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Objective We aimed to examine the association between respiratory severity score (RSS; mean airway pressure × fraction of inspired oxygen) and neurodevelopmental outcomes in extremely preterm infants. Study Design This was a single-center, retrospective cohort study. We analyzed data from extremely preterm infants who were admitted to the neonatal intensive care unit at Okayama Medical Center between 2010 and 2019. Infants without invasive respiratory management during the first day of life were excluded. The exposure variable was the highest RSS during the first day of life. RSS was categorized into two groups: low (<3.5) and high (≥3.5) RSS. The primary outcome was death or neurodevelopmental impairment at age 3 years, defined as cognitive impairment (developmental quotient <70) or the presence of cerebral palsy. Secondary outcomes were the components of the primary outcome. We conducted robust Poisson regression analyses to investigate the association between RSS category and primary and secondary outcomes, adjusting for perinatal confounders. Results The cohort included 97 infants with neurodevelopmental data, of whom 34 and 63 infants were in the low- and high-RSS categories, respectively. The median (interquartile range) gestational age and birth weight were 26.0 (24.7–26.9) and 25.7 (24.6–26.7) weeks and 761 (584–866) and 806 (618–898) g for infants in the low- and high-RSS categories, respectively. Compared with infants in the low-RSS category, those in the high-RSS category had a greater risk of death or neurodevelopmental impairment at age 3 years (26.3 vs. 42.3%; adjusted risk ratio [RR], 2.0; 95% confidence interval [CI], 1.1–3.5) and neurodevelopmental impairment at age 3 years (17.6 vs. 28.6%; adjusted RR, 2.7; 95% CI, 1.3–5.9). Conclusion High RSS (≥3.5) during the first day of life was associated with an increased risk of neurodevelopmental impairment at age 3 years in extremely preterm infants. Key Points RSS is a valuable tool for assessing respiratory failure. RSS = Mean airway pressure × fraction of inspired oxygen. RSS at age 1 day was associated with neurodevelopment. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has impacted the epidemiology of other infectious diseases. In particular, the respiratory syncytial (RS) virus infects almost all children during their first or second year of life. However, during the COVID-19 pandemic, many restrictions were enforced that isolated children from other children. Therefore, we hypothesized that the clinical features of RS virus infection were altered and conducted a study to evaluate these changes. This observational study included children below the age of six years who were admitted to the Tokyo Metropolitan Toshima Hospital. Their clinicodemographic data were extracted from medical records. The 369 children eligible for the study were assigned to three groups: "pre-pandemic" (group 1, n = 253); "during pandemic" (group 2, n = 77), and "post-pandemic" (group 3, n = 39). Logistic regression analysis revealed that compared to group 1, the odds ratio (OR) for oxygen use was significantly higher in groups 2 (OR 1.85. 95% confidence interval [CI] 1.06–3.23; p < 0.05) and 3 (OR 3.36, 95% CI 1.59–7.12; p < 0.01), and the use of mechanical ventilation was significantly higher in group 3 (OR 4.89, 95% CI 1.71–13.94; p < 0.01). This study highlights changes in the clinical features of RS virus infection during and after the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

In this study, we fabricated limiting current‐type oxygen microsensors capable of sensing a wide range of oxygen concentrations. The oxygen microsensors consist of yttria‐stabilized zirconia thin films on spiral Ta2O5 diffusion layers and high‐temperature micro‐hotplates. At temperatures above 575 °C, we observed a clear limiting current that increased proportionally with oxygen concentration between 0.4% and 94%. This wide‐range linearity is attributed to the Knudsen diffusion of the oxygen gas passing through the small gap in the spiral Ta2O5 diffusion layer. © 2023 Institute of Electrical Engineer of Japan and Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

The relationship among advanced airway management (AAM), ventilation, and oxygenation in patients with out-of-hospital cardiac arrest (OHCA) who achieve prehospital return of spontaneous circulation (ROSC) has not been validated. This study was designed to evaluate ventilation and oxygenation for each AAM technique (supraglottic devices [SGA] or endotracheal intubation [ETI]) using arterial blood gas (ABG) results immediately after hospital arrival. This observational cohort study, using data from the Japanese Association for Acute Medicine OHCA Registry, included patients with OHCA with prehospital and hospital arrival ROSC between July 1, 2014, and December 31, 2019. The primary outcomes were the partial pressure of carbon dioxide in the arterial blood (PaCO2) and partial pressure of oxygen in the arterial blood (PaO2) in the initial ABG at the hospital for each AAM technique (SGA or ETI) performed by paramedics. The secondary outcome was favorable neurological outcome (cerebral performance category [CPC] 1 or 2) for specific PaCO2 levels, which were defined as good ventilation (PaCO2 ≤45 mmHg) and insufficient ventilation (PaCO2 >45 mmHg). This study included 1,527 patients. Regarding AAM, 1,114 and 413 patients were ventilated using SGA and ETI, respectively. The median PaCO2 and PaO2 levels were 74.50 mmHg and 151.35 mmHg in the SGA group, while 66.30 mmHg and 173.50 mmHg in the ETI group. PaCO2 was significantly lower in the ETI group than in the SGA group (12.55 mmHg; 95% CI 15.27 to 8.20, P-value < 0.001), while no significant difference was found in PaO2 by multivariate linear regression analysis. After stabilizing inverse probability of weighting (IPW), the adjusted odds ratio for favorable neurological outcome at 1 month was significant in the good ventilation group compared to the insufficient ventilation cohort (adjusted odds ratio = 2.12, 95%CI: 1.40 to 3.19, P value < 0.001). The study showed that in OHCA patients with prehospital ROSC, the PaCO2 levels in the initial ABG were lower in the group with AAM by ETI than in the SGA group. Furthermore, patients with prehospital ROSC and PaCO2 ≤45 mmHg on arrival had an increased odds of favorable neurological outcome after stabilized IPW adjustment. [ABSTRACT FROM AUTHOR]

Background: Patients receiving long-term oxygen therapy are in a state of progressive respiratory dysfunction and have high mortality. However, the predictors of mortality in these patients have not yet been established. Objectives: This prospective observational study aimed to identify the predictors of two-year mortality in patients receiving long-term oxygen therapy. Design, Setting/Subjects: This two-year prospective observational study included 96 patients who received long-term oxygen therapy in the outpatient department of the National Hospital Organization Nishiniigata Chuo Hospital in Japan. Measurements: The updated Charlson Comorbidity Index, body mass index, handgrip strength, modified British Medical Research Council scale (mMRC), Barthel Index (BI), and Montreal Cognitive Assessment (MoCA) were collected in 2019 as a baseline. Outcome was defined as mortality due to chronic respiratory disease during the two-year follow-up period, and predictors were estimated using age- and sex-adjusted Cox proportional hazards model. Results: The 83 patients that were followed up, 30 (36%) died. The Cox proportional hazards model estimated handgrip strength (adjusted hazard ratio [HR]: 0.89; 95% confidence interval [CI]: 0.84–0.94; p < 0.01; Wald: 14.38.), mMRC (adjusted HR: 1.96; 95% CI: 1.36–2.83; p < 0.01; Wald: 13.16.), BI (adjusted HR: 0.95; 95% CI: 0.93–0.98; p < 0.01; Wald: 17.07.), and MoCA (adjusted HR: 2.17; 95% CI: 1.31–3.59; p < 0.01; Wald: 9.06) as predictors. Conclusions: This study indicated that handgrip strength, dyspnea, activities of daily living, and cognitive function were predictors of two-year mortality in patients receiving long-term oxygen therapy. [ABSTRACT FROM AUTHOR]

Background: Sensitive gag reflexes prevent dental patients from receiving appropriate treatment. Aromatherapy helps patients relax during dental procedures. However, the effect of aromatherapy on the gag reflex caused by the stimulation of the oral cavity is unknown. This study aimed to evaluate whether aromatherapy reduces gag reflexes during oral stimulation. Methods: In this randomized, placebo-controlled, single-blind, crossover study, the gag reflexes of 24 healthy individuals (12 females and 12 males; mean age: 34.3 ± 9.5 years) were quantified. A standard saliva ejector was slowly guided down the participant's throat to determine the maximum tolerance of the gag reflex, and the insertion distance was measured to quantify the gag reflex. All individuals participated in an aromatherapy session with peppermint essential oil and a placebo session with distilled water. The gag reflex was quantified before (baseline) and after each session. Another measurement was performed using nitrous oxide/oxygen inhalation as a positive control. Results: Gag reflex values significantly increased after aromatherapy with both peppermint essential oil and placebo compared to baseline values (paired t-test, P < 0.001 and P = 0.014, respectively). The gag reflex value also increased significantly during nitrous oxide/oxygen inhalation (paired t-test, P < 0.001). There was no significant difference in the increase rate of gag reflex values between the positive control and aromatherapy interventions, but it was significantly lower after the placebo intervention (repeated measures analysis of variance, P = 0.003; post-hoc test, P = 0.83 and P = 0.02). Conclusion: Aromatherapy with peppermint essential oil has the potential for reducing gag reflex during dental procedures. Trial registration: The study was registered in the University hospital Medical Information Network Clinical Trials Registry under the code UMIN000050616 (approved 17/03/2023). [ABSTRACT FROM AUTHOR]

