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Objective: Imaging is essential for diagnosing large-vessel vasculitis (LVV). During diagnostic imaging, assessing disease activity and vascular damage separately is important. Acute-phase findings represent disease activity, while chronic-phase findings represent vascular damage; however, whether the imaging findings are acute or chronic may be unclear. We investigated how vascular lesions change before and after treatment and whether they were acute- or chronic-phase findings. Methods: Fifty-one patients with LVV who had undergone contrast-enhanced computed tomography (CT) scans from the neck to the pelvis before treatment and 1-4 months after treatment were recruited. Wall thickening, wall contrast enhancement, stenosis, occlusion, dilation, aneurysm, and calcification were semi-quantitatively assessed in 21 vessels from the common carotid to the common iliac artery. Results: Twenty-four patients were diagnosed with Takayasu arteritis (TAK), and 27 with giant cell arteritis (GCA). Wall thickening and wall contrast enhancement improved after the treatment, which was especially significant in the GCA group. No significant differences in stenosis, occlusion, dilation, aneurysm, or calcification were observed before and after treatment. Stenosis and occlusion were more common with TAK, while calcification was more common with GCA. Conclusion: Wall thickening and wall contrast enhancement are acute-phase findings (activity), while stenosis, occlusion, dilation, aneurysm, and calcification are chronic-phase findings (damage). The frequencies of these findings differ between TAK and GCA. more...

Abstract Background Adult-onset Still’s disease (AOSD) is a rare systemic autoinflammatory disease which encompasses patients with heterogenous presentation and a wide range of clinical courses. In this study, we aimed to identify potential subgroups of AOSD and reveal risk factors for relapse. Methods We included a total of 216 AOSD patients who received treatment in nine hospitals between 2000 and 2019. All patients fulfilled the Yamaguchi classification criteria. We retrospectively collected information about baseline characteristics, laboratory tests, treatment, relapse, and death. We performed latent class analysis and time-to-event analysis for relapse using the Cox proportional hazard model. Results The median age at disease onset was 51.6 years. The median follow-up period was 36.8 months. At disease onset, 22.3% of the patients had macrophage activation syndrome. The median white blood cell count was 12,600/μL, and the median serum ferritin level was 7230 ng/mL. Systemic corticosteroids were administered in all but three patients (98.6%) and the median initial dosage of prednisolone was 40mg/day. Ninety-six patients (44.4%) were treated with concomitant immunosuppressants, and 22 (10.2%) were treated with biologics. Latent class analysis revealed that AOSD patients were divided into two subgroups: the typical group (Class 1: 71.8%) and the elderly-onset group (Class 2: 28.2%). During the follow-up period, 13 of 216 patients (6.0%) died (12 infections and one senility), and 76 of 216 patients (35.1%) experienced relapses. Overall and relapse-free survival rates at 5 years were 94.9% and 57.3%, respectively, and those rates were not significantly different between Class 1 and 2 (p=0.30 and p=0.19). Time-to-event analysis suggested higher neutrophil count, lower hemoglobin, and age ≥65 years at disease onset as risk factors for death and age ≥65 years at disease onset as a risk factor for relapse. Conclusions AOSD patients were divided into two subgroups: the typical group and the elderly-onset group. Although the survival of patients with AOSD was generally good, the patients often experienced relapses. Age ≥65 years at disease onset was the risk factor for relapse. more...

ABSTRACT Introduction: We evaluated the outcomes of the selective intercostal artery reconstruction for preventing spinal cord injury during thoracoabdominal aortic aneurysm repair. Methods: We retrospectively assessed 84 consecutive patients who underwent thoracoabdominal aortic aneurysm repairs between 2004 and 2016. The mean age of the patients was 57.3 years. We performed preoperative multidetector computed tomography in 74 patients (88.0%) to identify the Adamkiewicz artery. Spinal cord injury preventive measures included motor evoked potential monitoring, hypothermia induction, Adamkiewicz artery or other intercostal artery reconstruction, and cerebrospinal fluid drainage. Results: The hospital death rate was 5.9%, and paraplegia occurred in four patients (4.7%). The Adamkiewicz artery or other intercostal arteries were reconstructed selectively in 46 patients (54.7%). Of these patients, 41 underwent postoperative multidetector computed tomography, which revealed occlusion of the reconstructed grafts in 23 patients (56.0%). There was no paraplegia in the patients who underwent reconstruction of the Adamkiewicz artery, which was patent on postoperative multidetector computed tomography. Univariate analysis showed no significant effect of various risk factors on the development of spinal cord injury. Conclusion: Outcome of open surgery for thoracoabdominal aortic aneurysm in our institution regarding spinal cord injury was satisfactory. The benefits of Adamkiewicz artery reconstruction remain inconclusive, and further larger studies are required to identify its validation for spinal cord protection in thoracoabdominal aortic aneurysm repair. more...

