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C 14 H 20 (tetradecapentaene) is a simple model system exhibiting post transition-state behavior, wherein both the (6 + 4) and (4 + 2) cycloaddition products are formed from one ambimocal transition state structure. We studied the bifurcation dynamics starting from the two ambimodal transition state structures, the chair-form and boat-form, using the quasi-classical trajectory, classical molecular dynamics, and ring-polymer molecular dynamics methods on the parameter-optimized semiempirical GFN2-xTB potential energy surface. It was found that the calculated branching fractions differ between the chair-form and boat-form due to the different nature in the IRC pathways. We also investigated the effects of temperature on bifurcation dynamics and found that, at higher temperatures, trajectories stay longer in the intermediate region of the potential energy surface., (© 2024 The Author(s). Journal of Computational Chemistry published by Wiley Periodicals LLC.)

We show that strong subadditivity provides a simple derivation of the g theorem for the boundary renormalization group flow in two-dimensional conformal field theories. We work out its holographic interpretation and also give a derivation of the g theorem for the case of an interface in two-dimensional conformal field theories. We also geometrically confirm strong subadditivity for holographic duals of conformal field theories on manifolds with boundaries.

Dissociative photodetachment dynamics simulations were conducted to study the CH 3 O - (H 2 O) → CH 3 O + H 2 O + e - reaction using classical molecular dynamics (MD) and ring-polymer molecular dynamics (RPMD) techniques on two newly formulated neutral potential energy surfaces (PES1 and PES2) by different research groups. While the dissociation dynamics exhibited similarities between classical MD and RPMD, there were noticeable differences in the fluctuation of probability densities for the internal modes due to nuclear quantum effects. Upon comparison of our findings with experimental data concerning the electron binding energy distribution and photofragment relative energy, it suggests that the potential energy landscapes of PES2 are reasonably precise. The time evolution of occupied vibrational states of the H 2 O photofragment is presented in this study.

(1) Background: Proglucagon-derived peptides (PDGPs) including glucagon (Gcg), GLP-1, and GLP-2 regulate lipid metabolism in the liver, adipocytes, and intestine. However, the mechanism by which PGDPs participate in alterations in lipid metabolism induced by high-fat diet (HFD) feeding has not been elucidated. (2) Methods: Mice deficient in PGDP (GCGKO) and control mice were fed HFD for 7 days and analyzed, and differences in lipid metabolism in the liver, adipose tissue, and duodenum were investigated. (3) Results: GCGKO mice under HFD showed lower expression levels of the genes involved in free fatty acid (FFA) oxidation such as Hsl , Atgl , Cpt1a , Acox1 ( p < 0.05), and Pparα ( p = 0.05) mRNA in the liver than in control mice, and both FFA and triglycerides content in liver and adipose tissue weight were lower in the GCGKO mice. On the other hand, phosphorylation of hormone-sensitive lipase (HSL) in white adipose tissue did not differ between the two groups. GCGKO mice under HFD exhibited lower expression levels of Pparα and Cd36 mRNA in the duodenum as well as increased fecal cholesterol contents compared to HFD-controls. (4) Conclusions: GCGKO mice fed HFD exhibit a lesser increase in hepatic FFA and triglyceride contents and adipose tissue weight, despite reduced β-oxidation in the liver, than in control mice. Thus, the absence of PGDP prevents dietary-induced fatty liver development due to decreased lipid uptake in the intestinal tract.

Objective: To evaluate the efficacy and safety of 24-week cyclic administration of estetrol (E4) (15 mg)/drospirenone (DRSP) (3 mg) in Japanese patients with endometriosis., Design: A 24-week, multicenter, randomized, double-blind, placebo-controlled, parallel-group study., Setting: Twenty-five study centers in Japan., Patient(s): A total of 162 Japanese women diagnosed with endometriosis., Intervention(s): Participants were randomly allocated to the E4/DRSP group or the placebo group. In the E4/DRSP group, participants were orally administered one tablet containing E4 (15 mg) and DRSP (3 mg) daily for 24 days, followed by one placebo tablet for 4 days for a hormone-free interval, constituting a 1-cycle regimen. One placebo tablet was administered once daily for 28 days to participants in the placebo group. The treatments were continued for six cycles (24 weeks) throughout the confirmatory period., Main Outcome Measure(s): Changes in visual analogue scale (VAS) scores for the most severe pelvic pain (lower abdominal and back pain) from baseline to six treatment cycles at the end of the confirmatory study period., Result(s): Estetrol/drospirenone showed changes in the mean VAS scores for the most severe pelvic pain (-33.2 mm) from baseline to the end of the 6-cycle treatment. The between-group difference was significant (-8.5 mm; 2-sided 95% confidence interval, -16.1 to -0.9 mm), showing superiority to placebo. The responder rates, ≥30% and ≥50% reductions in the VAS scores from baseline, were higher in the E4/DRSP group than in the placebo group: 53.2% vs. 29.6% and 36.4% vs. 12.3%. Objective gynecological findings (induration of the cul-de-sac, pelvic tenderness, and limited uterine mobility) were significantly improved by E4/DRSP treatment, and the proportions of stable and worsened participants were significantly lower than in the placebo group. Estetrol/drospirenone decreased the size of endometriomas and improved quality of life, on the basis of quality of life-related questionnaires and global impression scores. No safety concerns were observed with E4/DRSP treatment. Few differences were observed in the proportion of participants with hemostasis parameters outside the reference range between the E4/DRSP and placebo groups., Conclusion(s): Estetrol/drospirenone effectively treats endometriosis-associated pain and improves gynecological findings. Estetrol/drospirenone may be a safe, new option for endometriosis treatment with a potentially decreased risk of thromboembolic events., Clinical Trial Registration Number: jRCT2011210027., Competing Interests: Declaration of Interests T.H. reports a medical writing and clinical trial advisory fee payment on the basis of the medical expert contract from Fuji Pharma Co., Ltd., and case study meeting fee payment on the basis of the medical expert contracts and medical writing fees for other clinical trials other than this manuscript in accordance with the medical expert contract from Fuji Pharma Co., Ltd. T.K. reports a medical writing and clinical trial advisory fee payment on the basis of the medical expert contract from Fuji Pharma Co., Ltd. A.H. reports a medical writing and clinical trial advisory fee payment on the basis of clinical biostatistics expert contract from Fuji Pharma Co., Ltd., and clinical biostatistics educational seminar fee payment on the basis of clinical biostatistics expert contract from Fuji Pharma Co., Ltd. T.T. reports salary and article processing charges from Fuji Pharma Co., Ltd. M.N. reports salary and article processing charges from Fuji Pharma Co., Ltd.; and patent filed with regard to the improvement of cul-de-sac induration, pelvic tenderness, and uterine mobility in subjects with endometriosis complicated by adenomyosis (Fuji Pharma Co., Ltd., and Mithra Pharmaceuticals). T.M. reports salary and article processing charges from Fuji Pharma Co., Ltd. M.H. reports salary and article processing charges from Fuji Pharma Co., Ltd.; and patent filed with regard to the improvement of cul-de-sac induration, pelvic tenderness, and uterine mobility in subjects with endometriosis complicated by adenomyosis (Fuji Pharma Co., Ltd., and Mithra Pharmaceuticals). J.-M.F. is a member of the Board at Mithra Pharmaceuticals and received financial support for the supervision of this study and consulting fees. Y.O. reports a medical writing and clinical trial advisory fee payment on the basis of the medical expert contract from Fuji Pharma Co., Ltd., and case study meeting fee payment on the basis of the medical expert contracts from Fuji Pharma Co., Ltd., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Ionoacoustics is a promising approach to reduce the range uncertainty in proton therapy. A miniature-sized optical hydrophone (OH) was used as a measuring device to detect weak ionoacoustic signals with a high signal-to-noise ratio in water. However, further development is necessary to prevent wave distortion because of nearby acoustic impedance discontinuities while detection is conducted on the patient's skin., Purpose: A prototype of the probe head attached to an OH was fabricated and the required dimensions were experimentally investigated using a 100-MeV proton beam from a fixed-field alternating gradient accelerator and k-Wave simulations. The beam range of the proton in a tissue-mimicking phantom was estimated by measuring γ-waves and spherical ionoacoustic waves with resonant frequency (SPIRE)., Methods: Four sizes of probe heads were fabricated from agar blocks for the OH. Using the prototype, the γ-wave was detected at distal and lateral positions to the Bragg peak on the phantom surface for proton beams delivered at seven positions. For SPIRE, independent measurements were performed at distal on- and off-axis positions. The range positions were estimated by solving the linear equation using the sensitive matrix for the γ-wave and linear fitting of the correlation curve for SPIRE; they were compared with those measured using a film., Results: The first peak of the γ-wave was undistorted with the 3 × 3 × 3-cm 3 probe head used at the on-axis and 3-cm off-axis positions. The range positions estimated by the γ-wave agreed with the film-based range in the depth direction (the maximum deviation was 0.7 mm), although a 0.6-2.1 mm deviation was observed in the lateral direction. For SPIRE, the deviation was <1 mm for the two measurement positions., Conclusions: The attachment of a relatively small-sized probe head allowed the OH to measure the beam range on the phantom surface., (© 2023 American Association of Physicists in Medicine.)