Strandings of striped dolphins (SD) and short-finned pilot whales (PW) in Hokkaido, northern Japan, are rare but have recently increased, probably due to global warming. We quantified δ13C, δ15N, and δ18O in muscles of SD (n = 7) and PW (n = 3) stranded in Hokkaido and compared these values with those in muscles (red meat products) of hunted SD and PW in three areas of central and southern Japan. δ18O in stranded SD, except for the calf, decreased with increasing body length (BL), whereas δ13C increased, with no BL-related changes in δ15N. The variability of δ18O (range of maximum and minimum) was larger in the stranded SD (7.5 ‰) than of the hunted SD in three areas (0.9, 1.9, and 1.4 ‰), whereas that of δ15N was smaller in the stranded SD than in the hunted SD. Similarly, the variability of δ18O was larger in the stranded PW in Hokkaido (3.3 ‰) than in the hunted PW in central Japan (1.4 ‰). The larger variability of δ18O and smaller variability of δ15N in stranded SD imply long-term sojourning in coastal waters and feeding on small amounts of limited prey species at low trophic levels before death. [ABSTRACT FROM AUTHOR]

The Hishikari low-sulfidation epithermal gold (Au) deposit in Kyushu, Japan, is world-famous for its premium ore. It has been hypothesized that magmatic contributions to the hydrothermal fluid during early stages of mineralization is possible, even if the hydrothermal fluids for many Au occurrences near the Hishikari deposit are of meteoric origin and are influenced by basement sedimentary rocks. The purpose of this study is to obtain constraints on the genesis and evolution of hydrothermal fluids in the formation of the high-grade Hishikari Au deposit by carbon and oxygen isotope ratios of calcite-bearing samples. Since the microanalysis of carbon and oxygen isotope ratios in every 12 μm of the calcite-bearing sample along the growth direction (corresponding to 10 years of the Hishikari mineralization) scatter in a particular range, the fluid evolution might not be a gradual change from a magmatic to a meteoric origin. Alternatively, a rapid turnover of two fluids might be happening locally. The average sulfur isotope ratio of hydrothermal pyrite is similar to that of the adjacent magma. However, according to the secondary ion mass spectrometry (SIMS) microanalysis, local pyrite with extremely low sulfur isotope ratios may interact with basement sedimentary rocks. Unlike other epithermal Au deposits in the vicinity, rapid local mixing of the magmatic-origin deep fluid and meteoric-origin fluid reacted with organic matter containing basement sedimentary rocks might cause gold precipitation at the Hishikari deposit. [ABSTRACT FROM AUTHOR]

Background: Bronchopulmonary dysplasia (BPD) has a lasting effect on the respiratory function of infants, imposing chronic health burdens. BPD is influenced by various prenatal, postnatal, and genetic factors. This study explored the connection between BPD and home oxygen therapy (HOT), and then we examined the association between HOT and a specific single-nucleotide polymorphism (SNP) in the hyaluronan and proteoglycan link protein 1 ( HAPLN1 ) gene among premature Japanese infants., Materials and Methods: Prenatal and postnatal data from 212 premature infants were collected and analyzed by four SNPs (rs975563, rs10942332, rs179851, and rs4703570) around HAPLN1 using the TaqMan polymerase chain reaction method. The clinical characteristics and genotype frequencies of HAPLN1 were assessed and compared between HOT and non-HOT groups., Results: Individuals with AA/AC genotypes in the rs4703570 SNP exhibited significantly higher HOT rates at discharge than those with CC homozygotes (odds ratio, 1.20, 95% confidence interval, 1.07-1.35, p  = .038). A logistic regression analysis determined that CC homozygotes in the rs4703570 SNP did not show a statistically significant independent association with HOT at discharge., Conclusions: Although our study did not reveal a correlation between HAPLN1 and the onset of BPD, we observed that individuals with CC homozygosity at the rs4703570 SNP exhibit a reduced risk of HOT.

Objectives: We aimed to evaluate the impact of hypertensive disorders of pregnancy (HDP) on short- and medium-term respiratory outcomes in extremely and very preterm infants using the Neonatal Research Network of Japan database.Study Design: This was a population-based retrospective study of preterm infants weighing ≤ 1500 g born between 22 and 31 weeks of gestation between 2003 and 2017. After 1:1 stratification matching by four factors (maternal age, gestational age, parity, and year of delivery), a total of 5137 infants in each group (HDP and non-HDP groups) were selected.Main Outcome Measures: The association between HDP and various respiratory outcomes was evaluated using univariate and multivariate logistic regression analyses.Results: In the multivariate analyses, HDP was associated with higher odds for respiratory distress syndrome (RDS) (odds ratio 1.83, 95% confidence interval [1.65-2.03]), but reduced odds of persistent pulmonary hypertension of the newborn (PPHN) (0.34 [0.26-0.46]) and inhaled nitric oxide use (0.43 [0.33-0.55]). Although HDP was associated with an increased risk of chronic lung disease (CLD) in the univariate analysis, this association was not significant after adjustment for covariates (0.94 [0.83-1.07]). No significant association was found between HDP and home oxygen therapy (HOT) and medium-term oxygen use.Conclusion: The impact of maternal HDP largely differed depending on respiratory disorders and respiratory support. HDP was associated with higher odds of RDS but reduced odds of PPHN. The risks for CLD, HOT, and medium-term respiratory outcomes in the HDP group were comparable to those in the non-HDP group. [ABSTRACT FROM AUTHOR]

Aim: Temporal changes in cerebral regional oxygen saturation (crSO2) are useful for predicting return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA) patients. However, little is known regarding the usefulness of peripheral regional oxygen saturation (prSO2) associated with OHCA patient outcomes. This study evaluated the association between temporal changes in prSO2 and ROSC in patients with OHCA.Methods: This was a prospective study at two tertiary emergency centres in Japan. We evaluated the relationship between ROSC and temporal changes in crSO2 and prSO2. The rSO2 sensor was attached to the patient's forehead and upper arm, and rSO2 was continuously measured until resuscitative efforts were terminated or until the patient with sustained ROSC (>20 min) arrived at the emergency department.Results: We included 145 patients with OHCA, of whom 35 achieved ROSC. Witness status (odds ratio [95% confidence interval]: 11.6 [3.13-58.1]) and ΔprSO2 (1.13 [1.06-1.24]) were significantly associated with ROSC in multiple logistic analysis. In the ROSC group, ΔprSO2 increased earlier than ΔcrSO2 during cardiopulmonary resuscitation. In the non-ROSC group, there was no significant difference between ΔcrSO2 and ΔprSO2, and neither increased before termination of resuscitation (TOR).Conclusion: We demonstrated for the first time that prSO2 is associated with ROSC in OHCA patients and showed that temporal changes in prSO2 could predict ROSC earlier than those in crSO2. Our findings could provide time to prepare early interventions after ROSC and assist in determining the TOR for OHCA patients in Japan. Further studies are needed to validate these findings. [ABSTRACT FROM AUTHOR]

