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The testing machine requires additional controller with existing one in the sake of improvement of its functions such as robustness and tracking performance. This approach is known as controller fusion method. In this approach, two controllers, one is additional and another is existing, can collaborate with each other to improve performance with cross-effect. However they also conflict each other since they designed each by each. This is called as confliction as a negative effect in cross-effect. This study developed the transfer function model for cross-effect in the fusion of acceleration feedback controller and displacement feedback controller since still not clearly described of details in the fusion of two controllers. The model equation was validated by experiment with small scale shaking table. The controllers for it designed using suggested transfer function model. The motion of this test rig marked well tracing to simulated output signal calculated by suggested model in both acceleration and displacement domain. The experiment results show the model well represent the cross-effect of controllers. According to these results, the detailed knowledge of controller fusion, the mechanism of why controllers conflicts each other, is shown clearly. Also, this results can apply not only for shaking tables but also for variety of mechatoronic systems with two controllers for one controlled plant.

A shaking table is a device used to examine the vibration characteristics of a specimen by applying vibration to it, and is used to evaluate the earthquake resistance of buildings and the ride comfort and safety of vehicles. Therefore, it is necessary to accurately reproduce the target vibration on the shaking table in order to investigate the accurate vibration characteristics of the specimen. For this reason, experiments with shaking tables require a controller with good tracking performance. Generally, shaking tables are controlled by feedback control, which uses displacement or acceleration as the controlled variable. However, acceleration feedback control can easily achieve good tracking performance in the high-frequency range, but performance deteriorates in the low-frequency range. On the other hand, the displacement feedback control can improve the tracking performance in low frequency. Considering these characteristics of the control system, a method using a control system that fuses acceleration feedback control system and displacement feedback control system has been proposed. This method of fusing different feedback control systems is called as Controller Fusion. However, controller fusion causes problems such as deterioration of tracking performance due to interference in the control system. In this study, we formulate the interference in the control system caused by controller fusion and use its inverse characteristics as a compensator to propose a control system that does not deteriorate the tracking performance no matter what kind of feedback controller is used. Then, experiments are conducted with the specimen mounted on a 3-DOF shaking table to verify the effectiveness of the proposed control system.

A hand-made apparatus to react copper concentrate (Cc)/pyrite (Py)/silica sand (Ss) mixture was developed for an imitated concentrate burner at laboratory scale. An instantaneous (< 1 s) ignition reaction was macroscopically observed by preheated oxygen gas blowing to Cc/Py/Ss mixture with a Fe/SiO2 mass ratio of 1.1. SEM-EDS analysis was used to observe microstructure and phase distribution in reacted and water-quenched particles. As for the Cc/Ss samples collected at the point close to the gas blowing spot, 70–80 mass% Cu matte phase and heterogeneous slag phase including large amounts of magnetite (Mag) particles were formed. At the lower part from the gas blowing spot with a distance of 275 mm, 60–65 mass% Cu matte phase was confirmed. The area fraction of Mag particles in the slag phase decreased with increasing Py adding concentration in the mixture sample. Our results suggested the concentration and microscopic distribution of Py in the mixture including Cc contributed to control both Cu concentration in matter phase and Mag particle concentration in slag phase.

To fully understand the physics of chiro-optical systems and to derive their potentials, it is essential to observe chiro-optical effects in situ from individual components, since the macroscopic chiro-optical effects cannot be directly translated into the microscopic effects. Here, we observed optical responses at the nanoscale level by detecting optical forces induced by irradiating circularly polarized light onto a tip-sample system. The induced optical forces were well correlated with the differential intensity of the simulated electric field. [ABSTRACT FROM AUTHOR]

The purpose of this study was to elucidate collisions between droplets and a liquid film, where the liquid film and the droplets are composed of different liquids. Understanding this phenomenon is important to improve the environmental performance of internal combustion engines. The collision behavior of different liquids under the simplified experimental system is discussed on the basis of experimental results. The impingement of a single droplet on a liquid film was observed using a high-speed video camera. Another observation was carried out to distinguish whether the secondary droplets by splash were derived from fuel or liquid film. The different splash phenomena from the same liquid collision experiment were observed. The collision behavior of different liquids was classified into four categories. The characteristics of the collision behavior and underlying mechanisms were discussed and elucidated. An empirical formula that represents the phenomena was derived.

