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The impacts of chemotherapy on patients with malignant gastrointestinal obstructions remain unclear, and multicenter evidence is lacking.To evaluate the effectiveness and safety of chemotherapy in patients with unresectable malignant gastrointestinal obstructions.We conducted a multicenter retrospective cohort study that compared the chemotherapy group who received any chemotherapeutics after interventions, including palliative surgery or self-expandable metal stent placement, for unresectable malignant gastrointestinal obstructionIn total, 470 patients in the chemotherapy group and 652 patients in the BSC group were analyzed. During the follow-up period of 54.1 mo, the median overall survival durations were 19.3 mo in the chemotherapy group and 5.4 mo in the BSC group (log-rank test,Chemotherapy after interventions for unresectable malignant gastrointestinal obstruction was associated with increased overall survival and patency duration.

Background: Oesophageal cancer comprises 2 different histological variants: oesophageal squamous-cell carcinoma (ESCC) and adenocarcinoma (EAC). While there are multiple therapeutic options for both types, patients with advanced or metastatic oesophageal cancer still suffer from poor prognosis. Aims: The study aimed to examine the association between the risk of oesophageal cancer and medications and to estimate the chemopreventive effects of commonly used drugs. Methods: A multicentre retrospective cohort study was conducted using data from 9 hospital databases of hospitalized patients between 2014 and 2019. The primary outcomes were ESCC and EAC. The association of oesophageal cancer with drug use and clinical factors was evaluated. Odds ratios (ORs) were adjusted for age, sex, Charlson comorbidity index scores, and smoking with/without gastro-oesophageal reflux disease. Results: The use of proton pump inhibitors (PPIs) (adjusted OR [aOR] 0.48, p < 0.0001), aspirin (aOR 0.32, p < 0.0001), cyclooxygenase-2 inhibitor (COX2I) (aOR 0.70, p = 0.0005), steroid (aOR 0.19, p < 0.0001), statin (aOR 0.43, p < 0.0001), and metformin (aOR 0.42, p < 0.0001) was associated with a lower risk of ESCC than that in non-use. The use of aspirin (aOR 0.33, p = 0.0006) and steroids (aOR 0.54, p = 0.022) was associated with a lower risk of EAC than that in non-use. Conclusion: COX2Is, statins, metformin, and PPIs could help in prevention of ESCC, and aspirin and steroids may be chemopreventive for both types of oesophageal cancer.

We proposed an exponentiation conversion circuit which can change its power exponent to any value to compensate the nonlinearity of electronic devices. The proposed circuit is a small scale circuit utilizing the exponential characteristic in the subthreshold operation of MOSFET. In the proposed circuit, the new exponential conversion circuit converts signal multiplied logarithmically transformed input signal by the power exponent value, thereby obtaining the exponential power raised power function characteristic. The proposed circuit is suitable to integrate on a microcomputer chip used for IoT. The performance of the circuit was evaluated by a prototype IC made by 0.6 μm CMOS process. In measured results, the exponential conversion characteristics as set were obtained, the exponent value was set to 0.50, 1.00 and 2.00. By using the cascode exponential conversion circuit, the signal dynamic range was expanded by 5.2 dB when the exponent value was set to 2.00.

Measurement of the elastic moduli of carbon fiber-reinforced plastics (CFRP) can be difficult owing to the anisotropic and viscoelastic characteristics of CFRP. In this study, a technique based on ...

Background and Aim Although gastric acid suppressants such as proton pump inhibitors (PPIs) and histamine‐2 receptor antagonists (H2RAs) are considered safe, the consequences of hypochlorhydria and hypergastrinemia caused by chronic use are unclear. This study aimed to investigate the association between the chronic use of gastric acid suppressants and high‐risk colorectal polyps, focusing on polyp size. Methods A population‐based, nested case–control study was conducted using data from the Japanese Diagnosis Procedure Combination database between 2014 and 2019. Cumulative PPI or H2RA use prior to polypectomy was evaluated during the study period. Endoscopic polypectomy was categorized as polypectomy 1 year prior to polypectomy. After adjusting for age, gender, and other confounders, a higher prevalence of high‐risk colorectal polyps was noted with PPI (OR: 2.67; 95% confidence interval: 2.37–3.01) and H2RA (OR: 1.86; 95% confidence interval: 1.52–2.26) use. Longer PPI or H2RA use was associated with increased risks of high‐risk colorectal polyps (P for trend, Chronic use of PPIs and H2RAs may be associated with high‐risk colorectal polyps. Requirements for long‐term gastric acid suppressant use should be reevaluated.

