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BackgroundEnd-of-life (EOL) care patterns may differ by physician age given differences in how physicians are trained or changes associated with aging. We sought to compare patterns of EOL care delivered to older Americans according to physician age.MethodsWe conducted a cross-sectional study of a 20% sample of Medicare fee-for-service beneficiaries aged ≥66 years who died in 2016-2019 (n = 487,293). We attributed beneficiaries to the physician who had >50% of primary care visits during the last 6 months of life. We compared beneficiary-level outcomes by physician age (<40, 40-49, 50-59, or ≥60) in two areas: (1) advance care planning (ACP) and palliative care; and (2) high-intensity care at the EOL.ResultsBeneficiaries attributed to younger physicians had slightly higher proportions of billed ACP (adjusted proportions, 17.1%, 16.1%, 15.5%, and 14.0% for physicians aged <40, 40-49, 50-59, and ≥60, respectively; p-for-trend adjusted for multiple comparisons <0.001) and palliative care counseling or hospice use in the last 180 days of life (64.5%, 63.6%, 61.9%, and 60.8%; p-for-trend <0.001). Similarly, physicians' younger age was associated with slightly lower proportions of emergency department visits (57.4%, 57.0%, 57.4%, and 58.1%; p-for-trend <0.001), hospital admissions (51.2%, 51.1%, 51.4%, and 52.1%; p-for-trend <0.001), intensive care unit admissions (27.8%, 27.9%, 28.2%, and 28.3%; p-for-trend = 0.03), or mechanical ventilation or cardiopulmonary resuscitation (14.2, 14.9%, 15.2%, and 15.3%; p-for-trend <0.001) in the last 30 days of life, and in-hospital death (20.2%, 20.6%, 21.3%, and 21.5%; p-for-trend <0.001).ConclusionsWe found that differences in patterns of EOL care between beneficiaries cared for by younger and older physicians were small, and thus, not clinically meaningful. Future research is warranted to understand the factors that can influence patterns of EOL care provided by physicians, including initial and continuin

Chimpanzees (Pan troglodytes) and bonobos (Pan paniscus) are humans’ closest living relatives. The two sister species shared a common evolutionary history until about one million years ago. Yet, despite their evolutionary closeness, chimpanzees and bonobos differ in a number of important ways. One of the most striking differences is the discrepancy in the reliance on tool use in wild populations of Pan. Chimpanzees are renowned for their extensive use of tools in a wide variety of contexts, including feeding, self-maintenance, and social contexts. Bonobos, on the other hand, use surprisingly few tools in the wild, and none in feeding. The tool use difference between the two species of Pan remains one of the most challenging topics in the study of our closest living relatives. In this chapter, I will provide an overview of what we know about bonobo tool use in the wild, and specifically how tool use at the study site of Wamba in the Democratic Republic of Congo compares to other long-term bonobo study sites. Moreover, I will summarize a number of comparative studies on wild bonobos and chimpanzees, which have aimed to elucidate the drivers of the tool use dichotomy between the two species. Lastly, I will discuss future research directions in the study of tool use in our ape relatives.

Characterization of the elemental distribution of samples with rough surfaces has been strongly desired for the analysis of various natural and artificial materials. Particularly for pristine and rare analytes with micrometer sizes embedded on specimen surfaces, non-invasive and matrix effect-free analysis is required without surface polishing treatment. To satisfy these requirements, we proposed a new method employing the sequential combination of two imaging modalities, i.e., microenergy-dispersive X-ray fluorescence (micro-XRF) and Raman micro-spectroscopy. The applicability of the developed method is tested by the quantitative analysis of cation composition in micrometer-sized carbonate grains on the surfaces of intact particles sampled directly from the asteroid Ryugu. The first step of micro-XRF imaging enabled a quick search for the sparsely scattered and micrometer-sized carbonates by the codistributions of Ca2+ and Mn2+ on the Mg2+- and Fe2+-rich phyllosilicate matrix. The following step of Raman micro-spectroscopy probed the carbonate grains and analyzed their cation composition (Ca2+, Mg2+, and Fe2+ + Mn2+) in a matrix effect-free manner via the systematic Raman shifts of the lattice modes. The carbonates were basically assigned to ferroan dolomite bearing a considerable amount of Fe2+ + Mn2+ at around 10 atom %. These results are in good accordance with the assignments reported by scanning electron microscopy-energy-dispersive X-ray spectroscopy, where the thin-sectioned and surface-polished Ryugu particles were applicable. The proposed method requires neither sectioning nor surface polishing; hence, it can be applied to the remote sensing apparatus on spacecrafts and planetary rovers. Furthermore, the non-invasive and matrix effect-free characterization will provide a reliable analytical tool for quantitative analysis of the elemental distrib

Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools.

Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools.