Japan is facing the threat of medical system collapse due to the rapid spread of coronavirus disease 2019 (COVID-19). The present scoring system may help assess disease severity and oxygen supply requirements in COVID-19 patients. Data on patient characteristics at baseline and throughout hospitalization for COVID-19 were extracted from medical records. Disease severity was dichotomized into two categories without or with oxygen supply as asymptomatic, mild, and moderate illness (AMMI), and severe and critical illness (CSI). The AMMI and CSI groups were compared. Predictors of disease severity, previously identified in the outpatient setting, were included in multivariable logistic regression analysis; the obtained coefficients were converted to integers and assigned a score. A total of 206 patients diagnosed with COVID-19 were included in this study. Correlation between COVID-19 severity and medical information was examined by comparing AMMI and CSI. Age, hemodialysis, and C-reactive protein (CRP) levels were candidate predictors of the need for oxygen supply in patients with COVID-19. Coefficients associated with age, hemodialysis, and CRP were as follows: 1 × age (in years, coded as 0 for values of <50, and as 1 for values of ≥50) + 1 × hemodialysis (coded as 0 for "no", and as 1 for "yes") + 1 × CRP (in mg/dL, coded as 0 for values of <1.0, and as 1 for values of ≥1.0). Patients with scores of ≥2 points required oxygen supply (sensitivity, 68.4%; specificity, 79.0%) The present model can help predict disease severity and oxygen requirements in COVID-19 patients in Japan. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the real-world safety and effectiveness of inhaled nitric oxide (INOflo ® for Inhalation 800 ppm) for perioperative pulmonary hypertension associated with cardiac surgery in Japan., Methods: This was a prospective, non-interventional, all-case, post-marketing study of pediatric and adult patients who received perioperative INOflo with cardiac surgery from November 2015-December 2020. Safety and effectiveness were monitored from INOflo initiation to 48 h after treatment completion or withdrawal. Safety outcomes included adverse drug reactions, blood methemoglobin concentrations, and inspired nitrogen dioxide concentrations over time. Effectiveness outcomes included changes in central venous pressure among pediatrics, mean pulmonary arterial pressure among adults, and the partial pressure of arterial oxygen/fraction of inspired oxygen ratio (PaO 2 /FiO 2 ) in both populations., Results: The safety analysis population included 2,817 Japanese patients registered from 253 clinical sites (pediatrics, n = 1375; adults, n = 1442). INOflo was generally well tolerated; 15 and 20 adverse drug reactions were reported in 14 pediatrics (1.0%) and 18 adults (1.2%), respectively. No clinically significant elevations in blood methemoglobin and inspired nitrogen dioxide concentrations were observed. INOflo treatment was associated with significant reductions in both central venous pressure among pediatrics and mean pulmonary arterial pressure among adults, and significant improvements in PaO 2 /FiO 2 among pediatrics and adults with PaO 2 /FiO 2  ≤ 200 at baseline., Conclusions: Perioperative INOflo treatment was a safe and effective strategy to improve hemodynamics and oxygenation in patients with pulmonary hypertension during cardiac surgery. These data support the use of INOflo for this indication in Japanese clinical practice., (© 2023. The Author(s).)

Background: This study aimed to investigate the utility of transcutaneous (tc) measurements of partial pressure of oxygen (tcPO2) and carbon dioxide (tcPCO2) monitoring in neonatal intensive care units (NICUs) in Japan. Methods: At the end of 2016,we sent a survey questionnaire on tc monitoring to all 106 NICUs registered with the Japanese Neonatologist Association. The questions included usage, subjects, methods, management, and the practical usefulness of tc monitoring. Results: The questionnaire was returned by 69 NICUs (65.1% of response rate). Seventeen institutions (24.6%) measured both tcPCO2 and tcPO2, and 42 (60.9%) measured tcPCO2 alone. Transcutaneous PCO2 or tcPO2 monitoring was applied for "pre‐viable" infants born at 22–23 weeks' gestational age (18.6% vs 23.5%), and infants of <500 g birthweight (30.5% vs 17.6%). The tcPCO2 and tcPO2 monitoring was started at birth in 49.2% and 70.6% of the newborn infants, respectively. The temperature of the sensor was set at <38°C for tcPCO2 in 54.3% and >42°C for tcPO2 in 58.9% of NICUs. The accuracy for tcPO2 was rated as good in 35.3% or moderate in 64.7%, of institutions but or for tcPCO2 as 1.7% or 93.2%of institutions , respectively. Conclusion: Transcutaneous monitoring was widely, but limitedly, used for preterm infants. The lower temperature of the tcPCO2 sensor compared to that reported in other developed countries might compromise the accuracy but increase the feasibility of tc monitoring in Japan. [ABSTRACT FROM AUTHOR]

BACKGROUND: The effects of high-flow nasal cannula (HFNC) therapy on postoperative atelectasis and duration of oxygen therapy after off-pump coronary artery bypass graft are unknown. The purpose of this study was to compare the effects of HFNC therapy for subjects who underwent off-pump coronary artery bypass graft with the effects of standard oxygen therapy in terms of oxygen requirement and atelectasis. METHODS: This prospective single-blinded randomized, controlled trial included 148 subjects who underwent off-pump coronary artery bypass graft between 2010 and 2015 with HFNC (n = 72) or without HFNC (standard O2, n = 76). The primary end point was the percentage difference in loss of lung volume between subjects with or without HFNC therapy. Secondary end points included the total amount of oxygen administered and duration of oxygen therapy with and without HFNC therapy. RESULTS: There were significant between-group differences in the percentage loss of lung volume (P < .001), total amount of oxygen administered (P < .001), duration of oxygen therapy (P < .001), and the need for postoperative diuretic therapy (P = .037). The amount (ρ = 0.569, P < .001) and duration (ρ = 0.678, P < .001) of oxygen administered were correlated with atelectasis volume. CONCLUSIONS: Using HFNC therapy after off-pump coronary artery bypass graft shortened the duration of oxygen therapy and reduced the percentage loss of lung volume and total amount of oxygen administered when compared with standard oxygen therapy. [ABSTRACT FROM AUTHOR]

Background: The role of oxygen therapy in end-of-life care for patients with advanced cancer is incompletely understood. We aimed to evaluate the association between oxygen use and survival in patients with advanced cancer and low oxygen saturation in home care. Methods: We conducted a retrospective cohort study at a primary care practice in suburban Tokyo. Adult patients in home care with advanced cancer demonstrating first low oxygen saturation (less than 90%) detected in home visits were consecutively included in the study. Cox proportional hazards regression was used to investigate the effect of oxygen use on overall survival and survival at home, adjusted for systolic blood pressure, decreased level of consciousness, dyspnea, oral intake, performance status, and cardiopulmonary comorbidity. Results: Of 433 identified patients with advanced cancer, we enrolled 137 patients (oxygen use, n = 35; no oxygen use, n = 102) who developed low oxygen saturation. In multivariable analysis, the adjusted hazard ratio (HR) of oxygen use was 0.68 (95% confidence interval 0.39–1.17) for death and 0.70 (0.38–1.27) for death at home. In patients with dyspnea, the HR was 0.35 (0.13–0.89) for death and 0.33 (0.11–0.96) for death at home; without dyspnea, it was 1.03 (0.49–2.17) for death and 0.84 (0.36–1.96) for death at home. Conclusions: Oxygen use was not significantly associated with survival in patients with advanced cancer and low oxygen saturation, after adjusting for potential confounders. It may not be necessary to use oxygen for prolongation of survival in such patients, particularly in those without dyspnea. [ABSTRACT FROM AUTHOR]

To elucidate the patterns and characteristics of dissolved oxygen (DO) decline near bottom in shallow polymictic eutrophic lakes, we conducted a statistical analysis of monthly measurements for 12 years at 14 stations and hourly observation for 8 years at two stations in Lakes Kasumigaura and Kitaura. Results indicated that DO decline (hereafter, <2 mg/L) was negligible at stations with a depth of <5 m. Thus, we consider this depth to be critical depth for studying DO decline conditions in these lakes. The collected data revealed that DO decline events lasting more than 2 days occurred a few times a year. During these events, wind blew weakly (usually, <2 m/s), and diurnal stratification was formed by solar radiation. The averaged DO declining rate leading up to these events was 4.3 (±2.7) mg L−1 d−1, suggesting that within a few days, DO can fall into a declined state. The occurrence probability of DO declined events in the respective summer increased significantly with the proportion of weak wind hours (<2 m/s). Significant correlations between wind velocity and DO change rate (1 hr difference in DO) supported the importance of wind on DO changes in polymictic lakes. The influence of mean air temperature on DO decline events was insignificant. [ABSTRACT FROM AUTHOR]

The skarn‐type tungsten deposit of the Date‐Nagai mine is genetically related to the granodiorite batholith of the Iidateyama body. Skarn is developed along the contact between pelitic hornfels and marble that remains as a small roof pendant body directly above the granodiorite batholith. Zonal arrangement of minerals is observed in skarn. The zonation consists of wollastonite, garnet, garnet‐epidote, and vesuvianite‐garnet zones, from marble to hornfels. Sheelite is included in garnet, garnet‐epidote, and vesuvianite‐garnet zones. The oxygen isotope values of skarn minerals were obtained as δ18O = 4.2–7.7‰ for garnet, 5.9–6.9‰ for vesuvianite, −0.3–3.4‰ for scheelite, 6.0–10.9‰ for quartz, and 8.2‰ for muscovite. The temperature of skarn‐formation was calculated from oxygen isotopic values of scheelite‐quartz pairs to be 288°C. Calculated oxygen isotope values of fluid responsible for skarn minerals were 6.1–9.5‰ for garnet, 1.2–4.8‰ for scheelite, −1.3‐3.6‰ for quartz, and 4.5‰ for muscovite. Garnet precipitated from the fluids of different δ18O values from scheelite, quartz, and muscovite. These δ18O values suggest that the origin of fluid responsible for garnet was magmatic water, while evidence for the presence of a meteoric component in the fluids responsible for middle to later stages minerals was confirmed. [ABSTRACT FROM AUTHOR]

