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Abstract This study aimed to evaluate the incidence and likelihood of antibiotic-associated encephalopathy (AAE), comparing rates among the classes of antibiotics in monotherapy or in combination therapy. We also investigated the associations between the incidence of AAE and the glomerular filtration rate (GFR) and electroencephalogram features. Consecutive admissions that used any kind of antibiotics to treat infectious diseases were identified from six hospitals. We classified antibiotics according to three distinct pathophysiologic mechanisms and clinical subtypes. We searched for the incidence of AAE as the primary outcome. A total of 97,433 admission cases among 56,038 patients was identified. Cases that received type 1 antibiotics had significantly more frequent AAE compared to those that received type 2 antibiotics (adjusted odds ratio [OR], 2.62; 95% confidence interval [CI] 1.15–5.95; P = 0.021). Combined use of type 1 + 2 antibiotics was associated with a significantly higher incidence of AAE compared to the use of type 2 antibiotics alone (adjusted OR, 3.44; 95% CI 1.49–7.93; P = 0.004). Groups with GFR

This work proposes LiquidListener, a novel liquid volume sensing method for containers. Specifically, it enables the ubiquitous measurement of liquid volume not available in existing work due to ${i}$ ) dependencies on dedicated sensing hardware (e.g., capacity sensors) and containers (e.g., transparent containers) and ii) a high training intensity. A key enabler of LiquidListener is listening to singing sounds. When a user taps a container using solid objects, such as pens and teaspoons, the container vibrates freely and produces a singing sound. As the container is filled with more liquid, the pitch of the sound decreases. Based on this relationship, we develop acoustic-based liquid volume sensing algorithms that support the precise measurement of liquid volume while using only a smartphone and requiring minimal user effort for calibration. The extensive experiments demonstrate that LiquidListener can support high accuracy with an average error ratio of 2.3% in sensing the liquid volume in various containers. In addition, the experimental results indicate that it can still maintain a similar level of accuracy in diverse and dynamically changing environments, even without additional calibration.

Background: According to the International Standard (ISO10993-4), a test model using human blood must be used for blood compatibility evaluation of medical devices. However, various safety investigations have reported outcomes from animal models simulating clinical conditions. Additionally, the validation of animal blood in blood compatibility assessment models is limited. In this study, the differences in the reactivity of different species to coagulation and complement, as well as the main mechanisms governing blood clot formation upon contact with medical devices, were examined. Moreover, it aimed to acquire information required to design a hemocompatibility evaluation model and interpret the results. Results: Rabbits, porcine, rhesus monkeys, and cynomolgus monkeys were exposed to one negative and two positive control substances, and variations in the partial thromboplastin time (PTT) were observed. The activity of the complement system was observed in accordance with the test method in ISO 10993-4. Although the PTT absolute values varied across animal species, the normalized PTT values—61% for rabbits, 66% for pigs, 63% for rhesus monkeys, and 65% for cynomolgus monkeys—exhibited no statistically significant differences. After reacting human and porcine sera with the material, the test model using human serum distinguished the positive and negative control candidates, whereas the test model using porcine serum could not discriminate them. Conclusions: These results suggest similar reactivity in blood coagulation across species after substance contact. However, complement system activity indicated a significant difference in reactivity between human and porcine blood. This finding will be useful in the design of a blood compatibility evaluation model for medical devices and interpretation of the results.

The northwestern Pacific region is an important habitat for sea turtles, hosting five species out of seven. There is still limited information available about the sea turtle aggregations around the Korean Peninsula, which is the northern boundary for many sea turtle species in the western Pacific area. The present study aims to investigate the migratory route of sea turtles visiting Jeju Island. Five species of sea turtles were identified from by-catch and stranding data between 2013 and 2022 on Jeju Island in Korea: green (Chelonia mydas; 24 individuals), loggerhead (Caretta caretta; 9), hawksbill (Eretmochelys imbricata; 2), olive ridley (Lepidochelys olivacea; 2), and leatherback (Dermochelys coriacea; 1). Mixed stock analysis using mitochondrial DNA haplotypes revealed that Jeju green turtles primarily originate from the rookeries of the Japanese Archipelago. This connectivity between two regions was also supported by the similar genetic composition of loggerhead turtles. Similarly, satellite tracking data showed that several green turtles originating from Jeju Island migrated to waters near the Ryukyu Archipelago in Japan. Nevertheless, about 60% of the tracked green turtles stayed near Jeju Island, with most overwintering there, indicating the long residency in Jeju Island. This study also provides the genetic sequences of other three species including new orphan haplotypes of hawksbill and olive ridley turtles. Our findings suggest that Jeju Island serves as a stable foraging habitat and provide insight into understanding the habitat range of sea turtles in the western Pacific.