Ion-molecular reactions play a significant role in molecular evolution within the interstellar medium. In this study, the entrance channel reaction, H 3 + + C 2 H 4 → H 2 + C 2 H 5 + , was investigated using classical molecular dynamic (classical MD) and ring polymer molecular dynamic (RPMD) simulation techniques. We developed an analytical potential energy surface function with a permutationally invariant polynomial basis, specifically employing the monomial symmetrized approach. Our dynamic simulations reproduced the rate coefficient of 300 K for H 3 + + C 2 H 4 → H 2 + C 2 H 5 + , aligning reasonably well with the values in the kinetic database commonly utilized in astrochemistry. The thermal rate coefficients obtained using both the classical MD and RPMD techniques exhibited an increase from 100 K to 300 K as the temperature rose. Additionally, we analyzed the excess energy distribution of the C 2 H 5 + fragment with respect to temperature to investigate the indirect reaction pathway of C 2 H 5 + → H 2 + C 2 H 3 + . This result suggests that the indirect reaction pathway of C 2 H 5 + → H 2 + C 2 H 3 + holds minor significance, although the distribution highly depends on the collisional temperature.

The efficacy of convolutional neural network (CNN)-enhanced electrocardiography (ECG) in detecting hypertrophic cardiomyopathy (HCM) and dilated HCM (dHCM) remains uncertain in real-world applications. This retrospective study analyzed data from 19,170 patients (including 140 HCM or dHCM) in the Shinken Database (2010-2017). We evaluated the sensitivity, positive predictive rate (PPR), and F1 score of CNN-enhanced ECG in a ''basic diagnosis'' model (total disease label) and a ''comprehensive diagnosis'' model (including disease subtypes). Using all-lead ECG in the "basic diagnosis" model, we observed a sensitivity of 76%, PPR of 2.9%, and F1 score of 0.056. These metrics improved in cases with a diagnostic probability of ≥ 0.9 and left ventricular hypertrophy (LVH) on ECG: 100% sensitivity, 8.6% PPR, and 0.158 F1 score. The ''comprehensive diagnosis'' model further enhanced these figures to 100%, 13.0%, and 0.230, respectively. Performance was broadly consistent across CNN models using different lead configurations, particularly when including leads viewing the lateral walls. While the precision of CNN models in detecting HCM or dHCM in real-world settings is initially low, it improves by targeting specific patient groups and integrating disease subtype models. The use of ECGs with fewer leads, especially those involving the lateral walls, appears comparably effective., (© 2024. Springer Nature Japan KK, part of Springer Nature.)

Background: The potential of utilizing artificial intelligence with electrocardiography (ECG) for initial screening of aortic dissection (AD) is promising. However, achieving a high positive predictive rate (PPR) remains challenging., Methods and Results: This retrospective analysis of a single-center, prospective cohort study (Shinken Database 2010-2017, N = 19,170) used digital 12-lead ECGs from initial patient visits. We assessed a convolutional neural network (CNN) model's performance for AD detection with eight-lead (I, II, and V1-6), single-lead, and double-lead (I, II) ECGs via five-fold cross-validation. The mean age was 63.5 ± 12.5 years for the AD group (n = 147) and 58.1 ± 15.7 years for the non-AD group (n = 19,023). The CNN model achieved an area under the curve (AUC) of 0.936 (standard deviation [SD]: 0.023) for AD detection with eight-lead ECGs. In the entire cohort, the PPR was 7 %, with 126 out of 147 AD cases correctly diagnosed (sensitivity 86 %). When applied to patients with D-dimer levels ≥1 μg/dL and a history of hypertension, the PPR increased to 35 %, with 113 AD cases correctly identified (sensitivity 86 %). The single V1 lead displayed the highest diagnostic performance (AUC: 0.933, SD: 0.03), with PPR improvement from 8 % to 38 % within the same population., Conclusions: Our CNN model using ECG data for AD detection achieved an over 30% PPR when applied to patients with elevated D-dimer levels and hypertension history while maintaining sensitivity. A similar level of performance was observed with a single-lead V1 ECG in the CNN model., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Suzuki has received lecture fees from Daiichi Sankyo and Bristol-Myers Squibb. Dr. Yamashita has received research funding and/or lecture fees from Daiichi Sankyo, Bayer Yakuhin, Bristol-Myers Squibb, Pfizer, Nippon Boehringer Ingelheim, Ono Pharmaceutical, and Toa Eiyo. J Motogi, T Umemoto, W Matsuzawa, T Takayanagi, A Hyodo, and K Satoh are employee at Nihon Kohden Corporation., (© 2024 The Authors.)

