should investigate their presence in other pathological conditions. Such research could potentially lead to a better understanding of the immunological impact of these bacteria on patients with cancer and their application as biomarkers. [ABSTRACT FROM AUTHOR]

A graph G is said to be distanced matchable if, for any matching M of G in which edges are pairwise at least distance d apart, there exists a perfect matching M ∗ of G which contains M. In this paper, we prove the following results: (i) if G is a cubic bipartite graph in which, for each e ∈ E (G) , there exist two cycles C 1 , C 2 of length at most d such that E (C 1) ∩ E (C 2) = { e } , then G is distance d - 1 matchable, and (ii) if G is a planar or projective planar cubic bipartite graph in which, for each e ∈ E (G) , there exist two cycles C 1 , C 2 of length at most 6 such that e ∈ E (C 1) ∩ E (C 2) , then G is distance 6 matchable. [ABSTRACT FROM AUTHOR]

Various immune mediators have crucial roles in the pathogenesis of intraocular diseases. Machine learning can be used to automatically select and weigh various predictors to develop models maximizing predictive power. However, these techniques have not yet been applied extensively in studies focused on intraocular diseases. We evaluated whether 5 machine learning algorithms applied to the data of immune-mediator levels in aqueous humor can predict the actual diagnoses of 17 selected intraocular diseases and identified which immune mediators drive the predictive power of a machine learning model. Cross-sectional study. Five hundred twelve eyes with diagnoses from among 17 intraocular diseases. Aqueous humor samples were collected, and the concentrations of 28 immune mediators were determined using a cytometric bead array. Each immune mediator was ranked according to its importance using 5 machine learning algorithms. Stratified k -fold cross-validation was used in evaluation of algorithms with the dataset divided into training and test datasets. The algorithms were evaluated in terms of precision, recall, accuracy, F-score, area under the receiver operating characteristic curve, area under the precision-recall curve, and mean decrease in Gini index. Among the 5 machine learning models, random forest (RF) yielded the highest classification accuracy in multiclass differentiation of 17 intraocular diseases. The RF prediction models for vitreoretinal lymphoma, acute retinal necrosis, endophthalmitis, rhegmatogenous retinal detachment, and primary open-angle glaucoma achieved the highest classification accuracy, precision, and recall. Random forest recognized vitreoretinal lymphoma, acute retinal necrosis, endophthalmitis, rhegmatogenous retinal detachment, and primary open-angle glaucoma with the top 5 F-scores. The 3 highest-ranking relevant immune mediators were interleukin (IL)-10, interferon-γ-inducible protein (IP)-10, and angiogenin for prediction of vitreoretinal lymphoma; monokine induced by interferon γ, interferon γ, and IP-10 for acute retinal necrosis; and IL-6, granulocyte colony-stimulating factor, and IL-8 for endophthalmitis. Random forest algorithms based on 28 immune mediators in aqueous humor successfully predicted the diagnosis of vitreoretinal lymphoma, acute retinal necrosis, and endophthalmitis. Overall, the findings of the present study contribute to increased knowledge on new biomarkers that potentially can facilitate diagnosis of intraocular diseases in the future. [ABSTRACT FROM AUTHOR]