There is increasing interest in using helium ions for radiotherapy, complementary to protons and carbon ions. A large number of patients were treated with ⁴He ions in the US heavy ion therapy project and novel ⁴He ion treatment programs are under preparation, for instance in Germany and Japan. ³He ions have been proposed as an alternative to ⁴He ions because the acceleration of ³He is technically less difficult than ⁴He. In particular, beam contaminations have been pointed out as a potential safety issue for ⁴He ion beams. This motivated a series of experiments with ³He ion beams at Gesellschaft für Schwerionenforschung (GSI), Darmstadt. Measured ³He Bragg curves and fragmentation data in water are presented in this work. Those experimental data are compared with FLUKA Monte Carlo simulations. The physical characteristics of ³He ion beams are compared to those of ⁴He, for which a large set of data became available in recent years from the preparation work at the Heidelberger Ionenstrahl-Therapiezentrum (HIT). The dose distributions (spread out Bragg peaks, lateral profiles) that can be achieved with ³He ions are found to be competitive to ⁴He dose distributions. The effect of beam contaminations on ⁴He depth dose distribution is also addressed. It is concluded that ³He ions can be a viable alternative to ⁴He, especially for future compact therapy accelerator designs and upgrades of existing ion therapy facilities.

A non-perturbative effect in $\kappa$ (renormalized string coupling) obtained from the large order behavior in the vicinity of the prototypical Argyres-Douglas critical point of $su(2)$, $N_f =2$, $\mathcal{N} =2$ susy gauge theory can be studied in the GWW unitary matrix model with the log term: the one as the work done against the barrier of the effective potential by a single eigenvalue lifted from the sea and the other as a non-perturbative function contained in the solutions of the nonlinear differential equation PII that goes beyond the asymptotic series. The leading behaviors are of the form $\exp (-\frac{4}{3}\frac{1}{\kappa} \, (1, \left(\frac{s}{K}\right)^{\frac{3}{2}} ))$ respectively. We make comments on their agreement., Comment: 14 pages

Recently, lattice formulations of Abelian chiral gauge theory in two dimensions have been devised on the basis of the Abelian bosonization. A salient feature of these 2D lattice formulations is that the gauge invariance is \emph{exactly\/} preserved for anomaly-free theories and thus is completely free from the question of the gauge mode decoupling. In the present paper, we propose a yet another lattice formulation sharing this desired property. A particularly unique point in our formulation is that the vertex operator of the dual scalar field, which carries the vector charge of the fermion and the ``magnetic charge'' in the bosonization, is represented by a ``hole'' excised from the lattice; this is the excision method formulated recently by Abe et al. in a somewhat different context., Comment: 16 pages, 3 figures, the final version to appear in PTEP

In $U(1)$ lattice gauge theory with compact $U(1)$ variables, we construct the symmetry operator, i.e.\ the topological defect, for the axial $U(1)$ noninvertible symmetry. This requires a lattice formulation of chiral gauge theory with an anomalous matter content and we employ the lattice formulation on the basis of the Ginsparg--Wilson relation. The invariance of the symmetry operator under the gauge transformation of the gauge field on the defect is realized, imitating the prescription by Karasik in continuum theory, by integrating the lattice Chern--Simons term on the defect over \emph{smooth\/} lattice gauge transformations. The projection operator for allowed magnetic fluxes on the defect then emerges with lattice regularization. The resulting symmetry operator is manifestly invariant under lattice gauge transformations. In an appendix, we give another way of constructing the symmetry operator on the basis of a 3D $\mathbb{Z}_N$ topological quantum field theory, the level-$N$ BF theory on the lattice., Comment: 47 pages, 5 figures, the final version to appear in PTEP

In tensor-network analysis of quantum many-body systems, it is of crucial importance to employ a tensor network with a spatial structure suitable for representing the state of interest. In the previous work [Hikihara et al., Phys. Rev. Research 5, 013031 (2023)], we proposed a structural optimization algorithm for tree-tensor networks. In this paper, we apply the algorithm to the Rainbow-chain model, which has a product state of singlet pairs between spins separated by various distances as an approximate ground state. We then demonstrate that the algorithm can successfully visualize the spatial pattern of spin-singlet pairs in the ground state., Comment: 9 pages, 5 figures, 1 table

Achaete-scute family bHLH transcription factor 1 (ASCL1) is a master transcription factor involved in neuroendocrine differentiation. ASCL1 is expressed in approximately 10% of lung adenocarcinomas (LUAD) and exerts tumor-promoting effects. Here, we explored miRNA profiles in ASCL1-positive LUADs and identified several miRNAs closely associated with ASCL1 expression, including miR-375, miR-95-3p/miR-95-5p, miR-124-3p, and members of the miR-17 similar to 92 family. Similar to small cell lung cancer, Yes1 associated transcriptional regulator (YAP1), a representative miR-375 target gene, was suppressed in ASCL1-positive LUADs. ASCL1 knockdown followed by miRNA profiling in a cell culture model further revealed that ASCL1 positively regulates miR-124-3p and members of the miR-17 similar to 92 family. Integrative transcriptomic analyses identified ZFP36 ring finger protein like 1 (ZFP36L1) as a target gene of miR-124-3p, and IHC studies demonstrated that ASCL1-positive LUADs are associated with low ZFP36L1 protein levels. Cell culture studies showed that ectopic ZFP36L1 expression inhibits cell proliferation, survival, and cell-cycle progression. Moreover, ZFP36L1 negatively regulated several genes including E2F transcription factor 1 (E2F1) and snail family transcriptional repressor 1 (SNAI1). In conclusion, our study revealed that suppression of ZFP36L1 via ASCL1-regulated miR-124-3p could modulate gene expression, providing evidence that ASCL1-mediated regulation of miRNAs shapes molecular features of ASCL1-positive LUADs.Implications: Our study revealed unique miRNA profiles of ASCL1-positive LUADs and identified ASCL1-regulated miRNAs with functional relevance.