Background: This study was conducted to confirm the reliability of an in vitro mechanically induced hemolysis test (ISO 10993-4:2017), which is essential for ensuring the safety of blood pumps. Methods: For appropriate anticoagulant selection, porcine blood was prepared in anticoagulant citrate dextrose solution A (ACD-A), heparin, and citrate phosphate dextrose adenine (CPDA-1), respectively, according to the ASTM F1830 standard. Anticoagulant-treated porcine and bovine blood were circulated in a mock circulatory loop (MCL) for 6 h to observe the rate of plasma-free hemoglobin (pfHb) and RBCs with morphological integrity. Results: A morphological loss of red blood cells (RBCs) was observed over time. While there were differences in morphological loss depending on the anticoagulant, no consistent trend could be identified. The pfHb concentration was significantly higher in bovine than in porcine blood. Conversely, the number of RBCs with morphological integrity decreased over time in both, but the ratio of RBCs with morphological integrity was similar across all timepoints. Conclusions: The percentage of RBCs with morphological integrity can be used as a reliable indicator for the interpretation of mechanically induced hemolysis results in different blood types. Furthermore, the reliability of the in vitro mechanically induced hemolysis test (ISO 10993-4:2017) was assessed.

Purpose We evaluated the associations between serum complement levels and tuberculous meningitis (TBM), bacterial meningitis (BM), and viral meningitis (VM), as well as the association between serum complement levels and mortality in TBM. Methods Background information and blood/cerebrospinal fluid analysis results were collected from 2009 to 2019. Patients who had serum complement level data collected at admission and who were diagnosed with TBM (n = 97), BM (n = 31), or VM (n = 557) were enrolled. Results Initial serum complement levels were significantly lower in the TBM group than the VM group in both the total population and the propensity score-matched population. In the TBM and VM groups, compared to patients with initial highest-quartile C4 level, patients in the lowest quartile (C4 < 24.3 mg/dL) had significantly greater odds of TBM diagnosis (odds ratio, 2.2; 95% confidence interval, 1.0–4.5; p = 0.038). In the TBM group, patients with the lowest-quartile C3 level (

Abstract Background Hypertension has been associated with Alzheimer’s disease (AD) dementia as well as vascular dementia. However, the underlying neuropathological changes that link hypertension to AD remain poorly understood. In our study, we examined the relationships of a history of hypertension and high current blood pressure (BP) with in vivo AD pathologies including β-amyloid (Aβ) and tau and also investigated whether a history of hypertension and current BP respectively affect the association between Aβ and tau deposition. Methods This cross-sectional study was conducted as part of the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer’s Disease, a prospective cohort study. Cognitively normal older adults who underwent both Aβ and tau positron emission tomography (PET) (i.e., [11C]-Pittsburgh compound B and [18F] AV-1451 PET) were selected. History of hypertension and current BP were evaluated and cerebral Aβ and tau deposition measured by PET were used as main outcomes. Generalized linear regression models were used to estimate associations. Results A total of 68 cognitively normal older adults (mean [SD] age, 71.5 [7.4] years; 40 women [59%]) were included in the study. Neither a history of hypertension nor the current BP exhibited a direct association with Aβ or tau deposition. However, the synergistic interaction effects of high current systolic (β, 0.359; SE, 0.141; p = 0.014) and diastolic (β, 0.696; SE, 0.158; p < 0.001) BP state with Aβ deposition on tau deposition were significant, whereas there was no such effect for a history of hypertension (β, 0.186; SE, 0.152; p = 0.224). Conclusions The findings suggest that high current BP, but not a history of hypertension, synergistically modulate the relationship between cerebral Aβ and tau deposition in late-life. In terms of AD prevention, the results support the importance of strict BP control in cognitively normal older adults with hypertension.