The realization of high‐performance, anti‐fouling optical diffusers is crucial for various light applications. However, this remains a major challenge for conventional diffusers because of the optical inefficiency of multiple scattering and/or surface reliefs vulnerable to contamination. Inspired by the disordered nanostructure of Morpho butterflies that enables the simultaneous fulfillment of wide‐angle diffraction, low color dispersion, and superhydrophobic self‐cleaning ability due to the lotus effect, this study demonstrates a novel Morpho‐type diffuser with high optical performance and anti‐fouling properties. Surface nanopatterns of the diffuser are newly designed to realize homogeneous light diffusion, combined with the suitable material selection of polydimethylsiloxane (PDMS) to induce the lotus effect. Consequently, the following properties are simultaneously achieved: i) high transmittance ≈90%; ii) wide‐angle diffusion (full width at half maximum ≈80°) with high spatial uniformity; iii) low dispersion; iv) high controllability of anisotropy; and v) anti‐fouling properties. Moreover, vi) the applicability of surface protection is demonstrated by exploiting the high flexibility/adhesivity of PDMS. These capabilities surpass other diffusers, and therefore the presented diffuser is promising for a wide range of applications such as lighting, displays, daylight harvesting, optoelectronics, and medicine. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of wearing high-heeled shoes (HHS) on gait variability of the lower limbs when the treadmill speed was sinusoidally changed. A total of 17 young females walked on a treadmill with HHS, HHS with detachable base sockets (HHS-Sockets), and low-heeled shoes (LHS) under sinusoidal speed-changing protocol of 60-s and 30-s periods with an amplitude of ± 0.56 m·s-1. The time course of the joint elevation angles of the thigh, shank, and foot in one gait cycle can be well approximated like a plan e in a triaxial space, so-called intersegmental coordination (IC). Standard deviation of the plane (IC thickness) was considered as the anteroposterior gait variability when the best-fitting plane of the angular covariation was obtained. The lateral gait variability was the coefficient of variance of step width (CV SW). To examine whether the gait parameters was associated with IC thickness, a sum of the time delay of the stride length and step frequency (TD SL+SF) against sinusoidal speed change was calculated. The IC thickness was not different across shoe conditions and periods. The CV SW was greater in the HHS and HHS-Sockets conditions than in the LHS condition. TD SL+SF was greater in the HHS condition than in the LHS and HHS-Sockets conditions at both periods; however, it was not correlated with IC thickness. Walking with HHS increased lateral gait variability at faster speed-changing situation, but not anteroposterior gait variability. Detachable sockets expanding the base area ten times greater than that of HHS could reduce TD SL+SF ; however, TD SL+SF could not explain the IC thickness. • Treadmill speed was sinusoidally changed at 30-s and 60-s periods. • Gait balance with high-heeled shoes was evaluated in speed changing conditions. • Wearing high-heeled shoes increased lateral gait variability. • High-heeled shoes did not influence anteroposterior gait variability. • Heel base area did not influence anteroposterior and lateral gait variability. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of wearing high-heeled shoes (HHS) on gait variability of the lower limbs when the treadmill speed was sinusoidally changed. A total of 17 young females walked on a treadmill with HHS, HHS with detachable base sockets (HHS-Sockets), and low-heeled shoes (LHS) under sinusoidal speed-changing protocol of 60-s and 30-s periods with an amplitude of ± 0.56 m·s-1. The time course of the joint elevation angles of the thigh, shank, and foot in one gait cycle can be well approximated like a plan e in a triaxial space, so-called intersegmental coordination (IC). Standard deviation of the plane (IC thickness) was considered as the anteroposterior gait variability when the best-fitting plane of the angular covariation was obtained. The lateral gait variability was the coefficient of variance of step width (CV SW). To examine whether the gait parameters was associated with IC thickness, a sum of the time delay of the stride length and step frequency (TD SL+SF) against sinusoidal speed change was calculated. The IC thickness was not different across shoe conditions and periods. The CV SW was greater in the HHS and HHS-Sockets conditions than in the LHS condition. TD SL+SF was greater in the HHS condition than in the LHS and HHS-Sockets conditions at both periods; however, it was not correlated with IC thickness. Walking with HHS increased lateral gait variability at faster speed-changing situation, but not anteroposterior gait variability. Detachable sockets expanding the base area ten times greater than that of HHS could reduce TD SL+SF ; however, TD SL+SF could not explain the IC thickness. • Treadmill speed was sinusoidally changed at 30-s and 60-s periods. • Gait balance with high-heeled shoes was evaluated in speed changing conditions. • Wearing high-heeled shoes increased lateral gait variability. • High-heeled shoes did not influence anteroposterior gait variability. • Heel base area did not influence anteroposterior and lateral gait variability. [ABSTRACT FROM AUTHOR]

