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Desalination is an important source of potable water for a large portion of the world that is expected to expand in response to population increase and climate change. Despite its benefits, desalination produces a hypersaline waste, termed ‘brine’, which has negative impacts on the marine ecosystem and is costly to dispose of safely. An integral step in making desalination more environmentally friendly is the elimination of liquid wastes, so-called ‘Zero Liquid Discharge’. To make Zero Liquid Discharge financially viable, it is critical to separate and purify the constituent salts into products. We report on the design and operation of a system for continuous production of high purity Mg-chloride from desalination brine. This system is part of a Zero Liquid Discharge process that makes desalination net negative in terms of CO2 emissions by converting magnesium chloride into magnesium carbonate. Precipitation of sodium and potassium chloride from brine was achieved by absorption of a super azeotropic HCl gas. The super azeotropic HCl gas was regenerated by mixing the acidified brine in a low-temperature, saturated magnesium chloride solution. The system recovered 89% of the Mg2+ content of desalination brine as 99.6 mol% purity magnesium chloride. This level of recovery and purity without the use of consumable chemicals is not found elsewhere in industry or the literature. Internal regeneration of HCl reached 66% at a HCl concentration of 54 wt%. Empirical results suggest a longer operation would yield 92% regeneration of 65 wt% HCl. Using lessons learned from this test program, a range of long-term continuous operation conditions were found that could regenerate >95% of HCl at a concentration of >90 wt%. Such performance may make this novel HCl regeneration process interesting to industries that require hydrochloric acid recycling, such as hydrometallurgy. With the recovery and purity of magnesium chloride achieved in the current system, desalination brine can be converted into product streams, including those applicable for atmospheric CO2 removal.

Carbon capture and storage (CCS) is an important technology to reduce CO2 emissions from power and industry. To accelerate large-scale CCS deployment, further reduction of the cost to implement the full technology chain is necessary. Full chain CCS cost depends on multiple technological, market, and societal factors. Therefore, case-specific cost analysis is important. This study estimates the CCS cost in Japan, which can be considered as a case study for specific countries where offshore sites are more suitable for CO2 storage than onshore sites regarding geological reasons and barrier reduction of public/political acceptance. With the phasedown of unabated coal power, retrofitting amine-based post-combustion CO2 capture system is a realistic way for pulverized coal-fired power plants. Capture cost was determined by the process simulation of coal-fired power plant retrofits. Current political realities in Japan suggest that CO2 transport will be done by ship. Transport cost was estimated via a bottom-up analysis of each sub-process. Injection and monitoring cost was based on the values reported by the Tomakomai demonstration project, which are applicable to onshore injection into an offshore storage site. We find the full chain CCS cost to be 99-111 USD/t-CO2. Though changing the solution in the CO2 capture process from monoethanolamine to the blend of 2-amino-2-methyl-1-propanol and piperazine reduces the regeneration energy by 0.85 GJ/t-CO2, the CCS cost was only reduced by ~9 USD/t-CO2. Likewise, even when the regeneration energy was reduced to 2.0 GJ/t-CO2 using a hypothetical amine solution embedded in a highly optimized PCC system, the CCS cost was still ~93 USD/t-CO2. Considering that capital expenditure accounts for ~65% of capture cost, downsizing capture facilities may provide further cost reduction. Since transport and storage costs were roughly equivalent to capture costs, full chain CCS implementation is likely necessary to reduce costs through learning-by-doing, scale-out, and market effects.

Aim: In Kampo medicine, there exists an important system of diagnosis called Fukushin, or abdominal diagnosis or palpation. By applying pressure to the abdomen of the patient, the physician can gain important information on the patient’s physical state and use those indications to choose a suitable Kampo formulation. We have previously developed a Fukushin simulator, a teaching tool that reproduces the important abdominal patterns that doctors will encounter in clinical practice and that has received favourable feedback for students and practitioners. In order to make diagnosis and prescription easier, it is desirable to have matched formula–pattern pairings. The present study aims to develop such pairings.Methods: With the previously developed models as a foundation, in the present study the production team (two members) used materials such as urethane foam and silicone rubber to build an additional 13 standard abdominal pattern models matched to Kampo herbal formulas commonly used by practitioners in Japan. Subsequently, the evaluation team (the remaining 10 authors) investigated the viability of these models.Results: The evaluation team determined that abdominal pattern models matched to the following typical Kampo formulas were created successfully: Dai-saiko-To (大柴胡湯), Dai-joki-To (大承気湯), Shigyaku-San (四逆散), Saiko-ka-ryukotsu-borei-To (柴胡加竜骨牡蛎湯), Keishi-bukuryo-Gan (桂枝茯苓丸), Hachimi-jio-Gan (八味地黄丸), Hange-shashin-To (半夏瀉心湯), Sho-saiko-To (小柴胡湯), Hochu-ekki-To (補中益気湯), Sho-kenchu-To (小建中湯), Toki-shakuyaku-San (当帰芍薬散), Ninjin-To (人参湯), and Dai-kenchu-To (大建中湯).Conclusion: We suggest that these new formula-pattern models can make an important contribution to the standardization of abdominal diagnosis and prescription and to Kampo education.

The aim of this study was to examine the effects of voluntary exercise on plasma and urinary metabolites and the changes in gut microbiota in mice fed with a high-fat-diet. Healthy male C57BL/6J mice (four-week-old, n = 27) were fed a normal controlled diet (CD) and a high-fat-diet (HFD) for 10 weeks under two conditions: voluntary wheel running (W) and sedentary controlled condition (C). The metabolites in the collected plasma and urine were detected using 1H-NMR spectroscopy techniques. Also, 16S-rRNA gene next-generation sequencing was carried out on the collected feces. Wheel running activity in HFDW mice was slightly higher than that in CDW mice (p = 0.075). Exercise and diet significantly altered body weight, fat accumulation, and glucose tolerance tests. In plasma, amino acids such as Leu, Ile, Ala and Tyr, were increased by exercise. Diet influenced the metabolites in both the plasma and urine of mice and showed significant differences; in plasma, Leu, Ile, Glu, 3-HB, lactate and acetate, whereas in urine, citrate, trimethylamine (TMA), trimethylamine-N-oxide (TMAO), taurine, hippurate and allantoin. With regard to beta diversity, unweighted UniFrac analysis (principal coordinate analysis: PCoA) showed the difference between CD and HFD mice could be observed under PC1 (22.61%). Although there was substantial overlap between two conditions (C vs. W), HFD groups were positioned in a slightly different area when compared to the C and W conditions. Firmicutes/Bacteroidetes ratio, which might be associated with obesity, in HFD mice was significantly higher than that in CD mice, but not affected by wheel running. Our results suggest that testing in both plasma and urinary metabolites may prove to be a more reliable approach to quantitative metabolite analysis on the effects of exercise-dependent hosts or as an independent alteration of gut microbiota on the hosts.

