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Summary: Microbial surveillance of environmental bacteria was performed in order to study the microbial changes in a newly established hospital building. Airborne bacteria and surface-associated bacteria on floors and sinks were systematically collected between 2002 and 2005. The number of isolates obtained from frequently used floors was significantly higher than that obtained from those floors used less often. A significant increase in Staphylococcus aureus, the appearance of Pseudomonas aeruginosa, and changes among species of Gram-negative bacilli were observed 8–11 months after the new building had been opened. Furthermore, pulsed-field gel electrophoresis (PFGE) typing of meticillin-resistant S. aureus (MRSA) and P. aeruginosa showed that strains of the same PFGE groups were isolated from different sinks, floors and the adjoining old buildings. The number of MRSA isolates obtained from the new building increased as time passed. The sinks from which P. aeruginosa strains of the same PFGE type were isolated are connected by the same drainage pipe. Human movement has considerable effects on bacterial flora and their subsequent spread. [Copyright &y& Elsevier]

Objectives: Our purpose was to determine whether systemic hypotension induced by rapid withdrawal of fetal blood would induce periventricular leukomalacia in the brain of premature fetal sheep.Study Design: At 113 days' gestation, systemic hypotension (mean blood pressure <30 mm Hg) was induced by withdrawing approximately 35% of the fetoplacental blood volume in the hemorrhage group (n = 6), whereas in the control group (n = 4) isovolemic exchange transfusion was carried out. Six days after the insult, fetal brains were removed and processed for histologic analysis.Results: Five of the 6 fetuses in the hemorrhage group exhibited periventricular white-matter lesions, consisting of nodular coagulation necrosis or diffuse axonal swellings or both. No abnormal findings other than these lesions were detected in the fetal brains in either experimental group.Conclusion: Hemorrhagic hypotension antenatally induced brain lesions similar to those of periventricular leukomalacia, suggesting that it is an essential element in the pathogenesis of periventricular leukomalacia in premature fetuses. [ABSTRACT FROM AUTHOR]

Abstract: We evaluated the relative clinical potency of cyclosporine (CyA) and tacrolimus (Tac) using pharmacodynamic and pharmacokinetic parameters of the drug to obtain the most suitable converting dose and target trough level. The relative pharmacodynamic potency was examined by the mean ratio of drug concentrations giving 50% inhibition of blastogenesis of lymphocytes (IC50) in 66 chronic renal failure patients. The relative potency estimated from clinical pharmacokinetic parameters was examined by the mean ratio of each pharmacokinetic parameter value of CyA versus Tac. The pharmacokinetic parameters were estimated by 12-hour monitoring of drug blood concentrations in seven CyA patients and seven Tac patients. The mean IC50 ratio of CyA and Tac (CyA/Tac of IC50) was 25.1. The mean area under the concentration-time curve (AUC) ratio (CyA/Tac of AUC) was 25.5, the mean trough level (Cmin) ratio (CyA/Tac of Cmin) was 13.2, and the mean dose per body weight ratio was 25.2. The relative potency estimated from AUC that is the most reliable pharmacokinetic parameter for the estimation of clinical efficacy of calcineurin inhibitors appeared to agree with the relative pharmacodynamic potency estimated from IC50. The data suggest that TAC 25-fold more potent than CyA, which represents a suitable converting dose ratio, and that target trough level of CyA is about 13-fold greater than Tac based on CyA/Tac of Cmin. We conclude that these relative values may be useful to estimate the suitable dose and target trough levels to convert between CyA and Tac. [Copyright &y& Elsevier]

Introduction/Background Upper extremity (UE) dysfunction is a common problem in patients with stroke. Recently, several neurorehabilitation approaches have been developed to improve the UE motor function (Langphorene P. Lancet Neurol , 2009). However, most approaches target either proximal or distal UE motor function, although interventions targeting both portions are necessary to restore functional UE in actual daily life. Therefore, we conducted stepwise intervention for both shoulder and finger function to improve UE motor function. Material and method Two stroke patients with severe hemiparetic stroke participated in the study. Firstly, we attempted to improve shoulder function using brain machine interface (BMI) technology for 7 days ( Fig. 1 ). After the shoulder BMI training, a combination of motor imagery and electrical stimulation (MI + ES) was conducted to improve finger function for 10 days ( Fig. 2 ). Motor function of the affected UE was assessed with motor items of the Fugl–Meyer assessment UE motor score (FMA-UE). FMA-UE consists of 4 categories (A: Shoulder/Elbow/Forearm; B: Wrist; C: Hand; D: Coordination) and has a maximum score of 66. Results The FMA-UE score increased remarkably after the stepwise intervention (Patient A: 17→33; Patient B: 11→25). The effect of shoulder BMI training is shown in Fig. 3 . It became possible for patients to raise their arms above the shoulder position after the shoulder BMI training. Patients’ UE motor function was also further improved by the subsequent MI + ES intervention. Conclusion The improvement in UE motor function with our stepwise intervention for proximal and distal motor functions greatly exceeded the minimal clinically important difference in the subjects of this study. [ABSTRACT FROM AUTHOR]

