Search

The effects of statins in patients with non-valvular atrial fibrillation (NVAF) taking oral anticoagulants (OACs) are not well-studied. This study was a historical multicenter registry of patients with NVAF taking OACs in Japan.We excluded those patients with mechanical heart valves or a history of pulmonary or deep vein thrombosis. Overall, 7826 patients were registered on 26 February 2013 and followed until 25 February 2017. We compared those with versus without statin treatment (statin vs. no-statin groups) for the primary outcome of major bleeding and secondary outcomes of all-cause mortality, ischemic events, hemorrhagic stroke, and ischemic stroke.Statins were administered in 2599 (33%) patients. The statin group was more likely to have paroxysmal AF (37% vs. 33%; p = 0.0003), hypertension (84% vs. 76%; p 0.0001), diabetes mellitus (41% vs. 27%; p 0.0001), and dyslipidemia (91% vs. 30%; p 0.0001) than the no-statin group. The cumulative incidence of major bleeding was 6.9% and 8.1% (p = 0.06). The adjusted hazard ratio [HR] (95% confidence interval [CI]) of the statin group for major bleeding was 0.77 (0.63-0.94) compared with the no-statin group. The adjusted HR (95% CI) for all-cause mortality, ischemic events, hemorrhagic stroke, and ischemic stroke were 0.58 (0.47-0.71), 0.77 (0.59-0.999), 0.85 (0.48-1.50), and 0.79 (0.60-1.05), respectively.Statins significantly reduced the risk of major bleeding, all-cause mortality, and ischemic events in patients with NVAF taking OACs. Their additive benefits should be considered in routine practice and thus be further researched.

The association between body mass index (BMI) and clinical outcomes of patients with non-valvular atrial fibrillation (NVAF) taking oral anticoagulants (OACs) are controversial, and we thus analyzed the large registry data to elucidate them.We conducted a historical cohort study at 71 centers in Japan and included outpatients with NVAF taking vitamin K antagonists (VKAs). Physicians in charge could change VKAs to direct OACs based on their judgement during follow-up period. We categorized patients into four BMI groups (kg/mAmong NVAF patients taking OACs, underweight patients had higher risks of all-cause death and ischemic events than other patients. Overweight patients had lower risk of all-cause death.

Background Soft tissue sarcomas (STS) are a rare type of malignancy comprising a variety of histological diagnoses. Chemotherapy constitutes the standard treatment for advanced STS. Doxorubicin-based regimens, which include the administration of doxorubicin alone or in combination with ifosfamide or dacarbazine, are widely accepted as first-line chemotherapy for advanced STS. Trabectedin, eribulin, pazopanib, and gemcitabine plus docetaxel (GD), which is the empirical standard therapy in Japan, are major candidates for second-line chemotherapy for advanced STS, although clear evidence of the superiority of any one regimen is lacking. The Bone and Soft Tissue Tumor Study Group of the Japan Clinical Oncology Group (JCOG) conducts this trial to select the most promising regimen among trabectedin, eribulin, and pazopanib for comparison with GD as the test arm regimen in a future phase III trial of second-line treatment for patients with advanced STS. Methods The JCOG1802 study is a multicenter, selection design, randomized phase II trial comparing trabectedin (1.2 mg/m2 intravenously, every 3 weeks), eribulin (1.4 mg/m2 intravenously, days 1 and 8, every 3 weeks), and pazopanib (800 mg orally, every day) in patients with unresectable or metastatic STS refractory to doxorubicin-based first-line chemotherapy. The principal eligibility criteria are patients aged 16 years or above; unresectable and/or metastatic STS; exacerbation within 6 months prior to registration; histopathological diagnosis of STS other than Ewing sarcoma, embryonal/alveolar rhabdomyosarcoma, well-differentiated liposarcoma and myxoid liposarcoma; prior doxorubicin-based chemotherapy for STS, and Eastern Cooperative Oncology Group performance status 0 to 2. The primary endpoint is progression-free survival, and the secondary endpoints include overall survival, disease-control rate, response rate, and adverse events. The total planned sample size to correctly select the most promising regimen with a probability of > 80% is 120. Thirty-seven institutions in Japan will participate at the start of this trial. Discussion This is the first randomized trial to evaluate trabectedin, eribulin, and pazopanib as second-line therapies for advanced STS. We endeavor to perform a subsequent phase III trial comparing the best regimen selected by this study (JCOG1802) with GD. Trial registration This study was registered with the Japan Registry of Clinical Trials (jRCTs031190152) on December 5, 2019.

