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Large-scale fabrication processes of high-power single-lateral-mode laser diodes (LDs) have been successfully demonstrated for the first time using 4-inch-wafer process technology. An excellent uniformity of the LD characteristics is obtained over an 88-mm-diameter area of the 4-inch wafer with small deviation, e.g., sigma/ave. = 3.5% (ave. plusmn sigma = 73.5 plusmn 2.6 mA) for the threshold current, and sigma/ave. = 0.12% (658.00 plusmn 0.79 nm) for the peak wavelength. The LDs show stable and kink-free high-power operation over 400 mW even at a high temperature of 75degC with an operation current of 600 mA. [ABSTRACT FROM PUBLISHER]

The aim of the study was to evaluate the outcome of a community-based prevention program against suicides among the elderly aged 65 and over in the Japanese rural town of Joboji (population 7,010), using a quasi-experimental design with two neighboring control areas. During the 10-year implementation of the program based on strategies including screening for depression, follow up with mental health care or psychiatric treatment and health education on depression, the relative risks estimated by the age-adjusted odds ratios for both males and females were reduced to almost one quarter more than a regional historical trend, with a better response to education for females than for males. A community-based management for later-life depression with mental health care supported by the psychiatric treatment can be effective against suicide among the elderly for both males and females. [ABSTRACT FROM AUTHOR]

The accuracy of radiological examinations has improved and their diagnostic ability has markedly increased. However, the cost of such examinations has also recently become an issue. In this study, the clinical significance of radiological examinations for sensorineural hearing loss (SNHL) was evaluated and the value of their utilization was reconsidered. A total of 1,276 ears of 724 patients who demonstrated unilateral or bilateral SNHL was studied retrospectively. Findings of radiological examinations such as plain X-ray (X-p), computed tomography (CT) and magnetic resonance imaging (MRI) of the brain or the temporal bone were investigated. Temporal bone X-p was usually performed to rule out acoustic tumors (AT). CT was further performed in 119 patients (16.4%) and MRI in 84 patients (11.6%) in total. The reasons or symptoms for further examination such as CT or MRI were X-p findings or auditory symptoms suspicious for AT or vertigo /dizziness suspicious for intracranial disease. Of five cases with AT, two with a small tumor exhibited normal findings for the internal auditory canal on temporal bone X-p. These small ATs were finally confirmed by MRI. MRI could also detect lacunar infarctions, cerebral atrophy and high jugular bulb which might be related to SNHL. These findings confirmed that MRI is very useful for detecting small ATs and suggested that MRI also reveals cerebral vascular insufficiency in patients with SNHL. [ABSTRACT FROM AUTHOR]

Sound lateralization and speech discrimination abilities are both closely related to central auditory system function. In this study, we investigated the relationship between sound lateralization and speech discrimination in patients with sensorineural hearing loss (SNHL) of unknown actiology or presbycusis. Interaural intensity difference (IID) and interaural time difference (ITD) discriminations were measured using a self-recording apparatus for dichotic sound presentation, and the means of bilateral maximum scores in speech discrimination tests were calculated. Subjects with normal sound lateralization had good speech discrimination scores above 70%, while those with abnormal sound lateralization had poor scores below 70%. Some patients, however, had good speech discrimination but abnormal sound lateralization. These findings were obtained in both III) and ITD discrimination tests. Furthermore, some subjects could not discriminate ITD, although all could discriminate IID. These findings suggest that sound lateralization ability may be affected more than speech discrimination in SNHL of unknown aetiology or in presbycusis. [ABSTRACT FROM AUTHOR]

To investigate the possibility of 14CO2 fixation using microorganisms in a high-dose area, the photosynthetic activity (specific production rate: SPR) and cellular proliferation (colony forming unit: CFU) of Euglena gracilis Z irradiated with gamma-rays at a dose of 0 to 500 Gy were determined. The dose responses of SPR and CFU suggested that it was possible to operate a CO2 fixation system of Euglena up to 100 Gy. Even at a dose of 500 Gy, about half of the photosynthetic activity under non-irradiated condition was considered possible. [ABSTRACT FROM AUTHOR]