Saltpetre constitutes one of the major ingredients of gunpowder, which was a driving force during the political changes in late medieval to early modern times in Japan. Two types of model saltpetre mineralization are studied. One represents efflorescent saltpetre formed as the byproduct of indigo dye manufacture, whereas the second is anthropogenic, derived from relict nitre‐beds. Here, oxygen and nitrogen isotopic analysis, as expressed by δ18O and δ15N notations, is applied. The calculated δ18O values for ambient water, responsible for the microbial‐mediated oxidation of ammonium into oxygen in nitrates, tended to have higher ranges than average local meteoric waters of the relevant regions. An overall trend could be seen, showing the apparent positive nitrogen isotopic fractionation during the microbial transformation from initial organic nitrogen into nitrate product. Dual isotopic analysis for industrial nitrates provides a useful tool for investigation of the provenance of historic gunpowder. Present anthropogenic saltpetre involves positive control over temperature–moisture regimes and oxygen fugacity during formation, the process being distinctive from those prevailed in British India and other European countries. [ABSTRACT FROM AUTHOR]

Background: Pulmonary alveolar proteinosis is a disease characterized by abnormal accumulation of surfactant in the alveoli. Most cases are autoimmune and are associated with an autoantibody against granulocyte-macrophage colony-stimulating factor (GM-CSF) that prevents clearing of pulmonary surfactant by alveolar macrophages. An open-label, phase 2 study showed some therapeutic efficacy of inhaled recombinant human GM-CSF in patients with severe pulmonary alveolar proteinosis; however, the efficacy in patients with mild-to-moderate disease remains unclear.Methods: We conducted a double-blind, placebo-controlled trial of daily inhaled recombinant human GM-CSF (sargramostim), at a dose of 125 μg twice daily for 7 days, every other week for 24 weeks, or placebo in 64 patients with autoimmune pulmonary alveolar proteinosis who had a partial pressure of arterial oxygen (Pao2) while breathing ambient air of less than 70 mm Hg (or <75 mm Hg in symptomatic patients). Patients with severe pulmonary alveolar proteinosis (Pao2 <50 mm Hg) were excluded to avoid possible exacerbation of the disease in patients who were assigned to receive placebo. The primary end point was the change in the alveolar-arterial oxygen gradient between baseline and week 25.Results: The change in the mean (±SD) alveolar-arterial oxygen gradient was significantly better in the GM-CSF group (33 patients) than in the placebo group (30 patients) (mean change from baseline, -4.50±9.03 mm Hg vs. 0.17±10.50 mm Hg; P = 0.02). The change between baseline and week 25 in the density of the lung field on computed tomography was also better in the GM-CSF group (between-group difference, -36.08 Hounsfield units; 95% confidence interval, -61.58 to -6.99, calculated with the use of the Mann-Whitney U test and the Hodges-Lehmann estimate of confidence intervals for pseudo-medians). Serious adverse events developed in 6 patients in the GM-CSF group and in 3 patients in the placebo group.Conclusions: In this randomized, controlled trial, inhaled recombinant human GM-CSF was associated with a modest salutary effect on the laboratory outcome of arterial oxygen tension, and no clinical benefits were noted. (Funded by the Japan Agency for Medical Research and Development and the Ministry of Health, Labor, and Welfare of Japan; PAGE ClinicalTrials.gov number, NCT02835742; Japan Medical Association Center for Clinical Trials number, JMA-IIA00205.). [ABSTRACT FROM AUTHOR]

Examines the effects of head-out-of-water immersion walking exercise on the heart rate and oxygen uptake in the elderly in Japan. Changes in water immersion-induced central redistribution of blood volume; Prevention of musculoskeletal diseases; Therapeutic effects of water activities.

Background: The coronavirus disease 2019 (COVID-19) pandemic has put a strain on the healthcare system, and sudden changes in disease status during home treatment have become a serious issue. Therefore, prediction of disease severity and allocation of sufficient medical resources, including high-flow nasal cannula (HFNC), to patients in need are important. We aimed to determine risk factors for the need of HFNC use in COVID-19., Methods: This was a single-center retrospective observational cohort study including all eligible hospitalized adult patients aged ≥18 years diagnosed with COVID-19 between April 14, 2020 and August 5, 2021 who were treated in the study hospital. The primary outcome is the need for HFNC. Nineteen potential predictive variables, including patient characteristics at hospital admission, were screened using least absolute shrinkage and selection operator and logistic regression to construct a predictive risk score. Accuracy of the risk score was determined using area under the receiver operating characteristic curve., Results: The study cohort included 148 patients. The rate of the need for HFNC was 22.9%. Among the 19 potential variables, percutaneous oxygen saturation (SpO2) <92% (odds ratio [OR] 7.50, 95% confidence interval [CI] 2.806-20.82) and IL-6 (OR 1.021, 95% CI 1.010-1.033) were included in developing the risk score, which was termed interleukin (IL)-6-based COVID-19 severity (IBC-S) score., Conclusions: The IBC-S score, an easy-to-use risk score based on parameters available at the time of hospital admission, predicted the need for HFNC in patients with COVID-19. The IBC-S score based on interleukin-6 and SpO2 might aid in determining patients who should be transported to a tertiary medical institution or an isolation facility., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Kurihara, Sugawara. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The Japanese Society of Hematology performed an observational cross-sectional study to clarify the morbidity, prognosis, and prognostic factors in patients with COVID-19 with hematological diseases (HDs) in Japan. The study included patients with HDs who enrolled in our epidemiological survey and had a COVID-19 diagnosis and a verified outcome of up to 2 months. The primary endpoints were characteristics and short-term prognosis of COVID-19 in patients with HDs. A total of 367 patients from 68 institutes were enrolled over 1 year, and the collected data were analyzed. The median follow-up among survivors was 73 days (range, 1-639 days). The 60-day overall survival (OS) rate was 86.6%. In the multivariate analysis, albumin ≤ 3.3 g/dL and a need for oxygen were independently associated with inferior 60-day OS rates (hazard ratio [HR] 4.026, 95% confidence interval (CI) 1.954-8.294 and HR 14.55, 95% CI 3.378-62.64, respectively), whereas 60-day survival was significantly greater in patients with benign rather than malignant disease (HR 0.095, 95% CI 0.012-0.750). Together, these data suggest that intensive treatment may be necessary for patients with COVID-19 with malignant HDs who have low albumin levels and require oxygen at the time of diagnosis., (© 2024. The Author(s).)

Princess Kaguya is a heroine of a famous folk tale, as every Japanese knows. She was assumed to be confined in a bamboo cavity with cylindrical shape, and then fortuitously discovered by an elderly man in the forest. Here, we pose a question as to how long she could have survived in an enclosed space such as the bamboo chamber, which had no external oxygen supply at all. We demonstrate that the survival time should be determined by three geometric attributes regarding her body and the bamboo chamber. We also emphasize that this geometric problem shed light on an interesting scaling relation between biological quantities for living organisms. [ABSTRACT FROM AUTHOR]

Background: Computed tomography (CT) imaging and artificial intelligence (AI)-based analyses have aided in the diagnosis and prediction of the severity of COVID-19. However, the potential of AI-based CT quantification of pneumonia in assessing patients with COVID-19 has not yet been fully explored. This study aimed to investigate the potential of AI-based CT quantification of COVID-19 pneumonia to predict the critical outcomes and clinical characteristics of patients with residual lung lesions., Methods: This retrospective cohort study included 1,200 hospitalized patients with COVID-19 from four hospitals. The incidence of critical outcomes (requiring the support of high-flow oxygen or invasive mechanical ventilation or death) and complications during hospitalization (bacterial infection, renal failure, heart failure, thromboembolism, and liver dysfunction) was compared between the groups of pneumonia with high/low-percentage lung lesions, based on AI-based CT quantification. Additionally, 198 patients underwent CT scans 3 months after admission to analyze prognostic factors for residual lung lesions., Results: The pneumonia group with a high percentage of lung lesions (N = 400) had a higher incidence of critical outcomes and complications during hospitalization than the low percentage group (N = 800). Multivariable analysis demonstrated that AI-based CT quantification of pneumonia was independently associated with critical outcomes (adjusted odds ratio [aOR] 10.5, 95% confidence interval [CI] 5.59-19.7), as well as with oxygen requirement (aOR 6.35, 95% CI 4.60-8.76), IMV requirement (aOR 7.73, 95% CI 2.52-23.7), and mortality rate (aOR 6.46, 95% CI 1.87-22.3). Among patients with follow-up CT scans (N = 198), the multivariable analysis revealed that the pneumonia group with a high percentage of lung lesions on admission (aOR 4.74, 95% CI 2.36-9.52), older age (aOR 2.53, 95% CI 1.16-5.51), female sex (aOR 2.41, 95% CI 1.13-5.11), and medical history of hypertension (aOR 2.22, 95% CI 1.09-4.50) independently predicted persistent residual lung lesions., Conclusions: AI-based CT quantification of pneumonia provides valuable information beyond qualitative evaluation by physicians, enabling the prediction of critical outcomes and residual lung lesions in patients with COVID-19., (© 2023. BioMed Central Ltd., part of Springer Nature.)