Abstract Aims/Introduction Taste receptors, T1rs and T2rs, and the taste‐selective G‐protein, α‐gustducin, are expressed outside the taste‐sensing system, such as enteroendocrine L cells. Here, we examined whether α‐gustducin also affects nutrition sensing and insulin secretion by pancreatic β‐cells. Materials and Methods The expression of α‐gustducin and taste receptors was evaluated in β‐cell lines, and in rat and mouse islets either by quantitative polymerase chain reaction or fluorescence immunostaining. The effects of α‐gustducin knockdown on insulin secretion and on cyclic adenosine monophosphate and intracellular Ca2+ levels in rat INS‐1 cells were estimated. Sucralose (taste receptor agonist)‐induced insulin secretion was investigated in INS‐1 cells with α‐gustducin suppression and in islets from mouse disease models. Results The expression of Tas1r3 and α‐gustducin was confirmed in β‐cell lines and pancreatic islets. Basal levels of cyclic adenosine monophosphate, intracellular calcium and insulin secretion were significantly enhanced with α‐gustducin knockdown in INS‐1 cells. The expression of α‐gustducin was decreased in high‐fat diet‐fed mice and in diabetic db/db mice. Sucralose‐induced insulin secretion was not attenuated in INS‐1 cells with α‐gustducin knockdown or in mouse islets with decreased expression of α‐gustducin. Conclusions α‐Gustducin is involved in the regulation of cyclic adenosine monophosphate, intracellular calcium levels and insulin secretion in pancreatic β‐cells in a manner independent of taste receptor signaling. α‐Gustducin might play a novel role in β‐cell physiology and the development of type 2 diabetes.

AimIn tongue diagnosis, a dark purple tongue and enlarged sublingual vein are important findings of Oketsu (blood stasis). However, the association between the tongue color and the sublingual vein has not been reported. This study investigated the association between the tongue color values and the sublingual vein width using tongue image analyzing system (TIAS) for the objective assessment of blood stasis.MethodsA total of 38 patients (age 68.7 ± 11.3 years, 14 men and 24 women) who visited the Department of Kampo Medicine at Chiba University Hospital were included. Physical findings, blood test results, blood stasis score from medical records, and tongue images obtained with TIAS were analyzed. The patients were classified into two groups: patients with a sublingual vein width of ≤2.5 mm (20 patients) and those with a width of >2.5 mm (18 patients). The physical findings and the blood test results of the two groups were analyzed by Wilcoxon's rank-sum test or χ2-test, whereas logistic regression analysis was used to determine the association between the tongue color values and sublingual vein width. Receiver operating characteristic (ROC) analysis was used to differentiate blood stasis.ResultsThe color values significantly related to the sublingual vein width (mm) were the P1-L* and P4-L* (darkness of the tongue edge and tongue apex) and the P1-b* and P2-b* (blueness of the tongue edge and tongue posterior). The area under the curve was greater for the combination of the tongue color values and the sublingual vein width than that for either of them.ConclusionThis study demonstrated an objective evaluation of blood stasis in the tongue of patients with dark-blue discoloration and an enlarged sublingual vein. In addition, the combination of the tongue color and the sublingual vein is expected to facilitate a more reliable diagnosis of blood stasis.

Praising behavior is considered to be verbal and nonverbal behaviors that expresses praise the behavior and character of the target. However, how one should use verbal and nonverbal behaviors to successfully praise a target has not been clarified. Therefore, we focus on attempts to analyze praising behavior in Japanese dialogue using verbal and nonverbal behaviors. In this study, we attempted to analyze the relationship between praising skills and human behaviors in Japanese dialogue by focusing on voice, head, and face behaviors. First, we created a new dialogue corpus in Japanese containing voice, head, and face behaviors from individuals giving praise (praiser) and receiving praise (receiver), as well as the degree of success of praising (praising score). Second, we developed machine learning models that uses features related to voice, head, and face behaviors to estimate praising skills to clarify which features of the praiser and receiver are important for estimating praising skills. Evaluation resulte showed that some audio features of the praiser are particularly important for estimation of praising skills. Our analysis results demonstrated the importance of features related to the zero-crossing rate, MFCCs of the praiser. Analyzing the features of high importance revealed that the praiser should praise with specific words that mean amazing or great in Japanese and the voice quality of the praiser is considered to be important for praising successfully.

Background: Complementary and alternative medicine, including Japanese traditional medicine (JTM), has been used for various allergic diseases, but the evidence is limited. Shoseiryuto (Xiao-Qing-Long-Tang), one of the representative JTM drugs, is frequently used to treat allergic rhinitis (AR). However, its efficacy for seasonal AR has not been fully established. Using an Environmental challenge chamber (ECC), we evaluated the therapeutic effects of shoseiryuto on AR induced by Japanese cedar pollen (JCP). Methods: A placebo-controlled double-blind crossover study with shoseiryuto was conducted using the ECC. The shoseiryuto or placebo was orally administered from 2 weeks before the exposure test. The pollen exposure test was conducted for 3 h, and the pollen concentration was set at 8000 pollen/m3. The primary endpoint of the study was the total nasal symptom score (TNSS) during pollen exposure. A physician certified by the Japanese Society of Oriental Medicine as a specialist checked each participant's “pattern”, a comprehensive expression of signs obtained from individual patients' subjective symptoms and other personal findings. Blood samples collected just before the first pollen exposure were stimulated with cedar antigens and used for immunological studies. Results: The results of the 46 participants were analyzed, and no significant side effects were detected. There was no significant difference in TNSS during pollen exposure for 3 h in the ECC between the shoseiryuto and placebo groups. However, some symptoms were improved in the shoseiryuto group after leaving the ECC. There was no significant correlation between the “fluid retention pattern” and TNSS. In immunological studies, shoseiryuto did not inhibit Th2-type cytokine production and mRNA expression. Conclusions: Oral administration of shoseiryuto from 2 weeks before pollen exposure did not prevent or inhibit immediate symptoms of AR induced by JCP in the ECC. Further study is needed to reevaluate the shoseiryuto specific “pattern” in JTM.

Background The number of people with obesity is rapidly increasing worldwide. Since obesity is a critical risk factor for cardiovascular diseases and mortality, the management of obesity is an urgent issue. However, anti-obesity drugs are insufficient in current clinical settings. Bofutsushosan (BTS, Fang-Feng-Tong-Sheng-San in China) is a traditional Japanese Kampo formula for patients with obesity. Recent basic studies have indicated that BTS potentially improves the pathophysiology of obesity. However, it is still unknown whether BTS clinically reduces body mass index (BMI) in patients with obesity. Methods We searched electronic databases, including the Medline, EMBASE, Cochrane Library, and Japanese/Chinese/Korean databases, on June 15, 2021. We conducted a meta-analysis of randomized controlled trials to evaluate the effects of BTS on BMI, waist circumference, glycolipid metabolism, and blood pressure in participants with obesity. The primary outcome was change in BMI. Results We included seven studies and 679 participants (351 in the BTS group and 328 in the control group). In participants with obesity, BTS significantly reduced BMI relative to controls (mean difference, MD [95% confidence interval]: −0.52 kg/m2 [−0.86, −0.18], P = 0.003). There was no significant difference in waist circumference, glycolipid parameters, or blood pressure. Sensitivity analyses showed robust outcomes for the primary endpoint, although the heterogeneity was considerable. Moreover, no serious adverse events were observed in the BTS group. Conclusion BTS showed a potential benefit in safely and tolerably improving BMI in participants with obesity.

