Search

Aims/Introduction We recently reported the beneficial effect of the combination of sodium–glucose cotransporter 2 inhibitor and dipeptidyl peptidase‐4 inhibitor on daily glycemic variability in patients with type 2 diabetes mellitus. Additional favorable effects of combination therapy were explored in this secondary analysis. Materials and Methods The CALMER study was a multicenter, open‐label, prospective, randomized, parallel‐group comparison trial for type 2 diabetes mellitus involving continuous glucose monitoring under meal tolerance tests. Patients were randomly assigned to switch from teneligliptin to canagliflozin (SWITCH group) or to add canagliflozin to teneligliptin (COMB group). The continuous glucose monitoring metrics, including time in target range, were investigated. Results All 99 participants (mean age 62.3 years; mean glycated hemoglobin 7.4%) completed the trial. The time in target range was increased in the COMB group (71.2–82.7%, P

Background and Aim The Gut and Obesity in Asia Workgroup recently reported that a two‐step approach using fibrosis scores followed by liver stiffness measurement (LSM) could accurately detect patients with non‐alcoholic fatty liver disease (NAFLD) having advanced fibrosis in low‐risk fibrosis populations. This study aimed to validate the utility of this approach using a Japanese health checkup registry. Methods This cross‐sectional study included subjects who underwent a health checkup from 2014 to 2019. Using estimated fibrosis stage measured by LSM as a standard, we calculated the percentage of misclassification from assessments made based on fibrosis scores (NAFLD fibrosis score [NFS] or Fibrosis‐4 score [FIB‐4]) and LSM, alone or in combination. Results Of 630 subjects with NAFLD, 4 (0.8%) had advanced fibrosis. In the first‐step evaluation, only 21.4–38.0% of subjects needed further testing. This approach was associated with a high specificity of approximately 100% and a negative predictive value of 99.7%. The percentage of misclassification based on NFS or FIB‐4 values followed by LSM in all subjects and using LSM after NFS or FIB‐4 determination only in subjects with indeterminate/high NFS or FIB‐4 values (two‐step approach) was 0% and 0.3% and 0.16% and 0.3%, respectively. In addition, very few false negatives occurred for both NFS and FIB‐4. Conclusion The two‐step approach helps to identify the subjects with NAFLD who have advanced fibrosis during a routine health checkup and is associated with only a few false negatives., We validated “two step approach” using health checkup subjects with nonalcoholic fatty liver disease. In the first‐step evaluation, only 21.4–38.0% of subjects needed further testing. The percentage of misclassification based on NAFLD fibrosis score (NFS) or Fibrosis‐4 score (FIB‐4) values followed by liver stiffness measurement (LSM) in all subjects and using LSM after NFS or FIB‐4 determination only in subjects with indeterminate/high NFS or FIB‐4 values (two‐step approach) was 0% and 0.3% and 0.16% and 0.3%, respectively.

Gallium antimonide (GaSb)-based devices operate efficiently in the infrared region. Investigating the toxicity of GaSb thin film is necessary for using embedded GaSb-based devices in living organisms. In this study, viability, oxidative stress, inflammatory responses, apoptosis induction and genotoxicity of GaSb were assayed using L929 cells following a 24 h exposure to GaSb. GaSb thin films were deposited on a quartz substrate using radio frequency (RF) magnetron sputtering. These films were soaked in cell culture medium to prepare test solutions. The viability of cells treated with the GaSb extract was lower than that of control cells. GaSb elicited little reactive oxygen species (ROS) generation. Tumor necrosis factor (TNF)-[Formula: see text] and interleukin (IL)-1[Formula: see text] levels were elevated in GaSb-treated cell culture supernatants. Apoptosis and genotoxicity were not evident following GaSb treatment. Overall, these results demonstrate the low toxicity of GaSb compared with previous studies examining arsenic-containing III–V materials, which is desirable for biological devices.

Background Atrial fibrillation (AF), which contributes to an increased risk of stroke, frequently remains undetected, suggesting an unmet need for easier and more reliable AF screening. The reports on screening AF using an Omron blood pressure (BP) monitor with an irregular heartbeat (IHB) detector show inconsistent results, so the aim of this study was to develop a novel algorithm to accurately diagnose AF with 3 BP measurements using an Omron automated BP monitor with IHB detector.Methods and Results:In total, 303 general cardiac patients were included. Real-time single-lead ECG revealed AF in 44 patients. BP measurement was performed 3 times per patient using the Omron BP monitor HEM-907, and the number of IHBs detected was recorded. Based on these data, we developed the following algorithm: ≥1 IHB is detected during at least 2 of 3 BP measurements and the maximum number of IHBs detected is ≥2. Using this algorithm, we achieved a sensitivity of 95.5% and specificity of 96.5%, for diagnosing AF. Conclusions The novel algorithm with 3 BP measurements using the Omron automated BP monitor with IHB detector showed high sensitivity and specificity for diagnosing AF in general cardiac patients.