The anatomical characteristics (fiber length and fiber area) and mechanical properties (modulus of elasticity, modulus of rupture, compressive strength, tensile Young’s modulus, and tensile strength) of Bambusa vulgaris, Bambusa maculata, and Gigantochloa atter, naturally growing at four different sites in Lombok Island, Indonesia, were examined for evaluating geographic and longitudinal variations by mixed-effects modeling to effectively utilize bamboo culm resources for structural materials. We found geographic and longitudinal variations of bamboo culm properties in these three species. Based on the results, we concluded that, for utilization of bamboo culm as a structural material, variation of individual culm rather than site, and longitudinal variations should be considered for Bambusa species and G. atter, respectively.

Background The Bayesian penalized likelihood PET reconstruction (BPL) algorithm, Q.Clear (GE Healthcare), has recently been clinically applied to clinical image reconstruction. The BPL includes a relative difference penalty (RDP) as a penalty function. The β value that controls the behavior of RDP determines the global strength of noise suppression, whereas the γ factor in RDP controls the degree of edge preservation. The present study aimed to assess the effects of various γ factors in RDP on the ability to detect sub-centimeter lesions. Methods All PET data were acquired for 10 min using a Discovery MI PET/CT system (GE Healthcare). We used a NEMA IEC body phantom containing spheres with inner diameters of 10, 13, 17, 22, 28 and 37 mm and 4.0, 5.0, 6.2, 7.9, 10 and 13 mm. The target-to-background ratio of the phantom was 4:1, and the background activity concentration was 5.3 kBq/mL. We also evaluated cold spheres containing only non-radioactive water with the same background activity concentration. All images were reconstructed using BPL + time of flight (TOF). The ranges of β values and γ factors in BPL were 50–600 and 2–20, respectively. We reconstructed PET images using the Duetto toolbox for MATLAB software. We calculated the % hot contrast recovery coefficient (CRChot) of each hot sphere, the cold CRC (CRCcold) of each cold sphere, the background variability (BV) and residual lung error (LE). We measured the full width at half maximum (FWHM) of the micro hollow hot spheres ≤ 13 mm to assess spatial resolution on the reconstructed PET images. Results The CRChot and CRCcold for different β values and γ factors depended on the size of the small spheres. The CRChot, CRCcold and BV increased along with the γ factor. A 6.2-mm hot sphere was obvious in BPL as lower β values and higher γ factors, whereas γ factors ≥ 10 resulted in images with increased background noise. The FWHM became smaller when the γ factor increased. Conclusion High and low γ factors, respectively, preserved the edges of reconstructed PET images and promoted image smoothing. The BPL with a γ factor above the default value in Q.Clear (γ factor = 2) generated high-resolution PET images, although image noise slightly diverged. Optimizing the β value and the γ factor in BPL enabled the detection of lesions ≤ 6.2 mm.

Outside of clinical trials, the prophylactic effect of dihydropyridine calcium channel blockers (CCBs) on ischemic events in patients with nonvalvular atrial fibrillation (NVAF) has not been confirmed. We compared the effect of dihydropyridine CCBs on ischemic events in anticoagulated NVAF patients. We conducted a multicenter historical cohort study at 71 centers in Japan. The inclusion criterion was taking vitamin K antagonists for NVAF. The exclusion criteria were mechanical heart valves and a history of pulmonary thrombosis or deep vein thrombosis. Consecutive patients (N = 7826) were registered in February 2013 and were followed until February 2017. The primary outcomes were ischemic events and ischemic strokes; the secondary outcomes were all-cause mortality, major bleeding, and hemorrhagic strokes. The mean patient age was 73 years old, and 67% of the patients were male. Seventy-eight percent of the patients had hypertension, and dihydropyridine CCBs were used by 2693 (34%) patients (CCB group). The cumulative incidences of ischemic events and ischemic strokes at 4 years in the CCB and No-CCB groups were 5.9% vs. 5.2% and 5.6% vs. 4.8%, respectively. The adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) of the CCB group for ischemic events and ischemic strokes were 1.22 (0.95-1.57) and 1.32 (1.02-1.71), respectively; the adjusted HRs (95% CIs) of the CCB group for all-cause mortality, major bleeding, and hemorrhagic strokes were 0.85 (0.69-1.04), 1.12 (0.92-1.35), and 1.08 (0.62-1.88), respectively. Dihydropyridine CCB use by anticoagulated NVAF patients significantly increased ischemic strokes in a real-world setting.

