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Abstract The cleavage reactions of catalytic antibodies are mediated by a serine protease mechanism involving a catalytic triad composed of His, Ser, and Asp residues, which reside in the variable region. Recently, we discovered a catalytic antibody, H34 wild type (H34wt), that is capable of enzymatically cleaving an immune-check point PD-1 peptide and recombinant PD-1; however, H34wt does not contain His residues in the variable region. To clarify the reason behind the catalytic features of H34wt and the amino acid residues involved in the catalytic reaction, we performed site-directed mutagenesis focusing on the amino acid residues involved in the cleavage reaction, followed by catalytic activity tests, immunological reactivity evaluation, and molecular modeling. The results revealed that the cleavage reaction by H34wt proceeds through the action of a new catalytic site composed of Arg, Thr, and Gln. This new scheme differs from that of the serine protease mechanism of catalytic antibodies.

One of the problems of SME is the low motivation to collaborate; the lack of research on exploring the motivation to collaborate is an issue that needs to be focused on solving. Objectives. This research aims to explore the level and type of motivation that influences SME's interest in collaborating to provide new insights for SME managers to apply appropriate treatment in developing collaborative activities. This study analyses six octalysis core drives that affect user interest in the use of SME collaboration gamification applications involving 293 SME respondents in the East Java Province. The research method is descriptive and quantitative, using Smart PLS, with a path analysis and analysis model. This study formulates six hypotheses to determine the effect of six core drives on using the collaborative gamification system. The results showed that the four constructs had a p-value less than 0.05 and a T-Statistic value greater than 1.96, while the other two constructs produced the opposite value. This finding reveals that four core drives (Epic Meaning, Development, Social Influence, and Avoidance) affect user interest in using collaborative gamification applications. In contrast, two core drives (Ownership and Unpredictable) do not affect it. The implication of this study is a recommendation for developers of collaboration-gamification systems to consider the results of this hypothesis, especially the role of core-drive catalysis as a reference in revising or developing collaborative gamification systems. Future work could apply the TAM model to analyze the technology acceptance rate of this system.

Abstract Background Health inequalities are widening in Japan, and thus, it is important to understand whether (and to what extent) there is a regional variation in long-term care (LTC) spending across municipalities. This study assesses regional variation in LTC spending and identifies the drivers of such variation. Methods We conducted a cross-sectional study using publicly available municipality-level data across Japan in 2019, in which the unit of analysis was municipality. The outcome of interest was per-capita LTC spending, which was estimated by dividing total LTC spending in a municipality by the number of older adults (people aged ≥ 65). To further identify drivers of regional variation in LTC spending, we conducted linear regression of per-capita spending against a series of demand, supply, and structural factors. Shapley decomposition approach was used to highlight the contribution of each independent variable to the goodness of fit of the regression model. Results In Fiscal 2019, per-capita LTC spending varied from 133.1 to 549.9 thousand yen (max/min ratio 4.1) across the 1460 municipalities analyzed, showing considerable regional variation. The included covariates explained 84.0% of the total variance in LTC spending, and demand-determined variance was remarkably high, which contributed more than 85.7% of the overall R2. Specifically, the highest contributing factor was the proportion of severe care-need level and care level certification rate. Conclusions Our results demonstrate that, even after adjusting for different municipalities’ age and sex distribution, there is a large variation in LTC spending. Furthermore, our findings highlight that, to reduce the spending gap between municipalities, the issues underlying large variations in LTC spending across municipalities must be identified and addressed.

Nickel oxide (NiO) is one of the p-type semiconductors with unique properties suitable for nanosensor applications. It has a wide range band gap and can be fabricated in various methods, leading to different nanostructures and results. In this study, undoped and lithium (Li)-doped NiO were fabricated using the immersion method to investigate their properties. The field emission scanning electron microscopy analysis revealed that both samples produced two layers of nanosheet and nano coral reef-like (CR) structures. X-ray diffraction patterns confirmed the average crystallite sizes for undoped and Li-doped NiO are 24.70 nm and 31.19 nm, respectively. According to ultraviolet-visible spectroscopy, Li-doped NiO has a higher average transmittance percentage of 53% compared to undoped NiO, which has 40%. The estimated optical band gap values are not much different, with 3.94 eV for undoped and 3.95 eV for Li-doped. Electrical measurements also indicated that Li-doped NiO has a higher conductivity value of 7.9 x 10-2 S.m-1, whereas undoped NiO has 7.71 x 10-2 S.m-1.

Abstract This study aimed whether the uptake of amino tracer positron emission tomography (PET) can be used as an additional imaging biomarker to estimate the prognosis of glioma. Participants comprised 56 adult patients with newly diagnosed and untreated World Health Organization (WHO) grade II–IV astrocytic glioma who underwent surgical excision and were evaluated by 11C-methionine PET prior to the surgical excision at Osaka City University Hospital from July 2011 to March 2018. Clinical and imaging studies were retrospectively reviewed based on medical records at our institution. Preoperative Karnofsky Performance Status (KPS) only influenced progression-free survival (hazard ratio [HR] 0.20; 95% confidence interval [CI] 0.10–0.41, p

To make the best clinical judgements, surgeons need to integrate information acquired via multimodal imaging [...]