Background and aim Although non-alcoholic fatty liver disease (NAFLD) is common in the general population, identifying patients with advanced fibrosis remains a challenge. We investigated whether the homeostasis model assessment parameter of insulin resistance (HOMA-IR), an index of IR and one of the most important metabolic factors, is an independent predictive factor for advanced fibrosis in nondiabetic patients with NAFLD. Methods This was a retrospective, cross-sectional multicenter study. We included 361 patients with biopsy-proven NAFLD who had not been diagnosed with type 2 diabetes mellitus: 175 (48%) were women and 48 (13%) had advanced fibrosis. We used simple random sampling; the sampling ratio of the estimation and validation groups was 7:3. A logistic model was constructed for both the estimation and validation groups. The explanatory variables were age ≥ 49 years, sex (women), body mass index ≥ 26.7 kg/m2 , the presence of hypertension, presence of dyslipidemia, fasting plasma glucose level ≥ 98 mg/dL, fasting immune reactive insulin level ≥ 12.0 μU/mL, and HOMA-IR ≥ 2.90. The median HOMA-IR of the patients was 2.88 (interquartile range: 2.1-4.8). Results In the estimation group, univariate and multivariate analyses showed that age, dyslipidemia, and HOMA-IR were independent predictors of advanced fibrosis. In the validation group, only age and HOMA-IR were found to be independent predictors of advanced fibrosis. Conclusions Homeostasis model assessment parameter of insulin resistance was an independent predictor of advanced liver fibrosis in nondiabetic patients with NAFLD. Given that most patients with NAFLD are nondiabetic, it is important to set goals with respect to improving IR to subsequently reduce liver fibrosis.

BACKGROUND The aim of the present study was to determine whether instructors could accurately assess chest compression quality visually, considering the association between chest compression depth and rate. Methods and Results: In this prospective, observational study, the quality of chest compressions performed by a simulated actor in a video was visually assessed by certified instructors. The film consisted of 14 case scenarios, each including a combination of depth (2 patterns: adequate, 5-6 cm; and inadequate

The purpose of this study was to evaluate the influence for image quality of diffusion weighted image (DWI) by gradient coil systems (two single gradient systems and a dual gradient system). We obtained DWIs of a phantom and three volunteer brains, changing gradient coil systems and echo time (TE) from configurable shortest TE to 130 ms. Image quality of DWI was evaluated by signal to noise ratio (SNR), image distortion, susceptibility artifact, and visual evaluation. SNR of dual gradient system and configurable shortest TE was the highest in phantom study, but there was no difference for SNR of volunteer brain images by each gradient coil system in visual evaluation. Image distortion of single gradient system with low gradient amplitude was the worst in phantom study, and the score of visual evaluation in susceptibility artifact was significantly lower than other gradient coil systems. Dual gradient system was low influence to image distortion and susceptibility artifact. In conclusion, using dual gradient system and configurable shortest TE is recommended for less distortion, low susceptibility artifact, and high SNR image.

This study aimed to prove that the FibroScan-aspartate aminotransferase (FAST) scores can be used to stratify disease severity in a Japanese cohort with fatty liver diseases [metabolic dysfunction-associated fatty liver disease (MAFLD) and nonalcoholic fatty liver disease (NAFLD)]. All the participants (n = 2254) underwent liver stiffness measurements and controlled attenuation parameter assessments. We compared the clinical characteristics of the patients with MAFLD and NAFLD using the FAST scores and explored the independent determinants of FAST scores ≥ 0.35, which indicated possible progressive disease. Overall, MAFLD was diagnosed in 789 patients (35.0%), while NAFLD was diagnosed in 618 (27.4%). The proportion of patients that had a condition that suggested progressive liver disease was higher in those with MAFLD than in those with NAFLD [68 (8.6%) vs 48 (7.7%)]. The area under the receiver-operating characteristic curve of the FAST score for diagnosing advanced fibrosis was 0.969 in MAFLD and 0.965 in NAFLD. Multivariate analyses determined that diabetes mellitus, alanine aminotransferase (ALT) levels, fatty liver index, and Fibrosis-4 index independently predict FAST scores ≥ 0.35 in patients with MAFLD. ALT levels had the strongest correlation with the FAST scores (p = 0.7817). The FAST score could stratify the disease severity in the Japanese cohort with fatty liver diseases.

