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Two high-temperature superconducting (HTS) coils are fabricated that simulate the windings of a HTS traction transformer for railroad rolling stock.

A study was conducted on the fabrication and testing of high temperature superconducting (HTS) current leads designed for a 1kWh/1MW module type superconducting magnetic energy storage system. Bulk HTS were employed to minimize the current leads' heat load. Test results of prototype leads reveal a 0.035 W heat load in steady state at 1 kA rated current and 0.05 g/s rated flow rate.

A design study was conducted on high temperature superconducting (HTS) current leads for application in a 11kWh/1MW module type superconducting magnetic energy storage system. Bulk HTS were employed to minimize the current leads' heat load. An optimal design was developed for HTS current leads that can accommodate less than 01.W heat load at the cold-end terminal.

A superconducting magnet system has been designed and constructed for a 1-MW gyrotron operating at frequencies between 110 GHZ and 140 GHz. Aside from superconducting magnets, it is composed of a cryostat, power supplies, a two-stage cooler. The latter is used to minimize the thermal load of liquid helium. Tests with a 5.0-T magnetic field in the resonance region of its superconducting split coil confirm the validity of the design.

We studied the possible application of high-TC superconducting traction transformer to railway rolling stock, and designed an iron core type two-leg 4 MVA superconducting traction transformer for Shinkansen. This traction transformer has a primary winding, four secondary windings and a tertiary winding. The four secondary windings are independent of each other. Two secondary windings are arranged around each leg of the iron core and placed inside and outside the primary and tertiary windings. In this study, we fabricated a high-TC super-conducting coil whose form and dimension are the same as those of the inner secondary winding. This coil can be used as the inner secondary winding of the experimental high TC superconducting traction transformer that will be fabricated in the future. The inner secondary winding has 96 turns and a later with eight parallel Bi2223 superconducting tapes. Transposition among the superconducting tapes is performed 15 times every six turns. We measured the voltage-current and AC loss characteristics when it was cooled in saturated and sub-cooled liquid nitrogen. [ABSTRACT FROM AUTHOR]

Abstract Background In the normal process of bioethanol production, biomass is transported to integrated large factories for degradation to sugar, fermentation, and recovery of ethanol by distillation. Biomass nutrient loss occurs during preservation and degradation. Our aim was to develop a decentralized ethanol production system appropriate for farm or co-operative level production that uses a solid-state fermentation method for producing bio-ethanol from whole crops, provides cattle feed, and produces no wastes. The idea is to incorporate traditional silage methods with simultaneous saccharification and fermentation. Harvested, fresh biomass is ensiled with biomass-degrading enzymes and yeast. Multiple parallel reactions for biomass degradation and ethanol and lactic acid production are induced in solid culture in hermetically sealed containers at a ranch. After fermentation, ethanol is collected on site from the vapor from heated fermented products. Results The parallel reactions of simultaneous saccharification and fermentation were induced efficiently in the model fermentation system. In a laboratory-scale feasibility study of the process, 250 g of freshly harvested forage rice with 62% moisture was treated with 0.86 filter paper units/g dry matter (DM) of cellulase and 0.32 U/g DM of glucoamylase. After 20 days of incubation at 28°C, 6.4 wt.% of ethanol in fresh matter (equivalent to 169 g/kg DM) was produced. When the 46 wt.% moisture was gathered as vapor from the fermented product, 74% of the produced ethanol was collected. Organic cellular contents (such as the amylase and pronase degradable fractions) were decreased by 63% and organic cell wall (fiber) content by 7% compared to silage prepared from the same material. Conclusions We confirmed that efficient ethanol production is induced in nonsterilized whole rice plants in a laboratory-scale solid-state fermentation system. For practical use of the method, further study is needed to scale-up the fermentation volume, develop an efficient ethanol recovery method, and evaluate the fermentation residue as an actual cattle feed.

