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Purpose: The Patient State Index (PSI) is a newly introduced electroencephalogram-based tool for objective and continuous monitoring of sedation levels of patients under general anesthesia. This study investigated the potential correlation between the PSI and the Richmond Agitation‒Sedation Scale (RASS) score in intensive care unit (ICU) patients and established the utility of the PSI in assessing sedation levels. Methods: In this prospective observational study, PSI values were continuously monitored via SedLine® (Masimo, Irvine, CA, USA); the RASS score was recorded every 2 h for patients on mechanical ventilation. Physicians and nurses were blinded to the PSI values. Overall, 382 PSI and RASS score sets were recorded for 50 patients. Results: The PSI score correlated positively with RASS scores, and Spearman's rank correlation coefficient between the PSI and RASS was 0.79 (95% confidence interval [CI]: 0.75‒0.83). The PSI showed statistically significant difference among the RASS scores (Kruskal‒Wallis chi-square test: 242, df = 6, P < 2.2-e16). The PSI threshold for distinguishing light (RASS score ≥ − 2) sedation from deep sedation (RASS score ≤ − 3) was 54 (95% CI: 50–65; area under the curve, 0.92 [95% CI: 0.89‒0.95]; sensitivity, 0.91 [95% CI: 0.86‒0.95]; specificity, 0.81 [95% CI: 0.77–0.86]). Conclusions: The PSI correlated positively with RASS scores, which represented a widely used tool for assessing sedation levels, and the values were significantly different among RASS scores. Additionally, the PSI had a high sensitivity and specificity for distinguishing light from deep sedation. The PSI could be useful for assessing sedation levels in ICU patients. University Hospital Medical Information Network (UMIN000035199, December 10, 2018). [ABSTRACT FROM AUTHOR]

An unhealthy communication structure at a workplace can adversely affect the mental health of employees. However, little is known about the relationship between communication structures in the workplace and the mental health of employees. Here, we evaluated the face-to-face interaction network among employees (N = 449) in a variety of real-world working environments by using wearable devices and investigated the relationship between social network characteristics and depressive symptoms. We found that the cohesive interaction structure surrounding each individual was negatively correlated with depressive symptoms: a universal relationship regardless of occupation type. This correlation was evident at the group scale and was strongly related to active interactions with abundant body movement. Our findings provide a quantitative and collective perspective on taking a systematic approach to workplace depression, and they suggest that the mental health of employees needs to be addressed systematically, not only individually. [ABSTRACT FROM AUTHOR]

Central venous catheters (CVCs) and pulmonary artery catheters (PACs) are widely used in intensive care and perioperative management. The detection and prevention of catheter-related thrombosis (CRT) are important because CRT is a complication of catheter use and can cause pulmonary embolism and bloodstream infection. Currently, there is no evidence for CRT in patients using both CVC and PAC. We conducted a single-center, prospective, observational study to identify the incidence, timing, and risk factors for CRT in patients undergoing cardiovascular surgery and using a combination of CVC and PAC through the right internal jugular vein (RIJV). Out of 50 patients, CRT was observed using ultrasonography in 39 patients (78%), and the median time of CRT formation was 1 day (interquartile range: 1–1.5) after catheter insertion. The mean duration of PAC placement was 3 days (interquartile range: 2–5), and the maximum diameter of CRT was 12 mm (interquartile range: 10–15). In short-axis images, CRT occupied more than half of the cross-sectional area of the RIJV in five patients (10%), and CRT completely occluded the RIJV in one patient (2%). Platelet count, duration of PAC placement, and intraoperative bleeding amount were found to be high-risk indicators of CRT. In conclusion, patients who underwent cardiovascular surgery and using both CVC and PAC had a high incidence of CRT. Avoiding unnecessary PAC placement and early removal of catheters in patients at high risk of developing CRT may prevent the development of CRT. [ABSTRACT FROM AUTHOR]

