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The existence of stress singularities and reliance on linear approximations pose significant challenges in comprehending the stress field generation mechanism around dislocations. This study employs differential geometry and calculus of variations to mathematically model and numerically analyse screw dislocations. The kinematics of the dislocation are expressed by the diffeomorphism of the Riemann–Cartan manifold, which includes both the Riemannian metric and affine connection. The modelling begins with a continuous distribution of dislocation density, which is transformed into torsion [Formula: see text] through the Hodge duality. The plasticity functional is constructed by applying the Helmholtz decomposition to bundle isomorphism, which is equivalent to the Cartan first structure equation for the intermediate configuration [Formula: see text]. The current configuration is derived by the elastic embedding of [Formula: see text] into the standard Euclidean space [Formula: see text]. The numerical analysis reveals that the elastic stress fields effectively eliminate the singularity along the dislocation line and exhibit excellent conformity with Volterra’s theory beyond the dislocation core. Geometrical frustration is the direct source of dislocation stress fields, as demonstrated through the multiplicative decomposition of deformation gradients. By leveraging the mathematical properties of the Riemann–Cartan manifold, we demonstrate that the Ricci curvature determines the symmetry of stress fields. These results substantiate a long-standing mathematical hypothesis: the duality between stress and curvature.

Tau is typically an axonal protein, but in neurons of brains affected by Alzheimer's disease (AD), aggregation of hyperphosphorylated tau in the somatodendritic compartment causes neuronal death. We have previously demonstrated that tau mRNA is transported within dendrites and undergoes immediate translation and hyperphosphorylation of AD epitopes in response to NMDA receptor stimulation. Although this explains the emergence of hyperphosphorylated tau in dendrites, the relationship between tau hyperphosphorylation and aggregation is not well understood. In this study, we found that recombinant highly phosphorylated tau purified from NG108-15 rodent neuroblastoma/glioma cells transfected with both tau and GSK3β expression vectors bound calcium ions and formed sarkosyl-insoluble aggregates. In addition, thioflavin T analysis revealed that this highly phosphorylated tau tended to aggregate on its own, further facilitated by calcium ions. When NG108-15 cells expressing the highly phosphorylated tau were treated with calcium ionophore, sarkosyl-insoluble tau was generated. Interestingly, these cells exhibited resistance to both calcium ionophore-induced cytotoxicity and glutamate-induced excitotoxicity. We further found that sarkosyl-insoluble phosphorylated tau was increased in cultured hippocampal neurons due to glutamate-induced hyperactivity. Our data suggest that hyperphosphorylated tau synthesized in response to NMDA receptor stimulation contributes to regulation of neuronal activity by binding calcium ions, but that this calcium binding may cause tau to adopt an aggregated form.

Abstract Two-dimensional freestanding membranes of materials, which can be transferred onto and make interfaces with any material, have attracted attention in the search for functional properties that can be utilized for next-generation nanoscale devices. We fabricated stable 1-nm-thick hafnia membranes exhibiting the metastable rhombohedral structure and out-of-plane ferroelectric polarizations as large as 13 μC/cm2. We also found that the rhombohedral phase transforms into another metastable orthorhombic phase without the ferroelectricity deteriorating as the thickness increases. Our results reveal the key role of the rhombohedral phase in the scale-free ferroelectricity in hafnia and also provide critical insights into the formation mechanism and phase stability of the metastable hafnia. Moreover, ultrathin hafnia membranes enable heterointerfaces and devices to be fabricated from structurally dissimilar materials beyond structural constrictions in conventional film-growth techniques.

Introduction: Acute Leriche syndrome is a rare but potentially life-threatening condition. Pain, pallor, and coldness of the lower extremities serve as clues for suspecting Leriche syndrome. However, the absence of these findings may pose a diagnostic challenge. Case Presentation: An 83-year-old man presented at our emergency department with a complaint of sudden-onset paraparesis. Initially, spinal cord infarction was suspected due to clinical course and neurological findings, but thoracolumbar MRI showed normal findings. On admission, symptoms associated with aortoiliac occlusion were not present, except for muscle atrophy in the thigh. CT angiography revealed aortoiliac occlusion, leading to a diagnosis of Leriche syndrome. Conclusion: Leriche syndrome should be considered as a potential differential diagnosis in patients with acute paraparesis. Muscle atrophy of the lower limbs disproportionate to the clinical course may be the clue for suspecting acute Leriche syndrome with symptoms related to atherosclerotic occlusion which are inconspicuous.

Abstract Histone H2B monoubiquitination (at Lys120 in humans) regulates transcription elongation and DNA repair. In humans, H2B monoubiquitination is catalyzed by the heterodimeric Bre1 complex composed of Bre1A/RNF20 and Bre1B/RNF40. The Bre1 proteins generally function as tumor suppressors, while in certain cancers, they facilitate cancer cell proliferation. To obtain structural insights of H2BK120 ubiquitination and its regulation, we report the cryo-electron microscopy structure of the human Bre1 complex bound to the nucleosome. The two RING domains of Bre1A and Bre1B recognize the acidic patch and the nucleosomal DNA phosphates around SHL 6.0–6.5, which are ideally located to recruit the E2 enzyme and ubiquitin for H2BK120-specific ubiquitination. Mutational experiments suggest that the two RING domains bind in two orientations and that ubiquitination occurs when Bre1A binds to the acidic patch. Our results provide insights into the H2BK120-specific ubiquitination by the Bre1 proteins and suggest that H2B monoubiquitination can be regulated by nuclesomal DNA flexibility.

