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Abstract In patients undergoing hemodialysis, the impact of atrial fibrillation (AF) through cardiac thromboembolism on the development of ischemic stroke may be influenced by the severity of atherosclerosis present. However, there are no large-scale reports confirming whether the severity of atherosclerosis influences the relationship between AF and stroke development in patients requiring hemodialysis. We aimed to investigate the effects of atherosclerotic disease on the relationship between AF and new-onset ischemic stroke. This nationwide longitudinal study based on dialysis facilities across Japan used data collected from the Japanese Renal Data Registry at the end of 2019 and 2020. The exposure was AF at the end of 2019, identified using a resting 12-lead electrocardiography. The primary outcome was the incidence of cerebral infarction (CI) after 1 year. To examine whether the number of atherosclerotic diseases modified the association between AF and the outcome, we estimated the odds ratios (ORs) using a logistic regression model and then assessed the presence of global interaction using Wald test. Following the study criteria, data from 151,350 patients (mean age, 69 years; men, 65.2%; diabetic patients, 48.7%) were included in the final analysis. A total of 9841 patients had AF (prevalence, 6.5%). Between 2019 and 2020, 4967 patients (3.2%) developed ischemic stroke. The adjusted OR of AF for new-onset CI was 1.5, which showed a decreasing trend with an increasing number of atherosclerotic diseases; the interaction was not significant (P = 0.34). While age, diabetes mellitus, smoking, systolic blood pressure, and serum C-reactive protein concentration were positively associated with CI, intradialytic weight gain, body mass index, and serum albumin level were negatively associated. While we demonstrated the association between AF and new-onset CI among Japanese patients on hemodialysis, we failed to demonstrate the evidence that the association was attenuated with an increasing numbers of atherosclerotic complications.

Cardiovascular medicine, especially for ischemic heart disease, has evolved and advanced over the past two decades, leading to substantially improved outcomes for patients, even those with chronic kidney disease. However, the prognosis for patients with end-stage kidney disease (ESKD) has not improved so greatly. Recent studies have reported that myocardial fibrosis in chronic kidney disease patients is characterized by patchy and interstitial patterns. Areas of fibrosis have been located in the perivascular space, and severe fibrotic lesions appear to spread into myocardial fiber bundles in the form of pericellular fibrosis. These findings are fully consistent with known characteristics of reactive fibrosis. In hemodialysis patients, a greater extent of myocardial fibrosis is closely associated with a poorer prognosis. In this review, we focus on non-ischemic cardiomyopathy, especially reactive myocardial fibrosis, in ESKD patients.

Abstract Previous studies have suggested submarine landslides as sources of the tsunami that damaged coastal areas of Palu Bay after the 2018 Sulawesi earthquake. Indeed, tsunami run-up heights as high as 10 m determined by field surveys cannot be explained by the earthquake source alone although the earthquake is definitely the primary cause of the tsunami. The quantitatively re-examined results using the earthquake fault models reported so far showed that none of them could fully explain the observed tsunami data: tsunami waveforms inferred from video footage and the field survey run-up tsunami height distribution. Here, we present probable tsunami source models including submarine landslides that are consistent with the observed tsunami data. We simulated tsunamis generated by submarine landslides using a simplified depth-averaged two-dimensional model. The estimated submarine landslide model consisted of two sources in the northern and southern parts of the bay, and it explained the observed tsunami data well. Their volumes were 0.02 and 0.07 km3. The radius of the major axis and the maximum thickness of the initial paraboloid masses and the maximum horizontal velocity of the masses were 0.8 km, 40 m and 21 m/s in the northern bay, and 2.0 km, 15 m and 19 m/s in the southern bay, respectively. The landslide source in the northern bay needed to start to move about 70 s after the earthquake to match the calculated and observed arrival times.