Abstract: Negative Bias Temperature Instability of pMOSFETs is investigated under various stress gate voltages and temperatures. It is shown that degradation tends to saturate and the dependence of lifetime on electric field (E ox) is expressed as a power-law of E ox. We propose new empirical and kinetic models. The E ox dependence of the lifetime described by the power-law is derived from our empirical model describing the saturation of degradation. Moreover, our kinetic model explains the saturation behavior. [Copyright &y& Elsevier]

Abstract: The target blood concentrations of tacrolimus (TAC) and cyclosporine (CYA) during continuous intravenous infusion (Css) have been determined based on clinical experience. However, it is desirable that Css should be set so that the AUC after intravenous infusion is equal to the AUC after oral administration (AUCpo). Accordingly, we performed 12-hour monitoring of blood concentrations to calculate Css from the blood trough levels (CTL) on 15 kidney recipients administered TAC and 12 recipients administered CYA (Neoral). We used an area under the trough level (AUTL) as a new pharmacokinetic parameter. The Css was evaluated from CTL, AUCpo, and AUTL was calculated to be Css = CTL × (AUCpo/AUTL). In addition, AUTL/AUCpo ratio and blood peak/trough level ratio (Cmax/Cmin) were examined to compare pharmacokinetics of TAC and CYA. The formula for TAC was Css = CTL × 1.40 and that for CYA, Css = CTL × 2.55. The calculated target Css of TAC was 1.40 times that of CTL, which was similar to the present clinical CTL. In contrast, the calculated target Css of CYA was 2.55 times the CTL, and therefore an extremely high Css was necessary to obtain a sufficient AUC that will be available after oral administration. Consequently, intravenous administration of CYA twice a day was considered to be more appropriate to obtain sufficient CYA pharmacokinetics, rather than a continuous intravenous administration. We conclude that the formula, Css = CTL × (AUCpo/AUTL) was useful to calculate the target blood concentration of calcineurin inhibitors when changing from continuous intravenous infusion to oral administration of these drugs. [Copyright &y& Elsevier]

Abstract: The caries preventive effect of fluoride-containing materials (FCMs) might depend on the caries risk of the individuals. Two pairs of demineralizing and remineralizing solutions of pH-cycling were prepared for simulating low and high caries risk. The purpose of this study was to determine fluorine (F) uptake into human enamel around FCMs under different pH-cycling using the in-air μ-PIGE/PIXE system. Fluoride-containing glass ionomer cement (Fuji IXGP FAST CAPSULE (FN)), and composite resin (BEAUTIFIL II with FLUORO BOND SHAKE ONE (BS)) were used in this study. The pH-cycling (pH 6.8–4.5) was carried out for 5weeks. After pH-cycling, the caries progression was analyzed using transverse micro-radiography (TMR). The fluorine and calcium distributions in the carious lesion in each specimen were evaluated using the PIGE/PIXE system. From TMR analysis, there was a difference in caries risk between the two kinds of pH-cycling. Although the caries preventive effect of BS and FN was confirmed at low risk, the effect at high risk was confirmed for FN only. From the analysis of the fluorine uptake in the outer 200μm of the lesion we concluded that there was no significant difference between the pH-cycling solutions. However, we found different fluorine concentrations in the enamel for the two FCMs. The decreased caries progression under high risk for FN indicated that an adequate amount of fluorine supplied from the material is required at higher caries risk. It was confirmed that the caries preventive effect of FCM depends on the caries risk. The fluorine analysis of teeth under various pH-cycling conditions gives information to evaluate the caries preventive effect of fluoride-containing materials according to the caries risk. [Copyright &y& Elsevier]

Abstract: The preparation of the highly refractive transparent TiO2-dispersed microspheres with uniform size was studied. These nanocomposite microspheres were prepared via TiO2 dispersion in an acrylic monomer and the emulsification by the Shirasu porous glass (SPG) membrane technique. Two kinds of the dispersion methods (bead mill dispersion with fine beads and ultrasonic dispersion) were carried out. The suspension prepared by bead mill included well-dispersed TiO2 nanoparticles and led to the uniformly sized TiO2-dispersed microspheres. It was indicated that the dispersibility of TiO2 in a monomer was the important factor in this process. [Copyright &y& Elsevier]