Extracting hierarchical structure in graph data is becoming an important problem in fields such as natural language processing and developmental biology. Hierarchical structures can be extracted by embedding methods in non-Euclidean spaces, such as Poincaré embedding and Lorentz embedding, and it is now possible to learn efficient embedding by taking advantage of the structure of these spaces. In this study, we propose embedding into another type of metric space called a metric cone by learning an only one-dimensional coordinate variable added to the original vector space or a pre-trained embedding space. This allows for the extraction of hierarchical information while maintaining the properties of the pre-trained embedding. The metric cone is a one-dimensional extension of the original metric space and has the advantage that the curvature of the space can be easily adjusted by a parameter even when the coordinates of the original space are fixed. Through an extensive empirical evaluation we have corroborated the effectiveness of the proposed cone embedding model. In the case of randomly generated trees, cone embedding demonstrated superior performance in extracting hierarchical structures compared to existing techniques, particularly in high-dimensional settings. For WordNet embeddings, cone embedding exhibited a noteworthy correlation between the extracted hierarchical structures and human evaluation outcomes. more...

In this review, the underlying mechanisms of health benefits and the risk of habitual behaviours such as internet use and media multitasking were explored, considering their associations with the reward/motivation system. The review highlights that several routines that are beneficial when undertaken normally may evolve into excessive behaviour and have a negative impact, as represented by “the inverted U-curve model”. This is especially critical in the current era, where technology like the internet has become mainstream despite the enormous addictive risk. The understanding of underlying mechanisms of behavioural addiction and optimal level of habitual behaviours for mental health benefits are deepened by shedding light on some findings of neuroimaging studies to have hints to facilitate better management and prevention strategies of addictive problems. With the evolution of the world, and the inevitable use of some technologies that carry the risk of addiction, more effective strategies for preventing and managing addiction are in more demand than before, and the insights of this study are also valuable foundations for future research. more...

Background The Generalized Problematic Internet Use Scale 2 (GPIUS2) is a self-administered questionnaire that evaluates problematic internet use (PIU) from a multidimensional perspective. We analysed the psychometric properties and adequacy of the theoretical model of Japanese version of the GPIUS2. Methods This study included 291 healthy Japanese adults (median age = 25 years; interquartile range 22–43 years; 128 women) who completed the GPIUS2 and several other questionnaires evaluating the degree of PIU, self-esteem, depression, and impulsivity. Results Exploratory factor analysis (EFA) revealed a similar factor structure between the original and Japanese versions of the GPIUS2, with only minor differences in item composition. Higher-order confirmatory factor analyses revealed a good overall fit for the factorial model suggested by EFA, indicating adequate construct validity. The model showed acceptable internal consistency. Partial correlation analyses between GPIUS2 and other measures, with age as a control variable, revealed good convergent validity. Finally, structural equation modelling showed a good fit to the data, supporting the cognitive-behavioural model of Caplan (2010). Conclusions The Japanese version of the GPIUS2 has good psychometric properties and the theoretical model of the original GPIUS2 is applicable to Japanese adults. more...

Introduction: Physical distancing under the coronavirus disease 2019 (COVID-19) pandemic had a significant impact on lifestyles, including exercise routines. In this study, we examined the relationship between mental health and addictive behaviors, such as excessive exercise and the use of image and performance enhancing drugs (IPEDs) across 12 sport disciplines.Materials and methods: A large cross-sectional sample of the adult population (N = 2,295) was surveyed. The mean age was 33.09 (SD = 11.40). The number of male participants was 668 (30.0%). The use of IPEDs was assessed in conjunction with psychometric measures such as the Exercise Addiction Inventory (EAI) and the Appearance Anxiety Inventory (AAI). The participants were grouped into activity group (AG) and non-activity group (NAG) according to the presence or absence of their exercise habits. The results were compared between these groups, as well as across sport disciplines, while taking into account the relationship between different psychological measures and IPEDs consumption.Results: The frequency of IPEDs use was higher among AG (34.6%) than NAG (14.6%), although AG participants reported less history of addictions (7.1%) than NAG (11.8%). The logistic regression analysis revealed that scores equal to or above cutoff points, in both the EAI and AAI, predicted the IPEDs use. Regarding the differences across the various sport disciplines, those who were involved in practicing Weight Lifting and Cross Fit were found to be more at risk of excessive exercising and more inclined to use a wide range of IPEDs.Conclusions: Although exercise could help to increase well-being and prevent addictions during the COVID-19 pandemic, our results show that those in the AG are particularly vulnerable to excessive IPEDs use. Sport disciplines associated with higher EAI and AAI scores have also shown a higher tendency to excessive IPEDs use. Furthermore, the factor of having above the cutoff scores in EAI or AAI in each sport could indicate larger IPEDs consumption regardless of the discipline. In light of the current findings, it is necessary to better define the “non-excessive” levels of exercise in various sport disciplines and an adequate intake of IPEDs to ensure the safety and well-being of people during a pandemic. more...