Although the assessment of nutrition is essential for stroke patients, detailed associations between nutritional status at admission, subsequent complications, and clinical outcomes in patients with acute intracerebral hemorrhage (ICH) are unclear. We aimed to elucidate these associations using the Controlling Nutritional Status (CONUT) score. Consecutive patients with acute ICH were investigated. Nutritional status was evaluated using the CONUT score, calculated from the serum albumin level, lymphocyte count, and total cholesterol level. Subsequent complications, such as hemorrhage expansion (HE) during the acute stage and aspiration pneumonia during hospitalization, were evaluated. Poor outcome was defined as a modified Rankin Scale score of ≥ 3 at 3 months. Of the 721 patients, 49 had HE, 111 had aspiration pneumonia, and 409 had poor outcomes. Patients with HE had significantly lower total cholesterol levels than those without HE. Patients with aspiration pneumonia had significantly lower albumin levels, lower lymphocyte counts, and higher CONUT scores than those without aspiration pneumonia. Patients with poor outcomes had significantly lower albumin levels, lower lymphocyte counts, lower total cholesterol levels, and higher CONUT scores than those with good outcomes. Multivariable logistic analysis showed that higher CONUT scores were independently associated with poor outcome (odds ratio, 1.28; 95% confidence interval, 1.09-1.49; P = 0.002) after adjusting for baseline characteristics, HE, and aspiration pneumonia. Each component of CONUT was a useful predictor of subsequent complications. Malnutrition, determined using the CONUT score, was independently associated with poor outcomes in patients with ICH after adjusting for these complications.

Cancer-associated ischemic stroke (CAS) refers to a hypercoagulation disorder related to malignant tumors, especially adenocarcinoma. Carbohydrate antigen (CA) 125 is a mucinous serum marker that might reflect hypercoagulation status, but the association between CA 125 and CAS is unclear across various types of cancer. The aim of this study was to investigate the associations among tumor markers, coagulation markers, and clinical factors in acute ischemic stroke (AIS) patients with active cancer. Consecutive AIS patients with active cancer (a diagnosis or ongoing active therapy for cancer within 6 months) were prospectively enrolled at four hospitals. D-dimer, C-reactive protein (CRP), carcinoembryonic antigen (CEA), CA19-9, and CA 125 levels were measured. Of 120 AIS patients with active cancer, 47 were diagnosed with CAS. CA 125 had the strongest correlations with D-dimer and CRP (ρ = 0.543, p

Promoting wood utilization from fast-growing tree species is one solution to address supply and demand issues relating to wood resources while sequestering carbon dioxide in large quantities. Information on the quality of wood from fast-growing tree species and its relationship with changes in stem size is essential for promoting the establishment of plantations and wood utilization of fast-growing tree species. To explore the relationship between the xylem maturation process and radial growth increments of stems in fast-growing tree species, we examined radial variations in annual ring widths and wood properties in Liriodendron tulipifera in Japan. The cambial ages at which current annual increment and mean annual increment values were greatest were 4.9 years and 7.4 years, respectively. Based on radial variations evaluated by mixed-effects modeling of wood properties, all properties increased or decreased near the pith before becoming stable towards the cambium. Changing ratios of multiple wood properties at 1-year intervals became stable after a cambial age of 9 years. These results point to an ecological strategy in L. tulipifera, in which there is a tradeoff between radial growth increments and wood properties. As part of this strategy, in response to competition among individual trees within a stand, the tree produces a large volume of xylem with lower physical and mechanical properties, allowing it to increase its volume faster than that of the surrounding trees. Subsequently, it produces xylem that is more stable, with greater physical and mechanical properties. This wood forms at a slower growth rate compared to the xylem that forms at the time of initial tree growth. Based on the ecological strategy adopted by L. tulipifera, wood that forms before a cambial age of 9 years can be used for utility applications, and wood that forms after a cambial age of 9 years can be used for structural applications.

