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Background and Objective: Inadequate response to antidepressant monotherapy is common among patients with major depressive disorder (MDD). The efficacy and safety of adjunctive brexpiprazole 2 mg/day has recently been confirmed during the 6-week, randomized, placebo-controlled phase 2/3 (BLESS) study, which evaluated brexpiprazole at 1 mg/day and 2 mg/day versus placebo as adjunctive therapy to antidepressant therapies in 740 Japanese patients with MDD and an inadequate response to antidepressant monotherapy. This study evaluated the long-term safety and efficacy of adjunctive fixed-dose brexpiprazole 2 mg/day in Japanese patients with MDD. Methods: An open-label, 52-week study enrolled rollover patients who completed the 6-week, double-blind, randomized, placebo-controlled phase 2/3 BLESS study (NCT03697603), and de novo patients aged ≥ 65 years. Patients were titrated to fixed-dose brexpiprazole 2 mg/day from Week 1. Safety assessments included treatment-emergent adverse events (TEAEs; primary outcome) and clinical and laboratory variables. Efficacy was assessed using the Montgomery–Åsberg Depression Rating Scale (MADRS), Clinical Global Impression-Improvement (CGI-I) scale, Hamilton Depression Rating Scale (HAM-D) 17-item total score, and Sheehan Disability Scale (SDS) score. Results: In total, 247 patients [rollover, n = 216; de novo (previously unexposed), n = 31] were included in the safety/efficacy populations, and 138 (rollover, n = 132; de novo, n = 6; 55.9%) completed the study. Common TEAEs (incidence ≥ 10%) were weight gain [33.2% (n = 82)], akathisia [23.5% (n = 58)], nasopharyngitis [21.1% (n = 52)], and somnolence [10.5% (n = 26)]. TEAEs leading to treatment discontinuation occurred in 26.7% of patients receiving brexpiprazole and 58.1% of de novo patients. The mean (SD) increase in body weight from baseline to Week 52 [observed cases (OC)] was 4.2 (6.5) kg (n = 138); 44.5% (n = 110) had weight gain ≥ 7% at any postbaseline visit. There were no cases of tardive dyskinesia and no AEs related to suicide/suicide attempts. One death occurred (unknown cause), which was unrelated to study treatment. Improvements in the MADRS total score were observed from baseline over the course of the 52-week study [mean (SD) change at Week 52 (OC): − 7.3 (8.7)] for all patients receiving brexpiprazole. The overall MADRS response rate and remission rate in patients receiving brexpiprazole was 41.3% (n = 57) and 34.8% (n = 48), respectively, at Week 52 (OC). Improvements in CGI-S, HAM-D 17 item total score, and SDS mean scores were also observed from baseline over the 52-week study, with a mean (SD) change from baseline at Week 52 (OC) of − 0.8 (1.0), − 5.9 (6.3), and − 1.0 (2.2), respectively, indicating a sustained improvement in symptoms with long-term brexpiprazole treatment. Conclusions: This is the first study to evaluate the safety profile of brexpiprazole 2 mg/day in Japanese patients with MDD, including older adults, which is similar to previous reports, with no new safety risks, and continued efficacy over 52 weeks. Study Registration: ClinicalTrials.gov (NCT03737474; registered on 29 July 2018). [ABSTRACT FROM AUTHOR]

Abstract The number of published scientific papers and patent applications are indicators of a country’s research and development (R&D) capabilities. Since the 2010s, these indicators have declined in Japan. One important reason for this decline is the change in science and mathematics education provided in schools. Education in school can greatly impact the quality of future researchers in science. To examine the impact of the number of class hours in science and mathematics that researchers received in school over the past 50 years, this study analysed data from two surveys conducted in 2016 and 2020. The results show that there is a decline in the number of patents for the younger generation that cannot be explained by age differences, and it is highly correlated with a decline in the total number of hours of science and math in junior high school. Educational policies influence student attitudes towards learning. Changes should be implemented only after validating their effects from a long-term perspective because education policies may have unintended negative impacts on a country’s economic growth.

The process of bioethanol production has several economic drawbacks such as the cost of enzymes, i.e., cellulase, which hydrolyze cellulose to produce fermentable sugars. In this study, to reduce the production cost of cellulase, agricultural wastes such as wheat straw (WS) and rice straw (RS) were used as carbon sources for cellulase production through solid-state fermentation. First, the standard cellulase production conditions were optimized, the initial moisture content of the solid medium was 60%, the biomass particle size was 100 µm to 4 mm size mixed, and the optimal carbon/nitrogen (C/N) ratio in the medium of WS and RS was 59.0 and 41.2, respectively. Subsequently, to simplify process handling, eliminating trace elements such as MgSO4, CaCl2, FeSO4, MnSO4, ZnSO4, CoCl2, and phosphorous compounds such as KH2PO4 in the general Mandel's medium was used for cellulase production medium and compared with the standard medium. Maximum 5.4 filter paper unit (FPU)/g-substrate (WS) and 5.3 FPU/g-substrate (RS) were attained under trace element eliminating medium; these were similar to that from the standard medium of WS (4.8 FPU/g-substrate) and RS (5.7 FPU/g-substrate). Moreover, the produced crude cellulases from RS were evaluated for their potential in hydrolysis of alkaline-treated RS. The performances of the crude cellulases were similar to those of commercial cellulases. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vaccination elicit both T cell and B cell immune responses in immunocompetent individuals. However, the mechanisms underlying the antiviral effects mediated by CD4+ T cells are not fully understood. In this study, we analyzed the culture supernatant (SN) from polyclonally stimulated human CD4+ T cells as a model for soluble mediators derived from SARS-CoV-2-stimulated CD4+ T cells. Interestingly, this SN inhibited SARS-CoV-2 propagation in a viral strain- and host cell type-dependent manner. The original wild-type showed the highest susceptibility, whereas the Delta variant exhibited resistance in the human monocyte cell line. In addition, antibody-dependent enhancement (ADE) of infection with the original strain was also abolished in the presence of the SN. The findings showed that the inhibitory effect on viral propagation by the SN was mostly attributed to interferon-γ (IFN-γ) that was present in the SN. These results highlight the potential role of IFN-γ as an anti-SARS-CoV-2 mediator derived from CD4+ T cells, and suggest that we need to understand the SARS-CoV-2 strain-dependent sensitivity to IFN-γ in controlling clinical outcomes. In addition, characterization of new SARS-CoV-2 variants in terms of IFN-γ-sensitivity will have important implications for selecting therapeutic strategies. [ABSTRACT FROM AUTHOR]

