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Abstract: The EVEDA Li test loop (ELTL) successfully completed its construction and installation of a total of 2.5-ton Li in the frame work of the IFMIF/EVEDA as one of the ITER-BA. Design for the ELTL had been done from March 2009 to December 2009 in large part, and then the construction was started on November 2009 in the O-arai site of the Japan Atomic Energy Agency and completed on the middle of November 2010 after passing an authority inspection by a fire department in O-arai town. Subsequently, the 2.5-ton Li was installed to the ELTL by using a glove box in the form of ingots which is 240mm long and 125mm in diameter. The nitrogen concentration in the 2.5-ton Li was found to be 127wppm. During the installation, the oxygen concentration and the humidity in the glove box were almost kept less than 20wppm, and any large contamination by air was prevented during the handling of Li. [Copyright &y& Elsevier]

Abstract: Engineering Validation and Engineering Design Activities (EVEDA) for the International Fusion Materials Irradiation Facility (IFMIF) were started under a collaborative international project known as the ITER Broader Approach. This paper presents the design of a cold trap for reducing oxygen concentration in Li installed in a purification loop of the EVEDA Li Test Loop (ELTL). Oxygen concentration during operation of the ELTL was estimated and the cold trap is designed with reference to the design of sodium cold trap developed for fast breeder reactor research. The presumed values in this design are expected to be reevaluated through the ELTL test program by using off- and on-line impurity monitors. [Copyright &y& Elsevier]

Objective: A Leu(7)-to-Pro(7) polymorphism exists in the signal peptide part of prepro-neuropeptide Y (NPY) and this polymorphism is associated with high serum cholesterol and LDL cholesterol levels in both Finnish and Dutch people. There was a significant difference in the allelic frequencies among populations with different genetic backgrounds. Therefore, the present study was designed to test whether Japanese people had the Leu(7)-to-Pro(7) polymorphism in the NPY signal peptide. Methods: A total of 102 healthy Japanese volunteers supplied blood samples, from which leucocyte DNA was isolated. Primer pairs for the polymerase chain reaction (PCR) were made according to Karvonen et al. Direct sequencing of the PCR product was carried out by the dye terminator method using a capillary electrophoresis sequencer. Results: All 102 young healthy Japanese subjects showed Leu(7)/Leu(7) but not Leu(7)/Pro(7) or Pro(7)/Pro(7) in the NPY signal peptide. Conclusions: The incidence of the Leu(7)-to-Pro(7) polymorphism in the signal peptide of NPY was extremely low in Japanese people, suggesting that the polymorphism producing Pro(7) is not one of the genetic determinant factors affecting serum cholesterol levels in Japanese people. [ABSTRACT FROM AUTHOR]

To show the Hertz-Knudsen equation is applicable to the prediction of the evaporation rates of Li and volatile impurities from the Li target surface at the International Fusion Materials Irradiation Facility (IFMIF), we analytically and experimentally studied these rates for a high-speed Li jet via engineering-scale tests performed under IFMIF conditions (vacuum pressure: 10 −3 Pa, Li temperature: 250 °C, jet speed: 7–15 m/s). The rates of evaporation and deposition were analytically predicted using the Hertz–Knudsen equation and the cosine law with known Li impurity concentrations (36 wppm for Na and 10 wppm or less for K). As pointed out in earlier works, Na and K are volatile impurities in Li. The evaporation rates of Na and K from liquid Li at a temperature of 250 °C are non-negligible, even if their concentrations in Li are as small as tens of wppm. To measure the deposition rate of evaporants from the Li jet, we used a quartz crystal microbalance and a neutralization titration method. The measured deposition rate was highly consistent with the deposition rate estimated analytically for weak evaporation. Also, the measured deposition rate was independent of the flow speed in the range of 7–15 m/s. We concluded that combining the Hertz–Knudsen equation and the cosine law is a reliable method for predicting the evaporation and deposition rates of Li and volatile impurities from a Li jet surface at the IFMIF. [ABSTRACT FROM AUTHOR]

