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To identify the risk factors for post-tonsillectomy hemorrhage (PTH) in adult patients (19 years).275 adult patients who underwent tonsillectomy between 2009 and 2019 were retrospectively analyzed. Possible risk factors associated with PTH were investigated by univariate and multivariate logistic regression analyses.PTH occurred in 39 of 275 patients (14.2%). Regarding underlying diseases, PTH occurred more frequently in focal infection of IgA nephropathy. Furthermore, bipolar electrocautery was the other risk factor for PTH on multivariate analysis.Focal infection of IgA nephropathy and bipolar electrocautery were identified as the risk factors for PTH.

Rapid diagnostic tests (RDTs) significantly impact disease treatment strategy. In Japan, information on the use of RDTs for patients with COVID-19 is limited. Here, we aimed to investigate the RDT implementation rate, pathogen detection rate, and clinical characteristics of patients positive for other pathogens by using COVIREGIJP, a national registry of hospitalized patients with COVID-19.A total of 42,309 COVID-19 patients were included. For immunochromatographic testing, influenza was the most common (n = 2881 [6.8%]), followed by Mycoplasma pneumoniae (n = 2129 [5%]) and group A streptococcus (GAS) (n = 372 [0.9%]). Urine antigen testing was performed for 5524 (13.1%) patients for S. pneumoniae and for 5326 patients (12.6%) for L. pneumophila.The completion rate of M. pneumonia loop-mediated isothermal amplification (LAMP) testing was low (n = 97 [0.2%]). FilmArray RP was performed in 372 (0.9%) patients; 1.2% (36/2881) of patients were positive for influenza, 0.9% (2/223) for the respiratory syncytial virus (RSV), 9.6% (205/2129) for M. pneumoniae, and 7.3% (27/372) for GAS. The positivity rate for urine antigen testing was 3.3% (183/5524) for S. pneumoniae and 0.2% (13/5326) for L. pneumophila. The positivity rate for LAMP test was 5.2% (5/97) for M. pneumoniae. Five of 372 patients (1.3%) had positive FilmArray RP, with human enterovirus being the most frequently detected (1.3%, 5/ 372).The characteristics of patients with and without RDTs submission and positive and negative results differed for each pathogen. RDTs remain an important diagnostic tool in patients with COVID-19 in whom coinfection with other pathogens needs to be tested based on clinical evaluation.

SummaryBrazilian basslet Gramma brasiliensis is a fish highly appreciated by the marine ornamental industry. There is an increasing interest in the development of a breeding protocol for this species. However, descriptions of the reproductive biology, eggs and larval development are scarce. This study was the first to describe the spawning, eggs and larvae of G. brasiliensis in captivity, including mouth size information. Six spawning events produced egg masses with 27, 127, 600, 750, 850, and 950 eggs. Larger egg masses showed embryos with at least two different developmental stages. Eggs are spherical (∼1.0 mm diameter), held together by filaments entangling chorionic projections. Larvae with fewer than 12 hph (hours post-hatch) presented 3.55 mm standard-length, well developed eyes, fully absorbed yolk sac, an inflated swim bladder and mouth opened. Exogenous feeding on rotifers began within 12 hph. The average mouth width at first feeding was 0.38 mm. The first settled larva was noted by day 21. This information should help to determine appropriate diets and prey-shift time during the larviculture of the species.

Since December 2020, coronavirus disease 2019 (COVID-19) vaccines have been distributed in most countries to prevent the onset and aggravation of COVID-19. There is little information regarding the long-term safety of the vaccines. We report three cases and a literature review of new-onset adult-onset Still's disease (AOSD) that occurred following COVID-19 vaccination. Our cases include moderate to severe AOSD, and two were complicated with macrophage activation syndrome. Seventeen cases of new-onset or relapse of AOSD following COVID-19 vaccination, including 14 identified in the literature review and our 3 patients, were all treated successfully with glucocorticoid therapy, immunosuppressive drugs, or biologic agents.

Dispersion-corrected DFT calculations quantitatively revealed the interactions of n-alkanes and n-perfluoroalkanes with circumcoronene as the models of molecular adsorption on graphite.