The relationships among eutrophication, anoxia, and microbial distribution were investigated for Nagatsura-Ura Lagoon on the northeastern Pacific coast of Japan. In September 2017, the bottom environment in a small area of the inner part of the lagoon (which has a basin-shaped bottom topology) was eutrophic and anoxic, with high carbon, nitrogen, phosphate, acid-volatile sulfide, and low dissolved oxygen and oxidation-reduction potential. Dissolved oxygen levels improved during the winter. Bacillariophyta (diatoms) were the main organic component according to pigment analysis and next-generation sequencing of nucleic acids in seawater samples. Phylum Proteobacteria was dominant among the bacterial flora in the sediment but the proportions of Class Epsilon-proteobacteria and Chlorobium (a green sulfur-utilizing bacterium) were high in the inner part of the lagoon compared to other stations, and these groups were also present in winter. Apparently groups able to thrive in both anoxic and aerobic conditions were predominant in the inner part of the lagoon., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background The International Liaison Committee on Resuscitation ( ILCOR) published Consensus 2015 in October 2015. Thereafter, the Japanese version of neonatal cardiopulmonary resuscitation programs was revised. Prior to the revision, we re-conducted questionnaire surveys in three types of medical facilities in January 2015. Methods Targeted groups included (i) 277 training hospitals authorized by the Japanese Society of Perinatal/Neonatal Medicine for training of physicians specialized in perinatal care (neonatology) in January 2015 (training hospitals; response rate, 70.8%); (ii) 459 obstetric hospitals/clinics (response rate, 63.6%); and (iii) 453 midwife clinics (response rate, 60.9%). The survey included systems of neonatal resuscitation, medical equipment and practices, and education systems. The results were compared with that of similar surveys conducted in 2005, 2010 and 2013. Results Almost all results were generally improved compared with past surveys. In training hospitals, however, the use of oxygen blenders or manometers was not widespread. Only 35% of institutions used continuous positive airway pressure systems frequently, and expert neonatal resuscitation doctors attended all deliveries in only 6% of training centers. In addition, only 71% of training hospitals had brain therapeutic hypothermia facilities. Not all obstetric hospitals/clinics prepared pulse oximeters, and only a few used manometers frequently. Some midwife clinics did not keep warming equipment, and few midwife clinics were equipped with pulse oximeters. In addition, some midwife clinics did not prepare ventilation bags (masks). Conclusions The equipment in Japanese delivery rooms is variable. Further efforts need to be made in the distribution of neonatal resuscitation devices and the dissemination of techniques. [ABSTRACT FROM AUTHOR]

Hypobaric hypoxic brain injury results in elevated peripheral S100B levels which may relate to blood-brain barrier (BBB) dysfunction. A period of acclimatisation or dexamethasone prevents altitude-related illnesses and this may involve attenuation of BBB compromise. We hypothesised that both treatments would diminish the S100B response (a measure of BBB dysfunction) on re-ascent to the hypobaric hypoxia of high altitude, in comparison to an identical ascent completed 48 h earlier by the same group. Twelve healthy volunteers, six of which were prescribed dexamethasone, ascended Mt Fuji (summit 3700 m) and serial plasma S100B levels measured. The S100B values reduced from a baseline 0.183 µg/l (95 % CI 0.083-0.283) to 0.145 µg/l (95 % CI 0.088-0.202) at high altitude for the dexamethasone group (n = 6) and from 0.147 µg/l (95 % CI 0.022-0.272) to 0.133 µg/l (95 % CI 0.085-0.182) for the non-treated group (n = 6) [not statistically significant (p = 0.43 and p = 0.82) for the treated and non-treated groups respectively]. [These results contrasted with the statistically significant increase during the first ascent, S100B increasing from 0.108 µg/l (95 % CI 0.092-0.125) to 0.216 µg/l (95 % CI 0.165-0.267) at high altitude]. In conclusion, an increase in plasma S100B was not observed in the second ascent and this may relate to the effect of acclimatisation (or hypoxic pre-conditioning) on the BBB. An exercise stimulated elevation of plasma S100B levels was also not observed during the second ascent. The small sample size and wide confidence intervals, however, precludes any statistically significant conclusions and a larger study would be required to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: Autoimmune pulmonary alveolar proteinosis (APAP) and congenital/hereditary PAP were labeled intractable diseases in Japan in 2015. Since then, patients registered in the National Database of Designated Incurable Diseases (NDDID) who met certain requirements became eligible for medical subsidies. Epidemiological studies using recent data are needed for the development of management protocols for patients with PAP., Methods: We conducted the first nationwide study describing the epidemiology and characteristics of PAP using data for patients registered in the Japanese NDDID between 2015 and 2020. We focused on patient demographics, diagnosis, disease severity score (DSS), symptoms, test results, and treatment., Results: We identified 110 patients with PAP, among whom 96.4% had APAP/idiopathic PAP (IPAP). The median age was 58 years, with a slight male predominance. Most patients had a DSS ≥3 (64.5%) and reported symptoms (e.g., dyspnea on exertion). High-resolution computed tomography typically revealed ground glass opacity and crazy paving appearances. Pulmonary function was relatively preserved, except for carbon monoxide diffusing capacity. Only 27.4% of patients underwent therapeutic whole-lung lavage and/or bronchoalveolar lavage, while 25% required long-term oxygen therapy. Serum Krebs von den Lungen-6, surfactant protein D, and lactate dehydrogenase levels significantly and positively correlated with the DSS., Conclusions: Most patients registered in the NDDID have APAP/IPAP with a DSS ≥3, and about one-quarter require long-term oxygen therapy and infrequent lavages. Our results provide important details of the current prevalence and clinical practice related to APAP/IPAP with a DSS ≥3 in Japan., Competing Interests: Conflict of Interest K.M. has no conflict of interest. H.H. has no conflict of interest. Y.I. received honoraria for lecture fees and for serving as a steering committee board member from Boehringer Ingelheim (none of which are related to this manuscript). T. Suzuki. belongs to endowed departments sponsored by Nippon Boehringer Ingelheim Co., Ltd., and AstraZeneca K.K. T. Suda. has no conflict of interest., (Copyright © 2023 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.)

An average O:CO exchange ratio for net turbulent O and CO fluxes in a cool temperate deciduous forest in central Japan was obtained based on an aerodynamic method using continuous measurements of atmospheric O/N ratio and CO concentration. The average daily mean O:CO exchange ratio was 0.86 during summer, 2013, a value significantly lower than the 1.1 used as a globally averaged terrestrial biospheric O:CO exchange ratio in a CO budget analysis. Using the value of 0.86, along with the O:CO exchange ratio of 1.11 for the ecosystem respiration (RE) and 1.00 for the gross primary production (GPP), the net ecosystem production (NEP) measured with an eddy covariance method was separated into GPP and RE using a one-box canopy O/CO budget model. The estimated average daily-mean GPP and RE values were consistent, within estimation errors, with those estimated from an empirical function of air temperature; the RE values were also comparable to the soil CO efflux observed using an open-flow soil chamber method. These results suggest that the simultaneous observation of O and CO concentrations in a forest has potential as a new tool to evaluate the forest CO budget. [ABSTRACT FROM AUTHOR]

Our primary objective was to prospectively evaluate the effects of corticosteroids on dyspnea in terminal cancer patients at Kasugai Municipal Hospital using the Japanese version of the Support Team Assessment Schedule (STAS-J). Our secondary objective was to report the side effects of corticosteroid use in these patients. The prospective investigation included two female patients with terminal breast cancer (Patients 1 and 2, ages 53 and 57 years, respectively) who satisfied the consecutive selection criteria and were hospitalized at Kasugai Municipal Hospital between January 2016 and March 2017. We used both interviews and a review of clinical records to evaluate these patients’ responses to oral or intravenous corticosteroid therapy for dyspnea. Patient 1 had an initial STAS-J dyspnea scale score of 4 before the commencement of corticosteroid administration, which decreased to scores of 2 (day 1) and 1 (day 2 and day 3) after corticosteroid administration. Patient 2 had an initial STAS-J scale score of 3, which decreased to 1 on day 1 and was maintained at this level until death occurred on day 15. Both patients experienced rapid relief of dyspnea (within 24 hours), indicating that corticosteroids may be used to effectively treat early dyspnea experienced by terminal cancer patients. [ABSTRACT FROM PUBLISHER]