Abstract The M w 6.9 earthquake off Fukushima Prefecture, Japan, of 22 November 2016 was followed by a tsunami that struck the Japanese coast from Hokkaido in northern Japan to Wakayama Prefecture in western Japan. We compared the performance of a seismologically deduced single-fault model, a seismologically deduced finite fault slip model (FFM), an optimized single-fault model based on tsunami data, the FFM with horizontal shift, and the tsunami waveform inversion models of the previous studies considered for this earthquake regarding reproduction of tsunami waves by tsunami computations. It is important to discuss how these models work well because it is sometimes desirable to obtain an earthquake source model to estimate tsunami waves with a simple process obtained with limited data from the viewpoint of tsunami prediction. The seismologically deduced FFM has an advantage in terms of the information of slip regions of fault plane and was superior to the seismologically deduced single-fault model, especially in predicting amplitudes of tsunami waves. This means that when only with seismic data, the FFM could narrow the range of forecast of tsunami amplitude. In the comparison of models optimized with tsunami data, the single-fault model showed the almost equivalent performance of the tsunami waveform inversion models of previous studies regarding the waveform coincidence with observations and the horizontal location at the negative peak of the initial sea surface displacement. In case the main generation region of the tsunami is concentrated in one place, the tsunamis can be expressed by a single-fault model by conducting the detailed grid search. We also confirmed that the centroid location of centroid moment tensor (CMT) solution and the absolute location of the FFM were not necessarily suitable to express tsunamis, while the moment magnitude, the focal mechanism, the centroid depth of CMT solution, and the relative slip distribution of the FFM were effective to represent tsunamis. Since this event occurred at the shallow depth, the speed of tsunami wave is particularly slow. Therefore, it would be advisable to pay attention to the horizontal uncertainty to apply seismologically obtained solution to tsunami forecast, especially when a tsunami occurs in shallow water.

Abstract Around the Ogasawara Islands, only a few seismic stations in the area can be used to determine the hypocenters of regional earthquakes; thus, hypocenter location precision tends to be low. To more precisely determine hypocenter locations, we deployed a temporary seismic observation network of pop-up ocean bottom seismometers around the Ogasawara Islands from July to October 2015. We identified a double seismic zone in the 70–200 km depth range associated with the subducting Pacific slab. The slab-normal distance between the two planes of the double seismic zone is about 30–35 km, similar to such distances observed along the Japan and Mariana trenches. Furthermore, we found unusual seismicity in the mantle wedge at 20–50 km depth beneath the Ogasawara trough that might be related to structure formed at the onset of the oceanic slab subduction. The hypocenters determined from the ocean bottom seismometer observation were horizontally separated by a few tens of kilometers from hypocenters published by the Seismological Bulletin of Japan. USGS locations (Preliminary Determination of Epicenters) seem to be offset westward about 30 km compared with the locations determined in this study.

Abstract Background It is widely supposed that there is no benefit, including extended survival and decreased rate of pneumonia, in patients with severe dementia receiving enteral tube feeding (TF). However, there have been few studies comparing the frequency of pneumonia before and after TF in severe dementia. Methods Nine psychiatric hospitals in Okayama Prefecture participated in this retrospective survey. All inpatients fulfilling the entry criteria were evaluated. All subjects suffered from difficulty in oral intake. Attending physicians thought that the patients could not live without long-term artificial nutrition, and they decided whether or not to make use of long-term artificial nutrition from January 1, 2014 to December 31, 2014. Results We evaluated 58 patients including 46 with TF and 12 without. The mean age of all patients was 79.6 ± 9.0 years old. Patients with probable Alzheimer’s disease (n = 38) formed the biggest group, and those with vascular dementia the second (n = 14). Median survival times were 23 months among patients with TF and two months among patients without TF. The start of TF decreased the frequency of pneumonia and the use of intravenous antibiotics. Conclusions TF decreased pneumonia and antibiotic use, even in patients with severe dementia. The results of this study do not necessarily indicate that we should administer TF to patients with severe dementia. We should consider the quality of life of patients carefully before deciding the use or disuse of TF for patients with severe dementia.

Background/Aims: Most patients with dementia suffer from dysphagia in the terminal stage of the disease. In Japan, most elderly patients with dysphagia receive either tube feeding or total parenteral nutrition. Methods: In this study, we investigated the factors determining longer survival with artificial nutrition. Various clinical characteristics of 168 inpatients receiving artificial nutrition without oral intake in psychiatric hospitals in Okayama Prefecture, Japan, were evaluated. Results: Multiple logistic regression analysis showed that the duration of artificial nutrition was associated with a percutaneous endoscopic gastrostomy (PEG) tube, diagnosis of mental disorder, low MMSE score, and absence of decubitus. Conclusion: Patients with mental disorders survived longer than those with dementia diseases on artificial nutrition. A PEG tube and good nutrition seem to be important for long-term survival.

