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Catalytic conversion of carbon dioxide (CO2) into useful chemical raw materials or fuels can help achieve the “dual carbon” goals of carbon peaking and carbon neutrality. As a sustainable green energy source, solar energy provides energy for human production and life. In recent years, the reported single-atom catalysts (SACs) have higher atom utilization and better catalytic efficiency than traditional heterogeneous catalysts. In the field of photocatalysis and photothermal synergistic catalysis of CO2 conversion, single-atom catalysts can reduce the reaction temperature and pressure, improve the catalytic activity, and improve the selectivity of the reaction. In this mini-review, the basic mechanism and classification of CO2 reduction are introduced, and then the roles and differences of single-atom catalysts in photocatalysis and photothermal catalysis are introduced. In addition, according to the reduction product types, the recent research progress of single-atom catalysts in photoconversion and photothermal CO2 conversion was reviewed. Finally, the challenges of monoatomic photocatalytic and photothermal CO2 reduction technologies have prospected. This mini-review hopes to provide an in-depth understanding of the roles of single atoms in photocatalysis and photothermal catalysis and to shed light on the actual production and application of renewable energy. High-performance single-atom catalysts are expected to achieve industrial applications of CO2 conversion, which will contribute to the early realization of the two-carbon goal.

Abstract Cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) are the standard agents for treating patients with estrogen receptor-positive and human epidermal growth factor receptor 2-negative advanced breast cancer (ER + HER2 − ABC). However, markers predicting the outcomes of CDK4/6i treatment have yet to be identified. This study was a single-center retrospective cohort study. We retrospectively evaluated 101 patients with ER + HER2 − ABC receiving CDK4/6i in combination with endocrine therapy at Fukuyama City Hospital between November 2017 and July 2021. We investigated the clinical outcomes and the safety of CDK4/6i treatment, and the absolute lymphocyte count (ALC) and neutrophil-to-lymphocyte ratio (NLR) as predictive markers for CDK4/6i. We defined the cut-off values as 1000/μL for ALC and 3 for NLR, and divided into “low” and “high” groups, respectively. We evaluated 43 and 58 patients who received abemaciclib and palbociclib, respectively. Patients with high ALC and low NLR had significantly longer overall survival than those with low ALC and high NLR (high vs. low; ALC: HR 0.29; 95% CI 0.12–0.70; NLR: HR 2.94; 95% CI 1.21–7.13). There was no significant difference in efficacy between abemaciclib and palbociclib and both had good safety profiles. We demonstrated that ALC and NLR might predict the outcomes of CDK4/6i treatment in patients with ER + HER2 − ABC.

Abstract New standard zircons applicable to in situ analysis of Hf/W ratio by Nanoscale secondary ion mass spectrometer (NanoSIMS) were prepared and applied to Hf-W dating of a differentiated meteorite classified as mesosiderite. The standard zircons were synthesized by high-pressure experiment from starting materials which were mixture of hafnium oxide, tungsten oxide and high-purity zircon powder. The mixed powders were stirred and pulverized by a high-energy ball mill. They were then sintered at 1000 °C and 6 GPa using multi-anvil apparatus. Homogeneity of Hf/W ratios of synthesized zircons was examined by SEM–EDS, EPMA, and Laser Ablation Inductively Coupled Plasma Mass Spectrometer (LA-ICPMS). Hf/W ratios of the same zircons were measured by a NanoSIMS with 2 nA oxygen primary beam and mass resolving power of 10,000. The relative sensitivity factor (RSF) of Hf/W ratio was determined by comparing zircon data measured by LA-ICPMS and NanoSIMS. Observed RSF (Hf/W) of zircon is 0.585 ± 0.180 (hereafter all error 2σ) consistent with 0.855 ± 0.468 of previous work within experimental error margin. The value is higher than observed RSF of glass matrix, 0.301 ± 0.062, and significantly higher than glass data of 0.21–0.22 in references. Based on the RSF, the Hf/W ratios of zircons extracted from mesosiderite “Asuka 882,023” were measured together with W isotopic compositions by NanoSIMS. Observed data in 180Hf/186W–182W/186W diagram are fitted by a straight line, yielding a slope (182Hf/180Hf) of 8.19 ± 3.50 × 10–6. This slope is converted into an absolute zircon Hf-W age of 4536.5+4.6 –7.2 Ma using the age anchor of CV3 chondrite. This age agrees well with a reference value of 4532.0+11.4 –20.8 Ma.