Ghost crabs, as a species of the Ocypode within the subfamily Ocypodinae, are distributed in the upper intertidal zone worldwide and are ecologically remarkable. They play an important role in the energy circulation in the intertidal zone and are used as an ecological indicator to predict the impacts of environmental change or anthropogenic activities on the marine ecosystem. In this study, we provide the first evidence for the distribution of O. sinensis in Jeju Island and the southern coastal area on the Korean Peninsula. We generated a high-fidelity mitochondrial genome (mitogenome) for the species. The mitogenome was assembled into a circular chromosome of 15,589 bp, including 13 protein-coding genes, two ribosomal RNA genes, and twenty-two transfer RNA genes. High genetic variation compared with closely related species enabled the precise reconstruction of phylogenetic relationships and an estimation of the divergence times among the Ocypode species. The phylogenetic inference indicated that O. sinensis forms a monophyletic clade with O. cordimanus and diverged from ancestral species approximately 20.41 million years ago.

In the crustacean immune system, leucine-rich repeat (LRR) is one of the major structures for recognizing pathogen-associated molecular patterns (PAMPs). LRR domain-containing proteins belong to the LRR family, which is a large group of proteins with more than 6000 genes in the database. They are involved in very diverse physiological functions, mainly by interacting with other proteins. In a previous study, the LvLRRm, a transmembrane protein containing only LRR domain, was identified in the white leg shrimp, Litopenaeus vannamei. Its versatile role in performing multiple immunomodulation activities has been reported. However, there is still a lack of research on its efficient function at the protein level. To investigate its interactions with other proteins, we applied a convenient method called the ‘Hybrid LRR technique’ to produce a recombinant LvLRRm. The LvLRRm and hagfish’s variable lymphocyte receptors (VLRs) fragments were fused to the conserved LxxLxLxxN motif while retaining the β-strand. In addition, we established interactions between hybrid proteins and the flagellin of Salmonella typhimurium by performing surface plasmon resonance (SPR) analysis. The results of the SPR analysis demonstrated notable affinity for both LvLRRm and hybrid proteins towards Salmonella flagellin. The designed LvLRRm hybrid proteins bring insight for universal applications without losing protein functions.

Abstract Animals living in extreme environments, such as hydrothermal vents, would be expected to have evolved protective shells or exoskeletons to maintain homeostasis. The outer part of the exoskeleton of vent crabs (Austinograea sp.) in the Indian Ocean hydrothermal vent was one of the hardest (approximately 7 GPa) biological materials ever reported. To explore the exoskeletal characteristics of vent crabs which enable them to adapt to severe environments, a comparative analysis was conducted with the Asian paddle crab (Charybdis japonica) living in coastal areas. Nanoindentation, thermogravimetric analysis, scanning electron microscopy, energy dispersive x-ray analysis, and Raman spectroscopy were used to analyze the mechanical properties, thermal stability, structure, surface components, and the composition of compounds, respectively. Though both species have four-layered exoskeletons, the outermost layer of the vent crab, a nano-granular structure, was much thicker than that of the coastal crab. The proportions of aluminum and sulfur that constitute the epicuticle of the exoskeleton were higher in the vent crab than in the coastal crab. There was a lack of water or volatile substances, lots of CaCO3, and no carotenoid-based compounds in the exoskeleton of the vent crab. These might have improved the mechanical properties and thermal stability of the hydrothermal species.

Background Although decades have passed since the introduction of pharmacologically induced hypertensive therapy (PIHT) against early neurologic deterioration (END) in acute ischemic stroke, the optimal duration of PIHT remains elusive. Case Report A 70-year-old man developed right hemiplegia and aphasia 25 hours before arrival. Computed tomography angiography (CTA) revealed acute infarction in the left middle cerebral artery (MCA) territory and occlusion of the left internal carotid artery. He experienced END 36 hours after admission, and CTA revealed a newly developed proximal MCA occlusion. PIHT was initiated to augment cerebral perfusion. As his neurologic symptoms were highly dependent on blood pressure, PIHT was inevitably sustained for over 3 weeks. Follow-up CTA revealed recanalization of the MCA. Conclusion Although further investigation is required to expedite the future clinical application, prolonged PIHT may serve as a viable collateral-enhancing treatment for a certain subset of patients with END without alternative treatment options.