Medical records of 16 Japanese Black calves with respiratory signs associated with perinatal rib fracture were analyzed, retrospectively, to speculate criteria of surgical intervention for the disease. For this analysis, the severity of respiratory condition was classified into three grades: Grade 1, with no wheezing, Grade 2, with wheezing after excitement but not at rest and Grade 3, with wheezing at rest. Grade 1 (n=3) received only conservative management. Seven of Grade 2 (n=8) and all of Grade 3 (n=5) had surgical management. Clinical outcome was good in all of Grade 1, and the surgical success rate was 83% in other groups. Our result suggests that surgical intervention should be considered for cases with more the severity of Grade 2.

Adjusting the balance of intermolecular and molecule–substrate interactions could determine the appearance/disappearance of the odd–even effect in curcumin derivatives, resulting in the control of their two-dimensional structures.

Flooding and dry-out are major drawback issues in proton exchange membrane fuel cells (PEMFC), which necessitate adequate prevention control techniques. In a fuel-cell stack, as flooding and dry-out occur on the inlet and outlet sides, respectively, both faults can exist simultaneously. Therefore, the timely detection of these two contradictory faults is crucial for implementing timely control measures. In this study, we propose a preventive control method that detects the fault signs early for more effective prevention. The proposed method uses a curve-fitting method, which uses overpotential as the control index. As the control index can be obtained by measuring the current, voltage, and temperature, the evaluation can be performed quickly, making it easy to implement in a PEMFC system. Under a single fault, the stack output power, hydrogen consumption, and power efficiency of the proposed preventive control method and the previous study on flooding were compared. The results showed that our preventive control method could detect flooding sooner and was superior in stack output power, hydrogen consumption, and power generation compared to the fault control method. Under conditions of mixed flooding and dry-out, both flooding and dry-out were detected using the overpotential as the control index. Thus, because the proposed method initiates control measures before the fault progresses, it is possible to ensure the continued stable operation of the fuel cells.

Electrolytes that transport only Li ions play a crucial role in improving rapid charge and discharge properties in Li secondary batteries. Single Li-ion conduction can be achieved via liquid materials such as Li ionic liquids containing Li+ as the only cations because solvent-free fused Li salts do not polarise in electrochemical cells, owing to the absence of neutral solvents that allow polarisation in the salt concentration and the inevitably homogeneous density in the cells under anion-blocking conditions. However, we found that borate-based Li ionic liquids induce concentration polarisation in a Li/Li symmetric cell, which results in their transference (transport) numbers under anion-blocking conditions (tabcLi) being well below unity. The electrochemical polarisation of the borate-based Li ionic liquids was attributed to an equilibrium shift caused by exchangeable B–O coordination bonds in the anions to generate Li salts and borate-ester solvents at the electrode/electrolyte interface. By comparing borate-based Li ionic liquids containing different ligands, the B–O bond strength and extent of ligand exchange were found to be directly linked to the tabcLi values. This study confirms that the presence of dynamic exchangeable bonds causes electrochemical polarisation and provides a reference for the rational molecular design of Li ionic liquids aimed at achieving single-ion conducting liquid electrolytes.

Information regarding effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant strains on clinical manifestations and outcomes of coronavirus disease 2019 (COVID-19) in pregnant women is limited.A retrospective observational study was conducted using the data from the nationwide COVID-19 registry in Japan. We identified pregnant patients with symptomatic COVID-19 hospitalized during the study period. The Delta and Omicron variants of concern (VOC) predominant periods were defined as August 1 to December 31, 2021 and January 1 to May 31, 2022, respectively. Clinical characteristics were compared between the patients in the Delta and Omicron VOC periods. In addition, logistic regression analysis was performed to identify risk factors for developing moderate-to-severe COVID-19.During the study period, 310 symptomatic COVID-19 cases of pregnant women were identified; 111 and 199 patients were hospitalized during the Delta and Omicron VOC periods, respectively. Runny nose and sore throat were more common, and fatigue, dysgeusia, and olfactory dysfunction were less common manifestations observed in the Omicron VOC period. In the multivariable logistic regression analysis, onset during the later stage of pregnancy (OR: 2.08 [1.24-3.71]) and onset during the Delta VOC period (OR: 2.25 [1.08-4.90]) were independently associated with moderate-to-severe COVID-19, whereas two doses of SARS-CoV-2 vaccine were protective against developing moderate-to-severe COVID-19 (OR: 0.34 [0.13-0.84]).Clinical manifestations of COVID-19 in pregnant women differed between the Delta and Omicron VOC periods. SARS-CoV-2 vaccination was still effective in preventing severe COVID-19 throughout the Delta and Omicron VOC periods.