Wood properties (annual ring width, tracheid length, microfibril angle [MFA], basic density, and air-dry density) and mechanical properties (modulus of elasticity [MOE], modulus of rupture [MOR], bending work, and compressive strength) in 34-year-old Chamaecyparis obtusa trees of six half-sib families were measured from pith to bark to clarify radial variations in inheritance of these traits and the relationships between wood properties and mechanical properties. In addition, within-tree and among-family differences in the load–deflection curves were discussed. Radial variations of all wood properties were fitted to linear or nonlinear mixed-effects models with random effects of families. The MFA was correlated with MOE in all radial positions, whereas air-dry density correlated with all mechanical properties in mature wood. Radial variations in broad-sense heritability differed between wood properties. A relatively higher broad-sense heritability was recognized in almost all wood properties for mature wood. Based on the results, it was concluded that mechanical properties in mature wood can be effectively improved using MFA and air-dry density as criteria. In addition, the types of load–deflection curve in mature wood differed from those in juvenile wood, suggesting that not only elastic properties, but also plastic properties in C. obtusa are affected by genetic controls, especially in mature wood.

Vital signs are important for patient assessment, but little is known about interpreting those of children in prehospital settings. We conducted an observational study to investigate the association between prehospital vital signs of children and their clinical outcomes in hospitals. We plotted the data of patients with critical outcomes on published reference ranges, such as those of healthy children to evaluate the clinical relevance. Of the 18,493 children screened, 4477 transported to tertiary hospitals were included in the analysis. The outcomes 12 h after being transported to a tertiary hospital were as follows: deceased, 41; hospitalization with critical deterioration events, 65; hospitalization without critical deterioration events, 1086; returned home, 3090; and unknown, 195. The reference ranges of the heart rates (sensitivity: 57.7%, specificity: 67.5%) and respiratory rates (sensitivity: 54.5%, specificity: 67.7%) of healthy children worked best to detect the critical outcomes. Therefore, the reference ranges of healthy children were concluded to be suitable in prehospital settings; however, excessive reliance on vital signs carried potential risks due to their limited sensitivities and specificities. Future studies are warranted to investigate indicators with higher sensitivities and specificities.

Functional and intelligent soft materials are useful for controlled release of medicines and other molecules. Poly(N-isopropylacrylamide) (PNIPAm) gels are well known as thermo-responsive gels with large discontinuous volume change which is commonly called as the volume phase transition. PNIPAm gels are expected to be applied to controlled-releasable material for drug delivery systems. Furthermore, we can fabricate arbitrary shapes made of gels freely by using 3D hydrogel printing techniques. Here we report that the effect of capsule shapes on behaviors of the PNIPAm objects under water flow with Reynolds number 102. In addition, we compared the behaviors of 3D-printed PNIPAm gel objects with 3D-printed polylactic acid (PLA) objects. The velocity at the first period of 2 or 3 s from the beginning of movement is slower than that of second period in the case of PNIPAm objects with ellipsoidal and bullet shapes. In other words, the capsules are accelerated after the period of 2 or 3 s. For the bullet shape objects, the velocity of the PNIPAm gel is approximately three times faster than that of PLA. It is considered that the cause of the difference between the velocities of PLA and PNIPAm gel is the difference of their frictions. The hydrogels possess commonly low friction properties. Finally, it is demonstrated that the 3D-printed PNIPAm capsules can release the solution inside the capsules by shrinking the PNIPAm gels, caused by volume phase transition.