Background/purpose: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new concept that better expresses the pathogenesis of nonalcoholic fatty liver disease (NAFLD). Although the Fibrosis-4 Index (FIB-4) can easily predict the degree of liver fibrosis, its diagnostic ability, especially in the elderly, requires validation. This study aimed to validate the diagnostic ability of revised cutoff points for FIB-4 in patients with MAFLD and NAFLD.Methods: This cross-sectional study included participants who underwent a health check-up from 2014 to 2019. The proportion and number of low, indeterminate, and high cutoff group between the conventional and revised cutoff points for FIB-4 were compared. The diagnostic ability of these points was compared using the aspartate aminotransferase (AST) to platelet ratio index (APRI) as a standard.Results: Of 21,801 participants, 5,559 (25.5%) had MAFLD and 4,463 (20.5%) had NAFLD. Using revised cutoff points, the proportion of the indeterminate group dropped from 46% to 15% in the MAFLD and 43% to 14% in the NAFLD group. Approximately 60% of patients with MAFLD and NAFLD from the indeterminate group with conventional FIB-4 moved to the low group with a revised FIB-4. Even after age adjustment, the APRI significantly increased for each FIB-4 category and the area under the receiver operating characteristic curve with a diagnosis of APRI ≥ 1.0 increased in both the MAFLD and NAFLD groups.Conclusions: Using cutoff points for the FIB-4 modified by age, the proportion of the indeterminate group dropped and the diagnostic ability increased for both MAFLD and NAFLD.

Recently, ammonia-thermal reaction has been used for molecular intercalation in layered FeSe, resulting a new Lix(NH3)yFe2Se2 superconductor with Tc ~ 45 K. Here, we have used temperature dependent extended x-ray absorption fine structure (EXAFS) to investigate local atomic displacements in single crystals of this new superconductor. Using polarized EXAFS at Fe K-edge we have obtained direct information on the local Fe-Se and Fe-Fe bondlengths and corresponding mean square relative displacements (MSRD). We find that the Se-height in the intercalated system is lower than the one in the binary FeSe, suggesting compressed FeSe4 tetrahedron in the title system. Incidentally, there is hardly any effect of the intercalation on the bondlengths characteristics, revealed by the Einstein temperatures, that are similar to those found in the binary FeSe. Therefore, the molecular intercalation induces an effective compression and decouples the FeSe slabs. Furthermore, the results reveal an anomalous change in the atomic correlations across Tc, appearing as a clear decrease in the MSRD, indicating hardening of the local lattice mode. Similar response of the local lattice has been found in other families of superconductors, e.g., A15-type and cuprates superconductors. This observation suggests that local atomic correlations should have some direct correlation with the superconductivity.

Simple Summary Uterine leiomyosarcoma (uLMS) is a rare and aggressive mesenchymal malignancy. Although approximately 65% of patients are diagnosed in stage I, more than 50% have relapsed disease, and effective therapies for recurrent and advanced cases are limited. This review summarizes the current standard therapies for uLMS and the molecular properties of uLMS and describes the status of promising novel molecular-targeted therapies. Uterine leiomyosarcoma (uLMS) is the most common subtype of mesenchymal tumors in the uterus. This review aims to summarize the current standard therapies and the molecular properties of uLMS for novel molecular-targeted therapies. Although 65% of uLMS cases are diagnosed in stage I, the 5-year overall survival rate is less than 60%. The only effective treatment for uLMS is complete and early resection, and chemotherapy is the main treatment for unresectable advanced or recurrent cases. No chemotherapy regimen has surpassed doxorubicin monotherapy as the first-line chemotherapy for unresectable advanced or recurrent cases in terms of overall survival in phase 3 trials. As a second-line treatment, pazopanib, trabectedin, and eribulin are used, but their therapeutic effects are not sufficient, highlighting the urgent need for development of novel treatments. Recent developments in gene analysis have revealed that homologous recombination deficiency (HRD), including breast cancer susceptibility gene 2 (BRCA2) mutations, are frequently observed in uLMS. In preclinical studies and several case series, poly(adenosine diphosphate-ribose)polymerase inhibitors showed antitumor effects on uLMS cell lines with BRCA2 mutations or HRD and in recurrent or persistent cases of uLMS with BRCA2 mutations. Thus, HRD, including BRCA mutations, may be the most promising therapeutic target for uLMS.

