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The progression of neuroinflammation after anti-parkinsonian therapy on the Parkinson's disease (PD) brain and in vivo evidence of the therapy purporting neuroprotection remain unclear. To elucidate this, we examined changes in microglial activation, nigrostriatal degeneration, and clinical symptoms longitudinally after dopamine replacement therapy in early, optimally-controlled PD patients with and without zonisamide treatment using positron emission tomography (PET). We enrolled sixteen PD patients (Hoehn and Yahr stage 1-2), and age-matched normal subjects. PD patients were randomly divided into two groups: one (zonisamide + ) that did and one (zonisamide - ) that did not undergo zonisamide therapy. Annual changes in neuroinflammation ([ 11 C]DPA713 PET), dopamine transporter availability ([ 11 C]CFT PET) and clinical severity were examined. Voxelwise differentiations in the binding of [ 11 C]DPA713 (BP ND ) and [ 11 C]CFT (SUVR) were compared with normal data and between the zonisamide + and zonisamide - PD groups. The cerebral [ 11 C]DPA713 BP ND increased with time predominantly over the parieto-occipital region in PD patients. Comparison of the zonisamide + group with the zonisamide - group showed lower levels in the cerebral [ 11 C]DPA713 BP ND in the zonisamide + group. While the striatal [ 11 C]CFT SUVR decreased longitudinally, the [ 11 C]CFT SUVR in the nucleus accumbens showed a higher binding in the zonisamide + group. A significant annual increase in attention score were found in the zonisamide + group. The current results indicate neuroinflammation proceeds to the whole brain even after anti-parkinsonian therapy, but zonisamide coadministration might have the potential to ameliorate proinflammatory responses, exerting a neuroprotective effect in more damaged nigrostriatal regions with enhanced attention in PD., (© 2024. The Author(s).)

Background and Aim: Our previous research suggested that heat-killed Lactobacillus sakei HS-1 (HK-LS HS-1) is potentially beneficial for improving intestinal microbes and reducing the number of medical treatments. This study aimed to investigate the effect of HK-LS HS-1 as a supplement in milk replacers (MRs) on clinical health during the 1-month preweaning period., Materials and Methods: Eighteen female calves were randomly assigned to either a group receiving the HK-LS HS-1 supplement (n = 9) or a control group without it (n = 9). We then investigated the effect of including supplementary HK-LS HS-1; 0.2% in MRs twice daily at 09:00 and 16:00 on the health, serum biochemical parameters (measured using an automated biochemical analyzer), and fecal bacteriological changes of preweaning Japanese Black calves at the day of the start of supplementation (before HK-LS HS-1 supplementation; day 0), at weaning (day 30), and at 2 weeks (day 45) and 4 weeks (day 60) after weaning., Results: During the supplementation period (0-30 days), (1) an increase (p = 0.023) was observed in albumin, and there was a tendency of increase in total cholesterol level in the HK-LS HS-1 group but not in the control group; (2) substantial differences were obtained after the weaning period (30-60 days), although no differences were observed from 0-30 days in both groups. The anti-Müllerian hormone (AMH) level was substantially increased after weaning in the control group. No differences were observed in the amounts of Coliform spp. and Staphylococcaceae spp. between the two groups; thus, HK-LS HS-1 supplementation had similar antibacterial effects. A significant reduction was observed in the time to weaning of the HK-LS HS-1 group in the field trial., Conclusion: Supplementation with HK-LS HS-1 from an early stage after birth to weaning is a cost-effective treatment to improve the growth rate of preweaning calves. However, supplementation during only preweaning periods appears to have no beneficial effects on preventing weaning stress, especially in terms of AMH levels., Competing Interests: The authors declare that they have no competing interests. No person from Daiwa Pharmaceutical Co., Ltd. was involved at any stage of the study., (Copyright: © Sasazaki, et al.)

While economic inequality continues to rise within countries, efforts to address it have been largely ineffective, particularly those involving behavioral approaches. It is often implied but not tested that choice patterns among low-income individuals may be a factor impeding behavioral interventions aimed at improving upward economic mobility. To test this, we assessed rates of ten cognitive biases across nearly 5000 participants from 27 countries. Our analyses were primarily focused on 1458 individuals that were either low-income adults or individuals who grew up in disadvantaged households but had above-average financial well-being as adults, known as positive deviants. Using discrete and complex models, we find evidence of no differences within or between groups or countries. We therefore conclude that choices impeded by cognitive biases alone cannot explain why some individuals do not experience upward economic mobility. Policies must combine both behavioral and structural interventions to improve financial well-being across populations., (© 2023. The Author(s).)

