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Purpose Dense deposit disease (DDD) is caused by dysregulation of the alternative pathway of the complement cascade and characterized by electron-dense deposits in the kidney glomerular basement membrane (GBM) and drusen in Bruch's membrane (BrM). Complement factor H (fH) and factor properdin (fP) regulate complement activation; fH inhibits alternative pathway (AP) activation, whereas fP promotes it. We report pathologic changes in eyes of an fH and fP double-mutant mouse, which we previously showed have dense deposits in the GBM and early mortality from nephropathy. Methods fHm/m, fP-/-, and fHm/m/fP-/- mice were generated on a C57BL/6-129J background. Fundus imaging at 8 weeks of age was followed by analysis via light and electron microscopy. Retinal function was assessed by electroretinography (ERG). Complement levels and localization were tested by immunohistochemistry and ELISA. Retinas of fHm/m/fP-/- mice treated with intraperitoneal injections of an anti-C5 antibody were compared to those of age- and genotype-matched mice injected with an isotype control antibody. Results fHm/m/fP-/- mice suffered early-onset retinal hypopigmented spots detected using in vivo retinal photography, and histologic examination showed basal laminar deposits (BLamD), degeneration of the photoreceptors, and RPE vacuolization. ERG showed diminished retinal function. The anti-C5 antibody was retina-protective. Conclusions This unique mouse represents a new model of complement-mediated rapid-onset DDD, and could be useful in exploring the pathologic changes associated with BLamD in age-related macular degeneration.

Two experiments assessed the extent to which grammatical gender provides a predictive basis for bilinguals' judgments about perceptual gender. In both experiments, French-English bilinguals and native English monolinguals were consecutively presented with images of objects manipulated for their (i) conceptual gender association and (ii) grammatical gender category and were instructed to make a decision on a subsequent target face. The experiments differed in the implicitness of the association between the object primes and target faces. Results revealed that when prior knowledge sources such as conceptual gender can be strategically used to resolve the immediate task (Experiment 1), this information was readily extracted and employed. However, grammatical gender demonstrated a more robust and persisting effect on the bilinguals' judgments, indicating that the retrieval of obligatory grammatical information is automatic and modulates perceptual judgments (Experiment 2). These results suggest that grammar enables an effective and robust means to access prior knowledge which may be independent of task requirements.

Purpose: To investigate image-registration errors when using fiducial markers with a manual method and the point-based rigid-body registration (PRBR) algorithm in accelerated partial breast irradiation (APBI) patients, with accompanying fiducial deviations. Methods: Twenty-two consecutive patients were enrolled in a prospective trial examining 10-fraction APBI. Titanium clips were implanted intraoperatively around the seroma in all patients. For image-registration, the positions of the clips in daily kV x-ray images were matched to those in the planning digitally reconstructed radiographs. Fiducial and gravity registration errors (FREs and GREs, respectively), representing resulting misalignments of the edge and center of the target, respectively, were compared between the manual and algorithm-based methods. Results: In total, 218 fractions were evaluated. Although the mean FRE/GRE values for the manual and algorithm-based methods were within 3 mm (2.3/1.7 and 1.3/0.4 mm, respectively), the percentages of fractions where FRE/GRE exceeded 3 mm using the manual and algorithm-based methods were 18.8%/7.3% and 0%/0%, respectively. Manual registration resulted in 18.6% of patients with fractions of FRE/GRE exceeding 5 mm. The patients with larger clip deviation had significantly more fractions showing large FRE/GRE using manual registration. Conclusions: For image-registration using fiducial markers in APBI, the manual registration results in more fractions with considerable registration error due to loss of fiducial objectivity resulting from their deviation. The authors recommend the PRBR algorithm as a safe and effective strategy for accurate, image-guided registration and PTV margin reduction.

The Soft X-ray Spectrometer (SXS) onboard the Hitomi (ASTRO-H) satellite observed several celestial objects. All the observations with the SXS were performed through a beryllium (Be) window installed on the gate-valve of the SXS dewar. However, the Be window had not been well calibrated before launching. Therefore, we measured the transmission of a spare Be window, which is from the same lot as the flight material. The measurements were preformed in 3.8–30 keV range with BL01B1 at SPring-8, and in 2.5–12 keV range combined with BL11B and BL7C at KEK-PF. In this paper, we report mainly the results of the KEK-PF experiment. With the KEK-PF, we measured five places of the Be window. Their estimated thicknesses are consistent with each other within 1.3 μm. In the five transmission data, we confirmed absorption edges by Fe-K, Ni-K and Mn-K and six edge like features at 3460, 6057, 6915, 7590, 8790 and 9193 eV, which can be interpreted as Bragg diffraction by Be polycrystal. By combining the transmissions measured at KEK-PF and at SPring-8, we estimated Be thickness of 259.73±0.01 μm. The amounts of contaminated materials are roughly comparable with the provided values from the provider. We also performed scanning measurements of whole surface in the Be window. In the results, thickness of Be window was found to be uniform in ±1µm from the measurement with 4 keV X-rays.

RÉSUMÉDans cet article, nous présentons les recherches, relativement récentes, sur l'intégration du genre dans la représentation mentale d'une lectrice ou d'un lecteur, en mettant l'accent sur leurs controverses ainsi que sur les pistes encore peu (ou pas) explorées. Nous espérons ainsi susciter l'intérêt de la communauté francophone sur ce sujet, jusqu'ici relativement discrète. Au travers de cette présentation, nous souhaitons également souligner les retombées sociétales des recherches sur ce sujet, principalement au travers de l'identification de processus langagiers discriminants.Si la recherche a jusqu'ici principalement ciblé des adultes dits monolingues entre 19 et 25 ans, nous présenterons également les quelques études qui ont été menées sur les enfants entre 6 et 15 ans, un projet en cours sur des enfants entre 2 et 3 ans et quelques résultats d'une étude récente examinant l'influence du bilinguisme sur la représentation du genre.