Background: We developed a convolutional neural network (CNN) model to detect atrial fibrillation (AF) using the sinus rhythm ECG (SR-ECG). However, the diagnostic performance of the CNN model based on different ECG leads remains unclear. Methods and Results: In this retrospective analysis of a single-center, prospective cohort study, we identified 616 AF cases and 3,412 SR cases for the modeling dataset among new patients (n=19,170). The modeling dataset included SR-ECGs obtained within 31 days from AF-ECGs in AF cases and SR cases with follow-up ≥1,095 days. We evaluated the CNN model's performance for AF detection using 8-lead (I, II, and V1-6), single-lead, and double-lead ECGs through 5-fold cross-validation. The CNN model achieved an area under the curve (AUC) of 0.872 (95% confidence interval (CI): 0.856-0.888) and an odds ratio of 15.24 (95% CI: 12.42-18.72) for AF detection using the eight-lead ECG. Among the single-lead and double-lead ECGs, the double-lead ECG using leads I and V1 yielded an AUC of 0.871 (95% CI: 0.856-0.886) with an odds ratio of 14.34 (95% CI: 11.64-17.67). Conclusions: We assessed the performance of a CNN model for detecting AF using eight-lead, single-lead, and double-lead SR-ECGs. The model's performance with a double-lead (I, V1) ECG was comparable to that of the 8-lead ECG, suggesting its potential as an alternative for AF screening using SR-ECG., Competing Interests: S.S. received lecture fees from Daiichi Sankyo and Bristol-Myers Squibb. T.Y. received research funds and/or lecture fees from Daiichi Sankyo, Bayer Yakuhin, Bristol-Myers Squibb, Pfizer, Nippon Boehringer Ingelheim, Eisai, Mitsubishi Tanabe Pharm, Ono Pharmaceutical, and Toa Eiyo. The remaining authors have nothing to disclose., (Copyright © 2024, THE JAPANESE CIRCULATION SOCIETY.)

Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous interstellar molecules. However, the formation mechanisms of PAHs and even the simplest cyclic aromatic hydrocarbon, benzene, are not yet fully understood. Recently, we reported the statistical and dynamical properties in the reaction mechanism of Fe + -catalyzed acetylene cyclotrimerization, whereby three acetylene molecules are directly converted to benzene. In this study, we extended our previous work and explored the possible role of the complex of other 3d transition metal cations, TM + (TM = Sc, Ti, Mn, Co, and Ni), as a catalyst in acetylene cyclotrimerization. Potential energy profiles for bare TM + -catalyst (TM = Sc and Ti), for TM + NC - -catalyst (TM = Sc, Ti, Mn, Co, and Ni), and for TM + -(H 2 O) 8 -catalyst (TM = Sc and Ti) systems were obtained using quantum chemistry calculations, including the density functional theory levels. The calculation results show that the scandium and titanium cations act as efficient catalysts in acetylene cyclotrimerization and that reactants, which contain an isolated acetylene and (C 2 H 2 ) 2 bound to a bare (ligated) TM cation (TM = Sc and Ti), can be converted into a benzene-metal-cation product complex without an entrance barrier. We found that the number of electrons in the 3d orbitals of the transition metal cation significantly contributes to the catalytic efficiency in the acetylene cyclotrimerization process. On-the-fly Born-Oppenheimer molecular dynamics (BOMD) simulations of the Ti + -NC - and Ti + -(H 2 O) 8 complexes were also performed to comprehensively understand the nuclear dynamics of the reactions. The computational results suggest that interstellar benzene can be produced via acetylene cyclotrimerization reactions catalyzed by transition metal cation complexes.

Aims/introduction: Glucagon is secreted from pancreatic α-cells and plays an important role in amino acid metabolism in liver. Various animal models deficient in glucagon action show hyper-amino acidemia and α-cell hyperplasia, indicating that glucagon contributes to feedback regulation between the liver and the α-cells. In addition, both insulin and various amino acids, including branched-chain amino acids and alanine, participate in protein synthesis in skeletal muscle. However, the effect of hyperaminoacidemia on skeletal muscle has not been investigated. In the present study, we examined the effect of blockade of glucagon action on skeletal muscle using mice deficient in proglucagon-derived peptides (GCGKO mice)., Materials and Methods: Muscles isolated from GCGKO and control mice were analyzed for their morphology, gene expression and metabolites., Results: GCGKO mice showed muscle fiber hypertrophy, and a decreased ratio of type IIA and an increased ratio of type IIB fibers in the tibialis anterior. The expression levels of myosin heavy chain (Myh) 7, 2, 1 and myoglobin messenger ribonucleic acid were significantly lower in GCGKO mice than those in control mice in the tibialis anterior. GCGKO mice showed a significantly higher concentration of arginine, asparagine, serine and threonine in the quadriceps femoris muscles, and also alanine, aspartic acid, cysteine, glutamine, glycine and lysine, as well as four amino acids in gastrocnemius muscles., Conclusions: These results show that hyperaminoacidemia induced by blockade of glucagon action in mice increases skeletal muscle weight and stimulates slow-to-fast transition in type II fibers of skeletal muscle, mimicking the phenotype of a high-protein diet., (© 2023 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)