Background/objectives: Opting to perform emotion regulation when facing high-arousal stimuli enhances the reduction in negative emotions. Previous research has indicated that self-choice, that is, personally choosing from multiple alternatives, can improve performance. However, it is unclear whether the emotion regulation strategy chosen among multiple alternatives in daily life enhances stress reduction compared to a forced strategy. This study aimed to reveal the effects of self-choice emotion regulation and its underlying neural basis., Methods: Participants were 40 healthy adults who met the inclusion criteria; they performed self-choice emotion regulation, forced emotion regulation, and no emotion regulation (the control condition) while their brain activity was captured using a functional magnetic resonance imaging scanner. First, the participants were shown a stressful scenario. Secondly, they rated the stress they experienced. Thirdly, they performed self-choice or forced emotion regulation or did nothing. Finally, participants rated their stress level again., Results: Self-choice emotion regulation reduced stress better than forced-choice emotion regulation. The stress reduction was associated with decreases in the activation of the left opercular part of the inferior frontal gyrus., Conclusions: Self-choice can improve emotion regulation, and this effect is likely mediated by the neural efficiency of the left inferior frontal gyrus.

Background: The aim of the present study was to conduct a prospective observational study to explore the effects of imeglimin on systemic energy metabolism/body composition and to identify potential mitochondria-related biomarkers of the efficacy of the drug in clinical settings., Methods: In this prospective observational study, 16 participants with type 2 diabetes mellitus in the diabetes clinic of Kyoto University Hospital were enrolled. Individuals were started on imeglimin as monotherapy or add-on therapy., Results: After 3 months under imeglimin treatment, there was no significant change in basal metabolism or body composition. However, serum levels of growth differentiation factor 15 (GDF15) were higher while those of serum fibroblast growth factor 21 and urine 8-hydroxy-2'-deoxyguanosine were not changed. Additional in vitro examination revealed that imeglimin induces GDF15 protein release from human hepatocytes., Conclusions: Three-month imeglimin treatment increased serum GDF15 levels in clinical type 2 diabetes mellitus patients along with little change in basal metabolism or body composition, suggesting GDF15 as a potential marker for the efficacy of imeglimin., Competing Interests: None to declare., (Copyright 2024, Wada et al.)

Insulinomas are the most common functional pancreatic neuroendocrine neoplasm; when treatment is delayed, they induce hyperinsulinemic hypoglycemia, which is life-threatening. As surgical resection is the only curative treatment for insulinoma, preoperative localization is crucial; however, localization based on conventional imaging modalities such as computed tomography (CT) and magnetic resonance imaging is often inconclusive. Somatostatin receptor-targeted imaging is another option for detecting pancreatic neuroendocrine neoplasms but has low sensitivity and is not specific for insulinoma. The clinical application of other localizing approaches such as selective arterial calcium stimulation and endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) is limited by their being invasive and/or technically complex. Moreover, an EUS-FNA specimen of an insulinoma may be negative on insulin immunostaining. Thus, a noninvasive and clinically practical insulinoma-specific diagnostic tool to discriminate insulinomas with high accuracy is anticipated. Glucagon-like peptide-1 receptor (GLP-1R)-targeted imaging has emerged in the effort to fulfill this need. We recently developed the novel fluorine-18-labeled exendin-4-based probe conjugated with polyethylene glycol, [ 18 F]FB(ePEG12)12-exendin-4 ( 18 F-exendin-4) for positron emission tomography (PET) imaging and reported its clinical benefit in a case of insulinoma in the pancreatic tail. We report here a case of insulinoma in the pancreatic head in which an EUS-FNA specimen was negative on insulin immunostaining while precise preoperative localization and conclusive evidence for curative enucleation was provided by 18 F-exendin-4 PET/CT (Japan Registry of Clinical Trials; jRCTs051200156).

Study Design: Retrospective cohort study., Purpose: This study aimed to compare data from patients who received intradiscal condoliase (chondroitin sulfate ABC endolyase) injection for primary lumbar disc herniation (LDH) and recurrent LDH., Overview of Literature: Chemonucleolysis with condoliase for LDH is a treatment with relatively good results and a high safety profile; however, few studies have reported recurrence after LDH surgery., Methods: The study participants were 249 patients who underwent intradiscal condoliase injection for LDH at nine participating institutions, including 241 patients with initial LDH (group C) and eight with recurrent LDH (group R). Patient characteristics including age, sex, body mass index, disease duration, intervertebral LDH level, smoking history, and diabetes history were evaluated. Low back pain/leg pain Numerical Rating Scale (NRS) scores and the Oswestry Disability Index (ODI) were used to evaluate clinical symptoms before treatment and at 6 months and 1 year after treatment., Results: Low back pain NRS scores (before treatment and at 6 months and 1 year after treatment, respectively) in group C (4.9 → 2.6 → 1.8) showed significant improvement until 1 year after treatment. Although a tendency for improvement was observed in group R (3.5 → 2.8 → 2.2), no significant difference was noted. Groups C (6.6 → 2.4 → 1.4) and R (7.0 → 3.1 → 3.2) showed significant improvement in the leg pain NRS scores after treatment. Group C (41.4 → 19.5 → 13.7) demonstrated significant improvement in the ODI up to 1 year after treatment; however, no significant difference was found in group R (35.7 → 31.7 → 26.4)., Conclusions: Although intradiscal condoliase injection is less effective for LDH recurrence than for initial cases, it is useful for improving leg pain and can be considered a minimally invasive and safe treatment method.