Employing the modified Villain lattice formulation of the axion QED, we present an alternative and much simpler derivation of the conclusion of~Ref.~\cite{Honda:2024sdz} that the sweep of the axial $U(1)$ non-invertible symmetry operator over the (non-genuine) gauge invariant 't~Hooft line operator with an integer magnetic charge does not leave any effect. The point is that such a 't~Hooft line can be represented by a boundary of a (non-topological) defect that is invariant under the axial transformation on the axion field., Comment: 12 pages, 1 figure

Tensor network (TN) states, including entanglement renormalization (ER), can encompass a wider variety of entangled states. When the entanglement structure of the quantum state of interest is non-uniform in real space, accurately representing the state with a limited number of degrees of freedom hinges on appropriately configuring the TN to align with the entanglement pattern. However, a proposal has yet to show a structural search of ER due to its high computational cost and the lack of flexibility in its algorithm. In this study, we conducted an optimal structural search of TN, including ER, based on the reconstruction of their local structures with respect to variational energy. Firstly, we demonstrated that our algorithm for the spin-$1/2$ tetramer singlets model could calculate exact ground energy using the multi-scale entanglement renormalization ansatz (MERA) structure as an initial TN structure. Subsequently, we applied our algorithm to the random XY models with the two initial structures: MERA and the suitable structure underlying the strong disordered renormalization group. We found that, in both cases, our algorithm achieves improvements in variational energy, fidelity, and entanglement entropy. The degree of improvement in these quantities is superior in the latter case compared to the former, suggesting that utilizing an existing TN design method as a preprocessing step is important for maximizing our algorithm's performance., Comment: 12 pages, 10 figures

The turn-to-turn contact resistance/resistivity is one of the most important parameters for no-insulation (NI) rare-earth barium copper oxide (REBCO) pancake coils. Our group has been working on the measurement of the contact resistances of NI REBCO pancake coils by alternating current, called a low-frequency ac current (LFAC) method. One of the advantages is that the LFAC method is able to measure the field and current dependencies on contact resistances in principle, while the conventional discharge method is not. The effectiveness of the LFAC method was well demonstrated using a single pancake coil. In this paper, contact resistances of a double pancake coil were measured with the LFAC method although the upper and lower pancake coils had different turn-to-turn contact conditions due to an accident. The experiment results well agree with the simulation results. In addition, the contact resistances of each pancake coil can be separately specified. The contact resistances measured with a conventional sudden discharge method also have a good agreement with the LFAC method; however, the contact resistance of sudden discharge simulation is underestimated. Meanwhile, the energy consumptions are also complicated. We need further investigation for multi-stacked NI pancake coils in the near future.

We study the problem of false vacuum decay in arbitrary dimensions, in the presence of gravity, and compute the transition probability within the thin-wall approximation, generalising the results of Coleman and de Luccia. In the particular case of one compact dimension, we present explicit formulae for the Euclidean Bounce configuration that drives the transition from a de Sitter to Minkowski or from a Minkowski to anti-de Sitter vacua.

Parmales (Bolidophyceae) is a minor eukaryotic phytoplankton group, sister to diatoms, which exists as two distinct forms of unicellular organisms: silicified cells and naked flagellates. Since their discovery, many field studies on Parmales have been performed; however, their global distribution has not yet been examined in detail. We herein compiled more than 3,000 marine DNA metabarcoding datasets targeting the V4 region of the 18S rRNA gene from the EukBank database. By linking this large dataset with the latest morphological and genetic information, we provide updated estimates on the diversity and distribution of Parmales in the global ocean at a fine taxonomic resolution. Parmalean amplicon sequence variants (ASVs) were detected in nearly 90% of the samples analyzed. However, the relative abundance of parmaleans in the eukaryotic community was less than 0.2% on average, and the estimated true richness of parmalean ASVs was approximately 316 ASVs, confirming their low abundance and diversity. A phylogenetic ana¬lysis divided these algae into four clades, and three known morphotypes of silicified cells were classified into three different clades. The abundance of Parmales is generally high in the poles and decreases towards the tropics, and individual clades/subclades show further distinctions in their distribution. Collectively, the present results suggest clade/subclade-specific adaptation to different ecological niches.

PURPOSE: To investigate the feasibility and application of a novel imaging technique, a three-dimensional dual adiabatic inversion recovery prepared ultrashort echo time (3D DIR-UTE) sequence, for high contrast assessment of cartilaginous endplate (CEP) imaging with head-to-head comparisons between other UTE imaging techniques. METHOD: The DIR-UTE sequence employs two narrow-band adiabatic full passage (AFP) pulses to suppress signals from long T2 water (e.g., nucleus pulposus (NP)) and bone marrow fat (BMF) independently, followed by multispoke UTE acquisition to detect signals from the CEP with short T2 relaxation times. The DIR-UTE sequence, in addition to three other UTE sequences namely, an IR-prepared and fat-saturated UTE (IR-FS-UTE), a T1-weighted and fat-saturated UTE sequence (T1w-FS-UTE), and a fat-saturated UTE (FS-UTE) was used for MR imaging on a 3 T scanner to image six asymptomatic volunteers, six patients with low back pain, as well as a human cadaveric specimen. The contrast-to-noise ratio of the CEP relative to the adjacent structures-specifically the NP and BMF-was then compared from the acquired images across the different UTE sequences. RESULTS: For asymptomatic volunteers, the DIR-UTE sequence showed significantly higher contrast-to-noise ratio values between the CEP and BMF (CNRCEP-BMF) (19.9 ± 3.0) and between the CEP and NP (CNRCEP-NP) (23.1 ± 1.7) compared to IR-FS-UTE (CNRCEP-BMF: 17.3 ± 1.2 and CNRCEP-NP: 19.1 ± 1.8), T1w-FS-UTE (CNRCEP-BMF: 9.0 ± 2.7 and CNRCEP-NP: 10.4 ± 3.5), and FS-UTE (CNRCEP-BMF: 7.7 ± 2.2 and CNRCEP-NP: 5.8 ± 2.4) for asymptomatic volunteers (all P-values < 0.001). For the spine sample and patients with low back pain, the DIR-UTE technique detected abnormalities such as irregularities and focal defects in the CEP regions. CONCLUSION: The 3D DIR-UTE sequence is able to provide high-contrast volumetric CEP imaging for human spines on a clinical 3 T scanner.