Background and Aims: This study evaluated the impact of the coronavirus disease 2019 (COVID-19) pandemic on pancreatic adenocarcinoma (PA) practice in our region and discussed the effects of our institution's regional collaborative system, the "Early Stage Pancreatic Cancer Diagnosis Project," which was originally unrelated to this study's purpose., Methods: We retrospectively investigated 150 patients with PA at Yokohama Rosai Hospital by defining three time periods: before (C0), during the first year (C1), and during the second year (C2) of the COVID-19 pandemic., Results: Among the three periods (C0, C1, and C2), there were significantly less patients with stage I PA (14.0%, 0%, and 7.4%, p = 0.032) in C1, and significantly more patients with stage III PA (10.0%, 28.3%, and 9.3%, p = 0.014) in C1. The pandemic significantly prolonged the median durations from disease onset to patients' first visits (28, 49, and 14 days, p = 0.012). In contrast, there was no significant difference in the median durations from referral to first visit to our institution (4, 4, and 6 days, p = 0.391)., Conclusions: The pandemic advanced the stage of PA in our region. Although the pancreatic referral network remained functional during the pandemic, there were delays from disease onset to patients' first visit to healthcare providers, including clinics. While the pandemic caused temporary damage to PA practice, the routine regional collaboration provided by our institution's project allowed for early resilience. A notable limitation is that the impact of the pandemic on PA prognosis was not evaluated., Competing Interests: Conflict of interest disclosure The authors declare no conflicts of interest associated with this study and received no funding or financial support for its conduct., (Copyright © 2023 IAP and EPC. Published by Elsevier B.V. All rights reserved.)

Objectives: Type 1 diabetes mellitus (T1DM) patients with diabetic kidney disease-induced kidney failure have a significantly impaired quality of life (QOL), resulting in a high level of physical, mental, and social anxiety. In this study, we evaluated the QOL of T1DM patients on the list for pancreas transplantation (PTx) at their registration, and determined whether PTx improved their QOL., Methods: There were 58 patients (men/women, 22/36; mean age, 42.8±8.0 years) with T1DM and who were registered on the waiting list for PTx. Quantitative QOL assessment was performed using the Medical Health Survey Short Form (SF-36) version 2. Changes in the QOL before and after PTx were also examined in 24 of these patients., Results: The mean value of each endpoint and the summary score of the SF-36 physical (PCS), mental (MCS), and role (RCS) components were all below the national normal level at PTx registration. No significant difference in QOL scores was observed in the intergroup comparison of 35 patients on dialysis, 13 patients without dialysis, and ten patients after kidney transplantation. The 24 patients who underwent PTx showed improvement in PCS, MCS, and most SF-36 scores., Conclusion: T1DM patients waiting for PTx had a decreased QOL, regardless of dialysis, and PTx improved their QOL., Competing Interests: There are no competing interests regarding all materials used in this study.

Alkanedithiols were used for the conjugation of gold nanoparticles (AuNP) prepared by a solution plasma process. Capillary zone electrophoresis was utilized for the monitoring of the conjugated AuNP. When 1,6-hexanedithiol (HDT) was used as a linker, a resolved peak from the AuNP was detected in the electropherogram; the resolved peak was attributed to the conjugated AuNP. The resolved peak was developed with increasing concentrations of HDT, while the peak of the AuNP decreased complementary. The resolved peak also tended to develop along with the standing time at least up to 7 weeks. The electrophoretic mobility of the conjugated AuNP was almost identical over the HDT concentrations examined, suggesting that the conjugation of the AuNP did not proceed further, such as aggregate/agglomerate formation. The conjugation monitoring was also examined with some dithiols and monothiols. Resolved peak of the conjugated AuNP was also detected with 1,2-ethanedithiol and 2-aminoethanethiol., (© 2023. The Author(s), under exclusive licence to The Japan Society for Analytical Chemistry.)

The process of protonated formic acid dissociating from the transition state was studied using ring-polymer molecular dynamics (RPMD), classical MD, and quasi-classical trajectory (QCT) simulations. Temperature had a strong influence on the branching fractions for the HCO + + H 2 O and CO + H 3 O + dissociation channels. The RPMD and classical MD simulations showed similar behavior, but the QCT dynamics were significantly different owing to the excess energies in the quasi-classical trajectories. Machine-learning analysis identified several key features in the phase information of the vibrational motions at the transition state. We found that the initial configuration and momentum of a hydrogen atom connected to a carbon atom and the shrinking coordinate of the CO bond at the transition state play a role in the dynamics of HCO + + H 2 O production.

In the interstellar medium, the H 2 adsorption and desorption on the solid water ice are crucial for chemical and physical processes. We have recently investigated the probabilities of H 2 sticking on the (H 2 O) 8 ice, which has quadrilateral surfaces. We have extended the previous work using classical MD and ring-polymer molecular dynamics (RPMD) simulations to the larger ice clusters, (H 2 O) 10 and (H 2 O) 12 , which have pentagonal and hexagonal surfaces, respectively. The H 2 sticking probabilities decreased as the temperature increased for both cluster cases, whereas the cluster-size-independent profiles were observed. It is thought that the size independence of the probabilities is qualitatively understood from the similar binding energies for all the three cluster systems. Furthermore, the RPMD sticking probabilities are smaller than the classical ones because of the reduction in the binding energies owing to nuclear quantum effects, such as vibrational quantization., (© 2023 The Authors. ChemPhysChem published by Wiley-VCH GmbH.)

An early diagnosis and intervention for congenital cytomegalovirus infection can reduce long-term disability; however, the introduction of universal neonatal screening has been controversial worldwide. The present study clarified the outcome of a targeted screening protocol for detecting congenital cytomegalovirus infection based on suggestive perinatal conditions. In addition, the positive rate was compared to those from the reported studies and the validity of the targeted screening criteria was discussed. A total of 2121 newborn infants were admitted to our hospital between October 2018 and October 2021. Cytomegalovirus DNA was examined by the isothermal nucleic acid amplification method for urine samples from newborns with any of the following: microcephaly, abnormal ultrasound findings in the brain and visceral organs, repeated failure in neonatal hearing screening, suspicious maternal cytomegalovirus infection during pregnancy, and other abnormal findings suggestive of congenital cytomegalovirus infection. Among 2121 newborns, 102 (4.8%) were subject to the urine cytomegalovirus DNA test based on the abovementioned criteria. Of them, three were cytomegalovirus DNA-positive. According to the protocol, the cytomegalovirus DNA-positive rates were 0.14% among the total enrollment of 2121 newborns and 2.9% (3/102) among the targeted newborns. This protocol may overlook congenital cytomegalovirus infection that is asymptomatic or exhibits inapparent clinical manifestations only at birth; however, it is feasible and helps lead to the diagnosis of congenital cytomegalovirus infection that may otherwise be overlooked., (© 2023 Japanese Teratology Society.)