Background: Effects of a multicomponent exercise programme have an impact on the physical, cognitive, and psychological domains in elderly community‐dwellers. However, some individuals aged 65 years or more have not shown positive effects after the intervention as reported in similar research. The objective of this quasi‐experimental study was to clarify the effectiveness of a multicomponent programme based on reality orientation therapy (ROT) on the physical performance, cognitive ability, and psychological state in the elderly. Method: Participants were recruited from the general public in 20 areas of Akita Prefecture, Japan, and they took part in each exercise programme for 90 min a day, once every 2 weeks, for 3 months, according to the group classification using cluster randomization into 20 cohorts in Akita. Physical, cognitive, and geriatric depression assessments were performed at baseline and after the 3‐month intervention in both the ROT‐based intervention group and the control group. Result: The final samples for analysis consisted of 31 participants in the control group and 30 participants in the intervention group. The results of the statistical analysis comparing the two groups showed that the 5‐repetition sit‐to‐stand test was performed significantly faster (P < 0.05) and that the results of the word list memory (WM) test and the Symbol Digit Substitution Task also had significantly improved (P < 0.05) after the intervention in both groups. The WM score did not show an interactive effect between the group and time factors, but it had a significant main effect on time in both groups (P < 0.05). Conclusion: The results of our quasi‐experimental study indicated that the multicomponent programme based on the ROT would be as effective as the original multicomponent programme combined with aerobic exercise and cognitive tasks, as highlighted in the WM. [ABSTRACT FROM AUTHOR]

Aim: Developing effective adjuvant therapies is essential for improving the surgical outcomes in patients with hepatocellular carcinoma (HCC). Immunotherapy against HCC has become a promising strategy; however, only approximately 30% of all HCC patients respond to immunotherapy. Previously, we generated the novel therapeutic vaccine comprising multi‐human leukocyte antigen‐binding heat shock protein 70/glypican‐3 peptides with a novel adjuvant combination of hLAG‐3Ig and poly‐ICLC. We also confirmed the safety of this vaccination therapy, as well as its capacity for the effective induction of immune responses in a previous clinical trial. Methods: In this phase I study, we administered this vaccine intradermally six times before surgery, and 10 times after surgery to patients with untreated, surgically resectable HCC (stage II to IVa). The primary end‐points of this study were the safety and feasibility of this treatment. We also analyzed the resected tumor specimens pathologically using hematoxylin–eosin staining and immunohistochemistry for heat shock protein 70, glypican 3, CD8 and programmed death‐1. Results: A total of 20 human leukocyte antigen‐matched patients received this vaccination therapy with an acceptable side‐effect profile. All patients underwent planned surgery without vaccination‐related delay. Immunohistochemical analyses revealed that potent infiltration of CD8+ T cells into tumors with target antigen expression was observed in 12 of 20 (60%) patients. Conclusions: This novel therapeutic vaccine was safe as perioperative immunotherapy for patients with HCC, and has the potential to strongly induce CD8+ T cells infiltration into tumors. [ABSTRACT FROM AUTHOR]

Reducing antibiotic usage among livestock animals to prevent antimicrobial resistance has become an urgent issue worldwide. This study evaluated the effects of administering chlortetracycline (CTC), a versatile antibacterial agent, on the performance, blood components, fecal microbiota, and organic acid concentrations of calves. Japanese Black calves were fed with milk replacers containing CTC at 10 g/kg (CON group) or 0 g/kg (EXP group). Growth performance was not affected by CTC administration. However, CTC administration altered the correlation between fecal organic acids and bacterial genera. Machine learning (ML) methods such as association analysis, linear discriminant analysis, and energy landscape analysis revealed that CTC administration affected populations of various types of fecal bacteria. Interestingly, the abundance of several methane-producing bacteria at 60 days of age was high in the CON group, and the abundance of Lachnospiraceae, a butyrate-producing bacterium, was high in the EXP group. Furthermore, statistical causal inference based on ML data estimated that CTC treatment affected the entire intestinal environment, potentially suppressing butyrate production, which may be attributed to methanogens in feces. Thus, these observations highlight the multiple harmful impacts of antibiotics on the intestinal health of calves and the potential production of greenhouse gases by calves. [ABSTRACT FROM AUTHOR]