We previously demonstrated that Alcaligenes-derived lipid A (ALA), which is produced from an intestinal lymphoid tissue-resident commensal bacterium, is an effective adjuvant for inducing antigen-specific immune responses. To understand the immunologic characteristics of ALA as a vaccine adjuvant, we here compared the adjuvant activity of ALA with that of a licensed adjuvant (monophosphoryl lipid A, MPLA) in mice. Although the adjuvant activity of ALA was only slightly greater than that of MPLA for subcutaneous immunization, ALA induced significantly greater IgA antibody production than did MPLA during nasal immunization. Regarding the underlying mechanism, ALA increased and activated CD11b+ CD103- CD11c+ dendritic cells in the nasal tissue by stimulating chemokine responses. These findings revealed the superiority of ALA as a mucosal adjuvant due to the unique immunologic functions of ALA in nasal tissue.

Human immunodeficiency virus (HIV) 1 infection is known to cause gut microbiota dysbiosis. Among the causes is the direct infection of HIV-1 in gut-resident CD4+ T cells, causing a cascade of phenomena resulting in the instability of the gut mucosa. The effect of HIV infection on gut microbiome dysbiosis remains unresolved despite antiretroviral therapy. Here, we show the results of a longitudinal study of microbiome analysis of people living with HIV (PLWH). We contrasted the diversity and composition of the microbiome of patients with HIV at the first and second time points (baseline_case and six months later follow-up_case, respectively) with those of healthy individuals (baseline_control). We found that despite low diversity indices in the follow-up_case, the abundance of some genera was recovered but not completely, similar to baseline_control. Some genera were consistently in high abundance in PLWH. Furthermore, we found that the CD4+ T-cell count and soluble CD14 level were significantly related to high and low diversity indices, respectively. We also found that the abundance of some genera was highly correlated with clinical features, especially with antiretroviral duration. This includes genera known to be correlated with worse HIV-1 progression (Achromobacter and Stenotrophomonas) and a genus associated with gut protection (Akkermansia). The fact that a protector of the gut and genera linked to a worse progression of HIV-1 are both enriched may signify that despite the improvement of clinical features, the gut mucosa remains compromised.

Glycoprotein 2 (GP2) is a widely distributed protein in the digestive tract, contributing to mucosal barrier maintenance, immune homeostasis, and antigen-specific immune response, while also being linked to inflammatory bowel disease (IBD) pathogenesis. This review sheds light on the extensive distribution of GP2 within the gastrointestinal tract and its intricate interplay with the immune system. Furthermore, the significance of GP2 autoantibodies in diagnosing and categorizing IBD is underscored, alongside the promising therapeutic avenues for modulating GP2 to regulate immunity and maintain mucosal balance.

Genomic rearrangements, encompassing mutational changes in the genome such as insertions, deletions or inversions, are essential for genetic diversity. These rearrangements are typically orchestrated by enzymes that are involved in fundamental DNA repair processes, such as homologous recombination, or in the transposition of foreign genetic material by viruses and mobile genetic elements1,2. Here we report that IS110 insertion sequences, a family of minimal and autonomous mobile genetic elements, express a structured non-coding RNA that binds specifically to their encoded recombinase. This bridge RNA contains two internal loops encoding nucleotide stretches that base-pair with the target DNA and the donor DNA, which is the IS110 element itself. We demonstrate that the target-binding and donor-binding loops can be independently reprogrammed to direct sequence-specific recombination between two DNA molecules. This modularity enables the insertion of DNA into genomic target sites, as well as programmable DNA excision and inversion. The IS110 bridge recombination system expands the diversity of nucleic-acid-guided systems beyond CRISPR and RNA interference, offering a unified mechanism for the three fundamental DNA rearrangements-insertion, excision and inversion-that are required for genome design.

Insertion sequence (IS) elements are the simplest autonomous transposable elements found in prokaryotic genomes1. We recently discovered that IS110 family elements encode a recombinase and a non-coding bridge RNA (bRNA) that confers modular specificity for target DNA and donor DNA through two programmable loops2. Here we report the cryo-electron microscopy structures of the IS110 recombinase in complex with its bRNA, target DNA and donor DNA in three different stages of the recombination reaction cycle. The IS110 synaptic complex comprises two recombinase dimers, one of which houses the target-binding loop of the bRNA and binds to target DNA, whereas the other coordinates the bRNA donor-binding loop and donor DNA. We uncovered the formation of a composite RuvC-Tnp active site that spans the two dimers, positioning the catalytic serine residues adjacent to the recombination sites in both target and donor DNA. A comparison of the three structures revealed that (1) the top strands of target and donor DNA are cleaved at the composite active sites to form covalent 5-phosphoserine intermediates, (2) the cleaved DNA strands are exchanged and religated to create a Holliday junction intermediate, and (3) this intermediate is subsequently resolved by cleavage of the bottom strands. Overall, this study reveals the mechanism by which a bispecific RNA confers target and donor DNA specificity to IS110 recombinases for programmable DNA recombination.