OBJECTIVES Medial heel wedges are commonly prescribed to manage the weight-bearing response of hindfoot valgus and the total weight-bearing responses of the navicular and talus bones. Previous studies have reported that a medial heel wedge is effective in the management of musculoskeletal injuries. However, it remains unclear the effect of a medial heel wedge on the weight-bearing responses of footarch bones in vivo. To clarify the effects of a medial heel wedge on the weight-bearing response of hindfoot valgus and the total weight-bearing responses of the navicular and talus bones is necessary to understand how best to treat musculoskeletal injuries clinically. The purpose of our study was to clarify the effects of a medial heel wedge on the weight-bearing response of hindfoot valgus and the total weight-bearing responses of the navicular and talus bones. METHODS Twenty-five healthy males were analyzed. We obtained MRI scanning of the right foot under non-loading (NL) and full weight-bearing (FW) conditions. Participants wore two insole types, a flat insole and a medial heel wedge. To evaluate the weight-bearing response in hindfoot valgus, the hindfoot alignment view (HAV) was measured. We also measured navicular and talus bone positions and calculated the total positional changes of the navicular and talus bones (ΔTPCN, ΔTPCT) from the vertical and medial displacements using the Pythagorean theorem. RESULTS Significant interactions were observed with the HAV. Under both NL and FW conditions, the HAV was smaller on the medial heel wedge than on the flat insole. In addition, the ΔTPCN was significantly smaller on the medial heel wedge than on the flat insole. However, no significant differences were observed for ΔTPCT. CONCLUSIONS Our results suggest that use of a medial heel wedge decreases hindfoot valgus values under both NL and FW conditions and stabilizes the total weight-bearing response of the navicular bone.

A new Ti smelting process via. Bi–Ti alloy is proposed. This process comprises reduction of TiCl4 to Bi–10 mol%Ti alloy by Bi–Mg alloy, precipitation of Ti-rich compound from the alloy, and vacuum distillation. In this study, we investigated the precipitation and distillation processes. In the precipitation process, the Bi–10 mol%Ti liquid alloy is cooled from 900 ℃ to 500 ℃ to precipitate Bi9Ti8 in the liquid alloy. The Bi9Ti8 is recovered by a two-step separation method: recovery of mixture of Bi9Ti8 and Bi and further removal of Bi by centrifugal filtration. We demonstrated the recovery of mixture. As the results, Ti concentration in the mixture was 31 mol%, and the Ti yield was about 45 %. Because the remained liquid alloy after the recovery contains a large amount of Bi9Ti8, it is required to reuse the remained alloy in the precipitation process. Assuming the reuse of remained alloy, the material flow of the process was designed based on the experimental results. The centrifugal filtration of the mixture of Bi9Ti8 and Bi was also carried out at 500 ℃. By the centrifugal filtration at 50 G, alloys with a size of 1.5 mm were obtained, and the Ti concentration in the alloys was increased from 31 mol% to 40 mol%. Vacuum distillation of alloy powder and ingot was demonstrated. The distillation rate was enhanced when using the powder than when using alloy ingot as a starting material.

