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Ice cores can provide long-term records of refractory black carbon (rBC), an important aerosol species closely linked to the climate and environment. However, previous studies of ice cores only analyzed rBC particles with a diameter of < 500 nm, which could have led to an underestimation of rBC mass concentrations. Information on the size distribution of rBC particles is very limited, and there are no Arctic ice core records of the temporal variation in rBC size distribution. In this study, we applied a recently developed improved technique to analyze the rBC concentration in an ice core drilled at the SIGMA-D site in northwestern Greenland. The improved technique, which uses the modified Single-Particle Soot Photometer (SP2) and a high-efficiency nebulizer, widens the measurable range of rBC particle size. For high-resolution continuous analyses of ice cores, we developed a continuous flow analysis (CFA) system. Coupling of the improved rBC measurement technique with the CFA system allows accurate high-resolution measurements of the size distribution and concentration of rBC particles with a diameter between 70 nm and 4 µm, with minimal particle losses. Using this technique, we reconstructed the size distributions and the number and mass concentrations of rBC particles during the past 350 years. On the basis of the size distributions, we assessed the underestimation of rBC mass concentrations measured using the conventional SP2s. For the period 2003–2013, the underestimation of the average mass concentration would have been 12 %–31 % for the SIGMA-D core.

The strength distributions of the Isoscalar Giant Monopole Resonance (ISGMR) and Isoscalar Giant Quadrupole Resonance (ISGQR) in 142,146−150Nd have been determined via inelastic α-particle scattering with the Grand Raiden (GR) Spectrometer at the Research Center for Nuclear Physics (RCNP), Japan. In the deformed nuclei 146−150Nd, the ISGMR strength distributions exhibit a splitting into two components, while the nearly spherical nucleus 142Nd displays a single peak in the ISGMR strength distribution. A noteworthy achievement in this study is the first-time detection of overtones in the Isoscalar Giant Quadrupole Resonance (ISGQR) strength distributions within Nd isotopes at an excitation energy around 25 MeV obtained through Multipole Decomposition Analysis (MDA).

The variations of δO2/N2 and δAr/N2 in the Dome Fuji ice core were measured from 112 m (bubbly ice) to 2001 m (clathrate hydrate ice). Our method, combined with the low storage temperature of the samples (−50 ∘C), successfully excludes post-coring gas-loss fractionation signals from our data. From the bubbly ice to the middle of the bubble–clathrate transition zone (BCTZ) (112–800 m) and below the BCTZ (>1200 m), the δO2/N2 and δAr/N2 data exhibit orbital-scale variations similar to local summer insolation. The data in the lower BCTZ (800–1200 m) have large scatter, which may be caused by millimeter-scale inhomogeneity of air composition combined with finite sample lengths. The insolation signal originally recorded at the bubble close-off remains through the BCTZ, and the insolation signal may be reconstructed by analyzing long ice samples (more than 50 cm for the Dome Fuji core). In the clathrate hydrate zone, the scatter around the orbital-scale variability decreases with depth, indicating diffusive smoothing of δO2/N2 and δAr/N2. A simple gas diffusion model was used to reproduce the smoothing and thus constrain their permeation coefficients. The relationship between δAr/N2 and δO2/N2 is markedly different for the datasets representing bubble close-off (slope ∼ 0.5), bubble–clathrate hydrate transformation (∼1), and post-coring gas loss (∼0.2), suggesting that the contributions of the mass-independent and mass-dependent fractionation processes are different for those cases. The method and data presented here may be useful for improving the orbital dating of deep ice cores over the multiple glacial cycles and further studying non-insolation-driven signals (e.g., atmospheric composition) of these gases.

Our study is the first to demonstrate a high-temporal-resolution record of mineral composition in a Greenland ice core over the past 100 years. To reconstruct past variations in the sources and transportation processes of mineral dust in northwestern Greenland, we analysed the morphology and mineralogical composition of dust in the SIGMA-D ice core from 1915 to 2013 using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). The results revealed that the ice core dust consisted mainly of silicate minerals and that the composition varied substantially on multi-decadal and inter-decadal scales, suggesting that the ice core minerals originated from different geological sources in different periods during the past 100 years. The multi-decadal variation trend differed among mineral types. Kaolinite, which generally formed in warm and humid climatic zones, was abundant in colder periods (1950–2004), whereas mica, chlorite, feldspars, mafic minerals, and quartz, which formed in arid, high-latitude, and local areas, were abundant in warmer periods (1915–1949 and 2005–2013). Comparison to Greenland surface temperature records indicates that multi-decadal variation in the relative abundance of these minerals was likely affected by local temperature changes in Greenland. Trajectory analysis shows that the minerals were transported mainly from the western coast of Greenland in the two warming periods, which was likely due to an increase in dust sourced from local ice-free areas as a result of shorter snow/ice cover duration in the Greenland coastal region during the melt season caused by recent warming. Meanwhile, ancient deposits in northern Canada, which were formed in past warmer climates, seem to be the best candidate during the colder period (1950–2004). Our results suggest that SEM–EDS analysis can detect variations in ice core dust sources during recent periods of low dust concentration.

Air in polar ice cores provides unique information on past climatic and atmospheric changes. We developed a new method combining wet extraction, gas chromatography and mass spectrometry for high-precision, simultaneous measurements of eight air components (CH4, N2O and CO2 concentrations; δ15N, δ18O, δO2∕N2 and δAr∕N2; and total air content) from an ice-core sample of ∼ 60 g. The ice sample is evacuated for ∼ 2 h and melted under vacuum, and the released air is continuously transferred into a sample tube at 10 K within 10 min. The air is homogenized in the sample tube overnight at room temperature and split into two aliquots for mass spectrometric and gas chromatographic measurements. Care is taken to minimize (1) contamination of greenhouse gases by using a long evacuation time, (2) consumption of oxygen during sample storage by a passivation treatment on sample tubes, and (3) fractionation of isotopic ratios with a long homogenization time for splitting. Precision is assessed by analyzing standard gases with artificial ice and duplicate measurements of the Dome Fuji and NEEM ice cores. The overall reproducibility (1 SD) of duplicate ice-core analyses are 3.2 ppb, 2.2 ppb and 2.9 ppm for CH4, N2O and CO2 concentrations; 0.006 ‰, 0.011 ‰, 0.09 ‰ and 0.12 ‰ for δ15N, δ18O, δO2∕N2 and δAr∕N2; and 0.63 mLSTP kg−1 for total air content, respectively. Our new method successfully combines the high-precision, small-sample and multiple-species measurements, with a wide range of applications for ice-core paleoenvironmental studies.