The formation of intermetallic compounds (IMCs) during the friction stir welding (FSW) of aluminum and steel is problematic because these IMCs can reduce weld strength. In this study, the mechanism behind the observed rapid growth of IMCs during the dissimilar FSW of aluminum and steel was investigated. The temperature during welding was measured using K-type thermocouples, and the microstructures of cross sections of the welded materials were examined via scanning electron microscopy. Microstructural observations indicated that the growth of IMCs was not constant, but occurred in two rapid growth steps. The first phase of rapid IMC growth was observed immediately after the probe contacted the steel, while the second began in the region subjected to the large downward pressure of the tool shoulder on the steel plate. The measurements showed that the temperature underneath the tool shoulder was higher than that at the tool probe. Additionally, it was found that the two IMC growth steps and the growth rate could be expressed by an equation based on metallic diffusion and the measured temperatures. As the IMCs grew rapidly via contact between the steel plate and the tool probe or shoulder, it is necessary to control such contacts to inhibit IMC growth. This strategy and the proposed formula for predicting IMC growth rates could help improve the strength of welds during the fabrication of lightweight materials in the automotive and aerospace industries.

Background Up to 6-months oxaliplatin-containing regimen is now widely accepted as a standard adjuvant chemotherapy for stage III colorectal cancer (CRC). However, oral fluoropyrimidine monotherapy is used for some part of patients, especially in Asian countries including Japan, and its optimal duration is yet to be fully investigated. Methods A total of 1306 patients with curatively-resected stage III CRC were randomly assigned to receive capecitabine (2500 mg/m2/day) for 14 out of 21 days for 6 (n = 654) or 12 (n = 650) months. The primary endpoint was disease-free survival (DFS), and the secondary endpoints were relapse-free survival (RFS), overall survival (OS), and adverse events. Results The 3- and 5-year DFS were 70.0% and 65.3% in the 6M group and 75.3% and 68.7% in the 12M group, respectively (p = 0.0549, HR = 0.858, 90% CI: 0.732–1.004). The 5-year RFS was 69.3% and 74.1% in the 6M and 12M groups, respectively (p = 0.0143, HR = 0.796, 90% CI: 0.670–0.945). The 5-year OS was 83.2% and 87.6%, respectively (p = 0.0124, HR = 0.727, 90% CI: 0.575–0.919). The incidence of overall grade 3–4 adverse events was almost comparable in both groups. Conclusions Although 12-month adjuvant capecitabine did not demonstrate superior DFS to that of 6-month, the observed better RFS and OS in the 12-month treatment period could be of value in selected cases.

PURPOSE: Breast cancer (BC) is a risk factor for major depressive disorder (MDD), yet little research has tested the efficacy of different psychotherapies for depressed women with BC. This study, the largest to date, compared outcomes of three evidence-based, twelve-week therapies in treating major depressive disorder among women with breast cancer. METHODS: This randomized trial compared interpersonal psychotherapy (IPT), problem solving therapy (PST), and brief supportive psychotherapy (BSP). Conducted at the outpatient clinic of the New York State Psychiatric Institute/Columbia University, the trial offered bilingual treatment by treatment-specific psychotherapists supervised by treatment experts. The primary outcome was change in the Hamilton Depression Rating Scale (HAM-D) at 12 weeks. Secondary outcomes included other validated patient-reported outcomes for depression and quality of life. RESULTS: Of 179 women with breast cancer screening positive for depression at the Columbia Cancer Center, 134 eligible patients signed informed treatment consent. Half of patients were Hispanic and economically disadvantaged. Most women had stage I (35.2%) or II (36.9%) BC; 9% had stage IV. The three brief psychotherapies showed similar improvements on the HAM-D, with large pre-post effect sizes (d~ 1.0); a priori defined response rates were 35% for IPT, 50% for PST and 31% for BSP, and remission rates 25%, 30% and 27%, respectively. The three treatments also showed similar improvements in the Quality of Life Enjoyment and Satisfaction Questionnaire. Dropout was high, ranging from 37–52% across treatments. Predictors of dropout included having