The number of incidents related to walking while using smartphones is rising. However, it is not clear how smartphone usage might affect a gait pattern in terms of the foot pressure, and this may address the mechanism leading to incidents while using smartphones. How do the characteristics of walking while using a smartphone affect foot pressure patterns? In this cross-sectional study, we recruited 40 healthy young participants and investigated the walking speed, step length, coefficient of variance of the walking cycle (CV), anteroposterior length of the center of pressure (COP) trajectory (%Long), partial foot pressure ratios (% partial foot pressure [%PFP]), and COP existence time (COPexT) under the following four conditions: normal walking, screen gazing, while using social networking services (SNS), and while using a cognitive application. Parameters were compared among the four conditions using a repeated-measures ANOVA. Further, according to the presence or absence of an incident history (e.g. stumbles, collisions), participants were divided into either the incident or non-incident group. Parameters were compared between the two groups using a two-way repeated-measures ANOVA. Under the SNS and cognitive application conditions, the walking speed, step length, %Long, %PFP, and COPexT in the heel were significantly lower, and the CV and %PFP in the metatarsal region were higher than those under normal walking or screen gazing. %PFP in the heel and metatarsal regions showed a significant group-by-condition interaction; the incident group had lower %PFP in the heel region and higher %PFP in the metatarsal region than the non-incident group. These findings indicate a trend of loading more pressure on the forefoot than on the heel. This pattern was markedly evident in individuals with a history of incidents related to the smartphone usage and may be one of the factors causing stumbles and collisions. • Effects of smartphone use on walking parameters and foot pressure were examined. • Dual-task walking with smartphone use increases CV of walking cycle significantly. • Trend of disproportionate load pressure on the forefoot was observed. • Cognitive load was greater on those with prior experience of related incidents. [ABSTRACT FROM AUTHOR]

Light emission from the M-type enantiomer of a helicene derivative (2,13-bis(hydroxymethyl)[7]-thiaheterohelicene) adsorbed on the clean Au(111) and the C60-covered Au(111) surfaces were investigated by tunneling-current-induced light-emission technique. Plasmon-originated light emission was observed on the helicence/Au(111) surface and it was strongly suppressed on the area where the helicene molecules were adsorbed at the edges of the Au(111) terraces. To avoid luminescence quenching of excited helicene molecules and to suppress strong plasmon light emission from the Au(111) surface, C60 layers were used as decoupling buffer layers between helicene molecules and the Au(111) surface. Helicene molecules were adsorbed preferentially on the Au(111) surface rather than on the C60 buffer layers due to the small interaction of the molecules and C60 islands. This fact motivated us to deposit a multilayer of helicene molecules onto the C60 layers grown on the Au(111) surface, leading to the fact that the helicene/C60 multilayer showed strong luminescence with the molecules character. We consider that such strong light emission from the multilayer of helicene molecules has a plasmon origin strongly modulated by the molecular electronic states of (M)-[7]TH-diol molecules. [ABSTRACT FROM AUTHOR]

Background: This study aims to assess the influence of intramedullary rods on the implantation positions of femoral components using Microplasty instrumentation in Oxford unicompartmental knee arthroplasty. We hypothesized that femoral components can be laterally implanted incorrectly when using intramedullary rods. Methods: This prospective study included all 45 consecutive patients (53 knees) who underwent Oxford unicompartmental knee arthroplasty surgery for anteromedial osteoarthritis or spontaneous osteonecrosis of the knee at our hospital during the study period. A custom-made toolset comprising a triangular caliper and circular trial bearings was used to evaluate the distance between the bearing and the vertical wall of the tibia implant (wall-bearing space) using the caliper at 90° flexion both with and without intramedullary rods. Results: The wall-bearing space was significantly larger when the intramedullary rod was used than when intramedullary rod was not used (1.8 ± 1.1 mm versus 3.4 ± 1.2 mm, P < 0.001). The mean difference of wall-bearing space with and without intramedullary rod was 1.6 ± 0.7 mm. Conclusions: Femoral components can be laterally implanted incorrectly by an average of 1.6 mm when using intramedullary rods. The wall-bearing space should be evaluated using trial components, and if the relationship is improper, it should be corrected before keel slot preparation. [ABSTRACT FROM AUTHOR]