Recent data on isoscalar giant monopole resonance (ISGMR) in the calcium isotopes 40,44,48Ca have suggested that Kτ, the asymmetry term in the nuclear incompressibility, has a positive value. A value of Kτ>0 is entirely incompatible with present theoretical frameworks and, if correct, would have far-reaching implications on our understanding of myriad nuclear and astrophysical phenomena. This paper presents results of an independent ISGMR measurement with the 40,42,44,48Ca(α,α′) reaction at Eα=386 MeV. These results conclusively discount the possibility of a positive value for Kτ, and are consistent with the previously-obtained values for this quantity. Keywords: Collectivity, Giant resonance, Nuclear incompressibility, Equation of state

In this study, we report the complete mitochondrial genome sequence of the Endangered Band-rumped Storm Petrel (Oceanodroma castro), a globally distributed seabird. The mitogenome is 17,023 bp in length and has a base composition of A (30.5%), T (24.0%), C (31.2%), and G (14.3%). Similar to other avifauna, it contains 13 protein-coding genes, two ribosomal RNA genes, 22 transfer RNA genes, and a control region, with arrangement and orientation identical to that of other seabirds. To our knowledge, this is the first complete mitochondrial genome sequenced within the family Hydrobatidae, or storm petrels, and will aid in taxonomic studies.

This paper describes a novel area-based stereo-matching method which aims at reconstructing the shape of objects robustly, correctly, with high precision and with high density. Our goal is to reconstruct correctly the shape of the object by comprising also edges as part of the resulting surface. For this purpose, we need to overcome the problem of how to reconstruct and describe shapes with steep and sharp edges. Area-based matching methods set an image area as a template and search the corresponding match. As a direct consequence of this approach, it becomes not possible to correctly reconstruct the shape around steep edges. Moreover, in the same regions, discontinuities and discrepancies of the shape between the left and right stereo-images increase the difficulties for the matching process. In order to overcome these problems, we propose in this paper the approach of reconstructing the shape of objects by embedding reliable edge line segments into the area-based matching process with parallax estimation. We propose a robust stereo-matching (the extended Edge TIN-LSM) method which integrates edges and which is able to cope with differences in right and left image shape, brightness changes and occlusions. The method consists of the following three steps: (1) parallax estimation, (2) edge-matching, (3) edge-surface matching. In this paper, we describe and explain in detail the process of parallax estimation and the area-based surface-matching with integrated edges; the performance of the proposed method is also validated. The main advantage of this new method is its ability to reconstruct with high precision a 3D model of an object from only two images (for ex. measurement of a tire with 0.14 mm accuracy), thus without the need of a large number of images. For this reason, this approach is intrinsically simple and high-speed.

We have been developing the stereo-matching method and its system by digital photogrammetry using a digital camera to make 3D Measurement of various objects. We are also developing the technology to process 3D point clouds of enormous amount obtained through Terrestrial Laser Scanner (TLS). But this time, we have developed the technology to produce a Surface-Model by detecting the 3D edges on the stereo-images of digital camera. Then we arrived to register the 3D data obtained from the stereo-images and the 3D edge data detected on the 3D point-cloud of TLS, and thus succeeded to develop the new technology to fuse the 3D data of Camera and TLS. The basic idea is to take stereo-pictures by a digital camera around the areas where the scanner cannot, because of the occlusion. The camera, with the digital photogrammetry, can acquire the data of complicated and hidden areas instantly, thus shutting out the possibility of noises in a blink. The data of the camera are then integrated into the data of the scanner to produce automatically the model of great perfection. In this presentation, therefore, we will show (1) how to detect the 3D edges on the photo images and to detect from the scanner's point-cloud, (2) how to register the data of both 3D edges to produce the unified model, (3) how to assess the accuracy and the speed of analysing process, which turned out to be quite satisfactory.

In this paper we present a novel method for the registration of point cloud data obtained using terrestrial laser scanner (TLS). The final goal of our investigation is the automated reconstruction of CAD drawings and the 3D modeling of objects surveyed by TLS. Because objects are scanned from multiple positions, individual point cloud need to be registered to the same coordinate system. We propose in this paper an automated feature based registration procedure. Our proposed method does not require the definition of initial values or the placement of targets and is robust against noise and background elements. A feature extraction procedure is performed for each point cloud as pre-processing. The registration of the point clouds from different viewpoints is then performed by utilizing the extracted features. The feature extraction method which we had developed previously (Kitamura, 2010) is used: planes and edges are extracted from the point cloud. By utilizing these features, the amount of information to process is reduced and the efficiency of the whole registration procedure is increased. In this paper, we describe the proposed algorithm and, in order to demonstrate its effectiveness, we show the results obtained by using real data.

Day-to-day fluctuations of the daily range of the geomagnetic field H at the equatorial electrojet stations Ancon (ANC, 77.0° W) and Sao Luis (SLZ, 44.2° W) are described for the period January–June 1993. The H field started increasing between midnight and sunrise, reaching a peak shortly before noon. The daily range of H was maximum during March and April and minimum during June. Regardless of the month, the range in H was significantly larger at ANC than at SLZ. The 27-day running mean of the range of H varied from 80 nT to 125 nT at SLZ and from 105 nT to 180 nT at ANC. The day-to-day values of the range of H showed very faithful variations at the two stations. The deviations of the daily range of H from its 27-day running mean values showed good correlation between the two stations. Some large storm-time effects were seen at both stations. The correlation was still significant, when data were corrected for Dst index values. It is suggested that the range in H at the two electrojet stations, separated by more than 2000 km, are affected by some common sources other than the ring current, which need to be identified. Spectral analysis of the range of H shows remarkable similarity at the two stations, with a dominant period of 15 days at both stations.

The paper discusses the variations of the horizontal (H), vertical (Z) and eastward (Y) components of the geomagnetic field at Peredinia (PRD), an electrojet station in Sri Lanka, with the time of the day, season, sudden commencement (SSC) and during geomagnetic storms. The daily variation of H showed a large peak around midday. The daily variation of Z appeared to be almost a time gradient curve of the daily variation of H, showing a maximum around 09:00 LT (75° EMT) when the H field was increasing fastest and not at noon when Δ H was the maximum. Storm time variation of H resembled the variation of the Dst index but that of Z showed a large minimum about 2-3h before the time of minimum Dst or at the time of maximum time gradient of Dst variation. These features are compared with corresponding variations at the equatorial stations Trivandrum (TRD) in India, and remarkable similarity in all observations is noticed at PRD and TRD. It is suggested that the observed abnormal features of Z variations at electrojet stations in India-Sri Lanka are due to (i) direct effect of the ionospheric electrojet current (ii) the induction effect of the image current by the average spatially extended conductivity region and (iii) the induction current in the local subsurface conductor. It is suggested that the conductor responsible for the observed features in Z in India and Sri Lanka has to have extended spatial domain to latitudes well south of India, rather than confined to narrow Palk Strait.