Objective We aimed to test our hypothesis that traditional Japanese (Kampo) medicine, hochuekkito (Hochu-ekki-to: HET) has a preventive effect for the symptoms on COVID-19. Trial design The study is designed as a multi-center, interventional, parallel-group, randomized (1:1 ratio), investigator sponsored, two-arm study. Participants Six thousand participants will be recruited from healthy hospital workers in 7 Japanese University Hospitals. Inclusion criteria: 1. Age from 20 to 75 years old at the time of registration 2. Asymptomatic and body temperature below 37°C at the time of registration 3. Capable of eating orally Exclusion criteria: 1. Previous upper respiratory inflammation due to viral infection (including suspected COVID-19) 2. Taking immunosuppressants 3. Allergic to the Kampo medicines used in this study 4. History of hypokalaemia, severe hypertension, severe liver dysfunction, and interstitial pneumonia 5. Regularly taking other Kampo medicines 6. Pregnant or possibly pregnant 7. Participating in other research 8. Judged to be unsuitable for this study by the doctor in charge Intervention and comparator Kampo group: participants receive HET in 9 tablets 2 times per day for 8 weeks. Control group: participants receive placebo in the same dosage as the Intervention group - 9 tablets 2 times per day for 8 weeks. Placebo tablets are identical in appearance and package to HET. Taste of placebo is different from that of HET. The Ohsugi Pharmaceutical Co. Ltd, Osaka, Japan manufactured the placebo and HET. Main outcomes Primary outcome: Number of patients with a SARS-CoV-2 RNA by ploymerase chain reaction (PCR) positive result with at least one symptom (fever, cough, sputum, malaise, shortness of breath) during the 12-week study period (including the 4-week observation period after oral administration). Secondary outcomes: 1. Period from infection to onset 2. Period from the appearance of symptoms to the disappearance of PCR positive 3. Number of days until the appearance or improvement of symptoms 4. Severe stage: presence of hospitalization 5. Shock stage: ICU management required for mechanical ventilation, shock vitals or failure of organ(s) other than lungs Safety endpoints include numbness in the hands and/or feet, edema, skin rash or other allergic symptoms, and gastric discomfort. Randomisation Patients are randomized (1:1 ratio) to each group using minimization implemented with the Electric data capture system (DATATRAK Enterprise Cloud), with balancing of the arms with age range (under 50 years of age or not) and having a history of risk factors for COVID-19 (cardiovascular disease, hypertension, diabetes, respiratory diseases). Blinding (masking) Only participants will be randomized. Numbers to be randomised (sample size) The main research hypothesis of this study is that Kampo medicines significantly prevent the onset of COVID-19. It is assumed that the infection rate before the administration of the drug under consideration will be 0% and that the incidence of COVID-19 thereafter will be 2- 3%, of which 70%-80% will show symptoms of COVID-19. Assuming that the pharmaceutical effect of the drug will be effective in 50% of patients and that the incidence rates in the placebo and drug groups will be 1.4%-2.4% and 0.7%-1.2%, respectively, the placebo is calculated at 2%, and the study drug at 1%. Since the frequency of verification is low and the number of cases will be large, we set a total of 10 analyses (9 interim analyses and a final analysis). Since the number of cases at the time of the final analysis will be 4,986 under the conditions of α = 0.05 and a power of 80% by the Peto method. We set at 600 cases in each interim analysis with an estimated dropout rate of 16.9%. Finally, the total number of cases is set to 6,000 with 3,000 in the placebo group and 3,000 in the HET group. Trial status Protocol version 1.3 of October 23rd , 2020. Recruitment start (expected): December 1st, 2020. Recruitment finish (expected): December 31st, 2022. Trial registration This trial is registered in the Japan Registry of Clinical Trials (jRCT) (jRCTs031200150) on 14 October 2020. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest of expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.