The gut microbiome influences the development of allergic diseases during early childhood. However, there is a lack of comprehensive understanding of microbiome-host crosstalk. Here, we analyzed the influence of gut microbiome dynamics in early childhood on atopic dermatitis (AD) and the potential interactions between host and microbiome that control this homeostasis. We analyzed the gut microbiome in 346 fecal samples (6–36 months; 112 non-AD, 110 mild AD, and 124 moderate to severe AD) from the Longitudinal Cohort for Childhood Origin of Asthma and Allergic Disease birth cohort. The microbiome-host interactions were analyzed in animal and in vitro cell assays. Although the gut microbiome maturated with age in both AD and non-AD groups, its development was disordered in the AD group. Disordered colonization of short-chain fatty acids (SCFA) producers along with age led to abnormal SCFA production and increased IgE levels. A butyrate deficiency and downregulation of GPR109A and PPAR-γ genes were detected in AD-induced mice. Insufficient butyrate decreases the oxygen consumption rate of host cells, which can release oxygen to the gut and perturb the gut microbiome. The disordered gut microbiome development could aggravate balanced microbiome-host interactions, including immune responses during early childhood with AD.

Abstract Administering anodal transcranial direct current stimulation at the left dorsal premotor cortex (PMd) but not right PMd throughout the repetitive practice of three novel motor sequences resulted in improved offline performance usually only observed after interleaved practice. This gain only emerged following overnight sleep. These data are consistent with the proposed proprietary role of left PMd for motor sequence learning and the more recent claim that PMd is central to sleep-related consolidation of novel skill memory.

Abstract We evaluated the association between hyponatremia and tuberculous meningitis (TBM) with the aim of providing additional information for differential diagnosis from other types of infectious meningitis, especially viral meningitis (VM). Cross-sectional and longitudinal data involving 5026 participants older than 18 years were analyzed in the total population and a propensity-matched population. The initial and lowest sodium levels and longitudinal changes in TBM, bacterial meningitis (BM), and VM patients were compared. Participants in the TBM group were enrolled when they were diagnosed as possible, probable, or definite TBM according to the Marais’ criteria. The initial serum sodium level was significantly lower in TBM patients than in BM and VM patients (136.9 ± 5.9 vs. 138.3 ± 4.7 mmol/L, p

In the present vignette, we describe a lateral medullary infarction developed immediately after strenuous straining owing to constipation in a 42-year-old female. There was a dissection in left vertebral artery V4 segment. Computed tomography (CT) angiography revealed beaded appearance of cervical V2 and V3 segments of bilateral vertebral arteries. A follow-up CT angiogram performed about 3 months later showed resolution of vasoconstriction and normalization of vertebral arteries. Reversible cerebral vasoconstriction syndrome (RCVS) is usually known as an intracranial pathologic condition. Extracranial RCVS is very rare. Therefore, the diagnosis of RCVS could be challenging when its location is extracranial, particularly when comingling vertebral artery dissection (VAD) is present because of their similar vascular luminal morphology. Physician should be vigilant about the possibility of a concomitant presence of RCVS and VAD, even in extracranial vessels.

When performing remote tasks using robots in nuclear power plants, a 3D shape measurement system is advantageous in improving the efficiency of remote operations by easily identifying the current state of the target object for example, size, shape, and distance information. Nuclear power plants have high-radiation and underwater environments therefore the electronic parts that comprise 3D shape measurement systems are prone to degradation and thus cannot be used for a long period of time. Also, given the refraction caused by a medium change in the underwater environment, optical design constraints and calibration methods for them are required. The present study proposed a method for developing an underwater 3D shape measurement system with improved radiation tolerance, which is composed of commercial electric parts and a stereo camera while being capable of easily and readily correcting underwater refraction. In an effort to improve its radiation tolerance, the number of parts that are exposed to a radiation environment was minimized to include only necessary components, such as a line beam laser, a motor to rotate the line beam laser, and a stereo camera. Given that a signal processing circuit and control circuit of the camera is susceptible to radiation, an image sensor and lens of the camera were separated from its main body to improve radiation tolerance. The prototype developed in the present study was made of commercial electric parts, and thus it was possible to improve the overall radiation tolerance at a relatively low cost. Also, it was easy to manufacture because there are few constraints for optical design.