The formation and evolution of leading jets can be described by jet functions which satisfy non-linear DGLAP-type evolution equations. Different than for inclusive jets, the leading jet functions constitute normalized probability densities for the leading jet to carry a longitudinal momentum fraction relative to the initial fragmenting parton. We present a parton shower algorithm which allows for the calculation of leading-jet cross sections where logarithms of the jet radius and threshold logarithms are resummed to next-to-leading logarithmic (NLL′) accuracy. By calculating the mean of the leading jet distribution, we are able to quantify the average out-of-jet radiation, the so-called jet energy loss. When an additional reference scale is measured, we are able to determine the energy loss of leading jets at the cross section level which is identical to parton energy loss at leading-logarithmic accuracy. We identify several suitable cross sections for an extraction of the jet energy loss and we present numerical results for leading subjets at the LHC. In addition, we consider hemisphere and event-wide leading jets in electron-positron annihilation similar to measurements performed at LEP. Besides the average energy loss, we also consider its variance and other statistical quantities such as the KL divergence which quantifies the difference between quark and gluon jet energy loss. We expect that our results will be particularly relevant for quantifying the energy loss of quark and gluon jets that propagate through hot or cold nuclear matter. [ABSTRACT FROM AUTHOR]

Background: Posterior reversible encephalopathy syndrome is characterized by reversible neurological symptoms with leukoencephalopathy detectable by computed tomography (CT) and magnetic resonance (MR) imaging. Case presentation: We here present a patient with no history of hypertension who, after being transferred back to the ward after undergoing total hysterectomy under general anesthesia, had several seizures and lost consciousness. Posterior reversible encephalopathy syndrome was suspected on the basis of brain CT images and clinical findings. She was treated with respiratory support, sedative drugs, and anticonvulsants, and MR imaging confirmed a diagnosis of posterior reversible encephalopathy syndrome. She regained consciousness and responsiveness the following day. Conclusions: Clinically, posterior reversible encephalopathy syndrome resembles cerebral infarction or intracranial hemorrhage; MR imaging is useful for differentiating it from these conditions. Including this condition in the differential diagnosis and instituting appropriate treatment is important in minimizing the risk of development of irreversible neurological damage during the perioperative period. [ABSTRACT FROM AUTHOR]

We refine the computation of the d̄ − ū flavor asymmetry in the proton sea with a complementary effort to reveal the dynamics of pion exchange in high-energy processes. In particular, we discuss the efficacy of pion exchange models to simultaneously describe leading neutron electroproduction at HERA along with the d̄ − ū flavor asymmetry in the proton. A detailed $${\chi^{2}}$$ analysis of the ZEUS and H1 data, when combined with constraints on the pion flux from Drell-Yan data, allows regions of applicability of one-pion exchange to be delineated. Based on the fit results, we also address a possible estimate for leading proton structure functions in upcoming tagged deep-inelastic scattering experiments at Jefferson Lab on the deuteron with forward protons. [ABSTRACT FROM AUTHOR]

From the theory of modular forms, we know that there are exactly $$[(k-2)/6]$$ linear relations among the Eisenstein series $$E_k$$ and its products $$E_{2i}E_{k-2i}\ (2\le i \le [k/4])$$ . We present explicit formulas among these modular forms based on the partial fraction decomposition, and use them to determine a basis for the space of modular forms of weight $$k$$ on $$\mathrm{SL}_2 ({\mathbb Z})$$ . [ABSTRACT FROM AUTHOR]

In this paper, we introduce the normalized Shintani L-function of several variables by an integral representation and prove its functional equation. The Shintani L-function is a generalization to several variables of the Hurwitz-Lerch zeta function and the functional equation given in this paper is a generalization of the functional equation of Hurwitz-Lerch zeta function. In addition to the functional equation, we give special values of the normalized Shintani L-function at non-positive integers and some positive integers. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to retrospectively investigate clinical outcomes by relative dose and dose intensity of docetaxel (DOC) as chemotherapy for Japanese patients with castration-resistant prostate cancer (CRPC). Methods: A total of 145 CRPC patients who received more than 4 courses of DOC chemotherapy at 14 hospitals between 2005 and 2011 were enrolled. Patients were divided into two groups-those receiving a higher or lower dose (mg/m) or dose intensity (mg/m/week). Differences between the groups regarding treatment outcomes and adverse events (AEs) were determined. Additionally, prognostic factors predictive of cancer-specific survival (CSS) in these patients were identified by both univariate and multivariate analysis. Results: The total patient group underwent a mean of 11.2 ± 7.4 DOC cycles, and the mean CSS after therapy was 15.6 ± 10.1 months. The higher-dose group had a better prostate-specific antigen (PSA) response than the lower-dose group. However, there was no significant difference between the groups in prognosis after DOC chemotherapy. Leukopenia and neutropenia were observed more frequently in the higher-dose group. Serum biomarkers (including PSA, lactate dehydrogenase and alkaline phosphatase), hemoglobin levels and presence of pain at initiation of chemotherapy, as well as the PSA nadir level on first-line hormone therapy, all were significant predictors of CSS. Conclusions: In the Japanese population, relatively low-dose DOC chemotherapy had no deleterious effect on the CSS of CRPC patients, and a lower incidence of AEs occurred, in spite of a diminished PSA response compared with those receiving a higher dose. [ABSTRACT FROM AUTHOR]