Objectives: We aimed to identify independent factors for intraoperative endoscopic lens cloudiness during gastric and colorectal endoscopic submucosal dissections, investigate the effectiveness of Cleastay, an endoscope anti-fog solution, and examine factors associated with severe submucosal fat deposition., Methods: A total of 220 patients who underwent gastric or colorectal endoscopic submucosal dissections in two institutions between January 2022 and October 2023 were included. Significant factors related to cloudiness were determined using univariate and multivariate analyses. Patient background and tumor characteristics related to severe submucosal fat deposition were investigated, and the degree of intraoperative endoscopic lens cloudiness and outcomes were compared between the Cleash and Cleastay groups., Results: In the multivariate analysis, factors increasing lens cloudiness included long procedure time (odds ratio [OR], 17.51; 95% confidence interval [CI], 1.52-202.08), stomach (vs. colon; OR, 5.08; 95% CI, 1.99-12.96), and severe submucosal fat deposition (OR, 12.19; 95% CI, 5.02-29.60). Conversely, the use of Cleastay (vs. Cleash; OR, 0.066; 95% CI, 0.021-0.21) was identified as a factor reducing cloudiness. Location analysis revealed that severe submucosal fat deposition was more common in the upper stomach and right colon., Conclusions: It was suggested that Cleastay is more useful for endoscopic submucosal dissection of the upper stomach and right colon, where severe submucosal fat deposition is expected., Competing Interests: None., (© 2024 The Author(s). DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.)

A 59-year-old woman was diagnosed with a pancreatic neuroendocrine tumor (P-NET; Grade 3, Ki67: 25%) with multiple liver and lymph node metastases and started chemotherapy with streptozosin (500 mg/m 2 /day) in combination with lanreotide acetate (120 mg). After six courses of (daily) streptozosin, the patient had progressive disease, as assessed by computed tomography (CT), and peptide receptor radionuclide therapy (PRRT) was started as second-line treatment. As PRRT was remarkably successful and the tumor shrank, surgery was performed to resect the primary pancreatic tumor, liver metastases, and lymph node metastases. CT evaluation performed six months after the surgery showed a complete response.

When conversing with an unacquainted person, if it goes well, we can obtain much satisfaction (referred to as conversational satisfaction). Can we predict how satisfied dyads will be with face-to-face conversation? To this end, we employed interpersonal similarity in whole-brain resting-state functional connectivity (RSFC), measured using functional magnetic resonance imaging before dyadic conversation. We investigated whether conversational satisfaction could be predicted from interpersonal similarity in RSFC using multivariate pattern analysis. Consequently, prediction was successful, suggesting that interpersonal similarity in RSFC is an effective neural biomarker predicting how much face-to-face conversation goes well. Furthermore, regression coefficients from predictive models suggest that both interpersonal similarity and dissimilarity contribute to good interpersonal relationships in terms of brain activity. The present study provides the potential of an interpersonal similarity approach using RSFC for understanding the foundations of human relationships and new neuroscientific insight into whether success in human interactions is predetermined., (© 2024. The Author(s).)