Introduction: This study compared the outcomes of dialysis patients who received SARS-CoV-2 vaccine with those who did not use data from the Japanese COVID-19 registry., Methods: A total of 1260 dialysis patients with confirmed positive SARS-CoV-2 infection was included in this study. Patients were divided into two groups: patients who experienced breakthrough infection and those who were unvaccinated. The need of oxygen supplementation and mortality risks were compared using multivariate logistic regression analysis., Results: The mortality rate was 24.2% in unvaccinated patients and 8.6% in breakthrough patients. The odds ratio of need of oxygen supplementation in the breakthrough patients relative to unvaccinated patients was 0.197. The hazard ratio of mortality in the breakthrough patients relative to unvaccinated patients was 0.464., Conclusion: Our prospective observational study showed that SRAS-CoV-2 vaccination in hemodialysis patients is vital for reducing need of oxygen supplementation and mortality risk., (© 2022 International Society for Apheresis and Japanese Society for Apheresis.)

Objective Little is known about the prevalence and characteristics of chronic cluster headache (CCH) in Japan. We therefore characterized the clinical profile of CCH in Japan by surveying patients with CCH who were registered at a Japanese regional headache center. We also reviewed the existing literature for the prevalence and clinical characteristics of CCH reported in various populations. Methods In this single-center retrospective study, we assessed consecutive patients with cluster headache (CH) who visited a regional tertiary headache center between February 2011 and July 2020. They were treated following the Clinical Practice Guideline for Chronic Headache 2013. We compared their demographic characteristics and clinical features according to the CCH onset pattern (primary vs. secondary). Results Of 420 patients with CH, 19 (4.2%) had CCH (9 primary and 10 secondary). The incidence of CCH in Japan is relatively low compared to that in Western countries but is comparable to that in other Asian countries. CCH showed a higher predominance of men than women. Compared to primary CCH, secondary CCH included a higher proportion of current smokers and older patients during clinic visits. Subcutaneous sumatriptan and oxygen inhalation were the most common abortive treatments, and oral prednisolone and verapamil were the most common preventive treatments. Home oxygen therapy was effective in six of seven patients. Only two patients with coexisting migraine received calcitonin gene-related peptide (CGRP)-targeted therapies. Conclusions CCH remains refractory to treatment. Improving treatment outcomes will require maximizing the use of currently available drugs and expanding the use of neuromodulation, nerve block, and CGRP-targeted therapies.

Background Several reports have shown the beneficial effects of early or prophylactic surfactant therapy for preterm infants, who often develop respiratory distress syndrome. No report, however, has addressed which infants should receive surfactant therapy in the delivery room. Therefore, the aim of this study was to assess the validity of identifying infants who need surfactant therapy based on fraction of inspiratory oxygen ( FiO2) requirement in the delivery room. Methods In this observational, retrospective study, FiO2 given in the delivery room, use of surfactant therapy, stable microbubble test ( SMT) results, and changes in FiO2 both before and after surfactant therapy were reviewed in infants born at <33 weeks' gestation. Results Overall, 170 infants were included. Forty infants were given oxygen with FiO2 ≥0.6, and all received surfactant therapy. Of these 40 infants, FiO2 could be reduced in 36 (90%) by an average of 0.46 after surfactant therapy. SMT was done in 22 of 40 infants, and surfactant insufficiency was suspected in 20 (91%). In contrast, 81 of 102 infants (79%) with FiO2 <0.4 did not need surfactant therapy within 48 h after birth. Conclusions Preterm infants who need FiO2 ≥0.6 in the delivery room appear to be at high risk of surfactant insufficiency and would benefit from surfactant. Surfactant therapy would provide a more effective resuscitation method for preterm infants, and thus a larger prospective study is needed to confirm these results. [ABSTRACT FROM AUTHOR]

Introduction: To describe clinical characteristics of patients in Japan with coronavirus disease 19 (COVID-19) and pre-existing rheumatic disease and examine the possible risk factors associated with severe COVID-19., Methods: Adults with rheumatic disease and a COVID-19 diagnosis who were registered in the COVID-19 Global Rheumatology Alliance (C19-GRA) physician-reported registry from Japan between 15 May 2020 and 12 May 2021 were included. Multivariable logistic regression models were used to assess factors associated with severe COVID-19 progression, defined as death or requiring oxygen inhalation., Results: In total, 222 patients were included in the study. Rheumatoid arthritis (48.2%), gout (14.4%), and systemic lupus erythematosus (8.1%) were the most common types of rheumatic disease, 55.1% of patients were in remission and 66.2% had comorbid disease. Most patients were hospitalised (86.9%) for COVID-19, 43.3% received oxygen, and 9.0% died. Older age (≥ 65 years), corticosteroid use, comorbid diabetes, and lung diseases are associated with higher risk for severe COVID-19 progression (odds ratio (OR) 3.52 [95% confidence interval (CI) 1.69-7.33], OR 2.68 [95% CI 1.23-5.83], OR 3.56 [95% CI 1.42-8.88], and OR 2.59 [95% CI 1.10-6.09], respectively)., Conclusions: This study described clinical characteristics of COVID-19 patients with rheumatic diseases in Japan. Several possible risk factors for severe COVID-19 progression were suggested. Key points • Clinical characteristics of 222 adult patients in Japan with coronavirus disease 19 (COVID-19) and pre-existing rheumatic diseases were described. • Most patients were hospitalised (86.9%) for COVID-19 in Japan, 43.3% received oxygen, and 9.0% died. • The COVID-19 characteristics of patients with rheumatic diseases did not show any obvious different pattern from those of the general population in Japan. • In this study, older age (≥ 65 years), corticosteroid use, comorbid diabetes, and lung diseases are associated with higher risk for severe COVID-19 progression., (© 2022. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

This study investigated the effects of firefighter personal protective equipment (PPE) on the determination of maximal oxygen uptake (VO2max) while using two different treadmill protocols: a progressive incline protocol (PIP) and a progressive speed protocol (PSP), with three clothing conditions (Light-light clothing; Boots-PPE with rubber boots; Shoes-PPE with running shoes). Bruce protocol with Light was performed for a reference test. Results showed there was no difference in VO2maxbetween Bruce Light, PIP Light, and PSP Light. However, VO2maxwas reduced in Boots and Shoes with shortened maximal performance time (7 and 6 min reduced for PIP Boots and Shoes, respectively; 11 and 9 min reduced for PSP Boots and Shoes, respectively), whereas the increasing rate of VO2in Boots and Shoes during submaximal exercise was greater compared with Light. Wearing firefighter boots compared with wearing running shoes also significantly affected submaximal VO2but not VO2max. These results suggest that firefighters’ maximal performance determined from a typical VO2maxtest without wearing PPE may overestimate the actual performance capability of firefighters wearing PPE. [ABSTRACT FROM PUBLISHER]