Introduction: Little is known about the impact of restrictive measures during the COVID-19 pandemic on self-image and engagement in exercise and other coping strategies alongside the use of image and performance-enhancing drugs (IPEDs) to boost performance and appearance.Objectives: To assess the role of anxiety about appearance and self-compassion on the practice of physical exercise and use of IPEDs during lockdown.Methods: An international online questionnaire was carried out using the Exercise Addiction Inventory (EAI), the Appearance Anxiety Inventory (AAI), and the Self-Compassion Scale (SCS) in addition to questions on the use of IPEDs.Results: The sample consisted of 3,161 (65% female) adults from Italy (41.1%), Spain (15.7%), the United Kingdom (UK) (12.0%), Lithuania (11.6%), Portugal (10.5%), Japan (5.5%), and Hungary (3.5%). The mean age was 35.05 years (SD = 12.10). Overall, 4.3% of the participants were found to engage in excessive or problematic exercise with peaks registered in the UK (11.0%) and Spain (5.4%). The sample reported the use of a wide range of drugs and medicines to boost image and performance (28%) and maintained use during the lockdown, mostly in Hungary (56.6%), Japan (46.8%), and the UK (33.8%), with 6.4% who started to use a new drug. Significant appearance anxiety levels were found across the sample, with 18.1% in Italy, 16.9% in Japan, and 16.7% in Portugal. Logistic regression models revealed a strong association between physical exercise and IPED use. Anxiety about appearance also significantly increased the probability of using IPEDs. However, self-compassion did not significantly predict such behavior. Anxiety about appearance and self-compassion were non-significant predictors associated with engaging in physical exercise.Discussion and Conclusion: This study identified risks of problematic exercising and appearance anxiety among the general population during the COVID-19 lockdown period across all the participating countries with significant gender differences. Such behaviors were positively associated with the unsupervised use of IPEDs, although no interaction between physical exercise and appearance anxiety was observed. Further considerations are needed to explore the impact of socially restrictive measures among vulnerable groups, and the implementation of more targeted responses. more...

An expanded silencer is well known in all other silencers and widely used in an industry field. As the theory of the expanded silencer has already been established and it is considered to be useful because it has exceptional prospects. There are many studies on the characteristics of the expanded silencer. For example, Davis D.D. et al. constructed the theory under the assumption of no reflection of the tail pipe. Fukuda et al. have left a trail of many fruitful results on the characteristics of the expanded silencer including the effect of the tail pipe. In general, the performance of silencers is evaluated by the silencing effect(ATT) and insertion loss(IL). When we calculated the silencing effect by using the transfer matrix method, we experienced that the silencing effect was completely independent of the inlet tube length. Is the fact true? It is the motivation of this investigation. We noticed the silencing effect was different from the insertion loss in the process of this study. This is considered to be natural and almost all people know that fact. In this paper, it will be verified that the silencing effect is independent of the inlet tube length and we modified the silencer effect by taking into account of radiation effect from the outlet tube and compared the modified silencing effect and the insertion loss. As a result, it was clarified that the both results are good agreement with each other. more...

Neurological deficits are a serious and common sequelae of congenital heart disease (CHD). While their underlying mechanisms have not been fully characterized, their manifestations are well-known and understood to persist through adulthood. Development of therapies to address or prevent these deficits are critical to attenuate future morbidity and improve quality of life. In this review, we aim to summarize the current status of neuroprotective therapy in CHD. Through an exploration of present research in the pre-operative, intra-operative, and post-operative phases of patient management, we will describe existing clinical and bench efforts as well as current endeavors underway within this research area. more...

Local hydration structures at solid-liquid interfaces are important in catalytic, electrochemical, and biological processes. Here, the authors demonstrate atomic-scale 3D hydration structures around the boundary on a heterogeneous mineral surface using atomic force microscopy experiments and molecular dynamics simulations. more...