Meconium peritonitis is a sterile chemical peritonitis, which frequently occurs after intestinal perforation in utero. Overall mortality rates have drastically decreased with earlier prenatal diagnosis and improved perinatal care. However, perinatal surgical management of meconium peritonitis is largely dependent on individual surgeon experience. We present a case of meconium peritonitis with emergent cesarean section delivery after the patient developed massive meconium ascites, hydrops fetalis, and non-reassuring fetal monitoring. In the immediate post-natal period, the patient was intubated and a peritoneal drain was placed for respiratory and hemodynamic stabilization. He was then taken to the operating room the following day for laparotomy and bowel resection. His post-operative course was uneventful, and he was discharged home in good clinical condition.

On a positron emission tomography (PET) scanner consisting of block detectors, coincidence responses to scattered radiation may differ from those to true depending on the crystal pair position within a coincidence block pair. Furthermore, these differences are considered to vary according to the radial position of the coincidence block pair. These conditions create ringing artifacts in the reconstructed image due to the lack of scatter compensation in detector normalization. In component-based normalization, a scatter-compensated crystal interference factor is therefore required in addition to the scatter-compensated block profile and intrinsic crystal efficiencies. In this study, we propose a scatter-compensated component-based normalization scheme using an annulus phantom, which provides true and scattered radiations over a large transaxial field of view, and evaluates the quality of three different-sized phantom images with whole-body PET. The results showed that the proposed normalization method significantly reduces the ringing artifacts in reconstructed images with different scattered/true fractions. The proposed algorithm, which introduced the scatter-compensated crystal interference factor, worked well under different scattered/true ratio conditions and was considered to be a robust, practical normalization method in high-resolution whole-body PET. [ABSTRACT FROM AUTHOR]

AbstractBackground:Patients suspected of having cervical tuberculous lymphadenitis are diagnosed using investigations such as fine needle aspiration cytology and the polymerase chain reaction for Mycobacterium tuberculosis. However, these investigations are intended for primary tuberculosis infection. The majority of cervical tuberculous lymphadenitis cases in the elderly are thought to be caused by reactivation.Objective:The aims of this study were (1) to examine the efficacy of fine needle aspiration cytology, polymerase chain reaction and blood tests in the diagnosis of cervical tuberculous lymphadenitis caused by reactivation, and (2) to clarify any differences when compared with primarily infected cervical tuberculous lymphadenitis cases.Materials and methods:Thirty-three elderly patients with neck lumps underwent excisional biopsy from 2003 to 2008. The efficacy of fine needle aspiration cytology was examined by comparing the results of excisional biopsy with those of fine needle aspiration cytology performed at the initial medical examination for cases of suspected tuberculous disease. Furthermore, the leucocyte count and C-reactive protein concentration were compared for cases of cervical tuberculous lymphadenitis versus cases of malignant lymphoma.Results:Although nine cases were diagnosed with cervical tuberculous lymphadenitis using excisional biopsy, only one of these had been suspected based on fine needle aspiration cytology results. Three cases with tuberculous lymphadenitis were suspected of having malignant lymphoma on initial examination. There was no significant difference in the leucocyte count and C-reactive protein concentration, comparing cases of tuberculous lymphadenitis versus malignant lymphoma.Conclusion:Unlike the primary infection often seen in endemic areas, the diagnosis of early stage tuberculous lymphadenitis of the swelling type caused by reactivation in elderly people is difficult to confirm unless excisional biopsy is performed. In elderly patients with neck lumps, cervical tuberculous lymphadenitis should be included in the differential diagnosis. [ABSTRACT FROM AUTHOR]

Angiosarcomas rarely arise from schwannomas, but we describe here a case of angiosarcoma that arose from a remnant of a benign vestibular schwannoma that had been removed 10 years earlier. The patient was a 66-year-old man with no sign of neurofibromatosis. Although we attempted surgical resection, we could not totally remove the tumour. The patient died nine months after diagnosis, primarily as result of an abscess in the cerebellum and base of the skull. The histological diagnosis was confirmed by the immunohistochemical findings of positivity for CD34 antigen and S-100 protein in the resected tumour.A review of the literature revealed four other cases of angiosarcoma with schwannoma, all of which arose from an extracranial nerve. The present case is the first report of an angiosarcoma with schwannoma arising from an intracranial locus. [ABSTRACT FROM AUTHOR]

A newly developed high-speed color video camera, which can record 103 frames at rates of up to 1 million frames per second, has been used to obtain time-resolved color schlieren visualizations of shock wave phenomena. These trials constitute the first successful time-resolved application of the direction-indicating color schlieren method with frame rates up to 125 kHz. The instabilities of a supersonic flow over a double cone were made visible in unprecedented clarity, and the potential of the camera for schlieren visualizations was further demonstrated in experiments showing the explosion of a small firecracker and the bursting of a helium-filled toy balloon. [ABSTRACT FROM AUTHOR]

We report an ultrahigh-density ferroelectric data recording system based on purely electrical principles, using a scanning nonlinear dielectric microscopy technique and ferroelectric thin films of LiTaO3 single crystals. A nano-sized domain dot array of areal density of 1.50Tbit inch-2 has been successfully demonstrated in a z surface of a congruent LiTaO3 single-crystal film. The radius of the domain dots was 10.4 nm. These nano-dots remained stable at least over 24 h, and could be over-written by dots. The ferroelectric domain inversion characteristics using a stoichiometric LiTaO3 single-crystal film was also studied. A very small nano-sized domain dot with a radius of 6 nm was successively formed. [ABSTRACT FROM AUTHOR]

AbstractUsing arterioles dissected from rat cerebral pial membrane, we investigated cell-to-cell communication by means of the amphotericin-B-perforated whole-cell patch clamp technique. During a brief voltage step or ramp in voltage clamp mode, the leak current through the membrane of a smooth muscle cell in situ in an arteriole was attenuated by different types of gap junction inhibitors. Macroscopic current recording via two electrodes attached to adjacent smooth muscle cells or to a smooth muscle cell and a nearby endothelial cell revealed transjunctional current flow between cells of the same or different types. The pseudo-junctional conductance-voltage relationship obtained from adjacent smooth muscle cells differed from that obtained from a smooth muscle cell and an endothelial cell (symmetrical for the former and asymmetrical for the latter). Single- or multiple-channel events could be recorded from weakly coupled cells of the two types: simultaneous, equal-sized events in opposite directions were recorded via two electrodes, demonstrating electrical coupling directly between cell pairs. The single-channel conductance observed most frequently varied: 200–230 pS for pairs of two smooth muscle cells and 240–260 pS for mixed pairs. These data suggest the existence of differential patterns of electrical communication in vascular cells present in rat intact cerebral arterioles.Copyright © 2003 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