Three different partners, ENEA, JAEA ed University of Tokyo, have been involved during 2014–2015 in the Round Robin experimentation for the assessment of the soundness of the analitycal procedure for the determination of the Nitrogen impurities contained inside a solid Lithium sample. Two different kinds of Lithium samples, differing by about an order of magnitude in Nitrogen concentration (∼230 wppm; ∼20–30 wppm), have been selected for this cross analysis. The agreement of the achieved results appears very good for what concerns the most concentrated Lithium and indicates each partner’s procedure is appropriate and intrinsecally able to lead to meaningful values, characterized by a relative uncertainty of just few %. The smaller agreement in the case of the less concentrated Lithium anyway points out that particular attention must be paid to reduce as much as possible any source of external contamination and highlights the importance of the proper blank subtraction. [ABSTRACT FROM AUTHOR]

A liquid-Li free-surface stream flowing at 15 m/s under a high vacuum of 10 −3 Pa is to serve as a beam target for the planned International Fusion Materials Irradiation Facility (IFMIF). The Engineering Validation and Engineering Design Activities (EVEDA) for the IFMIF is implemented under the Broader Approach. As a major activity for the Li target, the EVEDA Li test loop (ELTL) was constructed by the Japan Atomic Energy Agency. The present study demonstrates a stable Li target that satisfies the IFMIF design conditions (250 °C, 15 m/s, 10 −3 Pa) and presents the procedure for operating the Li target which consists of seven stages. We used a laser-based method to verify that the Li target is adequately stable. In addition, we examine cavitation occurring during startup of the Li target, and consequently, determine the appropriate startup pressure. [ABSTRACT FROM AUTHOR]

The article discusses a study on the follow-up of blood pressure lowering and glucose control in type 2 diabetic patients. Observations on the differences in blood pressure and glycated hemoglobin levels during and after the trial, and the risk of death from any cause and from cardiovascular causes in the intensive glucose-control group and the standard glucose control group are presented. The benefits of blood pressure lowering with respect to mortality or macrovascular events are examined.

Aims Early studies have shown that magnesium intake decreases the risk of Type 2 diabetes, but the results are still inconsistent. We prospectively examined the association between magnesium intake and incidence of Type 2 diabetes in a general Japanese population. Methods A total of 1999 subjects without diabetes aged 40-79 years who underwent a 75-g oral glucose tolerance test were followed up prospectively for a mean of 15.6 years. Results During the follow-up, 417 subjects developed Type 2 diabetes. The age- and sex-adjusted incidence of Type 2 diabetes significantly decreased with increasing magnesium intake quartile levels (≤ 148.5, 148.6-171.5, 171.6-195.5 and ≥ 195.6 mg/day, P for trend = 0.01). In multivariate analyses, after adjusting for comprehensive risk factors and other dietary factors, the hazard ratio of Type 2 diabetes was 0.67 (95% CI 0.49-0.92; P = 0.01) in the third quartile and 0.63 (95% CI 0.44-0.90; P = 0.01) in the highest quartile compared with the first quartile. In addition, the risk of Type 2 diabetes was 14% lower ( P = 0.04) for a 1- sd increment of log-transformed magnesium intake in the multivariate-adjusted model. In stratified analysis, there were statistically significant interactions between magnesium intake and levels of homeostasis model assessment of insulin resistance, high-sensitivity C-reactive protein or alcohol intake on the risk of Type 2 diabetes (all P < 0.05). Conclusions Our findings suggest that increased magnesium intake was a significant protective factor for the incidence of Type 2 diabetes in the general Japanese population, especially among subjects with insulin resistance, low-grade inflammation and a drinking habit. [ABSTRACT FROM AUTHOR]

