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Despite maximal care, the patient's condition continued to decline and the patient died of multi-organ failure on the 12th day of admission. B Results: b Strongyloides Hyperinfection Syndrome (SHS) typically occurs in immunocompromised patients. Although DAH secondary to SHS is rare, SHS is life-threatening and SHS should be included in work-up for DAH, especially among immunocompromised patients. [Extracted from the article]

Background: Sex differences in clinical characteristics of ischemic heart disease patients have been widely examined, differences in the type of coronary artery disease (CAD) and their impacts on prognosis have not been well elucidated in Japanese. Methods: The Kumamoto Intervention Conference Study (KICS) is a multicenter registry enrolling consecutive patients undergoing percutaneous coronary intervention (PCI) in 16 centers in Japan. Between August 2008 and March 2014, 11,095 consecutive patients were enrolled in this registry. To clarify the sex differences, depending on the type of coronary artery disease, 10,822 successful PCI subjects with 1-year follow-up were enrolled in this study. Results: In this patient population, 2,983 patients (28.3%) were female and the remaining 7,839 patients (71.7%) were male. Age and comorbidity of chronic kidney disease(CKD) were significantly higher in female, and other atherosclerotic factors were significantly higher in male. The 1-year MACE was significantly higher in female patients (2.6% vs. 2.0%, p=0.084). Sub-analysis in patients with stable coronary artery disease (sCAD) or unstable angina (UA), sex difference was not observed in any 1-year MACE, procedural factors, or medication treatments. Multivariate analysis revealed CKD and peripheral artery disease (PAD) in female, and PAD in males as independent predictors for 1-year MACE. As regards patients with acute myocardial infarction (AMI), 1-year MACE was significantly higher in female (2.5% vs. 1.5%, p=0.023). Proportion of Killip3/4 (11.5% vs. 9.2%, p=0.034) and slow flow/no reflow rate during PCI procedures (11.5% vs. 8.9%, p=0.015) were significantly higher in female than in male. Post dilatation after stent deployments was significantly fewer in female than in male (44.0% vs. 50.7%, p=0.001). Regarding with medication treatments, usage of beta-blocker was significantly lower in female than in male (48.6% vs. 53.4%, p=0.009). Predictive factors for 1-year MACE in AMI patients were high age and left main trunk (LMT) lesions in female, CKD and LMT lesion in male, respectively. Conclusion: Sex differences in the clinical events after PCI were observed only in AMI patients, furthermore, the predictors for the events, depending on the sex, were different among the different type of coronary artery disease. [ABSTRACT FROM AUTHOR]

IgG4-related disease (IgG4-RD) is a fibro-inflammatory condition characterized by increased serum IgG4 level, infiltration of lymphocytes and IgG4-positive (IgG4+) plasma cells and fibrosis. It can occur in almost all organs, commonly affecting the pancreas, biliary tract, salivary and lacrimal glands and kidneys. However, reports of IgG4-RD accompanied by pathologically confirmed, IgG4-related pleural disease are scarce. Here, we present a case of a 64-year-old man with suspected malignant pleural mesothelioma based on imaging findings but finally diagnosed with IgG4-RD (including pleuritis, periaortitis and bilateral submandibular gland enlargement) based on a high serum IgG4 level and pleural histopathological findings such as lymphoplasmacytic infiltration including IgG4+ plasma cells and fibrosis. Systemic corticosteroid therapy was effective at reducing serum IgG4, improving bilateral submandibular gland enlargement, and regressing pleural thickening and periaortic soft tissue. We also discuss clinical characteristics and pleural pathological features of previously reported cases with IgG4-related pleural disease based on a comprehensive literature review. Our case of IgG4-RD with pleura, aorta and submandibular gland involvement, pathologically confirmed by pleural specimen might be unique and very rare. [ABSTRACT FROM AUTHOR]

Purpose: The prevalence and its impact on mortality of sepsis-induced cardiomyopathy (SICM) remain controversial. In this systematic review and meta-analysis, we investigated the prevalence and prognosis of SICM. Materials and Methods: We searched MEDLINE, Cochrane Central Register of Controlled Trials, and Embase. Titles and abstracts were evaluated based on the following criteria: (1) published in English, (2) randomized controlled trials, cohort studies, or cross-sectional studies, (3) ≥ 18 years with sepsis, (4) reporting the prevalence and/or comparison of short-term mortality between those with and without SICM, defined as the new-onset reduction in left ventricular ejection fraction (LVEF) within 72 h on admission or from the diagnosis of sepsis. The random-effect model was used for all analyses. This meta-analysis was registered at PROSPERO (CDR42022332896). Results: Sixteen studies reported the prevalence of SICM and the pooled prevalence of SICM was 20% (95% confidence interval [CI], 16-25%; I 2 = 89.9%, P < 0.01). Eleven studies reported short-term mortality and SICM was associated with significantly higher short-term mortality (The pooled odds ratio: 2.30, 95% CI, 1.43-3.69; I 2 = 0%, P = 0.001). Conclusion: The prevalence of SICM was 20% in patients with sepsis, and the occurrence of SICM was associated with significantly higher short-term mortality. [ABSTRACT FROM AUTHOR]

Abstract Thermal efficiency was substantially improved and NOx emissions were reduced to a level at a single-digit ppm with PCC combustion by optimizing such characteristics as the direction, number and diameter of the injected jet and controlling the injection timing and also by combining with combustion of lean mixture. Output power declined by lean mixture was recovered by supercharging in keeping NOx emissions remained at the same level, while thermal efficiency was improved furthermore by slightly re-optimizing jet conditions. As a result, hydrogen engine which does not emit any CO2 and particulate matter in principle is worth to be called near-zero emission engines in both name and reality. Graphical abstract Thermal Efficiency and NOx Emission Level Achieved for all Variation of Injection Angle in MBT and LBT Conditions. Image 1 Highlights • Development of near-zero emission hydrogen engines. • Attainment of NOx reduction with high thermal efficiency and output power. • Optimization of hydrogen jet configuration and concentration by nozzle design. [ABSTRACT FROM AUTHOR]

