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Background Thanks to recent advancement in cancer treatment, an increasing number of cancer patients are expected to live longer with cancer. The ambulatory ability is essential for cancer patients to spend their own independent lives, but locomotive syndrome (LS), a condition of reduced mobility due to impairment of locomotive organs, in cancer patients has been seldom examined. Methods This was a single-institutional cross-sectional study. Cancer patients receiving cancer therapy between April 2020 and March 2021 were asked to participate. LS was classified as stage 0–3, and compared with their performance status (PS). Physical component summary (PCS) and mental component summary (MCS) were calculated from the results of Short Form-8. Logistic regression analysis was performed to identify risk factors for LS stage 3. Results One hundred and seventy-six cancer patients were included. The rate of LS was 96.0%. That of LS stage 3 was 40.9% and as high as 29.7% even if limited to those with PS 0. The mean PCS and MCS were both inferior to the national averages. PCS decreased as the LS stage advanced. Old age and underweight were revealed as independent risk factors for LS stage 3. Conclusions The ratio of LS in cancer patients was extremely high, and the LS stage correlated with physical QOL. Even those with PS 0 can have severe LS; thus, LS can be a sensitive detector of physical disability of cancer patients than PS. The improvement of LS can be a key to the preservation of their ADL and QOL.

Human factors research that addresses driver-automation interaction is required to mitigate crashes related to the deployment of automated vehicles. While Automated Driving Systems still require driver supervision, there will remain room for human error. This paper presents results from the first in a series of experiments that aim to estimate driver situation awareness using spontaneous gaze behavior and to ensure the driver is ready for takeover. Spontaneous gaze behavior was studied and compared among 13 participants between partial driving automaton and driver assistance automations condition to extract indicators of the out of the loop phenomenon.

Primary water stress corrosion cracking (PWSCC) of Alloy 600 has been a key issue in the field of nuclear energy. It is well known that dissolved hydrogen (DH) plays a crucial role in PWSCC initiation, and some studies showed that PWSCC initiation could be mitigated by decreasing the DH concentration. However, there is no consensus on the mechanism of the PWSCC mitigation in a low DH environment. Hence, to reveal the protective property of the passive film formed in various levels of DH, we analyzed the oxide film formed in simulated primary water at 345°C with the DH concentrations of 5 cc/kg and 30 cc/kg-H2O by electrochemical measurements (electrochemical impedance spectroscopy and Mott-Schottky test) and transmission electron microscopy (energy dispersive x-ray spectroscopy and electron energy loss spectroscopy) where the specimens of interest were tested by reverse U bend (RUB) tests, and it was confirmed that the PWSCC initiation time was longer for 5 cc/kg-H2O DH than for 30 cc/kg-H2O DH. Electrochemical measurements showed that the oxide film for the lower DH environment (5 cc/kg-H2O) had a higher electrical resistance and lower defect density than those for the higher DH (30 cc/kg- H2O). The microscopic observation indicated that the intergranular oxidation was relatively insignificant in the lower DH environment. The oxide film for both DH conditions consisted of outer oxides and inner Cr-rich barrier layer. The inner layer for 5 cc/kg-H2O DH had a higher concentration of Fe and a greater ratio of Fe3+/Fe2+ than that for 30 cc/kg-H2O DH. The results suggested that Fe3+ contributed to the formation of a less defective spinel-type structure in the inner oxide in the lower DH environment and thereby provided the alloy surface with corrosion protection. This protective oxide film prevented intergranular oxidation and led to the mitigation of PWSCC initiation in a low DH environment.