Background: Few studies have observed the direct effect of obesity on renal prognoses in immunoglobulin A nephropathy (IgAN) or separately evaluated its effects according to sex. We aimed to evaluate the direct and indirect effects of obesity on the renal outcomes of IgAN and observe these effects separately according to renal function and sex. Methods: We extracted patients with body mass index (BMI) descriptions from a multicenter retrospective cohort analysis in Japan, and excluded those with < 30 days of follow-up, diabetes mellitus, and steroid treatment. Patients were divided into normal (n = 720; 18.5 ≤ BMI < 25) and obese (n = 212; BMI ≥ 25) groups, which were then compared. The endpoints were a 1.5-fold increase in serum creatinine levels and the initiation of renal replacement therapy. Results: The obese group was older, included more males, and was more likely have hypertension, dyslipidemia, proteinuria, tubular atrophy, and lower renal function than the normal group. Patients with an eGFR < 60 mL/min/1.73 m2 had well-matched characteristics between the groups; however, hypertension, low high-density lipoprotein cholesterol, and hypertriglyceridemia were more common in the obese group. Obesity contributed to tubular atrophy, even when adjusted for renal function. In addition, it contributed to proteinuria only in females. However, obesity itself was not a significant prognostic factor. Conclusions: Although no independent effect on renal prognosis was observed during the study period, the obese group had more risk factors for IgAN progression and obesity contributed to tubular atrophy and female proteinuria. Our results suggest that separately analyzing the prognostic effect of obesity according to sex is important. [ABSTRACT FROM AUTHOR]

The density and sound-speed contrasts of Antarctic krill in the eastern Indian sector of the Southern Ocean were measured to estimate target strength (TS), which is essential for assessing abundance using acoustic methods. The density contrast of gravid females was significantly smaller than that of individuals at other maturity stages (1.039–1.045). Meanwhile, the sound-speed contrast was the highest in gravid females (1.049), followed by mature females (1.044) and juveniles (1.042). The sound-speed contrast tended to increase with total length. Assuming a body length of 38 mm as the average shape for this study, the TS was calculated using the distorted-wave Born approximation (DWBA) model with the density contrasts and the sound-speed contrasts for each maturity stage. Because the trends compensated each other, the maximum TS at 38 and 120 kHz was −79.9 dB and −64.0 dB, respectively, with no significant difference by maturity stage. In the TS pattern, in which body length and shape were estimated for each maturity stage, the main lobe was broader in gravid females, which differed from the TS pattern for other maturity stages. The effect of the expanded cephalothorax shape of the gravid females was particularly significant. [ABSTRACT FROM AUTHOR]

Zinc was focused on as an element causing hardening retardation due to delayed hydration of Ordinary Portland Cement (OPC), and its hardening inhibitory effect and the mechanism of hardening enhancement by sodium aluminate were analyzed by X-ray diffraction and scanning electron microscopy/energy dispersive X-ray spectroscopy. The addition of zinc hydroxide retarded hardening at more than 0.3 mass%, as previously reported, and zinc produced calcium zincate hydrates (qatranaite) and inhibited the hydration of tricalcium silicate (C3S), the main component of hydration of OPC. After the zinc had been fully consumed in qatranaite formation, C3S started normal hydration. The addition of sodium aluminate caused earlier re-hydration of C3S, which was inhibited by hydration, as the hydrates produced appeared to consume zincate anions. The rapid setting effect of sodium aluminate addition was also delayed by zinc hydroxide, but it was estimated that the addition of the same amount of zinc would ensure initial strength through early formation of hydrocalumite. In the longer term, strength was considered to be more enhanced by the onset of C3S hydration. [ABSTRACT FROM AUTHOR]

In skin aging, it has been hypothesized that aging fibroblasts accumulate within the epidermal basal layer, dermis, and subcutaneous fat, causing abnormal tissue remodeling and extracellular matrix dysfunction, thereby inducing an aging-related secretory phenotype (SASP). A new treatment for skin aging involves the specific elimination of senescent skin cells, especially fibroblasts within the dermis and keratinocytes in the basal layer. This requires the identification of specific protein markers of senescent cells, such as ribonucleoside-diphosphate reductase subunit M2 B (RRM2B), which is upregulated in various malignancies in response to DNA stress damage. However, the behavior and role of RRM2B in skin aging remain unclear. Therefore, we examined whether RRM2B functions as a senescence marker using a human dermal fibroblast model of aging. In a model of cellular senescence induced by replicative aging and exposure to ionizing radiation or UVB, RRM2B was upregulated at the gene and protein levels. This was correlated with decreased uptake of the senescence-associated β-galactosidase activity and proliferation marker bromodeoxyuridine. RRM2B upregulation was concurrent with the increased expression of SASP factor genes. Furthermore, using fluorescence flow cytometry, RRM2B-positive cells were recovered more frequently in the aging cell population. In aging human skin, RRM2B was also found to be more abundant in the dermis and epidermal basal layer than other proteins. Therefore, RRM2B may serve as a clinical marker to identify senescent skin cells. [ABSTRACT FROM AUTHOR]

We provide updated results (median follow-up duration: 20.4 months) of a retrospective study on the effectiveness of trastuzumab deruxtecan (T-DXd) in patients with human epidermal growth factor receptor 2-positive (HER2+) breast cancer with brain metastases (BM) and/or leptomeningeal disease (ROSET-BM). Median progression-free survival (PFS) was 14.6 months. Median overall survival (OS) was not reached (NR); 24-month OS rate was 56.0%. Subgroup analysis showed that median PFS was 13.2 months in patients with analytical active BM, 17.5 months in patients with leptomeningeal carcinomatosis (LMC), and NR in patients with analytical stable BM (24-month PFS rates in patients with analytical active BM, LMC, and analytical stable BM were 32.7%, 25.1%, and 60.8%, respectively). Median OS was 27.0 months in patients with analytical active BM and NR in patients with LMC or analytical stable BM (24-month OS rates in patients with analytical active BM, LMC, and analytical stable BM were 52.0%, 61.6%, and 71.6%, respectively). The most common adverse event leading to discontinuation of T-DXd was interstitial lung disease (ILD; 23.1%); median ILD onset time among patients who discontinued T-DXd treatment due to ILD was 5.3 months. T-DXd has promising effectiveness in heavily pre-treated HER2+ metastatic breast cancer patients with BM and LMC. The incidence and median onset time of ILD were similar to those of Japanese subgroups in previous studies. [ABSTRACT FROM AUTHOR]

Collateral is a significant challenge for small and medium enterprises (SMEs) in acquiring formal credit. Bank market concentration can cause to increase collateral demand through enhancing bank market power. This study explores the relationship between bank market concentration and the collateral challenges faced by SMEs in accessing bank credit by employing a probit regression model. The analysis utilizes a sample of over 25,000 firms from 19 developing Asian nations. The datasets combine firm-level data sourced from the Business Environment and Enterprise Performance Survey (BEEPS) with country-level financial data obtained from the Global Financial Development Data (GFDD) which are provided by the World Bank. The results reveal a significant positive correlation between bank market concentration and the collateral challenges encountered by SMEs in developing Asian countries. In markets characterized by high levels of banking concentration, financial institutions tend to exhibit risk-averse behavior, manifesting in an increased propensity to demand collateral for both SME and large enterprise loans. Consequently, this heightened bank concentration exerts additional pressure on SMEs in acquiring bank credit. To foster an environment conducive to SME financing, countries with high levels of banking concentration should enact regulatory measures aimed at managing and constraining market concentration levels. [ABSTRACT FROM AUTHOR]