Past research at the Advanced Light Source (ALS) provided a proof-of-principle demonstration that deep learning methods could be effectively employed to compensate for the significant perturbations to the transverse electron beam size induced by user-controlled adjustments of the insertion devices. However, incorporating these methods into the ALS’ daily operations has faced notable challenges. The complexity of the system’s operational requirements and the significant upkeep demands has restricted their sustained application during user operation. Here, we introduce the development of a more robust neural network (NN)-based algorithm that utilizes a novel online fine-tuning approach and its systematic integration into the day-to-day machine operations. Our analysis emphasizes the process of NN model selection, demonstrates the superior performance of the NN-based method over traditional feedback methods, and examines the effectiveness and resilience of the new algorithm during user-operation scenarios. Published by the American Physical Society 2024

Manabu Saito,1,&ast; Hiroshi Uchino,1,&ast; Yoko Iwata,1 Ayako Fuchigami,1 Genki Sato,1 Fukumi Yoshikawa,1 Masahiko Miyagi,1 Taito Miyazaki,2 Yoshihisa Urita,2 Kotaro Aoki,3 Yoshikazu Ishii,3 Kazuhiro Tateda,3 Takahisa Hirose1 1Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Graduate School of Medicine, Tokyo, Japan; 2Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan; 3Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan&ast;These authors contributed equally to this workCorrespondence: Hiroshi Uchino, Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Graduate School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan, Tel +81-3-3762-4151, Fax +81-3-3765-6488, Email h.uchino@med.toho-u.ac.jpPurpose: The severe pathogenic ancient-type COVID-19, SARS-CoV-2/WA-1/2020 was the predominant gene variant in early 2020 in Japan, however, its transmissibility was uncertain. The period before the public commenced using any personal protective equipment (PPE) was evaluating to describe the transmissibility of the SARS-CoV-2/WA-1/2020. We analyzed the secondary attack rate (SAR) among close contacts and the risk factor for SAR.Methods: This retrospective cohort study included a total of 539 patients who were anticipated for the SARS-CoV-2/WA-1/2020 infection at Toho University Medical Center Omori Hospital from February to May 2020. We selected 54 patients with 1) exclude other pathogens infection, 2) include “Three Cs” condition: crowded places between distance< 6 feet, closed spaces indoor and close contact settings involving contact > 15min with a person tested positive for SARS-CoV-2/WA-1/2020 without PPE. We evaluated alternative infection risks: the body mass index (BMI) and diabetes (DM) status (non-DM, pre-DM, and DM) as demographic determi

Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools.

Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools.

With the emergence of lung cancer screening programmes and newly detected localised and multifocal disease, novel treatment compounds and multimodal treatment approaches, the treatment landscape of non-small cell lung cancer is becoming increasingly complex. In parallel, in-depth molecular analyses and clonality studies are revealing more information about tumorigenesis, potential therapeutical targets and the origin of lesions. All can play an important role in cases with multifocal disease, oligoprogression and oligorecurrence. In multifocal disease, it is essential to understand the relatedness of separate lesions for treatment decisions, because this information distinguishes separate early-stage tumours from locally advanced or metastatic cancer. Clonality studies suggest that a majority of same-histology lesions represent multiple primary tumours. With the current standard of systemic treatment, oligoprogression after an initial treatment response is a common scenario. In this state of induced oligoprogressive disease, local ablative therapy by either surgery or radiotherapy is becoming increasingly important. Another scenario involves the emergence of a limited number of metastases after radical treatment of the primary tumour, referred to as oligorecurrence, for which the use of local ablative therapy holds promise in improving survival. Our review addresses these complex situations in lung cancer by discussing current evidence, knowledge gaps and treatment recommendations.

Semantic segmentation models comprise an encoder to extract features and a classifier for prediction. However, the learning of the classifier suffers from the ambiguity which is caused by two factors: (1) the weights of a classifier for similar categories may have positive similarities lowing the performance for similar categories, named correlation ambiguity , and (2) the classifier is prone to predict the category with a larger ' 2 norm and vice versa, termed prior ambiguity . To comedy the issues, we propose Category -Basis Prototype (CBP), frozen and mutually orthogonalized prototypes with equal ' 2 norm . Orthogonalization prevents the prototypes from being similar to each other and the equality decouples the prediction from the ' 2 norm. To better shape the feature space, we propose Online Centroid Contrastive Loss (OCCL) equipped with centroid and categorylevel losses. Experiments show that our method yields compelling results over two widely applied benchmarks indicating the effectiveness of our methods.