Toll-like receptor 8 (TLR8), a sensor for pathogen-derived single-stranded RNA (ssRNA), binds to uridine (Uri) and ssRNA to induce defense responses. We here show that cytidine (Cyd) with ssRNA also activated TLR8 in peripheral blood leukocytes (PBLs) and a myeloid cell line U937, but not in an embryonic kidney cell line 293T. Cyd deaminase (CDA), an enzyme highly expressed in leukocytes, deaminates Cyd to Uri. CDA expression enabled TLR8 response to Cyd and ssRNA in 293T cells. CDA deficiency and a CDA inhibitor both reduced TLR8 responses to Cyd and ssRNA in U937. The CDA inhibitor also reduced PBL response to Cyd and ssRNA. A Cyd analogue, azacytidine, is used for the therapy of myelodysplastic syndrome and acute myeloid leukemia. Azacytidine with ssRNA induced tumor necrosis factor-α expression in U937 and PBLs in a manner dependent on CDA and TLR8. These results suggest that CDA enables TLR8 activation by Cyd or its analogues with ssRNA through deaminating activity. Nucleoside metabolism might impact TLR8 responses in a variety of situations such as the treatment with nucleoside analogues. [ABSTRACT FROM AUTHOR]

Nanocrystal quantum dot (QD) films have been highlighted as unique building blocks of optoelectronic devices due to their unique properties based on electronic interactions among close-packed QDs. Although the creation and annihilation processes of trions play important roles in optical responses of isolated QDs, their contributions to photocurrent conversion processes in QD films are unclear. Here, we studied trion dynamics in QD films by transient photocurrent measurements. We observed that the transient photocurrent signal has two decay components: a fast trion component with a lifetime shorter than 1 ns and a slow exciton component with several tens of nanoseconds. Moreover, we control the signal amplitude of the fast trion decay component by tuning extra charge doping to QDs. These results demonstrate the control of optoelectronic responses of QD films via bias electric voltage and will pave the way for QD-based ultrafast optoelectronics. [ABSTRACT FROM AUTHOR]

Gold nanoparticles (AuNPs) are used as a contrast agent of the photoacoustic (PA) imaging. The efficiency of AuNPs has been discussed with the absorption cross section. However, the effects of the scattering of the light by AuNPs and surrounding medium on the PA signal from AuNPs have not been discussed. The PA signals from the aqueous solution of AuNPs were examined in the numerical simulation and the experiment. In the numerical simulation, the absorption and scattering cross sections of spherical and polyhedral AuNPs were calculated by Mie theory and discrete dipole approximation. Monte Carlo simulation calculated the absorbed light energy in the aqueous solution of AuNPs. Based on the PA wave equation, the PA signals were simulated. In the experiment, the PA signal from the aqueous solution of AuNP was measured by use of a piezoelectric film and a Q-switched Nd:YAG laser operated at 532 nm. The results of the numerical simulation and the experiment agreed well. In the numerical simulation and the experiment, a single Au nanocube with 50-nm edge generated the peak value of the PA signal significantly. It was approximately 350 times and twice as large as the peak values of the spherical AuNPs with 10- and 50-nm diameters, respectively. The peak value of the PA signal depended on both the absorption and scattering coefficients of the AuNPs and the surrounding medium. The peak value increased with the scattering coefficient in a quadratic manner. The character of the temporal profile of the PA signal such as full width at half maximum depended on the scattering coefficient of the AuNPs. [ABSTRACT FROM AUTHOR]

Herein, we report on a novel case of magnetic resonance imaging (MRI) and pathological findings in anti-PM/Scl antibody-positive juvenile myositis, and provide a literature review of the associated clinical features. Among the 27 patients, 9, 8, 6, and 4 patients were diagnosed with JDM, myositis/SSc overlap syndrome, juvenile myositis overlapping with another autoimmune or connective tissue disease (JCTM), and JPM, respectively. By contrast, our patient was diagnosed with anti-PM/Scl antibody-positive juvenile myositis but not with JDM, myositis/SSc, JCTM, or JPM. Therefore, we differentiated eosinophilic fasciitis, characterized by high fascial signals on MRI.[14] This novel report elucidates the MRI and pathological findings of anti-PM/Scl antibody-positive juvenile myositis. [Extracted from the article]

1,3a,6a-Triazapentalene (TAP) is a compact fluorescent chromophore whose fluorescence properties vary greatly depending on the substituents on the TAP ring. This study investigated the photo-induced cytotoxicities of various TAP derivatives. Among the derivatives, 2-p-nitrophenyl-TAP showed significant cytotoxicity to HeLa cells under UV irradiation but no cytotoxicity without UV. In addition, the photo-induced cytotoxicity of 2-p-nitirophenyl-TAP was found to be cancer cell selective and effective against HeLa cells and HCT 116 cells. Under UV irradiation, 2-p-nitrophenyl-TAP generated reactive oxygen species (ROS) that induced an apoptosis and ferroptosis in cancer cells. Therefore, it was revealed that 2-p-nitrophenyl-TAP is the most compact dye that can generate ROS by photoirradiation. Photoactive dyes can show promising cytotoxicity via reactive oxygen species generated by photoirradiation, however, the cytotoxicity of small molecule dyes is typically weak. Here, the authors develop 1,3a,6a-triazapentalene derivatives exhibiting selective and efficient photo-induced cytotoxicity. [ABSTRACT FROM AUTHOR]

Title compounds such as (V) and (IX) are prepared via a new three-step sequence including base-induced Sommelet-Hauser rearrangement, subsequent von Braun reaction and intramolecular α-alkylation. [ABSTRACT FROM AUTHOR]

The present method furnishes valuable intermediates for preparation of α-aryl-α-amino or α-aryl-β-amino carboxylic acid derivatives. [ABSTRACT FROM AUTHOR]