Parkinson’s disease (PD) is a neurological disorder caused by degeneration of dopaminergic neurons in the midbrain. PD patients mainly suffer from motor symptoms, which significantly impact their daily lives. The diagnostic criteria for PD include the presence of muscle rigidity, tremor, and postural reflex disturbances. The Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) is the standard tool for evaluating PD symptoms, part III of which is dedicated to motor symptoms. That part involves a comprehensive set of specific physical examinations, and physicians assign semi quantitative scores from 0 to 4. However, this approach faces notable challenges, including the requirement for movement-disorder experts proficient in using MDS-UPDRS and the presence of substantial inter rater variability even among experts. Overcoming these challenges requires a quantitative and objective assessment method. Given that the rating of motor symptoms predominantly involves assessing kinematic characteristics, the integration of sensor-based devices and machine learning techniques holds the potential to outperform human experts in symptom evaluations. This study used the Leap Motion optical motion-capture device to quantitatively measure and analyze hand movements while 45 PD patients performed the following 3 tasks from the MDS-UPDRS part III: finger tapping (FT), hand opening and closing (OC), and forearm pronation and supination (PS). Data from these tasks were collected and processed, resulting in the extraction of 31 movement patterns for each task. Additionally, 69 statistical features were extracted from each movement pattern, yielding 2139 features for each task. We subsequently employed a random forest algorithm to select the top 15% of features based on the reduction of Gini impurity. These selected features were subsequently fed into a sequential-forward-floating-selection algorithm, combined with a support vector machine, to identify relevant feature combinations and predict the severity of the motor symptoms. The classification accuracy was 87.0% for FT, 93.2% for OC, and 92.2% for PS. One-way analysis of variance identified 13 features of the OC task that were significantly more discriminative for classifying the movement disability of PD patients ( ${p}$

Abstract There is no standard formula for estimating the starting daily dose (SDD) of basal-bolus insulin therapy (BBT). We aimed to develop a formula for estimating SDD and evaluate its efficacy and safety in patients with type 2 diabetes hospitalized for BBT. In the first study (n = 104), we retrospectively analyzed the relationship between peak daily dose (PDD) during hospitalization and clinical parameters. The PDD was significantly associated with fasting plasma glucose (FPG) (R = 0.449, P < 0.0001) and HbA1c levels (R = 0.384, P < 0.0001) but not body weight, body mass index, body surface area, or serum C-peptide levels. Based on the results, we developed a formula for estimating SDD using FPG levels: SDD (U/day) = 0.08 × FPG (mg/dL). In the second study (n = 405), we assessed efficacy and safety of the formula by evaluating the M-value from the daily glucose profile and assessing the frequency of hypoglycemia (blood glucose level

Introduction: Primary neurolymphomatosis (NL) is a critical differential diagnosis of asymmetric multiple mononeuropathy and radiculoplexopathy. Its diagnosis is often challenging due to the lack of typical clinical signs of systemic lymphoma. We report a case of primary NL where nerve ultrasound (NUS) played an important role in the diagnosis and follow-up of the disease. Case presentation: A 52-year-old man developed asymmetric painful multiple mononeuropathy in the right upper limb with cranial nerve involvement. After being referred to our department, the patient underwent NUS, which revealed marked enlargement and increased vascularity in the right upper limb nerves, brachial plexus, and cervical nerve roots. Furthermore, an epineural hypoechoic mass, a characteristic finding of NL, was seen in the right median nerve. These NUS findings prompted us to perform 18F-fluorodeoxyglucose positron emission tomography/computed tomography and a subsequent biopsy on the right axillary lymph node, confirming NL. Notably, the NUS abnormalities dramatically subsided, demonstrating the effectiveness of chemotherapy. Discussion: The diagnostic utility of NUS for NL has been documented by many recent reports. Additionally, NUS can work as a quick follow-up tool for NL, as seen in our case.

Management of tumor lysis syndrome (TLS) associated with cancer chemotherapy for malignant tumors is important because of its potentially fatal course. The use of rasburicase, a recombinant urate oxidase, is recommended for TLS; however, because rasburicase is an enzymatic drug, one should be cautious of anaphylaxis during administration. Using claims data in Japan, we investigated the rate of rasburicase re-administration and the occurrence of anaphylaxis during re-administration in patients with hematopoietic malignancies in a multicenter setting. Re-administration of rasburicase was defined as administration after an interval of 21 days from the first dose. Of 373 patients, 18 were re-administered rasburicase (re-administration rate: 4.8%). No patient developed anaphylaxis. The median number of days from the first to the last dose of rasburicase was 256.5 days (interquartile range: 138.8–455.8 days). The median daily dose was 7.5 mg (4.5–11.3 mg), and the median total dose was 33.8 mg (19.1–64.1 mg). This claims database analysis revealed that the re-administration rate of rasburicase was low in Japanese patients with hematopoietic malignancies, suggesting that rasburicase was being used appropriately, and that associated anaphylaxis was not observed.

Abstract Background and purpose The diagnosis of functional neurological disorder should be actively made based on the neurological signs. We described two new complementary signs to diagnose functional weakness of the lower limb, “weak gluteus maximus (weak GM)” and “weak Iliopsoas with normal gluteus maximus (weak iliopsoas with normal GM),” and tested their validity. Methods The tests comprised Medical Research Council (MRC) examinations of the iliopsoas and GM in the supine position. We retrospectively enrolled patients with functional weakness (FW) or structural weakness (SW) who presented with weakness of either iliopsoas or GM, or both. Weak GM means that the MRC score of GM is 4 or less. Its complementary sign, weak ilopsoas with normal GM, means that the MRC score of ilopsoas is 4 or less, whereas that of GM is 5. Results Thirty‐one patients with FW and 72 patients with SW were enrolled. The weak GM sign was positive in all 31 patients with FW and in 11 patients with SW, that is, 100% sensitivity and 85% specificity. Therefore, the complementary sign, weak iliopsoas with normal GM, was 100% specific for SW. Discussion Although 100% should be discounted considering limitations of this study, these signs will likely be helpful in differentiating between FW and SW in the general neurology setting. Downward pressing of the lower limb to the bed in the supine position is interpreted by the patient as an active movement exerted with an effort and might be preferentially impaired in FW.

Organ bath experiments are conventionally used to investigate the physiological actions and effects of hormones and drugs on organ responses. We developed an experimental method to reproduce insulin secretion from isolated rat pancreas preparations, to investigate substances that promote insulin secretion ex vivo. 1,5-anhydro-D-glucitol (1,5-AG) is found in foods, and exists in humans and rodents; however, whether 1,5-AG stimulates insulin secretion remains unclear. This study aimed to assess the effects of short-term 1,5-AG stimulation on insulin secretion in both ex vivo and in INS-1E (rat-derived) cells in vitro. Our results indicated that 1,5-AG had no potency to increase the proportion of insulin outflow both in ex vivo and in vitro experiments. Insulin outflow significantly increased upon stimulation with 10 μM glimepiride, a member of the sulfonylurea class of drugs, ex vivo. Glucose-stimulated insulin secretion was observed not only in INS-1E cells but also in rat pancreatic preparations. Our findings demonstrated that short-term exposure to 1,5-AG had no effect on insulin secretion in rats.