Abstract Antibody responses, involving B cells, CD4 + T cells, and macrophages, are implicated in autoimmune diseases and organ transplant rejection. We have previously shown that inhibiting FROUNT with disulfiram (DSF) suppresses macrophage activation and migration, effectively treating inflammatory diseases. In this study, we investigated the effectiveness of DSF in antibody-producing reactions. Using a heart transplantation mouse model with antibody-mediated rejection, we administered anti-CD8 antibody to exclude cellular rejection. DSF directly inhibited B cell responses in vitro and significantly reduced plasma donor-specific antibodies and graft antibody deposition in vivo, resulting in prolonged survival of the heart graft. DSF also mediated various effects, including decreased macrophage infiltration and increased Foxp3+ regulatory T-cells in the grafts. Additionally, DSF inhibited pyrimidine metabolism-related gene expression induced by B-cell stimulation. These findings demonstrate that DSF modulates antibody production in the immune response complexity by regulating B-cell and macrophage responses.

Objectives: Hydrogel spacer (HS) was developed to reduce rectal toxicities caused by radiotherapy, but has been reported to cause major adverse events. Our institute has attempted to introduce a hyaluronic acid (HA) as an alternative spacer. This study aimed to compare rectal doses and geometric distributions between the HS and HA implantation in prostate cancer. Methods: HS and HA were inserted in 20 and 18 patients undergoing high-dose brachytherapy, respectively. The rectum spacer volumes injected were 10 mL and 22 mL, respectively. In the treatment planning system, 13.5 Gy was administered with common catheter positions. The rectal dose indices were assessed between the spacer groups for dosimetry evaluation. Distances between the prostate and rectum and configurations of the spacers were compared. Results: The mean doses irradiated to 0.1 and 2 mL of the rectum were 10.45 Gy and 6.71 Gy for HS, and 6.73 Gy and 4.90 Gy for HA (p

Therapeutic endoscopic ultrasonography (EUS) procedures using the forward-viewing convex EUS (FV-EUS) have been reviewed based on the articles reported to date. The earliest reported procedure is the drainage of pancreatic pseudocysts using FV-EUS. However, the study on drainage of pancreatic pseudocysts focused on showing that drainage is possible with FV-EUS rather than leveraging its features. Subsequently, studies describing the characteristics of FV-EUS have been reported. By using FV-EUS in EUS-guided choledochoduodenostomy, double punctures in the gastrointestinal tract can be avoided. In postoperative modified anatomical cases, using the endoscopic function of FV-EUS, procedures such as bile duct drainage from anastomosis, pancreatic duct drainage from the afferent limb, and abscess drainage from the digestive tract have been reported. When a perpendicular puncture to the gastrointestinal tract is required or when there is a need to insert the endoscope deep into the gastrointestinal tract, FV-EUS is considered among the options.

Background/Aims Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (EUS-HGS) is useful for patients with biliary cannulation failure or inaccessible papillae. However, it can lead to serious complications such as bile peritonitis in patients with ascites; therefore, development of a safe method to perform EUS-HGS is important. Herein, we evaluated the safety of EUS-HGS with continuous ascitic fluid drainage in patients with ascites. Methods Patients with moderate or severe ascites who underwent continuous ascites drainage, which was initiated before EUS-HGS and terminated after the procedure at our institution between April 2015 and December 2022, were included in the study. We evaluated the technical and clinical success rates, EUS-HGS-related complications, and feasibility of re-intervention. Results Ten patients underwent continuous ascites drainage, which was initiated before EUS-HGS and terminated after completion of the procedure. Median duration of ascites drainage before and after EUS-HGS was 2 and 4 days, respectively. Technical success with EUS-HGS was achieved in all 10 patients (100%). Clinical success with EUS-HGS was achieved in 9 of the 10 patients (90%). No endoscopic complications such as bile peritonitis were observed. Conclusions In patients with ascites, continuous ascites drainage, which is initiated before EUS-HGS and terminated after completion of the procedure, may prevent complications and allow safe performance of EUS-HGS.

