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This paper presents a double-mass dynamic vibration absorber (DVA) that rapidly reduces the motion of the object to be damped (main system) and converts it to the motion of the DVA. In this way, the DVA attenuates the vibration of the main system. A DVA is usually designed to improve the resonance amplitude and convergence time of the main system vibration, and the kinetic energy of the main system is dissipated as heat in the damping element of the DVA. We describe a novel configuration consisting of two DVAs connected by a spring and an inerter. This new structure enables a rapid response reduction of the main system and residual vibration in the DVA. By tuning the responses of both the main system and the DVA, two vibration modes can be realized: a damping mode and a residual vibration mode. The proposed device is optimized using a genetic algorithm and applied to a bridge to demonstrate its performance. [ABSTRACT FROM AUTHOR]

Purpose: Parenteral morphine is widely used for dyspnea of imminently dying cancer patients, but the outcomes to expect over time remain largely unknown. We examined outcomes after the administration of parenteral morphine infusion over 48 h in cancer patients with a poor performance status.Methods: This was a multicenter prospective observational study. Inclusion criteria were metastatic/locally advanced cancer, ECOG performance status = 3-4, a dyspnea intensity ≥ 2 on a Support Team Assessment Schedule, Japanese version (STAS-J), and receiving specialized palliative care. After initiating parenteral morphine infusion, we measured dyspnea STAS-J as well as Memorial Delirium Assessment Scale (MDAS), item 9, and Communication Capacity Scale (CCS), item 4, every 6 h over 48 h.Results: We enrolled 167 patients (median survival = 4 days). The mean age was 70 years, 80 patients (48%) had lung cancer, and 109 (65%) had lung metastases. The mean STAS-J scores decreased from 3.1 (95% confidence interval (CI) = 3.0-3.2) at the baseline to 2.1 (95%CI = 1.9-2.2) at 6 h, and remained 1.6-1.8 over 12-48 h. The proportion of patients with dyspnea relief (STAS-J ≤ 1) increased to 39% at 6 h, and ranged between 49 and 61% over 12-48 h. In contrast, up to 6.6 and 20% of patients showed hyperactive delirium (MDAS item 9 ≥ 2) and an inability to communicate (CCS item 4 = 3), respectively, over 48 h.Conclusions: Overall, terminal dyspnea was relatively well controlled with parenteral morphine, though a significant number of patients continued to suffer from dyspnea. Future efforts are needed to improve outcomes following standardized dyspnea treatment using patient-reported outcomes for imminently dying patients. [ABSTRACT FROM AUTHOR]

Purpose: Although corticosteroids can relieve dyspnea in advanced cancer patients, factors predicting the response remain unknown. We aimed to explore potential factors predicting the response to corticosteroids for dyspnea in advanced cancer patients.Methods: In this preliminary multicenter prospective observational study, we included patients who had metastatic or locally advanced cancer, were receiving specialized palliative care services, and had a dyspnea intensity of ≥3 on a 0-10 Numerical Rating Scale (NRS) (worst during the last 24 h). The primary endpoint was NRS of dyspnea on day 3 after the administration of corticosteroids. Univariate/multivariate analyses were conducted to identify factors predicting ≥1-point reduction in NRS.Results: Of 74 patients who received corticosteroids, 50 (68%) showed ≥1-point reduction in dyspnea NRS. Factors that significantly predicted the response were an age of 70 years or older (82 vs. 53%, p = 0.008), absence of liver metastases (77 vs. 46%, p = 0.001), Palliative Prognostic Index (PPI) ≤ 6 (90 vs. 61%, p = 0.041), presence of pleuritis carcinomatosa with a small collection of pleural effusions (84 vs. 55%, p = 0.011), presence of audible wheezes (94 vs. 60%, p = 0.014), and baseline dyspnea NRS ≥7 (76% vs. 52%, p = 0.041). In a multivariate analysis, factors predicting response included PPI <6 (odds ratio (OR), 36.2; p = 0.021), baseline dyspnea NRS (worst) ≥7 (OR, 6.6; p = 0.036), and absence of liver metastases (OR, 0.19; p = 0.029) or ascites/liver enlargement (OR, 0.13; p = 0.050).Conclusions: The patient characteristics, etiologies of dyspnea, and clinical manifestations may predict responses to corticosteroids for dyspnea. Larger prospective studies are promising to confirm our findings. [ABSTRACT FROM AUTHOR]