The effect of O2 on the decolorization of indigo carmine and on the production of dissolved species such as \documentclass{article}\usepackage{amsmath}\usepackage{amssymb}\usepackage{amsbsy}\usepackage{amsfonts}\pagestyle{empty}\begin{document}$\mathrm{NO}_{2}^{-} , \mathrm{NO}_{3}^{-} $ \end{document}, O3, and H2O2 in the treatment water by pulsed discharges in a water droplet spray was investigated by controlling the O2/N2 ratios as carrier gases in the reactor. The decolorization rate gradually increased with a rise in the O2 ratio, which reached a constant value in the range of 50 to 90% for the O2 ratio and decreased in pure O2. The maximum value was about two times that of 20% for the O2 ratio. The decolorization efficiency was not affected by the gas flow rate in the range of 4 to 50 L/min. \documentclass{article}\usepackage{amsmath}\usepackage{amssymb}\usepackage{amsbsy}\usepackage{amsfonts}\pagestyle{empty}\begin{document}$\mathrm{NO}_{2}^{-} $ \end{document} in the treatment water was detected only in pure N2, but \documentclass{article}\usepackage{amsmath}\usepackage{amssymb}\usepackage{amsbsy}\usepackage{amsfonts}\pagestyle{empty}\begin{document}$\mathrm{NO}_{3}^{-} $ \end{document} was produced in O2/N2. \documentclass{article}\usepackage{amsmath}\usepackage{amssymb}\usepackage{amsbsy}\usepackage{amsfonts}\pagestyle{empty}\begin{document}$\mathrm{NO}_{2}^{-} $ \end{document} added to the treatment water was not oxidized in pure N2, but was perfectly converted to \documentclass{article}\usepackage{amsmath}\usepackage{amssymb}\usepackage{amsbsy}\usepackage{amsfonts}\pagestyle{empty}\begin{document}$\mathrm{NO}_{3}^{-} $ \end{document} in O2/N2. These results implied that the hydroxyl radicals produced in the gas phase do not directly contribute to the oxidation of substances in water. The O3 concentration gradually increased with a rise in the O2 ratio, whereas the H2O2 concentration decreased. In the range of 50 to 80% for the O2 ratio, the O3 and H2O2 concentrations stayed at approximately constant values, similar to the trend of the decolorization rate. The rate constants for various gas mixing ratios for O2/N2 were determined from a kinetic study. These results suggest that hydroxyl radicals produced in the treatment water by the chain reactions of O3 and hydroperoxy radical (HO2·) play an important role in the decomposition of molecules in water. © 2013 Wiley Periodicals, Inc. Electr Eng Jpn, 183(4): 10-23, 2013; Published online in Wiley Online Library (wileyonlinelibrary.com). DOI 10.1002/eej.22284 [ABSTRACT FROM AUTHOR]

BACKGROUND In 2019, we developed a predictive formula of in-hospital mortality for inpatients aged ≥65 years transported by ambulance for endogenous diseases. In this study, we aimed to validate this previously developed predictive formula. MATERIAL AND METHODS In this single-center prospective observational study, we enrolled all patients aged ≥65 years who were transported by ambulance and admitted to an acute care hospital in Japan for endogenous diseases. We calculated the score according to our developed formula using age, disturbance of consciousness, the shock index, and amount of oxygen administered, with each item scoring 1 point and then totaling them. We subsequently evaluated the in-hospital mortality rate, stratum-specific likelihood ratio, and area under the receiver operating characteristic curve (AUC) of the formula, using in-hospital mortality as the primary outcome. RESULTS In total, 325 patients were included in this study. Forty-two patients died during hospitalization. Multivariable logistic regression analysis (forced-entry method) revealed that disturbance of consciousness and oxygen administration 5 L/min or more were significantly associated with mortality during hospitalization. In contrast, aged ≥90 years and shock index of 1 or higher were not significant. The mortality and stratum-specific likelihood ratios for scores in the predictive formula of 3 and 4 were 40.9% and 4.66, and 66.7% and 13.48, respectively. The AUC of the predictive formula for in-hospital mortality was 0.670 (95% confidence interval: 0.574-0.767). CONCLUSIONS This study showed that our predictive formula, consisting of factors available immediately after ambulance transport in older patients, is feasible with sufficient discrimination ability and reliability.

Evidence suggests that older people aged ≥65 years and those aged 60-64 years with chronic medical conditions are at higher risk of developing severe complications due to influenza virus infection when compared with young, healthy adults. Although seasonal influenza is monitored through a nationwide passive surveillance in Japan, influenza related outcomes and medical resource consumption have not been fully documented. This retrospective database study aimed to describe the epidemiological and clinical characteristics of medically attended influenza cases aged ≥60 years and the associated medical resource consumption in Japan. We used clinically diagnosed influenza (CDI) based on the international classification of disease codes, and laboratory-confirmed influenza (LCI) based on influenza test results, to identify the patient population during a total of nine seasons (2010/2011 to 2018/2019). A total of 372,356 CDI and 31,122 LCI cases were identified from 77 medical institutions. The highest numbers of medically-attended influenza episodes were in patients aged 65-74 years and 75-84 years. On average, across seasons, 5.9% of all-cause hospitalizations were attributable to CDI and 0.4% were LCI. Influenza viruses type A and B co-circulated annually in varying degree of intensity and were associated with similar level of complications, including cardiovascular-related. Oxygen therapy increased with age; by contrast, mechanical ventilation, dialysis, blood transfusion, and intensive care unit admission were higher in the younger groups. In-hospital mortality for inpatients aged ≥ 85 years with CDI and LCI were 18.6% and 15.5%, respectively. Considering the burden associated with medically-attended influenza in this population, influenza prevention, laboratory confirmation and clinical management should be emphasized by general practicians and specialists like cardiologists to protect this aging population., Competing Interests: SC, JN and YH are employed by and hold stocks of Sanofi, a company which produces influenza vaccines.　KH reports personal fees from Otsuka Pharmaceutical, Bayer Yakuhin, Ltd., Daiichi-Sankyo Company, Limited., Sumitomo Dainippon Pharma Co., Ltd., Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma K.K. YO has received personal fees from Cando, Inc., the Japan Medical Data Center, the Japan Medical Research Institute Co., Ltd, Ohara HealthCare Foundation, Merck & Co., Inc., and Otsuka Pharmaceutical Co., Ltd. This does not alter our adherence to PLOS ONE policies.

Fishes of the genus Seriola are widely farmed and highly valued in global aquaculture production. To further understand their economically important traits and help improve aquaculture product quality and sustainability, we performed a chromosome-level genome construction for Seriola aureovittata. Combining two technologies, PacBio and BGISEQ-500, we assembled 649.86 Mb S. aureovittata genome sequences with a contig N50 of 22.21 Mb, and 98% of BUSCO genes were detected in total. The initial assembly was then further scaffolded into 24 pseudochromosomes using Hi-C data, indicating the high quality of the genome. Genome evolution analysis showed that many genes related to fatty acid metabolism and oxygen binding, or transport were expanded, which provided insights into the metabolic characteristics of fatty acids and efficient oxygen transport. Based on the genome data, we confirmed the evolutionary relationship of S. aureovittata, S. dorsalis and S. lalandi and identified chr12 as the putative sex chromosome of S. aureovittata. Our chromosome-level genome assembly provides a genetic foundation for the phylogenetic and taxonomic investigation of different Seriola species. Moreover, the genome will provide an important genomic resource for further biological and aquaculture studies of S. aureovittata., (© 2022 John Wiley & Sons Ltd.)

Objectives: To analyse the clinical characteristics and prognosis of acute exacerbation (AE) in patients with idiopathic pulmonary fibrosis (IPF) and pulmonary emphysema., Design: A multicentre retrospective cohort study SETTING: Two university hospitals in Japan PARTICIPANTS: Patients admitted to hospitals due to AE of IPF diagnosed based on a multidisciplinary discussion., Interventions: None PRIMARY AND SECONDARY OUTCOME MEASURES: 90-day mortality rate METHODS: We retrospectively analysed consecutive patients with AE of IPF, with or without pulmonary emphysema, admitted to two university hospitals between 2007 and 2018., Results: Among 62 patients (median age, 75 years; 48 men) admitted for AE of IPF, 29 patients (46%) presented with concomitant pulmonary emphysema. There was no significant difference in the arterial partial oxygen pressure/fraction of inhaled oxygen (P/F) ratio or other laboratory and radiographic data between patients with and without emphysema. The 90-day mortality rate was significantly lower in patients with emphysema than in those with IPF alone (23% vs 52%, p=0.03). The median survival time was significantly longer in patients with emphysema than in those with IPF alone (405 vs 242 days, p=0.02)., Conclusion: Patients with IPF and emphysema had better short-term survival after AE than those with non-emphysematous IPF., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Diabet. Med. 29, 501-505 (2012) Abstract Aims To assess the efficacy of using magnetic resonance imaging measurements of retinal oxygenation response to detect early diabetic retinopathy in patients with Type 2 diabetes. Methods Magnetic resonance imaging was conducted during 100% oxygen inhalation in patients with Type 2 diabetes with either no diabetic retinopathy ( n = 12) or mild to moderate background diabetic retinopathy ( n = 12), as well as in healthy control subjects ( n = 12). Meanwhile, changes in retinal oxygenation response were measured. Results In the healthy control group, levels of retinal oxygenation response increased slowly during 100% oxygen inhalation. In contrast, they increased more quickly and attained homeostasis much earlier in the groups with background diabetic retinopathy (at the 20-min time point) and with no diabetic retinopathy (at the 25-min time point) than in the healthy control group (at the 42-min time point). Furthermore, levels of retinal oxygenation response in the group with background diabetic retinopathy increased more than that of the group with no diabetic retinopathy, which in turn increased more than that of the healthy control group. There are statistically significant differences between the group with background diabetic retinopathy and the healthy control group at 6-, 8-, 10-, 15-, 20- and 25-min time points ( P < 0.05). According to the normal range of the healthy control group by setting fundus photography results as 'gold standard' in our research, the sensitivity, specificity, positive predictive value, negative predictive value and receiver operating characteristic area for reporting the early indications of utility of diabetic retinopathy were 83.33%, 58.33%, 50%, 87.5% and 0.774, respectively. Conclusions The results indicate that magnetic resonance imaging is a potential screening method and probably a quantitative physiological biomarker to find early diabetic retinopathy in patients with Type 2 diabetes. [ABSTRACT FROM AUTHOR]