Background: Since gastric cancers (GCs) detected after Helicobacter pylori ( HP ) eradication present with different morphological characteristics from conventional HP -positive GCs, delayed detection of early-stage GCs may be observed. This study aimed to investigate the clinical impact of HP eradication on diagnosing GC during screening endoscopy., Methods: Eleven health checkup institutions in Japan participated in the present study. All GC cases newly diagnosed by screening endoscopy between January 2016 and December 2020 were included. After propensity score matching, multivariable regression analysis was performed to estimate the effect of HP eradication on deep tumor invasion among HP -eradicated and HP -positive GC cases., Results: A total of 231 patients with GCs (134 HP -eradicated and 97 HP -positive cases) were enrolled. After propensity score matching, there were 81 cases in each group. The distribution of the depth of tumor invasion (pT1a, pT1b1, pT1b2, and pT2) between the HP -eradicated group and HP -positive group was similar ( p = 0.82). In the propensity analysis, with HP -positive as the reference value, HP eradication was not significantly associated with T1b-T4-GCs and T1b2-T4-GCs, with odds ratios (95% confidence intervals) of 1.16 (0.48-2.81) and 1.16 (0.42-3.19), respectively., Conclusions: HP eradication does not adversely affect the clinical course of GCs, supporting the recommendation of HP eradication in screening programs to reduce the total number of GC cases without delaying diagnosis.

In the intestine, interleukin (IL)-23 and IL-22 from immune cells in the lamina propria contribute to maintenance of the gut epithelial barrier through the induction of antimicrobial production and the promotion of epithelial cell proliferation. Several previous studies suggested that some of the functions of the IL-23/IL-22 axis on intestinal epithelial cells are shared between the small and large intestines. However, the similarities and differences of the IL-23/IL-22 axis on epithelial cells between these two anatomical sites remain unclear. Here, we comprehensively analyzed the gene expression of intestinal epithelial cells in the ileum and colon of germ-free, Il23 -/- , and Il22 -/- mice by RNA-sequencing. We found that while the IL-23/IL-22 axis is largely dependent on gut microbiota in the small intestine, it is much less dependent on it in the large intestine. In addition, the negative regulation of lipid metabolism in the epithelial cells by IL-23 and IL-22 in the small intestine was revealed, whereas the positive regulation of epithelial cell proliferation by IL-23 and IL-22 in the large intestine was highlighted. These findings shed light on the intestinal site-specific role of the IL-23/IL-22 axis in maintaining the physiological functions of intestinal epithelial cells., (© 2023 Molecular Biology Society of Japan and John Wiley & Sons Australia, Ltd.)

It is crucial to develop practical and noninvasive methods to assess the functional beta-cell mass in a donor pancreas, in which monitoring and precise evaluation is challenging. A patient with type 1 diabetes underwent noninvasive imaging following simultaneous kidney-pancreas transplantation with positron emission tomography/computed tomography (PET/CT) using an exendin-based probe, [ 18 F]FB(ePEG12)12-exendin-4. Following transplantation, PET imaging with [ 18 F]FB(ePEG12)12-exendin-4 revealed simultaneous and distinct accumulations in the donor and native pancreases. The pancreases were outlined at a reasonable distance from the surrounding organs using [ 18 F]FB(ePEG12)12-exendin-4 whole-body maximum intensity projection and axial PET images. At 1 and 2 h after [ 18 F]FB(ePEG12)12-exendin-4 administration, the mean standardized uptake values were 2.96 and 3.08, respectively, in the donor pancreas and 1.97 and 2.25, respectively, in the native pancreas. [ 18 F]FB(ePEG12)12-exendin-4 positron emission tomography imaging allowed repeatable and quantitative assessment of beta-cell mass following simultaneous kidney-pancreas transplantation., (© 2023 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)