Purpose: Although corticosteroids are widely used to relieve anorexia, information regarding the factors predicting responses to corticosteroids remains limited. The purpose of the study is to identify potential factors predicting responses to corticosteroids for anorexia in advanced cancer patients.Methods: Inclusion criteria for this multicenter prospective observational study were patients who had metastatic or locally advanced cancer and had an anorexia intensity score of 4 or more on a 0-10 Numerical Rating Scale (NRS). Univariate and multivariate analyses were conducted to identify the factors predicting ≥2-point reduction in NRS on day 3.Results: Among 180 patients who received corticosteroids, 99 (55 %; 95 % confidence interval [CI], 47-62 %) had a response with ≥2-point reduction. Factors that significantly predicted responses were Palliative Performance Scale (PPS) > 40 and absence of drowsiness. In addition, factors that tended to be associated with ≥2-point reduction in NRS included PS 0-3, absence of diabetes mellitus, absence of peripheral edema, presence of lung metastasis, absence of peritoneal metastasis, baseline anorexia NRS of >6, presence of pain, and presence of constipation. A multivariate analysis showed that the independent factors predicting responses were PPS of >40 (odds ratio = 2.7 [95 % CI = 1.4-5.2]), absence of drowsiness (2.6 [1.3-5.0]), and baseline NRS of >6 (2.4 [1.1-4.8]).Conclusions: Treatment responses to corticosteroids for anorexia may be predicted by PPS, drowsiness, and baseline symptom intensity. Larger prospective studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Background: Various surgical procedures have been used to repair disc herniations and osteophytes at the cervicothoracic junction. Among these procedures, transvertebral anterior foraminotomy without fusion is a relatively less invasive, safe and useful method, although the majority of spinal surgeons remain unfamiliar with this method. We describe the surgical procedure for a transvertebral anterior keyhole foraminotomy without fusion at the cervicothoracic junction, and we assess the middle-term clinical and radiological outcomes. Methods: Of 118 patients undergoing this surgery in our institute between 2007 and 2010, five (4.2 %) had C8 radiculopathy causing C7/T1 disc herniations or osteophytes. We studied five patients who underwent trans-C7 vertebral keyhole foraminotomy without fusion. We retrospectively examined clinical data, pre- and postoperative neurological status. Results: In all cases, surgical decompression was successfully achieved without difficulty when accessing the pathology. No complications related to the surgical procedure were reported. The follow-up period was 12-28 (mean 20) months. In all patients, the visual analogue scale (VAS) due to radicular pain immediately decreased after the operation and did not increase thereafter. The mean VAS decreased from 7.8 (4.5-9.6) to 1.0 (0-2.1). The Cobb angle at C2-T1 in a neutral position improved from −12.6 (−2.8 to −24.7) degrees to −6.9 (4.2 to −25.4). The postoperative C7/T1 disc height decreased from 5.4 to 4.9 mm, indicating minimal loss. Conclusions: This procedure allows for direct access to the pathology and is less invasive. In this study, we clarified that this technique yields excellent radiological and clinical outcomes. [ABSTRACT FROM AUTHOR]

We compared the plant growth, stomatal conductance ( g), leaf water content (LWC), and root length density (RLD) of Oryza sativa L. ssp. japonica cv. Sensho (traditional upland), ssp. indica cv. Beodien (traditional upland), and ssp. japonica cv. Koshihikari (improved lowland) under two aerobic rice systems [well-irrigated (WI) and water-saving (WS) treatments]. Irrigation water was applied every 2 days from 21 to 68 days after sowing (DAS) and everyday thereafter in WI treatment and it was applied when soil water potential at 15 cm depth reached −15 kPa from 21 to 68 DAS and every 2 days thereafter in WS treatment to impose repetitive water stress. WS treatment used 35% less water than WI. Leaf area index (LAI) and shoot dry weight (SDW) were the lowest for Koshihikari in both treatments and the ratio of LAI and SDW in WS treatment to that in WI treatment was the lowest in Koshihikari. This indicates that aerobic cultivation was not suitable for Koshihikari even under well-irrigated conditions and that the effect of repetitive water stress was the most serious in Koshihikari. Midday g of Sensho and Beodien in WS treatment were affected by irrigation, whereas that of Koshihikari was low and stable. LWC of Koshihikari was smaller than those of upland genotypes in both treatments. LWC of upland genotypes in WI and WS reached maximum and minimum values at predawn and evening, respectively, and recovered at night, but LWC of Koshihikari in WS treatment did not recover at night. RLD of upland genotypes was higher than that of Koshihikari, but no significant differences were observed among treatments. These results indicate that genotypic difference of physiological traits under aerobic conditions (both WI and WS) was caused by the genotypic difference of water uptake capacity, which can be partly caused by the RLD. In Koshihikari, however, the LWC difference between treatments can not be explained only by the RLD. Further studies will be needed to clarify physiological mechanism responsible for the water uptake capacity of roots in aerobic rice systems. [ABSTRACT FROM AUTHOR]