Purpose: To evaluate a dosimetric accuracy of AcurosXB dose calculation algorithm for 4 MV photon beam. Methods: Four MV beam (Clinac‐6EX) and AAA and AcurosXB algorithms (pre‐release version 11.0.03.) were used in this study. The differences of the calculation with AAA (EAAA) and AcurosXB (EAXB) to the measurement were evaluated in the depth doses to 25 cm depth and dose profiles within the water and slab phantoms (water, lung and bone equivalent). In addition, the clinical cases, including three whole breast plans and three head and neck IMRT plans, were evaluated. First the AAA plans were calculated, then AcurosXB plans were recalculated with dose‐to‐medium with identical beam setup and monitor units as in the AAA plan. Results: In the water phantom study, the EAAA and EAXB were up to 2.2% and 1.5% in the depth doses for the open field (field size = 4 − 40cm square), respectively. Under the heterogeneity conditions, the EAAA and EAXB were less than 4.4% and 2.2% in lung region, and less than 12.5% and 6.3% in bone region, respectively. In the re‐buildup region after passing through the lung phantom, the AAA overestimated the doses about 10%; however AcurosXB had good agreement with measurement within 3%. Dose profiles with AcurosXB were better agreement with measurement than AAA. In the clinical cases, the dose of the skin surface region with AcurosXB were higher than AAA by at least 10%, and the dose differences over 5% appeared in heterogeneous region. However, DVH shapes of each organ were similar between AAA and AcurosXB within 2%. Conclusions: In phantom study, AcurosXB had better agreement to measurement than AAA, especially in heterogeneous region and re‐buildup region. In the clinical cases, there were large differences between AcurosXB and AAA in the surface region. Evaluation Agreement of non‐clinical versions of Acuros XB witha€€Varian Medical Systems.

Background: In Japan, Job assistance for SMI have been not active. Compared with mental retardation, employment rate of SMI was low. The needs of the effective job assistance for SMI are growing. The purpose of this study was to determine the effectiveness of the combination approach of Cognitive Remediation (CR) and Supported Employment (SE) in clinical outcomes, including cognitive functioning and psychiatric symptoms besides vocational outcomes. Methods: The participants diagnosed with schizophrenia or schizoaffective disorder were assigned to CR+SE group (n=52) and SE group (n=57). CR comprised computer based trainings using COGPACK and group works. SE was individualized vocational support provided by employment specialists. Outcome measures included cognitive functioning, psychiatric symptoms, social functioning, performance of tasks as clinical outcomes, employment rate, duration of employment, and earned wage as vocational outcome. Results: CR+SE group displayed significantly better psychiatric symptoms (F=3.490, pDiscussions: This is the first controlled study to determine the effectiveness of CR on vocational outcomes in Japan. The results showed that CR and SE programs were feasible in Japan and that CR using COGPACK had favorable effects on cognitive functioning, psychiatric symptoms, and social functioning, which is consistent with previous researches.

SMAP2 is an Arf GAP and modulates clathrin-coated vesicle formation. SMAP2-deficient male mice exhibited globozoospermia due to acrosome deformation. In SMAP2(−/−) spermatids, budding of proacrosomal vesicles from the TGN was distorted and clathrin traffic–related molecules such as CALM and syntaxin2 were mislocated., The trans-Golgi network (TGN) functions as a hub organelle in the exocytosis of clathrin-coated membrane vesicles, and SMAP2 is an Arf GTPase-activating protein that binds to both clathrin and the clathrin assembly protein (CALM). In the present study, SMAP2 is detected on the TGN in the pachytene spermatocyte to the round spermatid stages of spermatogenesis. Gene targeting reveals that SMAP2-deficient male mice are healthy and survive to adulthood but are infertile and exhibit globozoospermia. In SMAP2-deficient spermatids, the diameter of proacrosomal vesicles budding from TGN increases, TGN structures are distorted, acrosome formation is severely impaired, and reorganization of the nucleus does not proceed properly. CALM functions to regulate vesicle sizes, and this study shows that CALM is not recruited to the TGN in the absence of SMAP2. Furthermore, syntaxin2, a component of the soluble N-ethylmaleimide–sensitive factor attachment protein receptor (SNARE) complex, is not properly concentrated at the site of acrosome formation. Thus this study reveals a link between SMAP2 and CALM/syntaxin2 in clathrin-coated vesicle formation from the TGN and subsequent acrosome formation. SMAP2-deficient mice provide a model for globozoospermia in humans.

Complement receptor 1–related gene/protein y (Crry) and decay-accelerating factor (DAF) are two murine membrane C3 complement regulators with overlapping functions. Crry deletion is embryonically lethal whereas DAF-deficient mice are generally healthy. Crry−/−DAF−/− mice were viable on a C3−/− background, but platelets from such mice were rapidly destroyed when transfused into C3-sufficient mice. In this study, we used the cre-lox system to delete platelet Crry in DAF−/− mice and studied Crry/DAF-deficient platelet development in vivo. Rather than displaying thrombocytopenia, Pf4-Cre+-Crryflox/flox mice had normal platelet counts and their peripheral platelets were resistant to complement attack. However, chimera mice generated with Pf4-Cre+-Crryflox/flox bone marrows showed platelets from C3−/− but not C3+/+ recipients to be sensitive to complement activation, suggesting that circulating platelets in Pf4-Cre+-Crryflox/flox mice were naturally selected in a complement-sufficient environment. Notably, Pf4-Cre+-Crryflox/flox mouse platelets became complement susceptible when factor H function was blocked. Examination of Pf4-Cre+-Crryflox/flox mouse bone marrows revealed exceedingly active thrombopoiesis. Thus, under in vivo conditions, Crry/DAF deficiency on platelets led to abnormal platelet turnover, but peripheral platelet count was compensated for by increased thrombopoiesis. Selective survival of Crry/DAF-deficient platelets aided by factor H protection and compensatory thrombopoiesis demonstrates the cooperation between membrane and fluid phase complement inhibitors and the body’s ability to adaptively respond to complement regulator deficiencies.

OBJECTIVE Cognitive impairment is common in schizophrenia, and is associated with poor psychosocial functioning. Previous studies had inconsistently shown improvement in cognitive functions with cognitive remediation therapy. This study examined whether cognitive remediation is effective in improving both cognitive and social functions in schizophrenia in outpatient settings that provide learning-based psychiatric rehabilitation. This study is the first randomized controlled trial of cognitive remediation in Japan. METHOD Study participants were individuals with schizophrenia from 6 outpatient psychiatric medical facilities who were randomly assigned either a cognitive remediation program or treatment as usual. The cognitive remediation intervention includes Cognitive training using computer software (CogPack; Japanese version) administered twice a week and a weekly group over 12 weeks and was based on the Thinking Skills for Work program. Most study participants were attending day treatment services where social skills training, psychoeducation for knowledge about schizophrenia, group activities such as recreation and sport, and other psychosocial treatment were offered. Cognitive and social functioning were assessed using the Brief Assessment of Cognition in Schizophrenia (BACS) and Life Assessment Scale for Mentally Ill (LASMI) at pre- and postintervention. RESULTS Of the 60 people with schizophrenia enrolled, 29 were allocated to the cognitive remediation group and 31 were allocated to the treatment as usual group. Processing speed, executive function, and the composite score of the BACS showed significantly greater improvement for the cognitive remediation group than the treatment as usual group. In addition, there was significant improvement in interpersonal relationships and work skills on the LASMI for the cognitive remediation group compared with the treatment as usual group. Changes from pretreatment to posttreatment in verbal fluency and interpersonal relationships were significantly correlated, as well as changes in attention and work skills. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The present findings showed that providing cognitive remediation on addition to psychiatric rehabilitation contributed to greater improvement in both cognitive and social functioning than psychiatric rehabilitation alone. Cognitive remediation may enhance the efficacy of psychiatric rehabilitation improving social functioning. (PsycINFO Database Record