In the intestine, mucin 2 (Muc2) forms a network structure and prevents bacterial invasion. Glycans are indispensable for Muc2 barrier function. Among various glycosylation patterns of Muc2, sialylation inhibits bacteria-dependent Muc2 degradation. However, the mechanisms by which Muc2 creates the network structure and sialylation prevents mucin degradation remain unknown. Here, by focusing on two glycosyltransferases, St6 N-acetylgalactosaminide α-2,6-sialyltransferase 6 (St6galnac6) and β-1,3-galactosyltransferase 5 (B3galt5), mediating the generation of desialylated glycans, we show that sialylation forms the network structure of Muc2 by providing negative charge and hydrophilicity. The colonic mucus of mice lacking St6galnac6 and B3galt5 was less sialylated, thinner, and more permeable to microbiota, resulting in high susceptibility to intestinal inflammation. Mice with a B3galt5 mutation associated with inflammatory bowel disease (IBD) also showed the loss of desialylated glycans of mucus and the high susceptibility to intestinal inflammation, suggesting that the reduced sialylation of Muc2 is associated with the pathogenesis of IBD. In mucins of mice with reduced sialylation, negative charge was reduced, the network structure was disturbed, and many bacteria invaded. Thus, sialylation mediates the negative charging of Muc2 and facilitates the formation of the mucin network structure, thereby inhibiting bacterial invasion in the colon to maintain gut homeostasis., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Insulinomas are the most common functioning pancreatic neuroendocrine neoplasms, and these tumors induce hypoglycemia due to hyperinsulinemia. Hypoglycemia caused by insulinomas can cause seizures, coma or death due to the delayed diagnosis. The only curative treatment is surgical resection. To perform curative surgical resection of insulinomas, preoperative localization is crucial. However, localization of insulinomas is often challenging using conventional imaging methods such as computed tomography (CT) and magnetic resonance imaging. Although endoscopic ultrasound (EUS) fine-needle aspiration and selective arterial calcium stimulation test, which can reflect the endocrine character of the tumor, are performed in such cases, these modalities are invasive and require operator-dependent techniques. Additionally, somatostatin receptor (SSTR)-targeted imaging has a relatively low sensitivity for detecting insulinomas due to its low SSTR type 2 expression. Thus, there is an urgent need for developing a noninvasive diagnostic technique which is specific for detecting insulinomas. Consequently, glucagon-like peptide-1 receptor-targeted imaging has recently emerged and gained a wide interest. Recently, we have developed a novel 18 F-labeled exendin-4-based probe conjugated with polyethylene glycol, [ 18 F]FB(ePEG12)12-exendin-4 ( 18 F-exendin-4), for positron emission tomography (PET) imaging. Here we report a case of insulinoma in which 18 F-exendin-4 PET/CT noninvasively provided critical information for localization., Case Description: This is a case of a 58-year-old male with symptomatic hypoglycemia for 10 years; however, a preoperative diagnosis of insulinoma was not established due to the difficulty in differentiating it from an accessory spleen using conventional imaging. Moreover, the patient requested to avoid invasive diagnostic procedures including EUS. 18 F-exendin-4 PET/CT revealed significant uptakes in the pancreatic tail whereas no apparent uptakes were observed in the spleen; thus, curative laparoscopic enucleation of the pancreatic tail was performed. The diagnosis of insulinoma was confirmed via histopathological examination. This is the first case report of insulinoma diagnosed using 18 F-exendin-4 PET/CT., Conclusion: In this case, PET information led to curative resection through enucleation of the pancreas. 18 F-exendin-4 PET/CT may serve as a useful noninvasive clinical tool for insulinoma localization., Competing Interests: NI has patents registered with UHA Mikakuto Co., Ltd., asken Inc., and Shiratori Pharmaceutical Co., Ltd.; has received royalties from Drawbridge Health, Inc.; has received speaker honoraria from Kowa Co., Ltd., MSD K.K., Astellas Pharma Inc., Kissei Pharmaceutical Co., Ltd., Sanofi K.K., Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Kyowa Kirin Co., Ltd., Sumitomo Pharma Co., Ltd., Daiichi-Sankyo Co., Ltd., Eli Lilly Japan K.K., Nippon Boehringer Ingelheim Co., Ltd., Takeda Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corp., Taisho Pharmaceutical Holdings Co., Ltd., Terumo Corp., AstraZeneca K.K., Sanwa Kagaku Kenkyusho Co., Ltd., Abbott Japan LLC, Ajinomoto Co., Inc., Teijin Healthcare Ltd., Bayer Yakuhin, Ltd., Arkray Marketing, Inc., Johnson & Johnson K. K., Roche DC Japan K. K., Scohia Pharma, Inc., and Life Scan Japan K.K.; has served on advisory boards for Bayer Yakuhin, Ltd., Terumo Corp., Mitsubishi Tanabe Pharma Corp., Sanofi K.K., Novartis Pharma K.K., Kowa Co., Ltd., Abbott Japan LLC, Novo Nordisk Pharma Ltd., Scohia Pharma, Inc., Sumitomo Pharma Co., Ltd., Kissei Pharmaceutical Co., Ltd., Nippon Boehringer Ingelheim Co., Ltd., and Eli Lilly Japan K.K.; received consulting fees from Sumitomo Pharma Co., Ltd.; has received research grants from Terumo Corp., Drawbridge Health, Inc., asken Inc., and Japan Diabetes Foundation Inc.; and has received scholarship donations from Kissei Pharmaceutical Co., Ltd., Taisho Pharmaceutical Holdings Co., Ltd., Sanofi K.K., Daiichi-Sankyo Co., Ltd., Mitsubishi Tanabe Pharma Corp., Takeda Pharmaceutical Co., Ltd., Japan Tobacco Inc., Kyowa Kirin Co., Ltd., Sumitomo Pharma Co., Ltd., MSD K.K., Ono Pharmaceutical Co., Ltd., Sanwa Kagaku Kenkyusho Co., Ltd., Nippon Boehringer Ingelheim Co., Ltd., Eli Lilly Japan K.K., Novo Nordisk Pharma Ltd., Teijin Pharma Ltd., Tsumura & Co., Roche DC Japan K. K., Life Scan Japan K.K., and Kowa Co., Ltd; and is a recipient of endowed chairs from MSD K.K., Ono Pharmaceutical Co., Ltd., and Mitsubishi Tanabe Pharma Corp. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Sakaki, Murakami, Fujimoto, Shimizu, Miyake, Otani, Kiyobayashi, Okada, Fujimoto, Hakata, Yamauchi, Shimada, Shimizu, Nagai, Nakamoto and Inagaki.)