A risk assessment of ozone (O3) impact on the annual carbon absorption ( ACA) of Japanese representative conifers was conducted based on the results of an experimental study, monitoring data of oxidant concentrations and vegetation surveys. The areas with high O3-induced reduction in ACA did not necessarily correspond to the areas with relatively high O3-exposure. Widespread distribution of O3-sensitive tree species such as Pinus densiflora and Larix kaempferi, and high ACA were important factors that induced a high risk of O3 impact on the ACA. Therefore, we concluded that not only the accumulated O3-exposure but also the variety of tree habitat, the tree sensitivity to O3 and the ACA among the tree species must be taken into account to assess the risk of O3 impact on the ACA of Japanese conifers. The O3-induced reduction in the total ACA of the three tree species in Japan was estimated to be 0.8%. [ABSTRACT FROM AUTHOR]

Nausea and vomiting are among the most common and distressing symptoms in patients with advanced cancer. Olanzapine, an antipsychotic agent, is known to have an affinity for multiple neurotransmitter receptors. Previous studies have reported olanzapine to be efficacious in the treatment of nausea and vomiting. Although it has been administered at a number of facilities, its applicability to treat nausea and vomiting in patients with advanced cancer is poorly understood. We investigated the use of olanzapine for nausea and vomiting in patients with advanced cancer at multiple centers. This retrospective study was carried out at seven palliative care units and three facilities with palliative care teams in Japan from 2013 to 2015. The dosage of olanzapine, treatment duration, and duration from initial use until death were collected from the medical records. One hundred and eight patients met our inclusion criteria. The average dose of olanzapine was 3.6 mg (2.5 mg, n = 61; 5 mg, n = 46; 10 mg, n = 1) and average treatment duration was 18.7 days. The average duration from initial use until death was 39.0 days. There were no differences in the duration of administration until death between olanzapine doses (2.5 and 5 mg). Our results suggest that olanzapine have been used in patients with poor prognoses for nausea and vomiting in patients with advanced cancer. Conducting a prospective trial would further yield promising results. [ABSTRACT FROM AUTHOR]

To determine water uptake by rice in water-saving culture, we examined root hydraulic conductance ( L0), plant growth, and root anatomy of three rice genotypes ( Oryza sativa L. ssp. indica cv. Beodien, traditional upland; ssp. japonica cv. Sensho, traditional upland; ssp. japonica cv. Koshihikari, improved lowland) under three water regimes: water-saturated (hydroponic), well-irrigated aerobic (control), and water-saving aerobic in soil. In hydroponic culture, although shoot dry weight (SDW) and root number were the largest in Sensho, root L0 was the highest in Koshihikari. There was no significant relationship between root L0 and SDW in hydroponics, so root L0 might not limit shoot growth under flooding. Root L0 was much less in soil than in hydroponics, and that of Koshihikari was the lowest, especially in water-saving conditions. Root L0 was highly correlated with SDW under water-saving conditions but not in the control, so root L0 limits shoot growth under repeated water stress. Root anatomy was less affected by water regime than root L0 and is genetically controlled. Thus, root L0 may be more affected by water channels than by root anatomy. [ABSTRACT FROM AUTHOR]

To obtain basic information for evaluating critical levels of O3 under different nitrogen loads for protecting Japanese beech forests, two-year-old seedlings of Fagus crenata Blume were grown in potted andisol supplied with N as NH4NO3 solution at 0, 20 or 50 kg ha−1 year−1 and exposed to charcoal-filtered air or O3 at 1.0, 1.5 and 2.0 times the ambient concentration from 16 April to 22 September 2004. The O3 induced significant reductions in the whole-plant dry mass, net photosynthetic rate at 380 μmol mol−1 CO2 ( A 380), carboxylation efficiency ( CE) and concentrations of ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco) and total soluble protein (TSP) in the leaves. The concentrations of Rubisco and TSP were negatively correlated with the concentration of leaf acidic amino acid, suggesting that O3 enhanced the degradation of protein such as Rubisco. The N supply to the soil did not significantly change the whole-plant dry mass and A 380, whereas it significantly increased the CE and concentrations of Rubisco and total amino acid. No significant interactive effects of O3 and N supply to the soil were detected on the growth, photosynthetic parameters and concentrations of protein and amino acid in the leaves. In conclusion, N supply to the soil at ≤50 kg ha−1 year−1 does not significantly change the sensitivity to O3 of growth and net photosynthesis of Fagus crenata seedlings. [ABSTRACT FROM AUTHOR]