Introduction: Spinal cord stimulation (SCS) is an established strategy for pain reduction used in whole world including Japan to treat chronic intractable pain. Pain is a frequent comorbidity of Parkinson's disease (PD), leading to poorer quality of life. SCS has been reported to effectively reduce pain in PD and may also improve motor function, but most studies have employed the modality of tonic stimulation. As such, the effects of SCS using the newly developed paradigm of burst stimulation in PD remain relatively unexplored. Methods: This case series reviewed PD patients who underwent SCS using BurstDR stimulation to treat intractable lower back pain (LBP). Pain and motor outcomes were assessed before and at several timepoints after implantation over a 24-week observation period. Results: Pain indices (visual analogue scale [VAS] and short-form McGill Pain Questionnaire 2 [SF-MPQ-2] scores) improved in nearly all patients. Improvements were especially notable in the dimension of affective pain (SF-MPQ-2). Functional motor improvements were evident in the Unified Parkinson's Disease Rating Scale (UPDRS), especially walking-related items, and timed-up-and-go (TUG) test performance, which generally persisted through week 24 of observation. Conclusion: Burst SCS improved pain (especially the affective component) in PD patients with LBP, with effects generally lasting for at least 24 weeks. Neither paresthesia nor obvious adverse events were experienced in any case. Motor symptoms as scored of UPDRS Part III had the trends of improvement in lower limb akinesia at week 24 and gait at week 4. These findings suggest that burst SCS may be an effective treatment option for LBP and may be influenced to gait-related motor symptoms in PD. more...

Japanese martial arts, Budo, have been reported to improve cognitive function, especially attention. However, the underlying neural mechanisms of the effect of Budo on attention processing has not yet been investigated. Kendo, a type of fencing using bamboo swords, is one of the most popular forms of Budo worldwide. We investigated the difference in functional connectivity (FC) between Kendo players (KPs) and non-KPs (NKPs) during an attention-related auditory oddball paradigm and during rest. The analyses focused on the brain network related to “motivation.” Resting-state functional magnetic resonance imaging (rs-fMRI) and task-based fMRI using the oddball paradigm were performed in healthy male volunteers (14 KPs and 11 NKPs). Group differences in FC were tested using CONN-software within the motivation network, which consisted of 22 brain regions defined by a previous response-conflict task-based fMRI study with a reward cue. Daily general physical activities were assessed using the International Physical Activity Questionnaire (IPAQ). We also investigated the impact of major confounders, namely, smoking habits, alcohol consumption, IPAQ score, body mass index (BMI), and reaction time (RT) in the oddball paradigm. Resting-state fMRI revealed that KPs had a significantly lower FC than NKPs between the right nucleus accumbens and right frontal eye field (FEF) within the motivation network. Conversely, KPs exhibited a significantly higher FC than NKPs between the left intraparietal sulcus (IPS) and the left precentral gyrus (PCG) within the network during the auditory oddball paradigm [statistical thresholds, False Discovery Rate (FDR) < 0.05]. These results remained significant after controlling for major covariates. Our results suggest that attenuated motivation network integrity at rest together with enhanced motivation network integrity during attentional demands might underlie the instantaneous concentration abilities of KPs. more...

Background: Increasing evidence regarding the neural correlates of excessive or pathological internet use (IU) has accumulated in recent years, and comorbidity with depression and autism has been reported in multiple studies. However, psychological and neural correlates of non-clinical IU in healthy individuals remain unclear.Objectives: The aim of the current study was to investigate the relationships between non-clinical IU and functional connectivity (FC), focusing on the brain’s motivation network. We sought to clarify the influence of depression and autistic traits on these relationships in healthy individuals.Methods: Resting-state functional magnetic resonance imaging (fMRI) was performed in 119 healthy volunteers. IU, depression, and autistic traits were assessed using the Generalized Problematic Internet Use Scale 2 (GPIUS2), Beck Depression Inventory-II (BDI-II), and the autism spectrum quotient (AQ) scale, respectively. Correlational analyses were performed using CONN-software within the motivation-related network, which consisted of 22 brain regions defined by a previous response-conflict task-based fMRI study with a reward cue. We also performed mediation analyses via the bootstrap method.Results: Total GPIUS2 scores were positively correlated with FC between the (a) left middle frontal gyrus (MFG) and bilateral medial prefrontal cortex; (b) left MFG and right supplementary motor area (SMA); (c) left MFG and right anterior insula, and (d) right MFG and right insula. The “Mood Regulation” subscale of the GPIUS2 was positively correlated with FC between left MFG and right SMA. The “Deficient Self-Regulation” subscale was positively correlated with FC between right MFG and right anterior insula (statistical thresholds, FDR < 0.05). Among these significant correlations, those between GPIUS2 (total and “Mood Regulation” subscale) scores and FC became stronger after controlling for AQ scores (total and “Attention Switching” subscale), indicating significant mediation by AQ (95% CI < 0.05). In contrast, BDI-II had no mediating effect.Conclusion: Positive correlations between IU and FC in the motivation network may indicate health-promoting effects of non-clinical IU. However, this favorable association is attenuated in individuals with subclinical autistic traits, suggesting the importance of a personalized educational approach for these individuals in terms of adequate IU. more...