Background and Aim Proton pump inhibitors (PPIs) are a potential cause of gastric carcinogenesis after Helicobacter pylori eradication. Thus, appropriate management including chemoprevention is required. The aim of this study was to evaluate the association between nonsteroidal anti‐inflammatory drugs (NSAIDs) and the incidence of post‐eradication gastric cancer in PPI users. Methods A multicenter retrospective cohort study was conducted. Patients who used a PPI (≥30 days) after H. pylori eradication between 2014 and 2019 were analyzed in nine hospital databases. Gastric cancer incidence was a primary outcome, and their association with NSAIDs use and clinical factors was evaluated. Hazard ratios were adjusted by age, sex, smoking, and Charlson Comorbidity Index. Results During the mean follow‐up period of 2.38 years, 1.13% (31/2431) of all patients developed gastric cancer. The cumulative incidence of gastric cancer in PPI users was 0.25% at 1 year, 0.51% at 3 years, and 1.09% at 5 years in the NSAID users and 0.89% at 1 year, 2.32% at 3 years, and 3.61% at 5 years in nonusers. NSAIDs were associated with a lower gastric cancer risk (adjusted hazard ratio = 0.28, P = 0.005). No gastric cancer was observed in the cyclooxygenase‐2 inhibitor users (n = 256). NSAID use with high dose and long duration was significantly associated with a lower incidence of gastric cancer. Conclusion NSAIDs were associated with a 60% decrease in the gastric cancer incidence in H. pylori‐eradicated PPI users, with dose and duration response effects. NSAIDs may be effective for chemoprevention against PPI‐related gastric cancer., Nonsteroidal anti‐inflammatory drugs (NSAIDs) were associated with a 60% decrease in the gastric cancer incidence in Helicobacter pylori‐eradicated proton pump inhibitor (PPI) users, with dose and duration response effects. NSAIDs may be effective for chemoprevention against PPI‐related gastric cancer.

The shear and tensile strengths of carbon fiber-reinforced thermoplastic (CFRTP) laminate joints by ultrasonic welding were investigated by lap shear tests (LSTs) and cross tensile tests (CTTs). The adherends were the cross-ply and the twill woven CFRTP laminates, and the flat energy director (FED) was used to clarify its effectiveness. A modified jig and testing method for CTTs were newly proposed. In each test, the strengths were calculated in two ways: by indicators of “welding efficiency” and “welding quality.” From the experimental results, the strengths of the cross-ply laminate joints were saturated at high welding energy, and the “welding quality” was improved by FED. On the other hand, higher strengths of the twill woven laminate joints were obtained as the welding energy increased, and the effectiveness of FED was confirmed mainly for the “welding efficiency.” The fracture surfaces were then observed to clarify the fracture mechanisms of the joints., ファイル公開：2021-01-01

We investigated the association between early tumor shrinkage (ETS) and treatment outcome in patients with hepatocellular carcinoma treated with lenvatinib (LEN). A retrospective analysis was performed in 104 patients. ETS was defined as tumor shrinkage at the first evaluation in the sum of target lesions&rsquo, longest diameters from baseline according to the Response Evaluation Criteria in Solid Tumors (RECIST). The median overall survival (OS) was not reached, whereas the median progression-free survival (PFS) was 5.0 months. The receiver operating characteristic curve analysis in differentiating long-term responders (PFS &ge, 5.0 months) from short-term responders (PFS &lt, 5.0 months) revealed an ETS cut-off value of 10%. ETS &ge, 10% was significantly correlated with better PFS and OS compared with ETS &lt, 10%. Additionally, ETS &ge, 10% showed a better discrimination ability on prognosis compared with modified RECIST-based objective response at the first evaluation. Multivariate analysis confirmed ETS &ge, 10% as an independent predictor of better OS, as well as a Child&ndash, Pugh score of 5 and macrovascular invasion. In conclusion, ETS &ge, 10% was strongly associated with outcome in patients treated with LEN. This biomarker could allow earlier assessment of the treatment response and guide treatment decision-making for HCC.