ABSTRACT Objective Perioperative deep prosthetic joint infection (PJI) is a serious postoperative complication of total hip arthroplasty (THA). We aimed to compare the efficacy of cefazolin administered within 24 and 48 h of primary THA for PJI prophylaxis. Methods In this retrospective study, 720 patients were divided into two groups depending on whether cefazolin was administered as a single injection of 2 g twice daily within 24 (24-h group) or 48 h of surgery and the following day (48-h group). Sex, age at surgery, body mass index, co-existing diseases, blood test data, and PJI risk factors were evaluated. Results The 24- and 48-h groups included 364 and 356 patients, respectively. Diabetes mellitus was the most common risk factor for PJI in both groups. The corresponding incidence of perioperative deep PJI following primary THA was 0.55% and 0.28% in the 24- and 48-h groups, respectively. There was no significant difference in patient background characteristics between the groups. Conclusions Cefazolin administration within 24 h of primary THA may be appropriate for perioperative deep PJI. Level of Evidence II; Retrospective study.

Pheochromocytomas can present with various symptoms. Nonspecific manifestations of pheochromocytoma include intestinal pseudo-obstruction and weight loss. Here, we present a case of pheochromocytoma in which prolonged intestinal pseudo-obstruction due to excess catecholamines was one of the factors leading to the development of a liver abscess. An 18-year-old male patient with a history of status epilepticus and severe intellectual disability was transferred to our hospital for a thorough examination of fever and constipation that had lasted for 2 months. When admitted to our hospital, he had fever, and his body mass index was 9.5 kg/m 2 . Upon comprehensive examination of the patient’s fever, the blood culture was found positive for Bacteroides . Computed tomography showed findings of intestinal pseudo-obstruction and a low density region in the liver that indicated a liver abscess. Imaging studies also revealed a right adrenal mass and endocrinological test showed elevated plasma norepinephrine and urine normetanephrine levels. In addition, the right adrenal mass showed uptake on 123 I-metaiodobenzylguanidine scintigraphy. These findings led to a definite diagnosis of pheochromocytoma. The patient was eventually diagnosed with a pheochromocytoma coexisting with a liver abscess. After treating the liver abscess with antibiotics and ultrasound-guided drainage, an adrenalectomy was performed. The pathological findings were consistent with pheochromocytoma. Postoperatively, the catecholamine excess normalized and intestinal pseudo-obstruction and weight loss improved. We suspected that prolonged intestinal pseudo-obstruction resulted in bacterial translocation and development of a liver abscess. To the best of our knowledge, this is the first report of a pheochromocytoma associated with a liver abscess. Moreover, the clinical presentation of this patient was unusual for pheochromocytoma, as the patient did not have typical symptoms such as hypertension or tachycardia, but rather presented with constipation, intestinal pseudo-obstruction, and weight loss. This case provides valuable insight regarding the impact of catecholamine excess on the intestinal tract and body weight.

Abstract Background Hereditary motor and sensory neuropathy, also referred to as Charcot–Marie–Tooth disease (CMT), is most often caused by a duplication of the peripheral myelin protein 22 (PMP22) gene. This duplication causes CMT type 1A (CMT1A). CMT1A rarely occurs in combination with other hereditary neuromuscular disorders. However, such rare genetic coincidences produce a severe phenotype and have been reported in terms of “double trouble” overlapping syndrome. Waardenburg syndrome (WS) is the most common form of a hereditary syndromic deafness. It is primarily characterized by pigmentation anomalies and classified into four major phenotypes. A mutation in the SRY sex determining region Y-box 10 (SOX10) gene causes WS type 2 or 4 and peripheral demyelinating neuropathy, central dysmyelinating leukodystrophy, WS, and Hirschsprung disease. We describe a 11-year-old boy with extreme hypertrophic neuropathy because of a combination of CMT1A and WS type 2. This is the first published case on the co-occurrence of CMT1A and WS type 2. Case presentation The 11-year-old boy presented with motor developmental delay and a deterioration in unstable walking at 6 years of age. In addition, he had congenital hearing loss and heterochromia iridis. The neurological examination revealed weakness in the distal limbs with pes cavus. He was diagnosed with CMT1A by the fluorescence in situ hybridization method. His paternal pedigree had a history of CMT1A. However, no family member had congenital hearing loss. His clinical manifestation was apparently severe than those of his relatives with CMT1A. In addition, a whole-body magnetic resonance neurography revealed an extreme enlargement of his systemic cranial and spinal nerves. Subsequently, a genetic analysis revealed a heterozygous frameshift mutation c.876delT (p.F292Lfs*19) in the SOX10 gene. He was eventually diagnosed with WS type 2. Conclusions We described a patient with a genetically confirmed overlapping diagnoses of CMT1A and WS type 2. The double trouble with the genes created a significant impact on the peripheral nerves system. Severe phenotype in the proband can be attributed to the cumulative effect of mutations in both PMP22 and SOX10 genes, responsible for demyelinating neuropathy.

Abstract Background Conventional coagulation tests, such as prothrombin time and activated partial thromboplastin time, are not sensitive to anticoagulation by apixaban. We evaluated the antithrombotic effect of apixaban using a Russell viper venom (RVV) test for a patient who underwent posterior spine fusion surgery. Case presentation An 84-year-old man was scheduled for percutaneous posterior spine fusion. He continued apixaban until the night before surgery and resumed it on the first day after surgery. We performed an RVV test as point-of-care coagulation monitoring in combination with chromogenic anti-activated factor X (anti-Xa) activity, prothrombin time, and activated partial thromboplastin time. Clotting time with the RVV test was prolonged according to the anti-Xa activity of apixaban, which was in the therapeutic range during surgery. Conclusions An RVV test might be useful as a point-of-care assay for estimation of the anti-Xa level induced by apixaban during the perioperative period.