The retina plays a crucial role in processing and decoding visual information, both in normal development and during myopia progression. Recent advancements have introduced a library-independent approach for data-independent acquisition (DIA) analyses. This study demonstrates deep proteome identification and quantification in individual mice retinas during myopia development, with an average of 6,263 ± 86 unique protein groups. We anticipate that the use of a predicted retinal-specific spectral library combined with the robust quantification achieved within this dataset will contribute to a better understanding of the proteome complexity. Furthermore, a comprehensive mice retinal-specific spectral library was generated, encompassing a total identification of 9,401 protein groups, 70,041 peptides, 95,339 precursors, and 761,868 transitions acquired using SWATH-MS acquisition on a ZenoTOF 7600 mass spectrometer. This dataset surpasses the spectral library generated through high-pH reversed-phase fractionation by data-dependent acquisition (DDA). The data is available via ProteomeXchange with the identifier PXD046983. It will also serve as an indispensable reference for investigations in myopia research and other retinal or neurological diseases. [ABSTRACT FROM AUTHOR]

The periosteum is the layer of cells that covers nearly the entire surface of every bone. Upon infection, injury or malignancy the bone surface undergoes new growth—the periosteal reaction—but the mechanism and physiological role of this process remain unknown1,2. Here we show that the periosteal reaction protects against cancer invasion into the bone. Histological analyses of human lesions of head and neck squamous cell carcinomas (HNSCCs) show that periosteal thickening occurs in proximity to the tumour. We developed a genetically dissectible mouse model of HNSCC and demonstrate that inducible depletion of periosteal cells accelerates cancerous invasion of the bone. Single-cell RNA sequencing reveals that expression of the gene encoding the protease inhibitor TIMP1 is markedly increased in the periosteum at the pre-invasive stage. This increase is due to upregulation of HIF1α expression in the tumour microenvironment, and increased TIMP1 inactivates matrix-degrading proteases, promoting periosteal thickening to inhibit cancer invasion. Genetic deletion of Timp1 impairs periosteal expansion, exacerbating bone invasion and decreasing survival in tumour-bearing mice. Together, these data show that the periosteal reaction may act as a functional stromal barrier against tumour progression, representing a unique example of tissue immunity mediated by stromal cells.Experiments in mouse models and histology of human head and neck squamous cell carcinomas show that TIMP1-mediated periosteal thickening in proximity to tumours acts as a barrier to cancer invasion of the bone. [ABSTRACT FROM AUTHOR]

Purpose: To describe a case of multiple extremely rare cervical arterial variations. Methods: A 55-year-old man with a tentative diagnosis of right internal carotid artery (ICA) stenosis was examined using computed tomography (CT) angiography for the evaluation of vascular lesions in the neck and head region. A 64-slice CT machine was used. Results: On CT angiography, there was laterally located and narrowed petrous segment of the right ICA, indicative of aberrant course of the petrous ICA. Right vertebral artery (VA) was small in caliber and a relatively large anomalous artery arose from the proximal right ICA. This anomalous artery entered the posterior fossa via the foramen magnum, indicative of a type 1 proatlantal artery. Right occipital artery (OA) arose from the proximal ICA. The left OA also arose from the proximal ICA. Conclusion: An aberrant course of the petrous ICA is an extremely rare arterial variation which is formed by segmental agenesis of the cervical ICA, and the collateral channel passes through the middle ear cavity. It can be dangerous during middle ear surgery. The type 1 proatlantal artery is also an extremely rare arterial variation formed by the persistence of the proatlantal intersegmental artery. It is clinically significant because of its unique blood flow from the carotid system to the vertebrobasilar system. The OA rarely arises from the proximal ICA. Identification of these cervical arterial variations before surgery and vascular intervention are important to avoid complications during the procedure. [ABSTRACT FROM AUTHOR]

Degradation of vascular extracellular matrix is important in atherosclerosis. Cysteine protease legumain is upregulated in atherosclerotic plaques. We recently reported that plasma legumain levels are high in patients with complex coronary lesions. This study investigated the association between legumain levels and cardiovascular events in 372 patients undergoing coronary angiography. Patients with acute coronary syndrome were excluded. Of the 372 patients, 225 had coronary artery disease (CAD). During a mean follow-up of 7.0 ± 4.3 years, cardiovascular events occured in 62 patients. Compared with 310 patients without events, 62 with events tended to have higher prevalence of complex lesions (15% vs. 10%). Notably, patients with events had higher legumain levels (median 5.51 vs. 4.90 ng/mL, P < 0.01) than those without events. A Kaplan-Meier analysis showed lower event-free survival in patients with legumain > 5.0 ng/mL than in those with ≤ 5.0 ng/mL (P < 0.01). In multivariate Cox regression analysis, legumain level was an independent predictor of cardiovascular events. The hazard ratio for legumain > 5.0 ng/mL for cardiovascular events was 2.18 (95%CI = 1.27–3.77, P < 0.01). Only among 225 patients with CAD, patients with events had higher legumain levels (5.49 vs. 4.73 ng/mL) than without events (P < 0.02). Legumain level was also a predictor of cardiovascular events in patients with CAD. Thus, high plasma legumain levels were associated with an increased risk of cardiovascular events in patients undergoing coronary angiography and those with stable CAD. [ABSTRACT FROM AUTHOR]

Objective: High serum IgA and low serum C3 levels resulting from lectin and alternative pathway activation might be related to IgA nephropathy (IgAN) progression and exacerbation. This study examined whether the serum IgA/C3 ratio can serve as an IgAN progression marker. Methods: (1) This nationwide multicenter retrospective study in Japan included 718 patients with biopsy-confirmed IgAN. The patients whose serum creatinine levels at the time of renal biopsy had doubled were defined as having disease progression. (2) Furthermore, to investigate the pathological significance of a reduction in serum IgA/C3 ratio, we reviewed 63 patients whose serum IgA and C3 data at the end of the observation period were obtained. Results: (1) A Kaplan–Meier analysis of the patients with IgAN revealed that the group with a high serum IgA/C3 (≥ 3.3) had a significantly worse renal outcome. In a multivariate analysis of eGFR ≥ 60 mL/min per 1.73m2 at the time of biopsy, poor renal outcome was significantly predicted by a serum IgA/C3 ratio of ≥ 3.3. (2) A 15% reduction in the change of serum IgA/C3 ratio was associated with a significantly higher percentage of complete remission of proteinuria. Among the four groups divided by treatment, both the serum IgA/C3 ratio and proteinuria were reduced only in the tonsillectomy and steroid pulse group. Conclusion: The serum IgA/C3 level might reflect the disease activity and be a potent surrogate marker of therapeutic efficacy in patients with IgAN. [ABSTRACT FROM AUTHOR]