Significance: Quantification of elastic fiber in the tissue specimen is an important aspect of diagnosing different diseases. Though hematoxylin and eosin (H&E) staining is a routinely used and less expensive tissue staining technique, elastic and collagen fibers cannot be differentiated using it. So, in conventional pathology, special staining technique, such as Verhoeff's van Gieson (EVG), is applied physically for this purpose. However, the procedure of EVG staining is very expensive and time-consuming., Aim: The goal of our study is to propose a deep-learning-based computerized method for the generation of RGB EVG stained tissue from hyperspectral H&E stained one to save the time and cost of conventional EVG staining procedure., Approach: H&E stained hyperspectral image and EVG stained RGB whole slide image of human pancreatic tissue have been leveraged for this experiment. CycleGAN-based deep learning model has been proposed for digital stain conversion while images from source and target domains are of different modalities (hyperspectral and RGB) with different channel dimensions. A set of three basis functions have been introduced for calculating one of the losses of the proposed method, which retains the relevant features of EVG stained image within the reduced channel dimension of the H&E stained one., Results: The experimental results showed that a set of three basis functions including linear discriminant function and transmittance spectrum of eosin and hematoxylin better retained the essential properties of the elastic fiber to be discriminated from collagen fiber within the reduced dimension of the hyperspectral H&E stained image. Also, only a smaller number of paired training data with our proposed training method contributed significantly to the generation of more realistic EVG stained image with more precise identification of elastic fiber., Conclusions: RGB EVG stained image is generated from hyperspectral H&E stained image for which our model has performed two types of image conversion simultaneously: hyperspectral to RGB and H&E to EVG. The experimental results show that the intentionally designed set of three basis functions contains more relevant information and prove the effectiveness of our proposed method in generating realistic RGB EVG stained image from hyperspectral H&E stained one., (© 2023 The Authors.)

Background: Hyperspectral imaging (HSI) is an emerging modality for the gross pathology of the skin. Spectral signatures of HSI could discriminate malignant from benign tissue. Because of inherent redundancies in HSI and in order to facilitate the use of deep-learning models, dimension reduction is a common preprocessing step. The effects of dimension reduction choice, training scope, and number of retained dimensions have not been evaluated on skin HSI for segmentation tasks., Materials and Methods: An in-house dataset of HSI signatures from pigmented skin lesions was prepared and labeled with histology. Eleven different dimension reduction methods were used as preprocessing for tumor margin detection with support vector machines. Cluster-wise principal component analysis (ClusterPCA), a new variant of PCA, was proposed. The scope of application for dimension reduction was also investigated., Results: The components produced by ClusterPCA show good agreement with the expected optical properties of skin chromophores. Random forest importance performed best during classification. However, all methods suffered from low sensitivity and generalization., Conclusion: Investigation of more complex reduction and segmentation schemes with emphasis on the nature of HSI and optical properties of the skin is necessary. Insights on dimension reduction for skin tissue could facilitate the development of HSI-based systems for cancer margin detection at gross level., (© 2022 The Authors. Skin Research and Technology published by John Wiley & Sons Ltd.)

Significance: Malignant skin tumors, which include melanoma and nonmelanoma skin cancers, are the most prevalent type of malignant tumor. Gross pathology of pigmented skin lesions (PSL) remains manual, time-consuming, and heavily dependent on the expertise of the medical personnel. Hyperspectral imaging (HSI) can assist in the detection of tumors and evaluate the status of tumor margins by their spectral signatures., Aim: Tumor segmentation of medical HSI data is a research field. The goal of this study is to propose a framework for HSI-based tumor segmentation of PSL., Approach: An HSI dataset of 28 PSL was prepared. Two frameworks for data preprocessing and tumor segmentation were proposed. Models based on machine learning and deep learning were used at the core of each framework., Results: Cross-validation performance showed that pixel-wise processing achieves higher segmentation performance, in terms of the Jaccard coefficient. Simultaneous use of spatio-spectral features produced more comprehensive tumor masks. A three-dimensional Xception-based network achieved performance similar to state-of-the-art networks while allowing for more detailed detection of the tumor border., Conclusions: Good performance was achieved for melanocytic lesions, but margins were difficult to detect in some cases of basal cell carcinoma. The frameworks proposed in this study could be further improved for robustness against different pathologies and detailed delineation of tissue margins to facilitate computer-assisted diagnosis during gross pathology.