Background: Perioperative hyperglycemia is a risk factor for postoperative complications in the general population. However, it has not been clarified whether perioperative hyperglycemia increases postoperative complications in patients with type-2 diabetes mellitus (T2D). Therefore, we aimed to analyze the relationship between perioperative glycemic status and postoperative complications in non-intensive care unit (non-ICU) hospitalized patients with T2D. Materials and Methods: Medical records of 1217 patients with T2D who were admitted to the non-ICU in our hospital were analyzed retrospectively. Relationships between clinical characteristics including perioperative glycemic status and postoperative complications were assessed using univariate and multivariate analyses. Perioperative glycemic status was evaluated by calculating the mean, standard deviation (SD), and coefficient of variation (CV) of blood glucose (BG) measurements in preoperative and postoperative periods for three contiguous days before and after surgery, respectively. Postoperative complications were defined as infections, delayed wound healing, postoperative bleeding, and/or thrombosis. Results: Postoperative complications occurred in 139 patients (11.4%). These patients showed a lower BG immediately before surgery ( P = 0.04) and a higher mean postoperative BG ( P = 0.009) than those without postoperative complications. There were no differences in the other perioperative BG parameters including BG variability and the frequency of hypoglycemia. The multivariate analysis showed that BG immediately before surgery (adjusted odds ratio (95% confidence interval [CI]), 0.91 (0.85–0.98), P = 0.01) and mean postoperative BG (1.11 (1.05–1.18), P

Hydrogen (H2) converted to reducing equivalents is used by acetogens to fix and metabolize carbon dioxide (CO2) to acetate. The utilization of H2 enables not only autotrophic growth, but also mixotrophic metabolism in acetogens, enhancing carbon utilization. This feature seems useful, especially when the carbon utilization efficiency of organic carbon sources is lowered by metabolic engineering to produce reduced chemicals, such as ethanol. The potential advantage was tested using engineered strains of Moorella thermoacetica that produce ethanol. By adding H2 to the fructose-supplied culture, the engineered strains produced increased levels of acetate, and a slight increase in ethanol was observed. The utilization of a knockout strain of the major acetate production pathway, aimed at increasing the carbon flux to ethanol, was unexpectedly hindered by H2-mediated growth inhibition in a dose-dependent manner. Metabolomic analysis showed a significant increase in intracellular NADH levels due to H2 in the ethanol-producing strain. Higher NADH level was shown to be the cause of growth inhibition because the decrease in NADH level by dimethyl sulfoxide (DMSO) reduction recovered the growth. When H2 was not supplemented, the intracellular NADH level was balanced by the reversible electron transfer from NADH oxidation to H2 production in the ethanol-producing strain. Therefore, reversible hydrogenase activity confers the ability and flexibility to balance the intracellular redox state of M. thermoacetica. Tuning of the redox balance is required in order to benefit from H2-supplemented mixotrophy, which was confirmed by engineering to produce acetone.

In this study, we develop a new theoretical model for the quantitative prediction of atomic diffusion in a crystalline material. Concentration of the solute atom is expressed by a probability density function whose time evolution is governed by the Fokker–Planck equation. The stochastic differential equation describes the two competitive processes; drift motion by the stress field and thermal diffusion by the Brownian motion. Non-singular stress field by a lattice defect is obtained from nonlinear elastoplasticity on Riemann–Cartan manifold. Numerical integration is conducted using the finite difference method which satisfies the numerical stability criteria. Present analysis demonstrates the formation of Cottrell atmosphere around a straight edge dislocation. The probability density reaches to an equilibrium distribution and the time evolution satisfies the Cottrell’s theoretical prediction quantitatively. The mean diffusion path is predicted from the streamline which includes the surface effects. We also demonstrate the dislocation pipe diffusion, i.e., accelerated diffusion along a dislocation line.

The delithiation process in lithium excess cathode material of Li2MnO3 has remained unclear. Here, the authors report that delithiation is governed by the climb motion of dislocations with the aid of oxygen-release, determined directly by atomic-resolution STEM imaging and spectroscopy.

Abstract A 38‐year‐old woman with type 1 diabetes, whose fasting plasma glucose levels were >500 mg/dL under 176 U/day of subcutaneous insulin injection, was admitted to Nippon Medical School Hospital, Tokyo, Japan. When insulin was administered intravenously, she was able to maintain favorable glycemic control even under 24 U/day of regular insulin, showing that she was accompanied by subcutaneous insulin resistance. To choose an optimal insulin regimen, we carried out subcutaneous insulin challenge tests without or with heparin mixture, and found a cocktail of insulin lispro and heparin could reduce blood glucose levels markedly. As a consequence, she achieved favorable blood glucose control by continuous subcutaneous insulin infusion of the cocktail. In summary, the insulin and heparin challenge tests are useful for choosing an optimal insulin regimen in cases of subcutaneous insulin resistance.

Abstract Background McLeod syndrome is a rare X-linked recessive acanthocytosis associated with neurological manifestations including progressive chorea, cognitive impairment, psychiatric disturbances, seizures, and sensorimotor axonal polyneuropathy. However, no studies have investigated the functioning of central sensorimotor tracts in patients with McLeod syndrome. Case presentation A 66-year-old man had experienced slowly progressive chorea and gait disturbance due to lower limb muscle weakness since his early fifties. Blood examinations showed erythrocyte acanthocytosis and the reduction of Kell antigens in red blood cells. Brain magnetic resonance imaging showed atrophy of the bilateral caudate nuclei and putamen. The diagnosis of McLeod syndrome was confirmed by the presence of a mutation of the XK gene on the X chromosome. Somatosensory-evoked potential and transcranial magnetic stimulation studies demonstrated that the central sensory and motor conduction times were abnormally prolonged for the lower extremity but normal for the upper extremity. Conclusions This is the first report of the involvement of the central sensorimotor tracts for the legs in a patient with McLeod syndrome. The clinical neurophysiological technique revealed the central sensorimotor tracts involvements clinically masked by neuropathy.