Owing to its desirable ability to fabricate complex shapes, three-dimensional printing is preferred over casting for manufacturing dentures. Furthermore, titanium is widely used in dental implants and dentures because of its high corrosion resistance, biocompatibility, strength, and low density. In this study, we aimed to develop a new metal denture material from three-dimensional-printed (3DP) to achieve lighter weight and greater strength than those of PMMA dentures. Hollow (3DP-H) structure and solid (3DP-S) structure titanium plate specimens of 0.5, 1.0, and 3.0 mm in thickness were used. Casted Ti, casted Co-Cr, and PMMA plates were fabricated for comparison. Elastic modulus, density, thermal conductivity, hardness, and proof stress of the specimens were measured and plotted on a radar chart to enable multifaceted evaluation. The results indicated that the density of the 3DP-H plates reduced by 28–36% compared with those of 3DP-S and cast Ti plates. The weight of the metal-denture-equivalent section of the 0.5-mm-thick 3DP-H titanium-plated denture reduced to two-thirds that of the 2.0-mm-thick PMMA denture. The proof stress of the 0.5-mm-thick 3DP-H plate increased to about 3 times that of the 2.0-mm-thick PMMA plate. The total value of the 0.5-mm-thick 3DP-H titanium plates was higher than it of the 1.0-mm-thick PMMA plates. This study suggests that it is possible to produce 3DP-H titanium plate dentures exhibiting not only extremely lightweight compared to conventional PMMA dentures but also sufficient strength. [ABSTRACT FROM AUTHOR]

Background: The mutations in the presenilin 1 gene (PSEN1) are the main cause of familial Alzheimer's disease. PSEN1 mutations affect amyloid-beta peptide production, which accumulates in the brain as senile plaque and cotton wool plaques (CWPs) and relates to other neurodegenerative disorders. Here we report the second case of the PSEN1 G266S mutation, which showed distinctive neuropathological features, including abundant CWPs. Lewy body pathology, and altered amyloid-beta production. Method: Using the proband's samples, we performed genetic analysis of the PSEN1, APP, MAPT, and APOE genes, histopathological and immunohistochemical analysis of the brain tissue, and biochemical analysis of Aβ production in COS cells transfected with wild-type or mutant PSEN1. Results: The patient presented with memory loss, abnormal behavior, and visual hallucinations. Brain scans showed reduced blood flow, mild atrophy, and white matter lesions. Genetic analysis revealed a heterozygous mutation at codon 266 (G266S) of PSEN1 and polymorphism of MAPT (Q230R). The brain had many CWPs, severe cerebral amyloid angiopathy (CAA), senile plaque, Lewy bodies, and neurites. Electron microscopy displayed myelinated fiber degeneration, mitochondrial damage, and amyloid fibrils in the white matter. The production level of Aβ42 in PSEN1 G266S-transfected cells significantly increased. Conclusion: Our findings suggest that the PSEN1 G266S mutation may cause a heterogeneous clinical and pathological phenotype, influenced by other genetic or environmental factors. [ABSTRACT FROM AUTHOR]

The article discusses the landslides triggered by the 2024 Noto Peninsula earthquake in Ishikawa Prefecture, Japan. The earthquake, with a magnitude of 7.6, caused extensive damage and claimed 244 lives. Over 2300 landslides were triggered by the earthquake, including the Machinomachi and Ichinose landslides, which destroyed multiple houses. The article presents the results of field surveys, ring shear tests, and computer simulations to understand the mechanism of the landslides and validate the simulation results. The study highlights the importance of understanding long-runout landslides for future earthquake risk assessment. [Extracted from the article]

Understanding how preverbal infants perceive and differentiate the roles of teachers and students can provide profound insights into the early stages of human learning and cognition. We thus developed a paradigm based on the task order and the interactive position to determine if infants understand teacher–student relationships. Five experiments (N = 104), reveal that, after watching the teacher agent instruct the student agent from failure to success, 11-month-old infants looked at the teacher for a longer time when they watched a new naïve agent seek information in a new ambiguous scenario. Three additional control experiments excluded alternative interpretations of infants' selective looking, suggesting that agents' order-related actions influenced infants' identification. Another control experiment demonstrated the importance of the position when the teacher and the student had interactive exchanges. These findings indicate that preverbal infants can recognize the teacher–student relationship, which is crucial to accessing effective information in early life. [ABSTRACT FROM AUTHOR]

In human walking, the left and right legs move alternately, half a stride out of phase with each other. Although various parameters, such as stride frequency and length, vary with walking speed, the antiphase relationship remains unchanged. In contrast, during walking in left-right asymmetric situations, the relative phase shifts from the antiphase condition to compensate for the asymmetry. Interlimb coordination is important for adaptive walking and we expect that interlimb coordination is strictly controlled during walking. However, the control mechanism remains unclear. In the present study, we derived a quantity that models the control of interlimb coordination during walking using two coupled oscillators based on the phase reduction theory and Bayesian inference method. The results were not what we expected. Specifically, we found that the relative phase is not actively controlled until the deviation from the antiphase condition exceeds a certain threshold. In other words, the control of interlimb coordination has a dead zone like that in the case of the steering wheel of an automobile. It is conjectured that such forgoing of control enhances energy efficiency and maneuverability. Our discovery of the dead zone in the control of interlimb coordination provides useful insight for understanding gait control in humans. Analyses of the synchronization mechanism between the legs during walking using two coupled oscillators and Bayesian inference method reveal the presence of a "dead zone," where the control of interlimb coordination is ineffective. [ABSTRACT FROM AUTHOR]

Although luminescent aluminum compounds have been utilized for emitting and electron transporting layers in organic light-emitting diodes, most of them often exhibit not phosphorescence but fluorescence with lower photoluminescent quantum yields in the aggregated state than those in the amorphous state due to concentration quenching. Here we show the synthesis and optical properties of β-diketiminate aluminum complexes, such as crystallization-induced emission (CIE) and room-temperature phosphorescence (RTP), and the substituent effects of the central element. The dihaloaluminum complexes were found to exhibit the CIE property, especially RTP from the diiodo complex, while the dialkyl ones showed almost no emission in both solution and solid states. Theoretical calculations suggested that undesired structural relaxation in the singlet excited state of dialkyl complexes should be suppressed by introducing electronegative halogens instead of alkyl groups. Our findings could provide a molecular design not only for obtaining luminescent complexes but also for achieving triplet-harvesting materials. Luminescent aluminum compounds have been utilized for emitting and electron transporting layers in organic light-emitting diodes, but most exhibit fluorescence as opposed to phosphorescence. Here, the photophysical properties of β-diketiminate aluminum complexes are shown to depend on the nature of the metal substituents, with a diiodoaluminum complex displaying room temperature phosphorescence. [ABSTRACT FROM AUTHOR]

In female eutherian mammal development, X-chromosome inactivation (XCI) of one of the two X chromosomes is initiated early. Understanding the relationship between the initiation of XCI and cell fate is critical for understanding early female development and requires a system that can monitor XCI in single living cells. Traditional embryonic stem cells (ESCs) used for XCI studies often lose X chromosomes spontaneously during culture and differentiation, making accurate monitoring difficult. Additionally, most XCI assessment methods necessitate cell disruption, hindering cell fate tracking. We developed the Momiji (version 2) ESC line to address these difficulties, enabling real-time monitoring of X-chromosome activity via fluorescence. We inserted green and red fluorescent reporter genes and neomycin and puromycin resistance genes into the two X chromosomes of PGK12.1 ESCs, creating a female ESC line that retains two X chromosomes more faithfully during differentiation. Momiji (version 2) ESCs exhibit a more stable XX karyotype than other ESC lines, including the parental PGK12.1 line. This new tool offers valuable insights into the relationship between XCI and cell fate, improving our understanding of early female development. [ABSTRACT FROM AUTHOR]