Abstract The speed limit of information propagation is one of the most fundamental features in non-equilibrium physics. The region of information propagation by finite-time dynamics is approximately restricted inside the effective light cone that is formulated by the Lieb-Robinson bound. To date, extensive studies have been conducted to identify the shape of effective light cones in most experimentally relevant many-body systems. However, the Lieb-Robinson bound in the interacting boson systems, one of the most ubiquitous quantum systems in nature, has remained a critical open problem for a long time. This study reveals a tight effective light cone to limit the information propagation in interacting bosons, where the shape of the effective light cone depends on the spatial dimension. To achieve it, we prove that the speed for bosons to clump together is finite, which in turn leads to the error guarantee of the boson number truncation at each site. Furthermore, we applied the method to provide a provably efficient algorithm for simulating the interacting boson systems. The results of this study settle the notoriously challenging problem and provide the foundation for elucidating the complexity of many-body boson systems.

Introduction: Laparoscopic surgery (LAP) is now recognized as the standard procedure for colorectal surgery. However, the standard surgery for ulcerative colitis (UC) is total proctocolectomy with ileal pouch anal anastomosis (IPAA), which may be an overly complex procedure to complete laparoscopically. We conducted this systematic review and meta-analysis to evaluate the efficacy as well as the advantages and disadvantages of LAP-IPAA in patients with UC stratified by the outcome of interest. Method: We performed a systematic literature review by searching the PubMed/MEDLINE, the Cochrane Library, and the Japan Centra Reuvo Medicina databases from inception until January 2023. Meta-analyses were performed for surgical outcomes, including morbidity and surgical course, to evaluate the efficacy of LAP-IPAA. Results: A total of 707 participants, including 341 LAP and 366 open surgery (OPEN) patients in 9 observational studies and one randomized controlled study, were included. From the results of the meta-analyses, the odds ratio (OR) of total complications in LAP was 1.12 (95% CI: 0.58–2.17, p = 0.74). The OR of mortality for LAP was 0.38 (95% CI: 0.08–1.92, p = 0.24). Although the duration of surgery was extended in LAP (mean difference (MD) 118.74 min (95% CI: 91.67–145.81), p < 0.01) and hospital stay were not shortened, the duration until oral intake after surgery was shortened in LAP (MD −2.10 days (95% CI: −3.52–0.68), p = 0.004). Conclusions: During IPAA for UC, a similar morbidity rate was seen for LAP and OPEN. Although LAP necessitates extended surgery, there may be certain advantages to this procedure, including easy visibility during the surgical procedure or a shortened time to oral intake after surgery.

Functioning gonadotroph tumors are rare neoplasms that can cause ovarian hyperstimulation syndrome (OHSS) in women of reproductive age. Here, we present a case of a follicle-stimulating hormone (FSH)-producing pituitary neuroendocrine tumor (PitNET) with irregular menstrual cycles and OHSS in a Japanese woman. A 34-year-old woman with bilateral multi-cystic ovarian mass was referred to our hospital for ovarian surgery. The imaging feature of magnetic resonance imaging (MRI) of the ovary and elevated estradiol levels with normal FSH and low luteinizing hormone (LH) levels led us to suspect the presence of a functioning gonadotroph PitNET. MRI revealed a 19-mm pituitary tumor, and increased tracer uptake was observed in the pituitary lesion on 111In-pentetreotide scintigraphy. Transsphenoidal tumor resection resulted in the resolution of the ovarian enlargement, normalization of her menstrual cycles, and spontaneous pregnancy. Immunohistochemistry (IHC) of the resected tumor for pituitary transcription factors, including steroidogenesis factor 1 (SF1) and estrogen receptor alpha, demonstrated positive immunoreactivity, whereas IHC for pituitary-specific positive transcription factor 1 was negative, suggesting that the tumor belonged to the SF1 lineage of PitNETs (gonadotroph tumor). The tumor cells showed positive expression of FSHβ, while LHβ was mostly negative. Consistent with the high pituitary tumor uptake observed on 111In-pentetreotide scintigraphy, the pituitary tumor showed positive expression of somatostatin receptor 2A. Detailed clinical and histological evaluations will provide useful information to understand these rare functioning gonadotroph tumors better.