The variational quantum eigensolver (VQE) stands as a prominent quantum-classical hybrid algorithm for near-term quantum computers to obtain the ground states of molecular Hamiltonians in quantum chemistry. However, due to the noncommutativity of the Pauli operators in the Hamiltonian, the number of measurements required on quantum computers increases significantly as the system size grows, which may hinder practical applications of VQE. In this work, we present a protocol termed joint Bell measurement VQE (JBM-VQE) to reduce the number of measurements and speed up the VQE algorithm. Our method employs joint Bell measurements, enabling the simultaneous measurement of the absolute values of all expectation values of Pauli operators present in the Hamiltonian. In the course of the optimization, JBM-VQE estimates the absolute values of the expectation values of the Pauli operators for each iteration by the joint Bell measurement, while the signs of them are measured less frequently by the conventional method to measure the expectation values. Our approach is based on the empirical observation that the signs do not often change during optimization. We illustrate the speed-up of JBM-VQE compared to conventional VQE by numerical simulations for finding the ground states of molecular Hamiltonians of small molecules, and the speed-up of JBM-VQE at the early stage of the optimization becomes increasingly pronounced in larger systems. Our approach based on the joint Bell measurement is not limited to VQE and can be utilized in various quantum algorithms whose cost functions are expectation values of many Pauli operators. © 2024 authors. Published by the American Physical Society. Published by the American Physical Society under the terms of the Creative Commons Attribution 4.0 International license. Further distribution of this work must maintain attribution to the author(s) and the published article's title, journal citation, and DOI.

BACKGROUND: Evidence on the comparative outcomes following percutaneous microaxial ventricular assist devices (pVAD) versus intra-aortic balloon pump for nonacute myocardial infarction cardiogenic shock is limited. METHODS AND RESULTS: We included 704 and 2140 Medicare fee-for-service beneficiaries aged 65 to 99 years treated with pVAD and intra-aortic balloon pump, respectively, for nonacute myocardial infarction cardiogenic shock from 2016 to 2020. Patients treated using pVAD compared with those treated using intra-aortic balloon pump were more likely to be concurrently treated with mechanical ventilation, renal replacement therapy, and blood transfusions. We computed propensity scores for undergoing pVAD using patient- and hospital-level factors and performed a matching weight analysis. The use of pVAD was associated with higher 30-day mortality (adjusted odds ratio, 1.92 [95% CI, 1.59-2.33]) but not associated with in-hospital bleeding (adjusted odds ratio, 1.00 [95% CI, 0.81-1.24]), stroke (adjusted odds ratio, 0.91 [95% CI, 0.56-1.47]), sepsis (OR, 0.91 [95% CI, 0.64-1.28]), and length of hospital stay (adjusted mean difference, +0.4 days [95% CI, -1.4 to +2.3]). A quasi-experimental instrumental variable analysis using the cross-sectional institutional practice preferences showed similar patterns, though not statistically significant (adjusted odds ratio, 1.38; 95% CI, 0.28-6.89). CONCLUSIONS: Our investigation using the national sample of Medicare beneficiaries showed that the use of pVAD compared with intra-aortic balloon pump was associated with higher mortality in patients with nonacute myocardial infarction cardiogenic shock. Providers should be cautious about the use of pVAD for nonacute myocardial infarction cardiogenic shock, while adequately powered high-quality randomized controlled trials are warranted to determine the clinical effects of pVAD.

We construct a four-dimensional spacetime using a three-dimensional contact manifold equipped with a degenerate metric. The degenerate metric is set to be compatible with the contact structure. The compatibility condition is defined in this paper. Our construction yields a Ricci tensor of a particularly simple form, which leads to a solution of the Einstein equation with a null dust and cosmic strings. The solution includes two arbitrary functions: the energy density of the null dust and the number density of the cosmic strings. When there exist the cosmic strings, the spacetime is of Petrov type D. Otherwise, the spacetime is conformally flat. For some simple matter densities, we examine the Einstein equation in detail., Comment: 25 pages, 3 figures

Tensor network (TN) states, including entanglement renormalization (ER), can encompass a wider variety of entangled states. When the entanglement structure of the quantum state of interest is non-uniform in real space, accurately representing the state with a limited number of degrees of freedom hinges on appropriately configuring the TN to align with the entanglement pattern. However, a proposal has yet to show a structural search of ER due to its high computational cost and the lack of flexibility in its algorithm. In this study, we conducted an optimal structural search of TN, including ER, based on the reconstruction of their local structures with respect to variational energy. Firstly, we demonstrated that our algorithm for the spin-$1/2$ tetramer singlets model could calculate exact ground energy using the multi-scale entanglement renormalization ansatz (MERA) structure as an initial TN structure. Subsequently, we applied our algorithm to the random XY models with the two initial structures: MERA and the suitable structure underlying the strong disordered renormalization group. We found that, in both cases, our algorithm achieves improvements in variational energy, fidelity, and entanglement entropy. The degree of improvement in these quantities is superior in the latter case compared to the former, suggesting that utilizing an existing TN design method as a preprocessing step is important for maximizing our algorithm's performance., Comment: 12 pages, 10 figures

We study the problem of false vacuum decay in arbitrary dimensions, in the presence of gravity, and compute the transition probability within the thin-wall approximation, generalising the results of Coleman and de Luccia. In the particular case of one compact dimension, we present explicit formulae for the Euclidean Bounce configuration that drives the transition from a de Sitter to Minkowski or from a Minkowski to anti-de Sitter vacua., Comment: 26 pages, 2 figures