Surgical site infections (SSIs) after neurosurgery are common in daily practice. Although numerous reports have described SSIs in neurosurgery, reports specific to gliomas are limited. This study aimed to investigate the relationship between SSIs and glioma treatment characteristics, such as reoperations, radiation therapy, and chemotherapy.We examined 1012 consecutive patients who underwent craniotomy for glioma between November 2013 and March 2022. SSIs were defined as infections requiring reoperation during the observation period, regardless of their location. We retrospectively analyzed SSIs and patient factors.During the observation period, SSIs occurred in 3.1% (31/1012). In the univariate analysis, three or more surgeries (P = 0.007) and radiation therapy (P = 0.03) were associated with SSIs, whereas intraoperative magnetic resonance imaging (MRI) was not significantly associated (P = 0.35). Three or more surgeries and radiation therapy were significantly correlated with each other (P .0001); therefore, they were analyzed separately in the multivariate analysis. Three or more surgeries were an independent factor triggering SSIs (P = 0.02); in contrast, radiation therapy was not an independent factor for SSIs (P = 0.07). Several SSIs localized in the skin occurred more than 1 year after surgery.Undergoing three or more surgeries for glioma is an independent risk factor for SSIs. Glioma SSIs can occur long after surgery. These results are considered characteristic of gliomas. We recommend careful long-term observation of patients at a high risk of SSIs.

Testicular teratomas are the major histologic type of testicular germ cell tumors and their incidence continues to grow. Moreover, teratomas can develop from undifferentiated cells in induced pluripotent stem (iPS) cell transplantation therapy, seriously hampering the progress of regenerative medicine. Germinal center-associated nuclear protein (GANP) is thought to be important to the biogenetic control of primordial germ cells and is among the genes susceptible to testicular germ cell tumors. Thus, we analyzed the expression of GANP in human testicular postpubertal-type teratomas and established a novel mouse model to reveal the association between GANP and teratomagenesis. We analyzed 31 cases of human testicular postpubertal-type teratomas and, in all cases, GANP was overexpressed. The aberrant expression was also detected in germ cell neoplasia in situ accompanied by the teratoma. GANP expression was particularly high in the epithelia of the epidermis, cutaneous appendages, and trachea-like ciliated epithelium. To further clarify the association between GANP and teratomagenesis, we established a novel teratomagenesis mouse model (CAG-ganp

Youth become psychologically independent by emotionally separating from their parents and simultaneously developing a sense of trust in them. While these relational components have been addressed separately, studies focusing on the change in dynamics of these components are lacking. This study examined profiles of parent–youth relationship quality based on emotional separation and parental trust, age differences in the prevalence of these profiles, and age differences in the associations between the profiles, identity, and life satisfaction. Participants included 14,428 youth living in Japan from five age groups (44.8% girls/women; Mage = 20.6 years; range = 12–25 years). Six profiles were identified: healthy–independent, unhealthy–independent, balanced, moderate/ambivalent, connected, and distant. The connected profile was predominant among early adolescents, while the healthy–independent profile was predominant among late adolescents and early and middle emerging adults. Among all age groups, identity synthesis was the highest in the healthy–independent profile, and life satisfaction was the highest and identity confusion was the lowest in the healthy–independent and connected profiles. These findings indicate that young people navigate the process of becoming independent from their parents by balancing emotional separation and parental trust, and this balance relates to identity development and life satisfaction.

PlexinA1 (PlxnA1) is a transmembrane receptor for semaphorins (Semas), a large family of axonal guidance cues vital during neural development. PlxnA1 is expressed in embryonic interneurons, and