In the literature, several adult cases with myelin oligodendrocyte glycoprotein (MOG) antibodies (Abs)-associated disorders have been reported to have seizure and acute disseminated encephalomyelitis (ADEM) as the main clinical manifestations, but the number is somewhat low. Because of its rarity, the clinical characteristics and a consensus on treatment have not yet been established in the adult form of ADEM and seizure phenotypes in MOG-Abs-associated disorders. In this report, we described an adult patient who presented with status epilepticus as the index event, had been suffering from chronic epilepsy, and had positive antibodies for MOG. Neither increasing the doses of the antiseizure drugs (ASDs) nor adding another new ASD reduced the prevalence of the seizures. However, he became seizure-free after the addition of azathioprine and incremental increases of methylprednisolone dosage. This case clearly indicates the effectiveness of corticosteroid and azathioprine, as well as the futility of ASDs in the management of seizure control by showing the temporal trajectory relationship among ASDs, steroids, azathioprine and seizure frequency.

Background: Although low-intensity transcranial ultrasound stimulation (LI-TUS) has received more recognition for its neuromodulation potential, there remains a crucial knowledge gap regarding the neuromodulatory effects of LI-TUS and its potential for translation as a therapeutic tool in humans.Objective: In this review, we summarized the findings reported by recently published studies regarding the effect of LI-TUS on neuromodulation in both animals and humans. We also aim to identify challenges and opportunities for the translation process.Methods: A literature search of PubMed, Medline, EMBASE, and Web of Science was performed from January 2019 to June 2020 with the following keywords and Boolean operators: [transcranial ultrasound OR transcranial focused ultrasound OR ultrasound stimulation] AND [neuromodulation]. The methodological quality of the animal studies was assessed by the SYRCLE's risk of bias tool, and the quality of human studies was evaluated by the PEDro score and the NIH quality assessment tool.Results: After applying the inclusion and exclusion criteria, a total of 26 manuscripts (24 animal studies and two human studies) out of 508 reports were included in this systematic review. Although both inhibitory (10 studies) and excitatory (16 studies) effects of LI-TUS were observed in animal studies, only inhibitory effects have been reported in primates (five studies) and human subjects (two studies). The ultrasonic parameters used in animal and human studies are different. The SYRCLE quality score ranged from 25 to 43%, with a majority of the low scores related to performance and detection bias. The two human studies received high PEDro scores (9/10).Conclusion: LI-TUS appears to be capable of targeting both superficial and deep cerebral structures to modulate cognitive or motor behavior in both animals and humans. Further human studies are needed to more precisely define the effective modulation parameters and thereby translate this brain modulatory tool into the clinic.

7,3′,4′-Trihydroxyisoflavone (7,3′,4′-THIF) is a metabolite of daidzein which is a representative isoflavone found in soybean. Recent studies suggested that 7,3′,4′-THIF exerts a hypopigmentary effect in B16F10 cells, however, its underlying molecular mechanisms and specific target protein remain unknown. Here, we found that 7,3′,4′-THIF, but not daidzein, inhibited α-melanocyte-stimulating hormone (MSH)-induced intracellular and extracellular melanin production in B16F10 cells by directly targeting melanocortin 1 receptor (MC1R). Western blot data showed that 7,3′,4′-THIF inhibited α-MSH-induced tyrosinase, tyrosinase-related protein-1 (TYRP-1), and tyrosinase-related protein-2 (TYRP-2) expressions through the inhibition of Microphthalmia-associated transcription factor (MITF) expression and cAMP response element-binding (CREB) phosphorylation. 7,3′,4′-THIF also inhibited α-MSH-induced dephosphorylation of AKT and phosphorylation of p38 and cAMP-dependent protein kinase (PKA). cAMP and Pull-down assays indicated that 7,3′,4′-THIF strongly inhibited forskolin-induced intracellular cAMP production and bound MC1R directly by competing with α-MSH. Moreover, 7,3′,4′-THIF inhibited α-MSH-induced intracellular melanin production in human epidermal melanocytes (HEMs). Collectively, these results demonstrate that 7,3′,4′-THIF targets MC1R, resulting in the suppression of melanin production, suggesting a protective role for 7,3′,4′-THIF against melanogenesis.