No evidence has shown the efficacy of Sodium Risedronate (Risedronate) for glucocorticoid-induced osteoporosis (GIO) in patients with Rheumatoid arthritis (RA). The aim of this study was to explore the effectiveness and safety of Risedronate for GIO complicated with RA.This was a six-month randomized, double-blind, placebo-controlled trial of 95 patients with GIO complicated with RA from 19 centers. The primary endpoint was the change from baseline in lumbar spine bone mineral density (L-BMD). Secondary endpoints included changes in femoral neck and total hip BMD and bone turnover markers, as well as rheumatoid arthritis Disease Activity Score with 28-joint counts. Incident of non-traumatic spine fractures and adverse events were tracked as safety endpoints.Increase in L-BMD was significantly greater in the Risedronate group compared to the Placebo group (Risedronate: 3.49% [95% CI: 1.92-5.05] vs Placebo: 0.12% [95% CI: -2.07 to 2.30],Risedronate was effective in increasing L-BMD and was well tolerated in patients with GIO complicated with RA.

We aimed to investigate patient characteristics affecting their knowledge of surgical reconstruction for rheumatoid hand and wrist deformities, and to investigate such characteristics affecting their hope of receiving hand surgery if patients with rheumatoid arthritis (RA) knew surgical reconstruction options.We carried out a questionnaire survey for all patients with RA who came to our outpatient department of rheumatology. Multivariate logistic regression analysis was performed to examine significant characteristics associated with the knowledge of surgical reconstruction and patients' hope of receiving hand surgery.In total, 687 patients were evaluated in this study and 337 (49%) reported knowledge about surgical reconstruction. A multivariate logistic regression analysis showed that patients with good control of disease activity and with long-lasting hand and wrist deformities were significantly associated with having knowledge of surgical reconstruction. Among the 337 patients with knowledge, only 122 (36%) expressed a hope of receiving hand surgery. The statistical analysis showed that younger age and surgical history were significantly associated with the hope of receiving surgery.Surgeons and rheumatologists should enlighten patients about the importance of hand surgery to achieve functional remission in this new era of treatment for patients with RA.

Background and Aim Chronic liver diseases (CLDs) progress from chronic inflammation to fibrosis to tumorigenesis. Galectin-9, a β-galactoside-specific animal lectin, is indicated to contribute to all three steps of progression. The aim of this study was to determine which of the three steps was most dominant in elevating the serum galectin-9 concentration and to test the possibility of galectin-9 as a serum biomarker. Methods Japanese patients with chronic hepatitis (CH), liver cirrhosis (LC), hepatocellular carcinoma (HCC), nonalcoholic fatty liver disease or alcoholic liver disease who provided informed consent were enrolled in this study. Serum galectin-9 levels were measured using a sandwich ELISA. Multiple regression analyses were performed using EZR to identify factors which determined serum galectin-9 concentration. Results One hundred one patients with 50 of CH and 51 of LC were enrolled; the cohort included 45 cases of HCV infection, 13 cases of HBV infection, 46 cases with HCC-related complications. The median serum galectin-9 concentration was 77.54pg/ml (inter quartile range: 18.89-241.9pg/ml). Multiple linear regression analyses proved Fib-4 index and APRI, indexes of liver fibrosis, were able to predict the serum galectin-9 levels with statistical significance. A multiple logistic regression analysis determined 10pg/ml increase of the serum galectin-9 concentration presented an odds ratio of 3.90 for liver fibrosis progression. Conclusions The serum galectin-9 concentration represents a potential biomarker of liver fibrosis in patients with CLDs, regardless of chronic inflammation or the presence of HCC complications. Furthermore, higher serum galectin-9 levels are a predictor for liver fibrosis progression.