In this study, the negative through-the-thickness Poisson’s ratios of [±θ] woven laminates were analyzed based on the homogenization theory for elasto-viscoplastic materials. A [±θ] woven laminate model with the fiber bundle cross angle ±θ was considered and its diamond-shaped domain of analysis was defined. The elasto-viscoplastic homogenization analysis was performed to investigate the negativity of the through-the-thickness Poisson’s ratios for the [±θ] carbon fiber/epoxy and glass fiber/epoxy woven laminates. The through-the-thickness Poisson’s ratio of the [±30°] carbon fiber/epoxy woven laminate was negative in both the elastic and viscoplastic regions. However, that of the [±30°] glass fiber/epoxy woven laminate was positive in the elastic region but became negative in the viscoplastic region. The negative through-the-thickness Poisson’s ratios of the [±30°] woven laminates were caused by the compressive stress with respect to the in-plane direction and the viscoplastic deformation of the matrix., ファイル公開：2020-10-01

In the present paper, the interface fracture toughness between a Ti coating film and Al-alloy substrate is evaluated using a laser spallation method and a boundary element method. The fracture toughness can be estimated using inverse analyses by the boundary element method using a transfer function computed from the history of the displacement of the specimen. In the present study, an alternative boundary element program is developed for unsteady state vibration of an axi-symmetric solid body. The mode I interface fracture toughness between the Ti coating film and Al-alloy substrate is confirmed to be about 0.66 MPam1/2 from the present investigation.

The recent status of Japan's government-driven project to establish carbon fiber reinforced thermoplastic composites (CFRTP) technology for automotive applications conducted in the National Composites Center (NCC) Japan is introduced first. The baseline technology is discontinuous carbon fiber reinforced thermoplastic composites (C-LFT-D: carbon – long fiber thermoplastic-direct) using press compaction. All the components of the target car chassis made of aluminum alloy are replaced by C-LFT-D components and a 10% weight reduction with the same rigidity has been verified. The basic physics of the fiber length distribution mechanism and the experimental procedures to measure fiber length distributions are proposed. A basic theory to predict the flow behavior of extruded raw material of the mixture of melted resin and thermoplastics is proposed, and sophisticated CAE software to predict the flow patterns of the raw material is established. Measured elastic moduli of processed LFT-D plates show strong dependency on local fiber orientations and strong correlations between bending strengths and bending modulus are found. Hence, prediction of fiber orientation in the press compaction is a key point of the design of LFT-D components. The viscoelastic properties of C-LFT-D materials are characterized by using established theories. Certain important parameters, such as the shift factors, are identified by theory and experiments. The basic concepts of joining technology are also established, where ultrasonic fusion bonding is selected as the primary method. Joining procedures are defined and mechanical properties of the joints are evaluated. The essence of the other project conducted in the University of Tokyo for CFRTP applications to automobiles is also introduced. Several new composites are developed and evaluation technologies are developed.

Hepatitis E virus subtype 3f (HEV-3f) strains are usually isolated in Europe and Thailand. Recently, HEV-3f strains were detected from six acute hepatitis E patients in Japan, none of whom had a history of travel to endemic areas. We inferred the origin and transmission route of the six HEV-3f strains. A time-scaled phylogenetic tree of the six strains with reference strains was constructed using a Bayesian statistical inference framework. The time-scaled tree indicated that the six strains independently derived from similar European strains between 2008 and 2014. The pattern suggested recent inflow of multiple HEV-3f strains from Europe to Japan. Japan imports a substantial amount of pork from European countries every year. The emergence of acute hepatitis cases caused by HEV-3f strains in Japan, in patients with no history of travel abroad, might be influenced by the increased opportunities to consume pork products imported from European countries.