Significance: Skin cancer is one of the most prevalent cancers worldwide. In the advent of medical digitization and telepathology, hyper/multispectral imaging (HMSI) allows for noninvasive, nonionizing tissue evaluation at a macroscopic level., Aim: We aim to summarize proposed frameworks and recent trends in HMSI-based classification and segmentation of gross-level skin tissue., Approach: A systematic review was performed, targeting HMSI-based systems for the classification and segmentation of skin lesions during gross pathology, including melanoma, pigmented lesions, and bruises. The review adhered to the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. For eligible reports published from 2010 to 2020, trends in HMSI acquisition, preprocessing, and analysis were identified., Results: HMSI-based frameworks for skin tissue classification and segmentation vary greatly. Most reports implemented simple image processing or machine learning, due to small training datasets. Methodologies were evaluated on heavily curated datasets, with the majority targeting melanoma detection. The choice of preprocessing scheme influenced the performance of the system. Some form of dimension reduction is commonly applied to avoid redundancies that are inherent in HMSI systems., Conclusions: To use HMSI for tumor margin detection in practice, the focus of system evaluation should shift toward the explainability and robustness of the decision-making process.

Background: Changes in γ-aminobutyric acid (GABA) function are noted in patients with Parkinson's disease (PD) who have some non-motor impairments. However, dopamine-related GABA function and GABA-related cognitive changes are still unclear., Methods: Thirteen drug-naive early-stage PD patients underwent a series of PET scans with [ 11 C]flumazenil(FMZ) and [ 11 C]CFT. The [ 11 C]FMZ binding potential (BP ND ) derived from a Logan plot analysis was compared between PD patients and age-matched controls. The [ 11 C]CFT radioactivity relative to the cerebellar counterpart was estimated as a semiquantitative value [ 11 C]CFT SUVR. Correlations between [ 11 C]FMZ BP ND and [ 11 C]CFT SUVR in the same region of interest were also examined., Results: In patients in the PD group, [ 11 C]CFT SUVR was significantly lower in the putamen. The levels of [ 11 C]FMZ BP ND in the cerebral cortex (frontal lobe dominancy) and the affected-side putamen were also reduced. In addition, [ 11 C]CFT SUVR was negatively correlated with the [ 11 C]FMZ BP ND level in the affected-side putamen. In patients in the PD group, the total frontal assessment battery (FAB) score was positively correlated with the [ 11 C]FMZ BP ND in the frontal region., Conclusion: GABAergic dysfunction coexists with dopaminergic loss not only in the putamen but also over the extrastriatal region in patients with early PD and is related to frontal dysfunction. The negative correlation of [ 11 C]CFT SUVR with [ 11 C]FMZ BP ND in the affected putamen suggests that a greater dopaminergic demise would decelerate GABA release (or an increase in tracer binding), resulting in persistent failure of the GABAergic system in PD patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Takashima, Terada, Bunai, Matsudaira, Obi and Ouchi.)

Ceftiofur, a third-generation cephalosporin antimicrobial, was used in Japanese hatcheries for many years before 2012. We continue to study Salmonella in broilers and their antimicrobial resistance. The current study aimed to express how the cessation of ceftiofur affects the antimicrobial resistance of Salmonella isolated from broiler chickens in Kagoshima Prefecture, Japan in 2017 and 2018. A total of 274 Salmonella isolates were recovered from 1535 cecal content samples obtained from 96 broiler flocks over years 2017 and 2018. Among the S. enterica isolates, the predominant serovars were S. Manhattan (128/274, 46.7%), S. Schwarzengrund (120/274, 43.8%), and S. Infantis (26/274, 9.5%). The isolates showed a high proportion of antimicrobial resistance for oxytetracycline, sulfamethoxazole, and streptomycin. However, the β-lactam resistance rates were significantly decreased ( p  < 0.01) in 2017, while no β -lactam resistant isolates detected in 2018. The highlight of this study was the complete disappearance of β -lactam resistance in Salmonella isolates from broiler chicken in Kagoshima, Japan., Competing Interests: The authors declare that this research was conducted in the absence of any commercial or financial relationship that could be construed as a potential conflict of interest., (© 2022 The Author(s).)