Describing complex mammography examination processes is important for improving the quality of mammograms. It is often difficult for experienced radiologic technologists to explain the process because their techniques depend on their experience and intuition. In our previous study, we analyzed the process using a new bottom-up hierarchical task analysis and identified key components of the process. Leveraging the results of the previous study, the purpose of this study was to construct a mammographic examination process ontology to formally describe the relationships between the process and image evaluation criteria to improve the quality of mammograms. First, we identified and created root classes: task, plan, and clinical image evaluation (CIE). Second, we described an "is-a" relation referring to the result of the previous study and the structure of the CIE. Third, the procedural steps in the ontology were described using the new properties: "isPerformedBefore," "isPerformedAfter," and "isPerformedAfterIfNecessary." Finally, the relationships between tasks and CIEs were described using the "isAffectedBy" property to represent the influence of the process on image quality. In total, there were 219 classes in the ontology. By introducing new properties related to the process flow, a sophisticated mammography examination process could be visualized. In relationships between tasks and CIEs, it became clear that the tasks affecting the evaluation criteria related to positioning were greater in number than those for image quality. We developed a mammographic examination process ontology that makes knowledge explicit for a comprehensive mammography process. Our research will support education and help promote knowledge sharing about mammography examination expertise.

Although terminology requires continuous consideration of recorded technical terms, extracting these terms manually is difficult, because the number of recorded terms is constantly increasing. Text-mining acquires information from numerous documents, and is capable of extracting technical terms. The purpose of this study is to extract candidate terms using text-mining toward updating the terminology of Japanese society of radiological technology (JSRT). First, the subjects for this study were textbooks published by the JSRT, and morphological analysis was conducted, which is an analysis to break the books up into meaningful words. Additionally, index terms of textbooks were extracted. Second, we observed overlaps between the JSRT technical terms and the terms obtained from the morphological analysis and the indexes of textbooks and the extracted terms were absent in the JSRT terminology. The overlap was 53.6% (3090/5770 terms). The terms, "imaging technology for magnetic resonance" and "information and system in radiological technology" were missing from the JSRT terminology. From these results, it was estimated that half number of the JSRT technical terms were changing with time. This study demonstrated that text mining showed the differences between old and new technical terms.

Flexible devices have recently been actively investigated for various purposes. Sb-based materials particularly attractive for medical applications. We grew InSb and dilute nitride InSbN thin films on polyimide (PI) films and on quartz substrates by reactive radio frequency magnetron sputtering. By comparing the properties of thin films grown on PI films with those on quartz substrates, we revealed that InSb/PI contains large amount of native defects which originate from Sb clusters and Sb vacancies (VSb). Although the properties of the thin films grown on quartz substrates did not improve by nitridation, dilute nitride InSbN/PI showed superior properties to InSb/PI. These changes in thin film properties suggest that nitridation generates the substitution of VSb for N and the suppression of native defect formation. Consequently, dilute nitride InSbN/PI is potentially useful in electronic device applications. Furthermore, we evaluated the skin absorption of dilute nitride InSbN/PI. As a result, both In and Sb hardly permeated and were retained inside the skin. We conclude that the flexible dilute nitride InSbN/PI can be applied to epidermal optoelectronics.

GaSb may be suitable for biological applications, such as cellular sensors and bio-medical instrumentation because of its low toxicity compared with As (III) compounds and its band gap energy. Therefore, the biocompatibility and the film properties under physiological conditions were investigated for GaSb thin films with or without a surface coating. GaSb thin films were grown on quartz substrates by RF magnetron sputtering, and then coated with (3-mercaptopropyl) trimethoxysilane (MPT). The electrical properties, surface morphology, and crystal structure of the GaSb thin film were unaffected by the MPT coating. The cell viability assay suggested that MPT-coated GaSb thin films are biocompatible. Bare GaSb was particularly unstable in pH9 buffer. Ga elution was prevented by the MPT coating, although the Ga concentration in the pH 9 buffer was higher than that in the other solutions. The surface morphology and crystal structure were not changed by exposure to the solutions, except for the pH 9 buffer, and the thin film properties of MPT-coated GaSb exposed to distilled water and H 2 O 2 in saline were maintained. These results indicate that MPT-coated GaSb thin films are biocompatible and could be used for temporary biomedical devices.

GaSb thin films were grown on quartz substrate and Ge(100) 1°-off-axis substrate by RF magnetron sputtering at growth temperatures of 400, 500, and 600 °C. The crystalline quality of GaSb/quartz improved with increasing growth temperature. The GaSb/Ge(100) grown at 500 °C exhibited good crystalline quality with comparatively high mobility (219 cm 2 /V s); however, the mobility degraded in GaSb/Ge(100) films grown at higher temperatures because of the increase in crystal defects induced by strain relaxation. Undoped GaSb has been previously reported to always exhibit p -type conductivity, irrespective of the growth method and growth conditions. However, we prepared an undoped GaSb thin film with n -type conductivity by using a Ge(100) 1°-off-axis substrate. This finding led to the conclusion that the use of an off-axis substrate affects the defect formation mechanism and enables the control of the conduction mechanism in undoped GaSb thin films.