This prospective cohort study aimed to (i) examine stroke incidence and stroke subtypes by chronic kidney disease (CKD) stage, (ii) examine whether CKD patients with or without proteinuria have a high risk of stroke independent of traditional cardiovascular risk factors, and (iii) determine precise estimates of stroke risk by CKD stage while accounting for competing mortality risk.Participants were 2023 patients enrolled in the Project in Sado for Total Health between June 2008 and December 2016 (55% men; mean age, 69 years), of whom 52% had CKD (stage 1-2, 10%; G3a, 48%; G3b, 17%; G4-5, 11% and G5D, 14%).During a median follow-up of 5.7 years, 157 participants developed stroke and 448 died without developing stroke. Most stroke cases were ischaemic among non-dialysis-dependent CKD participants, but the relative frequency of ischaemic stroke was near that of intracerebral haemorrhage among dialysis-dependent CKD participants. After adjustment, stage 1-2 (hazard ratio [HR], 2.97; 95% confidence interval [CI], 1.60-5.51) and stage G3-5 participants with proteinuria (HR, 2.50; 95% CI, 1.56-4.02), but not stage G3-5 participants without proteinuria (HR, 0.64; 95% CI, 0.38-1.08), had a higher stroke risk compared to non-CKD participants. In competing risk analyses, the association was attenuated but remained significant.Although the distribution of stroke subtypes differed, CKD participants with proteinuria and those with CKD stage 5D had a 2- and 4-times higher risk of stroke, respectively, than that of non-CKD participants, after accounting for competing mortality risk and traditional risk factors.

Previous studies have demonstrated that the oral administration of food-derived peptides exerts beneficial effects on human health beyond conventional nutritional functions.

There is limited information available about the physiological content of glyceraldehyde, a precursor of toxic advanced glycation end products. The conventional derivatization method for aldoses using 1-phenyl-3-methyl-5-pyrazolone did not allow reproducible quantification of glyceraldehyde due to the instability of glyceraldehyde compared to other aldoses. We optimized the derivatization condition to achieve high and reproducible recovery of derivatives for liquid chromatography tandem mass spectrometry quantification. Based on the stability of glyceraldehyde during sample preparation and high recovery of spiked standard, the present method provides reproducible quantification of glyceraldehyde in the body. The glyceraldehyde contents in fasting conditions in the rodent liver (mice: 50.0 ± 3.9 nmol/g; rats: 35.5 ± 4.9 nmol/g) were higher than those in plasma (9.4 ± 1.7 and 7.2 ± 1.2 nmol/mL). The liver glyceraldehyde levels significantly increased after food consumption (p < 0.05) but remained constant in the plasma. High fat diet feeding significantly increased plasma glyceraldehyde levels in mice (p < 0.005). In healthy human volunteers, the plasma glyceraldehyde levels remained unchanged after the consumption of steamed rice. In patients with type 2 diabetes, the plasma glyceraldehyde level was positively correlated with the plasma glucose level (r = 0.84; p < 0.0001).

The objective of this study was to elucidate the metabolic fate of peptides in a rice protein hydrolysate (RPH) in rats. Peptides present in RPH and its in vitro exopeptidase digest were identified using liquid chromatography–tandem mass spectrometry. One hour after an oral administration of RPH (250 mg/kg body weight), the levels of in vitro exopeptidase-resistant pyroglutamyl peptides in the lumen and ileal tissue significantly increased, whereas those of exopeptidase-susceptible peptides remained unchanged. Among them, the concentrations of pyroGlu-Leu, pyroGlu-Val, and pyroGlu-Lys significantly yet slightly increased in portal blood, while those of other hydrophilic ones (pyroGlu-Gln, pyroGlu-Glu, etc.) remained unchanged. However, all of the pyroglutamyl peptides were stable in rat ileal extract and blood plasma. These findings indicate that the pyroglutamyl peptides can enter enterocytes and resist to peptidases, while small amounts are transported to the blood, suggesting that pyroglutamyl peptides in enterocytes might be returned to the lumen.