Abstract: An energy transduction technology that operates efficiently over a range of frequencies is important for practical energy harvesting devices such as ocean wave power generators. Dielectric elastomer is based on the change in capacitive energy of a deformable dielectric and is a candidate for such applications. A simple scale model of EPAM-based wave energy harvesting system was tested in a wave tank over a range of wave periods from 0.7 to 3s and wave heights from 2cm to 6cm. The energy output was found to be largely independent of wave period. [Copyright &y& Elsevier]

Diabet. Med. 29, 107-114 (2012) Abstract Aims Risk scoring methods are effective for identifying persons at high risk of Type 2 diabetes mellitus, but such approaches have not yet been established in Japan. Methods A total of 1935 subjects of a derivation cohort were followed up for 14 years from 1988 and 1147 subjects of a validation cohort independent of the derivation cohort were followed up for 5 years from 2002. Risk scores were estimated based on the coefficients (β) of Cox proportional hazards model in the derivation cohort and were verified in the validation cohort. Results In the derivation cohort, the non-invasive risk model was established using significant risk factors; namely, age, sex, family history of diabetes, abdominal circumference, body mass index, hypertension, regular exercise and current smoking. We also created another scoring risk model by adding fasting plasma glucose levels to the non-invasive model (plus-fasting plasma glucose model). The area under the curve of the non-invasive model was 0.700 and it increased significantly to 0.772 ( P < 0.001) in the plus-fasting plasma glucose model. The ability of the non-invasive model to predict Type 2 diabetes was comparable with that of impaired glucose tolerance, and the plus-fasting plasma glucose model was superior to it. The cumulative incidence of Type 2 diabetes was significantly increased with elevating quintiles of the sum scores of both models in the validation cohort ( P for trend < 0.001). Conclusions We developed two practical risk score models for easily identifying individuals at high risk of incident Type 2 diabetes without an oral glucose tolerance test in the Japanese population. [ABSTRACT FROM AUTHOR]

Abstract: The Engineering Validation and Engineering Design Activities (EVEDA) of the International Fusion Materials Irradiation Facility (IFMIF) have been started. As Japanese activities for the target system, the EVEDA Lithium (Li) Test Loop to simulate hydraulic and impurity conditions of the IFMIF Li loop is under design. The feasibility of the thermo-mechanical structure of the target assembly and the replaceable back-plate made of F82H and 316L stainless steel is a key research subject. Toward final validation at the EVEDA loop, diagnostics systems applicable to the high-speed free-surface Li flow and hot traps to control nitrogen and hydrogen in Li loop have been investigated. In the remote handling subject of target assemblies and the replaceable back-plates activated by irradiation up to 50dpa/y, lip welds on 316L-316L by laser and dissimilar metal welds on F82H-316L are necessary. Water experiments and hydraulic/thermo-mechanical analyses of the back-plate are underway. [Copyright &y& Elsevier]

Picosecond and femtosecond lasers having different pulsewidths were employed for the generation of multi-color laser emission via stimulated Raman scattering and four-wave Raman mixing using a KGd(WO4)2 crystal. Seven emission lines, consisting of high-order Stokes and anti-Stokes emissions, were observed at a laser pulsewidth of 20 ps and a pulse energy of 70 μJ. [Copyright &y& Elsevier]