The soil-borne Gram-negative β-proteobacterium Ralstonia solanacearum species complex (RSSC) infects tomato roots through the wounds where secondary roots emerge, infecting xylem vessels. Because it is difficult to observe the behavior of RSSC by a fluorescence-based microscopic approach at high magnification, we have little information on its behavior at the root apexes in tomato roots. To analyze the infection route of a strain of phylotype I of RSSC, R. pseudosolanacearum strain OE1-1, which invades tomato roots through the root apexes, we first developed an in vitro pathosystem using 4 day-old-tomato seedlings without secondary roots co-incubated with the strain OE1-1. The microscopic observation of toluidine blue-stained longitudinal semi-thin resin sections of tomato roots allowed to detect attachment of the strain OE1-1 to surfaces of the meristematic and elongation zones in tomato roots. We then observed colonization of OE1-1 in intercellular spaces between epidermis and cortex in the elongation zone, and a detached epidermis in the elongation zone. Furthermore, we observed cortical and endodermal cells without a nucleus and with the cell membrane pulling away from the cell wall. The strain OE1-1 next invaded cell wall-degenerated cortical cells and formed mushroom-shaped biofilms to progress through intercellular spaces of the cortex and endodermis, infecting pericycle cells and xylem vessels. The deletion of egl encoding β-1,4-endoglucanase, which is one of quorum sensing (QS)-inducible plant cell wall-degrading enzymes (PCDWEs) secreted via the type II secretion system (T2SS) led to a reduced infectivity in cortical cells. Furthermore, the QS-deficient and T2SS-deficient mutants lost their infectivity in cortical cells and the following infection in xylem vessels. Taking together, infection of OE1-1, which attaches to surfaces of the meristematic and elongation zones, in cortical cells of the elongation zone in tomato roots, dependently on QS-inducible PCDWEs secreted via the T2SS, leads to its subsequent infection in xylem vessels.

In recent years, the usefulness of androgen receptor axis-targeted agents (ARATs) such as abiraterone, enzalutamide, and apalutamide for the upfront treatment of metastatic hormone-sensitive prostate cancer (mHSPC) has been demonstrated. However, it remains unclear which patients would truly benefit from these treatments. Furthermore, intraductal carcinoma of the prostate (IDC-P) is a known poor prognostic factor in patients with prostate cancer. We investigated the association between the presence of IDC-P and response to therapy in patients with mHSPC.This retrospective analysis included 318 patients with mHSPC who received treatment at Nagoya University and its 12 affiliated institutions between 2014 and 2021. Their biopsy specimens were evaluated for the presence of IDC-P. The patients were classified according to their first-line treatment into the ARAT (n = 100, receiving a combination of androgen-deprivation therapy [ADT] and ARAT) or conventional therapy (n = 218, receiving ADT with or without standard antiandrogen agents) group. We compared the overall survival (OS) and second progression-free survival (PFS2) between the ARAT and conventional groups according to the presence of IDC-P to evaluate whether presence of IDC-P predicts the response to each treatment. PFS2 was defined as the period from mHSPC diagnosis to disease progression on second-line treatment or death. Propensity score matching with one-to-one nearest-neighbor matching was used to minimize the potential effects of selection bias and confounding factors. The clinicopathological variables of the patients were well-balanced after propensity score matching.Most patients in the ARAT (79%) and conventional therapy (71%) groups were ICD-P positive. In the propensity score-matched cohort, the OS and PFS2 of IDC-P-positive patients were significantly longer in the ARAT group than in the conventional group (OS: hazard ratio [HR], 0.36; p = 0.047; PFS2: HR, 0.30; p 0.001). In contrast, no difference in OS and PFS2 was observed between the ARAT and conventional groups in IDC-P-negative patients (OS: HR, 1.09; p = 0.920; PFS2: HR, 0.40; p = 0.264).The findings highlight a high prevalence of IDC-P among patients with mHSPC and suggest that IDC-P positivity may be a reliable indicator that ARAT should be implemented as first-line treatment.

Information regarding the clinical manifestations and outcomes of coronavirus disease 2019 (COVID-19) in children under the Omicron variant predominant period is still limited.A nationwide retrospective cohort study was conducted. Pediatric COVID-19 patients (18 years of age) hospitalized between August 1, 2021 and March 31, 2022 were enrolled. Epidemiological and clinical characteristics between the Delta variant predominant period (August 1 to December 31, 2021) and the Omicron variant predominant period (January 1 to March 31, 2022) were compared.During the study period, 458 cases in the Delta predominant period and 389 cases in the Omicron predominant period were identified. Median age was younger (6.0 vs. 8.0 years, P = 0.004) and underlying diseases were more common (n = 65, 16.7% vs. n = 53, 11.6%) in the Omicron predominant period than those in the Delta variant predominant era. For clinical manifestations, fever ≥38.0 °C at 2 to13 years old, sore throat at ≥ 13 years, and seizures at 2 to13 years old were more commonly observed, and dysgeusia and olfactory dysfunction at ≥ 6 years old were less commonly observed in the Omicron variant predominant period. The number of patients requiring noninvasive oxygen support was higher in the Omicron predominant period than that in the Delta predominant period; however, intensive care unit admission rates were similar and no patients died in both periods.In the Omicron variant predominant period, more pediatric COVID-19 patients experienced fever and seizures, although the overall outcomes were still favorable.