The Antarctic limpet, Nacella concinna, is one of the most abundant benthic marine invertebrates found in the intertidal zone of King George Island, Antarctica. The shell of N. concinna is often encrusted with the coralline algae Clathromorphum obtectulum. In this study, to reveal the relationship between the limpet and coralline algae, we examined how the coralline algae affect the physical condition (survival and health) and morphology of the limpet. We cultured the limpets for 22 days and compared mortality, weight, condition factor (CF), fatty acid content, and the structure of the shell surface between limpets both with and without coralline algae in the laboratory. We also measured the environmental factors (i.e., temperature, pH, and salinity) of the seawater at each sampling site and the CF of the limpets and correlated them with coverage of coralline algae. The presence of coralline algae significantly increased the mortality of the limpets by 40% and the shell weight by 1.4-fold but did not affect the CF. Additionally, coralline algae altered the fatty acid profiles related to the limpet’s lipid metabolism (saturated fatty acids (SFA) and some polyunsaturated fatty acids (PUFA)). Specifically, C16:0, C17:0, C18:0, and total SFA increased, whereas C18:2 and C18:3 decreased. However, observations with a scanning electron microscope showed that shell damage in limpets with coralline algae was much less than in limpets without coralline algae, suggesting that coralline algae may provide protection against endolithic algae. The area of coralline algae on the limpet shell was positively correlated with the pH and temperature of the seawater. The results suggest that although coralline algae are generally assumed to be parasitical, the relationship between N. concinna and coralline algae may change to mutualism under certain conditions.

Hydrothermal vents are chemosynthetically driven ecosystems and one of the most extreme environments on Earth. Vent communities exhibit remarkable taxonomic novelty at the species and supra-species levels, and over 80% of vent species are endemic. Here, we used mitochondrial DNA to identify the biogeographic distribution of Munidopsis lauensis and the heme-binding regions of A1-type COX1 from six species (including M. lauensis) to investigate whether genetic variation in the protein structure affects oxygen-binding ability. We verified the identity of Indian Ocean specimens by comparing sequences from the barcoding gene mitochondrial cytochrome oxidase subunit 1 (COI) with known M. lauensis sequences from the NCBI database. The data show that these are the first recorded specimens of M. lauensis in the Indian Ocean; previously, this species had been reported only in the southwest Pacific. Our findings support the hypothesis that vent fauna in the Pacific and Indian Oceans can interact via active ridges. In the case of the mitochondrial DNA-binding site, the arrangement of heme-binding ligands and type A1 motif of M. lauensis was identical to that in other species. Moreover, our findings suggest that the mechanism of oxygen binding is well conserved among species from terrestrial organisms to hydrothermal extremophiles. Overall, dispersal of the same species to geologically separated hydrothermal vents and conserved heme-binding regions in mitochondrial proteins suggest that hydrothermal species might have evolved from shallow sea organisms and became distributed geographically using a dispersion corridor.

To verify the effect of fasting on juvenile leopard mandarin fish (Siniperca scherzeri mean weight, 14.7 g), compensatory growth, body composition, and blood content of juveniles were investigated for six weeks following two-week feeding treatments: fed continuously (control), and fasted for 5 (F5), 10 (F10) and 14 days (F14). Full compensatory growth was evident after four weeks of food resupply in all fasting groups. Specific growth rate, feeding rate, and feed efficiency in all fasting groups were significantly higher than those of the control after the first 2 weeks of food resupply. At the end of fasting, the lipid content, ratio of lipid to lean body mass, hepatosomatic and viscerosomatic indices in all fasting groups, or total cholesterol content in F14 significantly decreased compared to the control. These results indicated that juvenile leopard mandarin fish subjected to 5–14 days of food deprivation could achieve full compensatory growth after feeding resumption for 4 weeks and that the morphological and biochemical indices, as well as body and blood composition, remained comparable to the control group after the completion of the study under our experimental conditions.