Abstract Background The respiratory syncytial virus (RSV) disease burden is significant, especially in infants and children with an underlying disease. Prophylaxis with palivizumab is recommended for these high-risk groups. Early recognition of a RSV epidemic is important for timely administration of palivizumab. We herein aimed to assess the correlation between national surveillance and Google Trends data pertaining to RSV infections in Japan. Methods The present, retrospective survey was performed between January 1, 2018 and November 14, 2021 and evaluated the correlation between national surveillance data and Google Trends data. Joinpoint regression was used to identify the points at which changes in trends occurred. Results A strong correlation was observed every study year (2018 [r = 0.87, p

Population sizes of the Japanese red coral Corallium japonicum have been severely affected by poaching and overfishing. Although genetic structure and connectivity patterns are considered important parameters for conservation strategies, there are few studies focusing on the population genetics of C. japonicum in the Northwest Pacific. We examined the genetic population structure of C. japonicum, in the Northwest Pacific. We used restriction-site-associated DNA sequencing (RAD-seq), which can be used to identify genome-wide single-nucleotide polymorphism (SNPs), to reveal detailed within-species genetic variations. Using the variable SNP loci identified from this analysis, we successfully evaluated the population-level genetic diversity and patterns of gene flow among multiple populations of C. japonicum around Japan. The results of genetic analysis basically showed that gene flow is widely maintained in the geographic range examined in this study, but the analysis in combination with larval dispersal simulations revealed several populations that were genetically distinct from the other populations, suggesting geographically limited gene flows. The information obtained from this study will be useful for the design of effective management schemes for C. japonicum, which is under threat from overfishing.

IMPORTANCE:. Although pulse (high-dose) methylprednisolone therapy can hypothetically control immune system flare-ups effectively, the clinical benefit of pulse methylprednisolone compared with dexamethasone in COVID-19 remains inconclusive. OBJECTIVES:. To compare pulse methylprednisolone to dexamethasone as a COVID-19 treatment. DESIGN, SETTING, AND PARTICIPANTS:. Using a Japanese multicenter database, we identified adult patients admitted for COVID-19 and discharged between January 2020 and December 2021 treated with pulse methylprednisolone (250, 500, or 1,000 mg/d) or IV dexamethasone (≥ 6 mg/d) at admission day 0 or 1. Main Outcomes and Measures:. The primary outcome was in-hospital mortality. Secondary outcomes were 30-day mortality, new ICU admission, insulin initiation, fungal infection, and readmission. Multivariable logistic regression was conducted to differentiate the dose of pulse methylprednisolone (250, 500, or 1,000 mg/d). Additionally, subgroup analyses by characteristics such as the need for invasive mechanical ventilation (IMV) were also conducted. RESULTS:. A total of 7,519, 197, 399, and 1,046 patients received dexamethasone, 250, 500, and 1,000 mg/d of methylprednisolone, respectively. The crude in-hospital mortality was 9.3% (702/7,519), 8.6% (17/197), 17.0% (68/399), and 16.2% (169/1,046) for the different doses, respectively. The adjusted odds ratio (95% CI) was 1.26 (0.69–2.29), 1.48 (1.07–2.04), and 1.75 (1.40–2.19) in patients starting 250, 500, and 1,000 mg/d of methylprednisolone, respectively, compared with those starting dexamethasone. In subgroup analyses, the adjusted odds ratio of in-hospital mortality was 0.78 (0.25–2.47), 1.12 (0.55–2.27), and 1.04 (0.68–1.57) in 250, 500, and 1,000 mg/d of methylprednisolone, respectively, among patients with IMV, whereas the adjusted odds ratio was 1.54 (0.77–3.08), 1.62 (1.13–2.34), and 2.14 (1.64–2.80) among patients without IMV. CONCLUSIONS AND RELEVANCE:. Higher doses of pulse methylprednisolone (500 or 1,000 mg/d) may be associated with worse COVID-19 outcomes when compared with dexamethasone, especially in patients not on IMV.