This study aimed to analyze the incidence of Campylobacter in a small-scale chicken meat processing plant producing "chicken-sashimi", and determine the effectiveness of surface burning as a treatment during processing. The most probable number (MPN) method was used to analyze the load of Campylobacter in 48 samples from four different processing steps (de-feathering, chilling, surface burning, and final-products; 12 samples each). We found the highest load of isolated bacteria in chicken skin after de-feathering. Campylobacter was not detected after the surface burning step despite a large load of bacteria present in the cecum content. Campylobacter was absent in the final products. Adequate surface burning can avoid Campylobacter contamination of chicken sashimi in the processing plant by applying the external stripping method.

Background/aims: The behavioral and psychological symptoms of dementia (BPSD) detract from the quality of life of not only dementia patients but also their family members and caregivers. Donepezil is used to treat Alzheimer's disease and is metabolized via cytochrome P450 (CYP) 2D6 and CYP3A4/5. It is controversial whether donepezil improves or exacerbates BPSD. This study investigated the relationships among BPSD, the pharmacokinetics of donepezil including its metabolite, 6-O-desmethyl donepezil, genetic polymorphisms of CYPs and P-glycoprotein, and patient backgrounds in 52 patients with Alzheimer's disease., Methods: BPSD were assessed using the Neuropsychiatric Inventory (NPI), with scores ≥20 points defined as severe BPSD. Plasma donepezil and 6-O-desmethyl donepezil concentrations were measured using liquid chromatography-tandem mass spectrometry., Results: Although significant relationships between NPI scores and plasma donepezil concentrations were not seen, none of the 15 patients (29%) with high plasma donepezil concentrations (≥60 ng/mL) developed severe BPSD. Polymorphisms of CYP2D6 , CYP3A5 , and ABCB1 did not influence NPI scores. There were no significant relationships between NPI and patient background factors such as dosing regimen, concomitant use of other drugs, or laboratory test results. Two patients who underwent multiple blood samplings over 2 years showed an inverse correlation between plasma donepezil concentrations and NPI scores., Discussion/conclusions: These results indicate that higher plasma concentrations of donepezil contribute to preventing or alleviating rather than developing or deteriorating BPSD., Competing Interests: The authors declare that there are no competing interests for this work., (Copyright © 2021 by The Author(s). Published by S. Karger AG, Basel.)

Cats are an important host of Toxoplasma gondii from an epidemiological perspective because they are the only definitive hosts that excrete oocysts in their feces. In this study, 201 free-ranging cats in Okinawa were examined for T. gondii infection. Using the latex agglutination test, we detected antibodies against T. gondii in 26.9% (54/201) of the cats. Oocysts of T. gondii were not detected upon microscopic examination of the feces of 128 cats. T. gondii was isolated from the tissues of 9 out of 24 seropositive or pseudo-seropositive cats with a bioassay using laboratory mice. Genotyping for the GRA6 gene revealed that five and four of the isolates were type I and II, respectively.

Background: Mitochondrial electron transport chain abnormalities have been reported in postmortem pathological specimens of Alzheimer's disease (AD). However, it remains unclear how amyloid and tau are associated with mitochondrial dysfunction in vivo. The purpose of this study is to assess the local relationships between mitochondrial dysfunction and AD pathophysiology in mild AD using the novel mitochondrial complex I PET imaging agent [ 18 F]BCPP-EF., Methods: Thirty-two amyloid and tau positive mild stage AD dementia patients (mean age ± SD: 71.1 ± 8.3 years) underwent a series of PET measurements with [ 18 F]BCPP-EF mitochondrial function, [ 11 C]PBB3 for tau deposition, and [ 11 C] PiB for amyloid deposition. Age-matched normal control subjects were also recruited. Inter and intrasubject comparisons of levels of mitochondrial complex I activity, amyloid and tau deposition were performed., Results: The [ 18 F]BCPP-EF uptake was significantly lower in the medial temporal area, highlighting the importance of the mitochondrial involvement in AD pathology. [ 11 C]PBB3 uptake was greater in the temporo-parietal regions in AD. Region of interest analysis in the Braak stage I-II region showed significant negative correlation between [ 18 F]BCPP-EF SUVR and [ 11 C]PBB3 BP ND (R = 0.2679, p = 0.04), but not [ 11 C] PiB SUVR., Conclusions: Our results indicated that mitochondrial complex I is closely associated with tau load evaluated by [ 11 C]PBB3, which might suffer in the presence of its off-target binding. The absence of association between mitochondrial complex I dysfunction with amyloid load suggests that mitochondrial dysfunction in the trans-entorhinal and entorhinal region is a reflection of neuronal injury occurring in the brain of mild AD.