C3 glomerulopathy is a potentially life-threatening disease of the kidney caused by dysregulated alternative pathway complement activation. The specific complement mediator(s) responsible for kidney injury in C3 glomerulopathy are yet to be defined and no specific therapy is currently available. We previously developed a mouse model of lethal C3 glomerulopathy with factor H and properdin gene double mutations. Therefore, we used this model to examine the role of C5 and C5a receptor (C5aR) in the pathogenesis of the disease. Disease severity in these factor H/properdin double-mutant mice was found to be correlated with plasma C5 levels, and prophylactic anti-C5 mAb therapy was effective in preventing lethal C3 glomerulopathy. When given to these double-mutant mice that had already developed active disease with severe proteinuria, anti-C5 mAb treatment also prevented death in half of the mice. Deficiency of C5aR significantly reduced disease severity, suggesting that C5aR-mediated inflammation contributed to C3 glomerulopathy. Thus, C5 and C5aR have a critical role in C3 glomerulopathy. Hence, early intervention targeting these pathways may be an effective therapeutic strategy for patients with C3 glomerulopathy.

Factor H (fH) and properdin both modulate complement; however, fH inhibits activation, and properdin promotes activation of the alternative pathway of complement. Mutations in fH associate with several human kidney diseases, but whether inhibiting properdin would be beneficial in these diseases is unknown. Here, we found that either genetic or pharmacological blockade of properdin, which we expected to be therapeutic, converted the mild C3 GN of an fH-mutant mouse to a lethal C3 GN with features of human dense deposit disease. We attributed this phenotypic change to a differential effect of properdin on the dynamics of alternative pathway complement activation in the fluid phase and the cell surface in the fH-mutant mice. Thus, in fH mutation-related C3 glomerulopathy, additional factors that impact the activation of the alternative pathway of complement critically determine the nature and severity of kidney pathology. These results show that therapeutic manipulation of the complement system requires rigorous disease-specific target validation.

This study evaluated the dosimetric difference between volumetric-modulated arc therapy (VMAT) and conventional fixed-field intensity-modulated radiotherapy (cIMRT) in whole-ventricular irradiation. Computed tomography simulation data for 13 patients were acquired to create plans for VMAT and cIMRT. In both plans, the same median dose (100% = 24 Gy) was prescribed to the planning target volume (PTV), which comprised a tumor bed and whole ventricles. During optimization, doses to the normal brain and body were reduced, provided that the dose constraints of the target coverage were satisfied. The dose-volume indices of the PTV, normal brain, and body as well as monitor units were compared between the 2 techniques by using paired t-tests. The results showed no significant difference in the homogeneity index (0.064 vs 0.065; p = 0.824) of the PTV and conformation number (0.78 vs 0.77; p = 0.065) between the 2 techniques. In the normal brain and body, the dose-volume indices showed no significant difference between the 2 techniques, except for an increase in the volume receiving a low dose in VMAT; the absolute volume of the normal brain and body receiving 1 Gy of radiation significantly increased in VMAT by 1.6% and 8.3%, respectively, compared with that in cIMRT (1044 vs 1028 mL for the normal brain and 3079.2 vs 2823.3 mL for the body; p

The aim of this study was to clarify whether improvement of cognitive functioning by cognitive remediation therapy can improve work outcome in schizophrenia and other severe mental illnesses when combined with supported employment.The subjects of this study were persons with severe mental illness diagnosed with schizophrenia, major depression, or bipolar disorder (ICD-10) and cognitive dysfunction who participated in both cognitive remediation using the Thinking Skills for Work program and a supported employment program in a multisite, randomized controlled study. Logistic and multiple linear regression analyses were performed to clarify the influence of cognitive functioning on vocational outcomes, adjusting for demographic and clinical variables.Improvement of cognitive functioning with cognitive remediation significantly contributed to the total days employed and total earnings of competitive employment in supported employment service during the study period. Any baseline demographic and clinical variables did not significantly contribute to the work-related outcomes.A cognitive remediation program transferring learning skills into the real world is useful to increase the quality of working life in supported employment services for persons with severe mental illness and cognitive dysfunction who want to work competitively.

Aim The aims of the present study were to revise the Community Re-entry Program–Japanese version and to review the effectiveness of the revised Program, named the Discharge Preparation Program. Methods This study was a randomized controlled trial. The Discharge Preparation Program (DPP) was the intervention condition (n = 26), and the usual rehabilitation program was the control condition (n = 23). Outcome indicators included factors that make patient discharge difficult (which nurses evaluated), psychiatric symptom, knowledge about the illness or medication, and the number of patients who were discharged within 6 months after the end of a program. Results Significant improvements were found in the score of the ‘Issues on treatment compliance’ factor and the score of the ‘Autistic life’ factor, which are subscales of the Discharge Difficulty Scale, for the DPP group, on two-way ANOVA (‘Issues on treatment compliance’: F = 3.818, P

Objectives: Japan has the largest number of psychiatric beds per capita in the world. Both reducing the number of beds and preventing long-term hospitalization of individuals with mental illness is essential. This study surveys Japanese acute psychiatric units to investigate the process by which care management is provided. Care management is important to prevent those with a higher need for care from becoming long-term inpatients. Methods: All of the psychiatric emergency units (PEUs) and acute psychiatric treatment units (PAUs) in Japan (N = 234) were surveyed. Chief nurses of each unit completed items from a questionnaire that assessed basic characteristics of the unit and the implementation of each element of care management (i.e., triage, assessment, care conferences, and care plan development). Additionally, the association between care management and the clinical outcomes of the unit is examined. Results: The length of stay is 52.0 days for PEUs and 65.2 days for PAUs, and more than 25 percent of p...