A quasi-phase-matched (QPM) optical parametric oscillator (OPO) was developed using a periodically poled Mg-doped stoichiometric LiTaO3 crystal to generate mid-IR light for excitation of laser ultrasound in carbon fiber reinforced plastic (CFRP). The ultrasound generation efficiency was measured at the three different wavelengths that emanate from the OPO: 1.064 μm, 1.59/1.57 μm, and 3.23/3.30 μm. The measurements indicate that mid-IR 3.2–3.3 μm light generates the most efficient ultrasonic waves in CFRP with the least laser damage. We used mid-IR light in conjunction with a laser interferometer to demonstrate the detection of flaws/defects in CFRP such as the existence of air gaps that mimic delamination and voids in CFRP, and the inhomogeneous adhesion of CFRP material to a metal plate was also clearly detected. [ABSTRACT FROM AUTHOR]

We report the fabrication of vertically aligned ultrafine ZnO nanorods using metal-organic vapor phase epitaxy and applying a two-temperature growth method. First, thick nanorods were grown vertically on the substrate at a lower temperature. Then, ultrafine ZnO nanorods with an average diameter of 17.7 nm were grown from the tips of the thick nanorods at a higher temperature. The direction of the ultrafine ZnO nanorods followed that of the preformed vertically aligned thick nanorods. Electron microscopy revealed that the ultrafine nanorods were single crystals and the growth direction was along the c axis. Excellent photoluminescence characteristics of the nanorods were confirmed. [ABSTRACT FROM AUTHOR]

We successfully produced a drastic decrease in the required growth temperature of single-crystalline ZnO nanorods, and enabled successful growth of vertically aligned ZnO nanorods on a Si(100) substrate using photoinduced metal organic vapour phase epitaxy (MOVPE). We introduced 325 nm light during the MOVPE growth, and achieved vertical growth of single-crystalline ZnO nanorods with a hexagonal crystal structure on Si(100) at a growth temperature of 270?°C. The successful low-temperature growth of ZnO nanorods on the Si(100) substrate described here is a promising step toward designing nanoscale photonic and electronic devices required by future systems. [ABSTRACT FROM AUTHOR]

Introduction: We previously reported the result of slow low-dose oral immunotherapy (SLOIT), which is a 1-year severity-stratified low-dose OIT for severe cow's milk allergy (CMA) (threshold dose ≤287 mg of cumulative cow's milk [CM] protein at the entry oral food challenge [OFC]). After completing the SLOIT protocol (exit-OFC to cumulative 287 mg of CM protein), the participants were instructed to gradually increase the amount of CM, roughly doubling the increasing pace, if they could consume it symptom-free for 2-3 months (SLOIT-plus). This study evaluated the long-term outcomes of SLOIT and identified the factors associated with these outcomes., Methods: The subjects were 23 children who completed the SLOIT protocol and proceeded with the SLOIT-plus instructions. The proportion of subjects who were desensitized to the full dose (FD; 200 mL of CM) was evaluated. Additionally, factors associated with FD 3 years after SLOIT (FD group) were analyzed. The allergic symptoms provoked in the OFC were quantified using the total score (TS) of the Anaphylaxis Scoring Aichi (ASCA), and the overall severity was expressed as TS/Pro (TS/cumulative protein dosage)., Results: The number of subjects who were desensitized to FD within 12, 24, and 36 months was 0 (0%), 3 (13%), and 8 (35%), respectively. The FD group exhibited a larger decrease in TS/Pro, IgE specific to CM, and casein after the SLOIT protocol., Conclusions: A third of the children with severe CMA were desensitized to FD within 36 months after SLOIT. A better response to the 1-year SLOIT protocol was associated with better long-term outcomes., (S. Karger AG, Basel.)

Aim: Evidence is lacking regarding associations between smoking/drinking and falls. This study aimed to determine longitudinal associations between smoking, alcohol consumption, and fall risk in middle-aged and older people., Methods: Participants of this cohort study were 7542 community-dwelling Japanese people aged 40-74 years. The baseline self-administered questionnaire survey was conducted in 2011-2013, and the second survey was conducted 5 years later. Predictors were smoking level and alcohol consumption. The outcome was the occurrence of recurrent falls. Information on self-reported falls in the previous year was obtained. Covariates were demographics, lifestyle factors, body mass index, general health status, and disease history., Results: The mean age of participants was 60.3 years. Higher smoking levels were associated with a higher recurrent fall risk (adjusted P for trend = 0.0386), with the ≥20 cigarettes/day group having a higher risk (adjusted odds ratio [OR] = 1.93, 95% confidence interval [CI]: 1.20-3.10) than lifetime non-smokers. The association between smoking and recurrent fall risk tended to be stronger in drinkers than in non-drinkers (adjusted OR = 2.75, 95% CI: 1.57-4.81), suggesting a potential interaction (P for interaction = 0.1035). Although there were no dose-dependent associations between alcohol consumption and recurrent fall risk overall, moderate alcohol consumption (150-299 g ethanol/week) was associated with a lower risk (adjusted OR = 0.57, 95% CI: 0.33-0.98) compared with no consumption in men., Conclusions: Smoking, but not alcohol consumption, is dose-dependently associated with high fall risk. However, moderate alcohol consumption may be associated with a decreased fall risk. Moreover, there may be a potential interaction between smoking and alcohol consumption on fall risk. Geriatr Gerontol Int 2024; ••: ••-••., (© 2024 Japan Geriatrics Society.)

Competing Interests: The authors declare that they have no conflict of interest.