Most of the metal-catalyzed C–H activation/annulation reactions were carried out in organic solvents using expensive oxidants such as Cu(ii) and Ag(i) salts. Here, we reported a new approach for a highly regioselective synthesis of isoquinolones from N-alkyl benzamides and alkynes using an Rh(iii) catalyst and inexpensive oxygen as the sole oxidant in an aqueous medium. In the reaction, water gave the highest product yield among the solvents used. In addition, at the end of the reaction, the isoquinolone product directly precipitated out from the aqueous solution. The methodology can be applied to a gram scale synthesis. This Rh(iii)-catalyzed reaction shows interesting meta selectivity with the meta substituted benzamide and shows various regioselectivities with different substituted alkynes. Moreover, the methodology can be applied to the preparation of biologically active compounds having the isoquinolone core. [ABSTRACT FROM AUTHOR]

Although previous meta-analyses suggested that LV systolic dysfunction defined by reduced LV ejection fraction in patients with sepsis was not associated with higher or lower mortality, studies included in these meta-analyses did not exclude patients with underlying myocardial diseases. Sepsis-induced cardiomyopathy (SICM), which can be defined as new-onset left ventricular (LV) systolic dysfunction, is one of such sepsis-induced organ failures. All studies reported the prevalence of SICM in patients with sepsis and the pooled prevalence of SICM was 28% [95% confidence interval (CI), 23 to 34%]. [Extracted from the article]

Recent studies have suggested that the clinical features of elderly-onset adult-onset Still's disease (AOSD) differ from those of young and middle-aged-onset patients, whereas the details remain unclear, and cytokine profiles of elderly-onset AOSD have not been reported. To clarify the clinical features and cytokine profiles of elderly-onset AOSD, we examined patients with AOSD who developed the disease between January 2006 and September 2021. We divided the patients into the young and middle-aged-onset group (aged < 65 years) and the elderly-onset group (aged ≥ 65 years) and compared the groups in terms of patient characteristics, clinical symptoms, laboratory findings including serum interleukin (IL)-6 and IL-18, treatment, and prognosis. A total of 48 patients were examined (10 in the elderly-onset group). In the elderly-onset group, atypical rash was significantly more frequent, typical rash and splenomegaly were significantly less frequent, white blood cell count and neutrophil ratio were significantly higher and serum IL-6 levels were significantly lower. Serum IL-6 showed a significantly negative correlation with age at onset. Treatment and relapse were comparable between the 2 groups, whereas infections were significantly more frequent in the elderly-onset group. The clinical features and cytokine profiles of elderly-onset AOSD might differ from those of young and middle-aged-onset AOSD. [ABSTRACT FROM AUTHOR]

Organic–inorganic lead halide perovskite quantum dots (PeQDs) are promising light source materials for wide color gamut displays because of their excellent optical properties. Green-emitting CH3NH3PbBr3 (MAPbBr3) obtained by ligand-assisted reprecipitation (LARP) demonstrate superior optical properties such as high photoluminescence quantum yield (PLQY) and high optical stability. However, red-emitting MAPbI3 by the LARP method remains a great challenge because its PLQY and optical stability are inferior to MAPbBr3 due to non-luminescent complexes formed by the coordination of polar solvents to iodine defects. Notably, polar solvents used in the LARP strongly collapse the perovskite structure, resulting in the degradation of optical properties. Therefore, the removal of the remaining polar solvents and non-luminescent complexes after the preparation of MAPbI3 dispersions is essential for their successful practical application. Herein, we report a simple purification method to improve the optical properties and stability of MAPbI3 dispersions by passing them through a column packed with molecular sieves. They exhibited markedly improved optical properties because the polar solvent was efficiently removed from MAPbI3 dispersions. The purified MAPbI3 exhibited a PLQY of 88% with a red PL peak at 619 nm. The PLQY could be maintained at approximately 80% after 14 days of storage with no fluctuation in its PL peak and no expansion of the full widths at half maximum. Thus, this simple purification is a promising method to obtain PeQDs containing iodide with high PLQY, high optical stability, and versatility. [ABSTRACT FROM AUTHOR]

Central diabetes insipidus (CDI) is a rare condition caused by various underlying diseases including inflammatory and autoimmune diseases, and neoplasms. Obtaining an accurate definitive diagnosis of the underlying cause of CDI is difficult. Recently, anti-rabphilin-3A antibodies were demonstrated to be a highly sensitive and specific marker of lymphocytic infundibuloneurohypophysitis (LINH). Here, we report a detailed case series, and evaluated the significance of anti-rabphilin-3A antibodies in differentiating the etiologies of CDI. A prospective analysis was conducted in 15 consecutive patients with CDI from 2013 to 2020 at a single referral center. Anti-rabphilin-3A antibodies were measured and the relationship between antibody positivity and the clinical/histopathological diagnoses was evaluated. Among 15 CDI patients, the positive anti-rabphilin-3A antibodies were found in 4 of 5 LINH cases, 3 of 4 lymphocytic panhypophysitis (LPH) cases, one of 2 sarcoidosis cases, and one intracranial germinoma case, respectively. Two Rathke cleft cyst cases and one craniopharyngioma case were negative. This is the first report of anti-rabphilin-3A antibodies positivity in CDI patients with biopsy-proven LPH. Measurement of anti-rabphilin-3A antibodies may be valuable for differentiating CDI etiologies. [ABSTRACT FROM AUTHOR]

Herein, PtRu solid‐solution alloy nanoparticles enable high‐performance H2 evolution reaction cocatalysts through the transfer of knowledge from electrocatalysis to photocatalysis. Ultrafine PtRu alloy nanoparticles (1.0 ± 0.2 nm in diameter) are synthesized by using a chemical polyol method and used for electro/photo‐catalyses. Integration of PtRu nanoparticles with carbon and Al‐doped SrTiO3 powders via liquid‐phase adsorption and successive two‐step air and H2 annealing ensures uniform deposition of PtRu alloy nanoparticles (<2 nm) with a solid‐solution structure. The PtRu alloy nanoparticles exhibit higher electrocatalytic activity for the hydrogen evolution reaction than monometallic Pt counterparts. Modifying Al‐doped SrTiO3 with PtRu alloy nanoparticles results in efficient photocatalytic overall water‐splitting activity with an apparent quantum yield of 65% at 365 nm and a solar‐to‐hydrogen energy conversion efficiency of 0.45%, which are the highest values among SrTiO3‐based photocatalytic water splitting systems with Rh‐free cocatalysts. Transient diffuse reflectance spectroscopy reveals that the PtRu nanoparticles have a superior electron‐capturing ability than the Pt counterparts, probably due to the decreased work function of Pt by alloying with Ru. This work establishes a framework to elucidate catalytic trends and provides rational design guidance toward the development of bimetallic solid‐solution nanoparticles as cost‐effective and highly active cocatalysts for overall water splitting. [ABSTRACT FROM AUTHOR]