Background: This study sought to develop an artificial intelligence-derived model to detect the dilated phase of hypertrophic cardiomyopathy (dHCM) on digital electrocardiography (ECG) and to evaluate the performance of the model applied to multiple-lead or single-lead ECG., Methods: This is a retrospective analysis using a single-center prospective cohort study (Shinken Database 2010-2017, n = 19,170). After excluding those without a normal P wave on index ECG (n = 1,831) and adding dHCM patients registered before 2009 (n = 39), 17,378 digital ECGs were used. Totally 54 dHCM patients were identified of which 11 diagnosed at baseline, 4 developed during the time course, and 39 registered before 2009. The performance of the convolutional neural network (CNN) model for detecting dHCM was evaluated using eight-lead (I, II, and V1-6), single-lead, and double-lead (I, II) ECGs with the five-fold cross validation method., Results: The area under the curve (AUC) of the CNN model to detect dHCM (n = 54) with eight-lead ECG was 0.929 (standard deviation [SD]: 0.025) and the odds ratio was 38.64 (SD 9.10). Among the single-lead and double-lead ECGs, the AUC was highest with the single lead of V5 (0.953 [SD: 0.038]), with an odds ratio of 58.89 (SD:68.56)., Conclusion: Compared with the performance of eight-lead ECG, the most similar performance was achieved with the model with a single V5 lead, suggesting that this single-lead ECG can be an alternative to eight-lead ECG for the screening of dHCM., Competing Interests: Dr. Suzuki received lecture fees from Daiichi Sankyo and Bristol-Myers Squibb. Dr. Yamashita received research funds and/or lecture fees from Daiichi Sankyo, Bayer Yakuhin, Bristol-Myers Squibb, Pfizer, Nippon Boehringer Ingelheim, Eisai, Mitsubishi Tanabe Pharm, Ono Pharmaceutical, and Toa Eiyo. J Motogi, T Umemoto, W Matsuzawa, T Takayanagi, A Hyodo, and K Satoh are employee at Nihon Kohden Corporation.The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Shinya Suzuki reports a relationship with Public Interest Incorporated Foundation The Cardiovascular Institute that includes: speaking and lecture fees. Takeshi Yamashita reports a relationship with Public Interest Incorporated Foundation The Cardiovascular Institute that includes: funding grants and speaking and lecture fees., (© 2023 The Author(s).)

Background: Proton range uncertainty has been the main factor limiting the ability of proton therapy to concentrate doses to tumors to their full potential. Ionoacoustic (IA) range verification is an approach to reducing this uncertainty by detecting thermoacoustic waves emitted from an irradiated volume immediately following a pulsed proton beam delivery; however, the signal weakness has been an obstacle to its clinical application. To increase the signal-to-noise ratio (SNR) with the conventional piezoelectric hydrophone (PH), the detector-sensitive volume needs to be large, but it could narrow the range of available beam angles and disturb real-time images obtained during beam delivery., Purpose: To prevent this issue, we investigated a millimeter-sized optical hydrophone (OH) that exploits the laser interferometric principle. For two types of IA waves [γ-wave emitted from the Bragg peak (BP) and a spherical IA wave with resonant frequency (SPIRE) emitted from the gold fiducial marker (GM)], comparisons were made with PH in terms of waveforms, SNR, range detection accuracy, and signal intensity robustness against the small detector misalignment, particularly for SPIRE., Methods: A 100-MeV proton beam with a 27 ns pulse width and 4 mm beam size was produced using a fixed-field alternating gradient accelerator and was irradiated to the water phantom. The GM was set on the beam's central axis. Acrylic plates of various thicknesses, up to 12 mm, were set in front of the phantoms to shift the proton range. OH was set distal and lateral to the beam, and the range was estimated using the time-of-flight method for γ-wave and by comparing with the calibration data (SPIRE intensity versus the distance between the GM and BP) derived from an IA wave transport simulation for SPIRE. The BP dose per pulse was 0.5-0.6 Gy. To measure the variation in SPIRE amplitude against the hydrophone misalignment, the hydrophone was shifted by ± 2 mm at a maximum in lateral directions., Results: Despite its small size, OH could detect γ-wave with a higher SNR than the conventional PH (diameter, 29 mm), and a single measurement was sufficient to detect the beam range with a submillimeter accuracy in water. In the SPIRE measurement, OH was far more robust against the detector misalignment than the focused PH (FPH) used in our previous study [5%/mm (OH) versus 80%/mm (FPH)], and the correlation between the measured SPIRE intensity and the distance between the GM and BP agreed well with the simulation results. However, the OH sensitivity was lower than the FPH sensitivity, and about 5.6-Gy dose was required to decrease the intensity variation among measurements to less than 10%., Conclusion: The miniature OH was found to detect weak IA signals produced by proton beams with a BP dose used in hypofractionated regimens. The OH sensitivity improvement at the MHz regime is worth exploring as the next step., (© 2022 American Association of Physicists in Medicine.)

The presence of main pancreatic duct (MPD) dilatation is important for diagnosing pancreatic ductal adenocarcinomas (PDACs). However, we occasionally encounter PDAC cases without MPD dilatation. The objectives of this study were to compare the clinical findings and prognosis of pathologically diagnosed PDAC cases with and without MPD dilatation and to extract factors related to the prognosis of PDAC. The 281 patients pathologically diagnosed with PDAC were divided into two groups: the dilatation group ( n = 215), consisting of patients with MPD dilatation of 3 mm or more, and the non-dilatation group ( n = 66), consisting of patients with MPD dilatation less than 3 mm. We found that the non-dilatation group had more cancers in the pancreatic tail, more advanced disease stage, lower resectability, and worse prognoses than the dilatation group. Clinical stage and history of surgery or chemotherapy were identified as significant prognostic factors for PDAC, while tumor location was not. Endoscopic ultrasonography (EUS), diffusion-weighted magnetic resonance imaging (DW-MRI), and contrast-enhanced computed tomography had a high tumor detection rate for PDAC even in the non-dilatation group. Construction of a diagnostic system centered on EUS and DW-MRI is necessary for the early diagnosis of PDAC without MPD dilatation, which can improve its prognosis.

We study holographic entanglement entropy in dS/CFT and introduce timelike entanglement entropy in CFTs. Both of them take complex values in general and are related with each other via an analytical continuation. We argue that they are correctly understood as pseudoentropy. We find that the imaginary part of pseudoentropy implies an emergence of time in dS/CFT.