In this article, the interlaminar tensile strength between CFRP prepregs with [0°/90°]s lay-up was evaluated with pulse laser spallation method. Transformation functions were applied to obtain the interlaminar stress in the inverse analyses. The pulsed laser spallation test was used to investigate the dynamic interlaminar strength and the static interlaminar strength was determined by the static stud-pull-test. Two different curing conditions (100 °C and 130 °C) were selected to track the curing degree using via interlaminar strength. Additionally, Arai et al. used in one configuration a carbon nanofiller interlayer film between the 0 and the 90 layer to increase the fracture toughness. The location and behaviour of the delamination was determined by fracture images. The results show that the dynamic interlaminar strength of the CFRP laminates was approximately 30 % higher than that of the static ones. The strength of the specimen cured at 100 °C was 20 % lower than that cured at 130 °C.

Background Factors associated with response to lenvatinib have not been clarified in patients with hepatocellular carcinoma (HCC). Patients and methods This study retrospectively analyzed 50 patients treated with lenvatinib as first-line therapy between March 2018 and March 2019. Patients were divided into two groups by the Modified Response Evaluation Criteria in Solid Tumours (mRECIST) (responders and non-responders, whose best overall responses were complete (CR)/partial response (PR) and stable (SD)/progressive disease (PD), respectively). Factors associated with response were assessed, including the relative dose intensity 8 weeks after lenvatinib induction (8W-RDI). Results The best overall responses were 0/22/14/14 of CR/PR/SD/PD. Multivariate analysis revealed that only 8W-RDI was significantly associated with response. The receiver operating characteristic curve for 8W-RDI in differentiating responders from non-responders revealed a cut-off value of 75%. Patients with 8W-RDI ≥75% experienced a higher response rate and longer progression-free survival than patients with 8W-RDI Conclusion Our results suggest that maintaining an RDI ≥75% during the initial 8 weeks of lenvatinib treatment has a favorable impact on response.

The present paper deals with the damping characteristics of symmetrically laminated plates. First, the effect of laminate configuration on the damping characteristics is investigated for cantilevered laminated plates. To examine the effect of laminate configuration, the concept of specific damping capacity is introduced and the damping characteristics are represented on the lamination parameter plane, where the damped stiffness invariants are newly proposed in this paper. Next, the optimal laminate configurations for the cantilevered laminated plates with maximal damping subjected to the constraints on the natural frequencies are determined by using differential evolution in which lamination parameters are used as intermediate design variables. The relation between the laminate configurations and the damping characteristics is discussed based on the concept of lamination parameters.

Improvement of interlaminar mechanical properties in Al/CFRP laminates, fabricated by carbon fiber reinforced plastic (CFRP) prepregs combined with Al alloy sheets, was studied experimentally and numerically. Three toughening methods including acid etching and mechanical patterning for surface treatment of Al alloy sheet, as well as addition of nanofiller (i.e., vapor grown carbon fiber (VGCF)) to the interface of CFRP and Al sheet, were investigated. Experimental results of double cantilever beam tests show the improvement on the interlaminar mechanical properties of Mode-I fracture in terms of much higher critical load PC and fracture toughness GIC. The highest GIC was obtained in the specimens with the combination of acid etching on Al sheet and 10 g/m2 VGCF addition, which was 41 and 6.5 times higher than those of the pristine samples without any treatment and the samples with only acid etching, respectively. Although further mechanical patterning had a positive effect for the case without VGCF addition, the minor effect was observed for the case of VGCF addition because of difficult dispersion of VGCF. Crack propagation and fracture surface were also observed to interpret the improvement mechanism. Moreover, by using the above experimental GIC, finite element analyses were carried out based on cohesive zone model to numerically simulate delamination propagation. The numerically predicted interlaminar tensile strength of Al/CFRP laminates also shows great improvement of interlaminar mechanical properties using the above toughening methods.