Rationale: Adalimumab (ADA) is an antitumor necrosis factor agent that is used for the treatment of inflammatory bowel disease. However, its cost has resulted in varying degrees of restricted access across global healthcare economies. Biosimilars are agents that contain a similar version of the active substance of an already approved original biologic agent and are intended to be used for the same indication as the reference product. In general, biosimilars follow the originator; therefore, information on its efficacy and safety had been few. Some studies have reported on replacement of the originator with a biosimilar of the same efficacy because of medical reasons., Patient Concerns: A 15-year-old girl with steroid-dependent ulcerative colitis that relapsed after vedolizumab was treated with ADA reference. Six weeks after starting ADA reference, her gastrointestinal symptoms had completely resolved, however, immediately after the eighth dose of ADA reference, redness, swelling, and pruritus were noted at the injection site on the left thigh., Diagnosis: Allergic reaction caused by the ADA reference., Intervention: ADA reference was changed to ADA biosimilar LBAL., Outcomes: ADA biosimilar LBAL was continued without any symptoms, such as local swelling, redness, or itching. In addition, there was no deterioration of gastrointestinal symptoms., Lessons: We showed the efficacy and safety of ADA biosimilar LBAL as an alternative to ADA reference, which caused injection site reactions. Changing from ADA reference to ADA biosimilar because of adverse events may be an option that needs careful observation, considering that the originator and the biosimilar are not exactly the same., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Telemedicine, or online medical care, has gained considerable attention worldwide. However, it has not been widely adopted in Japan, and the detailed status of received and provided online medical care and the reasons for its lack of popularity remain unknown., Objective: This study aims to investigate the current status of online medical care in Japan and the factors limiting its adoption from the perspective of both patients receiving and medical professionals providing online medical care., Methods: In total, 2 nationwide questionnaire surveys were conducted. The first survey, targeting both patients and healthy individuals, screened approximately 40,000 participants among 13 million people. The participants were selected to match the age distribution of the Japanese population based on government data, and their online medical care experience and medical visit status were recorded. To further investigate online medical care use and satisfaction, a web-based survey was conducted with 15% (6000/40,000) of the screened participants. The second survey, targeting medical professionals, was administered to a physician, a nurse, and a member of the administrative staff in each of 4900 randomly selected medical facilities to inquire about their online medical care practices and impressions. In addition, both surveys investigated the factors limiting online medical care expansion in Japan., Results: The response rates among patients and healthy individuals targeted for the screening and main surveys were 92.5% (36,998/40,000) and ˃80% (1312/1478, 88.77%; 1281/1522, 84.17%; 404/478, 84.5%; and 2226/2522, 88.26% in 4 survey groups), respectively. The survey of medical professionals yielded 1552 responses (n=618, 39.82% physicians; n=428, 27.58% nurses; n=506, 32.6% administrative staff). Although the facility-level response rate was low (794/4900, 16.2%), some facility categories had relatively high response rates. Only 5.29% (1956/36,998) of the patients and healthy individuals had online medical care experience. When there were more hospitals nearby and they felt it was more work to see a physician in person, they were more likely to use online medical care (more nearby hospitals: adjusted odds ratio [aOR] 1.33, 95% CI 1.18-1.50; more work: aOR 1.48, 95% CI 1.35-1.63 per survey response point in the patient group). Similarly, these factors were substantially associated with satisfaction (more nearby hospitals: aOR 1.40, 95% CI 1.14-1.73; more work: aOR 1.50, 95% CI 1.27-1.76 per survey response point in the patient group). In both surveys, the most frequently selected factor preventing the widespread use of online medical care was patients' need to switch to face-to-face medical care for mandatory tests and procedures. Inadequate awareness of and education on online medical care were also frequently selected., Conclusions: Our nationwide surveys provided insights into the current status of online medical care in Japan and simultaneously identified several problems and issues related to it, which will be useful in promoting its wider adoption., (©Yuka Sugawara, Yosuke Hirakawa, Masao Iwagami, Haruo Kuroki, Shuhei Mitani, Ataru Inagaki, Hiroki Ohashi, Mitsuru Kubota, Soichi Koike, Rie Wakimizu, Masaomi Nangaku. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 01.11.2024.)