Background: The influence of neurological or balance dysfunction on cognitive impairment has not been well studied. We compared the results of the balance test, measured by either head or foot sway to consider whole body sway, with those of the cognitive impairment test. Methods: Individuals of either gender, aged over 60 years, underwent a 30 s balance test. We measured sway while standing on one-leg or two-legs. Sway was evaluated by the distance or area of movement of the head or foot pressure. We also evaluated the effect of visual condition: eyes-open (EO) or -closed (EC). The Mini-Mental State Examination (MMSE) was used to evaluate the degree of cognitive impairment. Results: The head sway area standing on one leg was significantly correlated to MMSE score with EO (correlation r = −0.462). In standing on two legs, no sway test results showed a significant correlation to MMSE scores with EO. With EC, the magnitude of sway became greater, and was significantly correlated to MMSE scores in the head distance. Conclusion: Although the correlation between head sway and MMSE was not strong, head sway showed a stronger correlation than did foot pressure sway. Standing on one leg, as measured by head sway area, may thus predict cognitive impairment.

In order to investigate the far-infrared excess detected from the western hot spot of the radio galaxy Pictor A with the Herschel observatory, submillimeter photometry is performed with the Atacama Compact Array (ACA) of the Atacama Large Millimeter/submillimeter Array at Band 8 with the reference frequency of 405 GHz. A submillimeter source is discovered at the radio peak of the hot spot. Because the 405 GHz flux density of the source, 80.7 ± 3.1 mJy, agrees with the extrapolation of the synchrotron radio spectrum, the far-infrared excess is suggested to exhibit no major contribution at the ACA band. In contrast, by subtracting the power-law spectrum tightly constrained by the radio and ACA data, the significance of the excess in the Herschel band is well confirmed. No diffuse submillimeter emission is detected within the ACA field of view, and thus, the excess is ascribed to the western hot spot itself. In comparison to the previous estimate based on the Herschel data, the relative contribution of the far-infrared excess is reduced by a factor of ∼1.5. The spectrum of the excess below the far-infrared band is determined to be harder than that of the diffusive shock acceleration. This strengthens the previous interpretation that the excess originates via the magnetic turbulence in the substructures within the hot spot. The ACA data are utilized to evaluate the magnetic field strength of the excess and of diffuse radio structure associated with the hot spot.

We investigated the inner buried nucleus of a nearby luminous infrared galaxy, NGC 4418, using high-resolution spectroscopy of fundamental carbon monoxide (CO) rovibrational absorptions around 4.67 μ m for the first time. This method allowed us to examine the physical and kinematical properties in the hot inner region of this nucleus. We detected a series of both very deep (partly saturated) ^12 CO and moderately deep (optically thin) ^13 CO absorption lines and inferred a large column density ( N _H2 = (5 ± 3) × 10 ^23 cm ^−2 in front of the 5 μ m photosphere) of warm ( T _ex ≃ 170 K) molecular gas by assuming an isothermal plane-parallel slab illuminated by a compact background mid-infrared-emitting source. We modeled that the warm CO absorber almost covers the central heating source and that it is an inner layer around the 5 μ m photosphere (at r = several parsecs) of a compact shroud of gas and dust ( d ∼ 100 pc). The width of the absorption lines (110 km s ^−1 ) and their small deviation from the systemic velocity (

The Subaru telescope is currently performing a strategic program (SSP) using the high-precision near-infrared (NIR) spectrometer IRD to search for exoplanets around nearby mid/late M dwarfs via radial velocity (RV) monitoring. As part of the observing strategy for the exoplanet survey, signatures of massive companions such as RV trends are used to reduce the priority of those stars. However, this RV information remains useful for studying the stellar multiplicity of nearby M dwarfs. To search for companions around such “deprioritized” M dwarfs, we observed 14 IRD-SSP targets using Keck/NIRC2 with pyramid wave-front sensing at NIR wavelengths, leading to high sensitivity to substellar-mass companions within a few arcseconds. We detected two new companions (LSPM J1002+1459 B and LSPM J2204+1505 B) and two new candidates that are likely companions (LSPM J0825+6902 B and LSPM J1645+0444 B), as well as one known companion. Including two known companions resolved by the IRD fiber injection module camera, we detected seven (four new) companions at projected separations between ∼2 and 20 au in total. A comparison of the colors with the spectral library suggests that LSPM J2204+1505 B and LSPM J0825+6902 B are located at the boundary between late M and early L spectral types. Our deep high-contrast imaging for targets where no bright companions were resolved did not reveal any additional companion candidates. The NIRC2 detection limits could constrain potential substellar-mass companions (∼10–75 M _Jup ) at 10 au or further. The failure with Keck/NIRC2 around the IRD-SSP stars having significant RV trends makes these objects promising targets for further RV monitoring or deeper imaging with the James Webb Space Telescope to search for smaller-mass companions below the NIRC2 detection limits.

The platter, which is the data-storage component of hard-disk drives, contains platinum group metals on a substrate. It is necessary to separate the metal layer from the substrate to recover the platinum group metals and other valuable elements. The separation of the metal layer from the glass substrate were investigated by using two types of pulsed-power generators (PPGs), namely a nanosecond and a microsecond PPG. By conducting repetitive pulse discharges to the platter surface, the metal layer was peeled off and the maximum exfoliation rate reached about 60% for both the nanosecond PPG and the microsecond PPG. The higher the single pulse energy, the higher the exfoliation efficiency. The maximum peeling energy efficiency were 16%/kJ and 30%/kJ for the nanosecond PPG and microsecond PPG, respectively. It was demonstrated that the pulse width affected the formation of the discharge plasma. In the nanosecond PPG, a discharge plasma was formed between the edge of the metal layer and the electrode, whereas in the microsecond PPG, a discharge plasma channel was formed across the metal layer. SEM images of the substrate surface after discharge treatment showed that part of the removed metal layer was molten and reattached to the glass substrate. The reattached particles were spherical with a diameter of ∼10 μm, and were enriched by 20% in terms of ruthenium mass. The exfoliation process of the metal layer by electric pulses and the generation of metal particles were explained.

Diabetic kidney disease (DKD) is a critical complication associated with diabetes; however, there are only a few animal models that can be used to explore its pathogenesis. In the present study, we established a mouse model of DKD using a technique based on the Developmental Origins of Health and Disease theory, i.e., by manipulating the embryonic environment, and investigated whether a dietary intervention could ameliorate the model’s pathology. Two-cell embryos were cultured in vitro in α-minimum essential medium (MEM; MEM mice) or in standard potassium simplex-optimized medium (KSOM) as controls (KSOM mice) for 48 h, and the embryos were reintroduced into the mothers. The MEM and KSOM mice born were fed a high-fat, high-sugar diet for 58 days after they were 8 weeks old. Subsequently, half of the MEM mice and all KSOM mice were fed a diet containing rice powder (control diet), and the remaining MEM mice were fed a diet containing barley powder (barley diet) for 10 weeks. Glomerulosclerosis and pancreatic exhaustion were observed in MEM mice, but not in control KSOM mice. Renal arteriolar changes, including intimal thickening and increase in the rate of hyalinosis, were more pronounced in MEM mice fed a control diet than in KSOM mice. Immunostaining showed the higher expression of transforming growth factor beta (TGFB) in the proximal/distal renal tubules of MEM mice fed a control diet than in those of KSOM mice. Pathologies, such as glomerulosclerosis, renal arteriolar changes, and higher TGFB expression, were ameliorated by barley diet intake in MEM mice. These findings suggested that the MEM mouse is an effective DKD animal model that shows glomerulosclerosis and renal arteriolar changes, and barley intake can improve these pathologies in MEM mice.