Ube Industries' Isa Cement Factory introduced a rock cutting machine“2500SM”capable of continuous excavation by rotating a drum equipped with a cemented carbide bit from the viewpoint of effective recovery limestoneresources. Because it can excavate with low vibration and low noise, it can reduce the distance from the surrounding private houses that have been secured in consideration of the effect of blasting, and in order not to loosen the excavated surface, the bench angle of the excavated surface is steeply inclined and berm is minimized. It was because it was judged that the minable amount could be expanded by minimizing the berm. In the early stages of the introduction, cutting bits were broken unexpectedly, and the frequency of replacement increased, resulting in a decrease in mining efficiency. In addition, the excavation slope using a rock cutting machine“2500SM” has a smoother surface and no large cracks. In addition, in the evaluation using methods of elastic wave exploration, ground penetrating radar and infrared camera, the slope of excavation is compared with that by blasting. It was confirmed that the soundness was high. The effects of cutting bit improvements was evaluated, the expected excavation area, the soundness and safety of the rock slope, and the expansion of the minable amount that were expected when the rock cutting machine “2500SM” was introduced. In this paper,we repot the evaluation results.

Generating novel design concepts in the conceptual design phase is a cornerstone for producing innovative products. This paper proposes a method to support the generation of new design concepts from patent documents. The proposed method is based on the theory of novelty potential that the combination of abstract concepts leads to the generation of the novel design concept and that the distance between the combined abstract concepts correlates to the possibility of generating it. This research adopts the distributed word representation model of word2vec to extract abstract concepts from patent documents and to measure the concept distance. The two matrices are introduced to visualize the relationships of the extracted abstract concepts; the novelty potential matrix which shows the value of the novelty potential between the abstract concepts, and the void matrix which shows the numbers of existing patents of the abstract concepts. They help a designer to identify the combinations of abstract concepts that are high novelty potential and no existing patent. This paper demonstrates a case study of generating novel ideas of sports business with blockchain using the proposed method. The results show its uniqueness and effectiveness.

The impingement of a single droplet on a liquid film is observed using a high-speed video camera. Specifically, an experiment is conducted to simulate the impingement behaviors of a fuel droplet on an engine oil film in a real engine. The droplets are composed of n-heptane and ethanol. The films pertain to engine oils with two viscosities. The impact of the engine oil type, droplet liquid type, droplet release height, and temperature and thickness of the oil film on the collision phenomenon is evaluated. The design of experiments scheme is used to identify the dominant parameters affecting the crown height and splash generation. The dominant parameters for the crown height are the oil film temperature, which affects the oil viscosity; droplet release height, which is related with the impinging velocity, and oil film thickness. The splash phenomena can be divided into two types, specifically, splash phenomena with split early type and crown break type, which are affected by the droplet release height and oil film temperature, respectively. The results demonstrate that the design of experiments scheme can help evaluate the dominant parameters in impingement phenomena.

Synthetic fuel derived from renewable energy is expected as a means of reducing CO2 in internal combustion engines. OME (OxyMethylene Ether) can be handled like a diesel fuel because its specification of distillation is almost same with it. Therefore, it is expected to introduced in the market as alternative or additional fuel. In this report, fuel properties, engine performance, combustion characteristics and exhaust emission of OME and its diesel blended fuels were investigated. The energy density was decreased with increasing of OME blending ratio because the energy density of OME is lower than that of diesel fuel. Since OME fuel has the effect of expanding rubber materials, an immersion test of rubber material was conducted with OME blending diesel fuel. As the result, exceeding permissible range was observed with beyond 10% OME blending. Engine power was decreased under same injection quantity condition with increasing OME blending ratio because of its lower energy density. In the test under the same torque condition, blending OME with diesel fuel resulted in deterioration of thermal efficiency and reduction of SOOT, HC, and CO emissions.