Abstract: Hydrogen in nominally anhydrous minerals (NAMs) in volcanic rocks can be used as a proxy for dissolved H2O in melt prior to eruption. Plagioclase is a NAM that accommodates hydrogen in concentrations of up to hundreds of wt. ppm H2O. The species of hydrogen in volcanic plagioclase is structural OH. We report the analytical results of OH concentrations in Ca-rich plagioclase from the 1986–1987 summit eruption of Izu-Oshima volcano, a frontal-arc volcano in Izu arc. We demonstrate that the island arc low-K tholeiitic basalt magmas erupting from the frontal-arc volcanoes are H2O-saturated and undergo polybaric degassing during the magma ascent. The analyzed OH concentrations in plagioclase range from 20 to 300 wt. ppm H2O, and three levels of OH (20–80 wt. ppm H2O, 100–180 wt. ppm H2O, and 220–300 wt. ppm H2O) are found. These variations in OH indicate that crystallized plagioclase is equilibrated with H2O-saturated melt at three depths beneath the Izu-Oshima volcano prior to eruption: near the surface level (≈1wt.% H2O in melt), at a 4-km-deep magma chamber (≈3wt.% H2O in melt), and at a 8–10-km-deep magma chamber (≈5wt.% H2O in melt). It is proposed that deep-seated island arc low-K tholeiitic basalt magmas erupting from frontal-arc volcanoes are richer in H2O than previously thought, containing approximately 1wt.% H2O based on analyses of “leaked” melt inclusions and phase equilibrium studies at “low-pressure conditions”. [Copyright &y& Elsevier]

Organic pollution in eutrophic river water dammed by estuary weirs was studied in the Shin and Kasuga rivers of the Shikoku region, Japan. Both rivers are located in a low-precipitation region of Japan. The investigation was performed at intervals of 3–14 days from 12 July 2002 to 13 July 2003. The annual averages of chlorophyll a concentration were approximately 150 and 40 μg L−1 in the Shin and Kasuga rivers, respectively. The concentration often exceeded 500 μg L−1 in the Shin River in winter. Dissolved oxygen saturation exhibited marked variation. High and low values, i.e., >150% in the surface water layer and 0% in the bottom water layer, were occasionally observed. Dissolved methane concentrations >2,000 nM were often observed from spring to fall. In both rivers, the serious organic substance pollution was confirmed through 1 year. [ABSTRACT FROM AUTHOR]

To clarify the effects of altitude acclimatization on postural instability at altitudes, six female climbers stood with their eyes open or closed on a force-measuring platform under normoxia (NC) and hypobaric hypoxia, equivalent to a 5,000 m altitude (HC), before and after an expedition to Mt. Cho-Oyu (8,201 m). The expedition extended over 84 days. We recorded sways in the center of foot pressure, electromyograms (EMGs) of lower-leg muscles, blood components and arterial oxygen saturation (SpO(2)). Before the expedition, the maximum amplitude of sway with the eyes open and integrated EMG from the medial gastrocnemius increased for HC. After the expedition, red blood cell (from 423.4 ± 15.4 to 498.0 ± 24.5 × 10(4) μl(-1)), hemoglobin content (from 12.6 ± 0.32 to 14.5 ± 1.00 g/dl) and 2,3-diphosphoglycerate (from 1.93 ± 0.21 to 2.24 ± 0.34 μmol/ml) increased. The SpO(2) under HC increased from 69.2 ± 9.6 to 77.2 ± 10.0%. The maximum amplitude of sway with the eyes open decreased for HC. No difference in the sway path length and integrated EMGs was observed between NC and HC. These results suggest that acclimatization can improve the impaired postural stability on initial arrival at altitudes. However, it is still unclear how long acclimatization period is needed. Further studies are needed to reveal this point. [ABSTRACT FROM AUTHOR]

Abstract  We carried out a 24-h station experiment at Lake Biwa (Japan) to measure mixing events and concurrent biological signals using a free-fall microstructure profiler (TurboMAP-L), conventional hydrographic measurement device (F-probe), and the Tracker acoustic profiling system (TAPS). A clearly defined three-layer physical system was observed. Two layers were actively mixed: the surface-mixed layer and the subsurface-mixed layer. Both winds and night-time convection create the surface-mixed layer, and vertical shear due to a counterclockwise gyre maintains turbulence in the subsurface mixing layer. A strongly stratified layer between these two mixing layers is almost turbulence free, so no material flux is expected. A local oxygen maximum layer, a local oxygen minimum layer, and layers of increased chlorophyll and zooplankton abundance are all located in this strongly stratified layer. The data show the intricate influence of physical processes on the structure of biological systems and their combined influence on biogeochemical and trophic transfers in aquatic systems. [ABSTRACT FROM AUTHOR]

Abstract: In this paper, oxygen budget was estimated for the lower layer of water column in a semi-enclosed bay, Ago Bay, Japan. Benthic oxygen consumption rates were measured directly with an in situ measurement device from 13 July to 16 August 2004. Oxygen budget was calculated based on physical, chemical and biological processes using the observed data. Along with the change of the water column structure at the time of a hit of typhoon, dominant phytoplankton species shifted from the diatom Skeletonema costatum to the dinoflagellate Heterocapsa circularisquama. During the diatom-dominating period, oxygen supply rate in the lower layer due to photosynthesis was comparable to or slightly lower than the sediment oxygen consumption rate. In contrast, during the dominance of the dinoflagellate, net oxygen budget was significantly negative in the lower layer while it was positive in the upper layer. This could be attributed to the migration behavior of the dominant dinoflagellate H. circularisquama that swim up to the upper layer and produce oxygen in daytime, and swim down to the lower layer and consume oxygen in nighttime. The results of the present study suggest that phytoplankton migration behavior can enhance the development of oxygen depleted water mass in the lower layer of eutrophic shallow coastal seas. [Copyright &y& Elsevier]

In Japan, tert-butyl mercaptan (TBM) is mainly employed as an odorant of LPG. However, the sulfur component in TBM gives the adverse effect for environment and human body and/or has a negative impact on reforming catalyst of fuel cell and other types of cogeneration systems. In this way, the development of sulfur-free odorant is expected. This study focuses on the thermal stability and combustibility of 2-hexyne, 1-pentyne, n-butyl isocyanide (BIC), and ethyl isocyanide (EIC) that is expected as the candidate odorants. As the result of DSC measurement, the comparison of TDSC indicated that 2-hexyne and 1-pentyne are more thermally stable than BIC and EIC. However, in 2-hexyne and 1-pentyne, the slight exothermic peaks were observed at lower temperature region before those main exothermic peaks. In 2-hexyne, copper or aluminum increased the heat amount of that slight exothermic peak observed before main peak. In 1-pentyne with zinc, TDSC was approximately decreased to 279 °C from 337 °C of 1-pentyne alone. As the results of ARC measurement, in the presence of oxygen, the exothermic heat of 2-hexyne and 1-pentyne was observed at approximately 50–100 °C. This heat release may be corresponding to the slight heat release observed by DSC, and it thought to be results from the reaction with atmospheric oxygen. In this way, for the practical application of 2-hexyne and 1-pentyne as odorants, it is important to suppress the invasion of oxygen in the cylinder to low as much as possible in respect of the storage of the candidate odorant. As a result of thermal equilibrium calculation, even if either candidate odorant is added at about 100 ppm, there is little influence on propane combustibility from the adiabatic flame temperature, species of combustion gas and their yields. [ABSTRACT FROM AUTHOR]

High-flow nasal cannula is a new modality of respiratory support and is increasing in popularity despite the lack of supporting evidence. We investigated the prevalence of its use in tertiary neonatal units in Japan. A paper-based survey was conducted. The response rate was 83%. High-flow nasal cannula was used in 46/80 units (58%), of which 96% used the high-flow nasal cannula without guidelines. It was used for several indications, including weaning off nasal continuous positive airway pressure and post-extubation respiratory support. The main perceived benefits of the cannula included better access to the neonate and reduced risk of nasal trauma. This survey found that high-flow nasal cannula is used without clear criteria and that clinical practice varies across neonatal units in Japan. Its use in neonates needs to be urgently evaluated. [ABSTRACT FROM AUTHOR]