Endosialin, also known as tumor endothelial marker-1, is a transmembrane glycoprotein that plays a role in inflammation and tumor progression. Endosialin is upregulated in atherosclerotic lesions. To elucidate the association between blood endosialin levels and cardiovascular events, we measured plasma endosialin levels in 389 patients undergoing coronary angiography who were followed up for a mean follow-up of 6.4 ± 4.2 years for cardiovascular events (cardiovascular death, myocardial infarction, unstable angina, heart failure, stroke, or need for coronary revascularization). Of the 389 patients, 223 had coronary artery disease (CAD). No significant difference was found in plasma endosialin levels between patients with and without CAD (median 0.92 vs. 0.92 ng/mL). During the follow-up, cardiovascular events occurred in 62 patients. Compared with patients without events, those with events had higher endosialin levels (1.12 vs. 0.89 ng/mL), and more often had endosialin level of > 1.1 ng/mL (53% vs. 31%) (P < 0.01). A Kaplan-Meier analysis showed lower event-free survival in patients with endosialin > 1.1 ng/mL than those with ≤ 1.1 ng/mL (P < 0.01). In a multivariate Cox regression analysis, endosialin > 1.1 ng/mL was an independent predictor of cardiovascular events (hazard ratio = 2.00; 95%CI = 1.21–3.32; P < 0.01). Thus, high plasma endosialin levels were associated with an increased risk of cardiovascular events in patients undergoing coronary angiography. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the occupational radiation exposure of medical workers between general hospitals and university hospitals. Methods: Radiation exposure data from three hospitals in Hiroshima city, including one university hospital and two general hospitals, were collected using personal dosimeters. Monthly radiation doses were analyzed, and the annual sum of radiation exposure dose was calculated for 538 subjects in general hospitals and 1224 subjects in the university hospital. To assess the impact of locality, additional data from Nagasaki University Hospital and Fukushima Medical University Hospital were included for comparative analysis. Professional affiliations, such as doctors, nurses, and radiological technologists, were considered in the evaluation. Results: The study revealed slight but significant differences in radiation doses between general and university hospitals. In general hospitals, except for radiological technologists, a slightly higher radiation dose was observed compared to university hospitals. Despite the annual increase in the use of medical radiation, the majority of hospital workers in both settings adhered to safety guidelines, with occupational radiation exposure remaining below the limit of detection (LOD). Workers who involved in fluoroscopic procedure, whether at university or general hospitals, had higher radiation doses than those who did not. Conclusion: The study's primary conclusion is that workers in general hospitals experience a slight but significantly higher radiation dose and a lower percentage below the LOD compared to university hospitals. The observed difference is attributed to the greater workload at general hospitals than at university hospitals, and also may be due to the different nature of university hospital and general hospital. University hospitals, characterized by greater academic orientation, tend to benefit from comprehensive support systems, specialized expertise, and advanced technology, leading to more structured and regulated radiation control. These findings provide a basis for targeted interventions, improved safety protocols. [ABSTRACT FROM AUTHOR]

We report a case of temporary Berlin Heart EXCOR® explantation in a pediatric patient with idiopathic dilated cardiomyopathy who suffered an uncontrollable inflow cannulation site infection while on bridge-to-transplantation. Despite failure to thrive and catheter-related infections, once free of the device, the patient was cured of infection using systemic antibiotics and surgical debridement. The patient underwent EXCOR® reimplantation after four months, and is awaiting heart transplantation in stable condition. A life-threatening ventricular assist device-related infection may require device explantation under conditions that may not fulfill conventional explantation criteria despite risks. Temporary explantation can be an effective strategy if isolated systolic dysfunction is managed carefully. [ABSTRACT FROM AUTHOR]

During continuous-flow left ventricular assist device (CF-LVAD) support, hemodynamic shear stress causes a burden on aortic valve (AV) leaflets, leading to de novo aortic insufficiency (AI). This study investigated the influence of preoperative hemodynamic parameters on de novo AI in CF-LVAD recipients. We reviewed 125 patients who underwent CF-LVAD implantation without concomitant AV surgery between 2005 and 2018. De novo AI was defined as moderate or severe AI in those with none or trivial preoperative AI. During mean 30 ± 16 months of CF-LVAD support, de novo AI-free rate was 86% and 67% at 1 and 2 years, respectively. Multivariable analysis showed that higher right ventricular stroke work index (RVSWI) (hazard ratio, 1.12 /g/m2/beat; 95% confidence interval, 1.00–1.20; p = 0.047) and trivial grade AI (hazard ratio, 2.8; 95% confidence interval, 1.2–6.4; p = 0.020) were independent preoperative risk factors for de novo AI. The longitudinal analysis using generalized mixed effects model showed that higher RVSWI was associated with continuous AV closure after LVAD implantation (Odd ratio, 1.20/g/m2/beat; 95% confidence interval, 1.00–1.43 /g/m2/beat; p = 0.047). Right heart catheterization revealed that preoperative RVSWI was positively correlated with postoperative pump flow index in patients with continuously closed AV (r = 0.44, p = 0.04, n = 22). Preoperative higher RVSWI was a significant risk factor for de novo AI following CF-LVAD implantation. In patients with preserved right ventricular function, postoperative higher pump flow may affect AI development via hemodynamic stress on the AV. [ABSTRACT FROM AUTHOR]

Metaplastic thymoma (MT), a rare subtype of thymic epithelial tumors (TETs), harbors YAP1::MAML2 fusions. Poroma, a skin tumor, also carries these fusions and exhibits a unique staining pattern for YAP1 immunohistochemistry (IHC), namely, a YAP1 N-terminus (YAP1[N])-positive but YAP1 C-terminus (YAP1[C])-negative pattern. In this context, MT was recently reported to lack YAP1(C) expression exclusively among TET subtypes. However, a lack of information about YAP1(N) expression in that study and another report that wild-type YAP1 expression was diminished in type B3 thymoma and thymic carcinoma warrants further studies for YAP1 expression in TETs. Thus, we immunohistochemically examined YAP1(N) and YAP1(C) staining patterns in our TET samples, including 14 cases of MT. In addition, 11 of the 14 MT cases were genetically analyzed with the formalin-fixed paraffin-embedded tissues if they harbored YAP1::MAML2 fusions. MT consistently exhibited YAP1(N)-positive and YAP(C)-negative staining, whereas type B3 thymoma and thymic carcinoma showed relatively heterogeneous staining patterns for YAP1(N) and YAP1(C) and were sometimes negative for both antibodies. Furthermore, a lower expression of YAP1 was found in type B3 compared to B2 thymomas. Among genetically analyzed 11 MT cases, 6 cases showed YAP1::MAML2 fusions, whereas the analysis failed in 5 very old cases due to poor RNA quality. These results indicate that IHC of both YAP1(N) and YAP1(C) is recommended to obtain staining patterns almost unique to MT. The biological significance of YAP1 in high-grade TETs warrants further investigation. [ABSTRACT FROM AUTHOR]