Before and after sound therapy, how does the pitch of the tinnitus change? Determine the change of the tinnitus pitch and THI, VAS, SDS (depression degree), relations with STAI (anxiety degree). Give sound therapy for the chronic tinnitus in our department; 206 patients with chronic tinnitus passed more than 12 months after the start of therapy (127 men, women 79). The age distribution was 15-78 years old, an average of 60.9 years old. We evaluated evaluation, THI of the pitch of the tinnitus by the pitch match test, tinnitus VAS, SDS (depression degree), STAI (anxiety degree) by sound therapy using the following instruments enforcement initiation time and 12 months later. We evaluated the effect of treatment of the sound therapy with five phases of subjective degree of improvement. The tinnitus pitch before and after the sound therapy - 84 patients in decrease group (more than a decrease 1.5 octave: 38, lower than decrease octave: 46), 78 in immutability group, in increase group 44. The tinnitus pitch and the subjective improvement were 59.1% for 90.5% of decrease group, immutability case 75.6%, increase case. Concerning THI, tinnitus VAS, SDS (depression degree), STAI (anxiety degree) and the tinnitus pitch, all showed the percent improvement that was higher than increase group in pitch decrease group. About 206 chronic ringing in the ears cases, we can put it one year after sound therapy. We examined the change of the tinnitus pitch. As for tinnitus pitch one year later, an improvement example was found a lot in the decrease group that was 44 increase (21.4%), decrease 38 (18.4%), mild decrease 46 (22.3%), immutability 78 (37.9%), increase 44 (21.4%). In the decrease group, THI degree of improvement, the SDS score one year after the SDS degree of improvement shop were better than a constant group, and VAS, THI, SDS, THI one year after the degree of improvement shop of STAI (state anxiety), SDS score were better than increase group. [ABSTRACT FROM AUTHOR]

We conducted an additional analysis using the data from the post-marketing surveillance of Alglucosidase alfa for Pompe disease. We aimed to investigate the changes in the percentage of predicted forced vital capacity (%FVC) and the changes in the distance of the 6-min walk test (6MWT) by overall improvement and to investigate the %FVC change by the duration from symptom onset to survey registration (shorter/longer groups) using a linear mixed model. Thirty-seven and eighteen survey participants had %FVC and 6MWT data available, respectively; of the patients whose overall improvement was rated as "relatively improved," %FVC and 6MWT worsened in 71.4% and 66.7%, respectively. The %FVC at the survey registration estimated using a linear mixed model was significantly higher in the shorter group than in the longer group (P = 0.0413). The estimated slope of %FVC was significantly lower in the shorter group than in the longer group (P = 0.0051). These results suggest the importance of early treatment initiation and quantitative evaluation of each symptom.

Objective　This study aimed to investigate changes in attitudes toward suicide following a universal home visitation program that included a brief face-to-face educational session focusing on gatekeeper roles in Japan.Methods　Between 2015 and 2017, members of 169 households in an intervention district from a northern Japanese township were invited to attend an educational session during home visits. The participation rate was 72.8%, with 94.5% of the participants aged over 40. Repeated cross-sectional population-based surveys were conducted among adults in the towns in 2015 and 2021. Data from the surveys, focusing on individuals aged 40-79 years and residing in the intervention and matched control districts (where no visits occurred and only information was distributed through leaflets), were used to assess the prevalence of self-reported views toward suicide. The self-reported views encompassed "no substantial thoughts," "inevitable," "shameful," "annoying," "tragic," "must be managed," and "romantic" in addition to personal and perceived stigma, depressive symptoms (assessed using the Kessler Psychological Distress Scale-6), and suicidal ideation. Data were analyzed using generalized linear mixed models. The Cochran-Armitage test was used to analyze linear trends in the proportion of views that exhibited changes.Results　Participation rates were 61.8% (n ＝ 357) in 2015 and 52.8% (n ＝ 257) in 2021. The intervention group showed a significant difference in the prevalence of the "inevitable" view between baseline and 4-year follow-up (P ＝ 0.026). Marginal pre-post differences were observed among the two types of stigma; however, the symptoms remained unchanged. A marginally significant difference in the change of the "inevitable" view was observed between the two groups. In the follow-up, more knowledgeable respondents in the intervention group were less likely to view suicide as "inevitable," a trend not seen in the control group.Conclusions　The universal home visitation program, including a face-to-face session focusing on the gatekeeper role, was associated with a decreased prevalence of the "inevitable" attitude between the baseline and 4-year follow-up among community-dwelling adults aged 40-79. This suggests that face-to-face interactions with healthcare professionals can reduce the tendency to condone suicide among middle-aged and older adults in community settings.