Development of polymeric magnetic adsorbents is a promising approach to obtain efficient treatment of contaminated water. However, the synthesis of magnetic composites involving multiple components frequently involves tedious preparation steps. In the present study, a magnetic chitosan-palygorskite (MCP) nanocomposite was prepared through a straight-forward one pot synthesis approach to evaluate its lead (Pb2+) removal capacity from aqueous solution. The nano-architectural and physicochemical properties of the newly-developed MCP composite were described via micro- and nano-morphological analyses, and crystallinity, surface porosity and magnetic susceptibility measurements. The MCP nanocomposite was capable to remove up to 58.5 mg Pb2+ g−1 of MCP from water with a good agreement of experimental data to the Langmuir isotherm model (R2 = 0.98). The Pb2+ adsorption process on MCP was a multistep diffusion-controlled phenomenon evidenced by the well-fitting of kinetic adsorption data to the intra-particle diffusion model (R2 = 0.96). Thermodynamic analysis suggested that the adsorption process at low Pb2+ concentration was controlled by chemisorption, whereas that at high Pb2+ concentration was dominated by physical adsorption. X-ray photoelectron and Fourier transform infrared spectroscopy results suggested that the Pb adsorption on MCP was governed by surface complexation and chemical reduction mechanisms. During regeneration, the MCP retained 82% Pb2+ adsorption capacity following four adsorption–desorption cycles with ease to recover the adsorbent using its strong magnetic property. These findings highlight the enhanced structural properties of the easily-prepared nanocomposite which holds outstanding potential to be used as an inexpensive and green adsorbent for remediating Pb2+ contaminated water. Refereed/Peer-reviewed

Early detection of atrial fibrillation (AF) is important. Japan has a universal screening system, and regular health screening (HS) is available to support AF detection without a hospital visit. However, health-related outcomes and other characteristics of HS-detected and conventionally diagnosed AF remain unknown.That the characteristics and health-related outcomes of patients with HS-detected AF may differ from those of patients whose AF was detected by other procedures.In total, 3318 consecutive newly referred AF cases were enrolled; demographic characteristics and health-related and clinical outcomes were compared between two groups created based on the mode of AF detection (the HS and non-HS groups). Health-related outcomes were assessed using the AF Effect on QualiTy-of-life (AFEQT) questionnaire at baseline and after 1 year of follow-up.AF was detected by HS in 25.0% of patients; these patients had lower CHADSIn the Japanese registry, AF was detected via HS in 25% of patients referred to specialty centers for management. Notably, the overall health status of patients with HS-detected AF improved after medical interventions, including catheter ablations.

Our aim was to investigate the predictive factors for Hartmann's reversal and to describe the differences in the rates and timings of Hartmann's reversal for various causative diseases.In this multicentre retrospective cohort study patients who underwent Hartmann's procedure (HP) between 2006 and 2018 were enrolled. To describe the demographic patterns of Hartmann's reversal through to 2021, we analysed the cumulative incidence rate of Hartmann's reversal over time based on the Kaplan-Meier failure estimate. Multivariable Cox proportional hazard analysis was performed with cluster-adjusted robust standard errors to calculate hazard ratios (HRs) for the assessment of variables associated with colostomy reversal.Of 250 patients who underwent the index HP and survived to discharge, 112 (45%) underwent subsequent Hartmann's reversal (36% for malignant and 51% for benign disease). The causative diseases with the highest probability of colostomy reversal were trauma (85%) and diverticular disease (73%). Conversely, colostomy reversal was performed in only 16% for colonic volvulus and 17% for bowel ischaemia. Home discharge after index HP (HR 5.22, 95% CI 3.31-8.23) and a higher body mass index (HR 1.03, 95% CI 1.01-1.04) were associated with a higher probability of Hartmann's reversal, whereas older age, malignant disease and a history of cardiovascular and psychoneurological diseases were independently associated with a lower probability of colostomy reversal.The probability and timing of Hartmann's reversal varied considerably with the surgical indications for colostomy creation. Our results could help surgeons counsel patients and their families regarding stoma closure surgery to set realistic expectations.