Abstract The murine model of subarachnoid hemorrhage (SAH) is a valuable experimental tool for investigating molecular and cellular mechanisms, and the endovascular filament perforation technique can be used to simulate prominent pathophysiological features observed after human SAH; however, current validation methods for assessing an appropriate SAH model are limited. Here, we introduce a simple procedure for selecting a mouse model of diffuse SAH. SAH was induced in 24 mice using a standard filament perforation method. After confirming survival at 24 h, SAH was scored 0–1 based on T2*‐weighted images on whole‐brain magnetic resonance imaging (MRI) and visual surveillance of the cisterna magna (CM) through the dura mater. The CM‐based SAH grading correlated well with a reference parameter defined by extracted brain (r2 = 0.53, p

Abstract During mid-Cretaceous Oceanic Anoxic Event 2, significant increase of atmospheric carbon dioxide concentrations from the eruption of the large igneous provinces is hypothesized to have induced a humid climate and an elevation in nutrient runoff from continents to the oceans, resulting in oxygen depletion in the ocean. However, hitherto there is limited insight into the driving factors of Oceanic Anoxic Event 2 from the Pacific and Asian continental margins, even though the former and the latter were the largest ocean and landmass at that time. Here, a multiproxy analysis for the Oceanic Anoxic Event 2 interval of the Yezo Group –deposited on northwestern Pacific along the active Asian continental margin– is interpretated to identify seven volcanic pulses, five of which may have elevated humidity, weathering intensity, and vegetational change in the eastern margin of Asia. Moreover, oxygen depletion occurred simultaneously in the northwest Pacific. Given that these environmental changes in the eastern margin of Asia were penecontemporaneous with the global carbon burial intervals during Oceanic Anoxic Event 2, the elevated nutrient supply from the Asian continental margin to the Pacific Ocean may have, in part, contributed to the worldwide depletion of oxygen of the ocean during Oceanic Anoxic Event 2.

ABSTRACTBayesian optimization, coupled with Gaussian process regression and acquisition functions, has proven to be a powerful tool in the field of experimental design. Nevertheless, it demands a profound proficiency in software programming, machine learning, and statistical concepts. This steep learning curve presents a substantial obstacle when implementing Bayesian optimization for experimental design. In order to overcome this challenge, a user-friendly graphical interface for Gaussian process regression and acquisition functions is proposed. This accessible tool can be readily accessed via web browsers, courtesy of the established CADS platform (available at https://cads.eng.hokudai.ac.jp/). Thus, the interface offers to perform Bayesian optimization without any programming or any extensive prior knowledge about Bayesian optimization and machine learning.

Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a life-threatening birth defect that often occurs with other major birth defects (EA/TEF+). Despite advances in genetic testing, a molecular diagnosis can only be made in a minority of EA/TEF+ cases. Here, we analyzed clinical exome sequencing data and data from the DECIPHER database to determine the efficacy of exome sequencing in cases of EA/TEF+ and to identify phenotypic expansions involving EA/TEF. Among 67 individuals with EA/TEF+ referred for clinical exome sequencing, a definitive or probable diagnosis was made in 11 cases for an efficacy rate of 16% (11/67). This efficacy rate is significantly lower than that reported for other major birth defects, suggesting that polygenic, multifactorial, epigenetic, and/or environmental factors may play a particularly important role in EA/TEF pathogenesis. Our cohort included individuals with pathogenic or likely pathogenic variants that affect TCF4 and its downstream target NRXN1, and FANCA, FANCB, and FANCC, which are associated with Fanconi anemia. These cases, previously published case reports, and comparisons to other EA/TEF genes made using a machine learning algorithm, provide evidence in support of a potential pathogenic role for these genes in the development of EA/TEF.