Abstract: Particle charging during coagulational growth is widely used in material synthesis processes as well as with industrial particle removal equipment. Coagulation behavior of charged particles is significantly different from that of neutral particles. To calculate the change in size/charge distribution of particles undergoing bipolar coagulation, a two-dimensional sectional model has been usually used. This method, however, needs considerable computation time although it gives very accurate prediction. In this study, the moment model, to solve the bipolar coagulation problem in the free-molecule regime, was developed to provide a time-efficient tool. Simultaneous particle charging by bipolar ions was also considered in this study. The developed model is based on the assumption that particles cannot have more than one unit charge and the particle size distribution remains log normal. The developed model was compared to the two-dimensional sectional model, with good agreement being shown. Some characteristics of bipolar coagulation were investigated using the developed model. The bipolar coagulation with simultaneous bipolar diffusion charging was shown to significantly increase the coagulation rate compared to the neutral Brownian coagulation. It was also shown from the simulation results that if one needs a higher coagulation rate in the initial stage, bipolar coagulation without ions is recommended, while bipolar coagulation with simultaneous charging by bipolar ions should be used if one wants a high coagulation rate for a long time. [Copyright &y& Elsevier]

Non-agglomerated spherical silicon, titanium and zirconium oxide nanoparticles were prepared using an electrospray assisted chemical vapor deposition (ES-CVD) process. Metal alkoxides in conjunction with an electrospray method were used to introduce charged precursors into a CVD reactor. The ions are produced during evaporation of the charged droplets, and they probably act as seed nuclei (i.e., ion-induced nucleation) and/or, they are attached to the produced particles. The experimental results were compared with those obtained using a conventional evaporation CVD method. The particles generated using the conventional evaporation method were agglomerated to a considerable extent irregardless of the type of particle. Whereas, at the same conditions, high concentrations of non-agglomerated nanoparticles having diameters in the range of 10–40 nm were obtained using the ES-CVD method. This appears to be due to the charging effects of the generated particles, that is, the electrostatic dispersion of unipolarly charged particles. The size of the non-agglomerated particles in the ES-CVD method was reduced as the results of the decease in the concentration of precursors introduced by electrospray. [Copyright &y& Elsevier]

Condensational growth of a polydisperse aerosol was studied employing the moment method of log-normal size distribution function. The previous analytical solution for the size distribution of a condensationally growing aerosol (Park et al., J. Aerosol. Sci. 32 (2001) 187) was extended to cover the low Knudsen number transition regime. In order to cover the transition regime, the harmonic mean method was used for obtaining the transition correction factors for mass and heat fluxes. Comparisons were made with the existing solution and good agreement was obtained. [Copyright &y& Elsevier]

Abstract: This report presents a falsely abnormally elevated blood trough concentration (Ct) of tacrolimus measured by antibody-conjugated magnetic immunoassay (ACMIA) methods in a renal transplant recipient. Because the Ct of tacrolimus was 78.5 ng/mL at day 2 after a 52-year-old man underwent renal transplantation, we stopped the tacrolimus extended-release formulation. However, because the abnormally elevated blood Ct continued in the range of 41.1–59.1 ng/mL, we then measured the tacrolimus concentration in a stored blood sample before renal transplantation, it was 43 ng/mL. Consequently, the day-7 blood sample was measured with both ACMIA and enzyme-linked immunoassay, showing Ct values of 42.8 ng/mL and 0.89 ng/mL, respectively. Because the abnormally elevated Ct was falsely measured by the ACMIA method, we restarted tacrolimus However, the calcineurin inhibitor was subsequently converted to cyclosporine at day 21 after renal transplantation. Although cyclosporine was also measured by ACMIA, there was not an abnormally elevated Ct. Subsequently, the tacrolimus concentration ratio in plasma and whole blood (P/B-tacrolimus concentration ratio) was measured by ACMIA in a posttacrolimus blood sample. The P/B-tacrolimus concentration ratio was 100%. In contrast, the P/B-tacrolimus concentration ratio was <30% in 2 control patients administered tacrolimus. It has been reported recently that there were cases showing falsely slightly elevated Ct of tacrolimus within the therapeutic range of concentrations. Therefore, we must be careful not to reduce the tacrolimus dose falsely. We consider confirmatory methods for a falsely abnormally elevated Ct of tacrolimus measured by ACMIA to (1) measure P/B-tacrolimus concentration ratio, (2) compare ACMIA with another measurement, and (3) evaluate a blood sample stored before tacrolimus administration. [Copyright &y& Elsevier]