Background: The optimal resection for pancreatic neck cancer is challenging in clinical practice because we could dissect by pancreaticoduodenectomy or distal pancreatectomy. The purpose of this study was to evaluate the effectiveness of lymph node dissection and to help determine the optimal surgical treatment for pancreatic neck cancer., Methods: We retrospectively evaluated 462 patients with pancreatic cancer who underwent curative-intent pancreatectomy between 2012 and 2022, 35 of whom had pancreatic neck cancer without preoperative radiologic gastroduodenal artery contact. We analyzed the clinicopathological characteristics, lymph node metastasis stations, and the efficacy index of lymph node dissection, which was calculated by multiplying the frequency of lymph node metastasis to each station by the 5-year survival rate of patients with positive lymph nodes at each station., Results: The lymph node station with the greatest rate of metastasis was #11p (28.6%), followed by #8 (17.1%), #14 (14.3%), #13 (14.3%), #17 (9.5%), and #6 (4.8%). The efficacy indices of lymph node dissection were 14.3 for #11, 4.76 for #13, and 8.57 for #14. There were no significant differences in 5-year recurrence-free survival and 5-year overall survival between patients undergoing pancreaticoduodenectomy and those undergoing distal pancreatectomy (23.7% vs 54.7%, P = .142; 29.9% vs 51.1%, P = .179, respectively). Univariate survival analysis showed that tumor size ≥2 cm was associated with poor prognosis (hazard ratio, 3.842, P = .009)., Conclusions: PD with #11p lymph node dissection is preferable to DP in terms of survival benefit for pancreatic neck cancer with lymph node metastasis., Competing Interests: Conflict of Interest/Disclosure The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Adrenomedullin has angiogenic and vasoprotective effects in acute ischemic stroke (AIS). This investigator-initiated trial aimed to evaluate the safety, efficacy, and optimal administration of adrenomedullin in treating AIS., Methods: In this single-center, multi-cohort, double-blinded, randomized, placebo-controlled, Phase II trial, patients with AIS received pulsed adrenomedullin (9 ng/kg/min for 8 h daily over 7 days) or placebo in the first-half cohort, and continuous-pulsed adrenomedullin (9 ng/kg/min for 72 h during the first 3 days and 8 h daily between Day 4-7) or placebo in the second-half cohort. We included male and female patients aged 20-90 years with newly confirmed ischemic lesions on diffusion-weighted magnetic resonance imaging, and for whom protocol treatment could be initiated within 24 h of symptom onset. The primary safety endpoint was the occurrence of intervention-related severe adverse events. For the primary efficacy endpoint, the least square means and 95% confidence intervals of National Institutes of Health Stroke Scale (NIHSS) scores up to 7 days post-intervention initiation were calculated using generalized estimating equation models. This trial was registered at Japan Registry of Clinical Trials, jRCT2051190092., Findings: Between January 16, 2020, and November 14, 2021, 60 patients were enrolled (median [interquartile range] age, 75 [66-81] years; NIHSS score, 3 [2-4]; 21 [35.0%] females). Neither intervention-related serious adverse events nor severe adverse events were observed in patients receiving adrenomedullin. No life-threatening adverse events or deaths were reported. The least square means (95% confidence intervals) of the changes in NIHSS scores from pre-treatment to Day 7 were -0.76 (-1.43 to -0.09) in the adrenomedullin group (-1.08 [-2.17 to 0.00] in the pulsed adrenomedullin group and -0.42 [-1.12 to 0.29] in the continuous-pulsed adrenomedullin group) and -1.08 (-2.11 to -0.05) in the placebo group., Interpretation: Adrenomedullin was well tolerated in patients with non-severe, non-embolic AIS, although its beneficial effects were not demonstrated. It is necessary to show the efficacy of adrenomedullin in further clinical trials., Funding: Japan Agency for Medical Research and Development., Competing Interests: Kitamura K holds a patent for methods of producing adrenomedullin lyophilised formulations (P6781974, Japan Patent Office). Yamagami H, Nagatsuka K, and Tsuji M were the members of the Data Safety Monitoring Board of the AMFIS study. Furthermore, Yamagami H reports lecturer fees from Boston Scientific, Daiichi-Sankyo, Stryker, Otsuka Pharmaceutical, Abbott Medical, Bristol-Myers Squibb, and Medtronic, and grant support from Bristol-Myers Squibb. Tanaka T reports lecture fees from Eisai, Daiichi Sankyo, and UCB Japan and grant support from PDRadiopharma and Nihon Medi-Physics Corporation. Ihara M reports lecturer fees from Daiichi Sankyo and Eisai and grant support from Panasonic, GE Precision Healthcare LLC, Bristol-Myers Squibb, and Shimadzu Corporation. The other authors declare no conflicts of interest., (© 2024 The Author(s).)

Prosaposin is a glycoprotein widely conserved in vertebrates, and it acts as a precursor for saposins that accelerate hydrolysis in lysosomes or acts as a neurotrophic factor without being processed into saposins. Neurogenesis in the olfactory neuroepithelia, including the olfactory epithelium (OE) and the vomeronasal epithelium (VNE), is known to occur throughout an animal's life, and mature olfactory neurons (ORNs) and vomeronasal receptor neurons (VRNs) have recently been revealed to express prosaposin in the adult olfactory organ. In this study, the expression of prosaposin in the rat olfactory organ during postnatal development was examined. In the OE, prosaposin immunoreactivity was observed in mature ORNs labeled using olfactory marker protein (OMP) from postnatal day (P) 0. Immature ORNs showed no prosaposin immunoreactivity throughout the examined period. In the VNE, OMP-positive VRNs were mainly observed in the basal region of the VNE on P10 and showed an adult-like distribution from P20. On the other hand, prosaposin immunoreactivity was observed in VRNs from P0, suggesting that not only mature VRNs but also immature VRNs express prosaposin. This study raises the possibility that prosaposin is required for the normal development of the olfactory organ and has different roles in the OE and the VNE.

We described a rare case of acute ischemic stroke due to calcified cerebral emboli from calcified carotid plaque (CCP). Radiological examinations revealed that the CCP had an irregular configuration containing a calcified nodule and scattered spotty calcifications, and a large calcified plate. The patient underwent carotid endarterectomy to prevent embolic recurrence. Histopathological examination confirmed the presence of an erupted plaque with a disrupted fibrous cap. Calcified nodular protrusion and spotty calcifications in CCP are predictive of a high risk of embolic stroke with plaque rupture. Thus, careful treatment strategies are crucial to prevent the CCP-related embolic recurrence., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Study Design: Retrospective multicenter study., Objectives: To evaluate how preoperative neck pain influences clinical outcomes following posterior decompression for cervical ossification of the posterior longitudinal ligament (OPLL)., Setting: Fourteen medical institutions in Japan., Methods: We enrolled 90 patients with cervical OPLL who underwent posterior decompression and were followed for a minimum of two years. We collected demographic data, medical history, and imaging findings. Patients were divided into two groups based on preoperative neck pain presence (Pre-op. neck pain (-) and (+) groups), and their outcomes were compared., Results: There were no significant differences in patient demographics between the Pre-op. neck pain (-) and (+) groups. Both groups showed similar distributions of ossification types and K-line positivity. Perioperative complications were comparable between the two groups. Radiographic analysis revealed no significant differences in C2-7 angles or cervical range of motion, pre- and postoperatively. Both groups demonstrated significant improvement in postoperative Japanese orthopedic association (JOA) scores, but there were no significant differences in scores or recovery rates. In the Pre-op. neck pain (-) group, factors associated with appearance of postoperative neck pain included pre- and postoperative lower JOA scores and larger C2-7 angles in neutral and extension positions., Conclusions: It emerges that lower pre- and postoperative JOA scores or larger C2-7 angles in neutral and extension positions predispose to postoperative neck pain even in those patients without preoperative neck pain. Therefore, this is worth discussing at the time of consenting patients for surgical decompression and fixation., (© 2024. The Author(s), under exclusive licence to International Spinal Cord Society.)