The aim of this study was to evaluate temporal changes in endometrial blood flow after laparoscopic myomectomy (LM). Nineteen infertile women with uterine fibroids who underwent LM were included. The uterine radial artery resistance index (RA-RI) and recovery index were measured before and at 1 week and 3 months after LM. The median RA-RI at 1 week but not 3 months after LM was significantly higher than before. The median recovery indexes at 1 week and 3 months after LM were 14.3% and 1.3%, respectively. Although there was no significant correlation between the patient's age and recovery index at 1 week (r = 0.28, p = .24) after LM, a moderately significant correlation was observed at 3 months (r = 0.54, p = .002). In conclusion, the endometrial blood flow after LM changed over time, and recovery of blood flow was negatively correlated with patient age.IMPACT STATEMENTWhat is already known on this subject? Uterine blood flow is important for wound healing after myomectomy, but no studies have evaluated endometrial blood flow after myomectomy.What do the results of this study add? The endometrial blood flow impedance of RA-RI increased after LM and returned to before surgery at 3 months postoperatively. RA-RI recovery index negatively correlated with patient age.What are the implications of these findings for clinical practice and/or further research? The changes in endometrial blood flow impedance after myomectomy suggest that endometrial blood flow may be involved in wound healing at the enucleation site. The impairment of endometrial blood flow recovery after myomectomy due to increased age may provide a rationale for individualised wound healing after myomectomy. The measurement of endometrial blood flow may be useful in personalising the assessment of the waiting period for pregnancy after myomectomy.

Purpose: External rectal prolapse (ERP) is frequently associated with other pelvic disorders, such as enterocele, rectocele, and perineal descent. Evacuation proctography makes it possible to visualize the development of such anatomical abnormalities. The aim of this study was to identify the variables that would predict associated abnormalities in patients with ERP.Methods: Between February 2010 and August 2019, 124 female patients with ERP, who were evaluated using proctography were included in this study. Enterocele was diagnosed when the extension of the loop of the small bowel was located between the vagina and rectum. A significant rectocele was defined as >20 mm in diameter. Multivariate analysis was used to establish which morphological parameters best predicted the presence of enterocele or rectocele.Results: Sixty-five patients had ERP alone, while 59 patients (47.6%) had additional findings on proctography. The most frequently associated abnormality was enterocele with 48 of the patients (38.7%) having this condition. Rectocele was detected in 17 of the 124 patients (13.7%). The median length of the ERP was 30 mm (range, 7 to 147 mm). The results of the stepwise multiple regression analysis showed that a history of hysterectomy and the length of the ERP were significantly associated with the presence of enterocele. The analysis showed that the longer the prolapse, the higher the incidence of enterocele. A history of hysterectomy was also significantly associated with the presence of rectocele.Conclusion: Patients with ERP often have associated anatomical abnormalities and should be investigated thoroughly before planning surgical treatment.

AIM Decreased use of life spaces, as reflected in decreased Life-Space Assessment (LSA) scores, is associated with poor prognosis in older adults. The purpose of this study was to examine factors affecting the extent of life-space activities in older adults with cardiovascular disease. METHODS We carried out a prospective observational study in 98 older adults (minimum age 65 years; mean age 79.5 ± 7.4 years) who were admitted to our hospital due to cardiovascular disease. Once their medical condition was stable, they underwent cardiopulmonary exercise testing, echocardiography and physical evaluation, and completed questionnaires. RESULTS The LSA score was significantly associated with the ability to drive a car (driving 95.1 ± 21.1 points, not driving 60.4 ± 30.3 points, P