Dicholesteryl isophthalate ( 1m ), dicholesteryl terephthalate ( 1p ) and tricholesteryl trimesate ( 2 ) were synthesized as new cholesterol-based A(LS) n -type gelators ( n =2 and 3) without hydrogen bond linkers. Their molecular structural details were investigated experimentally by 1 H and 13 C NMR, UV–vis and IR spectroscopies and theoretically by DFT calculations. Compounds 1p and 2 have relatively high degrees of symmetry and exhibit efficient gelation abilities, whereas compound 1m could not be gelated in any common organic solvents. The self-assembly behavior of the compound was largely affected by the type of solvent and the number and substitution positions of the cholesteryl groups, as revealed by scanning electron microscopy (SEM) measurements. Notably, the xerogel of 2 using benzene displayed an aggregated microfibrous strand structure that included helical fibers. [ABSTRACT FROM AUTHOR]

Background: Recessive mutations in SLC12A6 have been linked to hereditary motor sensory neuropathy with agenesis of the corpus callosum. Patients with early‐onset peripheral neuropathy associated with SLC12A6 heterozygous variants were reported in 2016. Only five families and three variants have been reported to date, and the spectrum is unclear. Here, we aim to describe the clinical and mutation spectra of SLC12A6‐related Charcot–Marie–Tooth (CMT) disease in Japanese patients. Methods: We extracted SLC12A6 variants from our DNA microarray and targeted resequencing data obtained from 2598 patients with clinically suspected CMT who were referred to our genetic laboratory by neurological or neuropediatric departments across Japan. And we summarized the clinical and genetic features of these patients. Results: In seven unrelated families, we identified one previously reported and three novel likely pathogenic SLC12A6 heterozygous variants, as well as two variants of uncertain significance. The mean age of onset for these patients was 17.5 ± 16.1 years. Regarding electrophysiology, the median motor nerve conduction velocity was 39.6 ± 9.5 m/sec. For the first time, we observed intellectual disability in three patients. One patient developed epilepsy, and her brain MRI revealed frontal and temporal lobe atrophy without changes in white matter and corpus callosum. Conclusions: Screening for the SLC12A6 gene should be considered in patients with CMT, particularly those with central nervous system lesions, such as cognitive impairment and epilepsy, regardless of the CMT subtype. [ABSTRACT FROM AUTHOR]

Cardiovascular and cerebrovascular diseases are considered the principal cause of morbidity and mortality worldwide; the effect of stroke-induced cardiac manifestations is well recognized; however, not enough clinical data have been found about the impact of stroke with underlying cardiac disease. This study's objective is to assess the impact of stroke on the prognosis of patients with underlying IHD, who underwent PCI treatment. This was a multicenter, 1-year observational study in patients undergoing PCI in one of the 17 participating centers across Japan. 18,495 patients were registered on the PCI list; 2481 patients had a prior stroke experience, whereas 15,979 were stroke-free. Our study revealed that stroke patients were significantly older (mean age 73.5 ± 9.6, 69.7(± 11.5), respectively), and suffered from more comorbidities (diabetes, hypertension, and chronic kidney disease, p < 0.0001). During the 1-year period, subjects with stroke showed higher incidence of clinical events compared to those without stroke; to illustrate, all-cause death accounted for 6.2% in patients with stroke, in contrast to only 2.8% in stroke-free patients (p < 0.0001), cardiac death amounted for 2.2 and 1.2%, respectively (p < 0.0001), recurrent stroke for 3.1% and 1.2% (p < 0.0001), non-cardiac death for 3.6 and 1.54% (p < 0.0001), and finally, hemorrhagic complications with 2.6 and 1.3% (p < 0.0001). Kaplan–Meier analysis revealed that stroke patients had a higher probability of all-cause mortality, cardiac death, and recurrent stroke (log-rank p < 0.0001). Cox hazard analysis also showed that the presence of stroke is a significant indicator in determining the outcome of cardiac death (HR = 1.457, 95% CI 1.036–2.051, p = 0.031); hence, proving it to be a crucial predictor on cardiac prognosis. History of prior stroke was common in PCI patients, and independently associated with a higher rate of subsequent cardiovascular and cerebrovascular events recurrence. Thus, highlighting an urgent need for comprehensive prevention of cardiac and cerebrovascular diseases. [ABSTRACT FROM AUTHOR]

Perimesencephalic subarachnoid hemorrhage (PMSAH) is a group of diseases characterized by bleeding around the brainstem. In recent years, it has been suggested that PMSAH is associated with the venous system. We report a case of PMSAH caused by stenosis of the junction of the vein of Galen (VG) and the rectus sinus (RS). A 39-year-old man presented with restlessness at work. He was administered diazepam, and a few minutes later, his consciousness became clear. Imaging showed subarachnoid hemorrhage (SAH) around the right midbrain, occlusion of the right sigmoid sinus and the right transverse sinus, stenosis of the junction of the VG and RS, T2 hyperintensity in the right middle temporal gyrus, and obstruction of the right vein of Labbe. The location of the SAH coincided with stenosis of the junction of the VG and RS. PMSAH was diagnosed due to the increase in intracranial venous pressure caused by the patient's sinus obstruction in addition to the stenosis of the junction of the VG and RS. It is necessary to pay attention to venous return when PMSAH is observed. [ABSTRACT FROM AUTHOR]