Clinical pathways have been defined as an optimal sequencing and timing of interventions by staff for a particular diagnosis or procedure, designed to better utilize resources, maximize quality of care and minimize delays. The aim of the present study was to develop a clinical pathway for long-term inpatients with schizophrenia. A review of clinical records was conducted for 17 patients with schizophrenia who had stayed in one psychiatric hospital for >1 year, and who remained in the community >3 months after hospital discharge. A review of clinical routine records was conducted. The discharge process of each patient was expressed in a clinical pathway around phases and care components. They were integrated into one clinical pathway. The discharge process was divided into assessment and goalsetting, preparation, and discharge phases. Care components included discharge planning, daily activity, living environment, health management, and basic life skills. Discharge planning was an important care component that was combined with all three phases. A clinical pathway was developed from reviewing past patient records, and discharge planning was found to be an important care component, which was combined with all three phases: assessment and goalsetting, preparation, and discharge. Further study is needed to examine the validity of the pathway for use in other hospitals.

DNA microarray technology has enabled genomewide analysis of gene transcript levels, yielding insight into the molecular nature of liver disease. We compared gene expression of liver biopsy specimens in 16 patients with different stages of chronic hepatitis B, five with autoimmune hepatitis (AIH), five with primary biliary cirrhosis (PBC), and six with druginduced hepatitis. Of 21 073 genes, 424 showed different expression in a particular disease group on analysis of variance. Genes associated with extracellular matrix, cell growth, and DNA repair were noted in the advanced fibrotic stage of chronic hepatitis B (B-3), while gene expression regarding complement activation and the innate immune response decreased. When we compared gene expression at the relatively early stage in each disease group with pathway analysis, pathways relating to chemotaxis and cell homeostasis were selected in chronic hepatitis B. In PBC, gene expression relating to structural constituents and contractions of muscle such as actin and myosin were enhanced, in contrast to the downregulation of genes relating to protein binding in AIH. A hierarchical clustering analysis of hepatitis B genes defined five clusters. Generally, the transcripts upregulated according to disease progression were associated with signaling pathway/transcription, including tumor-associated calcium signal transducer 1 and chemokine ligand 19, and with cell communication, such as collagen. In two groups, all transcripts were downregulated; transcripts related to chemokine ligands and metallothionein were further depressed in B-3. Analysis of gene expression in liver may be useful for understanding features of distinct liver diseases and for guiding disease progression, particularly in chronic hepatitis B.

AIM DNA microarray technology has enabled genome-wide analysis of gene transcript levels, which has yielded insight into the molecular nature of hepatitis C virus infection. However, little insight into the molecular nature of the early to advanced stages of chronic liver disease has as yet been obtained. METHODS We compared the gene expression profiles of liver biopsy specimens from 14 patients at different stages of chronic hepatitis C. We also evaluated the liver tissue of hepatocellular carcinoma and its surrounding region obtained surgically in seven patients with hepatitis C virus infection. RESULTS Of 21 073 genes, 582 genes showed significant changes in expression levels across the disease group. Twenty-eight samples from six disease groups clustered according to the histological classification except for 4 samples. A heat map produced by hierarchical clustering revealed nine clusters where gene expression profiles were changed in abundance. Among 44 genes which changed twofold or more in transcript abundance, transcripts from chronic hepatitis tended to be upregulated, and gradually downregulated according to disease progression toward hepatocellular carcinoma in five of nine clusters. In chronic hepatitis, transcripts relating to metabolism and immune response were upregulated, while in hepatocellular carcinoma, transcripts associated with cell cycle, growth, proliferation, apoptosis and signaling pathway were upregulated. CONCLUSION Disease progression in hepatitis C virus-infected patients appeared to be associated with changes in gene expression profiles in the liver consistent with plausible functional categories, although we should confirm these findings using larger samples.

読解過程において指示的一貫性を得ることはテキスト理解において必要不可欠な手続きである.読み手は照応形(anaphora)に行き当たった場合,テキスト上の情報及び読み手自身の既有知識を用い,可能な先行詞(antecedent)の候補と適合させる.これらの候補は幾つかの制約を満たさなければならず,そのために必要とされる処理は些末ではない.これから解るように,これらの処理過程は決して容易なものではなく,第二言語(L2)においてはその難易度は第一言語(L1)以上に増すと考えられる.Just& Carpenterが提唱するCapacity Hypothesis (1992)によると我々には限られた認知資源しか備わっていないために低い水準の処理過程と高水準の処理過程との間にトレードオフが起きる.これを前提として,本論文ではL2における照応解析の研究課題を提案すると同時にL2のコンテキストにおいて同一指示的でない橋渡し指示表現(bridging description)の解析が直接照応形(direct anaphora)に比べ,より認知資源を要するという主張を議論する., Establishing referential coherence during reading comprehension is a necessary process in text comprehension. When readers encounter anaphora, they use information from the text and their world knowledge in order to refer back to potential antecedents. These candidates need to satisfy certain constraints, and therefore, resolution of anaphora requires non-trivial processing. As can be understood, these processes are not simple procedures, and the difficulty in the resolution process is likely to be greater than that in first language (LI) than in second language (L2). The Capacity Hypothesis by Just & Carpenter (1992) suggests that the cognitive resources that we possess are limited, and thus, a tradeoff between low level tasks and high level tasks can occur. Under this theoretical framework, this article discusses some current research issues, and we argue that in the L2 context, resolving a bridging description which is not co-referential, calls for a greater demand of cognitive resources than the resolution of direct anaphora.

Recent studies on psychoneuroimmunology have indicated that positive psychological events are related to immune functions; however, limited information is available regarding associations among the central nervous, endocrine, and immune systems when positive emotions are elicited. In the present study, we demonstrated associations among these systems by simultaneously recording brain, endocrine, and immune activities when positive emotions were evoked in participants as they watched films featuring their favorite persons. Interestingly, the activity of peripheral circulating natural killer cells and the peripheral dopamine level were elevated while participants experienced positive emotions, and these values were positively correlated. The following brain regions were significantly activated in the positive condition relative to the control condition: medial prefrontal cortex, thalamus, hypothalamus, subcallosal gyrus, posterior cingulate cortex, superior temporal gyrus, and cerebellum. Further, covariate analyses indicated that these brain regions were temporally associated with endocrine and immune activities. These results suggest that while an individual experiences positive emotions, the central nervous, endocrine, and immune systems may be interrelated and attraction for favorite persons may be associated with the activation of the innate immune function via the dopaminergic system.