Background: There is increasing evidence that 12-lead electrocardiograms (ECG) can be used to predict biological age, which is associated with cardiovascular events. However, the utility of artificial intelligence (AI)-predicted age using ECGs remains unclear., Methods: Using a single-center database, we developed an AI-enabled ECG using 17 042 sinus rhythm ECGs (SR-ECG) to predict chronological age (CA) with a convolutional neural network that yields AI-predicted age. Using the 5-fold cross validation method, AI-predicted age deriving from the test dataset was yielded for all ECGs. The incidence by AgeDiff and the areas under the curve by receiver operating characteristic curve with AI-predicted age for cardiovascular events were analyzed., Results: During the mean follow-up period of 460.1 days, there were 543 cardiovascular events. The annualized incidence of cardiovascular events was 2.24 %, 2.44 %, and 3.01 %/year for patients with AgeDiff < -6, -6 to ≤6, and >6 years, respectively. The areas under the curve for cardiovascular events with CA and AI-predicted age, respectively, were 0.673 and 0.679 (Delong's test, P = 0.388) for all patients; 0.642 and 0.700 (P = 0.003) for younger patients (CA < 60 years); and 0.584 and 0.570 (P = 0.268) for older patients (CA ≥ 60 years)., Conclusions: AI-predicted age using 12-lead ECGs showed superiority in predicting cardiovascular events compared with CA in younger patients, but not in older patients., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr Suzuki received research funding from Mitsubishi Tanabe Pharm and Daiichi Sankyo. Dr Yamashita received research funds and/or lecture fees from Daiichi Sankyo, Bayer Yakuhin, Bristol Myers Squibb, Pfizer, Nippon Boehringer Ingelheim, Eisai, Mitsubishi Tanabe Pharm, Ono Pharmaceutical, and Toa Eiyo. The remaining authors have no conflicts of interest to declare., (© 2023 The Author(s).)

Background: In Japan, the mortality rate of extremely low birth weight (ELBW) infants is notably low in comparison with other developed countries, but the prevalence of chronic lung disease (CLD) and retinopathy of prematurity (ROP) is relatively high. This study aimed to estimate the mortality and morbidity of ELBW infants born in 2015 who were admitted to neonatal intensive care units (NICUs) in Japan and to examine the factors that affected the short-term outcomes of these infants. We also compared the mortality of ELBW infants born in 2005, 2010, and 2015., Methods: We analyzed the mortality, morbidity, and factors related to short-term outcomes of ELBW infants, using data from 2782 infants born in 2015 and registered at NICUs in Japan., Results: The mortality rates during NICU stays were 17.0%, 12.0%, and 9.8% for ELBW infants born in 2005, 2010, and 2015, respectively. Among ELBW infants born in 2015, multiple logistic regression analysis showed that short gestational age and low birthweight Z-score contributed to the increased risk of death. Births by cesarean section and antenatal corticosteroid administration were significantly associated with a reduced risk of death. Among infants who survived, CLD was observed in 53.1% and ROP requiring treatment was observed in 30.4%., Conclusions: Mortality in ELBW infants decreased significantly from 2005 to 2015. As CLD and ROP may affect quality of life and long-term outcomes of infants who survived, prevention strategies and management for these complications are critical issues in neonatal care in Japan., (© 2023 Japan Pediatric Society.)

The H - + C 2 H 2 → H 2 + C 2 H - reaction is important in understanding the production mechanisms of anionic molecules in interstellar environments. Herein, the rate coefficients for the H - + C 2 H 2 → H 2 + C 2 H - reaction were calculated using ring-polymer molecular dynamics (RPMD), classical molecular dynamics (MD), and quasi-classical trajectory (QCT) approaches on a newly developed ab initio potential energy surface (PES) in full dimensions. PES was constructed by fitting a large number of ab initio energy points and their gradients using the permutationally invariant polynomial basis set method. There was no barrier in the reaction coordinates, which was a collinear-dominated reaction, and the reaction proceeded exothermically. It is found that the fitted PES provides the appropriate thermal rate coefficients based on all RPMD, classical MD, and QCT simulations at higher temperatures. The evaluation of the rate coefficients at lower temperatures should be conducted carefully because the fitting of the PES associated with the long-range interaction should be further improved. The spatial distribution of the nucleus allows a more effective attraction between the reactants.

Benzene is the simplest building block of polycyclic aromatic hydrocarbons and has previously been found in the interstellar medium. Several barrierless reaction mechanisms for interstellar benzene formation that may operate under low-temperature and low-pressure conditions in the gas phase have been proposed. In this work, we studied different mechanisms for interstellar benzene formation based on acetylene cyclotrimerization catalyzed by Fe + bound to solid water clusters through quantum chemistry calculations. We found that benzene is formed via a single-step process with one transition state from the three acetylene molecules on the Fe + (H 2 O) n ( n = 1, 8, 10, 12 and 18) cluster surface. Moreover, the obtained mechanisms differed from those of single-atom catalysis, in which benzene is sequentially formed via multiple steps.

Tyrosinase catalyzes the oxidation of l-tyrosine in two stages to produce l-dopa and l-dopaquinone stepwise, and l-dopaquinone is subsequently converted to dopachrome. Most of the conventional analyses subjected only one-step reaction from l-tyrosine to l-dopa or from l-dopa to l-dopaquinone. In this study, kinetic analyses of two-steps oxidation of l-tyrosine with tyrosinase were made by capillary electrophoresis/dynamic frontal analysis (CE/DFA). When l-dopa was introduced into a capillary as a sample plug in a CE/DFA format, the enzymatic oxidation continuously occurred during the electrophoresis, and the product l-dopaquinone was subsequently converted to dopachrome which was detected as a plateau signal. A Michaelis-Menten constant of the second-step kinetic reaction, K m,Do , was determined as 0.45 ± 0.03 mmol L -1 . In the analysis of the first-step kinetic reaction from l-tyrosine to l-dopa, l-dopa was not resolved by CE/DFA because both l-tyrosine and l-dopa are electrically neutral. The l-dopa formed and co-migrated at the l-tyrosine zone was calibrated beforehand with the final product of dopachrome detected as a plateau signal. Constantly formed l-dopa was successfully detected as a plateau signal of dopachrome, and a Michaelis-Menten constant of K m,Ty was also determined as 0.061 ± 0.009 mmol L -1  by the CE/DFA. CE/DFA is applicable to two-steps enzymatic reactions., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Aiming to understand how Maasai women use informal learning and literacy to access to health information and improve well-being of their family at the village level, this qualitative study explores the significance of village based informal learning and literacy in maintain good health among village women and girls in the male-dominated community in rural Kenya. Data were collected through semi-structured interviews, informal conversations and observations. 15 Village women, 12 women's group leaders and 10 government officials were interviewed during an intensive six-month field study in Kenya. The information obtained from the interviews was analysed thematically and as narrative case studies. Results indicate that the village women initiate manageable health promotion activities to improve the well-being of their family and community via informal learning and literacy approaches. The study also concludes that the interviewed Maasai women developed their own effective communication mechanism to improve the situation of gender inequality in their community.