To discover susceptibility genes of late-onset Alzheimer's disease (LOAD), we conducted a 3-stage genome-wide association study (GWAS) using three populations: Japanese from the Japanese Genetic Consortium for Alzheimer Disease (JGSCAD), Koreans, and Caucasians from the Alzheimer Disease Genetic Consortium (ADGC). In Stage 1, we evaluated data for 5,877,918 genotyped and imputed SNPs in Japanese cases (n = 1,008) and controls (n = 1,016). Genome-wide significance was observed with 12 SNPs in the APOE region. Seven SNPs from other distinct regions with p-values

Background: Lumbar disc herniation (LDH) at the upper levels (L1–2 and L2–3) is different from that at the lower levels with regard to clinical characteristics and surgical outcomes. Discectomy using the transdural approach is a good option for central LDH at the upper levels; however, postoperative instability and recurrence are the major concerns. Case presentation: A 57-year-old woman experienced severe back pain and dysuria. Magnetic resonance imaging (MRI) revealed a massive LDH at the L1–2 level. Despite conservative treatment for 3 months, her low back pain was not relieved. Posterior lumbar interbody fusion (PLIF) with bilateral facetectomy was performed, and the residual LDH was subsequently removed using the transdural approach. The patient’s preoperative symptoms were relieved after surgery. Conclusions: PLIF followed by discectomy using the transdural approach is a safe and useful surgical method to treat a massive LDH at the upper levels.

On 17 July 1998, a tsunami caused serious damage on the northern coast of Papua New Guinea about 20min after the mainshock of an Mw7.0 earthquake. The tsunami has been attributed to a submarine landslide that occurred about 13min after the mainshock because its arrival at the coast was too late and its height too great to be the direct result of the fault slip of the earthquake. Bathymetric data recorded after the tsunami revealed an amphitheater-like structure that was consistent with a recent submarine landslide. Most current tsunami warning systems are based on analysis of the early arrivals of seismic waves generated by an earthquake. In this study we investigated whether evidence of the landslide could be identified in the coda waves recorded after the mainshock. Based on previous studies of the tsunami source, we constructed synthetic seismograms to represent the submarine landslide and compared them to the observed coda waves of the preceding earthquake, with particular attention to the period around 13min after the mainshock. We found phases possibly corresponding to the landslide event. However, they were easily covered with coda waves from the mainshock. We concluded that the 1998 landslide was too small to be evident in the coda waves following the magnitude 7 earthquake. [ABSTRACT FROM AUTHOR]

Susceptibility to Alzheimer's disease (AD) is thought to be regulated by multiple genetic factors. Recently, three independent studies have reported that loci on chromosome 10q are linked with AD, and the insulin degrading enzyme (IDE; MIM 146680) gene located on chromosome 10q23-q25; IDE is located close to the maker D10S583, which exhibits a maximum LOD score for late-onset AD. We examined seven polymorphisms in the IDE gene, the marker D10S583 in the 5' flanking region, and SNPs in introns 1, 3, 11, 20, 21, and 22 (rs#1999764, 1855915, 1970244, 538469, 551266, and 489517, respectively). Four SNPs in introns 3, 11, 20, and 22 did not exhibit any polymorphisms in the Japanese population that was studied. D10S583 and two SNPs in introns 1 and 21 did not exhibit a significant association with early- or late-onset AD. In addition, no associations were observed for subgroups of AD grouped according to APOE status. The present study indicates that the IDE gene polymorphisms do not confer susceptibility to early- or late-onset AD at least in a Japanese population. © 2003 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

A new mixed-valence Cu(I)–Cu(II) 1D coordination polymer, [CuI4CuIIBr4(Cy2dtc)2]n, with an infinite chain structure is synthesized by the reaction of Cu(Cy2dtc)2 (Cy2dtc− = dicyclohexyl dithiocarbamate, C13H22NS2) with CuBr·S(CH3)2. The as-synthesized polymer consists of mononuclear copper(II) units of CuII(Cy2dtc)2 and tetranuclear copper(I) cluster units, CuI4Br4. In the cluster unit, all the CuI ions have distorted trigonal pyramidal coordination geometries, and the CuI–CuI or CuI–CuII distances between the nearest copper ions are shorter than the sum of van der Waals radii for Cu–Cu.