Background. The global point prevalence survey (Global-PPS) is the standard for the surveillance of prescribed antimicrobials among inpatients and provides data for the development of hospital antimicrobial stewardship programs. Aim. To evaluate the prevalence and quality of antimicrobial prescriptions using the universally standardized Global-PPS protocol in a non-acute care hospital in Saitama Prefecture, Japan. Methods. Antimicrobial prescriptions for inpatients, staying at the hospital overnight, were surveyed on three separate week days in November 2018, January 2019, and May 2019. Information on the prescribed antimicrobials on the survey target day was obtained from the in-hospital pharmacy. Survey data were collected by physicians, based on the extracted information. Patient information was anonymized and entered in the Global-PPS Web application by physicians. We report the antimicrobial use prevalence, the indication for prescription, diagnosis, the most prescribed antimicrobials, and a set of quality indicators related to antimicrobial prescribing. Results. In total, 6.7% of the surveyed inpatients (120/1796) were prescribed antimicrobials on the survey day. Sulfamethoxazole/trimethoprim was the most commonly prescribed, with 20.0% of systemic antibiotic prescriptions (ATC J01). Of all antibiotics for systemic use, up to 58.4% were Watch antibiotics, as defined by the World Health Organization AWaRe classification. The most prescribed group of systemic antibiotics was non-penicillin beta-lactam antibiotics (34.4%), followed by penicillin antibiotics in combination with beta-lactamase inhibitors (25.6%), and sulfonamides with trimethoprim (20.8%). Healthcare-associated infections and medical prophylaxis were the most common indications reported in 69.3% and 26.3% of prescriptions, respectively. The most common diagnosis for systemic antibiotic prescriptions was pneumonia (49.6%). Reasons for antimicrobial prescriptions were indicated in the medical records for 67.1% of prescriptions, and the stop/review date was documented to be 50.3%. Compliance with local guidelines reached 66.7%. Conclusions. This study highlights important challenges related to antimicrobial prescription in a highly specific, non-acute care patient population. [ABSTRACT FROM AUTHOR]

Similarly, there was no significant improvement in mortality amongst patients with solid-tumor malignancy (2011: 47.80% to 2020: 41.37%, p=0.913) and non-solid tumor (2011: 56% to 2020: 42.35%, p=0.393). We report the trend in survival over the last decade for patients with septic shock without malignancy and those with septic shock and malignancy. [Extracted from the article]

Septic cardiomyopathy is associated with poor outcomes but its definition remains unclear. In a previous meta-analysis, left ventricular (LV) longitudinal strain (LS) showed significant prognostic value in septic patients, but findings were not robust due to a limited number of studies, differences in effect size and no adjustment for confounders. We conducted an updated systematic review (PubMed and Scopus up to 14.02.2023) and meta-analysis to investigate the association between LS and survival in septic patients. We included studies reporting global (from three apical views) or regional LS (one or two apical windows). A secondary analysis evaluated the association between LV ejection fraction (EF) and survival using data from the selected studies. We included fourteen studies (1678 patients, survival 69.6%) and demonstrated an association between better performance (more negative LS) and survival with a mean difference (MD) of −1.45%[−2.10, −0.80] (p < 0.0001;I2 = 42%). No subgroup differences were found stratifying studies according to number of views used to calculate LS (p = 0.31;I2 = 16%), severity of sepsis (p = 0.42;I2 = 0%), and sepsis criteria (p = 0.59;I2 = 0%). Trial sequential analysis and sensitivity analyses confirmed the primary findings. Grade of evidence was low. In the included studies, thirteen reported LVEF and we found an association between higher LVEF and survival (MD = 2.44% [0.44,4.45]; p = 0.02;I2 = 42%). We confirmed that more negative LS values are associated with higher survival in septic patients. The clinical relevance of this difference and whether the use of LS may improve understanding of septic cardiomyopathy and prognostication deserve further investigation. The association found between LVEF and survival is of unlikely clinical meaning. PROSPERO number CRD42023432354 [ABSTRACT FROM AUTHOR]

[Display omitted] 1,3a,6a-Triazapentalene (TAP) derivatives were developed as erasable fluorescent cell staining reagents that can be used with a confocal laser microscope. To enhance the utility of previously developed erasable fluorescent cell staining reagents such as 2-biphenyl-TAP (1a) for practical applications in confocal laser microscopy, a carbonyl group with strong electron-withdrawing properties was introduced between the TAP core skeleton and the biphenyl group, leading to a longer wavelength shift in absorption and emission maxima. While the analog 1b , featuring only the carbonyl group insertion, declined significantly in fluorescence intensity, the two-carbon extended ketone analog 1d showed a desirable shift in absorption maximum towards longer wavelengths, green fluorescence, and high fluorescence intensity. Cell staining experiments using 1d demonstrated its usefulness, including rapid staining, erasable fluorescent staining, and compatibility with confocal laser microscopy employing a standard filter. [ABSTRACT FROM AUTHOR]

Nucleic-acid (NA)-sensing Toll-like receptors (TLRs) are synthesized in the endoplasmic reticulum and mature with chaperones, such as Unc93B1 and the protein associated with TLR4 A (PRAT4A)–gp96 complex. The TLR–Unc93B1 complexes move to the endosomal compartment, where proteases such as cathepsins activate their responsiveness through proteolytic cleavage of the extracellular domain of TLRs. Without proteolytic cleavage, ligand-dependent dimerization of NA-sensing TLRs is prevented by the uncleaved loop in the extracellular domains. Additionally, the association of Unc93B1 inhibits ligand-dependent dimerization of TLR3 and TLR9 and, therefore, Unc93B1 is released from these TLRs before dimerization. Ligand-activated NA-sensing TLRs induce the production of pro-inflammatory cytokines and act on the endosomal compartment to initiate anterograde trafficking to the cell periphery for type I interferon production. In the endosomal compartment, DNA and RNA are degraded by DNases and RNases, respectively, generating degradation products. DNase 2A and RNase T2 generate ligands for TLR9 and TLR8, respectively. In this mechanism, DNases and RNases control innate immune responses to NAs in endosomal compartments. NA-sensing TLRs and the endosomal compartment work together to monitor environmental cues through endosomes and decide to launch innate immune responses. [ABSTRACT FROM AUTHOR]