Background and Objectives: This study aimed to examine the development of clinical competence of novice physical therapists (PTs) during their first year of employment, following the implementation of an original in-house educational program. The educational program was designed to offer diverse training opportunities at an early stage, during the first year of employment., Methods: Thirty-eight novice PTs (21 males and 17 females, mean age 23.4 ± 3.2 years) participated in this study. All participants underwent educational programs and a self-assessment using the Clinical Competence Evaluation Scale in Physical Therapy (CEPT) on the first day of employment (entry-level) and after 1, 3, 6, and 12 months of employment. The total score and CEPT component-wise scores-"knowledge," "clinical reasoning," "skill," "communication," "attitude," "self-education," and "self-management"-at the 4 assessment points (1, 3, 6, and 12 months) were compared with values on the first day., Results: The total scores at 3, 6, and 12 months of employment were significantly higher than those on the first day of employment (P < .05). Among the total scores on the 7 components, those for "knowledge," "clinical reasoning," "skill," and "communication" at 3, 6, and 12 months after employment were also significantly higher than those on the first day of employment (P < .05). The scores for "attitude" and "self-education" 12 months after employment were significantly higher than those on the first day of employment. However, the "self-management" scores at 1, 3, 6, and 12 months after employment did not significantly change compared with those on the first day of employment., Conclusions: The total score was significantly higher after 3 months. The participant's clinical competence may have improved because they participated in an educational program related to "knowledge," "clinical reasoning," "skills," and "communication" at an earlier stage in the first year. However, their progress was comparatively slower in other areas, suggesting that the content might not have been sufficient. This study revealed the effectiveness of the educational program on novice PTs' clinical competence at a single institution in Japan. Positive outcomes were obtained for several parameters. Furthermore, the results reveal the need for content modifications within the educational program to improve PTs' performance across all evaluated items., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Detection of microRNAs (miRNAs) in the serum is an effective liquid biopsy technique for cancer diagnosis. However, conventional diagnostic methods are time-consuming and complex. Therefore, in this study, we established a signaling probe-based DNA microarray system for miRNA detection. PCR, fluorescence labeling, and washing are not necessary for signaling probes. Four probes were designed using different miRNAs as diagnostic cancer markers. The developed system is useful for various miRNAs, regardless of their target lengths (18-26-mer) and GC content (36%-89%). Here, all the assays were performed within 40 min. Overall, our signaling probe-based DNA hybridization system facilitates the simple and rapid detection of serum miRNAs without the need for gene amplification, fluorescence labeling and washing., (© 2024 Wiley Periodicals LLC.)

Systematic assessments of interprofessional collaboration barriers and enablers in long-term care settings are critical for delivering person-centered healthcare. However, research on factors influencing interprofessional collaboration in long-term care settings is limited. For this study, 65 healthcare professionals across multiple facilities experienced in long-term care in Japan participated in online focus group discussions and individual interviews to discuss cases. The qualitative data were analyzed using qualitative content analysis. Seven themes emerged: coordination, the need for care manager training, hierarchy among healthcare professionals, specialization but not the mind-set of overspecialization, casual conversations, electronic group communication tools, and excessive fear of personal information protection. These findings highlight the need to develop coordinator roles and for interprofessional education on the proper approach to personal information protection laws. Furthermore, daily casual conversations, the use of online platforms, and the prevention of patients being left behind due to overspecialization are required.

Background: Plasma is a collection of active particles generated by dissociating molecules and ionizing atoms through applying high energy to a gas, such as high-sound heating or electrical shock. Recently, many reports have been published on the effectiveness of non-thermal atmospheric pressure gas discharge plasma (NTAPP) on living organisms. Furthermore, we have reported on the promotion of bone and tendon repair by NTAPP irradiation. We hypothesized that irradiation of NTAPP would promote the repair of the tendon-bone junction in a rotator cuff repair. This study investigated the effect of NTAPP irradiation on the healing process of the tendon-bone junction., Methods: Among 36 Japanese white rabbits, the infraspinatus tendon was detached from the humeral insertion site. A 3.2 mm bone tunnel was then created at the original insertion site of the infraspinatus muscle. The left shoulder was irradiated with NTAPP at a distance of 1 cm from the bone tunnel for 5 minutes (plasma-treated group), while the right shoulder was not irradiated (control group). The rabbits were sacrificed at 2, 4, and 8 weeks postoperatively, and six of each were used for histological evaluation. Mechanical tests were also performed on six specimens each at 4 and 8 weeks., Results: Histological evaluation showed that at 4 weeks, the histological tendon to bone maturing score was 6.8±1.3 in the plasma-treated group and 4.8±1.6 in the control group (p<0.01); at 8 weeks it was 9.0±1.0 in the plasma-treated group and 5.2±1.1 in the control group (p<0.01). Fibrocartilage formation and new bone formation were observed at both 4 and 8 weeks. In the mechanical test, the plasma-treated group had 75.0 ± 18.9 N in ultimate load to failure at 8 weeks. In the control group, it was 51.1±7.9 N. (p=0.04) CONCLUSION: The repair of the rotator cuff at the tendon-bone junction was significantly improved at 4 and 8 weeks by irradiation with NTAPP., (Copyright © 2024. Published by Elsevier Inc.)