Gold nanoparticles (AuNP) were prepared by a solution plasma process in the presence of H 2 O 2 , and they were dispersed in an aqueous solution without any stabilizer generally used. The dispersion stability of the AuNP in an aqueous solution was evaluated by capillary zone electrophoresis (CZE). An anionic broad peak was detected with the AuNP by CZE based on its wide variations in size and net charge. The broad peak also suggests that the AuNP were well dispersed in an aqueous solution. The dispersion stability of AuNP was evaluated from the viewpoints of long-term dispersion, salt concentration, and organic co-solvent. The anionic broad peak attributed to the dispersed AuNP was successfully detected for at least 55 weeks from the preparation with less shot signals of the aggregates. The AuNP was also well dispersed in aqueous NaCl solutions with its concentrations up to 30 mmol L -1 , as well as with ethanol co-solvent up to 40%(v/v). The AuNP prepared by the solution plasma process was proved to be highly stable in an aqueous solution., (© 2022. The Author(s), under exclusive licence to The Japan Society for Analytical Chemistry.)

Background: The median arcuate ligament syndrome (MALS) is a disease in which the celiac artery is compressed by the arcuate ligament and causes stenosis. If abdominal pain or an aneurysm is observed in the head of the pancreas, it is necessary to release the arcuate ligament, and recently laparoscopic surgery has been reported. However, the indication for treatment in asymptomatic cases is unknown. The treatment for asymptomatic MALS in patients with gastric cancer who are indicated for surgery is also novel., Case Presentation: A 70-year-old female was found with early gastric cancer in the middle body of the stomach. An enhanced CT scan showed no metastasis, but a gallstone and stenosis of the celiac artery due to the MALS were found. The patient underwent releasing median arcuate ligament after lymph node dissection. A median arcuate ligament was located on the ventral side of the left gastric artery stump, and the celiac artery was exposed when cutting it off. The operation time was 4 h and 59 min, and the bleeding was 6 ml. It took about 5 min to dissect the medial arcuate ligament. The postoperative course was satisfactory, and the patient was discharged 7 days after the operation. CT scan and 3-D CT angiography were performed about 2 months after the operation, and the findings revealed that the celiac artery's stenosis resolved., Conclusion: The patient underwent laparoscopic gastrectomy and simultaneously the median arcuate ligament release under an excellent visual field. Therefore, median arcuate ligament release may be considered if MALS is found in a gastrectomy case., (© 2022. The Author(s).)

In this Letter, we propose a holographic duality for classical gravity on a three-dimensional de Sitter space. We first show that a pair of SU(2) Chern-Simons gauge theories reproduces the classical partition function of Einstein gravity on a Euclidean de Sitter space, namely S^{3}, when we take the limit where the level k approaches -2. This implies that the conformal field theory (CFT) dual of gravity on a de Sitter space at the leading semiclassical order is given by an SU(2) Wess-Zumino-Witten model in the large central charge limit k→-2. We give another evidence for this in the light of known holography for coset CFTs. We also present a higher spin gravity extension of our duality.

Aims: Although skin manifestations are common in diabetic patients, its characteristics are poorly identified. This study explored the differentiation process of keratinocytes in type 2 diabetes mellitus (T2DM) in vivo., Methods: Back skin of T2DM model KKAy/TaJcl mice (KKAy) and C57BL/6JJcl mice (control) aged 8 and 12 weeks was used. The mRNA expression of differentiation markers of keratinocytes was measured by quantitative real-time polymerase chain reaction (qRT-PCR). The expression of each marker in situ was examined immunohistochemically., Results: KKAy mice showed hyperglycemia versus control mice. The histological findings showed increased thickness and structural impairment of epidermal tissue in KKAy mice. The qRT-PCR revealed that the expression of integrin beta 1 and keratin 14 in KKAy and control mice was identical. However, the expression of involucrin at 8 weeks, keratin 10 at 12 weeks, and filaggrin and loricrin at 8 and 12 weeks was decreased in KKAy mice. Immunohistochemical findings showed that filaggrin was markedly decreased in KKAy mice, though Ki-67 remained unchanged., Conclusion: The terminal differentiation process was impaired in the diabetic skin, while keratinocyte proliferation was preserved. Damaged terminal differentiation of keratinocytes may contribute to impairment of the skin barrier function in diabetic dermatoses., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

(1) Background: Protein stimulates the secretion of glucagon (GCG), which can affect glucose metabolism. This study aimed to analyze the metabolic effect of a high-protein diet (HPD) in the presence or absence of proglucagon-derived peptides, including GCG and GLP-1. (2) Methods: The response to HPD feeding for 7 days was analyzed in mice deficient in proglucagon-derived peptides (GCGKO). (3) Results: In both control and GCGKO mice, food intake and body weight decreased with HPD and intestinal expression of Pepck increased. HPD also decreased plasma FGF21 levels, regardless of the presence of proglucagon-derived peptides. In control mice, HPD increased the hepatic expression of enzymes involved in amino acid metabolism without the elevation of plasma amino acid levels, except branched-chain amino acids. On the other hand, HPD-induced changes in the hepatic gene expression were attenuated in GCGKO mice, resulting in marked hyperaminoacidemia with lower blood glucose levels; the plasma concentration of glutamine exceeded that of glucose in HPD-fed GCGKO mice. (4) Conclusions: Increased plasma amino acid levels are a common feature in animal models with blocked GCG activity, and our results underscore that GCG plays essential roles in the homeostasis of amino acid metabolism in response to altered protein intake.