Study Design: Retrospective single-center study., Objectives: K-line is a decision-making tool to determine the appropriate surgical procedures for patients with cervical ossification of the posterior longitudinal ligament (C-OPLL). Laminoplasty (LAMP) is one of the standard surgical procedures indicated on the basis of K-line measurements (+: OPLL does not cross the K-line). We investigated the impact of K-line tilt, a radiographic parameter of cervical sagittal balance measured using the K-line, on surgical outcomes after LAMP., Methods: The study included 62 consecutive patients with K-line (+) C-OPLL who underwent LAMP. The following preoperative and postoperative radiographic measurements were evaluated: (1) the K-line, (2) K-line tilt (an angle between the K-line and vertical line), (3) center of gravity of the head -C7 sagittal vertical axis, (4) C2-C7 lordotic angle, (5) C7 slope, and (6) C2-C7 range of motion. Clinical results were evaluated using the Japanese Orthopedic Association scoring system for cervical myelopathy (C-JOA score)., Results: All the patients had non-kyphotic cervical alignment (CL ≥ 0°) preoperatively; however, kyphotic deformity (CL < 0°) was observed in 6 patients (9.7%) postoperatively. The recovery rate of the C-JOA scores was poor in the kyphotic deformity (+) group (7.8%) than in the kyphotic deformity (-) group (47.5%). The K-line tilt was identified to be a preoperative risk factor in the multivariate analysis, and the cutoff K-line tilt for predicting the postoperative kyphotic deformity was 20°., Conclusions: LAMP is not suitable for K-line (+) C-OPLL patients with K-line tilts >20°.

Anterior decompression and fusion (ADF) using the floating method for cervical ossification of the posterior longitudinal ligament (OPLL) is an ideal surgical technique, but it has a specific risk of insufficient decompression caused by the impingement of residual ossification. Augmented reality (AR) support is a novel technology that enables the superimposition of images onto the view of a surgical field. AR technology was applied to ADF for cervical OPLL to facilitate intraoperative anatomical orientation and OPLL identification. In total, 14 patients with cervical OPLL underwent ADF with microscopic AR support. The outline of the OPLL and the bilateral vertebral arteries was marked after intraoperative CT, and the reconstructed 3D image data were transferred and linked to the microscope. The AR microscopic view enabled us to visualize the ossification outline, which could not be seen directly in the surgical field, and allowed sufficient decompression of the ossification. Neurological disturbances were improved in all patients. No cases of serious complications, such as major intraoperative bleeding or reoperation due to the postoperative impingement of the floating OPLL, were registered. To our knowledge, this is the first report of the introduction of microscopic AR into ADF using the floating method for cervical OPLL with favorable clinical results.