To predict endoleaks after thoracic endovascular aneurysm repair (TEVAR) we submitted patient characteristics and vessel features observed on pre- operative computed tomography angiography (CTA) to machine-learning. We evaluated 1-year follow-up CT scans (arterial and delayed phases) in patients who underwent TEVAR for the presence or absence of an endoleak. We evaluated the effect of machine learning of the patient age, sex, weight, and height, plus 22 vascular features on the ability to predict post-TEVAR endoleaks. The extreme Gradient Boosting (XGBoost) for ML system was trained on 14 patients with- and 131 without endoleaks. We calculated their importance by applying XGBoost to machine learning and compared our findings between with those of conventional vessel measurement-based methods such as the 22 vascular features by using the Pearson correlation coefficients. Pearson correlation coefficient and 95% confidence interval (CI) were r = 0.86 and 0.75 to 0.92 for the machine learning, r = − 0.44 and − 0.56 to − 0.29 for the vascular angle, and r = − 0.19 and − 0.34 to − 0.02 for the diameter between the subclavian artery and the aneurysm (Fig. 3a–c, all: p < 0.05). With machine-learning, the univariate analysis was significant higher compared with the vascular angle and in the diameter between the subclavian artery and the aneurysm such as the conventional methods (p < 0.05). To predict the risk for post-TEVAR endoleaks, machine learning was superior to the conventional vessel measurement method when factors such as patient characteristics, and vascular features (vessel length, diameter, and angle) were evaluated on pre-TEVAR thoracic CTA images. [ABSTRACT FROM AUTHOR]

We discover new cancellations upon H 2 (R n) -estimate of the Hall term, n ∈ { 2 , 3 } . Consequently, first, we derive a regularity criterion for the 3-dimensional Hall-magnetohydrodynamics system in terms of horizontal components of velocity and magnetic fields. Second, we are able to prove the global regularity of the 2 1 2 -dimensional electron magnetohydrodynamics system with magnetic diffusion (- Δ) 3 2 (b 1 , b 2 , 0) + (- Δ) α (0 , 0 , b 3) for α > 1 2 despite the fact that (- Δ) 3 2 is the critical diffusive strength. Lastly, we extend this result to the 2 1 2 -dimensional Hall-magnetohydrodynamics system with - Δ u replaced by (- Δ) α (u 1 , u 2 , 0) - Δ (0 , 0 , u 3) for α > 1 2 . The sum of the derivatives in diffusion that our result requires is 11 + ϵ for any ϵ > 0 , while the sum for the classical 2 1 2 -dimensional Hall-magnetohydrodynamics system is 12 considering - Δ u and - Δ b , of which its global regularity issue remains an outstanding open problem. [ABSTRACT FROM AUTHOR]

The development of new cultivars is essential for establishing a method of producing licorice in Japan. A suitable new cultivar for domestic licorice production, known as the interspecific hybrid strain C-18, was developed by crossbreeding Glycyrrhiza uralensis Fisch. (as the seed parent, possessing a high glycyrrhizin (GL) content, strain OMP-28) and Glycyrrhiza glabra L. (as the pollen parent, known for vigorous growth, strain OMP-10). Both G. uralensis and G. glabra are specified in the Pharmacopoeia of Japan (18th edition) as the source plants for Glycyrrhizae Radix. After 2 years of cultivation, strain C-18 exhibited robust growth, with a fresh weight of 148.8 g and a stem diameter of 0.89 mm. The GL content in the dry weight was measured at 3.61%. Seedlings cultivated from rhizomes in the field for 2 years showed a tap root fresh weight per plant of 120 ± 21 g, with an average GL content relative to the dry weight of 2.68% ± 0.38%. Although glabridin, a characteristic compound of G. glabra, was not detected, glycycoumarin, a characteristic compound of G. uralensis, was detected via HPLC analysis. Strain C-18 contained glycycoumarin as a characteristic compound of G. uralensis but lacked glabridin, a compound characteristic of G. glabra. Additionally, 2,3-dehydrokievitone (1) and parvisoflavone A (2) were identified as distinctive components of the interspecific hybrid (G. uralensis × G. glabra) C-18. [ABSTRACT FROM AUTHOR]

Background: Both small-cell carcinoma (SCLC) and large-cell neuroendocrine carcinoma (LCNEC) of the lung are often clinically dealt with as being in the same category as neuroendocrine carcinoma, and their clinical differences have not been adequately assessed. Methods: The postoperative prognosis was retrospectively analyzed using the data of 196 patients who underwent resection for SCLC or LCNEC. Results: Of the patients included, 99 (50.5%) had SCLC and 97 (49.5%) had LCNEC. The median duration of follow-up was 39 months (interquartile range [IQR] 21–76) and 56 months (IQR 21–87) for SCLC and LCNEC, respectively. The estimated 5-year overall survival (OS) probabilities were 53.7% and 62.7% (p = 0.133) for patients with SCLC and LCNEC, respectively. In the SCLC group, a multivariate analysis showed that adjuvant chemotherapy (hazard ratio 0.54, 95% confidence interval 0.30–0.99, p = 0.04) was the only factor that was significantly associated with OS. In the LCNEC group, univariate analyses demonstrated that pathologic stage I (p = 0.01) was the only factor that was associated with better OS after surgery. Conclusions: We found different clinical features in SCLC and LCNEC; in patients with SCLC, because OS could be expected to significantly improve with postoperative adjuvant chemotherapy, patients with resected SCLC of any pathologic stage should receive adjuvant chemotherapy. For patients with LCNEC, because pathologic stage I LCNEC is related to better prognosis than any other stages, a thorough clinical staging, including invasive staging, according to present guidelines should be performed to identify clinical stage I LCNEC with the highest certainty. [ABSTRACT FROM AUTHOR]