Background: A prolonged QT interval plays a causal role in fatal arrhythmia and is known to be a risk factor for sudden cardiac death. Although diabetic patients with microvascular complications tend to have a longer QT interval, the therapeutic effect of diabetes on the QT interval remains unclear. Here, we assessed the changes in QT interval in patients with type 2 diabetes (T2D) who received multiple daily insulin injections. Materials and methods: Patients with T2D ( n = 34) who were admitted to our hospital and initiated multiple daily insulin injections for glycemic control were enrolled in this study. Clinical measurements, including electrocardiogram, were taken on admission and discharge. The QT interval was measured manually in lead II on the electrocardiogram, and corrected QT interval (QTc) was calculated using Bazett’s formula. The change in QTc (ΔQTc) during hospitalization (median, 15 days) and clinical parameters affecting ΔQTc were investigated. Results: QTc was shortened from 439 ± 24 to 427 ± 26 ms during hospitalization ( p

In this study, we conduct modeling and numerical analysis of a straight edge dislocation in a three-dimensional geometrically nonlinear elastic medium. Based on the fundamental framework of geometrical elasto-plasticity, kinematics of the continuum is represented by the reference R, intermediate B and current S states and local deformations are described by the multiplicative decomposition of the deformation gradient; F = Fe·Fp. Here, the reference and current states are Euclidean submanifolds while the intermediate state B is represented by Weitzenböck manifold with non-zero torsion in the affine connection. Following to the equivalence of torsion and dislocation density tensor through Hodge star operation, a plastic deformation gradient Fp is obtained from the Cartan first structure equation using the homotopy operator. The current state S is determined so that it minimizes the strain energy functional. We solve the variational problem by using isogeometric analysis; Galerkin method with non-uniform B-spline basis function. The present analysis shows that all stress components agree quantitatively well with those of the Volterra dislocation model. Around the dislocation core, stress fields are non-singular on the contrary to the Volterra dislocation. In addition, we found that all stress components distribute asymmetrically due to the geometrical nonlinearity of the model.

The decisions we make are sometimes influenced by interactions with other agents. Previous studies have suggested that the prefrontal cortex plays an important role in decision-making and that the dopamine system underlies processes of motivation, motor preparation, and reinforcement learning. However, the physiological mechanisms underlying how the prefrontal cortex and the dopaminergic system are involved in decision-making remain largely unclear. The present study aimed to determine how decision strategies influence event-related potentials (ERPs). We also tested the effect of levodopa, a dopamine precursor, on decision-making and ERPs in a randomized double-blind placebo-controlled investigation. The subjects performed a matching-pennies task against an opposing virtual computer player by choosing between right and left targets while their ERPs were recorded. According to the rules of the matching-pennies task, the subject won the trial when they chose the same side as the opponent, and lost otherwise. We set three different task rules: (1) with the alternation (ALT) rule, the computer opponent made alternating choices of right and left in sequential trials; (2) with the random (RAND) rule, the opponent randomly chose between right and left; and (3) with the GAME rule, the opponent analyzed the subject’s past choices to predict the subject’s next choice, and then chose the opposite side. A sustained medial ERP became more negative toward the time of the subject’s target choice. A biphasic potential appeared when the opponent’s choice was revealed after the subject’s response. The ERPs around the subject’s choice were greater in RAND and GAME than in ALT, and the negative peak was enhanced by levodopa. In addition to these medial ERPs, we observed lateral frontal ERPs tuned to the choice direction. The signals emerged around the choice period selectively in RAND and GAME when levodopa was administered. These results suggest that decision processes are modulated by the dopamine system when a complex and strategic decision is required, which may reflect decision updating with dopaminergic prediction error signals.

Dyspnea is a common, distressing symptom of cardiopulmonary and neuromuscular diseases and is defined as “a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity.” However, Japanese intensive care units (ICUs) do not routinely screen for dyspnea, as no validated Japanese version of the Respiratory Distress Observation Scale (RDOS) is available. Therefore, we aimed to translate the English version of this questionnaire into Japanese and assess its validity and reliability. To translate the RDOS, we conducted a prospective observational study in a 12-bed ICU of a universal hospital that included 42 healthcare professionals, 10 expert panels, and 128 ventilated patients. The English version was translated into Japanese, and several cross-sectional web-based questionnaires were administered to the healthcare professionals. After completing the translation process, a validity and reliability evaluation was performed in the ventilated patients. Inter-rater reliability was evaluated using Cohen’s weighted kappa coefficient. Criterion validity was ascertained based on the correlation between RDOS and the dyspnea visual analog scale. The area under the receiver operating characteristic curve analysis was used to evaluate the ability of the RDOS to identify patients with self-reported dyspnea. The average content validity index at the scale level was 0.95. Data from the 128 patients were collected and analyzed. Cohen’s weighted kappa coefficient and the correlation coefficient between the two scales were 0.76 and 0.443 (95% confidence intervals 0.70–0.82 and 0.23–0.62), respectively. For predicting self-reported dyspnea, the area under the receiver operating characteristic curve was 0.81 (95% confidence interval 0.67–0.97). The optimal cutoff used was 1, with a sensitivity and specificity of 0.89 and 0.61, respectively. Our findings indicated that the Japanese version of the RDOS is acceptable for face validity, understandability, criterion validity, and inter-rater reliability in lightly sedated mechanically ventilated patients, indicating its clinical utility.

This study conducts the modeling and numerical analysis of a screw dislocation in a three-dimensional continuous medium. Our modeling is based on the differential geometry of Weitzenböck manifold, i.e., a Riemann-Cartan manifold which equips itself with non-zero torsion in the affine connection. Following to the standard framework of geometrical elasto-plasticity, we introduce the three smooth manifolds representing the reference R, intermediate B and current S configurations and express the kinematics using the diffeomorphisms between them. Our primary concern is the geometrical construction of the intermediate configuration B. For a given dislocation density τ, we calculated the plastic distorsion Fp through the integration of τ by homotopy operator. This analysis yields the dual frame ϑ of the Cartan moving frame, which satisfies the first structure equation and Bianchi identity, simultaneously. The current configuration S is obtained by embedding of B to the conventional Euclidean space R3 so as to minimize the strain energy functional. The variational problem is solved numerically using the isogeometric analysis; Galerkin method with non-uniform rational B-spline basis functions. Present analysis revealed that far-field stresses around a screw dislocation agree quantitatively well with those of the Volterra dislocation. A notable difference is non-singularity at the dislocation core. Another remarkable feature is the emergence of hydrostatic pressure due to the geometrical nonlinearity. We also found that surface displacements include a vortex centered at the dislocation line. This is a realization of Eshelby twist.

A twisted nematic (TN) liquid crystal display (LCD) with embedded Ag nanoparticles (NPs) covered with a diffusion cloud exhibits peculiar frequency dependent behavior. In particular, no TN response is observed below the dielectric relaxation frequency, fR, whereas above this frequency, revival of the TN response occurs. Such a device is called a frequency modulation (FM) TN-LCD, and its behavior is attributed to the reduction of the dielectric anisotropy Δɛ far below the relaxation frequency, fR. However, above this frequency, the revival of the torque driving the TN-LCD occurs, and the TN-LCD operation is revived with a fast response speed. The reduction of Δɛ may be due to the prevalence of the amplified dielectric constant caused by the inclusions covering the entire region. However, above fR, this amplification gradually vanishes, and the normal TN-operation is revived due to the revival of dielectric torque force. In this paper, an interpretation of the FM-LCD operation through dielectric spectroscopy and equivalent circuit analysis is presented. Interpretation of the dielectric constant amplification [whose factor, AC, is equal to 52 through a postulation of negative ɛ2 for the inclusions (NPs and diffusion cloud)] is also presented.