Leaves develop as flat lateral organs from the indeterminate shoot apical meristem. The establishment of polarity along three-dimensional axes, proximal-distal, medial-lateral, and adaxial-abaxial axes, is crucial for the growth of normal leaves. The mutations of ASYMMETRIC LEAVES1 ( AS1) and AS2 of Arabidopsis thaliana cause defects in repression of the indeterminate state and the establishment of axis formation in leaves. Although many mutations have been identified that enhance the adaxial-abaxial polarity defects of as1 and as2 mutants, the roles of the causative genes in leaf development are still unknown. In this study, we found that wild-type plants treated with berberine produced pointed leaves, which are often observed in the single mutants that enhance phenotypes of as1 and as2 mutants. The berberine-treated as1 and as2 mutants formed abaxialized filamentous leaves. Berberine, an isoquinoline alkaloid compound naturally produced in various plant sources, has a growth inhibitory effect on plants that do not produce berberine. We further showed that transcript levels of meristem-specific class 1 KNOX homeobox genes and abaxial determinant genes were increased in berberine-treated as1 and as2. Berberine treated plants carrying double mutations of AS2 and the large subunit ribosomal protein gene RPL5B showed more severe defects in polarity than did the as2 single mutant plants. We suggest that berberine inhibits (a) factor(s) that might be required for leaf adaxial cell differentiation through a pathway independent of AS1 and AS2. Multiple pathways might play important roles in the formation of flat symmetric leaves. [ABSTRACT FROM AUTHOR]

We developed monoclonal antibodies against human thyroid cancer-associated antigen by fusing mouse myeloma cells with mouse spleen cells immunized by insoluble fraction of homogenized thyroid papillary carcinoma cells. One monoclonal antibody (KTC-3, IgM) was selected to evaluate basic usefulness for radioimmunoscintigraphy in xenografted human thyroid carcinoma. KTC-3 was labeled withI by Iodogen method of 20 to 1 Iodogen to IgM molar ratio. It was also labeled withIn by cyclic DTPA anhydride method of 20 to 1 DTPA to IgM molar ratio. The labeling efficiency and specific activity forI labeling were 16.5% and 0.66 mCi/mg IgM respectively, and those forIn labeling were 12.7% and 1.6 mCi/mg IgM. Imaging and biodistribution of labeled KTC-3 were evaluated in nude mice bearing thyroid anaplastic carcinoma (THC-5-JCK). The tumors were well visualized 3 and 5 days after injection ofI KTC-3. Tumor uptake ofI KTC-3 on day 7 was 0.52 ± 0.27% ID/g and tumor to blood ratio was 1.98 ± 0.76 (n=6). Those ofIn KTC-3 were 0.88±0.09% ID/g and 5.51 ±3.36 (n=6). In conclusion, KTC-3 is promising for radioimmunoscintigraphy of thyroid cancer. [ABSTRACT FROM AUTHOR]

Systolic anterior motion (SAM) after mitral valve repair (MVR) can adversely affect hemodynamics due to exacerbation of left ventricular outflow tract obstruction and mitral regurgitation. Intraoperative transient SAM after MVR can usually be managed with hemodynamic maneuvers under continuous monitoring by transesophageal echocardiography (TEE). However, during postoperative intensive care management, transient SAM is seldom diagnosed and the start of treatment may be delayed. We present a case of transient SAM after MVR with abrupt deterioration due to junctional rhythm in the intensive care unit (ICU). TEE revealed that conversion from normal sinus rhythm into junctional rhythm induced the exacerbation of SAM. TEE was useful for identifying the etiology of unstable hemodynamics after cardiac surgery in the ICU, similar to its use in the operating room. [ABSTRACT FROM AUTHOR]