Background A subanalysis study of the ENGAGE AF-TIMI 48 trial showed that cardiac troponin I, N-terminal proB-type natriuretic peptide, and D-dimer, were powerful predictors of cerebrovascular adverse events. We aimed to evaluate D-dimer and cardiac troponin I levels during the acute period of ischemic stroke in anticoagulation-naïve patients with non-valvular atrial fibrillation (NVAF) and also studied the association between these biomarkers and stroke severity. Methods Consecutive anticoagulation-naïve patients with acute ischemic stroke due to NVAF were enrolled within two days after each stroke event, and all patients were stratified into either moderate-to-severe or mild neurologic deficit groups using the National Institutes of Health Stroke Scale (NIHSS) at admission. Results A total of 98 patients were enrolled in this study. The median value for the D-dimer was above the upper limit of the normal reference range, but the troponin I value was within the normal range for all patients. After adjusting for CHA2DS2-VASc risk factors, the log-transformed values for D-dimer were positively correlated with an increasing NIHSS score (r=0.233; P=0.051). In the multivariate logistic analysis, the log-transformed D-dimer was positively associated with more severe strokes (odds ratio, 30.1; 95% confidence interval [CI], 1.9-486.2 and 29.7; 95% CI, 2.0-430.8 in the upper two quartiles respectively). The log-transformed values for troponin I did not correlate with the NIHSS score. Conclusion D-dimer levels were higher and an independent risk factor for severe stroke in anticoagulation-naïve patients with NVAF related stroke. In contrast, troponin I levels were normal and were not associated with stroke severity.

We investigated the response of the Manila clam Venerupis philippinarum to possible temperature and salinity changes in a holding facility. First, clams were exposed to four temperatures for 15 days. Valve closure and survival of clams exposed to seawater at 18 °C were higher than that of those exposed to seawater at 24 °C. Second, clams were exposed to six salinities for 15 days. Survival of clams exposed to two salinity fluctuation conditions (24–30 and 27–24 psu) was lower than that of clams exposed to constant 30 psu conditions. Valve closures of clams exposed to constant low salinity conditions (24 psu) and two salinity fluctuation conditions (24–30 and 27–24 psu) were higher than those exposed to constant 30 psu conditions. Lastly, clams were exposed to two different temperatures and three different salinity conditions for 8 days. Valve closure and survival decreased significantly under the combination of 24 °C and 18 psu. These results suggest that an increase in temperature or a wider range of salinity fluctuations are detrimental to the survival of the Manila clam. The synergistic effect of temperature and salinity stressors may decrease the survival period of clams compared to the effect of a single stressor.

Purpose: The present study was to use the aggregate data meta-analytic approach to examine the effects of attentional focus during balancing tasks in motor learning. Method: A literature search was conducted based on five electronic database searches, cross-referencing and expert review. Studies included randomized trials of external (EF) versus internal focus (IF). Risk of bias was assessed using a self-developed instrument. Random effects models using the standardized mean difference effect size (ES) were used to pooled results. Heterogeneity was examined using the Q statistic and inconsistency using I2. Results: Of 790 studies screened, 16 representing 541 males and females and up to 17 ES met the inclusion criteria. Analyses indicated that the EF groups outperformed the IF groups for acquisition phase (ES= 0.48, n= 16; CI95%= 0.07 to 0.90, Q= 68.7, I2= 78.2%), retention (ES= 0.44, n= 17, CI95%= 0.14 to 0.74; Q= 26.1, I2= 38.6%), and transfer (ES= 1.41, n= 4, CI95%= 1.00 to 1.82, Q= 22, I2= 0%). Conclusion: The overall results suggest that EF results in better balance learning when compared to IF.