Aim: The clinical efficacy of chemoradiotherapy (CRT) is largely dependent on host immune status. The aim of this study was to identify possible markers expressed on circulating mononuclear cells to predict tumour response in patients with locally advanced rectal cancer (LARC). Methods: Peripheral blood samples were obtained from 47 patients diagnosed with LARC before and after CRT. The numbers of lymphocytes and monocyte subsets were analysed using flow cytometry. Based on clinical and pathological findings, patients were classified as high or low responders. Results: Lymphocyte counts were markedly decreased after CRT. Total numbers of lymphocytes (p = 0.030) and CD4(+) T cells (p = 0.041) in post‐CRT samples were significantly lower in low responders than in high responders. In contrast, monocyte counts were not reduced and the number of CD14dim(+) CD16(+) nonclassical (patrolling) monocytes were somewhat increased after CRT (p = 0.050). Moreover, the ratios of programmed cell death ligand 1 (PD‐L1) (+) cells on patrolling monocytes before and after CRT were significantly higher in low responders than in high responders (p = 0.0046, p = 0.0006). The same trend was observed for classical and intermediate monocytes. The expression of PD‐L1 on patrolling monocytes before CRT correlated inversely with the number of T cells and natural killer (NK) cells after CRT. PD‐L1(+) ratio in patrolling monocytes was an independent predictor for response to CRT. Conclusion: Programmed cell death ligand 1 (PD‐L1) expression on patrolling monocytes suppresses cell‐mediated immunity in patients receiving CRT which could be related to tumour response, and may be a useful biomarker for decision‐making in the management of patients with LARC. [ABSTRACT FROM AUTHOR]

Idiopathic superior oblique muscle palsy is a major type of paralytic, non-comitant strabismus and presents vertical and cyclo-torsional deviation of one eye against the other eye, with a large vertical fusion range and abnormal head posture such as head tilt. Genetic background is considered to play a role in its development, as patients with idiopathic superior oblique muscle palsy have varying degrees of muscle hypoplasia and, rarely, the complete absence of the muscle, that is, aplasia. In this study, whole genome sequencing was performed, and single nucleotide variations and short insertions/deletions (SNVs/InDels) were annotated in two patients each in three small families (six patients in total) with idiopathic superior oblique muscle palsy, in addition to three normal individuals in one family. At first, linkage analysis was carried out in the three families and SNVs/InDels in chromosomal loci with negative LOD scores were excluded. Next, SNVs/InDels shared by the six patients, but not by the three normal individuals, were chosen. SNVs/InDels were further narrowed down by choosing low-frequency (<1%) or non-registered SNVs/InDels in four databases for the Japanese population, and then by choosing SNVs/InDels with functional influence, leading to one candidate gene, SSTR5-AS1 in chromosome 16. The six patients were heterozygous for 13-nucleotide deletion in SSTR5-AS1, except for one homozygous patient, while the three normal individuals were wild type. Targeted polymerase chain reaction (PCR) and direct sequencing of PCR products confirmed the 13-nucleotide deletion in SSTR5-AS1. In the face of newly-registered SSTR5-AS1 13-nucleotide deletion at a higher frequency in a latest released database for the Japanese population, the skipping of low-frequency and non-registration sorting still resulted in only 13 candidate genes including SSTR5-AS1 as common variants. The skipping of linkage analysis also led to the same set of 13 candidate genes. Different testing strategies that consisted of linkage analysis and simple unintentional bioinformatics could reach candidate genes in three small families with idiopathic superior oblique muscle palsy. [ABSTRACT FROM AUTHOR]

We present a case of severe bowel perforation during lenvatinib treatment for advanced hepatocellular carcinoma. Although the Hartmann's procedure was performed, the patient died 48 h after the operation. The histopathological findings suggested that lenvatinib was involved in the etiology of bowel perforation in this case. [ABSTRACT FROM AUTHOR]