Background: To determine the precise frequency of main pancreatic duct (MPD) dilatation within the remnant pancreas at 1 year after pancreatoduodenectomy (PD) and its clinical implications, a prospective multicenter cohort study was performed in patients without MPD dilatation before PD (registry number: UMIN000029662)., Study Design: Between October 2017 and July 2020, patients with an MPD diameter less than 3 mm who were planned to undergo PD for periampullary lesions at 21 hospitals were enrolled. The primary endpoints were frequency of MPD dilatation at 1 year after PD, and the relationship between MPD dilatation and pancreatic endo- and exocrine function, nutritional status, and fatty liver. Secondary endpoints were risk factors for MPD dilatation at 1 year after PD and time-course change in MPD diameter., Results: Of 200 registered patients, 161 patients were finally analyzed. Pancreatic fistula was the most frequent complication (76; 47.2%). MPD dilatation (MPD > 3 mm) at 1 year after PD was seen in 35 patients (21.7%). Pancreatic exocrine function, assessed by steatorrhea, was significantly impaired in patients with MPD dilatation. However, endocrine function, nutrition status, and fatty liver development were comparable between the 2 groups. In multivariate analysis, the serum total protein level 7.3 g/dL or more was an independent predictor for MPD dilatation at 1 year after PD (odds ratio 3.12, 95% CI 1.31 to 7.15). A mean MPD diameter significantly increased at 6 months after PD and kept plateau thereafter., Conclusions: MPD dilatation at 1 year after PD was seen in 21.7% of patients and significantly associated with exocrine function impairment but not with endocrine function, nutrition status, or development of fatty liver., (Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Background and Aim: Effective treatment of lesions that develop in the irradiated area of head and neck squamous cell carcinoma is a major concern. This study aimed to clarify the efficacy and safety of endoscopic resection for such lesions., Methods: Among consecutive patients who underwent endoscopic resection for histologically proven head and neck squamous cell carcinoma between January 2014 and December 2021, those who received definitive radiotherapy/chemoradiotherapy before endoscopic resection were included in this single-center, retrospective study. Short- and long-term outcomes were evaluated., Results: Among 422 patients who underwent endoscopic resection for 615 lesions, 43 patients with 57 lesions were eligible. All 57 lesions were treated with endoscopic submucosal dissection and en bloc resection was achieved in all lesions. Grade 3 of Common Toxicity Criteria for Adverse Events v5.0 occurred in eight (19%) patients (dysphagia, seven; stricture, three; aspiration pneumonia, two; and pharyngeal necrosis, one [some cases overlapped]), but no grade ≥ 4 events occurred. Enteral nutrition by gastrostomy was temporarily required in two patients owing to dysphagia and laryngeal necrosis. During the median follow-up of 40 (interquartile range, 29.5-61) months after endoscopic submucosal dissection for the lesions developed in the irradiated area, local recurrence and metachronous lesions developed in two (5%) and nine (21%) patients, respectively. However, total laryngectomies and tracheostomies were avoided in all patients. The 3-year overall and disease-specific survivals were 81% (95% confidence interval, 64%-91%) and 94% (95% confidence interval, 79%-99%), respectively., Conclusions: Favorable local control and safety of endoscopic submucosal dissection were demonstrated., (© 2024 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)

The LitR/CarH family comprises adenosyl B 12 -based photosensory transcriptional regulators that control light-inducible carotenoid production in nonphototrophic bacteria. In this study, we established a blue-green light-inducible hyperexpression system using LitR and its partner ECF-type sigma factor LitS in streptomycin-producing Streptomyces griseus NBRC 13350. The constructed multiple-copy number plasmid, pLit19, carried five genetic elements: pIJ101rep, the thiostrepton resistance gene, litR, litS, and σ LitS -recognized light-inducible crtE promoter. Streptomyces griseus transformants harboring pLit19 exhibited a light-dependent hyper-production of intracellular reporter enzymes including catechol-2,3-dioxygenase and β-glucuronidase, extracellular secreted enzymes including laccase and transglutaminase, and secondary metabolites including melanin, flaviolin, and indigoidine. Cephamycin-producing Streptomyces sp. NBRC 13304, carrying an entire actinorhodin gene cluster, exhibited light-dependent actinorhodin production after the introduction of the pLit19 shuttle-type plasmid with the pathway-specific activator actII-ORF4. Insertion of sti fragment derived from Streptomyces phaeochromogenes pJV1 plasmid into pLit19 increased its light sensitivity, allowing gene expression under weak light irradiation. The two constructed Escherichia coli-Streptomyces shuttle-type pLit19 plasmids were found to have abilities similar to those of pLit19. We successfully established an optogenetically controlled hyperproduction system for S. griseus NBRC 13350 and Streptomyces sp. NBRC 13304., (© 2024. The Author(s).)