Employing the modified Villain lattice formulation of the axion QED, we present an alternative and much simpler derivation of the conclusion of~Ref.~\cite{Honda:2024sdz} that the sweep of the axial $U(1)$ non-invertible symmetry operator over the (non-genuine) gauge invariant 't~Hooft line operator with an integer magnetic charge does not leave any effect. The point is that such a 't~Hooft line can be represented by a boundary of a (non-topological) defect that is invariant under the axial transformation on the axion field., Comment: 12 pages, 1 figure

We extend a recently proposed framework, dubbed inflation by supersymmetry breaking, to hybrid inflation by introducing a waterfall field that allows to decouple the supersymmetry breaking scale in the observable sector from the inflation scale, while keeping intact the inflation sector and its successful predictions: naturally small slow-roll parameters, small field initial conditions and absence of the pseudo-scalar companion of the inflaton, in terms of one free parameter which is the first order correction to the inflaton K\"ahler potential. During inflation, supersymmetry is spontaneously broken with the inflaton being the superpartner of the goldstino, together with a massive vector that gauges the R-symmetry. Inflation arises around the maximum of the scalar potential at the origin where R-symmetry is unbroken. Moreover, a nearby minimum with tuneable vacuum energy can be accommodated by introducing a second order correction to the K\"ahler potential. The inflaton sector can also play the role of the supersymmetry breaking 'hidden' sector when coupled to the (supersymmetric) Standard Model, predicting a superheavy superparticle spectrum near the inflation scale. Here we show that the introduction of a waterfall field provides a natural way to end inflation and allows for a scale separation between supersymmetry breaking and inflation. Moreover, the study of the global vacuum describing low energy Standard Model physics can be done in a perturbative way within a region of the parameter space of the model., Comment: 26 pages, 5 figures. V2: revised version; accepted to EPJC

We study how the symmetry operator of the axial $U(1)$ non-invertible symmetry acts on the 't~Hooft line operator in the $U(1)$ gauge theory by employing the modified Villain-type lattice formulation. We model the axial anomaly by a compact scalar boson, the ``QED axion''. For the gauge invariance, the simple 't~Hooft line operator, which is defined by a line integral of the dual $U(1)$ gauge potential, must be ``dressed'' by the scalar and $U(1)$ gauge fields. A careful consideration on the basis of the anomalous Ward--Takahashi identity containing the 't~Hooft operator with the dressing factor and a precise definition of the symmetry operator on the lattice shows that the symmetry operator leaves no effect when it sweeps out a 't~Hooft loop operator. This result appears inequivalent with the phenomenon concluded in the continuum theory. In an appendix, we demonstrate that the half-space gauging of the magnetic $\mathbb{Z}_N$ 1-form symmetry, when formulated in an appropriate lattice framework, leads to the same conclusion as above. A similar result is obtained for the axion string operator., Comment: 21 pages, 1 figure. The final version to appear in PTEP

Gas Distribution Mapping (GDM) is a valuable tool for monitoring the distribution of gases in a wide range of applications, including environmental monitoring, emergency response, and industrial safety. While GDM is actively researched in the scope of gas-sensitive mobile robots (Mobile Robot Olfaction), there is a potential for broader applications utilizing sensor networks. This study aims to address the lack of deep learning approaches in GDM and explore their potential for improved mapping of gas distributions. In this paper, we introduce Gas Distribution Decoder (GDD), a learning-based GDM method. GDD is a deep neural network for spatial interpolation between sparsely distributed sensor measurements that was trained on an extensive data set of realistic-shaped synthetic gas plumes based on actual airflow measurements. As access to ground truth representations of gas distributions remains a challenge in GDM research, we make our data sets, along with our models, publicly available. We test and compare GDD with state-of-the-art models on synthetic and real- world data. Our findings demonstrate that GDD significantly outperforms existing models, demonstrating a 35% improvement in accuracy on synthetic data when measured using the Root Mean Squared Error over the entire distribution map. Notably, GDD appears to have superior capabilities in reconstructing the edges and characteristic shapes of gas plumes compared to traditional models. These potentials offer new possibilities for more accurate and efficient environmental monitoring, and we hope to inspire other researchers to explore learning-based GDM.

Ichthyosporea is an underexplored group of unicellular eukaryotes closely related to animals. Thanks to their phylogenetic position, genomic content, and development through a multinucleate coenocyte reminiscent of some animal embryos, the members of Ichthyosporea are being increasingly recognized as pivotal to the study of animal origins. We delve into the existing knowledge of Ichthyosporea, identify existing gaps and discuss their life cycles, genomic insights, development, and potential to be model organisms. We also discuss the underestimated diversity of ichthyosporeans, based on new environmental data analyses. This review will be an essential resource for researchers venturing into the study of ichthyosporeans. Ichthyosporea are unicellular eukaryotes crucial for understanding animal origins and evolution. This Review outlines the history and recent advancements in ichthyosporean biology, genomics, and genetics, and provides insight into their environmental diversity., De tre första författarna delar förstaförfattarskapet

When someone violates a social norm, others may think that some sanction would be appropriate. We examine how the experience of emotions like anger and disgust relate to the judged appropriateness of sanctions, in a pre-registered analysis of data from a large-scale study in 56 societies. Across the world, we find that individuals who experience anger and disgust over a norm violation are more likely to endorse confrontation, ostracism and, to a smaller extent, gossip. Moreover, we find that the experience of anger is consistently the strongest predictor of judgments of confrontation, compared to other emotions. Although the link between state-based emotions and judgments may seem universal, its strength varies across countries. Aligned with theoretical predictions, this link is stronger in societies, and among individuals, that place higher value on individual autonomy. Thus, autonomy values may increase the role that emotions play in guiding judgments of social sanctions.