X chromosomes are unusual in many regards, not least of which is their nonrandom gene content. The causes of this bias are commonly discussed in the context of sexual antagonism and the avoidance of activity in the male germline. Here, we examine the notion that, at least in some taxa, functionally biased gene content may more profoundly be shaped by limits imposed on gene expression owing to haploid expression of the X chromosome. Notably, if the X, as in primates, is transcribed at rates comparable to the ancestral rate (per promoter) prior to the X chromosome formation, then the X is not a tolerable environment for genes with very high maximal net levels of expression, owing to transcriptional traffic jams. We test this hypothesis using The Encyclopedia of DNA Elements (ENCODE) and data from the Functional Annotation of the Mammalian Genome (FANTOM5) project. As predicted, the maximal expression of human X-linked genes is much lower than that of genes on autosomes: on average, maximal expression is three times lower on the X chromosome than on autosomes. Similarly, autosome-to-X retroposition events are associated with lower maximal expression of retrogenes on the X than seen for X-to-autosome retrogenes on autosomes. Also as expected, X-linked genes have a lesser degree of increase in gene expression than autosomal ones (compared to the human/Chimpanzee common ancestor) if highly expressed, but not if lowly expressed. The traffic jam model also explains the known lower breadth of expression for genes on the X (and the Z of birds), as genes with broad expression are, on average, those with high maximal expression. As then further predicted, highly expressed tissue-specific genes are also rare on the X and broadly expressed genes on the X tend to be lowly expressed, both indicating that the trend is shaped by the maximal expression level not the breadth of expression per se. Importantly, a limit to the maximal expression level explains biased tissue of expression profiles of X-linked genes. Tissues whose tissue-specific genes are very highly expressed (e.g., secretory tissues, tissues abundant in structural proteins) are also tissues in which gene expression is relatively rare on the X chromosome. These trends cannot be fully accounted for in terms of alternative models of biased expression. In conclusion, the notion that it is hard for genes on the Therian X to be highly expressed, owing to transcriptional traffic jams, provides a simple yet robustly supported rationale of many peculiar features of X’s gene content, gene expression, and evolution., Laurence Hurst, Lukasz Huminiecki, and the FANTOM5 consortium propose a new explanation for the peculiar expression properties of genes on the human X chromosome, based on the premise that very high expression levels cannot be achieved on a haploid-expressed chromosome., Author Summary Genes located on the human X chromosome are not a random mix of genes: they tend to be expressed in relatively few tissues or are specific for a particular set of tissues, e.g., brain regions. Prior attempts to explain this skewed gene content have hypothesized that the X chromosome might be peculiar because it has to balance mutations that are advantageous to one sex but deleterious to the other, or because it has to shut down during the process of sperm manufacture in males. Here we suggest and test a third possible explanation: that genes on the X chromosome are limited in their transcription levels and thus tend to be genes that are lowly or specifically expressed. We consider the suggestion that since these genes can only be expressed from one chromosome, as males only have one X, the ability to express a gene at very high rates is limited owing to potential transcriptional traffic jams. As predicted, we find that human X-located genes have maximal expression rates far below that of genes residing on autosomes. When we look at genes that have moved onto or off the X chromosome during recent evolution, we find the maximal expression is higher when not on the X chromosome. We also find that X-located genes that are relatively highly expressed are not able to increase their expression level further. Our model explains both the enrichment for tissue specificity and the paucity of certain tissues with X-located genes. Genes underrepresented on the X are either expressed in many tissues—such genes tend to have high maximal expression—or are from tissues that require a lot of transcription (e.g., fast secreting tissues like the liver). Just as many of the findings cannot be explained by the two earlier models, neither can the traffic jam model explain all the peculiar features of the genes found on the X chromosome. Indeed, we find evidence of a reproduction-related bias in X-located genes, even after allowing for the traffic jam problem.

The purpose of this study was to investigate the status of the implementation of quality assurance (QA) for intensity-modulated radiation therapy (IMRT) in Japan using a questionnaire survey.The questionnaire consisted of seven sections: (1) clinical uses of IMRT, (2) treatment planning systems, treatment machines, phantoms for verification and CT scanning, (3) absorbed dose verification, (4) dose distribution verification, (5) fluence map verification, (6) acceptance criteria for each verification, and (7) comments.The questionnaire was completed by 129 institutions (response rate: 76.8%). IMRT was performed for prostate cancer in 125 institutions (96.9%), followed by head and neck cancer in 83 (64.3%), and brain tumors in 69 (53.5%). Although at least three individuals were engaged in IMRT QA in 77.5% of the institutions, the number of full-time persons involved in IMRT QA was one or less in 94 institutions (72.9%). This indicated that most institutions in Japan have a staff shortage. More than 90% of the institutions verified both the absorbed dose and dose distribution. The acceptance criterion for the absorbed dose verification was set to ±3% in at least 80% of the institutions. Gafchromic film was used for the majority of dose distribution verifications. The acceptance criteria for dose distribution verification mainly involved gamma analysis and a comparison of dose profiles; however, the judgment of acceptance did not depend on the results of the gamma analysis.This survey increases our understanding of how institutions currently perform IMRT QA analysis. This understanding will help to move institutions toward more standardization of IMRT QA in Japan.

To investigate image-registration errors when using fiducial markers with a manual method and the point-based rigid-body registration (PRBR) algorithm in accelerated partial breast irradiation (APBI) patients, with accompanying fiducial deviations.Twenty-two consecutive patients were enrolled in a prospective trial examining 10-fraction APBI. Titanium clips were implanted intraoperatively around the seroma in all patients. For image-registration, the positions of the clips in daily kV x-ray images were matched to those in the planning digitally reconstructed radiographs. Fiducial and gravity registration errors (FREs and GREs, respectively), representing resulting misalignments of the edge and center of the target, respectively, were compared between the manual and algorithm-based methods.In total, 218 fractions were evaluated. Although the mean FRE/GRE values for the manual and algorithm-based methods were within 3 mm (2.3/1.7 and 1.3/0.4 mm, respectively), the percentages of fractions where FRE/GRE exceeded 3 mm using the manual and algorithm-based methods were 18.8%/7.3% and 0%/0%, respectively. Manual registration resulted in 18.6% of patients with fractions of FRE/GRE exceeding 5 mm. The patients with larger clip deviation had significantly more fractions showing large FRE/GRE using manual registration.For image-registration using fiducial markers in APBI, the manual registration results in more fractions with considerable registration error due to loss of fiducial objectivity resulting from their deviation. The authors recommend the PRBR algorithm as a safe and effective strategy for accurate, image-guided registration and PTV margin reduction.