Tiopronin is a key drug used to treat cystinuria. A 41-year-old Japanese woman with cystinuria presented with eyelid edema and weight gain after the administration of tiopronin. Her serum albumin was 1.8 g/dL and her urinary protein level was 5.5 g/gCre. After cessation of tiopronin, she achieved remission of nephrotic syndrome (NS). Secondary NS due to tiopronin was evident based on the clinical course and laboratory values. A kidney biopsy showed membranous nephropathy (MN), and an immunofluorescence analysis revealed strong deposition of immunoglobulin G4 (IgG4). However, a previous case report of tiopronin-induced MN showed staining for IgG1 and IgG3. This case report suggests a novel etiology for tiopronin-induced MN.

Background: The term "nonrestorative sleep (NRS)" refers to an unrefreshed feeling at wake-up and is a domain of poor sleep quality. Previous research has demonstrated that NRS is linked to a number of diseases and adverse health outcomes, but less is known regarding the link between NRS and diabetes, particularly in Japanese., Methods: We studied 3,665 middle-aged male participants of the Aichi Workers' Cohort Study who were followed-up from 2002 through 2019. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of incident type 2 diabetes mellitus (T2DM) in relation to NRS adjusted for potential confounding variables., Results: During a median follow-up of 14.6 years, 421 type 2 diabetes cases were identified. Participants with NRS had a higher crude incidence rate of T2DM (11.2/1,000 person-years), compared to participants without NRS (9.3/1,000 person-years). In the fully adjusted model, individuals who reported having NRS had a significantly higher risk of developing T2DM (HR1.36; 95% CI, 1.10-1.67). The association was observed only in participants under 50 years old (HR 1.82; 95% CI, 1.36-2.43), not in the older (50 years or older) participants (P for interaction = 0.025). In contrast, stratified analyses by the presence of shift work, obesity, or sleep duration showed similar associations in all the strata., Conclusion: NRS was associated with higher risk of T2DM in middle-aged Japanese male workers independent of a variety of lifestyle factors and other sleep problems.

Background: Although the Lee Silverman Voice Treatment BIG® (LSVT BIG®) improves motor symptoms in patients with Parkinson's Disease, no reports exist for patients with Progressive Supranuclear Palsy (PSP)., Objective: To describe the effect of LSVT BIG® on the motor symptoms of a participant with PSP., Case Description: The participant was a 74-year-old man with PSP. His goals were to improve limb movement, balance ability, and festinating gait over the 4-week LSVT BIG® program., Outcomes: All assessments of limb movement and balance ability showed improvements after intervention for the limb and gait subsections of the PSP rating scale. Scores improved from 9 to 5, and 8 to 6, respectively for the Unified Parkinson's Disease Rating Scale (UPDRS) Part 3, from 30 to 21 and for the Berg balance scale (BBS), from 45 to 50 points. The improvements in UPDRS Part 3 and BBS exceeded the minimum detectable change values (7-8 and 2 points, respectively). After intervention, improvements in festinating gait and rapid walking pace were noted on the UPDRS Part 3 (2 to 1 point) and 10-meter walk test (1.65 m/s to 1.10 m/s)., Conclusion: The intervention was effective for the participant but further studies with diverse populations are needed.