To prompt the use of driving automation in an appropriate and safe manner, system designers require knowledge about the dynamics of driver trust. To enhance this knowledge, this study manipulated prior information of a partial driving automation into two types (detailed and less) and investigated the effects of the information on the development of trust with respect to three trust attributions proposed by Muir (1994): predictability, dependability, and faith. Furthermore, a driving simulator generated two types of automation failures (limitation and malfunction), and at six instances during the study, 56 drivers completed questionnaires about their levels of trust in the automation. Statistical analysis found that trust ratings of automation steadily increased with the experience of simulation regardless of the drivers’ levels of knowledge. Automation failure led to a temporary decrease in trust ratings; however, the trust was rebuilt by a subsequent experience of flawless automation. Results showed that dependability was the most dominant belief of drivers’ trust throughout the whole experiment, regardless of their knowledge level. Interestingly, detailed analysis indicated that trust can be accounted by different attributions depending on the drivers’ circumstances: the subsequent experience of error-free automation after the exposure to automation failure led predictability to be a secondary predictive attribution of drivers’ trust in the detailed group whilst faith was consistently the secondary contributor to shaping trust in the less group throughout the experiment. These findings have implications for system design regarding transparency and for training methods and instruction aimed at improving driving safety in traffic environments with automated vehicles.

Introduction BCOR-CCNB3 sarcoma (BCS) is one of the histological types classified as undifferentiated small round cell sarcoma of bone and soft tissue. This sarcoma frequently develops in males under 20 years of age. Histologically, it has been reported that a delicate capillary network is a conspicuous finding. In this study, the cytological findings of BCS were observed in 2 cases of primary lesions and 1 case of a lung metastatic lesion. The cytological findings of BCS were compared with its histological mimics, and the characteristic findings of BCS were examined. Methods Three cases of BCS were studied, and a cytological comparison was performed with 8 cases of Ewing sarcoma (ES) and 10 cases of synovial sarcoma (SS) (monophasic type SS: 7 cases, biphasic type SS: 2 cases, poorly differentiated SS: 1 case). Results In all BCS cases, small clusters with thin and delicate vascular cores and tiny vascular fragments were conspicuous. In ES and SS cases, although small clusters with vascular cores were observed, the vascular cores were thicker than in BCS, and no tiny vascular fragments appeared in most cases. Cytomorphological differences of tumor cells were also observed among BCS, ES, and SS. Predominantly rounded nuclei with fine chromatin and inconspicuous nucleoli can be cytological clues for BCS. Conclusions BCS shows characteristic cytological findings that make the diagnosis of BCS more likely than that of ES and SS. Cytological evaluation is a useful tool for appropriate differential diagnosis that leads to a more accurate final diagnosis and rapid treatment.

Placenta previa complicates 0.3-0.5% of pregnancies and can cause sudden antepartum massive hemorrhage (APH). Previous studies have indicated that cervical length (CL) measured by transvaginal ultrasonography may be a predicting parameter for APH in patients with placenta previa; however, conflicting data exist. Thus, we investigated the association between CL and APH in patients with placenta previa.In total, 129 singleton pregnant women with placenta previa, who delivered at our institution from January 2010 to December 2016, were included in this study. The shortest CL measured throughout gestation was used for analysis, and we defined CL less or more than 30 mm as short or normal CL, respectively. We performed univariate and multivariate analyses, and a receiver-operating characteristics (ROC) curve was plotted to determine the cut-off CL value to predict APH.APH occurred in 26 patients. The adjusted odds ratio for APH was 3.80 (95% CI, 1.36-10.65) in patients with short CL. ROC analysis was performed to determine a cut-off CL value of 35 mm to predict APH, with a sensitivity of 80.7% and a specificity of 60.2%.Our data indicated that CL measurements may be useful in determining patients at high risk of APH.