Background: The Rist diagram is useful for predicting changes in blast furnaces when the operating conditions are modified. In this paper, we revisit this methodology to provide a general model with additions and corrections. The reason for this is to study a new concept proposal that combines oxygen blast furnaces with Power to Gas technology. The latter produces synthetic methane by using renewable electricity and CO2 to partly replace the fossil input in the blast furnace. Carbon is thus continuously recycled in a closed loop and geological storage is avoided. Methods: The new model is validated with three data sets corresponding to (1) an air-blown blast furnace without auxiliary injections, (2) an air-blown blast furnace with pulverized coal injection and (3) an oxygen blast furnace with top gas recycling and pulverized coal injection. The error is below 8% in all cases. Results: Assuming a 280 tHM/h oxygen blast furnace that produces 1154 kgCO2/tHM, we can reduce the CO2 emissions between 6.1% and 7.4% by coupling a 150 MW Power to Gas plant. This produces 21.8 kg/tHM of synthetic methane that replaces 22.8 kg/tHM of coke or 30.2 kg/tHM of coal. The gross energy penalization of the CO2 avoidance is 27.1 MJ/kgCO2 when coke is replaced and 22.4 MJ/kgCO2 when coal is replaced. Considering the energy content of the saved fossil fuel, and the electricity no longer consumed in the air separation unit thanks to the O2 coming from the electrolyzer, the net energy penalizations are 23.1 MJ/kgCO2 and 17.9 MJ/kgCO2, respectively. Discussion: The proposed integration has energy penalizations greater than conventional amine carbon capture (typically 3.7 – 4.8 MJ/kgCO2), but in return it could reduce the economic costs thanks to diminishing the coke/coal consumption, reducing the electricity consumption in the air separation unit, and eliminating the requirement of geological storage.

Abstract Objective We aimed to test our hypothesis that traditional Japanese (Kampo) medicine, hochuekkito (Hochu-ekki-to: HET) has a preventive effect for the symptoms on COVID-19. Trial design The study is designed as a multi-center, interventional, parallel-group, randomized (1:1 ratio), investigator sponsored, two-arm study. Participants Six thousand participants will be recruited from healthy hospital workers in 7 Japanese University Hospitals. Inclusion criteria: 1. Age from 20 to 75 years old at the time of registration 2. Asymptomatic and body temperature below 37°C at the time of registration 3. Capable of eating orally Exclusion criteria: 1. Previous upper respiratory inflammation due to viral infection (including suspected COVID-19) 2. Taking immunosuppressants 3. Allergic to the Kampo medicines used in this study 4. History of hypokalaemia, severe hypertension, severe liver dysfunction, and interstitial pneumonia 5. Regularly taking other Kampo medicines 6. Pregnant or possibly pregnant 7. Participating in other research 8. Judged to be unsuitable for this study by the doctor in charge Intervention and comparator Kampo group: participants receive HET in 9 tablets 2 times per day for 8 weeks. Control group: participants receive placebo in the same dosage as the Intervention group - 9 tablets 2 times per day for 8 weeks. Placebo tablets are identical in appearance and package to HET. Taste of placebo is different from that of HET. The Ohsugi Pharmaceutical Co. Ltd, Osaka, Japan manufactured the placebo and HET. Main outcomes Primary outcome: Number of patients with a SARS-CoV-2 RNA by ploymerase chain reaction (PCR) positive result with at least one symptom (fever, cough, sputum, malaise, shortness of breath) during the 12-week study period (including the 4-week observation period after oral administration). Secondary outcomes: 1. Period from infection to onset 2. Period from the appearance of symptoms to the disappearance of PCR positive 3. Number of days until the appearance or improvement of symptoms 4. Severe stage: presence of hospitalization 5. Shock stage: ICU management required for mechanical ventilation, shock vitals or failure of organ(s) other than lungs Safety endpoints include numbness in the hands and/or feet, edema, skin rash or other allergic symptoms, and gastric discomfort. Randomisation Patients are randomized (1:1 ratio) to each group using minimization implemented with the Electric data capture system (DATATRAK Enterprise Cloud), with balancing of the arms with age range (under 50 years of age or not) and having a history of risk factors for COVID-19 (cardiovascular disease, hypertension, diabetes, respiratory diseases). Blinding (masking) Only participants will be randomized. Numbers to be randomised (sample size) The main research hypothesis of this study is that Kampo medicines significantly prevent the onset of COVID-19. It is assumed that the infection rate before the administration of the drug under consideration will be 0% and that the incidence of COVID-19 thereafter will be 2- 3%, of which 70%-80% will show symptoms of COVID-19. Assuming that the pharmaceutical effect of the drug will be effective in 50% of patients and that the incidence rates in the placebo and drug groups will be 1.4%-2.4% and 0.7%-1.2%, respectively, the placebo is calculated at 2%, and the study drug at 1%. Since the frequency of verification is low and the number of cases will be large, we set a total of 10 analyses (9 interim analyses and a final analysis). Since the number of cases at the time of the final analysis will be 4,986 under the conditions of α = 0.05 and a power of 80% by the Peto method. We set at 600 cases in each interim analysis with an estimated dropout rate of 16.9%. Finally, the total number of cases is set to 6,000 with 3,000 in the placebo group and 3,000 in the HET group. Trial status Protocol version 1.3 of October 23rd , 2020. Recruitment start (expected): December 1st, 2020. Recruitment finish (expected): December 31st, 2022. Trial registration This trial is registered in the Japan Registry of Clinical Trials (jRCT) ( jRCTs031200150 ) on 14 October 2020. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest of expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.

Balloon pulmonary angioplasty (BPA) has been reported to be effective and safe to an acceptable level in patients with distal-type, inoperable chronic thromboembolic pulmonary hypertension (CTEPH), resulting in improved long-term survival. However, evidenced treatment options and strategy including medical therapy of antithrombotic therapy, glucocorticoids, immunosuppressants, and pulmonary hypertension (PH)-specific therapies are scarce in patients with significant PH and right heart failure associated with Takayasu arteritis and peripheral pulmonary artery stenosis, both of which mimic CTEPH. Moreover, there has been still concern on safety and lack of established methodology in performing BPA for these conditions. In this report, we would like to review recent publications including several case reports and discuss the efficacy, safety, and suitable methods of BPA in this population.