Masahiro Satake,1 Takanobu Shioya,1 Sachiko Uemura,1 Hitomi Takahashi,2 Keiyu Sugawara,2 Chikage Kasai,2 Noritaka Kiyokawa,2 Toru Watanabe,2 Sayaka Sato,2 Atsuyoshi Kawagoshi2 1Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan; 2Department of Rehabilitation, Akita City Hospital, Akita, Japan Abstract: The purpose of this study was to investigate the relationship between dynamic hyperinflation and dyspnea and to clarify the characteristics of dyspnea during the 6-minute walk test (6MWT) in chronic obstructive pulmonary disease patients. Twenty-three subjects with stable moderate chronic obstructive pulmonary disease (age 73.8±5.8 years, all male) took part in this study. During the 6MWT, ventilatory and gas exchange parameters were measured using a portable respiratory gas analysis system. Dyspnea and oxygen saturation were recorded at the end of every 2 minute period during the test. There was a significant decrease in inspiratory capacity during the 6MWT. This suggested that dynamic hyperinflation had occurred. Dyspnea showed a significant linear increase, and there was a significant negative correlation with inspiratory capacity. It was suggested that one of the reasons that dyspnea developed during the 6MWT was the dynamic hyperinflation. Even though the tidal volume increased little after 2 minutes, dyspnea increased linearly to the end of the 6MWT. These results suggest that the mechanisms generating dyspnea during the 6MWT were the sense of respiratory effort at an early stage and then the mismatch between central motor command output and respiratory system movement. Keywords: field walking test, chronic respiratory diseases, respiratory gas analysis, inspiratory capacity, IC, inspiratory reserve volume, IRV, Borg CR-10 scale, COPD

As aging and disease structure has changed mainly in accordance with adult disease, general medical treatment has been expected to take a role as a part of the"Comprehensive Care" that contributes to improve the quality of life. The similar paradigm change is needed for the treatment for the people with severe mental illness. The goal of this change is to realize the dissemination of prevention, early intervention, and comprehensive treatment in the community for the people with severe mental illness. The challenge for this change is reform on traditional structure of hospital based treatment and immaturity of staff skill. This article discuss the recent reforms of "Day care" and outreach team in National Center of Neurology and Psychiatry, focusing on these system-wide change and improvement of clinical skills of the staff. The key points of reforms are summarized as follows: (1) strongly focusing on the consumers' needs in their daily life, (2) establishing case management by the mental health staff, and (3) transforming the hierarchy system from in which psychiatrists are at the top of the multidisciplinary team to in which all staff are as equal members of the team. Some areas for necessary improvement required for the future are indicated in the end of this article.

Complement is implicated in asthma pathogenesis, but its mechanism of action in this disease remains incompletely understood. In this study, we investigated the role of properdin (P), a positive alternative pathway complement regulator, in allergen-induced airway inflammation. Allergen challenge stimulated P release into the airways of asthmatic patients, and P levels positively correlated with proinflammatory cytokines in human bronchoalveolar lavage (BAL). High levels of P were also detected in the BAL of OVA-sensitized and challenged but not naive mice. Compared with wild-type (WT) mice, P-deficient (P−/−) mice had markedly reduced total and eosinophil cell counts in BAL and significantly attenuated airway hyperresponsiveness to methacholine. Ab blocking of P at both sensitization and challenge phases or at challenge phase alone, but not at sensitization phase alone, reduced airway inflammation. Conversely, intranasal reconstitution of P to P−/− mice at the challenge phase restored airway inflammation to wild-type levels. Notably, C3a levels in the BAL of OVA-challenged P−/− mice were significantly lower than in wild-type mice, and intranasal coadministration of an anti-C3a mAb with P to P−/− mice prevented restoration of airway inflammation. These results show that P plays a key role in allergen-induced airway inflammation and represents a potential therapeutic target for human asthma.

The purpose of this study was to evaluate the accuracy of positional verification during overall radiation treatment periods in accelerated partial breast irradiation using one or more surgical clips. We first investigated the appropriate computed tomography (CT) slice thickness and detectability of clips for a matching criterion in a phantom study. Next, clinical investigations were carried on 12 patients with multiple clips positioned around the lumpectomy cavity. During radiation treatment planning, a 5-mm region of interest (5-mm ROI) was defined by adding a three dimentional (3D) margin of 5 mm to each clip. During treatment, the clips on two orthogonal kilovoltage X-ray images acquired were moved so as to be included in the corresponding 5-mm ROI on digitally reconstructed radiographs (DRRs). Positional accuracy was calculated using the displacement of each clip in the verification images. The displacements of each clip acquired in all setups were then calculated throughout the overall radiation treatment period and the factors affecting the displacement of clips were investigated. Positional accuracy was also investigated in setups using skin marks and in setups using the bone structure around the thorax. We demonstrated in a phantom study that a CT slice thickness of 2.5 mm was appropriate. In our clinical investigations, 91% of the clips were included in the 5-mm ROI. The interfractional displacement of clips was large, with a long distance between the isocenter and each clip at the time of radiation treatment planning.

A novel three‐dimensional unicursal irradiation technique “Dynamic WaveArc” (DWA), which employs simultaneous and continuous gantry and O‐ring rotation during dose delivery, has been implemented in Vero4DRT. The purposes of this study were to develop a commissioning and quality assurance procedure for DWA irradiation, and to assess the accuracy of the mechanical motion and dosimetric control of Vero4DRT. To determine the mechanical accuracy and the dose accuracy with DWA irradiation, 21 verification test patterns with various gantry and ring rotational directions and speeds were generated. These patterns were irradiated while recording the irradiation log data. The differences in gantry position, ring position, and accumulated MU (EG,ER, and EMU, respectively) between the planned and actual values in the log at each time point were evaluated. Furthermore, the doses delivered were measured using an ionization chamber and spherical phantom. The constancy of radiation output during DWA irradiation was examined by comparison with static beam irradiation. The mean absolute error (MAE) of EG and ER were within 0.1° and the maximum error was within 0.2°. The MAE of EMU was within 0.7 MU, and maximum error was 2.7 MU. Errors of accumulated MU were observed only around control points, changing gantry, and ring velocity. The gantry rotational range, in which EMU was greater than or equal to 2.0 MU, was not greater than 3.2%. It was confirmed that the extent of the large differences in accumulated MU was negligibly small during the entire irradiation range. The variation of relative output value for DWA irradiation was within 0.2%, and this was equivalent to conventional arc irradiation with a rotating gantry. In conclusion, a verification procedure for DWA irradiation was designed and implemented. The results demonstrated that Vero4DRT has adequate mechanical accuracy and beam output constancy during gantry and ring rotation. PACS number: 87