Septic pelvic thrombophlebitis (SPT) is a rare condition that forms thrombosis in the pelvic veins, typically the ovarian veins, with subsequent infection and inflammation. We present a case of right ovarian vein thrombosis (ROVT), methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, and delayed onset of SPT symptoms, requiring tissue-plasminogen activator. A 40-year-old woman, G3P2, at 38 weeks' gestation, was admitted with a fever of 39°C. She had cervical insufficiency and had been often on bed rest. Blood culture revealed MRSA and computed tomography revealed a large ROVT. She received vancomycin and direct oral anticoagulant, and her fever resolved by day 3. On day 16, fever recurred with severe pain over the ROVT. Second computed tomography showed thickening of venous wall with enhancement around ROVT, consistent with SPT. Since pain and fever gradually exacerbated despite treatment with DOAC and antimicrobials, she was started on heparin and tissue plasminogen activator on days 23 and 25, respectively. Along with recanalization on the thrombosis by day 29, fever and abdominal pain resolved. We experienced a case of delayed onset SPT associated with MRSA bacteremia and a large ROVT. MRSA bacteremia might cause the originally existing ROVT to become an infection source, resulting in SPT with recurrent symptoms and long-term treatment. Early and strict anticoagulation is crucial in cases with a large thrombosis and bacteremia, due to the high risk of progression to SPT. This case highlights the importance of recanalization for the treatment of SPT and usefulness of administration of tissue-plasminogen activator for the massive thrombosis., (© 2024 The Author(s). Journal of Obstetrics and Gynaecology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Obstetrics and Gynecology.)

Purpose: To predict side effects and optimize injection doses in the dosimetry of 177 Lu imaging, highly accurate quantitative SPECT images are required. Monte Carlo simulations were performed to verify the accuracy and variability of quantitative values for 177 Lu imaging under various imaging conditions., Methods: SPECT data of NEMA body phantom were assumed to simulate intrahepatic tumors 6 h after administration of 7.4 GBq of 177 Lu-Dotatate. SPECT data were acquired using the SIMIND program with different combinations of collimators and energy windows. For variability evaluation, 30 SPECT images with Poisson noise were generated for each acquisition time. The relative error was evaluated for accuracy evaluation, and the coefficient of variation was estimated for variability evaluation., Results: The accuracy of BG quantification was less than 10% relative error. The accuracy of hot sphere quantification was highest with the combination of MEGP and an energy window of 208 keV±10%. However, the accuracy of hot sphere quantification decreased significantly with decreasing hot sphere diameter. Variability varied with imaging conditions and improved with longer acquisition time., Conclusion: Monte Carlo simulations revealed the accuracy and variability of quantitative values for each SPECT imaging condition for 177 Lu imaging.

Purpose: During computed tomography pulmonary angiography (CTPA), a decrease in the CT value of the pulmonary artery may be observed due to poor contrast enhancement, even though the imaging is performed at the optimum timing while continuously injecting a contrast medium. This study focused on the increase in blood flow in the superior and inferior vena cava during inspiration that affects the decrease in the CT value of the pulmonary artery and investigated a radiography method in which a delay time was set after inspiration in clinical cases., Methods: A total of 50 patients who underwent CTPA for suspected pulmonary thromboembolism were included. Using the bolus tracking method, we monitored the pulmonary arteries before and after inspiration, and investigated the CT value changes., Results: A decrease in the CT value of the pulmonary artery after inspiration was observed in approximately 30% of cases. By setting the delay time, the contrast enhancement effect before and after inspiration became equivalent., Conclusion: As a result of this study, avoiding a decrease in the CT value of the pulmonary artery is possible by setting a delay time after inspiration, which is considered useful during CTPA.