Non-alcoholic fatty liver disease (NAFLD), which includes the subtype non-alcoholic steatohepatitis (NASH), is a major complication of type 2 diabetic mellitus (T2DM), even among non-obese patients. However, the exact cause of NAFLD/NASH in non-obese patients with T2DM is unclear. We studied a non-obese mouse model of T2DM created through the malnourishment of embryos by culture in vitro for 48 h in α-minimum essential medium (MEM) at the two-cell stage. We compared the development of steatohepatitis in these MEM mice with control mice that were similarly cultured in standard potassium simplex-optimized medium (KSOM). We also studied the effects of 10 weeks of consumption of barley, which contains large amounts of the soluble fiber β-glucan, on the steatohepatitis of the adult MEM mice. The size of lipid droplets, the area of fibrosis, and the mRNA expression of the transforming growth factor beta (Tgfb) gene in the liver were higher in adult MEM mice fed a rice-based diet than in KSOM mice fed the same diet. However, barley consumption reduced the area of fibrosis and TGFB expression in MEM mice. In conclusion, adult mice that are cultured in MEM at the two-cell embryo stage develop steatohepatitis and T2DM, accompanied by higher hepatic TGFB expression, than KSOM controls. Furthermore, the consumption of barley during adulthood ameliorates the steatohepatitis and reduces the TGFB expression.

In the accident at the Fukushima Daiichi Nuclear Power Station, reaction of water vapor with hot zirconium led to the generation of hydrogen and a subsequent explosion in the reactor building. From the perspective of defense-in-depth, multiple hydrogen explosion prevention measures are desirable to improve the safety of nuclear power generation. In this research, we focus on a hydrogen treatment system that re-oxidizes hydrogen into water vapor using a fixed, packed bed of copper oxide pellets. The advantages of this method are that the hydrogen oxidation rate is rapid and no external source of oxygen is necessary. In this study, we conducted experiments and complementary numerical calculations for the hydrogen oxidation reaction using copper oxide pellets. The oxidation reaction of hydrogen by copper oxide is decomposed into five elementary reactions, the rate of each was determined experimentally. The resultant numerical calculation accurately modeled experimentally observed hydrogen oxidation rates and provides insights into the phenomena controlling the reaction progression. The results suggest that the commonly observed induction period is due to the presence of poorly adsorbing sites on the copper oxide surface. Moreover, when water vapor is present, competition between water vapor and hydrogen for adsorption sites further suppresses the hydrogen oxidation reactions.

Abstract Objectives We aimed to test our hypothesis that additional administration of traditional Japanese (Kampo) medicine, kakkonto (kakkon-to: KT) and shosaikotokakikyosekko (sho-saiko-to-ka-kikyo-sekko: SSKKS), is more effective in relieving symptoms and preventing the onset of severe infection in mild-to-moderate COVID-19 patients compared to those treated only with conventional treatment. Trial design The study is designed as a multi-center, interventional, parallel-group, randomized (1:1 ratio), investigator-sponsored, two-arm study. Participants Patients and inpatients will be recruited from 8 Japanese academic and non-academic hospitals. The inclusion and exclusion criteria are as follows: Inclusion criteria: 1. Diagnosed as positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 2. Clinical stages of mild-to-moderate COVID-19 3. Symptomatic 4. ≥ 20 years of age 5. Male or female 6. Ability to communicate in Japanese 7. Outpatients and inpatients 8. Provided informed consent Exclusion criteria: 1. Difficulty in providing informed consent due to dementia, psychosis, or psychiatric symptoms 2. Allergic to Kampo or Western medicines used in this study 3. Pregnant and lactating 4. Unable to follow up 5. Participating in another clinical trial or interventional study 6. Hypokalemic or taking oral furosemide or steroids 7. Determined unsuitable for this study by the physician Intervention and comparator Patients in the control group will receive conventional treatment with antipyretics, painkillers, or antitussives for symptoms that occurred after they contracted the SARS-CoV-2 infection. Patients in the Kampo group will receive 2.5 g of KT (TJ-1@TSUMURA and Co.) and 2.5 g of SSKKS (TJ-109@TSUMURA and Co.) 3 times a day, orally, for 14 days in addition to the conventional treatment as mentioned above. Main outcomes The number of days till at least one of the symptoms (fever, cough, sputum, malaise, shortness of breath) improves in the first 14 days of treatment. To assess the cough, sputum, malaise, and shortness of breath, a numeric rating scale will be used to define improvement in terms of a 2-point decrease in the number of days from the start of treatment for at least 2 days. Fever will be defined as an improvement when the temperature is less than 37 °C. Randomization Patients are randomized (1:1 ratio) to each group using the minimization method, with balancing of the arms with severity of disease stage and patient age (

Background: While bathing styles vary among countries, most Japanese people prefer tub bathing to showers and saunas. However, few studies have examined the relationship between tub bathing and health outcomes. Accordingly, in this prospective cohort study, we investigated the association between tub bathing frequency and the onset of functional disability among older people in Japan. Methods: We used data from the Japan Gerontological Evaluation Study (JAGES). The baseline survey was conducted from August 2010 through January 2012 and enrolled 13,786 community-dwelling older people (6,482 men and 7,304 women) independent in activities of daily living. During a 3-year observation period, the onset of functional disability, identified by new certification for need of Long-Term Care Insurance, was recorded. Tub bathing frequencies in summer and winter at baseline were divided into three groups: low frequency (0–2 times/week), moderate frequency (3–6 times/week), and high frequency (≥7 times/week). We estimated the risks of functional disability in each group using a multivariate Cox proportional hazards model. Results: Functional disability was observed in a total of 1,203 cases (8.7%). Compared with the low-frequency group and after adjustment for 14 potential confounders, the hazard ratios of the moderate- and high-frequency groups were 0.91 (95% confidence interval [CI], 0.75–1.10) and 0.72 (95% CI, 0.60–0.85) for summer and 0.90 (95% CI, 0.76–1.07) and 0.71 (95% CI, 0.60–0.84) for winter. Conclusion: High tub bathing frequency is associated with lower onset of functional disability. Therefore, tub bathing might be beneficial for older people’s health.

Although intestinal obstruction is a relatively common condition to be seen in daily clinical practice, cases with no history of laparotomy can often create difficulties in determining its diagnosis and surgical indication. This is a case report of a recurrent intestinal obstruction, with no surgical history, treated successfully using laparoscopy for both diagnosis and surgical operation.The patient, 62-year-old male, was hospitalized about a year ago due to abdominal pain and diarrhea likely caused by acute enteritis. As the inflammation had reduced and X-Ray image no longer indicated any gas patterns in the small intestine, he was later discharged from the hospital. However, the symptoms recurred after seven months which included abdominal pain, diarrhea as well as bloating. The patient was then introduced to our hospital through a local clinic for further diagnosis.The results resembled patient's previous hospitalization observing a formation of niveau, or mirror-image, in the upper abdomen as well as a sentinel loop with some swelling on computed tomography (CT) image. With conservative treatment, the patient showed rather a quick recovery soon after his admission. The inflammation and the intestinal obstruction had reduced. However, as recurrence had appeared in a similar area as his previous experience, the patient underwent diagnostic laparoscopy for further inspection of its underlying cause.Adhesion of the ileum and the sigmoid colon was observed. After diagnosis, laparoscopic adhesiolysis was performed in order to divide the adhesion and to remove the inflated part of the small intestine. The postoperative course was positive and the patient was discharged from the hospital 13 days after the surgery. There has been no report of recurrence thereafter.Technological development of CT scanners in recent years has enabled new levels of information. However, cases with no surgical history and fluctuating symptoms, such as the patient mentioned in this paper, requires direct observation of the tract. Doing so also helps determine the possibility of an internal hernia. Furthermore, laparoscopy enables a smooth shift from diagnosis to treatment, with the assistance of laparoscope, which avoids unnecessary invasion and requires only small incisions; serving it as a very effective approach to certain cases of intestinal obstruction.