Introduction/Background Recent clinical studies have shown that electroencephalogram- (EEG) based neurofeedback training promotes functional recovery of finger movements in poststroke patients (Pichiorri F et al., Ann Neurol. 2015). However, impairment of shoulder elevation in poststroke severe chronic hemiplegia is a debilitating condition with no evidence-based, accessible treatment. To verify motor recovery evidence of neurofeedback training with our shoulder exoskeleton robot, this study reports upper extremity section of Fugl-Meyer assessment (FMA-UE) associated with the evaluation of up-conditioning of contralesional corticospinal pathways. Material and method Eight poststroke patients with severe hemiplegia in the chronic stage were recruited (FMA-UE score = 16.8 ± 4.4). Patients engaged in 1 hour daily training for 7 consecutive days ( Fig. 1 ), and clinical and neurophysiological measurements were performed 1 day before and after the intervention. FMA-UE was used for the primary outcome measure. A 128-channel whole-head EEG was used to assess the hemispheric lateralization of event-related desynchronization (ERD). Single-pulse transcranial magnetic stimulation (TMS) was applied to the contralesional primary motor cortex to assess the corticospinal excitability in 6 tested patients. Results All participants finished the intervention without adverse events. FMA-UE was significantly improved after the intervention (paired t -test, P < 0.01). All patients demonstrated improved FMA-UE (mean change = 6.6 ± 3.2) and 6 of 8 patients exceeded the minimal clinically important difference that is set to 5. From the group analysis of hemispheric lateralization of ERD, the contralesional ERD became stronger after interventions (Wilcoxon signed-rank test, P < 0.01). Motor evoked potentials became more apparent after interventions in 3 of the 6 tested patients. Conclusion The results from this study demonstrated targeted up-conditioning of contralesional corticospinal pathways and efficacy of neurofeedback training with our shoulder exoskeleton robot. [ABSTRACT FROM AUTHOR]

Introduction/Background Genu recurvatum is one of the common problems in patients with hemiplegia after stroke. For its improvement, it may be important to manipulate the ankle movement in coordination with the knee during gait. However, no device is available yet that can achieve it. We are developing a new exoskeleton robot that can assist knee and ankle joints simultaneously. This study aimed to test the feasibility of the robot in healthy individuals and patients with stroke, and to investigate its effect on genu recurvatum during gait. Material and method Two healthy individuals and two patients with chronic stroke participated in this study. Healthy individuals received the robot-assisted gait training for 60 min in total. We assessed the safety of the training and muscle activities during gait with or without the robot-assistance. Patients with stroke had moderate lower-limb paralysis and genu recurvatum during gait. They received the robot-assisted gait training for 30 min in total. The robot consisted of a knee ankle foot orthosis and an actuator with pneumatic artificial muscles ( Fig. 1 ). We adjusted the assist parameters to prevent their knee hyper-extension during the stance phase. We evaluated the range of knee joint motion, temporal and spatial parameters during over-ground gait without the robot before and after the intervention. Results All participants safely completed the training. The robot decreased muscle activities during gait in healthy individuals. One of the patients showed a decrease in the maximum knee extension range during the stance phase, an increase in the maximum knee flexion range during the swing phase, and improvements in the temporal and spatial asymmetries. Conclusion The robot which can assist knee and ankle joints simultaneously has a potential to be a new therapeutic device for genu recurvatum in patients with hemiparetic stroke. [ABSTRACT FROM AUTHOR]

Abstract: We performed 24-hour monitoring of cyclosporine (NEO) and tacrolimus (TAC) blood concentrations, evaluating pharmacokinetic parameters and characterizing circadian variations. The monitoring was performed in 10 instances on nine patients administered NEO and 12 out of 11 patients administered TAC. All cases were administered equally divided doses of drugs twice daily orally. Blood samples were taken before and 1, 2, 3, 4, 6, and 12 hours after NEO or TAC administration in the morning and evening. The pharmacokinetic parameters were compared between morning and evening administrations of both drugs. AUC0–12, AUC0–4, Cmax, C2, and Cmax/Cmin of NEO and TAC were significantly lower during the evening compared with morning administrations. Cmin values were significantly higher in the evening. Tmax of NEO was longer in evening, although there was not a significant difference; Tmax of TAC was significantly longer in the evening. We found that NEO and TAC administrations in the evening resulted in reduced bioavailability and delayed absorption when compared with drug administrations in the morning. It was thought that the difference in bioavailability between morning and evening administrations was smaller with TAC, because TAC shows lower peak levels and a flatter blood concentration curve than NEO. Cmin was higher after evening administration than morning because of delayed absorption, though the bioavailability of both drugs decreased in the evening. These results suggest that we have to appreciate apparently high trough levels. [Copyright &y& Elsevier]