Purpose The development of business continuity plans (BCP) at birth centers ensures the safety of the management and staff in the event of a disaster, and ensures the continuity and survival of midwifery services to protect the lives and health of mothers and children in the area. This study aimed to clarify the current situation regarding preparations for disasters by birth centers as well as to determine the pre-disaster status of BCP creation at birth centers in order to identify methods for promoting BCP creation. Methods This was a cross-sectional study design, and an online survey using an anonymous self-administered questionnaire was conducted on midwifery managers at birth centers. The questionnaire contents were the attributes of the birth center, recognition and creation of a BCP, preparations for disasters at the birth center and correspondence during a disaster, and preparations and correspondence during an infectious disease outbreak such as the COVID-19 pandemic. Results Responses were received from 292 midwifery managers. Among them, 76.0% were not familiar with the term "BCP". Furthermore, only 2.4% of birth centers had a BCP, 18.5% were preparing one, and 79.1% had none. Overall, only 18.2% of birth centers had actually developed a basic policy on disaster situations, even though they did not have a BCP. Most midwifery centers were taking measures to prepare for and respond to an outbreak of COVID-19. Conclusion Many of the birth centers did not know about BCP, and only a few had created BCPs. Although some birth centers have made preparations for disasters, it is clear that a more systematic response is needed for the continuation of operations during disasters. Further activities are needed to promote the establishment of a BCP at every birth center so that they can continuously provide care that meets the needs of mothers and children, even following a disaster. [ABSTRACT FROM AUTHOR]

A 74-year-old man visited a nearby hospital because of vomiting and abdominal pain. An abdominal CT scan revealed a tumor measuring 35mm in the terminal ileum, accompanied by calcification, as well as dilation of the proximal small bowel. Four years earlier, a similar tumor was incidentally pointed out, but no further investigation was conducted at that time. Although the size of the tumor had not increased since the previous examination, the patient had developed bowel obstruction, requiring surgical intervention after improvement of bowel distension. Since the possibility of malignancy could not be ruled out, a laparoscopic ileocecal resection was performed, including lymphadenectomy of the surrounding small bowel mesentery. Macroscopic examination of the resected specimen showed a yellowish, well-circumscribed lesion with calcification inside. The histopathological examination revealed a nodular lesion measuring 40×35×32 mm, primarily involving the muscularis propria in the terminal ileum. The tumor was positive for desmin and α-SMA, while c-kit was negative by immunohistochemical staining and leiomyoma was diagnosed. The patient was discharged on the 7th postoperative day. At the one-year follow-up, no recurrence of the leiomyoma was observed. [ABSTRACT FROM AUTHOR]

We report a single-incision laparoscopic assisted ileocecal resection on a case of low-grade appendiceal mucinous neoplasm (LAMN). The patient was a 65-year-old man with positive fecal occult blood test. Colonoscopic examination showed a submucosal tumor-like lesion measuring 40 mm in the cecum. Abdominal enhanced CT scan showed a cystic mass in the cecum, but physical examination revealed no abdominal pain and laboratory tests showed no elevated inflammatory response. We considered an appendiceal mucinous tumor at first; carcinoid, appendiceal cancer, and malignant lymphoma were listed as differential diagnoses. We performed singleincision laparoscopic assisted ileocecal resection with D3 lymph node dissection for the purpose of diagnosis and treatment, in view of minimally invasive and esthetic aspects, by devising surgical techniques and the surgical field. The final pathologic diagnosis was LAMN. Surgery is the principal of treatment for LAMN, but there is no clear standard opinion regarding the diagnostic method, surgical procedure, postoperative follow-up period, etc. More cases need to be accumulated and further investigation conducted in the future. [ABSTRACT FROM AUTHOR]

We report two cases in which dyssynergic defecation with rectocele was considered to be the cause of defecation disorder. Case 1 was a 51-year-old woman with the main complaints of dyschezia and a feeling of incomplete evacuation. Rectocele of about 4cm was detected in defecography and radical operation for rectocele was performed. The patient complained dyschezia even after the operation, so defecography was performed again. The defecography showed dyssynergic defecation was the cause of outlet obstruction and the complaint improved by biofeedback therapy. Case 2 was a 74-year-old woman with the main complaint of dyschezia. Rectocele of about 2.5cm was detected and dyssynergic defecation was found by defecography. The complaint improved by biofeedback treatment. A rectocele can be diagnosed by digital examination, but the cause of outlet obstruction should be considered and treated not only due to rectocele but also due to dyssynergic defecation. [ABSTRACT FROM AUTHOR]