Objectives Several reports have compared the efficacy of linezolid (LZD) in Methicillin-resistant Staphylococcus aureus (MRSA) infections with that of vancomycin (VCM); however, these two antibiotics for the treatment of nosocomial MRSA pneumonia in elderly patients has not been well evaluated. The purpose of this study is to evaluate the efficacy and safety of LZD compared with VCM for the treatment of elderly patients with nosocomial MRSA pneumonia in a retrospective chart review of a cohort. Methods We included 28 consecutive patients aged ≥65years hospitalized with a confirmed diagnosis of MRSA pneumonia and treated with LZD ( n =11) or VCM ( n =17) between November 2010 and May 2015. We collected patient, disease, and laboratory data. The primary outcome was 30-day mortality. The secondary outcomes were the sequential organ failure assessment (SOFA) total, respiratory, renal, coagulation, hepatic, cardiovascular, and central nervous system scores on days 1, 3, 7, and 14. Results There were no significant differences between the two groups with regard to baseline characteristics. The 30-day mortality rate was significantly lower in the LZD group than in the VCM group (0% vs. 41%, P =.02). The SOFA total score on days 3, 7, and 14 were significantly lower those at baseline in the LZD group ( P P Conclusion LZD may be more efficacious than VCM for treating elderly patients with nosocomial MRSA pneumonia.

Gallium antimonide (GaSb) is a group III-V compound semiconductor with a comparatively narrow band gap energy (0.73 eV at 300 K) that allows efficient operation in the near-infrared region. This property may be useful in developing new biomedical instruments such as epidermal optoelectronic devices. The present study investigated the absorption of GaSb in pig skin in vitro for 24 h using Franz cells. A donor solution was prepared by soaking GaSb thin films in synthetic sweat. The results showed that both gallium and antimony penetrated the skin, and permeation and resorption occurred for gallium. Histopathological findings showed no inflammatory responses in pig skin exposed to GaSb for 24 h. Cytotoxicity was significantly elevated after 3 and 7 days, and pro-inflammatory cytokines and IL-8 levels were low after 1 and 3 days but elevated 7 days following the direct culturing of human dermal fibroblasts (HDF) on GaSb thin films. These results demonstrate that the short-term cytotoxicity and pro-inflammatory effect of GaSb on HDF were relatively low.

ObjectivesMultiple system atrophy (MSA) is a refractory neurodegenerative disease, but novel treatments are anticipated. An accurate natural history of MSA is important for clinical trials, but is insufficient. This regional registry was launched to complement clinical information on MSA.SettingPatient recruitment started in November 2014 and is ongoing at the time of submission. The number of participating facilities was 66. Postal surveys were sent to medical facilities and patients with MSA in Hokkaido, Japan.ParticipantsAfter obtaining written consent from 196 participants, 184 overview surveys and 115 detailed surveys were conducted.Primary and secondary outcome measuresAn overview survey evaluated conformity to diagnostic criteria and a detailed survey implemented an annual assessment based on the Unified Multiple System Atrophy Rating Scale (UMSARS).ResultsAt the time of registration, 58.2% of patients were diagnosed with cerebellar symptoms predominant type MSA (MSA-C) and 29.9% were diagnosed with parkinsonism predominant type MSA (MSA-P). UMSARS Part Ⅳ score of 4 or 5 accounted for 53.8% of participants. The higher the UMSARS Part Ⅳ score, the higher the proportion of MSA-P. At baseline, levodopa was used by 69 patients (37.5%) and the average levodopa dose was 406.7 mg/day. The frequency of levodopa use increased over time. Eleven cases changed from MSA-C to MSA-P during the study, but the opposite was not observed. Information about survival and causes of death was collected on 54 cases. Half of deaths were respiratory-related. Sudden death was recorded even in the group with UMSARS Part Ⅳ score of 1.ConclusionsThis study is the first large-scale prospective MSA cohort study in Asia. MSA-C was dominant, but the use of antiparkinsonian drugs increased over the study period. Changes from MSA-C to MSA-P occurred, but not vice versa.