Objective— Inflammation contributes to hypertension-induced cardiac damage and fibrotic remodeling. Complement activation produces anaphylatoxins, which are major inflammatory effectors. Here, we investigated the role of complement anaphylatoxins in angiotensin II (Ang II)–induced cardiac remodeling. Approach and Results— We measured human plasma levels of complement anaphylatoxins in hypertensive individuals and controls and studied the role of complement activation in a mouse model of Ang II–induced hypertension and cardiac injury. We found that complement 5a (C5a) concentration was more elevated in hypertensive individuals than in controls. Infusion of Ang II in mice for 7 days led to increased anaphylatoxin concentration in plasma and perivascular C3b deposition in the heart. C5a receptor (C5aR)–deficient but not C3a receptor–deficient mice exhibited markedly reduced cardiac remodeling and inflammation after Ang II infusion. Pharmacological inhibition of C5a production by an anti-C5 monoclonal antibody produced similar effects to C5aR deficiency. Bone marrow chimera experiments revealed that C5aR expression on bone marrow–derived cells was critical in mediating Ang II–induced cardiac injury and remodeling. The C5aR pathway regulated the expression of adhesion molecules on peripheral monocytes, as well as infiltration and cytokine production of macrophage in the heart. Conclusions— Complement is activated in hypertensive hearts, and the C5aR signaling pathway on blood monocytes/macrophages plays a pathological role in Ang II–induced cardiac inflammation and remodeling. Therapeutic inhibition of complement may protect patients from hypertension-related heart injury.

We have identified cDNA and genomic clones encoding a homologue of pancreatic trypsin, termed TESP4, as a candidate protein involved in the sperm penetration of the egg zona pellucida in mouse. The deduced amino acid sequence indicates that TESP4 is 90% identical to pancreatic trypsin. Analysis of Northern blotting and reverse transcriptase-polymerase chain reaction reveals that the mouse TESP4 gene is ubiquitously expressed in all tissues tested, including the pancreas and testis, and the transcript is present in the haploid stages of male germ cells. Moreover, immunochemical analysis of mouse cauda epididymal sperm using an affinity-purified antibody against bovine pancreatic trypsinogen shows that TESP4 is localized only in the sperm acrosome and is released during the acrosome reaction induced by calcium ionophore A23187. These findings may open a new point of view regarding the molecular mechanisms of the sperm/egg interactions, including the sperm penetration of the egg zona pellucida.

A sodium ion-sensing plate was prepared as an easily-handled ion-sensing optical chemical sensor (optode) probe. The sensing plate consisted of an ion-sensing liquid thin layer containing a Na+-selective neutral ionophore (16-crown-5 derivatives) and a lipophilic anionic dye (KD-A3), which was placed on a chemically modified (octadecyl silanized) frosted glass plate that was covered with a cellulose dialysis membrane. This ion-sensing plate can easily determine Na+ ranging from 10-4 to 10-1 M by simply dipping the plate into the sample solution. The response time was ca. 80 s for 10-1 M NaCl with good reproducibility (relative standard deviation (RSD)=±1.33% for ten sequential measurements).

We investigated the effects of grammatical and stereotypical gender information on the comprehension of human referent role nouns among bilinguals of a grammatical (French) and a natural gender language (English). In a sentence evaluation paradigm, participants judged the acceptability of a gender-specific sentence referring to either a group of women or men following a sentence containing the plural form of a role noun female (e.g., social workers), male (e.g., surgeons) or neutral (e.g., musicians) in stereotypicality. L1 French and L1 English bilinguals were tested both in French and English. The results showed that bilinguals construct mental representations of gender associated with the language of the task they are engaged in, shifting representations as they switch languages. Specifically, in French, representations were male-dominant (i.e., induced by the masculine form), whereas in English, they were stereotype-based. Furthermore, the results showed that the extent to which representations shifted was modulated by participants’ proficiency in their L2, with highly proficient L2 participants resembling native speakers of the L2 and less proficient L2 participants being influenced more by their native language.

The murine cell surface protein Crry (complement receptor 1–related protein/gene y) is a key complement regulator with similar activities to human membrane cofactor protein (MCP) and decay-accelerating factor. MCP has a critical role in preventing complement-mediated tissue injury and its mutation has been implicated in several human kidney diseases. The study of Crry in mice has relevance to understanding MCP activity in human diseases; however, such efforts have been hampered by the embryonic lethality phenotype of Crry gene knockout. Here we used a conditional gene–targeting approach and deleted Crry from the mouse proximal tubular epithelial cells where Crry is prominently expressed. Absence of Crry from proximal tubular epithelial cells resulted in spontaneous C3 deposition on the basolateral surface but no apparent renal disease in unchallenged mice. However, mice deficient in Crry on proximal tubular epithelial cells developed exacerbated renal injury when subjected to renal ischemia–reperfusion, showing increased blood urea nitrogen levels, higher tubular injury scores, more tubular epithelial cell apoptosis, and inflammatory infiltrates. Renal ischemia–reperfusion injury in the Crry conditional knockout mice was prevented by blocking C3 and C5 activation using an anti-properdin or anti-C5 monoclonal antibody (mAb), respectively. Thus, Crry has a critical role in protecting proximal tubular epithelial cells during ischemia–reperfusion challenge. Our results highlight the latent risk for inflammatory kidney injury associated with defects in membrane complement regulators.