From an evolutionary aspect, dolphins share a very close phylogenetic relationship with pigs. Previously, we characterized porcine cerebral artery responsiveness to intrinsic vasoactive substances. Therefore, here, we investigated dolphin (Tursiops truncatus) cerebral artery responsiveness to 5-hydroxytryptamine (5-HT), histamine (His), angiotensin (Ang) II, acetylcholine (ACh), noradrenaline (NA), and bradykinin (BK) to characterize their related receptor subtypes. We also compared dolphin cerebral artery responsiveness with porcine cerebral artery responsiveness. We found that 5-HT and His induced concentration-dependent contraction of the dolphin cerebral artery. Ketanserin (a 5-HT 2 antagonist) and methiothepin (a 5-HT 1 and 5-HT 2 antagonist) shifted the concentration-response curve for 5-HT to the right. Although diphenhydramine (an H 1 antagonist) shifted the concentration-response curve for His to the right, cimetidine (an H 2 antagonist) had no such effect. Ang II and ACh did not produce any vasomotor actions. NA induced concentration-dependent relaxation. Propranolol (a β antagonist) shifted the concentration-response curve for NA to the right, whereas phentolamine (an α antagonist) had no significant effect. BK induced relaxation followed by contraction in pre-contracted arteries with intact endothelium. HOE140 (a B 2 antagonist) shifted the concentration-response curve for BK to the right, whereas des-Arg 9 -[Leu 8 ]-BK (a B 1 antagonist) had no significant effect. These results suggest that 5-HT 1 , 5-HT 2 , and H 1 receptor subtypes are important in arterial contraction and that β and B 2 receptor subtypes modify these contractions to relaxations. The responsiveness of the dolphin cerebral artery is very similar to that of porcine cerebral artery, supporting their evolutionary linkage.

This study investigated the effect of heat-killed Lactobacillus sakei HS-1 (HK-LS HS-1) on the health and fecal bacteriological change of suckling Japanese Black calves as a supplement in milk replacers. Twelve calves were separated from dams to calf-hatch after calving for milk replacers feeding. They were randomly assigned to an HK-LS HS-1 supplement or a control without HK-LS HS-1 group in milk replacers. HK-LS HS-1 was administered from separation day to 3 weeks. Blood and fecal samples were examined. Two calves with a haptoglobin concentration of >500 µg/ml on day 0 were excluded from the experiment, and 10 calves were finally included. Glucose and vitamin A levels on day 7 were significantly higher (P<0.05) in the supplement group than in the control group. No significant differences were observed in haptoglobin or serum amyloid A between the groups. The number of Escherichia coli in feces was lower in the control group than in the supplement group on day 21 (P=0.06). No difference was observed in the number of bifidobacteria, but that of lactic acid bacteria was significantly higher (P<0.05) in the supplement group on day 21. The number of medications administered was significantly lower (P<0.05) in the supplement group (5.2 ± 3.9) than in the control group (10.6 ± 5.9) during the experimental period. The results indicated that HK-LS HS-1 is potentially beneficial for improving intestinal microbes and reducing the number of medical treatments.

Objectives: Currently, patients' consent is essential to use their medical records for various purposes; however, most people give their consent using paper forms and have no control over it. Healthcare organizations also have difficulties in dealing with patient consent. The objective of this research is to develop a system for patients to manage their consent flexibly and for healthcare organizations to obtain patient consent efficiently for a variety of purposes., Methods: We introduce a new e-consent model, which uses a purpose-based access control scheme; it is implemented by a blockchain system using Hyperledger Fabric. All metadata of patient records, consents, and data access are written immutably on the blockchain and shared among participant organizations. We also created a blockchain chaincode that performs business logic managing patient consent., Results: We developed a prototype and checked business logics with the chaincode by validating doctors' data access with purpose-based consent of patients stored in the blockchain. The results demonstrate that our system provides a fine-grained way of handling medical staff 's access requests with diverse intended purposes for accessing data. In addition, patients can create, update, and withdraw their consents in the blockchain., Conclusions: Our consent model is a solution for consent management both for patients and healthcare organizations. Our system, as a blockchain-based solution that provides high reliability and availability with transparency and traceability, is expected to be used not only for patient data sharing in hospitals, but also for data donation for biobank research purposes.