Abstract: A detailed chemical kinetic model with a reaction mechanism consisting of thousands of elementary step-like reactions has been successfully applied to predict the combustion and pyrolysis characteristics of hydrocarbon fuels. This approach, however, has seldom been used for predicting steam reforming of aromatic hydrocarbons. In this study, the predictive capability of an existing detailed chemical kinetic model was critically evaluated for the thermal conversion rates of aromatic hydrocarbons in the presence of hydrogen and steam. Published experimental data on steam reforming of simulated coke oven gas (a mixture of hydrogen, steam, and an aromatic hydrocarbon such as benzene, toluene, or naphthalene) in a tubular flow reactor (total pressure of 160kPa, temperature of 1073–1673K, and residence time of up to 1s) were used for the evaluations. Simulations based on a kinetic model that consists of more than 200 chemical species, more than 2000 elementary step-like reactions, and a plug flow reactor model well reproduced experimental results for major products such as CO, CO2, and CH4 as well as the conversion trends of source aromatic hydrocarbons. The coke yield was also fairly well predicted under the assumption that the computationally obtained total yields of polycyclic aromatic hydrocarbons and acetylene, both of which are the most likely coke precursors, correspond to the experimentally determined coke yields. In addition, the influences of the hydrogen partial pressure and residence time on the product distributions were also well predicted for the naphthalene conversion. [Copyright &y& Elsevier]

Abstract: Epitaxial 3C-SiC (β-SiC) thin layers are grown on Si (001) substrates by carbonization in moderate-pressure microwave plasmas, typically used for diamond film deposition. The substrate temperature and the CH4 gas concentration diluted in H2 gas are varied from 1000 to 1200°C and from 2 to 8vol.%, respectively. The grown layers are characterized by scanning electron microscopy, Raman spectroscopy, x-ray diffraction, Fourier transform infrared spectroscopy, reflection high energy electron diffraction, and energy-dispersive x-ray spectroscopy. For 2% CH4, epitaxial 3C-SiC about 10nm thick is grown only when the temperature is increased to 1200°C, while polycrystalline 3C-SiC is grown for temperatures less than 1200°C. For 8% CH4, epitaxial 3C-SiC is grown even for temperatures less than 1200°C, but the thickness of the SiC layer is reduced. Some amounts of amorphous carbon and diamond phases are found to grow on the SiC layers. [Copyright &y& Elsevier]

The epidemic of coronavirus disease‐2019 (COVID‐19) is the major public health issue in the world. COVID‐19 vaccines are one of the most effective strategies against COVID‐19. Here we report a 36‐year‐old female patient who had thirst, polydipsia, polyuria, palpitations, loss of appetite, and fatigue 3 days after the first dose of COVID‐19 RNA‐based vaccines without a prior history of diabetes. Ten days after vaccination, she visited our hospital with diabetic ketoacidosis and was diagnosed with type 1 diabetes. Hyperglycemia (501 mg/dL), anion gap metabolic acidosis and ketonuria were observed. The glycated hemoglobin level was 7.0%. Islet‐related autoantibodies were all negative. The glucagon tolerance test revealed attenuated secretion of insulin. Human leukocyte antigen was haplotype DRB1*0405‐DQB1*0401, which was associated with type 1 diabetes in Japan. The present case suggests that COVID‐19 RNA‐based vaccines might trigger the onset of type 1 diabetes, even in subjects without prior histories of diabetes. [ABSTRACT FROM AUTHOR]

The new-generation QuantiFERON (QFT)-TB Gold Plus (QFT-Plus) is expected to be useful because it includes a new peptide that is supposed to induce a CD8+ T cell response. There is a need for a new marker with sensitivity higher than that of the conventional IFN-γ release assays owing to false-negative results in the latter. This study aimed to compare cytokines in QFT-plus and QuantiFERON-Gold In-Tube (QFT-GIT) supernatants to discriminate between active tuberculosis and latent tuberculosis infection (LTBI). A cross-sectional study was conducted at Tokyo National Hospital, wherein 21 LTBI patients and age and sex-matched active TB patients were randomly selected. The levels of various cytokines were measured and compared using the MAGPIX System, and receiver operating characteristic (ROC) curves were generated. IL-1RA, IFN-γ, CXCL10/IP-10, and CCL4/MIP-1β levels were higher in the active TB group than in the LTBI group in QFT-GIT antigen (GIT Ag) tubes. In QFT-plus tubes, IL-1RA was higher in TB1 and TB2 tubes, while CCL2/MCP-1 was higher only in TB2 tubes. In Nil tubes, CCL5/RANTES, TNF-α, PDGF-BB, and IL-2 levels were significantly higher in the active TB group. IL-1RA in GIT Ag tubes showed the highest area under the curve of 0.8367. The sensitivity and specificity of IL-1RA were 66.7% (95% confidence interval [CI]: 43.0–85.4) and 90.5% (95% CI: 69.6–98.8), respectively, which were the highest among the cytokines. IL-1RA level in the QFT-GIT supernatant can be a good marker for discriminating active TB from LTBI. [ABSTRACT FROM AUTHOR]

This study evaluated the efficacy of the following interferon (IFN)-γ release assays (IGRAs): QuantiFERON-TB Gold Plus (QFT-Plus), QFT-Gold In-Tube (QFT-GIT), and T-SPOT. TB (T-SPOT) with the quantitative values of IFN-γ response. Blood samples were collected from patients with active tuberculosis (TB), latent TB infection (LTBI), individuals with previous TB infection, and healthy volunteers enrolled between May 2017 and June 2018. IGRAs results were analyzed in 175 subjects (76 had active TB, 14 had LTBI, 35 had prior TB infection, and 50 were healthy). QFT-Plus and QFT-GIT revealed equal efficacy for IFN-γ values, and the IFN-γ response in QFTs tended to increase with the spot counts in T-SPOT, with similar high sensitivities (approximately 90%) in the active TB group. The test concordance of two of three IGRAs was optimal among all subjects (κ coefficients: 0.82–0.96). Additionally, the median quantitative values of IFN-γ with QFT-Plus and QFT-GIT were higher in the active TB group than in the LTBI and previous TB groups. Three IGRAs showed equivalent efficacy with high sensitivities and higher IFN-γ response in active TB group than that in non-active TB group. [ABSTRACT FROM AUTHOR]