Objective: To examine the association between human papillomavirus (HPV) infection and penile cancer among Japanese patients. Methods: Thirty-four patients with penile cancer were enrolled in this study. DNA was extracted from paraffin-embedded tumor tissue samples, and HPV-DNA tests and genotyping were performed. For all of the samples, in situ hybridization (ISH) was performed to locate HPV-DNA in tumor tissue. Furthermore, expression levels of p16-INK4a, mini-chromosome maintenance protein 7 (mcm-7), HPV-L1, and Ki-67 were analyzed using immunohistochemical methods. Results: HPV and high-risk (HR)-HPV were detected in 14 (41.1%; 95% confidence interval (CI) 24.6–57.7%) and 12 (35.2%; 95% CI 19.2–51.4%) cases, respectively. HPV16 was the most frequently detected HPV type. Among the HR-HPV-positive cases, a punctate HR-HPV-DNA signal pattern was detected by ISH in tumor cell nuclei. P16-INK4a was expressed in 66.7% (95% CI 42.8–90.1%) of HR-HPV-positive cases and was significantly more frequent and stronger in HR-HPV-positive cases than in HPV-negative cases. There was no significant difference in the occurrence or distribution of mcm-7 or Ki-67 expression between HPV-positive and HPV-negative cases. HPV-L1 expression was not observed in any of the cases examined. Conclusions: HPV infection may have had an etiological role in 41% of the examined cases of penile cancer in Japan. Keywords: Penile cancer, Human papillomavirus, p16-INK4a, Mini-chromosome maintenance protein 7, Ki-67

The application of okara treated by a wet-type grinder (WG) is discussed in this paper. We examined the effect of WG-treated okara on the mechanical properties and intermolecular forces in soybean protein isolate (SPI) gels. SPI gels were prepared with varying amounts of WG-treated okara, and compression tests were performed. Protein solubility was also examined by homogenizing the gel in four different solutions (S1, 0.6 M sodium chloride (NaCl); S2, 0.6 M NaCl and 1.5 M urea; S3, 0.6 M NaCl and 8.0 M urea; and S4, 1.0 M sodium hydroxide). The gel with WG-treated okara had higher breaking stress but not breaking strain. In contrast, the protein solubility in S3 was lower than those of the gel without okara or with WG-untreated okara. A negative correlation (R2 = 0.86) was observed between breaking stress and protein solubility in S3. These results suggest that WG-treated okara enhanced the hydrophobic interactions of SPI gels because protein solubilization by S3 is caused by the differences in hydrophobic interactions.

Object manipulation automation in logistic warehouses has recently been actively researched. However, shelf replenishment is a challenge that requires the precise and careful handling of densely piled objects. The irregular arrangement of objects on a shelf makes this task particularly difficult. This paper presents an approach for generating a safe replenishment process from a single depth image, which is provided as an input to two networks to identify arrangement patterns and predict the occurrence of collapsing objects. The proposed inference-based strategy provides an appropriate decision and course of action on whether to create an insertion space while considering the safety of the shelf content. In particular, we exploit the bimanual dexterous manipulation capabilities of the associated robot to resolve the task safely, without re-organizing the entire shelf. Experiments with a real bimanual robot were performed in three typical scenarios: shelved, stacked, and random. The objects were randomly placed in each scenario. The experimental results verify the performance of our proposed method in randomized situations on a shelf with a real bimanual robot.

Robots have been increasingly involved in global construction and are considered one of the most promising solutions for the reform of the construction industry. The superiority of the robotic construction process compared to the present stage of actual construction with predominantly human participation is mainly reflected in the high efficiency and high accuracy of its construction, thus improving the benefits to the natural, economic, and social environment and significantly changing the current construction labor market. At present, the development and application of robotic construction technology worldwide are mostly at the laboratory stage and are not applied to actual construction projects on a large scale. In this paper, we explore the methods and steps of robotic involvement in the construction of a complete timber building through the reconstruction of a completed timber building, from the design process and construction process to the final evaluation of construction efficiency. Finally, by comparing the advantages and disadvantages of the two design and construction methods, manual construction and robotic construction, the problems and difficulties in current robotic construction and the opportunities and challenges faced by robotic automation in the construction industry are identified.

Summary: Duchenne muscular dystrophy (DMD) is a muscle degenerating disease caused by dystrophin deficiency, for which therapeutic options are limited. To facilitate drug development, it is desirable to develop in vitro disease models that enable the evaluation of DMD declines in contractile performance. Here, we show MYOD1-induced differentiation of hiPSCs into functional skeletal myotubes in vitro with collagen gel and electrical field stimulation (EFS). Long-term EFS training (0.5 Hz, 20 V, 2 ms, continuous for 2 weeks) mimicking muscle overuse recapitulates declines in contractile performance in dystrophic myotubes. A screening of clinically relevant drugs using this model detects three compounds that ameliorate this decline. Furthermore, we validate the feasibility of adapting the model to a 96-well culture system using optogenetic technology for large-scale screening. Our results support a disease model using patient-derived iPSCs that allows for the recapitulation of the contractile pathogenesis of DMD and a screening strategy for drug development.

Coronavirus disease 2019 (COVID-19) spread to Japan in 2020, where the number of infected patients exceeded 250,000 and COVID-related deaths exceeded 3,500 in one year. Basic guidelines for infection control were implemented in Japan, and research and development of effective drugs and vaccines were promoted. This included considering Kampo medicine, which has a long history of treating recurring emerging viral infections. Considering the characteristics of the disease (inflammation of the upper and lower respiratory tract as well as potential neural damage and vasculitis), Kampo medicine could be considered as a treatment strategy due to its antiviral and anti-inflammatory effects induced by multiple active substances that could aid in disease prevention and recovery. In this study, case reports on the management of COVID-19 with Kampo medicine, which were published until March 31, 2021, were reviewed. The search strategy involved the use of Medline and hand-searching. Twenty two patients were treated using Kampo medicines with or without Western medicine, based on individual conditions. On the other hand, the effects of Kampo medicines as a potential preventive treatment (pre-infection), active treatment (especially in the acute and subacute stage), or treatment of sequelae to aid recovery (after infection) in the different stages of COVID-19 are being studied as research projects in the Japan Society for Oriental Medicine (JSOM). JSOM has also organized a pioneering project of clinical trials for COVID-19, some of which are now in progress.