Translocator protein (TSPO) is a mitochondrial outer membrane protein expressed on a variety of immune cells, including macrophages, dendritic cells, and T cells, in addition to neurons and steroid-producing cells. Previous studies of TSPO ligands have suggested that TSPO is involved in multiple cellular functions, including steroidogenesis, immunomodulation, and cell proliferation. Currently, there are limited reports on the effects of TSPO or TSPO ligands on T cell-mediated immune responses. We here investigated the involvement of TSPO/TSPO ligand in T cell responses using a 2,4-dinitro-1-fluorobenzene (DNFB)-induced contact hypersensitivity (CH) model. Treatment with Ro5-4864, a TSPO ligand, during DNFB sensitization reduced the number and activation status of CD4+ and CD8+ T cells in draining lymph nodes and alleviated skin inflammation after DNFB challenge. Adoptive transfer of Ro5-4864-treated mouse-derived DNFB-sensitized T cells to naïve mice inhibited CH responses after DNFB challenge. Ro5-4864-treated sensitized T cells showed lower proliferative responses when stimulated with DNFB-pulsed antigen-presenting cells compared to control-treated sensitized T cells. Ro5-4864 also suppressed cell proliferation, as well as adenosine triphosphate and lactate production, during T cell activation. Moreover, the inhibitory effects of Ro5-4864 on T cell responses were conserved in TSPO-deficient cells. Our results suggest that Ro5-4864 inhibits CH responses by suppressing energy metabolism, at least via glycolysis, to reduce the T cell primary response in a TSPO-independent manner., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Japanese Society for Immunology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Head and neck small-cell carcinoma (HNSmCC) is a rare and aggressive cancer with a high tendency for distant metastasis. It is treated with multimodal treatment involving chemotherapy. Occasionally, surgery is performed for the management of locoregional HNSmCC. However, the benefits of surgery in this context have not yet been elucidated. Therefore, in this study, we aimed to investigate whether surgery could improve the survival of patients with HNSmCC., Patients and Methods: We obtained data from patients with locoregional HNSmCC treated with chemoradiation therapy (CRT) from the Surveillance, Epidemiology, and End Results database. Patients who did and did not undergo surgery were matched using propensity scores. The overall survival (OS) and disease-specific survival (DSS) rates were estimated using the Kaplan-Meier method and tested using the log-rank test. Hazard ratios (HRs) were calculated using the Cox proportional hazard model., Results: The 5-year OS rates of the patients who did and did not undergo surgery were 57.2% and 50.6%, respectively (P = 0.689); the corresponding 5-year DSS rates were 61.0% and 57.5% (P = 0.769). The adjusted HRs for surgery were 0.85 (95% confidence interval [CI]: 0.54-1.33) for OS and 0.87 (95% CI: 0.51-1.49) for DSS., Conclusion: The addition of surgery to CRT did not improve the survival of patients with locoregional HNSmCC., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Hosokawa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Carney's triad is a rare syndrome characterized by the co-occurrence of gastric gastrointestinal stromal tumor (GIST), pulmonary chondroma, and extra-adrenal paraganglioma. We present a case of a young woman with GISTs associated with this triad., Case Presentation: A 28-year-old woman was identified with multiple gastric tumors and a right lung nodule during a routine health check-up. CT scans and upper gastrointestinal endoscopy revealed a 50 mm mass on the lesser curvature of the stomach, along with two additional gastric lesions and a 20 mm nodule in the right lung. The patient had a history of right middle lobectomy at the age of 19 for pulmonary chondroma. During surgery, enlarged lymph nodes were observed, indicating metastasis, which necessitated a total gastrectomy with radical (D2) lymph node dissection. Pathological examination confirmed seven GISTs, with immunohistochemical staining positive for KIT (+), DOG1 (+), and negative for SDHB (-). The postoperative course was uneventful, and the patient was discharged on the seventh postoperative day. Despite opting out of adjuvant imatinib therapy, she remains disease-free 2 years postoperatively., Conclusions: This case underscores the necessity of total gastrectomy with lymph node dissection due to the high incidence of metastasis in GISTs associated with Carney's triad. Further research is required to determine the optimal extent of lymph node dissection in such cases., (© 2024. The Author(s).)

Two genomic genes, which rescue ammonium assimilation defect in the glutamate-requiring Schizosaccharomyces pombe glu1 mutant, were identified. The maa1 , encoding a mitochondrial aspartate aminotransferase, is the causative gene of glu1 mutation because an inseparable linkage between maa1 and glu1 on the chromosome, and also the glu1 mutant strain has a nonsense mutation within the maa1 coding region, which is responsible for its defective phenotype. The yhm2 , a mitochondrial 2-oxoglutarate carrier, was also isolated as a weak multicopy suppressor gene. These findings reiterate the importance of the mitochondria in utilizing the amino acids for cellular nitrogen metabolism., Competing Interests: The authors declare that there are no conflicts of interest present., (Copyright: © 2024 by the authors.)

Background: This study aimed to determine the acetabular position to optimize hip biomechanics after transposition osteotomy of the acetabulum (TOA), a specific form of periacetabular osteotomy, in patients with hip dysplasia., Methods: We created patient-specific finite-element models of 46 patients with hip dysplasia to simulate 12 virtual TOA scenarios: lateral rotation to achieve a lateral center-edge angle (LCEA) of 30°, 35°, and 40° combined with anterior rotation of 0°, 5°, 10°, and 15°. Joint contact pressure (CP) on the acetabular cartilage during a single-leg stance and simulated hip range of motion without osseous impingement were calculated. The optimal acetabular position was defined as satisfying both normal joint CP and the required range of motion for activities of daily living. Multivariable logistic regression analysis was used to identify preoperative morphological predictors of osseous impingement after virtual TOA with adequate acetabular correction., Results: The prevalence of hips in the optimal position was highest (65.2%) at an LCEA of 30°, regardless of the amount of anterior rotation. While the acetabular position minimizing peak CP varied among patients, approximately 80% exhibited normalized peak CP at an LCEA of 30° and 35° with 15° of anterior rotation, which were the 2 most favorable configurations among the 12 simulated scenarios. In this context, the preoperative head-neck offset ratio (HNOR) at the 1:30 clock position (p = 0.018) was an independent predictor of postoperative osseous impingement within the required range of motion. Specifically, an HNOR of <0.14 at the 1:30 clock position predicted limitation of required range of motion after virtual TOA (sensitivity, 57%; specificity, 81%; and area under the receiver operating characteristic curve, 0.70)., Conclusions: Acetabular reorientation to an LCEA of between 30° and 35° with an additional 15° of anterior rotation may serve as a biomechanics-based target zone for surgeons performing TOA in most patients with hip dysplasia. However, patients with a reduced HNOR at the 1:30 clock position may experience limited range of motion in activities of daily living postoperatively., Clinical Relevance: This study provides a biomechanics-based target for refining acetabular reorientation strategies during TOA while considering morphological factors that may limit the required range of motion., Competing Interests: Disclosure: This work was supported by a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (No. JP21K09281). The funder did not play a role in the investigation. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/I245)., (Copyright © 2024 by The Journal of Bone and Joint Surgery, Incorporated.)

The renal glomerulus produces primary urine from blood plasma by ultrafiltration. The ultrastructure of the glomerulus is closely related to filtration function and disease development. The ultrastructure of glomeruli has mainly been evaluated using transmission electron microscopy; however, the volume that can be observed using transmission electron microscopy is extremely limited relative to the total volume of the glomerulus. Consequently, observing structures that exist in only one location in each glomerulus, such as the vascular pole, and evaluating low-density or localized lesions are challenging tasks. Array tomography (AT) is a technique used to analyze the ultrastructure of tissues and cells via scanning electron microscopy of serial sections. In this study, we present an AT workflow that is optimized for observing complete serial sections of the whole glomerulus, and we share several analytical examples that use the optimized AT workflow, demonstrating the usefulness of this approach. Overall, this AT workflow can be a powerful tool for structural and pathological evaluation of the glomerulus. This workflow is also expected to provide new insights into the ultrastructure of the glomerulus and its constituent cells., Competing Interests: Competing interests The authors declare no competing or financial interests., (© 2024. Published by The Company of Biologists Ltd.)