Complement is implicated in the pathogenesis of ischemia-reperfusion injury (IRI). The activation pathway(s) and effector(s) of complement in IRI may be organ specific and remain to be fully characterized. We previously developed a renal IRI model in decay-accelerating factor (DAF) and CD59 double-knockout (DAF−/−CD59−/−) mice. In this study, we used this model to dissect the pathway(s) by which complement is activated in renal IRI and to evaluate whether C3aR- or C5aR-mediated inflammation or the membrane attack complex was pathogenic. We crossed DAF−/−CD59−/− mice with mice deficient in various complement components or receptors including C3, C4, factor B (fB), factor properdin (fP), mannose-binding lectin, C3aR, C5aR, or Ig and assessed renal IRI in the resulting mutant strains. We found that deletion of C3, fB, fP, C3aR, or C5aR significantly ameliorated renal IRI in DAF−/−CD59−/− mice, whereas deficiency of C4, Ig, or mannose-binding lectin had no effect. Treatment of DAF−/−CD59−/− mice with an anti-C5 mAb reduced renal IRI to a greater degree than did C5aR deficiency. We also generated and tested a function-blocking anti-mouse fP mAb and showed it to ameliorate renal IRI when given to DAF−/−CD59−/− mice 24 h before, but not 4 or 8 h after, ischemia/reperfusion. These results suggest that complement is activated via the alternative pathway during the early phase of reperfusion, and both anaphylatoxin-mediated inflammation and the membrane attack complex contribute to tissue injury. Further, they demonstrate a critical role for properdin and support its therapeutic targeting in renal IRI.

Flow-through type fiber-optic silver ion selective optodes based on novel cyclic and noncyclic thia crown ether compounds and a lipophilic anionic indicator dye have been developed. Pellicular octadecylsilica beads were coated with a lipophilic organic liquid containing the thia ether compound as the silver ion selective ionophore and LAD-3 as the color changeable indicator dye. The optode system was constructed by packing these color changeable ion sensing beads in a flow-through optical cell (cell volume, 7 μL) having a quartz window attached directly to the distal end of a bifurcated optical fiber. The optode based on a lipophilic thia crown ether that has two sulfur atoms (tetradecyl-14-dithiacrown-4) exhibited the most sensitive response to silver ion of all the optodes investigated. This optode could detect silver ion in concentrations ranging from 10 -6 to 10 -2 M at pH 7.0 with 0.05 M Tris-H 2 SO 4 buffer as the flowing solution by measuring the absorbance change in the sensing beads at 516 nm. This optode showed a highly selective response to Ag + without any interference from other transition metal ions, except for Hg 2+ , up to 10 -3 M, as well as alkali metal and alkaline earth metal ions up to 1 M. Optodes employing high lipophilic ionophores showed good reproducible response to Ag + for at least 2 weeks

The double-armed diazacrown ethers, which have a base diazacrown ether ring with two diamide-type side chains, were designed and synthesized on the basis of the proposed molecular model for the novel neutral Ca 2+ and Mg 2+ ionophores. The potentiometric ion-selective electrodes were prepared with over 20 kinds of systematic synthesized diazacrown ether derivatives. The relationship between the molecular structures of the ionophores and the ion selecticties was fully discussed. The electrodes based on the 21- and 18-membered diazacrown ether derivatives possessing a glycolic diamide and malonic diamide in their side chains (K23E1 and K22B5) exhibited excellent Ca 2+ and Mg 2+ selectivities, respectiveed

Methods to improve neurocognitive impairments are of important research interest. This study sought to examine the synergistic effects of neurocognitive rehabilitation and antipsychotics for schizophrenia.Subjects were 43 patients diagnosed with schizophrenia or schizoaffective disorder in a randomized trial of the effects of neurocognitive rehabilitation or a quasi-randomized experimental trial of supported employment with neurocognitive rehabilitation. We compared the effects of risperidone and aripiprazole in neurocognitive rehabilitation for schizophrenia. Subjects were divided into the following groups: (i) the control-risperidone group (CR group) (n = 13); (ii) the rehabilitation-risperidone group (RR group) (n = 9); (iii) the control-aripiprazole group (CA group) (n = 10); and (iv) the rehabilitation-aripiprazole group (RA group) (n = 11). Subjects in the rehabilitation group were engaged in computer-based cognitive exercises (24 sessions) with bridging group (12 sessions) over 12 weeks. Psychiatric symptoms, neurocognitive functioning and social functioning assessments were evaluated at baseline and at 12 weeks.A two-way anova with neurocognitive rehabilitation and antipsychotic medication as factors revealed a significant interaction effect on motor speed. Working memory and motor speed significantly improved in the RA group compared with the CA group. We found no significant improvements between the CR group and the RR group.A synergistic effect of neurocognitive rehabilitation and aripiprazole was observed as improvement of motor speed. In patients treated with aripiprazole, neurocognitive rehabilitation appeared to improve working memory and motor speed. Further studies of synergistic effects of neurocognitive rehabilitation and antipsychotic medication are necessary to verify these findings.

The aims of the present study were to revise the Community Re-entry Program-Japanese version and to review the effectiveness of the revised Program, named the Discharge Preparation Program.This study was a randomized controlled trial. The Discharge Preparation Program (DPP) was the intervention condition (n = 26), and the usual rehabilitation program was the control condition (n = 23). Outcome indicators included factors that make patient discharge difficult (which nurses evaluated), psychiatric symptom, knowledge about the illness or medication, and the number of patients who were discharged within 6 months after the end of a program.Significant improvements were found in the score of the 'Issues on treatment compliance' factor and the score of the 'Autistic life' factor, which are subscales of the Discharge Difficulty Scale, for the DPP group, on two-way ANOVA ('Issues on treatment compliance': F = 3.818, P0.10; 'Autistic life': F = 4.155, P0.05) These factors affected discharge outcome. Thus, the program may be capable of promoting discharge of long-term hospitalized psychiatric patients. With regard to the number of patients discharged in 6 months after the end of a program, there was no significant difference between both groups.The present result is in agreement with past studies, and the DPP is useful in discharge support for patients with schizophrenia in Japan.

We investigated the neonatal entrance-surface dose (ESD) and doses of scattered radiation emitted by a digital mobile X-ray system. The system is equipped with a novel flat-panel detector and is used in the neonatal intensive care unit. In the present study, the following three experiments were performed on frequently used X-ray-imaging condition: (1) the digital characteristics of the FPD were evaluated; (2) the ESD to a water-equivalent phantom was measured with a patient skin dosimeter (PSD); and (3) the scattered radiation around the incubator was measured with an ionization chamber survey meter. The digital characteristic curve showed that the system had excellent linearity and that the contrast characteristics were not affected by the tube voltage in the range of 50–110 kV. The ESD was 51–52 μGy with an 8-cm-thick phantom and 33–34 μGy with a 4.5-cm phantom, for one exposure. The doses measured around the incubator were 0.1–0.6 μSv or below measurable limits. Use of the new device demonstrates the potential of reducing the ESD to the patient and operator.