Liquorice is usually used as crude drug in traditional Japanese Kampo medicine and traditional Chinese medicine. Liquorice-containing glycyrrhizin (GL) can cause pseudohyperaldosteronism as a side effect. Previously, we identified 18β-glycyrrhetyl-3-O-sulfate (3) as a GL metabolite in Eisai hyperbilirubinuria rats (EHBRs) with the dysfunction of multidrug resistance-related protein (Mrp2). We speculated that 3 was associated with the onset of liquorice-induced pseudohyperaldosteronism, because it was mainly detected in serum of patients with suspected to have this condition. However, it is predicted that other metabolites might exist in the urine of EHBRs orally treated with glycyrrhetinic acid (GA). We explored other metabolites in the urine of EHBRs, and investigated the pharmacokinetic profiles of the new metabolite in EHBRs and normal Sprague-Dawley rats. We further analyzed the serum concentrations of the new metabolite in the patients of pseudohyperaldosteronism. Finally, we developed the analyzing method of these metabolites as a preventive biomarker for the onset of pseudohyperaldosteronism using an enzyme-linked immunosorbent assay (ELISA). We isolated a new GL metabolite, 18β-glycyrrhetyl-3-O-sulfate-30-O-glucuronide (4). Compound 4 significantly inhibited rat type-2 11β-hydroxysteroid dehydrogenase (11β-HSD2) and was a substrate of both organic anion transporter (OAT) 1 and OAT3. Compound 4 was also detected in the serum of patients with suspected pseudohyperaldosteronism at an approximately 10-fold lower concentrations than 3, and these concentrations were positively correlated. Compound 4 showed a lower serum concentration and weaker inhibitory titer on 11β-HSD2 than 3. We developed an enzyme-linked immunosorbent assay system using an anti-18β-glycyrrhetyl-3-O-glucuronide (3MGA) monoclonal antibody to measure the serum concentration of 3 to facilitate the measurement of biomarkers to predict the onset of pseudohyperaldosteronism. Although we found 4 as the secondary candidate causative agent, 3 could be the main potent preventive biomarker of liquorice-induced pseudohyperaldosteronism. Compound 3 was detected in serum at a higher concentration than GA and 4, implying that 3 may be a pharmacologically active ingredient mediating not only the development of pseudohyperaldosteronism but anti-inflammatory effects in humans administered GL or other liquorice-containing preparations.

Summary: Antiviral treatments targeting the coronavirus disease 2019 are urgently required. We screened a panel of already approved drugs in a cell culture model of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and identified two new agents having higher antiviral potentials than the drug candidates such as remdesivir and chroloquine in VeroE6/TMPRSS2 cells: the anti-inflammatory drug cepharanthine and human immunodeficiency virus protease inhibitor nelfinavir. Cepharanthine inhibited SARS-CoV-2 entry through the blocking of viral binding to target cells, while nelfinavir suppressed viral replication partly by protease inhibition. Consistent with their different modes of action, synergistic effect of this combined treatment to limit SARS-CoV-2 proliferation was highlighted. Mathematical modeling in vitro antiviral activity coupled with the calculated total drug concentrations in the lung predicts that nelfinavir will shorten the period until viral clearance by 4.9 days and the combining cepharanthine/nelfinavir enhanced their predicted efficacy. These results warrant further evaluation of the potential anti-SARS-CoV-2 activity of cepharanthine and nelfinavir.

We present a case of reverse Z-effect phenomenon in a basicervical femoral fracture using a cephalomedullary nail together with two superior antirotation screws and evaluate the procedure. An 86-year-old woman fell in her home and could not stand due to right hip joint pain. X-ray and CT imaging showed a right basicervical femoral fracture (AO/OTA classification; 31B3), and open reduction and internal fixation (OR/IF) was performed with a cephalomedullary nail and two superior antirotation screws (TES Nail, HOMS, Tokyo, Japan). Two months later, X-ray showed penetration of the femoral head by the inferior lag screw with lateral migration of the two superior antirotation screws; the so-called “reverse Z-effect”; without any trauma. We performed the exchange of a shorter inferior lag screw for the longer one, and replaced the sliding type end cap with one of rocking type. The reverse Z-effect has been reported in cases with two lag screws, i.e. one inferior and one superior, in the past; however, to our knowledge, there has been no case reported in the literature using two superior antirotation screws together with one inferior lag screw.

Natural gas-fired combined cycle power plants (NGCC) have the advantages of high efficiency and low CO2 intensity compared to coal-fired power plants. When variable renewable energy sources are introduced to the grid in large quantities, the NGCC is expected to have rapid start-ups, rapid shutdowns, and increased partialload operations to stabilize the grid. Due to these temporary operations, the ratio of NO2/NOX in the NGCC exhaust gas changes significantly. In general, when the NO2/NOX ratio is high, the efficiency of the de-NOX systems decreases. Moreover, the performance of de-NOX systems has a transient response due to changes at the catalyst surface and the adsorption of NH3. Considering the trajectory of increased variable renewable energy, it is necessary to develop an efficient NOx removal system that is effective over a wide range of NO2/NOX ratios. In the modeling of de-NOX system performance, this study extends the general Eley-Rideal reaction between adsorbed NH3 and gas-phase NOX to include the existence of O2, H2O, CO2, and transient NO2 in the exhaust gas along with changes in redox sites (i.e., V5+=O and V4+-OH). A two-dimensional transient numerical simulation code was developed and adapted using experimental results obtained from treating simulated NGCC exhaust gas using a commercial honeycomb-shaped selective catalyst. Numerical simulations incorporating the empirically determined kinetic equations accurately predict the transient and equilibrium concentrations of NOX and NH3 exiting a honeycomb catalyst even under gas conditions including high NO2.

Inflammatory pseudotumors (IPTs) are benign masses arising from nonspecific inflammatory conditions including surgical invasion. We herein report the rare case of an IPT mimicking port-site metastasis in a 69-year-old patient who underwent retroperitoneal robotic partial nephrectomy for stage T1a renal cell carcinoma. Radiological examination performed six months after the surgery revealed the presence of a mass underneath the abdominal wall which coincided with a port site. The tumor was resected by laparoscopic transperitoneal approach, and histological examination led to the diagnosis of an IPT that consists of xanthogranulomatous inflammation. We also discuss the etiology of IPT formation and features distinguishing IPTs from port-site metastasis.

Recent years have seen numerous studies into how applying pulsed high electric fields (PEF) to living organisms induces various stress reactions. Plants produce glucose through photosynthesis and use this as a source of energy for living, yet there are few studies on the photosynthetic response characteristics when PEF is applied to growing plants. In this study, the photosynthetic response when electric fields of 10 to 100 V/mm were applied to light and dark-acclimated leaves of lettuce was measured by combined gas exchange and chlorophyll fluorescence, and the exposure time was kept constant at 500 s. The responses to PEF with regard to the photosynthetic parameters of electron transfer rate (ETR), non-photochemical quenching (NPQ), photosynthetic rate (A), and transpiration rate (E) were recorded during the experiment. Results showed that PEF can cause both the activation and deactivation of photosynthetic activity in lettuce, that there is an optimum value for activation, and that the application of excessive energy leads to inactivation. This study also found that stomata on both active and deactivated lettuce had been open to a greater extent than lettuce to which PEF had not been applied. All the results of statistical significance in this study were p < 0.05 and p < 0.01.

Abstract This paper focuses on robot picking of objects in warehouses and stores. Objects are often regularly stacked or aligned in specific arrangement patterns to increase storage efficiency. There are typical patterns in arrangement patterns. A specific picking strategy set is often linked to specific arrangement patterns. By linking the arrangement patterns of various object categories to picking strategy sets, the picking performance of a robot is expected to improve. In this paper, we propose a method in which groups of regularly arranged objects are detected from an image, and the arrangement pattern of each group is identified. In this paper, we describe the effectiveness of the proposed method based on experiment results for “book” as the target.