Summary:. Accurate burn depth assessment is essential to decide an appropriate surgical procedure. However, most cases of burn depth are diagnosed with subjective judgment by an experienced plastic surgeon. There is a need for a simple, noninvasive, and accurate diagnostic method. Here, the authors present two burn cases in which burn depth was predicted using high-frequency power Doppler ultrasonography. In case 1, the patient showed partial deep burn area prediagnosed by clinical inspection in dorsal area. However, pulsatile microcirculation was detected in the deep dermal layer using high-frequency power Doppler ultrasonography, and we rediagnosed it as deep dermal burn. Tangential excision was performed to debride necrotic tissue, preventing excessive removal of viable dermal tissue. In case 2, the patient showed anterior chest burn covered eschar. Pulsatile microcirculation was detected in the dermis using high-frequency power Doppler ultrasonography. The authors diagnosed the area as superficial dermal burn and opted for conservative treatment. Dermal microvascular damage is a more sensitive indicator of tissue injury. Hence, the burn depth can be assessed using dermal microcirculation. To the best of the authors’ knowledge, there are no reports on the evaluation of blood flow in burn wounds using high-frequency power Doppler ultrasonography. In this case report, the authors introduce the possibility of using high-frequency ultrasonography to assess burn depth.

IntroductionThis article explores teacher and student mimicry of one another’s nodding in the classroom and whether it impacts teacher wellbeing. Studies have consistently demonstrated correlations between physical mimicry and various desirable outcomes, including empathy, rapport, affiliation, and personal liking. While students experiencing such emotional connections with their teachers tend to achieve more academically, teachers also benefit, showing, for example, reduced stress levels. Research exploring the link between mimicry of nonverbal communication such as nodding and teacher wellbeing is limited, however. This paper reports on a very small data set to explore the analysis of synchrony between teacher and learner in the English as a Foreign Language classroom.MethodsQuantitative and qualitative methodologies were combined to gather both objective and subjective data. A Granger causality analysis was undertaken to understand both immediate and delayed mimicry of nodding, and cross-correlograms produced. Teacher stress levels were measured using the ratio of the low-frequency (LF) and high-frequency (HF) heartrate power bands, which was then validated with a two-dimensional model. Next, the teacher was interviewed about her wellbeing and pedagogy while watching the video data. The results were then combined and analyzed.Results and discussionWhile much immediate mimicry during active teaching sessions was evident in the video data, it was not found to be at a statistically significant level. The Granger Causality analysis showed, however, that students consistently mimicked changes in teacher nodding rate in the following dyad activity. Cross-correlation analysis between teacher and student participants during active teaching sessions and also within student dyads during pairwork activities showed strong relationships at lags spanning 0–60 s. No statistical significance between student and/or teacher nodding and either teacher self-assessed wellbeing or physiological stress levels was found, however. This is explained first by the teacher evaluating her normal baseline state as neutral rather than positive (as was reflected by the LF/HF), and second by her physiological responses to the emotional regulation strategies of surface and deep acting. Qualitative observational data, however, indicated that teacher nodding positively influenced student comprehension, interest, and confidence, and the teacher’s own professional wellbeing.

Background/Purpose We aimed to investigate whether there is an interaction between life-space assessment (LSA) and movement control during one-leg standing on bone strength on the non-fractured side in patients with hip fracture. Methods Two-way analysis of variance (ANOVA) was applied for osteoporosis parameter to examine the interaction and main effects of LSA and movement control during one-leg standing. Results Two-way ANOVA revealed significant interaction and main effects of LSA and movement control during one-leg standing on bone mineral density (BMD) and Z -score. In parameters of hip structural analysis (HSA), the interaction and main effect of movement control during one-leg standing were detected only in cross-sectional area (CSA). Conclusion The results of this study suggest that both high LSA and good movement control during one-leg standing are necessary to maintain or improve some parameters of bone strength, such as BMD (neck and total hip), Z-score (neck and total hip), and CSA.

Immune checkpoint inhibitors (ICIs) are indispensable agents that may improve the long-term prognosis of non-small cell lung cancer. However, clinicians should always be aware that its immune-modulating mechanism of action may lead to unexpected immune-related adverse events (irAE). We report here a case of a 72-year-old man with adenocarcinoma of the lung who achieved a complete response to nivolumab plus ipilimumab plus chemotherapy but also suffered from a variety of immune-related adverse events. In this patient, Th1 immunity, which is involved in antitumor immunity, and Th2 immunity were activated, resulting in allergy-related reactions, including increased airway hyperresponsiveness and a marked increase in serum IgE levels. After starting corticosteroids, the allergic symptoms were well controlled. Remarkably, despite discontinuing ICI treatment, the patient has maintained a complete response for 27 months. Fortunately, we obtained lung and lymph node tissues from this patient after ICI administration and histologically examined the Th1 and Th2 immune status.