Although previous research has characterized the important role for spatial and affective pre-cues in the control of visual attention, less is known about the impact of pre-cues on preference formation. In preference formation, the gaze cascade phenomenon suggests that the gaze serves both to enhance and express “liking” during value-based decision-making. This phenomenon has been interpreted as a type of Pavlovian approach toward preferred objects. Decision-making here reflects a process of gradual commitment in which the gaze functions as a precursor to choice; by this account, overt attention produces a necessarily positive, additive effect on the value of the attended object. The implication is that drawing attention to an object should initiate, and therefore promote, preference formation for that object. Alternatively, information-integration models of attention propose that attention produces a multiplicative effect on the value of the attended object, implying that negative information can impede preference formation. To pitch the gradual-commitment hypothesis against the information-integration hypothesis, we conducted four experiments that combined the spatial-cueing paradigm with a value-based choice paradigm. In each trial in all experiments, subjects were presented with an irrelevant, peripheral pre-cue for a duration of 500 ms, followed by a 500 ms blank, and then a pair of abstract images (one at the pre-cued position; one in the opposite hemifield). The subjects were asked to choose their preferred abstract image by pressing the corresponding button. We manipulated the type of pre-cues (images of faces versus foods; with varying affective associations) and the time constraints (a deadline of 1,500 ms versus self-paced). Overall, the choice data showed a clear pattern of influence from the pre-cues, such that, given a deadline, abstract images were chosen less often if they had been preceded by a pre-cue with a negative affective association (both for face and food images). Analyses of the gaze data showed the emergence of significant gaze biases in line with the subjects’ choices. Taken together, the data pattern provided support for the information-integration hypothesis, particularly under urgency. When tasked with a speeded preference choice, subjects showed affective disengagement following pre-cues that carried a negative association.

Autoimmune GFAP astrocytopathy is a new clinical entity and only a limited number of cases have been reported. Here we report the results of multimodal central conduction studies performed in a case of this disorder.A 72-year-old woman developed gradual cognitive decline and gait disturbance. A neurological examination revealed moderate amnesia, papilloedema, and pyramidal tract impairment of the bilateral lower limbs. The diagnosis of autoimmune GFAP astrocytopathy was made based on the typical MRI findings of periventricular radial linear gadolinium enhancement in the brain and longitudinally extensive lesions in the spinal cord, and anti-GFAP antibody detected in the cerebrospinal fluid. Somatosensory evoked potentials and transcranial magnetic stimulation studies revealed prolongation of conduction times. Visual evoked potentials showed an unusual W-shaped pattern. To our knowledge, this is the first neurophysiological demonstration of prolonged central conduction times in the autoimmune GFAP astrocytopathy. Further investigations are needed to establish the clinical value the neurophysiological examinations in this disorder. Keywords: Autoimmune GFAP astrocytopathy, Somatosensory evoked potentials, Transcranial magnetic stimulation, Central conduction time, Visual evoked potentials

Improving the performance of Li-ion batteries relies on understanding charging/discharging mechanisms. Here the authors visualize the interfacial structure and composition of a partially delithiated lithium iron phosphate single crystal as a function of time, revealing a mechanism of relaxation.

Tau is a major component of the neurofibrillary tangles (NFT) that represent a pathological hallmark of Alzheimer's disease (AD). Although generally considered an axonal protein, Tau is found in the somato-dendritic compartment of degenerating neurons and this redistribution is thought to be a trigger of neurodegeneration in AD. Here, we show the presence of tau mRNA in a dendritic ribonucleoprotein (RNP) complex that includes Ca2+-calmodulin dependent protein kinase (CaMK)IIα mRNA and that is translated locally in response to glutamate stimulation. Further, we show that Tau mRNA is a component of mRNP granules that contain RNA-binding proteins, and that it interacts with Myosin Va, a postsynaptic motor protein; these findings suggest that tau mRNA is transported into dendritic spines. We also report that tau mRNA localized in the somato-dendritic component of primary hippocampal cells and that a sub-toxic concentration of glutamate enhances local translation and hyperphosphorylation of tau, effects that are blocked by the gluatamatergic antagonists MK801 and NBQX. These data thus demonstrate that alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) and N-methyl-d-aspartate (NMDA) stimulation redistributes tau to the somato-dendritic region of neurons where it may trigger neurodegeneration.

Tau is a microtubule-associated protein, localizing mainly in the axon of mature neurons. Phenotypic analysis of Tau knockout mice has revealed an impairment of synaptic plasticity but without gross changes in brain morphology. Since we previously described the presence of tau mRNA in the somatodendritic compartment, including the postsynapse, and demonstrated that it could be locally translated in response to glutamate, it appears that the regulated translation of synaptic tau can have a direct impact on synaptic function. Using SH-SY5Y cells, we herein confirm that glutamate dose-dependently regulates the translation of tau protein without altering tau mRNA levels. This is supported by the finding that cycloheximide blocks glutamate-stimulated increases in tau protein levels. Our observation that neural excitation can directly upregulate tau mRNA translation helps explain the pathological accumulation of tau in the somatodendrite.

Risk derives from the variation of rewards and governs economic decisions, yet how the brain calculates risk from the frequency of experienced events, rather than from explicit risk-descriptive cues, remains unclear. Here, we investigated whether neurons in dorsolateral prefrontal cortex process risk derived from reward experience. Monkeys performed in a probabilistic choice task in which the statistical variance of experienced rewards evolved continually. During these choices, prefrontal neurons signaled the reward-variance associated with specific objects (‘object risk’) or actions (‘action risk’). Crucially, risk was not derived from explicit, risk-descriptive cues but calculated internally from the variance of recently experienced rewards. Support-vector-machine decoding demonstrated accurate neuronal risk discrimination. Within trials, neuronal signals transitioned from experienced reward to risk (risk updating) and from risk to upcoming choice (choice computation). Thus, prefrontal neurons encode the statistical variance of recently experienced rewards, complying with formal decision variables of object risk and action risk.