Ichthyosporea is an underexplored group of unicellular eukaryotes closely related to animals. Thanks to their phylogenetic position, genomic content, and development through a multinucleate coenocyte reminiscent of some animal embryos, the members of Ichthyosporea are being increasingly recognized as pivotal to the study of animal origins. We delve into the existing knowledge of Ichthyosporea, identify existing gaps and discuss their life cycles, genomic insights, development, and potential to be model organisms. We also discuss the underestimated diversity of ichthyosporeans, based on new environmental data analyses. This review will be an essential resource for researchers venturing into the study of ichthyosporeans. Ichthyosporea are unicellular eukaryotes crucial for understanding animal origins and evolution. This Review outlines the history and recent advancements in ichthyosporean biology, genomics, and genetics, and provides insight into their environmental diversity., De tre första författarna delar förstaförfattarskapet

When someone violates a social norm, others may think that some sanction would be appropriate. We examine how the experience of emotions like anger and disgust relate to the judged appropriateness of sanctions, in a pre-registered analysis of data from a large-scale study in 56 societies. Across the world, we find that individuals who experience anger and disgust over a norm violation are more likely to endorse confrontation, ostracism and, to a smaller extent, gossip. Moreover, we find that the experience of anger is consistently the strongest predictor of judgments of confrontation, compared to other emotions. Although the link between state-based emotions and judgments may seem universal, its strength varies across countries. Aligned with theoretical predictions, this link is stronger in societies, and among individuals, that place higher value on individual autonomy. Thus, autonomy values may increase the role that emotions play in guiding judgments of social sanctions.

Ichthyosporea is an underexplored group of unicellular eukaryotes closely related to animals. Thanks to their phylogenetic position, genomic content, and development through a multinucleate coenocyte reminiscent of some animal embryos, the members of Ichthyosporea are being increasingly recognized as pivotal to the study of animal origins. We delve into the existing knowledge of Ichthyosporea, identify existing gaps and discuss their life cycles, genomic insights, development, and potential to be model organisms. We also discuss the underestimated diversity of ichthyosporeans, based on new environmental data analyses. This review will be an essential resource for researchers venturing into the study of ichthyosporeans. Ichthyosporea are unicellular eukaryotes crucial for understanding animal origins and evolution. This Review outlines the history and recent advancements in ichthyosporean biology, genomics, and genetics, and provides insight into their environmental diversity., De tre första författarna delar förstaförfattarskapet

When someone violates a social norm, others may think that some sanction would be appropriate. We examine how the experience of emotions like anger and disgust relate to the judged appropriateness of sanctions, in a pre-registered analysis of data from a large-scale study in 56 societies. Across the world, we find that individuals who experience anger and disgust over a norm violation are more likely to endorse confrontation, ostracism and, to a smaller extent, gossip. Moreover, we find that the experience of anger is consistently the strongest predictor of judgments of confrontation, compared to other emotions. Although the link between state-based emotions and judgments may seem universal, its strength varies across countries. Aligned with theoretical predictions, this link is stronger in societies, and among individuals, that place higher value on individual autonomy. Thus, autonomy values may increase the role that emotions play in guiding judgments of social sanctions.

Evergreeness is a substantial strategy for temperate and boreal plants and is as common as deciduousness. However, whether evergreen plants switch foliage functions between seasons remains unknown. We conduct an in natura study of leaf senescence control in the evergreen perennial, Arabidopsis halleri. A four-year census of leaf longevity of 102 biweekly cohorts allows us to identify growth season (GS) and overwintering (OW) cohorts characterised by short and extended longevity, respectively, and to recognise three distinct periods in foliage functions, i.e., the growth, overwintering, and reproductive seasons. Photoperiods during leaf expansion separate the GS and OW cohorts, providing primal control of leaf senescence depending on the season, with leaf senescence being shut down during winter. Phenotypic and transcriptomic responses in field experiments indicate that shade-induced and reproductive-sink-triggered senescence are active during the growth and reproductive seasons, respectively. These secondary controls of leaf senescence cause desynchronised and synchronised leaf senescence during growth and reproduction, respectively. Conclusively, seasonal switching of leaf senescence optimises resource production, storage, and translocation for the season, making the evergreen strategy adaptively relevant.

Herein, we introduce a model of electronic spin isomers, the electronic counterpart of nuclear spin isomers, by using a stable organic diradical. The diradical, composed of two benzotriazinyl radicals connected by a rigid triptycene skeleton, exhibits a small singlet–triplet energy gap of −3.0 kJ/mol, indicating ca. 1:1 coexistence of the two spin states at room temperature. The diradical shows characteristic near-IR absorption bands, which are absent in the corresponding monoradical subunit. Variable temperature measurements revealed that the absorbance of the NIR band depends on the abundance of the singlet state, allowing us to identify the NIR band as the singlet-specific absorption band. It enables photoexcitation of one of the two spin states coexisting in thermal equilibrium. Transient absorption spectroscopy disclosed that the two spin states independently follow qualitatively different excited-state dynamics. These results demonstrate a novel approach to the design and study of electronic spin isomers based on organic diradicals.