Backgrounds: Remote cardiac rehabilitation has proven useful in patients with cardiovascular disease; however, the methodology had not been fully validated. This study aimed to investigate the efficacy and safety of remote cardiac rehabilitation (RCR) with real-time monitoring and an ergometer using a bidirectional communication tool during the recovery phase of cardiovascular diseases. Methods: This multicenter, nonrandomized, interventional study was conducted at 29 institutions across Japan and enrolled patients with cardiovascular diseases who met indications for cardiac rehabilitation (CR) after receiving in-hospital treatment. The RCR group exercised at home using an ergometer and was monitored in real-time using interactive video and monitoring tools for 2–3 months. Educational instructions were provided concurrently through e-learning approaches. The safety of the RCR protocol and the improvement in peak oxygen consumption (VO2) were compared with those of the historical control group that participated in center-based CR. Results: Fifty-three patients from the RCR group were compared with 103 historical controls having similar background characteristics. No patients in RCR experienced significant cardiovascular complications while engaging in exercise sessions. After 2–3 months of RCR, the peak VO2 improved significantly, and the increases in the RCR group did not exhibit any significant differences compared to those in the historical controls. During follow-up, the proportion of patients whose exercise capacity increased by 10% or more was also evaluated; this finding did not indicate a statistically significant distinction between the groups. Conclusions: RCR during the recovery phase of cardiovascular diseases proved equally efficient and safe as center-based CR.

Abstract This study aimed to determine whether heat acclimation could induce adaptations in exercise performance, thermoregulation, and the expression of proteins associated with heat stress in the skeletal muscles of Thoroughbreds. Thirteen trained Thoroughbreds performed 3 weeks of training protocols, consisting of cantering at 90% maximal oxygen consumption (VO2max) for 2 min 2 days/week and cantering at 7 m/s for 3 min 1 day/week, followed by a 20‐min walk in either a control group (CON; Wet Bulb Globe Temperature [WBGT] 12–13°C; n = 6) or a heat acclimation group (HA; WBGT 29–30°C; n = 7). Before and after heat acclimation, standardized exercise tests (SET) were conducted, cantering at 7 m/s for 90 s and at 115% VO2max until fatigue in hot conditions. Increases in run time (p = 0.0301), peak cardiac output (p = 0.0248), and peak stroke volume (p = 0.0113) were greater in HA than in CON. Pulmonary artery temperature at 7 m/s was lower in HA than in CON (p = 0.0332). The expression of heat shock protein 70 (p = 0.0201) and 90 (p = 0.0167) increased in HA, but not in CON. These results suggest that heat acclimation elicits improvements in exercise performance and thermoregulation under hot conditions, with a protective adaptation to heat stress in equine skeletal muscles.

Objectives Japanese medical academia continues to depend on quantitative indicators, contrary to the general trend in research evaluation. To understand this situation better and facilitate discussion, this study aimed to examine how Japanese medical researchers perceive quantitative indicators and qualitative factors of research evaluation and their differences by the researchers’ characteristics.Design We employed a web-based cross-sectional survey and distributed the self-administered questionnaire to academic society members via the Japanese Association of Medical Sciences.Participants We received 3139 valid responses representing Japanese medical researchers in any medical research field (basic, clinical and social medicine).Outcomes The subjective importance of quantitative indicators and qualitative factors in evaluating researchers (eg, the journal impact factor (IF) or the originality of the research topic) was assessed on a four-point scale, with 1 indicating ‘especially important’ and 4 indicating ‘not important’. The attitude towards various opinions in quantitative and qualitative research evaluation (eg, the possibility of research misconduct or susceptibility to unconscious bias) was also evaluated on a four-point scale, ranging from 1, ‘strongly agree’, to 4, ‘completely disagree’.Results Notably, 67.4% of the medical researchers, particularly men, younger and basic medicine researchers, responded that the journal IF was important in researcher evaluation. Most researchers (88.8%) agreed that some important studies do not get properly evaluated in research evaluation using quantitative indicators. The respondents perceived quantitative indicators as possibly leading to misconduct, especially in basic medicine (strongly agree—basic, 22.7%; clinical, 11.7%; and social, 16.1%). According to the research fields, researchers consider different qualitative factors, such as the originality of the research topic (especially important—basic, 46.2%; social, 39.1%; and clinical, 32.0%) and the contribution to solving clinical and social problems (especially important—basic, 30.4%; clinical, 41.0%; and social, 52.0%), as important. Older researchers tended to believe that qualitative research evaluation was unaffected by unconscious bias.Conclusion Despite recommendations from the Declaration on Research Assessment and the Leiden Manifesto to de-emphasise quantitative indicators, this study found that Japanese medical researchers have actually tended to prioritise the journal IF and other quantitative indicators based on English-language publications in their research evaluation. Therefore, constantly reviewing the research evaluation methods while respecting the viewpoints of researchers from different research fields, generations and genders is crucial.