Abstract Balloon test occlusion (BTO) is an angiographic test to evaluate ischemic tolerance after permanent occlusion of an internal carotid artery (ICA). BTO can simulate ischemia caused by parent artery occlusion and can be used to select a suitable bypass surgery using specific criteria. On the other hand, a postoperative thrombus can form despite proper case selection, optimal radiological evaluation, and an appropriate surgical strategy. Postoperative ischemic complications related to perforating branches are clinically significant. This simulation study aimed to analyze postoperative flow characteristics and elucidate the cause of ischemic complications related to the perforating branch using computational fluid dynamics (CFD). An unexpected postoperative thrombus formation related to the perforating branch occurred after treating a giant aneurysm in the cavernous portion of the ICA in a patient. Three-dimensional digital subtraction angiography was used to acquire flow data and set up the CFD simulation. The flow simulations were performed at various bypass flow rates. The CFD analysis indicated flow stagnation in the ICA only when surgical treatment using a low-flow bypass graft was performed. Thrombus formation may lead to ischemic complications related to the perforating branch, such as the anterior choroidal artery. BTO did not reflect the influence of bypass blood flow. Therefore, recognizing that blood flow stagnation may occur and comprehensively deciding on the surgical strategy by CFD analysis can be helpful to prevent ischemic complications in patients with giant aneurysms.

Dysembryoplastic neuroepithelial tumors (DNTs) are benign brain tumors classified as grade 1 in the 2021 World Health Organization (WHO) classification of central nervous system tumors. DNTs rarely undergo malignant transformation and cause symptomatic intracranial hemorrhage. We report a case of malignant transformation of DNT presenting with intraventricular hemorrhage and review the literature on malignant transformation of DNTs. An 18-year-old woman with a history of epilepsy presented with a sudden headache and vomiting. Radiological examination revealed a mass lesion in the left parietal lobe and intraventricular hemorrhage. The patient underwent an emergency craniotomy for brain tumor resection. The lesion was pathologically diagnosed as a malignant transformation of DNT. She had been followed up without tumor recurrence for 2 years after surgery.

Abstract Background Although numerous studies have investigated out-of-hospital cardiac arrest, few studies have been conducted on in-hospital cardiac arrest (IHCA). Knowledge of the nationwide epidemiology of IHCA in Japan, with its super-aging society, is important to understand the current situation of IHCA and to establish evidenced-based medicine in the future. The present study aimed to determine the incidence and outcomes of IHCA and their trends in Japan. Methods This observational cohort study was performed using a national administrative inpatient database for more than 1600 acute-care hospitals covering about 50% of all acute-care hospital beds in Japan from April 2011 to March 2018. We defined cardiac arrest patients who received cardiopulmonary resuscitation (chest compression) during hospitalization as IHCA. We excluded out-of-hospital cardiac arrest patients from the source population. The incidence of IHCA per 1000 hospital admissions and survival to discharge rate was reported with trend analyses by calendar year 2011–2017. Results Among 53,871,101 hospitalized patients without out-of-hospital cardiac arrest patients in 1626 hospitals, 2,136,038 (4.0%) had cardiac arrest. Of them, 274,664 (12.9%) received cardiopulmonary resuscitation at least once during hospitalization and were identified as IHCA, and 1,861,374 (87.1%) did not receive cardiopulmonary resuscitation. The incidence of IHCA per 1000 hospital admissions was 5.1, with a significant decreasing trend from 6.1 in 2011 to 4.6 in 2017 (P for trend = 0.033). Our estimated incidence can be translated to approximately 87,000 IHCA cases in Japan each year. The percentage of IHCA patients among cardiac arrest patients was 12.9%, with a significant decreasing trend from 14.0% in 2011 to 12.2% in 2017 (P for trend = 0.006). The overall rate of survival to discharge was 12.7%, with a significant increasing trend from 10.5% in 2011 to 14.0% in 2017 (P for trend

Abstract Arsenic is a major global threat to the ecosystem. Here we describe a highly accurate sensing platform using silica nanoparticles/graphene at the surface of aluminum interdigitated electrodes (Al IDE), able to detect trace amounts of arsenic(III) in rice grain samples. The morphology and electrical properties of fabricated Al IDEs were characterized and standardized using AFM, and SEM with EDX analyses. Micrometer scale Al IDEs were fabricated with silicon, aluminum, and oxygen as primary elements. Validation of the bare Al IDE with electrolyte fouling was performed at different pH levels. The sensing surface was stable with no electrolyte fouling at pH 7. Each chemical modification step was monitored with current–volt measurement. The surface chemical bonds were characterized by fourier transform infrared spectroscopy (FTIR) and revealed different peaks when interacting with arsenic (1600–1000 cm−1). Both silica nanoparticles and graphene presented a sensitive limit of detection as measured by slope calibration curves at 0.0000001 pg/ml, respectively. Further, linear regression was established using ΔI (A) = 3.86 E−09 log (Arsenic concentration) [g/ml] + 8.67 E−08 [A] for silica nanoparticles, whereas for graphene Y = 3.73 E−09 (Arsenic concentration) [g/ml] + 8.52 E−08 on the linear range of 0.0000001 pg/ml to 0.01 pg/ml. The R2 for silica (0.96) and that of graphene (0.94) was close to the maximum (1). Modification with silica nanoparticles was highly stable. The potential use of silica nanoparticles in the detection of arsenic in rice grain extract can be attributed to their size and stability.