The quality of dimension lumber (2 by 4 lumber) was preliminarily investigated in four common Mongolian softwoods: Pinus sylvestris L., Pinus sibirica Du Tour, Picea obovata Ledeb., and Larix sibirica Ledeb. to produce high quality dimension lumber for structural use. In total 61, 39, 67, and 37 pieces of lumber were prepared for Pinus sylvestris, Pinus sibirica, Picea obovata, and L. sibirica, respectively. The lumber was visually graded and then tested in static bending to obtain the 5% lower tolerance limits at 75% confidence level (f0.05) of the modulus of elasticity (MOE) and the modulus of rupture (MOR). In addition, the effects of sawing patterns on bending properties were also analyzed. The f0.05 of the MOE and MOR were 4.75 GPa and 15.6 MPa, 3.39 GPa and 11.0 MPa, 3.78 GPa and 11.7 MPa, and 6.07 GPa and 22.3 MPa for Pinus sylvestris, Pinus sibirica, Picea obovata, and L. sibirica, respectively. These results suggested that with a few exceptions, characteristic values of MOR in the four common Mongolian softwoods resembled those in similar commercial species already used. In visual grading, over 80% of total lumber was assigned to select structural and No. 1 grades in Pinus sylvestris and Pinus sibirica, whereas approximately 40% of total lumber in L. sibirica was No. 3 and out of grades. Sawing patterns affected bending properties in Pinus sylvestris and L. sibirica, but did not affect Pinus sibirica and Picea obovata. Dynamic Young's modulus was significantly correlated with bending properties of dimension lumber for the four species. Based on the results, it was concluded that dimension lumber for structural use can be produced from the four common Mongolian softwoods.

Panel sequencing of susceptibility genes for hereditary breast and ovarian cancer (HBOC) syndrome has uncovered numerous germline variants; however, their pathogenic relevance and ethnic diversity remain unclear. Here, we examined the prevalence of germline variants among 568 Japanese patients with BRCA1/2-wildtype HBOC syndrome and a strong family history. Pathogenic or likely pathogenic variants were identified on 12 causal genes for 37 cases (6.5%), with recurrence for 4 SNVs/indels and 1 CNV. Comparisons with non-cancer east-Asian populations and European familial breast cancer cohorts revealed significant enrichment of PALB2, BARD1, and BLM mutations. Younger onset was associated with but not predictive of these mutations. Significant somatic loss-of-function alterations were confirmed on the wildtype alleles of genes with germline mutations, including PALB2 additional somatic truncations. This study highlights Japanese-associated germline mutations among patients with BRCA1/2 wildtype HBOC syndrome and a strong family history, and provides evidence for the medical care of this high-risk population.

The modulus of elasticity (MOE) and modulus of rupture (MOR) were evaluated for 190 pieces of dimension lumber (2 by 4 lumber, 38 by 89 mm in cross-section) produced from Larix sibirica trees grown in Mongolia. The 5% tolerance limits of the MOE and MOR were 5.70 GPa and 15.1 MPa, respectively. The value of the 5% tolerance limit of the MOR exceeded the characteristic value of 2 by 4 lumber in visual grading class No. 3 of the Japanese Agricultural Standard for the D. fir-L, Hem-Tam, JS-III and S-P-F softwood species groups. A significant positive correlation was found between the MOE and MOR, although air-dry density was weakly correlated with bending properties in L. sibirica.

D-dimer levels are used in several clinical settings, such as in predicting venous thrombosis, cardioembolic stroke and cancer status. In the present study, we investigated the associations between plasma D-dimer levels at admission, clinical characteristics and mortality at discharge in cryptogenic stroke patients. We also investigated whether D-dimer levels can predict long-term outcomes in those patients, including those with and without right-to-left shunt (RLS). Acute cryptogenic stroke patients (n = 295, 72 ± 13 years old) were consecutively enrolled and retrospectively analyzed. We defined the cryptogenic stroke as an undetermined etiology according to the Trial of Org 10172 in Acute Stroke Treatment criteria. Plasma D-dimer levels at admission were evaluated. Assessments for RLS were performed using saline contrast-transcranial Doppler ultrasonography or contrast-transesophageal echography. Survivors (at discharge) underwent follow-up for up to 3 years after stroke onset. Of the total enrolled cohort, 17 patients died at discharge. D-dimer levels correlated with initial National Institutes of Health Stroke Scale (NIHSS) score (r = 0.391, P