Background: Tri-weekly cisplatin and radiotherapy (CDDP + RT) is a standard of care for locally advanced head and neck squamous cell carcinoma (LA-HNSCC) but is sometimes challenging to complete in older patients. Weekly CDDP + RT has shown mild toxicity compared to tri-weekly CDDP + RT for LA-HNSCC and is a promising option for older adults. We aimed to report the treatment outcomes and prognostic factors in patients with LA-HNSCC treated with weekly CDDP + RT., Methods: We analyzed patients aged ≥ 70 years who started weekly CDDP + RT for LA-HNSCC between July 2006 and October 2022. LA-HNSCC includes cancer in the oropharynx, hypopharynx, or larynx with a clinical stage of 3 or 4 without distant metastases based on the Union for International Cancer Control staging system 8th edition. The radiation dose of 70 Gy was delivered in 35 fractions by 3-dimensional conformal radiotherapy, intensity-modulated radiotherapy, or proton beam therapy. The primary endpoint was the 3-year overall survival (OS), and the secondary endpoints were the 3-year progression-free survival (PFS) and 3-year cause-specific survival (CSS). The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used to evaluate statistical significance. A Cox proportional hazards model was used for the multivariate analysis of prognostic factors., Results: The median age of the 49 patients was 72 (range: 70-78) years. The median CDDP dose was 200 (40-280) mg/ m 2 , and 47 patients completed scheduled radiotherapy. Forty-eight patients (98.0%) had a performance status of ≥ 1 at the initial visit. The 3-year OS, PFS, and CSS were 80.9% (95% confidence interval [CI]: 64.8-90.7), 68.3% (95% CI 51.8-81.2), and 85.0% (95% CI 68.7-93.4), respectively. In the multivariate analysis, the cumulative CDDP dose (< 200 or ≥ 200 mg/m 2 ) was a significant factor for OS (hazard ratio: 0.29 [95% CI 0.08-0.97], p = 0.044). There was one case of early mortality. Grade 3 or higher late adverse events were observed in four patients (8.2%)., Conclusions: Weekly CDDP + RT in older patients led to good survival outcomes with an acceptable rate of adverse events. CDDP should be administered at a dose of at least 200 mg/m 2 in older patients. Trial registration Retrospectively registered., (© 2023. The Author(s).)

Objectives: External color Doppler ultrasonography is reported to be a useful monitoring technique that is simple and noninvasive; however, details of imaging of the transferred free jejunal flap have not been reported. We reviewed our experience using external color Doppler ultrasonography to monitor a transferred free jejunal flap and examined its utility., Study Design: Retrospective study., Methods: Subjects were 43 patients who underwent total pharyngolaryngectomy, reconstruction with a free jejunal flap, and color Doppler ultrasonography before, during, and after surgery between September 2017 and December 2021., Results: During surgery, arterial thrombosis was detected up to 100% with the loss of continuous color signals in the entire circumference. After surgery, the positive predictive value was 100% for each of wiggling movement, dynamic intestinal movement, and continuous color signals in the entire circumference on color Doppler ultrasonography for detecting flap viability. Their negative predictive value was 100%, 7.1%, and 50%, respectively., Conclusions: During surgery, the continuous color signals in the entire circumference sign were useful with 100% negative predictive value for detecting the arterial thrombosis. After surgery, the wiggling movement sign very was useful with 100% positive and negative predictive values, enabling salvage surgery to be performed soon after detection of flap failure., Level of Evidence: 4 Laryngoscope, 133:3361-3369, 2023., (© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)