Background and study aims In Japan, intramucosal gastric adenocarcinoma with ulcerative finding having a predominantly differentiated type with an undifferentiated component, tumor diameter ≤ 3 cm, and no lymphovascular invasion is included in the expanded pathological criteria for curative endoscopic treatment. This indication is based on retrospective examination of surgical resection cases, and is determined to have a negligible risk of lymph node metastasis (LNM). We performed endoscopic submucosal dissection on a 78-year-old man with early gastric cancer in 2011, and pathology revealed a well-differentiated tubular adenocarcinoma (21 × 10 mm in diameter), with poorly differentiated adenocarcinoma components, limited to the mucosa, fibrosis by ulcer scar in the submucosal layer, no lymphovascular invasion, and tumor-free margins. Resection was determined to be curative under expanded indications of the gastric cancer treatment guidelines, 4th edition. However, 55 months after the initial diagnosis, invasive local and distant recurrence was noted. Ultimately, the patient died of gastric cancer 3 months after recurrence.

The well-known gaze cascade hypothesis proposes that as people look longer at an item, they tend to show an increased preference for it. However, using single food images as stimuli, we recently obtained results that clearly deviated from the general proposal that the gaze both expresses and influences preference formation. Instead, the pattern of data depended on the self-determination of exposure duration as well as the type of evaluation task. In order to disambiguate how the type of evaluation determines the relationship between viewing and liking we conducted the present follow-up study, with a fixed response set size as opposed to the varying set sizes in our previous study. In non-exclusive evaluation tasks, subjects were asked how much they liked individual food images. The recorded response was a number from 1 to 3. In exclusive evaluation tasks, subjects were asked for each individual food image to give one of three response options toward a limited selection: include it, exclude it, or defer the judgment. When subjects were able to determine the exposure duration, both the non-exclusive and exclusive evaluations produced inverted U-shaped trends such that the polar ends of the evaluation (the positive and negative extremes) were associated with relatively short viewing times, whereas the middle category had the longest viewing times. Thus, the data once again provided firm evidence against the notion that longer viewing facilitates preference formation. Moreover, the fact that non-exclusive and exclusive evaluation produced similar inverted U-shaped patterns suggests that the response set size is the critical factor that accounts for the observations here versus in our previous study. When keeping the response set size constant, with an equal opportunity to observe inverted U-shaped patterns, the findings are suggestive of a role for the level of decisiveness in determining the length of viewing time. For items that can be categorically identified as positive or negative, the evaluations are soon completed, with relatively brief viewing times. The prolonged visual inspection for the middle category may reflect doubt or uncertainty during the evaluative processing, possibly with an increased effort of information integration before reaching a conclusion.

Solid electrolytes, such as perovskite Li3xLa2/1−xTiO3, LixLa(1−x)/3NbO3 and garnet Li7La3Zr2O12 ceramic oxides, have attracted extensive attention in lithium-ion battery research due to their good chemical stability and the improvability of their ionic conductivity with great potential in solid electrolyte battery applications. These solid oxides eliminate safety issues and cycling instability, which are common challenges in the current commercial lithium-ion batteries based on organic liquid electrolytes. However, in practical applications, structural disorders such as point defects and grain boundaries play a dominating role in the ionic transport of these solid electrolytes, where defect engineering to tailor or improve the ionic conductive property is still seldom reported. Here, we demonstrate a defect engineering approach to alter the ionic conductive channels in LixLa(1−x)/3NbO3 (x = 0.1~0.13) electrolytes based on the rearrangements of La sites through a quenching process. The changes in the occupancy and interstitial defects of La ions lead to anisotropic modulation of ionic conductivity with the increase in quenching temperatures. Our trial in this work on the defect engineering of quenched electrolytes will offer opportunities to optimize ionic conductivity and benefit the solid electrolyte battery applications.

This paper reports the generation of an extra phase and the accompanying temporal effects in an asymmetric optically compensated in-pane-switching (IPS) liquid crystal (LC) system and a fringe-field-switching (FFS) liquid crystal display (LCD) exhibiting a twofold faster response speed in the switching-off process compared with that in single and symmetric IPS-LCDs and FFS LCDs for the first time. To explain the experimental results, we derived an approximate analytical formula for the optical output intensity that includes an extra phase advancement and conducted simulations to achieve normally black operation using a dynamic optical retarder.

Economic decisions are based on perceived reward value but it is unclear how individual neurons encode value estimates as input for decision mechanisms. Here authors show that dorsolateral prefrontal cortex uses a dynamic value code based on object-specific valuations by single neurons.

Parkinson's disease (PD) patients experience various symptoms including extrapyramidal motor disturbances and cognitive impairments, which cause difficulties in daily life. However, PD patients have rarely been studied under realistic task situations that require high-level interaction of cognitive and motor skills. The aim of this study was to investigate the contribution of cognitive and motor factors to the performance of PD patients under high cognitive and kinematic loads. Twenty-six PD patients and 14 control subjects participated in the study. The PD patients performed a task involving hitting targets and avoiding distractors in levodopa On and Off states. A robotic manipulandum device recorded the numbers of target and distractor hits and hand kinematics, including movement area and speed. Performance on standard cognitive batteries and the Movement Disorder Society – Unified Parkinson's Disease Rating Scale motor scores were examined. The results indicated that the PD patients hit significantly fewer targets and more distractors than did the controls (p < 0.05). In PD patients, the average hand speed was slower and the area of hand movement was smaller than those of the control subjects (p < 0.001). Levodopa significantly increased the average hand speed and movement area (p < 0.01), but levodopa had an insignificant effect on the number of correct targets hit and erroneous distractor hits. The scores of cognitive batteries predicted the performance with regard to both targets hit and distractor avoidance. Our results were indicative of a dynamic interaction between cognitive and kinematic skills while the PD patients performed a virtual reality game. Single-dose levodopa enhanced kinematic capacity, and the global intelligence level predicted game performance.