Objectives: Urinary incontinence is a major concern after radical prostatectomy because it can decrease quality of life. The aim of the present study was to explore the effect of preoperative skeletal muscle on urinary quality of life after robot‐assisted radical prostatectomy. Methods: A total of 762 patients underwent robot‐assisted radical prostatectomy. Longitudinal health‐related quality of life was evaluated using the Expanded Prostate Cancer Index Composite instrument. The skeletal muscle area at the level of the third lumbar vertebra was assessed preoperatively by computed tomography and was standardized to height to obtain the skeletal muscle index. Reduced skeletal muscle size (RSMS) was defined as a skeletal muscle index ≤ 53 or ≤ 43 cm2/m2 in patients with a body mass index (BMI) ≥25 or < 25, respectively. Results: A total of 301 patients were included in this study, of whom 91 were classified as having RSMS (30.2%). Non‐RSMS patients exhibited better urinary function at 12 months (P =.012) and better urinary continence recovery at 2 weeks and 12 months (P =.033 and P =.014, respectively) after prostatectomy compared with RSMS patients. Univariate and multivariate analyses identified preoperative RSMS as a significant and independent predictor of urinary incontinence (odds ratio = 1.77, P =.028). Conclusions: Patients with RSMS had a lower urinary quality of life compared with non‐RSMS patients after robot‐assisted radical prostatectomy, and RSMS, independent of age or BMI, was predictive of postoperative urinary incontinence. [ABSTRACT FROM AUTHOR]

Influenza D virus (IDV) can potentially cause respiratory diseases in livestock. We isolated a new IDV strain from diseased cattle in Japan; this strain is phylogenetically and antigenically distinguished from the previously described IDVs. [ABSTRACT FROM AUTHOR]

Background: We previously reported the association between blood–brain barrier (BBB) dysfunction and glucose‐regulated protein 78 (GRP 78) autoantibodies in neuromyelitis optica (NMO). Objective: We clarify whether the BBB‐endothelial cell activation induced by immunoglobulin G (IgG) is associated with the clinical phenotype, disease activity, and markers of BBB disruption. Methods: We purified serum IgG from 24 serum samples from patients with NMO spectrum disorder (NMOSD), who were positive for anti‐AQP4 antibodies (longitudinally extensive transverse myelitis [LETM], n = 14; optic neuritis [ON], n = 6; other phenotype, n = 4) and nine healthy controls. IgG was exposed to human brain microvascular endothelial cells (TY10) and the number of nuclear NF‐κB p65‐positive cells, as a marker of endothelial cell activation, was analyzed using a high‐content imaging system. Change in BBB permeability was also measured. The presence of GRP78 autoantibodies was detected by Western blotting. Results: In the LETM group, IgG significantly induced the nuclear translocation of NF‐κB p65 in comparison to the ON and healthy control groups. A significant correlation was observed between the number of NF‐κB nuclear‐positive cells and clinical markers of BBB disruption, including Gd enhancement in spinal MRI and the cerebrospinal fluid/serum albumin ratio. This effect was significantly reduced at the remission phase in the individual NMOSD patients. Furthermore, GRP78 antibody positivity was associated with the LETM phenotype and disease severity in NMOSD patients. Conclusion: Endothelial cell activation was associated with the LETM phenotype, clinical markers of BBB disruption and disease activity. These observations may explain the phenotypic differences between the NMOSD subtypes, LETM, and isolated ON. [ABSTRACT FROM AUTHOR]

Geometrical modification of airfoils by leading-edge protuberances has attracted plenty of attention as a passive separation control method. In this research, the effect of a single leading-edge protuberance with different amplitudes on the performance of a two-dimensional airfoil (NACA 634-021) is investigated through wind tunnel experiment and theoretical analysis. Force measurement experiment shows that all the modified airfoils demonstrate a special two-step stall performance. When the first step of stall occurs, the lift coefficient of the modified airfoils drops to a medium value between the pre-stall and post-stall lift coefficients of the baseline airfoil and keeps nearly constant within a range of AOA (angle of attack). Tuft visualization reveals that during the first step of stall, the flow pattern on different sides of the protuberance is distinctly different, respectively, showing leading-edge separation and trailing-edge separation, which are compartmentalized by the attached flow originated from the peak of the protuberance. The flow control mechanism is contributed to the combined effect of the early occurrence of the leading-edge separation around the protuberance root, the inherent hysteretic performance, and the flow compartmentalization effect. A theoretical model based on the lifting line theory, which takes the amendment of the hysteresis and compartmentalization effects into consideration, is proposed to analyze the performance of the modified airfoils. The sectional and overall performances by theoretical analysis are highly consistent with the tendency of the experiment results. Based on the theoretical model, the spanwise circulation gradient induced by the protuberance is considered to be responsible for the earlier separation around the protuberance roots at pre-stall AOAs. Further investigation on the effect of the geometrical parameters of the protuberance reveals that the amplitude-to-wavelength ratio plays a dominant role on the performance of the modified airfoils. The special flow phenomenon induced by the single leading-edge protuberance discovered in this research and the proposed mechanism provide an essential point of view for fully understanding the combined mechanism of multiple protuberances. [ABSTRACT FROM AUTHOR]