The Izumi Plain in Kagoshima Prefecture, Japan, is a major wintering ground for wild cranes. Between October 2009 and March 2016, a total of 204 Hooded Cranes Grus monacha and White-naped Cranes G. vipio were found dead or in a weak condition in the plane. Of these, 56 cranes had bone fractures. The rate of incidence of fracture was considered to be higher in White-naped than in Hooded Cranes. Tibia fractures were the most common. The leg and wing fracture numbers were almost equal. Forty six percent of the fracture cases were believed to be caused by collisions with the power line.

This study aimed to analyze the Salmonella serovars, measure the minimum inhibitory concentration of antimicrobials, and examine the antimicrobial resistance genes of Salmonella isolated from 192 broiler flocks in Kagoshima Prefecture in Japan, from 2013 to 2016. We found that all Salmonella isolates belonged to three serovars: Salmonella Manhattan, S. Infantis, and S. Schwarzengrund. Among them, S. Schwarzengrund prevalence has recently increased annually making the main serovar. Most recovered isolates were highly resistant to streptomycin, sulfamethoxazole, and oxytetracycline. We saw the reduction of third-generation cephalosporin resistance and identified the reason of increased kanamycin resistance to be the increased number of S. Schwazengrund isolates. Among the kanamycin-resistant Salmonella isolates, aphA1 constituted the main resistance gene detected.

Background: Functional somatic syndrome (FSS) is a disorder characterized by clusters of medically unexplained symptoms. Some women suffer from persistent FSS after human papillomavirus (HPV) vaccination. However, a causal relationship has not been established, and the pathophysiology of FSS remains elusive. Here, we aimed to identify the brain regions showing altered cerebral metabolism and neuroinflammation in patients with FSS and to correlate the measures of positron emission tomography (PET) with clinical data. Twelve women diagnosed with FSS following HPV vaccination (FSS group) underwent both [ 18 F]FDG-PET to measure glucose metabolism and [ 11 C]DPA713-PET to measure neuroinflammation. [ 18 F]FDG standardized uptake value ratio (SUVR) and [ 11 C]DPA713 binding potential (BP ND ) values were compared voxel-wise between the FSS and control groups (n = 12 for [ 18 F]FDG, n = 16 for [ 11 C]DPA713). A region-of-interest (ROI)-based analysis was performed to correlate PET parameters with clinical scores. Statistical significance was set at p < 0.05 corrected for multiple comparisons., Results: Statistical parametric mapping revealed a concomitant significant decrease of [ 18 F]FDG SUVR and increase of [ 11 C]DPA713 BP ND in the regions covering the thalamus, mesial temporal area, and brainstem in the FSS group. Correlation analysis revealed that intelligence and memory scores were significantly positively correlated with [ 18 F]FDG SUVR and negatively so with [ 11 C]DPA713 BP ND in these regions. A direct comparison between [ 18 F]FDG SUVR and [ 11 C]DPA713 BP ND revealed a significant positive correlation in the right hippocampus and amygdala., Conclusions: Cerebral hypometabolism with neuroinflammation occurring in the thalamo-limbic-brainstem region may reflect the pathophysiology of FSS.

Objectives: Electronic Health Record (EHR) systems are increasingly used as an effective method to share patients' records among different hospitals. However, it is still a challenge to access scattered patient data through multiple EHRs. Our goal is to build a system to access patient records easily among EHRs without relying on a centralized supervisory system., Methods: We apply consortium blockchain to compose a distributed system using Hyperledger Fabric incorporating existent EHRs. Peer nodes hold the same ledger on which the address of a patient record in an EHR is written. Individual patients are identified by unique certificates issued by a local certificate authorities that collaborate with each other in a channel of the network. To protect a patient's privacy, we use a proxy re-encryption scheme when the data are transferred. We designed and implemented various chaincodes to handle business logic agreed by member organizations of the network., Results: We developed a prototype system to implement our concept and tested its performance including chaincode logic. The results demonstrated that our system can be used by doctors to find patient's records and verify patient's consent on access to the data. Patients also can seamlessly receive their past records from other hospitals. The access log is stored transparently and immutably in the ledger that is used for auditing purpose., Conclusions: Our system is feasible and flexible with scalability and availability in adapting to existing EHRs for strengthening security and privacy in managing patient records. Our research is expected to provide an effective method to integrate dispersed patient records among medical institutions., Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported., (© 2020 The Korean Society of Medical Informatics.)