Background and aim Hepatitis E virus (HEV) is mainly transmitted orally, either waterborne or zoonotic foodborne. Intestinal viruses such as rotavirus are known to induce type III interferon (IFN) in the gastrointestinal (GI) tract where type III IFN dominantly functions in comparison with type I IFN. Therefore, the aim of this study is to investigate the significance of type III IFN (IFN-λ3) in acute hepatitis E. Methods IFN-λ3 and HEV RNA levels in the sera of patients with acute HEV infection and in the supernatant of HEV-inoculated cells were measured, using an in-house high-sensitivity method and reverse transcription-polymerase chain reaction, respectively. Results High serum IFN-λ3 levels were found in the early phase of acute HEV infection, which normalized after resolution. Interestingly, serum IFN-λ3 levels correlated well with serum HEV RNA titers in the same sera, both of which showed the peak before the robust increase of transaminases. In vitro experiments demonstrated that HEV replicated well in the cells with little IFN-λ3 induction (Caco-2, A549) and recombinant IFN-λ3 inhibited HEV replication in a dose-dependent manner. In contrast, in HT-29 cells, a colon cancer cell line, HEV poorly replicated and induced IFN-λ3 in a titer-dependent manner. Conclusions These clinical and experimental observations suggest that HEV induced IFN-λ3 as a host innate immune response, which may play a protective role against HEV.

Mode-II interlaminar mechanical properties of CFRP/Al(aluminum) laminates were improved by acid treatment to an Al plate and adding vapor-grown carbon fiber (VGCF) between the Al plate and a CFRP layer. The influence of VGCF addition on the Mode-II interlaminar mechanical properties was explored by end-notched flexure tests. The experimental results demonstrated that the critical load and Mode-II fracture toughness of the specimen with acid treatment and 10 g/m2 addition of VGCF increase by 73.66 and 175.76 %, respectively, compared to those of the specimen with acid treatment only. The improvement mechanisms were investigated by the observation of crack propagation path and fracture surface under laser scanning and scanning electron microscopies. Moreover, finite element analyses were undertaken based on the cohesive zone model to verify the experimental fracture toughness and to predict the interfacial shear strength between the Al plate and the CFRP layer.

Non-thermal plasma (NTP) has been introduced over the past several years as a promising method for nitrogen oxide (NOx) removal. The intent, when using NTP, is to selectively transfer input electrical energy to the electrons, and to not expend this in heating the entire gas stream, which generates free radicals through collisions, and promotes the desired chemical changes in the exhaust gases. The generated active species react with the pollutant molecules and decompose them. This paper reviews and summarizes relevant literature regarding various aspects of the application of NTP technology on NOx removal from exhaust gases. A comprehensive description of available scientific literature on NOx removal using NTP technology is presented, including various types of NTP, e.g. dielectric barrier discharge, corona discharge and electron beam. Furthermore, the combination of NTP with catalyst and adsorbent for better NOx removal efficiency is presented in detail. The removal of NOx from both simulated gases and real diesel engines is also considered in this review paper. As NTP is a new technique and is not yet commercialized, there is a need for more studies to be performed in this field.

In the present study the effect of carbon nanofiber interlayers on the fatigue crack propagation of woven fabric CFRP laminates made by VaRTM is investigated. Double cantilever beam (DCB) tests are carried out to determine the mode I static fracture toughness and mode I fatigue crack propagation curve. The experimental results clearly show that the interlaminar fracture toughness and the fatigue crack growth resistance can be substantially improved by the addition of CNF interlayers to the CFRP laminates. In more details, as far as the mode I fatigue crack tests are concerned, thanks to the addition of MWNT-7 interlayers the number of cycles to failure becomes 1.5 or more times greater than that of base laminates. Furthermore, it is found that the fatigue fracture toughness G Imax (the upper limit of the energy release rate in a fatigue test) is increased by about 300%.