We developed segmental Lp-TAE, which is transcatheter hepatic sub-subsegmental, subsegmental, or segmental chemoembolization using Lipiodol introduced into the tumor-bearing hepatic sub-subsegment, subsegment, or segment as the target area. A total of 98 patients with nonresectable hepatocellular carcinoma (HCC) undergoing segmental Lp-TAE (Seg-Lp-TAE) were studied, and the relationship between the CT pattern observed after Seg-Lp-TAE (Seg-Lp-CT) and the therapeutic results obtained in those patients was evaluated. Seg-Lp-CT was classified into four types (type I, homogeneous; type II, defective; type III, inhomogeneous; and type IV, only slight accumulation, if any) according to the Lipiodol accumulation pattern observed after Seg-Lp-TAE. The cumulative nonrecurrence rates of type I were higher than those of types II-IV. The cumulative survival rates of type Ia, in which Lp accumulation is also seen around the main tumor, were the highest (93.8% at 1 year, 85.9% at 2 years, 85.9% at 3 years, and 57.3% at 4 years). The cumulative survival rates achieved with Seg-Lp-TAE were 89.2% at 1 year, 69.4% at 2 years, 58.9% at 3 years, 44.0% at 4 years, and 30.2% at 5 years, which were higher than those achieved with conventional Lp-TAE. Seg-Lp-TAE is very useful in the treatment of HCC limited to one sub-subsegment, subsegment, or segment, and it is important to choose subsubsegmental, subsegmental, subsegmental, or segmental Lp-TAE on the basis of the size and site of the tumor as well as the type and the number of feeding arteries. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the feasibility of combining placement of a transjugular intrahepatic portosystemic shunt (TIPS) and transcatheter hepatic segmental artery chemoembolization with Lipiodol (Seg-Lp-TAE) in patients with cirrhosis, esophagogastric varices, and hepatocellular carcinoma (HCC).Methods: Five patients with bleeding or large, high-flow esophagogastric varices and HCC were treated by TIPS and Seg-Lp-TAE.Results: The mean portosystemic pressure gradient decreased from 20.8 cm H2O to 7.8 cm H2O after TIPS. The direct portogram and endoscopic examination revealed reduction of varices. At 6 months, one shunt had functionally occluded and could not be reopened; the other TIPS remained functional. Follow-up CT and the changes of alpha fetoprotein indicated effective therapy of Seg-Lp-TAE for HCC. Four patients are in stabile clinical condition at 9, 6, 1, and 1 months after the combined therapy; one died after 14 months due to decompensated liver cirrhosis.Conclusion: The combined therapy of TIPS and Seg-Lp-TAE will become a new interventional approach for patients with HCC and esophagogastric varices. [ABSTRACT FROM AUTHOR]

Transcatheter chemoembolization using Lipiodol (Lp) mixed with chemotherapeutic agents followed by Gelfoam particle injection only to the tumor-bearing hepatic segment (segmental Lp transcatheter hepatic artery embolization) (TAE) was applied to more than 100 patients with hepatocellular carcinoma and metastatic liver cancer. For segmental Lp-TAE, knowledge of the variations of intrahepatic arterial anatomy is important. Furthermore, the catheters and guidewires, volume of Lp, kinds and dose of chemotherapy, preparation of the mixture of Lp and chemotherapy (Lp-emulsion), method of injection of Lp-emulsion and Gelfoam particles, as well as the follow-up computed tomography examination are key items to the success of the procedure and are reviewed. [ABSTRACT FROM AUTHOR]

Transcatheter hepatic segmental arterial chemoembolization using Lipiodol mixed with an anticancer drug followed by the injection of Gelfoam particles, introduced into the tumor-bearing hepatic segment as the target area (segemental Lipiodol-TAE), was carried out in 54 patients with hepatocellular carcinoma (HCC), 7 of whom were later resected. In 5 of the resected 7 cases, complete necrosis was histologically verified. No death due to HCC was encountered in 47 nonoperated cases, and better therapeutic results were obtained with segmental Lipiodol-TAE. It was concluded that this technique does not adversely affect normal tissues, and it does reinforece the effect of TAE. [ABSTRACT FROM AUTHOR]

Twelve cases of hepatocellular carcinoma treated by arterial embolization were followed with ultrasonography. Shrinkage of the tumor after the therapy was confirmed in all cases. Echo level reduction in the tumor occurred in 10 cases. High-level reverberation echoes with acoustic shadows emerged in seven cases; however, these echoes were not detected in any cases 3 weeks after the procedure. Echoes were considered either as the consequence of gas produced in the tumor or air trapped in the embolic substance. Ultrasonography, therefore, is an effective technique for the posttherapeutic evaluation of arterial embolization therapy for hepatocellular carcinoma. [ABSTRACT FROM AUTHOR]