In vehicle system development, complying with ISO 21448 and ISO 26262 grows in demand. However, the challenge lies in realizing an efficient safety analysis method that can comply with both standards by effectively sharing their respective parts. To address this challenge, we focus on STAMP/STPA. STAMP/STPA is applicable to safety analysis in the concept phase of the product development process, and examples of the application of STAMP/STPA are provided in the appendix of ISO 21448. In this paper, we propose an extended STAMP/STPA that can efficiently comply with both international standards. [ABSTRACT FROM AUTHOR]

Seafloor Polymetallic Sulphides (PMS) is deep sea mineral that is confirmed to exist within Japanese exclusive economic zones and expected to develop as a new supply source for Japan. However, deep sea minerals including PMS have not been commercially developed so far, although various countries are eagerly working it. Japan Oil, Gas and Metals National Corporation (JOGMEC) has been commissioned by Ministry of Economy, Trade and Industry (METI) to conduct practical study on PMS for commercialization. As part of the efforts, JOGMEC implemented “Excavating and Ore-lifting Pilot Test” from the middle of August to end of September 2017. In the test, JOGMEC succeeded in consecutive lifting of ore and sea water in a state of solid-liquid flow from a depth of approximately 1,600m for the first time in the world. Through the test, it became clear that there are still many technical challenges left to be resolved for development of PMS such as improvement in durability of equipment, system optimization, adjustability of ore grain size and slurry concentration and so on. JOGMEC will continue efforts aimed at commercialization of PMS from a long-term perspective.

Droplet impingement to wet wall is observed and classified. The wet wall has a thin liquid film which is different kind of liquid from the droplets. The present study models the droplets impingements to wet engine walls in gasoline engine. The alternative fuel droplets injected by the injector for port injection system impinge to the silicon oil film simulating wet cylinder wall of actual gasoline engine. In this experiment, a rectangular flow section is used as an example of collision between different liquids in a port injection engine. The viscosity of the liquid film was varied as experimental parameter. The experimental results are well organized using Weber number calculated by using vertical velocity. As Weber number increases, the impingement type changes from rebound to deposit then splash. The tendency is same as impingement regime under the case of same liquid for wet wall and droplets, however critical Weber number is different from them. The liquid film viscosity strongly affects the droplet impingement form. Splash does not occur under the large liquid film viscosity. It is difficult to categorize the impingement regime by common Laplace number based on droplet viscosity. The modified Laplace number which is based on the viscosity of the liquid film is proposed. In the case of different kinds of liquids droplet-film impingement, the phenomenon can be categorized by modified Laplace number and Weber number based on the vertical velocity component of droplet velocity.

An effective method for handling turbulent fluctuations in temperature and in partial pressure of infrared-active gas is proposed in order to make a fairly accurate simulation within feasible calculation load in relation to radiative heat transfer in the large-scale hydrocarbon flame formed in industrial furnaces. As for the case of large-scale turbulent hydrogen flame in industrial furnace, an effective method for handling turbulent fluctuations has been proposed and verified in our previous papers. And yet, it’s applicability to large-scale turbulent hydrocarbon flames has not been confirmed. In this paper, the abovementioned method is examined as to the applicability to hydrocarbon flames, and then, an improved method is proposed. In regard to the method proposed in our previous papers to reduce the enormous calculation load contingent on detailed non-gray analysis like line-by-line analysis, it’s validity is easily confirmed not only for hydrogen flames but also for hydrocarbon flames. On the other hand, the method proposed in our previous paper for reducing the calculation load required for tracing turbulent fluctuation in temperature in great detail cannot give satisfactory results in relation to the large-scale hydrocarbon flame. So, in this paper, major attention is concentrated on the improvement of our method for reducing the calculation load associated with detailed trace of turbulent fluctuation. The assumption that temperature fluctuations of arbitrary two positions are independent from each other and the treatment of energy radiation associated with turbulent fluctuation are maintained also for hydrocarbon flames. In contrast, the treatment of fluctuating absorption is changed from the case of hydrogen flames. While the temporal mean amount of absorption is evaluated using the absorption coefficient at temporal mean temperature in the case of hydrogen flames, such value is evaluated using the temporal mean value of instantaneous absorptance. Validity of the improved method is examined on a model optical path imaging the typical course of radiative energy in large-scale industrial furnaces fueled by propane. It is indicated by examination that the error caused by improved method is satisfactorily smaller than that caused by entire disregard of turbulent fluctuation of temperature and gas composition. Moreover, this improvement related to the treatment of turbulent fluctuation is satisfactorily valid even if coupled with our efficient method for treating complicated spectrum of absorption coefficient.