‘Severe acute respiratory syndrome coronavirus 2’ (SARS-CoV-2) is a highly transmissible viral pathogen responsible for the ongoing ‘coronavirus disease 2019’ (COVID-19) pandemic. The current re-purposed antiviral interventions against SARS-CoV-2 are classified into two major groups: Group-1 represents the family of drugs, mainly the vaccines that directly target the virus, and Group-2 includes a specific class of inhibitors that interfere with the host-cell machinery, which is critical for viral infection and replication. Global efforts to control COVID-19 pandemic with vaccines and repurposed therapeutics represent only a phased victory. The emergence of several SARS-CoV-2 variants of concern (VOCs) has compromised several vaccinations and pharma-therapeutic protocols, which highlights the dire necessity for specific antiviral interventions that target highly conserved domains, which are less likely to mutate in the SARS-CoV-2 genome. Several bioactive phytochemicals that block viral enzymes such as nsp5/main proteinase (Mpro) and RNA-dependent nsp7/nsp8/nsp12 RNA-dependent RNA-polymerase (RdRp) complex, are extensively investigated in this direction. The SARS-CoV-2 infection triggers a complex human host-pathogen interaction(s) resulting in ‘host metabolic reprogramming’ (HMR), iron (Fe)-redox dysregulation (FeRD), and altered mitochondrial function that cumulatively disrupt several metabolic pathways involved in cellular energy and antioxidant enzyme function; thereby, compromise the innate host defense. The circulatory/RAAS axis contributes to FeRD and any alteration or imbalance in the Fe-redox homeostasis (Fe-R-H) may lead to ‘new onset’ metabolic disorders (i.e., diabetes). Such inherent body damage and its long-term health consequences in post-acute sequelae of COVID-19 (PASC) require effective nutritional intervention strategies, particularly at the interface of organ system functions and immune system dynamics. The long-term sequelae of PASC indicate an accelerated rate of immune exhaustion in COVID-19 patients, due to prolonged antigen stimulation (also due to vaccine exposure). Abnormal immune metabolism may also cause systemic perturbations (i.e., FeRD), ROS/RNS production, oxidative and nitrosative stress, which could trigger multi-organ disorders ranging from mild symptoms to an incapacitating state and reduced quality of life that could last for weeks or longer following recovery from COVID-19. The five most long-term clinical manifestations of PASC include fatigue, headache, attention disorder, hair loss, and dyspnea. This narrative review elucidates the intricate impairments and sequelae associated with eight major physiological systems in COVID-19 survivors (i.e., pulmonary, neuro-cognitive, cardiovascular, renal, gastrointestinal/hepato-biliary, endocrinal, skeleton-muscular, and reproductive) – triggered by the FeRD, amplified by the HMR, altered mitochondrial function and ACE2/RAAS axis. We have attempted to explain the ongoing epidemic of the residual, non-viral host metabolic disorders and complications in COVID-19 survivors and the supportive role of specific host system-targeted nutritional interventions such as natural plant-based anti-inflammatories, immune-modulators, antioxidants, and macro-/micronutrient metabolic optimizers to manage PASC, the newly emerged post-COVID metabolic syndrome.

Dedifferentiated liposarcoma occurs predominantly in the retroperitoneum. Given the paucity of cases, information on the clinical characteristics of this entity in the extremities and trunk wall is quite limited. In particular, the significance of preoperative evaluation and principles of intraoperative management of the different components, i.e., well-differentiated and dedifferentiated areas, are still to be defined.Clinical characteristics, treatment outcomes, and risk factors for poor oncological outcomes in cases of dedifferentiated liposarcoma in the extremity or trunk wall were analyzed by a retrospective, multicentric study.A total of 132 patients were included. The mean duration from the initial presentation to dedifferentiation was 101 months in dedifferentiation-type cases. The 5-year local recurrence-free survival, metastasis-free survival, and disease-specific survival rates were 71.6%, 75.7%, and 84.7%, respectively. Among 32 patients with metastasis, 15 presented with extrapulmonary metastasis. A percentage of dedifferentiated area over 87.5%, marginal/intralesional margin, and R1/2 resection in the dedifferentiated area were independent risk factors for local recurrence. Dedifferentiated areas over 36 cmThe typical clinical characteristics of dedifferentiated liposarcoma in the extremity and trunk wall were reconfirmed in the largest cohort ever. The evaluation of the dedifferentiated area in terms of grade, extension, and pathological margin, together with securing adequate surgical margins, was critical in the management of this entity.