Murine contact hypersensitivity (CHS) is an animal model of allergic contact dermatitis (ACD). We investigated the inhibitory effects of dietary pomegranate polyphenol concentrate (PPC) on CHS. Mice were fed diets containing low or high doses of PPC for 3 weeks prior to CHS induction. Both the low- and high-dose PPC diets attenuated ear swelling and edema, and resulted in reduced infiltration of Gr-1-positive myeloid cells into ear tissues. The ear tissues of PPC-treated mice exhibited reduced mRNA expression of Cxcl2 and Cxcl3 and decreased production of chemokine (C-X-C motif) ligand 2 (CXCL2) and chemokine (C-C motif) ligand 12 (CCL12). Furthermore, the effects of urolithin A (UA) on splenic cell activation were studied. UA reduced the number of INF-γ-producing cells. These results indicate that low doses of dietary PPC alleviate CHS symptoms, suggesting that dietary PPC may provide beneficial effects on ACD at physiologically relevant doses to humans.

Abstract Background Insomnia has a high prevalence in modern society. Various tools have been developed to assess insomnia. We performed a direct comparison between the Insomnia Severity Index (ISI) and the Athens Insomnia Scale (AIS) in a Japanese population. Methods A cross-sectional questionnaire-based study was conducted in September 2017 as part of the Night in Japan Home Sleep Monitoring Study. In addition to insomnia, assessed using the AIS and ISI, depression, sleepiness, quality of life, and work performance were assessed using the Patient Health Questionnaire (PHQ)-9, a Japanese version of the Epworth Sleepiness Scale, the Short Form-8 Health Survey Questionnaire (SF-8), and the World Health Organization Health and Work Performance Questionnaire, respectively. Receiver operating characteristic (ROC) curves were constructed to compare the outcomes of the AIS and the ISI. Results A total of 1685 (81.9%) of all eligible employees were enrolled. The total scores of the AIS and ISI had a Pearson correlation coefficient (r) of 0.80 (p

Ischemic colitis, often idiopathic, is a disease of the digestive system commonly found in patients with symptoms of abdominal pain and/or melena. In most cases, however, ischemic colitis is treated with conservative treatment and only in rare cases requires surgery. This is a case report of a patient who was diagnosed with ischemic colitis and later was required surgery due to advanced cicatricial stenosis. Patient is a 75-year-old female who had been experiencing abdominal pain followed by diarrhea and melena from several days before. Making a visit to a local clinic, she was recommended and admitted to our hospital for further diagnosis as well as adequate treatment. After conducting a colonoscopy, a lesion consisting of a 5 centimeter-long submucosal bleeding around the entire circumference of the descending colon, closer to the anus, was found. Under a pre-condition of fasting, the patient was given medical treatment via central venous hyperalimentation. In a later colonoscopy, only a mild case of cicatricial stenosis was found. However, even after resuming oral intake, there were no recurrences of symptoms such as abdominal pain, melena or ileus. On the 14th day of illness, patient was discharged from the hospital. Nevertheless, after some time of ambulatory care visits, on the 54th day of illness, the patient was again hospitalized for a thorough reexamination of the narrow pass. After conducting a colonoscopy, it was found that the lesioned part had generated a more severe, stiffer cicatricial stenosis. After checking with family members about patient's progress, a decline in amount of ingestion was revealed which, as a result, necessitated surgery on the patient. Postoperative course was uneventful, and the patient was able to leave the hospital rather quickly, 12 days after the surgery. Ten to 15 % of ischemic colitis cases are regarded constrictive. Most cases are ischemic changes on the outside layer of the mucosa. However, in case of significant ischemic change, the surface layer of the mucous membrane can be replaced with a fibrous structure which results in the occurrence of delayed cicatricial stenosis. In this case, possibilities of significant ischemia at first endoscopy, as well as possibilities of delayed changes at the following endoscopy, should have been considered. Patient's refusal to undergo surgery caused a delay in finding ileus of the intestine. As far as symptoms of significant ischemia and constriction were found, swift reexamination with awareness of possibilities of surgery should have taken place.

Introduction: Failed spinal fusion surgery sometimes requires salvage surgery when symptomatic, especially with postsurgical decrease in intervertebral disc height followed by foraminal stenosis. For such cases, an anterior approach to lumbar lateral interbody fusion (LLIF) provides safe, direct access to the pathological disc space and a potential improvement in the fusion rate. One LLIF approach, oblique lateral interbody fusion (OLIF), targets the oblique lateral window of the intervertebral discs to achieve successful lateral interbody fusion. The current technical note describes spinal revision surgery using the OLIF procedure. Technical Note: The subjects were patients with leg pain and/or lower back pain derived from decreased intervertebral height followed by foraminal stenosis due to failed spinal fusion surgery. These patients underwent additional OLIF surgery and posterior fusion with no additional posterior direct decompression. Their outcomes were evaluated using the Japanese Orthopaedic Association (JOA) scores at baseline and final follow-up. Bony union was also evaluated using computed tomography images at final follow-up. Six subjects were evaluated, with two representative cases described in detail. Four patients had an adjacent segment disorder, and the other two patients had pseudarthrosis due to postoperative infection. The mean JOA score improved from 5.7 ± 5.4 to 21.2 ± 2.3, with a mean recovery rate of 65.0%. All cases showed intervertebral bony union. Conclusions: We introduced a salvage strategy for failed posterior spine fusion surgery cases using the OLIF procedure. Patients effectively achieved recovered intervertebral and foraminal height with no additional posterior direct decompression.

Hydrogels made from the cardiac extracellular matrix (ECM) as two-dimensional (2D) or 3D cell-culture substrates have beneficial biochemical effects on the differentiation of stem cells into cardiomyocytes. The mechanical properties of the substrates that match those of the host tissues have been identified as critical biophysical cues for coaxing the tissue-specific differentiation of stem cells. The objectives of the present study are (1) to fabricate hydrogels comprising pure ventricular ECM (vECM), (2) to make the gels possess mechanical properties similar to those of the decellularized ventricular tissue, and (3) to evaluate the cellular compatibility of the hydrogels. In order to achieve these aims, (1) a simplified protocol was developed to produce vECM solution easily and rapidly, (2) N-(3-Dimethylaminopropyl)-N’-ethylcarbodiimide hydrochloride (EDAC) was chosen to crosslink the hydrogels made from the vECM solution to enhance their mechanical properties and stabilize the microstructure of the gels, (3) rat embryonic fibroblasts or cardiomyocytes were cultured on these gels to determine the cellular compatibility of the gels. In particular, the nonlinearity and viscoelasticity of the gels were characterized quantitatively using a newly proposed nonlinear Kelvin model. The results showed that EDAC treatment allowed modulation of the mechanical properties of the gels to the same level as those of decellularized ventricular tissue in terms of the equilibrium elasticity and relaxation coefficient. Cell culture confirmed the cellular compatibility of the gels. Furthermore, an empirical relationship between the equilibrium elastic modulus of the gels and the vECM and EDAC concentrations was derived, which is important to tailor the mechanical properties of the gels. Finally, the influence of the mechanical properties of the gels on the behavior of cultured fibroblasts and cardiomyocytes was discussed.