Background: While nontuberculous mycobacterial (NTM) pleuritis rarely complicates pulmonary NTM infection, high mortality has been reported in case reports and small studies. Objectives: The purpose of this study was to clarify the clinical features and treatment outcomes of pulmonary NTM infection cases accompanied by NTM pleuritis. Methods: Medical records of 1,044 patients with pulmonary NTM disease were retrospectively reviewed to select patients complicated by NTM-proven pleuritis. We investigated clinical characteristics, pathogens, pleural effusion examinations, radiographic findings, treatments, and clinical course of the NTM pleuritis patients. Results: Among 1,044 cases with pulmonary NTM, NTM pleuritis occurred in 15 cases (1.4%). The mean age was 69 years with a performance status of mostly 2 or better (80.0%), and 6 cases (40.0%) were complicated by pneumothorax. Subpleural cavities were radiologically detected in 11 cases (73.3%), and extrapulmonary air-fluid level was detected in 14 cases (93.3%). Eleven patients were treated with combinations of 2–4 antimycobacterial drugs, including clarithromycin, and 2 patients were treated with isoniazid, rifampicin, and ethambutol. Chest tube drainage was performed in 11 cases, and surgical approach was added in 6 cases. The pleural effusion of 2 patients treated with only antimycobacterial medications gradually deteriorated. Two patients died from NTM pleuritis, and 1 patient died from pneumonitis during a mean of 1.8 years of follow-up. Conclusions: Comorbid NTM pleuritis was difficult to treat by medical therapy alone and resulted in a poor prognosis. In addition to antimycobacterial agents, chest tube drainage and surgical procedures in the early stages should be considered to treat NTM pleuritis. [ABSTRACT FROM AUTHOR]

Purpose: We investigated whether diffusion kurtosis imaging (DKI) and quantitative susceptibility mapping (QSM) could detect pathological changes that occur in Parkinson's disease (PD), multiple system atrophy with predominant parkinsonism (MSA-P) or predominant cerebellar ataxia (MSA-C), and progressive supranuclear palsy syndrome (PSPS) and thus be used for differential diagnosis that is often difficult. Methods: Seventy patients (41 with PD, 6 with MSA-P, 7 with MSA-C, 16 with PSPS) and 20 healthy controls were examined using a 3.0 T MRI scanner. From DKI and QSM data, we automatically obtained mean kurtosis (MK), fractional anisotropy (FA), and mean diffusivity (MD) values of the midbrain tegmentum (MBT), pontine crossing tract (PCT), and superior/middle cerebellar peduncles (CPs), which were used to calculate diffusion MBT/PCT ratios (dMPRs) and diffusion superior/middle CP ratios (dCPRs), as well as MS (magnetic susceptibility) values of the anterior/posterior putamen (PUa and PUp) and globus pallidus (GP). Results: dMPRs of MK were significantly decreased in PSPS and increased in MSA-C compared with the other groups, while dCPRs of MK showed significant differences only between MSA-C and PD, PSPS, or control. MS values were significantly increased in the PUp of MSA-P and in the PUa and GP of PSPS compared with those in PD. The combined use of MK-dMPR and MS-PUp showed sensitivities of 83-100% and specificities of 81-100% for discriminating among the disease groups, respectively. Conclusion: A quantitative assessment using DKI and QSM analyses, particularly MK-dMPR and MS-PUp values, can readily identify patients with parkinsonism. [ABSTRACT FROM AUTHOR]

Tracking animal movements such as walking is an essential task for understanding how and why animals move in an environment and respond to external stimuli. Different methods that implemented image analysis and a data logger such as GPS have been used in laboratory experiments and in field studies, respectively. Recently, animal movement patterns without stimuli have attracted an increasing attention in search for common innate characteristics underlying all of their movements. However, it is difficult to track the movements in a vast and homogeneous environment without stimuli because of space constraints in laboratories or environmental heterogeneity in the field, hindering our understanding of inherent movement patterns. Here, we applied an omnidirectional treadmill mechanism, or a servosphere, as a tool for tracking two-dimensional movements of small animals that can provide both a homogenous environment and a virtual infinite space for walking. To validate the use of our tracking system for assessment of the free-walking behavior, we compared walking patterns of individual pillbugs (Armadillidium vulgare) on the servosphere with that in two types of experimental flat arenas. Our results revealed that the walking patterns on the servosphere showed similar diffusive characteristics to those observed in the large arena simulating an open space, and we demonstrated that our mechanism provides more robust measurements of diffusive properties compared to a small arena with enclosure. Moreover, we showed that anomalous diffusion properties, including Lévy walk, can be detected from the free-walking behavior on our tracking system. Thus, our novel tracking system is useful to measure inherent movement patterns, which will contribute to the studies of movement ecology, ethology, and behavioral sciences. [ABSTRACT FROM AUTHOR]

Further research is needed to establish the utility of these distinct LV systolic function phenotypes in outcomes of patient with sepsis and septic shock. B Conclusions: b In this analysis of systolic function among patients with sepsis, (LVEF >= 55% & MASV < 8.5 cm/sec) and (LVEF < 55 & MASV < 8.5 cm/sec) phenotypes were associated with higher mortality. The ICU mortality was 28% for the phenotype; 36% for the phenotype; 29% for the phenotype; and 35% for the phenotype. [Extracted from the article]

Purpose There have been scarce data evaluating the differences of clinical characteristics and prognosis of chronic pulmonary aspergillosis (CPA) depending on underlying pulmonary diseases. We tried to clarify them in CPA patients who had pulmonary emphysema or previous pulmonary tuberculosis. Methods We reviewed and evaluated CPA patients diagnosed between 2007 and 2013 with pulmonary emphysema (PE group; n = 29), with previous pulmonary tuberculosis (PT group; n = 47) and with combination of these 2 underlying conditions (CTE group; n = 24). Results In CT findings, fungus balls were rare in PE group (7% in PE group and 36% in PT group; p = 0.006). Compared with PT group, PE group patients exhibited more frequent preceding antibiotics administration (45% vs 11%; p = 0.002) and fever (52% vs 17%; p = 0.002), less frequent hemosputum (24% vs 57%; p = 0.008), and more frequent consolidations in imaging (79% vs 38%; p = 0.001) and respiratory failure (34% vs 13%; p = 0.020), possibly suggesting more acute clinical manifestations of CPA in emphysematous patients. Trend of the differences between PT and PE group was not changed when patients with fungal balls were excluded. Multivariate Cox regression analysis of risks for all-cause mortality revealed age (HR, 1.079; p = 0.002) and emphysema (HR, 2.45; p = 0.040) as risk factors. Conclusions Assessment of underlying lung diseases is needed when we estimate prognosis and consider treatment of CPA patients. Particularly, emphysematous patients can be presented as refractory pneumonia and show poor prognosis. [ABSTRACT FROM AUTHOR]