Background: Insomnia is more common as people age. Several common hypnotics used to treat insomnia often do not adequately alleviate sleep issues in older adults and may be associated with negative residual effects such as an increased risk of falls, cognitive impairment, automobile accidents, and lack of response to auditory stimuli. The objective of these analyses of three clinical studies was to investigate the efficacy and safety of the dual orexin-receptor antagonist lemborexant (LEM) in older adults. Methods: Study E2006-G000-304 (Study 304; NCT02783729) was a randomized, double-blind, placebo (PBO)-controlled, active-comparator trial where subjects with insomnia disorder received LEM 5 mg (LEM5), LEM 10 mg (LEM10), zolpidem tartrate extended-release 6.25 mg (ZOL), or PBO for 30 days. In crossover Study E2006-E044-106 (Study 106; NCT02583451), healthy subjects (good sleepers) received LEM 2.5 mg, LEM5, LEM10, or PBO for eight nights or zopiclone on days 1 and 8 (and PBO on days 2–7). In crossover Study E2006-A001-108 (Study 108; NCT03008447), healthy subjects received a single dose of LEM5, LEM10, PBO, or ZOL. Sleep assessments included polysomnography-based latency to persistent sleep (LPS), wake after sleep onset (WASO), WASO in the second half of the night (WASO2H), sleep efficiency, postural stability, middle-of-the-night and next-day cognitive performance, middle-of-the-night auditory awakening threshold and return-to-sleep latency, and driving performance. Results: Overall, 453 of 1006 (45%; Study 304), 24 of 48 (50%; Study 106), and 28 of 56 (50%; Study 108) subjects were aged ≥ 65 years. In Study 304, LEM decreased (improved) LPS, WASO, and WASO2H from baseline more than ZOL and PBO; subjects treated with LEM had greater increases in sleep efficiency (improved) than with ZOL or PBO. In both Studies 304 and 108, postural stability was not impaired at waketime in subjects who received LEM compared with PBO. At waketime, LEM did not impair memory compared with PBO. In Study 108, following middle-of-the-night awakening, LEM and ZOL did not affect subjects' ability to awaken to auditory stimuli; LEM did not affect tests of memory and attention. In Study 106, LEM did not impair next-day driving performance in healthy elderly compared with PBO. LEM was well tolerated in subjects aged ≥ 65 years. Conclusions: LEM provided benefits on sleep variables without next-morning residual effects in subjects aged ≥ 65 years, supporting LEM as a treatment option for older adults with insomnia. Trial Registration Numbers and Dates of Registration: Study 304: ClinicalTrials.gov identifier, NCT02783729, date of registration, 26 May 2016. Study 106: ClinicalTrials.gov identifier, NCT02583451, date of registration, 22 October 2015. Study 108: ClinicalTrials.gov identifier, NCT03008447, date of registration, 2 January 2017. Plain Language Summary: The prevalence of insomnia increases with age; however, some hypnotics used for treating insomnia do not adequately resolve sleep problems in older adults and may be associated with adverse residual effects. Specifically, some hypnotics pose safety concerns in this population of patients who are generally more vulnerable to treatment-related effects, including increasing the risk of falls, risks of cognitive impairment, automobile accidents, and unresponsiveness to auditory stimuli. Safer and more effective insomnia medications are needed to reduce sleep problems with improved side-effect profiles. This analysis of lemborexant clinical studies conducted in adult subjects at least 65 years old found the drug to be effective without impairing memory, attention or balance the following day compared with placebo. These subjects were normal sleepers (for age) or had insomnia disorder. Furthermore, lemborexant was not associated with impaired ability to drive the next morning or awaken to loud middle-of-the-night sounds. Lemborexant was well tolerated in these older adults, similar to findings for adults aged at least 18 years. These findings indicate that lemborexant may be an appropriate treatment option for insomnia in older adults. [ABSTRACT FROM AUTHOR]

Evaluating ion-conductive solid electrolytes (SEs) accurately is crucial for advancing solid-state battery technology. Scanning/transmission electron microscopy (S/TEM) is a valuable technique for examining the local characteristics of battery materials. However, the tolerance of SEs to high-energy electron beams is notably lower than that of electrode active materials, because SEs generally have low electron conductivity. Here, we propose a specialized coating technique for TEM samples, termed "nano-shield," which enables stable and accurate observation of their micro-/nano-structures. Nano-shield consists of a dual-layer coating combining an amorphous insulating layer of aluminum oxide (AlOx) with a conductive carbon (C) film. The AlOx layer blocks ion diffusion in the TEM samples, and the C layer minimizes electron charging during electron-beam irradiation. By applying a nano-shield, we successfully visualized the atomic structures of a lithium-ion-conductive SE, Li1.3Al0.3T1.7(PO4)3 (LATP), by using STEM at room temperature. Additionally, we performed a precise elemental analysis of a sodium-ion-conductive SE, Na3Zr2Si2PO12 (NZSP), via STEM equipped with energy-dispersive X-ray spectroscopy (STEM-EDS). Our findings demonstrate that nano-shield enhances the reliability of S/TEM observations of SEs and sheds light on its underlying protective mechanisms. [ABSTRACT FROM AUTHOR]

As a result of the recent advances in first-line treatment including chemotherapy, radiation therapy, targeted therapy, and immune checkpoint inhibitor immunotherapy (ICI) for locally advanced/metastatic initially unresectable esophageal and esophagogastric junction cancer, surgery aiming at cure after initial treatment, so-called "conversion surgery" has become more common in this field. Several studies have indicated encouraging survival outcomes for patients after conversion surgery with R0 resection. However, various issues, such the utility and the safety of conversion surgery remain unclear. In this review, we will focus on the surgical treatment for initially unresectable esophageal and esophagogastric junction cancer after first- or later- line treatment and review recent evidence regarding the safety and the efficacy of conversion surgery. Multidisciplinary treatment including surgery may serve as a novel treatment strategy for esophageal and esophagogastric junction cancer, thus provide a curative treatment option and potentially contribute to better prognosis for initially untreatable diseases. [ABSTRACT FROM AUTHOR]

Background: Lateral node metastasis confers a poor prognosis in rectal cancer. Several multidisciplinary treatments have been proposed with favorable outcomes. However, appropriate neoadjuvant/adjuvant treatments or follow-up plans based on information about the probable recurrence site have not been specified. We aimed to clarify the distinctive features of recurrence patterns for lateral node-positive low rectal cancer according to the lateral and mesorectal lymph node status. Methods: We retrospectively analyzed 508 patients with stage III low rectal cancer who underwent lateral node dissection. We investigated the impact of lateral and mesorectal lymph node status on site-specific recurrence rates and patient survival. Results: Analyses for relapse-free survival revealed the prognostic impact of lateral node positivity in stage III low rectal cancer (p < 0.0001). Lateral node-positive patients exhibited higher risk of overall recurrence, local recurrence, and recurrence in extra-regional nodes than lateral node-negative patients (p < 0.0001, p = 0.001, and p < 0.0001, respectively). However, lateral node positivity was not statistically associated with a hematogenous recurrence rate. In lateral node-positive patients, both tumor-node-metastasis (TNM)-N status and number of lateral nodes involved were revealed as significant prognostic factors (p < 0.0001, both). In addition, the number of lateral nodes involved could be a discriminatory indicator of probabilities of local recurrence and recurrence in extra-regional nodes (p = 0.02, and p < 0.0001, respectively). Conclusions: Lateral node-positive low rectal cancer exhibits higher local recurrence and extra-regional node recurrence rates that correlate with the number of lateral nodes involved. [ABSTRACT FROM AUTHOR]

We prove non-uniqueness in law of the three-dimensional magnetohydrodynamics system that is forced by random noise of an additive and a linear multiplicative type and has viscous and magnetic diffusion, both of which are weaker than a full Laplacian. We apply convex integration to both equations of velocity and magnetic fields in order to obtain the non-uniqueness in law in the class of probabilistically strong solutions. [ABSTRACT FROM AUTHOR]