The tumor-infiltrating lymphocyte (TIL) is a crucial factor in controlling tumor growth. A therapeutic method activating TIL is desired for treating patients with metastatic tumors. Here, we show that treating a local tumor with a combination therapy of UV-irradiated hemagglutinating virus of Japan envelope (HVJ-E) plus agonist antibodies, including OX40, against T cell costimulatory molecules induces systemic anti-tumor effects in a T cell-dependent manner in multiple cancer cell lines. Transcriptome and T cell receptor repertoire analyses revealed that HVJ-E + anti-OX40 antibody treatment activates CD4 and CD8 T cells and promotes T cell trafficking between tumors. These systemic anti-tumor effects required an association between Nkg2d and Nkg2d ligands. Our findings provide insights into how systemic anti-tumor effects are induced and may help the development of therapeutic strategies for eliciting such effects., Competing Interests: A.I. and K.N. applied for a patent based on the study with Osaka University., (© 2024 The Author(s).)

Spine disorders are the leading cause of disability worldwide. To promote social inclusion, it is essential to ensure that people can participate in their societies by improving their ability, opportunities, and dignity, through access to high-quality, evidence-based, and affordable spine services for all.To achieve this goal, SPINE20 recommends six actions.- SPINE20 recommends that G20 countries deliver evidence-based education to the community health workers and primary care clinicians to promote best practice for spine health, especially in underserved communities.- SPINE20 recommends that G20 countries deliver evidence-based, high-quality, cost-effective spine care interventions that are accessible, affordable and beneficial to patients.- SPINE20 recommends that G20 countries invest in Health Policy and System Research (HPSR) to generate evidence to develop and implement policies aimed at integrating rehabilitation in primary care to improve spine health.- SPINE20 recommends that G20 countries support ongoing research initiatives on digital technologies including artificial intelligence, regulate digital technologies, and promote evidence-based, ethical digital solutions in all aspects of spine care, to enrich patient care with high value and quality.- SPINE20 recommends that G20 countries prioritize social inclusion by promoting equitable access to comprehensive spine care through collaborations with healthcare providers, policymakers, and community organizations.- SPINE20 recommends that G20 countries prioritize spine health to improve the well-being and productivity of their populations. Government health systems are expected to create a healthier, more productive, and equitable society for all through collaborative efforts and sustained investment in evidence-based care and promotion of spine health., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Hypertensive emergency is a critical disease that causes multiple organ injuries. Although the renin-angiotensin-aldosterone system (RAS) is enormously activated in this disorder, whether the RAS contributes to the development of the organ damage has not been fully elucidated. This cross-sectional study was conducted to characterize the association between RAS and the organ damage in patients with hypertensive emergencies., Methods: We enrolled 63 patients who visited our medical center with acute severe hypertension and multiple organ damage between 2012 and 2020. Hypertensive target organ damage was evaluated on admission, including severe kidney impairment (eGFR less than 30 mL/min/1.73 m 2 , SKI), severe retinopathy, concentric left ventricular hypertrophy (c-LVH), thrombotic microangiopathy (TMA), heart failure with reduced ejection fraction (HFrEF) and cerebrovascular disease. Then, whether each organ injury was associated with blood pressure or a plasma aldosterone concentration was analyzed., Results: Among 63 patients, 31, 37, 43 and 8 cases manifested SKI, severe retinopathy, c-LVH and ischemic stroke, respectively. All populations with the organ injuries except cerebral infarction had higher plasma aldosterone concentrations than the remaining subset but exhibited a variable difference in systolic or diastolic blood pressure. Twenty-two patients had a triad of SKI, severe retinopathy and c-LVH, among whom 5 patients manifested TMA. Furthermore, the number of the damaged organs was correlated with plasma aldosterone levels (Spearman's coefficient = 0.50), with a strong association observed between plasma aldosterone (≥ 250 pg/mL) and 3 or more complications (odds ratio = 9.16 [95%CI: 2.76-30.35])., Conclusion: In patients with hypertensive emergencies, a higher aldosterone level not only contributed to the development of the organ damage but also was associated with the number of damaged organs in each patient., (© 2024. The Author(s).)

Background: Over the last decade, novel anticancer drugs have improved the prognosis for recurrent or metastatic squamous cell carcinoma of the head and neck (RM-SCCHN). However, this has increased healthcare expenditures and placed a heavy burden on patients and society. This study investigated the frequency of use and costs of select palliative chemotherapy regimens in Japan., Methods: From July 2021 to June 2022 in 54 healthcare facilities, we gathered data of patients diagnosed with RM-SCCHN and who had started first-line palliative chemotherapy with one of eight commonly used regimens. Patients with nasopharyngeal carcinomas were excluded. The number of patients receiving each regimen and the costs of each regimen for the first month and per year were tallied., Results: The sample comprised 907 patients (674 were < 75 years old, 233 were ≥ 75 years old). 330 (36.4%) received Pembrolizumab monotherapy, and 202 (22.3%) received Nivolumab monotherapy. Over 90% of patients were treated with immune checkpoint inhibitors as monotherapy or in combination with chemotherapy. Treatment regimens' first-month costs were 612 851-849 241 Japanese yen (JPY). The cost of standard palliative chemotherapy until 2012 was about 20 000 JPY per month. The incremental cost over the past decade is approximately 600 000-800 000 JPY per month, a 30- to 40-fold increase in the cost of palliative chemotherapy for RM-SCCHN., Conclusion: First-line palliative chemotherapy for RM-SCCHN exceeds 600 000 JPY monthly. Over the last decade, the prognosis for RM-SCCHN has improved, but the costs of palliative chemotherapy have surged, placing a heavy burden on patients and society., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

A whole-cell patch-clamp study was carried out to investigate membrane and synaptic properties of cholinergic interneurons in the striatum of aristaless-related homeobox gene (ARX) mutant mice. Brain slices were prepared from mice knocked in two types of ARX, P355L (PL) and 333ins (GCG)7 (GCG). The input resistance of cholinergic interneurons in PL or GCG mice was significantly smaller than that in wild type (WT), whereas resting membrane potential, threshold of action potentials, spontaneous firing rate, sag ratio or afterhyperpolarization of the mutant mice were not significantly different from those of WT mice. In GCG mice, NMDA/AMPA ratio of excitatory postsynaptic currents (EPSCs) evoked in cholinergic interneurons was significantly smaller than that in WT and PL mice, whereas the ratio between PL and WT mice was not significantly different. Although inhibitory effects induced by dopamine D2-like receptor activation on the inhibitory postsynaptic currents (IPSCs) were not significantly different between WT and PL or GCG mice, increase in the paired pulse ratio of IPSCs by dopamine D2-like receptor activation was abolished in PL and GCG mice. The present results have found abnormalities of neuronal activities as well as its modulation in the basal ganglia in ARX mutant mice, clarifying basic mechanisms underlying related disorders., (© 2024 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)