In general, mechanical systems are stabilized on their equilibrium point. Equilibrium point is often not unique and they are continuously connected, which is an equilibrium manifold. To stabilize the mechanical system on an equilibrium manifold will enable optimal control including the selection of the stabilizing position. In this paper, we propose a controller design method that stabilizes a mechanical system on an equilibrium manifold based on vector field. The equilibrium manifold is derived from dynamic equations, and by setting an appropriate evaluation function, (1) an optimal equilibrium point from arbitrary initial value is calculated, (2) a trajectory, input and vector field are derived based on linear control theory, (3) a controller is designed using functional approximation. Simulations show that different initial values are stabilized to different equilibrium points, and experimental results show the effectiveness of the proposed method.

For robotic teleoperation, semi-autonomous control, i.e. autonomous control allowing human interposition will be an effective way overcoming delay of electrical communication and emergency operation. We have proposed semi-autonomous control method focusing on excavation in teleoperation environments. In the method, a model of human operation is designed and human internal state is estimated by Extended Kalman Filter. In this paper, experimental evaluations are conducted and reported about ”Digging” process. A human skill of excavation is modeled by an attractor-based dynamics embedding shallow and deep digging trajectories for soft and hard soil, respectively. An index parameter is changed based on the load of the bucket, and a seamless motion transition is realized satisfying the restriction by setting a threshold. Moreover, by adding a human operation to the autonomy, the proposed method will cope with the emergency, which is experimentally evaluated.

This study investigated experimentally a response of premixed Bunsen flame to transient change in a fuel composition and a method to control the variation. Fuel mixtures were composed of methane, ethane and propane. The volumetric fraction of methane was varied from 92 % to 76 % by 4 % and the ethane/propane ratio was 5. Transition time of the fuel composition was 1, 5, 10 and 20 s. Flow velocity and the equivalence ratio were 0.8 m/s and 0.85 respectively before the transition. Channel length L between the merging point of fuels and the point of air was 0, 500, 1000, 1500 mm. The motion of flame was recorded by a high-speed video camera at 60 fps. The experiment was conducted under the fuel flow rate constant and the equivalence ratio constant conditions. In the former condition, the flame height varied almost linearly not depending on the conditions. In the latter condition, variation of the steady flame height was smaller than the former condition. However, the unsteady flame height exceeded or fell below temporarily the steady flame height. This is due to the time lag between the transmission of fuel flow rate variation and fuel compositions variation. Therefore, considering this time lag, the experiment was conducted with a system which had a density meter to detect the fuel composition variation. The system controlled automatically the fuel flow rate. At long L and short transition time, there were some peaks in the flame height variation. It is considered that this is caused by the difference between the actual density and the output of the density meter due to Taylor dispersion and response time of the density meter. However, the flame height variation was smaller than the variation without control, and particularly at long transition time, the variation was suppressed sufficiently.