Background Virchow’s triad, consisting of atrial tissue damage, a hypercoagulable state, and blood stasis, has been used to explain the thrombogenic mechanisms of non-valvular atrial fibrillation (NVAF). Blood stasis is thought to be attributable to loss of left atrial systole and left atrial enlargement, while the hypercoagulable state is partly reflected by elevated serum D-dimer levels. The aim of this study was to evaluate the correlation between risk factors for CHA2DS2-VASc and left atrial enlargement/serum D-dimer levels in order to explore whether LAE with D-dimer elevation is one of the key factors in the thrombogenic mechanisms of atrial fibrillation. Methods Consecutive patients with acute ischemic stroke due to NVAF who were anticoagulation-naïve were enrolled. All patients were evaluated for left atrial volume index (LAVI) by transthoracic echocardiography. The association between CHA2DS2-VASc scores and LAVI/D-dimer levels was evaluated. Results A total of 98 anticoagulation-naïve patients who presented with acute ischemic stroke due to NVAF were enrolled in this study. CHA2DS2-VASc scores were significantly correlated with left atrial volume index (r=0.325, P=0.002). There was also a significant correlation between CHA2DS2-VASc scores and serum D-dimer levels (r=0.309, P=0.006). Conclusions CHA2DS2-VASc scores were associated with left atrial enlargement (LAE) and increased D-dimer levels in anticoagulation-naïve patients with acute ischemic stroke due to NVAF. LAE may play a crucial role in the link between CHA2DS2-VASc risk factors and the development of ischemic stroke, and these hypercoagulable conditions seem to be reflected by an elevation in D-dimer levels.

Seawater acidification and freshening in the intertidal zone of Marian Cove, Antarctica, which occurs by the freshwater inflow from snow fields and glaciers, could affect the physiology and behavior of intertidal marine organisms. In this study, we exposed Antarctic limpets, Nacella concinna, to two different pH (8.00 and 7.55) and salinity (34.0 and 27.0 psu) levels and measured their righting ability after being flipped over, mortality, condition factor, and shell dissolution. During the 35-day exposure, there was no significant difference in behavior and mortality between different treatments. However, the condition factor was negatively affected by low salinity. Both low pH and low salinity negatively influenced shell formation by decreasing the aragonite saturation state (Ωarg) and enhancing shell dissolution. Our results suggest that, though limpets can tolerate short-term low pH and salinity conditions, intrusions of meltwater accompanied by the glacial retreat may act as a serious threat to the population of N. concinna.

A cylindrical tool was applied for ultrasonic bonding of multi-layered copper foil and a copper sheet to prevent damage to the foil during bonding. The strength of the joints bonded with the cylindrical tool was comparable to that of the joints bonded with a conventional knurled tool. The effect of the cylindrical surface tool on bondability was investigated thorough relative motion behaviors between the tool surface and the bonding materials, as well as on bond microstructure evolution. The relative motion was visualized with in-situ observation using a high-speed camera and digital image correlation. At shorter bonding times, relative motions occurred at the bonding interfaces of the foil and the copper sheet. Thereafter, the relative motion between the tool and the bonding material became predominant owing to bond formation at the bonding interface, resulting in a macroscopic plastic flow in the bonded region. This relative motion damaged the foil in knurled tool bonding, and the cylindrical tool achieved bonding without any damage.

This study first reviewed previous studies on floor heating systems based on the installation of a phase change material (PCM) and the current status of technical developments and found that PCM-based research is still in its infancy. In particular, the improvement of floor heat storage performance in indoor environments by combining a PCM with existing floor structures has not been subject to previous research. Thus, a PCM-based radiant floor heating system that utilizes hot water as a heat source and can be used in conjunction with the widespread wet construction method can be considered novel. This study found the most suitable PCM melting temperature for the proposed PCM-based radiant floor heating system ranged from approximately 35 °C to 45 °C for a floor thickness of 70 mm and a PCM thickness of 10 mm. Mock-up test results, which aimed to assess the performance of the radiant floor heating system with and without the PCM, revealed that the PCM-based room was able to maintain a temperature that was 0.2 °C higher than that of the room without the PCM. This was due to the rise in temperature caused by the PCM’s heat storage capacity and the emission of waste heat that was otherwise lost to the underside of the hot water pipe when the PCM was not present.