The prevalence of antibiotic resistance in 376 Escherichia coli (E. coli) isolates from fecal samples of Hooded and White-naped cranes was investigated on the Izumi plain in Kagoshima prefecture, Japan, during winter 2016 and 2017. Resistance to oxytetracycline, ampicillin, and nalidixic acid were observed in 10.9%, 3.1-4.4%, and 2.1-7.7% of isolates, respectively. Since the previous surveillance in 2007, isolation rates of antibiotic-resistant E. coli recovered from wild cranes have remained at significantly low levels compared with those in Japanese livestock. Our results indicate that surveillance of antibiotic-resistant E. coli from wild cranes wintering in the Izumi plain could be a useful strategy to indicate natural environmental pollution by antibiotic-resistant bacteria in the environment.

Background: This study aimed to examine the prevalence, serovars, and antimicrobial resistance of Salmonella isolates from broiler chickens in Kagoshima, Japan. A total of 192 flocks and 3071 samples were collected from broiler chickens at local farms in Kagoshima, Japan from 2009 to 2012., Result: Among the tested farms, 49.0% of flocks were positive for Salmonella, and 243 isolates were obtained from 3071 cecal samples (7.9%). All the Salmonella isolates were one of three serovars: S. Infantis (57.6%); (140/243), S. Manhattan (40.3%; 98/243 and S. Schwarzengrund (2.1%; 5/243). The proportion of S. Infantis isolates decreased from 66.0% in 2009 to 50.0% in 2011 but increased to 57.6% in 2012, while the proportion of S. Manhattan isolates significantly increased from 26.4 to 50% from 2009 to 2011, and decreased moderately to 40.9% in 2012. Most of the recovered Salmonella isolates were resistant to three antimicrobials, i.e., streptomycin (95.1%), sulfamethoxazole (91.0%) and oxytetracycline (91.4%). In contrast, all Salmonella strains were susceptible to chloramphenicol. Comparison of this study to previous studies of the antimicrobial susceptibility of Salmonella isolates showed that: the percentage of antibiotic-resistance isolates increased dramatically for two antibiotics, ampicillin (from 22.4 to 55.1%) and cefotaxime (from 9.1 to 52.7%). In contrast, the percentage of ofloxacin-resistant isolates decreased across the three survey periods, from 20.8% in 2004-2006 to 1.6% in the present study period (2009-2012). In addition, S. Infantis exhibited a variety of resistance to antimicrobials examined from sensitive to resistance to eight antimicrobials. Multidrug resistance to more than 6 six antimicrobials was detected in 113 (46.5%) of the isolates, and most of them were S. Manhattan., Conclusions: There was a marked change in the serovars and antimicrobial resistance profiles of the Salmonella isolates in this study compared to those in previous studies. The percentage of S. Manhattan isolates increased as did the percentages of ampicillin- and cefotaxime-resistant isolates.

Objectives: Home-based nursing care services have increased over the past decade. However, accountability and privacy issues as well as security concerns become more challenging during care provider visits. Because of the heterogeneous combination of mobile and stationary assistive medical care devices, conventional systems lack architectural consistency, which leads to inherent time delays and inaccuracies in sharing information. The goal of our study is to develop an architecture that meets the competing goals of accountability and privacy and enhances security in distributed home-based care systems., Methods: We realized this by using a context-aware approach to manage access to remote data. Our architecture uses a public certification service for individuals, the Japanese Public Key Infrastructure and Health Informatics-PKI to identify and validate the attributes of medical personnel. Both PKI mechanisms are provided by using separate smart cards issued by the government., Results: Context-awareness enables users to have appropriate data access in home-based nursing environments. Our architecture ensures that healthcare providers perform the needed home care services by accessing patient data online and recording transactions., Conclusions: The proposed method aims to enhance healthcare data access and secure information delivery to preserve user's privacy. We implemented a prototype system and confirmed its feasibility by experimental evaluation. Our research can contribute to reducing patient neglect and wrongful treatment, and thus reduce health insurance costs by ensuring correct insurance claims. Our study can provide a baseline towards building distinctive intelligent treatment options to clinicians and serve as a model for home-based nursing care., Competing Interests: Conflict of Interest: No potential conflict of interest relevant to this article was reported.