Human’s ability to work upon, or manipulate objects in the environment depends on the psychological function to perceive objects’ size appropriately. In daily situation, human recognizes object size by using visual and haptic cues concurrently. In experimental psychology, human visual information processing of object size has long been a major research area, and substantial amount of knowledge has been accumulated, but relatively little is known concerning the haptic information processing. In this study, characteristics of haptic size perception were examined in discrimination and magnitude estimation (ME) experiments for ‘one-dimensional (1D)‘ stimuli (bars of which lengths were varied) and ‘two-dimensional (2D)’ stimuli (circles, triangles and squares of which areas were varied). In the experiments, participants held the 1D standard and comparison stimuli with two fingers (thumb and index or middle finger), or 2D stimuli with three (or four) fingers (thumb, index, and middle (plus third) fingers), and discriminated or evaluated the sizes of the stimuli. The results of the discrimination experiment showed that Weber ratios, defined as discrimination threshold/standard stimulus size, for the two 2D stimuli (circles and squares, but not for triangles) were lower (i.e., discrimination sensitivities were higher) than those for the 1D stimuli. The difference in the discrimination sensitivities was explained by taking into account probability summation between multiple inter-finger distance cues available for the 2D stimuli. Weber ratio for the triangles may be affected by the uncertain factor that the figures were not identified only by the information of contact points. The results of the ME experiment showed that the evaluated value vs. stimulus size functions had different slopes for the 1D and 2D stimuli, suggesting that size perception for the 1D and 2D stimuli may be mediated by different mechanisms specialized for processing of the length and the area of haptic stimuli.

The concept of "Science Identity" has been receiving growing attention in science education worldwide, and yet, it remains to be fully explored in Japan. The concept was recently announced to be incorporated into the science framework of PISA 2025. This installation likely facilitates the new wave of science education research in Japan. Prior to such a wave, I wish to briefly summarize the development and transition of Science Identity research conducted in the last 20 years. My intention is to demonstrate the breadth and depth of Science Identity research, along with a variety of theories behind it (e.g. identity theory, social cognitive career theory, post-structuralist feminism, cultural capital), to provide a stepping stone for future research. [ABSTRACT FROM AUTHOR]

Regenerative medicine products share important characteristics with pharmaceuticals and medical devices. We hypothesized that information should be provided to reflect the characteristics of regenerative medicine products. As they are a new style of product, there are few medical provider-focused surveys on regenerative medicine products. We conducted an efficacy survey, evaluating whether the regenerative medicine package insert meets the informational needs of those in the clinical field. Hospital pharmacists were the target survey group. The survey asked about the importance of each item of information in the package insert, the importance of the specific information included in the package insert, and the degree to which desirable information is not included in the package insert. The format of the survey was based on a five-point scale of importance. In a survey of the specific information contained in Kymriah's package insert, more than 50% of respondents rated all the information covered in the survey as important. However, some information currently not included in the package insert also had a high importance rating. The results of the survey indicated that the current information provided in the regenerative medicine product package inserts is important. However, respondents indicated additional information was required. Information provided during the approval review process is not adequately provided to clinical practice. As the package insert already contains a large amount of important information, it is proposed that package insert creation is improved by developing Optimal Clinical Use Guidelines, to systematically incorporate approval review process information and supplement the package insert information. [ABSTRACT FROM AUTHOR]

Dysfibrinogenemia is characterized by the presence of functional abnormalities despite the maintenance of normal levels of fibrinogen antigen. Plasma fibrinogen level is commonly measured by Clauss fibrinogen assay (CFA). Although CFA may underestimate the true antigen level in patients with dysfibrinogenemia, the clot waveform helps distinguish between true low fibrinogen values and those caused by qualitative abnormalities. Case 1 was a woman in her 50s with persistent proteinuria and no history of bleeding disorders who showed a low fibrinogen level before renal biopsy. Based on the CFA clot waveform, dysfibrinogenemia was diagnosed. The renal biopsy was performed without significant bleeding complications, and replacement therapy was not required. Case 2 was a pregnant woman in her 30s with no history of bleeding disorders who showed a low fibrinogen level prior to her second childbirth. The CFA clot waveform indicated a preserved antigen level, leading to a diagnosis of dysfibrinogenemia. She had a successful delivery without any replacement therapy. In both cases, the presence of a heterozygous missense mutation in the fibrinogen γchain (γArg301His) was confirmed. The CFA clot waveform is useful in diagnosing dysfibrinogenemia and determining treatment strategies in patients with low levels of fibrinogen without bleeding symptoms. [ABSTRACT FROM AUTHOR]