When using underwater optical wireless communication in areas close to human habitats— such as shallow sea areas—specifications for highly-secure, large-capacity optical transceivers are required. Real-time transmission of 850 nm, direct-current optical orthogonal frequency division multiplexing signals for full-duplex underwater invisible light communication has been achieved. We experimentally confirmed that subcarrier adaptive modulation could transmit at maximum capacity depending on the transmission distance, while changing the transmission distance in shallow seawater channels. We confirmed that there was no disturbing influence due to sunlight by using a honeycomb structure for sunlight shielding. Moreover, we found that the effect of disruption caused by the sea surface vibrating due to the 3 m/s wind speed did not affect the signal quality. 4K video streaming is also done on a 1.2 m underwater channel transmission. To the best of our knowledge, this is the first report of full-duplex transmission of invisible-band underwater optical wireless communication for shallow waters.

Abstract Serine metabolism is involved in various biological processes. Here we investigate primary functions of the phosphorylated pathway of serine biosynthesis in a non-vascular plant Marchantia polymorpha by analyzing knockout mutants of MpPGDH encoding 3-phosphoglycerate dehydrogenase in this pathway. Growth phenotypes indicate that serine from the phosphorylated pathway in the dark is crucial for thallus growth. Sperm development requires serine from the phosphorylated pathway, while egg formation does not. Functional MpPGDH in the maternal genome is necessary for embryo and sporophyte development. Under high CO2 where the glycolate pathway of serine biosynthesis is inhibited, suppressed thallus growth of the mutants is not fully recovered by exogenously-supplemented serine, suggesting the importance of serine homeostasis involving the phosphorylated and glycolate pathways. Metabolomic phenotypes indicate that the phosphorylated pathway mainly influences the tricarboxylic acid cycle, the amino acid and nucleotide metabolism, and lipid metabolism. These results indicate the importance of the phosphorylated pathway of serine biosynthesis in the dark, in the development of sperm, embryo, and sporophyte, and metabolism in M. polymorpha.

Benign biliary stricture (BBS) is a complication of chronic pancreatitis (CP). Despite endoscopic biliary stenting, some patients do not respond to treatment, and they experience recurrent cholangitis. We report two cases of CP with refractory BBS treated using endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) fistula creation. A 50-year-old woman and a 60-year-old man both presented with obstructive jaundice secondary to BBS due to alcoholic CP. They underwent repeated placement of a fully covered self-expandable metal stent for biliary strictures. However, the strictures persisted, causing repeated episodes of cholangitis. Therefore, an EUS-CDS was performed. The stents were eventually removed and the patients became stent-free. These fistulas have remained patent without cholangitis for more than 2.5 years. Fistula creation using EUS-CDS is an effective treatment option for BBS.

Obesity is one of the factors associated with the severity of asthma. Obesity is associated with aggravation of the pathophysiology of asthma, including exacerbations, airway inflammation, decreased pulmonary function, and airway hyperresponsiveness. The present review addresses the characteristics of asthma with obesity, focusing especially on the heterogeneity caused by the degree of type 2 inflammation, sex differences, the onset of asthma, and race differences. To understand the severity mechanisms in asthma and obesity, such as corticosteroid resistance, fatty acids, gut microbiome, and cytokines, several basic research studies are evaluated. Finally, possible future therapies, including weight reduction, microbiome-targeted therapies, and other molecular targeted therapies are addressed. We believe that the present review will contribute to better understanding of the severity mechanisms and the establishment of novel treatments for severe asthma patients with obesity.