Background: Cognitive training aims to improve cognitive function through cognitive tasks or training games. Neurofeedback is a technique to monitor brain signals with either visual or auditory feedback. Previous studies suggest that a combination of cognitive training and neurofeedback has a superior effect on cognitive functions compared with cognitive training alone. However, no systematic reviews and meta-analyses of the benefits of cognitive training with neurofeedback (CTNF) exist. The purpose of this study was to examine the beneficial effects of CTNF in healthy adults using a systematic review and multilevel meta-analysis., Methods: PubMed, Scopus, PsychoINFO, and MEDLINE were searched for research papers reporting the results of interventions using CTNF., Results: After an initial screening of 234 records, three studies using near-infrared spectroscopy (NIRS) and one study using electroencephalography were extracted from the database. We performed a multi-level meta-analysis with three NIRS studies including 166 participants (mean ages ranged from 21.43 to 65.96 years). A multi-level meta-analysis revealed that CTNF has a beneficial effect on the episodic, long-term, and working memory domains., Conclusions: Although three studies were included in the systematic review and meta-analysis, our results indicate that CTNF using NIRS would lead to improvements in memory functioning.

We prospectively investigated the postoperative dysphagia in cervical posterior longitudinal ligament ossification (C-OPLL) and cervical spondylotic myelopathy (CSM) to identify the risk factors of each disease and the incidence. A series of 55 cases with C-OPLL: 13 anterior decompression with fusion (ADF), 16 posterior decompression with fusion (PDF), and 26 laminoplasty (LAMP), and a series of 123 cases with CSM: 61 ADF, 5 PDF, and 57 LAMP, were included. Vertebral level, number of segments, approach, and with or without fusion, and pre and postoperative values of Bazaz dysphagia score, C2-7 lordotic angle (&ang;C2-7), cervical range of motion, O-C2 lordotic angle, cervical Japanese Orthopedic Association score, and visual analog scale for neck pain were investigated. New dysphagia was defined as an increase in the Bazaz dysphagia score by one grade or more than one year after surgery. New dysphagia occurred in 12 cases with C-OPLL; 6 with ADF (46.2%), 4 with PDF (25%), 2 with LAMP (7.7%), and in 19 cases with CSM; 15 with ADF (24.6%), 1 with PDF (20%), and 3 with LAMP (1.8%). There was no significant difference in the incidence between the two diseases. Multivariate analysis demonstrated that increased &ang;C2-7 was a risk factor for both diseases.

Background: Surgical procedures for cervical myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) are often chosen based on OPLL size and cervical spine alignment. Recently, cervical sagittal alignment based on sagittal vertical axis (SVA) has received increased attention as an important determinant of radiological and clinical outcomes after surgery. This study aimed to investigate the impact of SVA-based cervical sagittal alignment on surgical treatment for cervical OPLL by reviewing a previous retrospective cohort in which its concept was not taken into account in the surgical procedure choices., Methods: We reviewed a total of 96 consecutive patients who underwent surgery for cervical myelopathy caused by OPLL from 2008 to 2014. We performed anterior decompression with fusion (ADF) or posterior decompression with fusion (PDF) on patients with massive OPLL or kyphotic alignment, and we performed laminoplasty (LAMP) on patients without massive OPLL or kyphotic alignment. CSVA (center of gravity of the head - C7 SVA), CL (C2-7 lordotic angle) and C7 slope were measured in cervical X-ray at standing position. Clinical results were evaluated using C-JOA score. We divided patients into two subgroups based on the preoperative CSVA: the Low-CSVA (CSVA <40 mm) and High-CSVA (CSVA ≥40 mm) subgroups., Results: In the Low-CSVA subgroup, none of the three operations had an effect on the CL. In contrast, in the High-CSVA subgroup, while ADF and PDF had no effect on the CL, LAMP worsened the CL postoperatively. The recovery rates of the C-JOA scores in the Low-CSVA subgroup showed no significant differences among the three operations; however in the High-CSVA subgroup, LAMP resulted in worse recovery rate of the C-JOA score than ADF or PDF., Conclusions: LAMP is not suitable for patients with cervical myelopathy caused by OPLL who have high CSVA alignment, even in cases without massive OPLL or kyphotic alignment., Competing Interests: Declaration of competing interest The manuscript submitted does not contain information about medical device(s)/drug(s)., (Copyright © 2021. Published by Elsevier B.V.)