We analyzed the gizzards, and grits retained in the gizzards of 41 cranes that migrated to the Izumi Plain during the winter of 2015/2016 and died there, either due to accident or disease. These included 31 Hooded Cranes (Grus monacha) and 10 White-naped Cranes (G. vipio). We determined body weight, gizzard weight, total grit weight and number per gizzard, and size, shape, and surface roundness of the grits. Average gizzard weights were 92.4 g for Hooded Cranes and 97.1 g for White-naped Cranes, and gizzard weight positively correlated with body weight in both species. Average total grit weights per gizzard were 19.7 g in Hooded Cranes and 25.7 g in White-naped Cranes, and were significantly higher in the latter. Average percentages of body weight to grit weight were 0.8% in Hooded Cranes and 0.5% in White-naped Cranes. Average grit number per gizzard was 693.5 in Hooded Cranes and 924.2 in White-naped Cranes, and were significantly higher in the latter. The average grit size was 2.8 mm in both species. No differences were found in the shape and surface roundness of grits between the two species. To the best of our knowledge, this is the first study on the grits retained in the gizzards of Hooded and White-naped Cranes.

Competing Interests: Competing interests: Pramod Puligandla received a one-time honorarium, outside the submitted work, for participation in a meeting regarding the use of inhaled nitric oxide in adults and children hosted by Ikaria Canada Inc. Ian Adatia reports a forthcoming grant award from Malinkcrodt. No other competing interests were declared.

A survey of beak morphological abnormalities was performed on 6,201 chickens (egg-laying hens and chickens for meat production belonging to 25 flocks) brought to a poultry processing plant. The observed abnormalities varied among flocks with occurrence rates ranging from 0.48 to 46.67%. The occurrence was high in flocks subjected to beak trimming and varied significantly according to chicken breed, with the highest rates of abnormalities in a certain chicken breed. The most widely observed abnormalities were: 1) uneven growth of the upper and lower mandibles, mostly with elongation of the lower mandible (accounting for 64.8% of all abnormalities); 2) misalignment of the upper and lower mandibles, causing lateral deviation or crossing (16.3%); 3) sharp or jagged deformities of the mandible tips (10.1%); 4) permanent open beak, a deformity in which the beak did not close completely even when closed (5.8%); and 5) formation of tubercular swellings at the tips of the upper or lower mandibles (3.1%). This is the first report on the occurrence of beak abnormalities in beak-trimmed poultry in Japan.

Objectives: To determine the potential utility of the frontal assessment battery (FAB) in assessing cognitive impairments in amyotrophic lateral sclerosis (ALS), we investigated the association between the FAB score and regional gray matter volume, and ascertained whether the regional brain alterations related to cognitive impairments occur in relatively mild stage of ALS., Materials and Methods: Twenty-four ALS patients with a Mini-Mental State Examination score of >23, a normal score on the Self-Rating Depression Scale, little or no disturbance in speech and handling utensils on the ALS Functional Rating Scale (ALSFRS), and normal measures on respiratory tests (respiratory function test and arterial blood gas analysis), and two age-matched normal control groups (one for FAB assessment and the other for brain morphometry) underwent FAB testing and structural magnetic resonance imaging. We applied voxel-based morphometry to investigate the relationship between the FAB score and regional brain alteration, and assessed the relationship between the altered regional brain volume and ALSFRS or respiratory tests., Results: Frontal assessment battery scores were significantly lower in ALS patients than in normal controls. Volume reduction in the right orbitofrontal gyrus in ALS was correlated with a lower FAB score. There was no correlation between the right orbitofrontal gyrus volume and ALSFRS or respiratory tests., Conclusions: The results suggest that the FAB is an adequate tool for detecting cognitive impairments related to frontal lobe pathology in the relatively mild stage of ALS, independent of physical dysfunctions.