Previous research suggested a role of gaze in preference formation, not merely as an expression of preference, but also as a causal influence. According to the gaze cascade hypothesis, the longer subjects look at an item, the more likely they are to develop a preference for it. However, to date the connection between viewing and liking has been investigated predominately with self-paced viewing conditions in which the subjects were required to select certain items from simultaneously presented stimuli on the basis of perceived visual attractiveness. Such conditions might promote a default, but non-mandatory connection between viewing and liking. To explore whether the connection is separable, we examined the evaluative processing of single naturalistic food images in a 2 × 2 design, conducted completely within subjects, in which we varied both the type of exposure (self-paced versus time-controlled) and the type of evaluation (non-exclusive versus exclusive). In the self-paced exclusive evaluation, longer viewing was associated with a higher likelihood of a positive evaluation. However, in the self-paced non-exclusive evaluation, the trend reversed such that longer viewing durations were associated with lesser ratings. Furthermore, in the time-controlled tasks, both with non-exclusive and exclusive evaluation, there was no significant relationship between the viewing duration and the evaluation. The overall pattern of results was consistent for viewing times measured in terms of exposure duration (i.e., the duration of stimulus presentation on the screen) and in terms of actual gaze duration (i.e., the amount of time the subject effectively gazed at the stimulus on the screen). The data indicated that viewing does not intrinsically lead to a higher evaluation when evaluating single food images; instead, the relationship between viewing duration and evaluation depends on the type of task. We suggest that self-determination of exposure duration may be a prerequisite for any influence from viewing time on evaluative processing, regardless of whether the influence is facilitative. Moreover, the purported facilitative link between viewing and liking appears to be limited to exclusive evaluation, when only a restricted number of items can be included in a chosen set.

A 44-year-old man presenting to our hospital emergency room with abdominal pain was hospitalized for hyperlipidemic acute pancreatitis. A pig-tail catheter was placed percutaneously to drain an abscess on day 22. Although the abscess improved gradually and good clinical progress was seen, pancreatic duct disruption was strongly suspected and endoscopic retrograde cholangiopancreatography was performed on day 90. An endoscopic nasopancreatic drainage tube was placed, but even with concurrent use of a somatostatin analogue, treatment was ineffective. Surgical treatment was elected, but was subsequently postponed as the abscess culture was positive for extended-spectrum β-lactamase-producing Escherichia coli and methicillin-resistant Staphylococcus aureus. Drainage tubography showed a small fistula of the colon at the splenic flexure on day 140. Colonoscopy was performed on day 148. After indigo carmine had been injected, a fistula into the splenic flexure of the colon showed blue staining. The over-the-scope clip (OTSC) system was used to seal the fistula and complete closure was shown. A liquid diet was started on day 159 and was smoothly upgraded to a full diet. Following removal of the pancreatic stent on day 180, drainage volume immediately decreased and the percutaneous drain was removed. On day 189, computed tomography showed no exacerbation of the abscess and the patient was discharged on day 194. This case of colonic fistula caused by severe acute pancreatitis was successfully treated using the OTSC system, avoiding the need for an open procedure.

We examined the effects of lomerizine on serotonin (5-hydroxytryptamine, 5-HT)– induced contraction of the basilar artery and compared them with those of nifedipine. Although both lomerizine and nifedipine completely blocked K+-induced vasoconstriction, 5-HT–induced vasoconstriction was more strongly inhibited by lomerizine than nifedipine. A 5-HT2A antagonist inhibited the 5-HT–induced vasoconstriction, but a 5-HT1B antagonist did not. Lomerizine, but not nifedipine, suppressed 5-HT–induced Ca2+ release in 5-HT2A–expressing HEK293 cells. Moreover, neither antagonist affected ATP-induced Ca2+ release. These results suggest that lomerizine may inhibit not only voltage-dependent Ca2+ channels but also 5-HT2A receptors and so inhibit 5-HT–induced contraction in the basilar artery. Keywords:: lomerizine, serotonin (5-hydroxytryptamine), basilar artery

Nature Communications 7: Article number: 12554 (2016); Published: 13 September 2016; Updated: 23 November 2017. The previously published version of this Article contained an error in Figure 1. In panel b the x and y axis labels of the scatter graph were inadvertently inverted. This error has been corrected in both the PDF and HTML versions of the Article.

Hereditary predisposition to diet-induced type 2 diabetes has not yet been fully elucidated. We recently established 2 mouse lines with different susceptibilities (resistant and prone) to high-fat diet (HFD)-induced glucose intolerance by selective breeding (designated selectively bred diet-induced glucose intolerance-resistant [SDG-R] and -prone [SDG-P], respectively). To investigate the predisposition to HFD-induced glucose intolerance in pancreatic islets, we examined the islet morphological features and functions in these novel mouse lines. Male SDG-P and SDG-R mice were fed a HFD for 5 weeks. Before and after HFD feeding, glucose tolerance was evaluated by oral glucose tolerance test (OGTT). Morphometry and functional analyses of the pancreatic islets were also performed before and after the feeding period. Before HFD feeding, SDG-P mice showed modestly higher postchallenge blood glucose levels and lower insulin increments in OGTT than SDG-R mice. Although SDG-P mice showed greater β cell proliferation than SDG-R mice under HFD feeding, SDG-P mice developed overt glucose intolerance, whereas SDG-R mice maintained normal glucose tolerance. Regardless of whether it was before or after HFD feeding, the isolated islets from SDG-P mice showed impaired glucose- and KCl-stimulated insulin secretion relative to those from SDG-R mice; accordingly, the expression levels of the insulin secretion-related genes in SDG-P islets were significantly lower than those in SDG-R islets. These findings suggest that the innate predispositions in pancreatic islets may determine the susceptibility to diet-induced diabetes. SDG-R and SDG-P mice may therefore be useful polygenic animal models to study the gene-environment interactions in the development of type 2 diabetes.

Drug therapy with selective serotonin reuptake inhibitors (SSRIs) has been used as a treatment for obsessive-compulsive disorder (OCD). In the present case report, exposure therapy was used in addition to escitalopram (20 mg) to treat a 28-year-old female patient with OCD for 6 months. Her obsessive-compulsive symptoms comprised thoughts of words such as rape, crematorium, neck hanging, unhappy, death, die, and kill and images such as a shelf of gods, a shrine, a Buddhist altar, the sun, the sky, and the faces of her parents, siblings, and relatives. As exposure therapy, she was asked to view the images associated with these symptoms three times a day along with drug therapy. With the combination of drug and exposure therapies, her obsessive-compulsive symptoms improved within 6 months, with no interference in her daily life. Multichannel near-infrared spectroscopy (NIRS) showed improvement of brain function in the temporal and frontal lobes after treatment. These results suggest that NIRS can be used as an indicator of brain function improvement in patients with OCD.