Raman spectroscopy is commonly used in chemistry to identify molecular structure. This technique is a nondestructive analysis and needs no sample preparation. Recently, Raman spectroscopy has been shown to be effective as a multipurpose analytical method for forensic applications. In the present study, blood identification and discrimination between human and nonhuman blood were performed by a portable Raman spectrometer, which can be used at a crime scene. To identify the blood and to discriminate between human and nonhuman blood, Raman spectra of bloodstains from 11 species (human, rat, mouse, cow, horse, sheep, pig, rabbit, cat, dog, and chicken) were taken using a portable Raman spectrometer. Raman peaks for blood (742, 1001, 1123, 1247, 1341, 1368, 1446, 1576, and 1619 cm−1) could be observed by the portable Raman spectrometer in all 11 species, and the human bloodstain could be distinguished from the nonhuman ones by using a principal component analysis. This analysis can be performed on a bloodstain sample of at least 3 months old. The portable Raman spectrometer can be used at a crime scene, and this analysis is useful for forensic examination.

Antimony is widely used in industrial applications. In this study, we develop a method for total antimony analysis using a hydride generation-microwave plasma-atomic emission spectroscopy (HG-MP-AES) system equipped with a multimode sample introduction system (MSIS). Before analysis, antimony was reduced with potassium iodide and acidified with hydrochloric acid. The samples and a sodium tetrahydroborate/sodium hydroxide solution were infused into a spray chamber for hydride generation, MSIS. The limits of detection and quantification were 0.05 μg/L and 0.15 μg/L, respectively. Furthermore, semiconductor materials and blood samples have been analyzed in order to demonstrate the possible applications of this method. The total antimony content eluted from GaSb thin films in a pH 5 buffer agreed with the thin film structure. The spiked blood sample analysis showed that the recovery rate of antimony from the whole blood samples was 92.2 ± 1.67%. Relative standard deviations for inter-day and intra-day assays of whole blood were 1.99% and 5.31%, respectively. The developed method was determined to have good accuracy and precision with the obtained values, and can be utilized for antimony analysis in the engineering and toxicological fields.

Understanding the behavior of excess Ga is important for fabrication methods that employ the sputtering of GaSb-based materials. This is due to the comparatively low vapor pressure of Ga, which can result in GaSb becoming Ga-rich under experimental conditions. In this study, the growth and characterization of nonstoichiometric polycrystalline GaSb thin films with excess Ga, grown by RF magnetron sputtering, are reported. Ga content was adjusted by mixing N2in the Ar sputtering gas. The structural properties indicate that the grown thin films maintain the zinc blend structure of GaSb, and have an induced tensile strain along a direction parallel to the substrate. Excess Ga segregates towards the film surface and forms micro/nanoclusters. The internal tensile strain and the Ga cluster formation have little effect on the intrinsic properties of GaSb. These findings could lead to the fabrication of GaSb-based thin films using sputtering with excellent mass productivity.

BACKGROUND The Japanese government has established a law encouraging early detection and treatment of developmental disorders in children. Child behavior problems (CBP) tend to be recognized at school as a result of developmental disorders. The aim of this study was to identify factors associated with CBP in Japan. We hypothesized that factors other than developmental disorders are important in explaining CBP. METHODS The study was conducted between February and March 2015. Parents of 3,515 children aged 2-5 years attending one of 34 public nursery schools in Takamatsu, Kagawa, Japan received self-administered questionnaires addressing parental socioeconomic factors, mental health, parenting style (i.e. hostile, overreactive, or lax), developmental disorders in children, and CBP. A multiple regression analysis was applied to explore associations between CBP and possible factors. RESULTS Overall, 1,410 mothers were eligible to participate in the study. Children diagnosed with developmental disorders accounted for 7.8% of the sample, while on the Eyberg Child Behavior Inventory 17% of children had behavior problems needing clinical intervention. After adjustment for confounding factors, as well as for the diagnosis of developmental disorders, poor mental status and all three dysfunctional parenting styles had strong associations with CBP, and hostile, overreactive, and lax parenting had standardized β-values (β) of 0.29, 0.28, and 0.15, respectively (P < 0.01). A problematic relationship between the parents was also significantly associated with CBP (β = -0.29, P < 0.01). CONCLUSION When CBP are identified, parenting skills, mental health status and parental relationships should be considered along with the possibility of developmental disorders in the development of interventions.