Introduction: Psychological disorders, such as depression, are markedly prevalent in patients with airway diseases. In this study, we assessed the effect of treatment with dupilumab, an IL-4 receptor α chain antibody, on depressive symptoms in a cohort of patients with asthma with eosinophilic chronic rhinosinusitis (ECRS). Methods: The study participants, diagnosed with asthma and ECRS, were assessed for symptoms and quality of life (QOL) scores for asthma and ECRS and medications. The Patient Health Questionnaire-9 (PHQ-9) scores were used to evaluate the depressive state. The depressive symptoms were compared with asthma and ECRS symptoms both at the time of initiation and after 4 months of dupilumab treatment. Results: Ultimately, 31 patients were included in the study. Most patients demonstrated a depressive state that was correlated with the nasal symptom score. In the evaluation 4 months after dupilumab treatment, the PHQ-9 score was significantly reduced, and the decrease was remarkable in patients whose nasal symptom score was reduced by 50% or more. Additionally, the PHQ-9 scores in patients with improved nasal and asthma symptoms were significantly reduced. Discussion/Conclusion: Dupilumab may improve QOL in patients with bronchial asthma with ECRS by reducing depressive symptoms through the improvement of clinical symptoms. [ABSTRACT FROM AUTHOR]

Peritoneal dissemination is a major metastatic pathway for gastrointestinal and ovarian malignancies. The miR-29b family is downregulated in peritoneal fluids in patients with peritoneal metastases (PM). We examined the effect of miR-29b on mesothelial cells (MC) which play critical a role in the development of PM through mesothelial-mesenchymal transition (MMT). Human peritoneal mesothelial cells (HPMCs) were isolated from surgically resected omental tissue and MMT induced by stimulation with 10 ng/ml TGF-β1. MiR-29b mimics and negative control miR were transfected by lipofection using RNAiMAX and the effects on the MMT evaluated in vitro. HPMC produced substantial amounts of miR-29b which was markedly inhibited by TGF-β1. TGF-β1 stimulation of HPMC induced morphological changes with decreased expression of E-cadherin and calretinin, and increased expression of vimentin and fibronectin. TGF-β1 also enhanced proliferation and migration of HPMC as well as adhesion of tumor cells in a fibronectin dependent manner. However, all events were strongly abrogated by simultaneous transfection of miR-29b. MiR-29b inhibits TGF-β1 induced MMT and replacement of miR-29b in the peritoneal cavity might be effective to prevent development of PM partly through the effects on MC. [ABSTRACT FROM AUTHOR]

Age-associated intramuscular adipose tissue (IntraMAT) deposition induces the development of insulin resistance and metabolic syndrome. However, the relationship between IntraMAT and biochemical parameters in older adults remains unclear. The purpose of this study, therefore, was to elucidate the relationship between adiponectin and echo intensity–estimated IntraMAT using ultrasonography in normal-weight older adults (men 9, women 13) and examine biochemical parameters. Blood tests were performed to determine fasting levels of glucose, insulin, hemoglobin A1c, total cholesterol (Total-C), high-density-lipoprotein cholesterol, low-density-lipoprotein cholesterol (LDL-C), free fatty acid, triglycerides (TGs), adiponectin, leptin, high-sensitivity C-reactive protein, and high-sensitivity tumor necrosis factor, and homoeostasis model assessment index of insulin resistance (HOMA-IR). Mean gray-scale echo intensity was calculated as the IntraMAT index of the vastus lateralis. Waist circumference was measured at the level of the navel as the visceral adipose tissue (VAT) index. Echo intensity was significantly inversely correlated with adiponectin or LDL-C, and that was significantly positively correlated with TG. Adiponectin level was inversely correlated with waist circumference. Partial correlation analysis with waist circumference as the control variable revealed that adiponectin was inversely correlated with echo intensity, independent of waist circumference, whereas no such correlation was observed after controlling for LDL-C and TG levels. When biochemical parameters were grouped in the principal component analysis, among men, Total-C, insulin, and HOMA-IR or hemoglobin A1c, and high-sensitivity tumor necrosis factor–alpha were grouped with the same distribution for factors 1 and 2. Among women, glucose, insulin, HOMA-IR, and Total-C or TGs were grouped with the same distribution for factors 1 and 2. These data suggest that adiponectin level is related to IntraMAT content, independent of VAT in normal-weight older adults. The dynamics of adiponectin might not be similar to those of other circulating biochemical parameters in older men and women. [ABSTRACT FROM AUTHOR]