Background: Recurrent laryngeal nerve (RLN) palsy is a common complication in esophagectomy and its main risk factor is reportedly intraoperative procedure associated with surgeons' experience. We aimed to improve surgeons' recognition of the RLN during robot-assisted minimally invasive esophagectomy (RAMIE) by developing an artificial intelligence (AI) model. Methods: We used 120 RAMIE videos from four institutions to develop an AI model and eight other surgical videos from another institution for AI model evaluation. AI performance was measured using the Intersection over Union (IoU). Furthermore, to verify the AI's clinical validity, we conducted the two experiments on the early identification of RLN and recognition of its location by eight trainee surgeons with or without AI. Results: The IoUs for AI recognition of the right and left RLNs were 0.40 ± 0.26 and 0.34 ± 0.27, respectively. The recognition of the right RLN presence in the beginning of right RLN lymph node dissection (LND) by surgeons with AI (81.3%) was significantly more accurate (p = 0.004) than that by surgeons without AI (46.9%). The IoU of right RLN during right RLN LND recognized by surgeons with AI (0.59 ± 0.18) was significantly higher (p = 0.010) than that by surgeons without AI (0.40 ± 0.29). Conclusions: Surgeons' recognition of anatomical structures in RAMIE was improved by our AI system with high accuracy. Especially in right RLN LND, surgeons could recognize the RLN more quickly and accurately by using the AI model. [ABSTRACT FROM AUTHOR]

How will structural change unfold beyond the rise of services? Motivated by the observed dynamics within the service sector we propose a model of structural change in which productivity is endogenous and output is produced with two intermediate substitutable capital goods. In the productive sector the accumulation of specialized skills leads to an unbounded increase in TFP, as sector becoming asymptotically dominant. We are then able to recover the increasing shares of workers, the increasing real and nominal shares of the output observed in productive service and IT sectors in the US. Interestingly, the economy follows a growth path converging to a particular level of wealth that depends on the initial price of capital and knowledge. As a consequence, countries with the same fundamentals but lower initial wealth will be characterized by lower asymptotic wealth. [ABSTRACT FROM AUTHOR]

Perforated esophageal cancer rarely results in the formation of mediastinal abscess. Endoscopic ultrasound (EUS)-guided abscess drainage (AD) has increasingly been used in the management of abscesses in locations that are difficult to treat percutaneously. We describe a case of EUS-AD for mediastinal abscess due to perforating esophageal cancer and successful bridge to surgery. A 71-year-old man with suspected esophageal issues was referred to our hospital. Computed tomography showed an esophageal cancer perforating the mediastinum, forming a mediastinal abscess. EUS-AD was planned before curative resection, because there was little improvement in inflammatory response with antimicrobial therapy. The mediastinal abscess cavity was confirmed on EUS and punctured using a 19-G needle, and then, a 0.025-inch guidewire was placed in the abscess cavity. The fistula was dilated with a 7-Fr dilator and a 6-Fr, single-pigtail nasobiliary tube was placed in the abscess cavity. One month later, clinical signs had improved and curative surgery was performed. Postoperative adjuvant therapy was administered using fluorouracil/cisplatin therapy. As of 2 years postoperatively, the patient remains free of recurrence. [ABSTRACT FROM AUTHOR]

Encotyllabe percussan. sp. is proposed based on morphology and DNA sequences analysis of ribosomal (18S, 28S) and mitochondrial (COI) gene fragments. Encotyllabe percussan. sp. was found infecting the spangled emperor Lethrinus nebulosus (n = 75) with higher prevalence from Dibba, Musandam (Gulf of Oman) than in Dhofar Salalah (Indian Ocean), Oman (p = 0.03). The general morphology of E. percussan. sp. resembles E. caballeroi, E. chironemi and E. spari, which exhibit pre-equatorial testes. However, E. percussan. sp. shows unique morphological characteristics distinguishing from congeneric species: the large hamuli bear notch allocated externally between the first half proximal of the root, and the small hamuli exhibit semicircular shape with undivided roots. Phylogenetic relationships within the Encotyllabe genus remain unresolved. However, the tree topology with the 28S showed overall consistency with the principal component analysis arrangement (PCA) derived from the morphological analysis. Which showed that the large and small hamuli, marginal hooks, ovary, testes (length and width) and peduncle are currently the most important morphological traits within the genus. Cytochrome c oxidase subunit I (COI) gene fragment showed high interspecific genetic divergence adding unambiguous resolution to discriminate/designate species identity. Interrelations within the genus support the identity of Encotyllabe percussa as a new species. This is the first species characterized with three gene fragments, the second congeneric species described in L. nebulosus and the first recorded in Oman. [ABSTRACT FROM AUTHOR]

Abstract The problem of ‘uneven distribution of wealth’ accelerated during the COVID-19 pandemic. In the chaotic modern society, there is an increasing demand for the realisation of true ‘fairness’. In this study, we propose a fair distribution method ‘using physics’, which imitates the Greek mythology, Themis, having a ‘balance of judgement’ in her left hand, for the profit in games of characteristic function form. Specifically, we show that the linear programming problem for calculating ‘nucleolus (a solution for the fair distribution)’ can be efficiently solved by considering it as a physical system in which gravity works. In addition to significantly reducing the computational complexity, the proposed scheme provides a new perspective to open up a physics-based policymaker that is adaptable to real-time changes. We will be able to implement it not only in liquid systems but also in many other physical systems, including semiconductor chips. The fair distribution problem can be solved immediately using physical systems, which should reduce disputes and conflicts based on inaccurate information and misunderstandings, eliminating fraud and injustice.

Tongue brushing improves respiratory function in older adults. Considering connection between the respiratory-related and suprahyoid muscles, this study aimed to investigate whether tongue-brushing interventions can improve myoelectric activity during respiration. A six-week randomized controlled trial was conducted in Kitakyushu, Japan, with 50 participants aged ≥ 65 years. The participants were allocated to the intervention (tongue brushing with routine oral hygiene) or control (routine oral hygiene alone) groups. Surface electromyography (sEMG) was used to assess the myoelectric activity of the suprahyoid muscles during inhalation, exhalation, and forced vital capacity (FVC). A survey was conducted at baseline and the end of the follow-up period. Thirty-six participants were recruited for the analysis. The root mean squares (RMS) of sEMG during exhalation increased significantly at the end of the follow-up period compared with that at baseline in the intervention group [48.7 (18.0–177.5) vs. 64.9 (21.6–163.0), p = 0.001], but not in the control group. The generalized linear model revealed that the ratio of change in FVC was correlated with the change in the RMS of sEMG of the suprahyoid muscles during exhalation after adjusting for potential confounders. Tongue brushing enhances the myoelectric activity of the suprahyoid muscle. [ABSTRACT FROM AUTHOR]

A scoring system to discriminate between uncomplicated and complicated appendicitis is beneficial to determine the optimal treatment for acute appendicitis. We developed a scoring system to discriminate between uncomplicated and complicated appendicitis and assessed the clinical usefulness of the scoring system using external validation. A total of 299 patients with acute appendicitis were retrospectively reviewed. One hundred and ninety-nine patients were assigned to the model development group, while the other 100 patients were assigned to an external validation group. A scoring system for complicated appendicitis was created using a final multivariate logistic regression model with six independent predictors. The area under the receiver operating characteristic curve of the scoring system was 0.882 (95% confidence interval: 0.835–0.929). The cutoff point of the scoring system was 12, and the sensitivity and specificity were 82.9% and 86.2%, respectively. In the external validation group, the area under the receiver operating characteristic curve of the scoring system was 0.868 (95% confidence interval 0.794–0.942), and there was no significant difference between the groups in the area under the receiver operating characteristic curve (P = 0.750). Our newly developed scoring system may contribute to prompt determination of the optimal treatment for acute appendicitis. [ABSTRACT FROM AUTHOR]