Background: This study aimed to increase the knowledge on how to enhance the performance of artificial intelligence (AI)-enabled electrocardiography (ECG) to detect atrial fibrillation (AF) on sinus rhythm ECG (SR-ECG)., Methods: It is a retrospective analysis of a single-center, prospective cohort study (Shinken Database). We developed AI-enabled ECG using SR-ECG to predict AF with a convolutional neural network (CNN). Among new patients in our hospital (n = 19,170), 276 AF label (having ECG on AF [AF-ECG] in the ECG database) and 1896 SR label with following three conditions were identified in the derivation dataset: (1) without structural heart disease, (2) in AF label, SR-ECG was taken within 31 days from AF-ECG, and (3) in SR label, follow-up ≥ 1,095 days. Three patterns of AF label were analyzed by timing of SR-ECG to AF-ECG (before/after/before-or-after, CNN algorithm 1 to 3). The outcome measurement was area under the curve (AUC), sensitivity, specificity, accuracy, and F1 score. As an extra-testing dataset, the performance of AI-enabled ECG was tested in patients with structural heart disease., Results: The AUC of AI-enabled ECG with CNN algorithm 1, 2, and 3 in the derivation dataset was 0.83, 0.88, and 0.86, respectively; when tested in patients with structural heart disease, 0.75, 0.81, and 0.78, respectively., Conclusion: We confirmed high performance of AI-enabled ECG to detect AF on SR-ECG in patients without structural heart disease. The performance enhanced especially when SR-ECG after index AF-ECG was included in the algorithm, which was consistent in patients with structural heart disease., Competing Interests: 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: [Dr. Suzuki received research funding from Mitsubishi Tanabe Pharm and Daiichi Sankyo. Dr. Yamashita received research funds and/or lecture fees from Daiichi Sankyo, Bayer Yakuhin, Bristol-Myers Squibb, Pfizer, Nippon Boehringer Ingelheim, Eisai, Mitsubishi Tanabe Pharm, Ono Pharmaceutical, and Toa Eiyo.]., (© 2022 The Authors.)

The reaction between H 3 + and CO is important in understanding the H 3 + destruction mechanism in the interstellar medium. In this work, thermal rate coefficients for the H 3 + + CO and D 3 + + CO reactions are calculated using ring-polymer molecular dynamics (RPMD) on a high-level machine-learning potential energy surface. The RPMD results agree well with the classical molecular dynamics results, where nuclear quantum effects are completely ignored, whereas the agreement between the RPMD results and the previous quasi-classical trajectory is good only at low temperatures. The calculated [HCO + ]/[HOC + ] product branching ratios decrease as the temperature increases, and the product branching is exclusively determined by the initial collisional orientation, which governs the formation of an ion-dipole complex, H 3 + ···CO or H 3 + ···OC, that dissociates into H 2 + HCO + or H 2 + HOC + , respectively, via a direct mechanism. However, the contribution of the indirect mechanism via the rearrangement between H 3 + ···CO and H 3 + ···OC increases as the temperature increases, although its absolute fraction is small.

The dissociative photodetachment dynamics of the oxalate anion, C 2 O 4 H - + h ν → CO 2 + HOCO + e - , were theoretically studied using the on-the-fly path-integral and ring-polymer molecular dynamics methods, which can account for nuclear quantum effects at the density-functional theory level in order to compare with the recent experimental study using photoelectron-photofragment coincidence spectroscopy. To reduce computational time, the force acting on each bead of ring-polymer was approximately calculated from the first and second derivatives of the potential energy at the centroid position of the nuclei beads. We find that the calculated photoelectron spectrum qualitatively reproduces the experimental spectrum and that nuclear quantum effects are playing a role in determining spectral widths. The calculated coincidence spectrum is found to reasonably reproduce the experimental spectrum, indicating that a relatively large energy is partitioned into the relative kinetic energy between the CO 2 and HOCO fragments. This is because photodetachment of the parent anion leads to Franck-Condon transition to the repulsive region of the neutral potential energy surface. We also find that the dissociation dynamics are slightly different between the two isomers of the C 2 O 4 H - anion with closed- and open-form structures.

Background: Serum adiponectin circulates in three multimeric isoforms: high-molecular-weight (HMW), middle-molecular-weight (MMW), and low-molecular-weight (LMW) isoforms. Potential change in the circulating adiponectin levels in patients with nephrotic syndrome (NS) remain unknown. This study aimed to assess the levels of total adiponectin and the distribution of its isoforms in pediatric patients with NS., Methods: We sequentially measured total adiponectin and each adiponectin isoform levels at the onset of NS, initial remission, and during the remission period of the disease in 31 NS patients. We also calculated the ratios of HMW (%HMW), MMW (%MMW), and LMW (%LMW) to total adiponectin incuding 51 control subjects., Results: The median of total serum adiponectin levels in patients were 36.7, 36.7, and 20.2 μg/mL at the onset, at initial remission, and during the remission period of NS, respectively. These values were significantly higher than those in control subjects. The median values of %HMW, %MMW, and %LMW values were 56.9/27.0/14.1 at the onset, 62.0/21.8/13.4 at the initial remission, and 58.1/21.7/17.5 at during the remission period of NS, respectively. Compared with control subjects, %HMW at initial remission and %MMW at the onset were high, and the %LMW values at the onset and at initial remission were low., Conclusions: In patients with NS, total serum adiponectin levels increase at the onset of the disease, and the ratio of adiponectin isoforms changes during the course of the disease. Further studies are needed to delineate the mechanisms between proteinuria and adiponectin isoforms change., (© 2021. The Author(s).)

Purpose: Ionoacoustics is one of the promising approaches to verify the beam range in proton therapy. However, the weakness of the wave signal remains a main hindrance to its application in clinics. Here we studied the potential use of a fixed-field alternating gradient accelerator (FFA), one of the accelerator candidates for future proton therapy. For such end, magnitude of the pressure wave and range accuracy achieved by the short-pulsed beam of FFA were assessed, using both simulation and experimental procedure., Methods: A 100 MeV proton beam from the FFA was applied on a water phantom, through the acrylic wall. The beam range measured by the Bragg peak (BP)-ionization chamber (BPC) was 77.6 mm, while the maximum dose at BP was estimated to be 0.35 Gy/pulse. A hydrophone was placed 20 mm downstream of the BP, and signals were amplified and stored by a digital oscilloscope, averaged, and low-pass filtered. Time-of-flight (TOF) and two relative TOF values were analyzed in order to determine the beam range. Furthermore, an acoustic wave transport simulation was conducted to estimate the amplitude of the pressure waves., Results: The range calculated when using two relative TOF was 78.16 ± 0.01 and 78.14 ± 0.01 mm, respectively, both values being coherent with the range measured by the BPC (the difference was 0.5-0.6 mm). In contrast, utilizing the direct TOF resulted in a range error of 1.8 mm. Fivefold and 50-fold averaging were required to suppress the range variation to below 1 mm for TOF and relative TOF measures, respectively. The simulation suggested the magnitude of pressure wave at the detector exceeded 7 Pascal., Conclusion: A submillimeter range accuracy was attained with a pulsed beam of about 21 ns from an FFA, at a clinical energy using relative TOF. To precisely quantify the range with a single TOF measurement, subsequent improvement in the measuring system is required., (© 2021 American Association of Physicists in Medicine.)