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There has been an expansion of the fallow areas in the mountainous terrain of Northern Laos, resulting in a significant effect on greenhouse gas emissions in the region. This study estimated living biomass of variously aged fallow areas (4–35 years old) in mountainous terrain. The living biomass of study sites, which was estimated by applying original allometric equations in each plant component, ranged from 49.4 to 390.1 Mg ha−1. Using individual biomass data, we then developed a growth model based on a correlation between stand age (years after slash-and-burn) and living biomass in fallow areas >20 years old. The developed growth model was well fitted by a theoretical formula of Mitscherlich (Living biomass = 372.9 × [1 – 1.117 × exp(−0.05556 × stand age)]) (R2 = 0.670). In addition, the area of each aged fallow area was estimated by analysis of time series of satellite imagery and change-detection analysis to detect past fire events (slash-and-burn). All of the living biomass of the fallow area...

Seasonal changes of activity patterns are an important survival strategy for several species. Seasonal changes in the activity patterns of Japanese flying squirrels (Pteromys momonga) were studied at Daibosatsu Mountain on Honshu Island, Japan from 2 June to 20 November 2007 and 11 April to 14 November 2008, to discuss their survival strategy based on the change. Activity patterns were assessed using long-term sensor camera traps at 214 sites for 14 months of a 2-year period. The cameras were placed for a total of 7317 camera trap nights over which total of 90 photographs of this species were collected from 22 of the 214 sites. Although distinct nocturnal activity was detected throughout the study period, activity patterns differed between temperate (June-September) and cold (April, May, October, and November) seasons. So, activity peaks were found to be bimodal during the temperate seasons and trimodal during the cold seasons. It is possible that the squirrels reduce their activity times per bout during the cold seasons to reduce energy loss arising from prolonged exposure to cold temperatures, as a survival strategy.

The distance at which animals start to flee from approaching threats should reflects the degree of fearfulness, and thus, provides a useful measurement to evaluate animal personality and tolerance to human disturbance. Such metrics measurements, however, are mostly limited to open, high visible habitats, such as grasslands and urban parks. Alternative measurements are required for other types of habitats, such as typical forests. For arboreal species, we expect that a vertical escape distance (VED), the height at which animals stop climbing in a tree toward approaching threats, would reflect animal fearfulness. We compared VED and two commonly used metrics, alert distance (AD) and flight initiation distance (FID) in the Eurasian red squirrel (Sciurus vulgaris) towards human approach. We found that VED was significantly related with FID, but not AD. Data collection rate in VED was two to three times higher than that in the two previous metrics in vegetated areas. In natural environments, VED woul...

Herein, we report the case of a 35-year-old female with a trapped right lung secondary to catamenial haemothorax. Following surgical decortication, re-expansion of the lung was not observed until postoperative day 81. This delay represents a heretofore unencountered complication that should be considered in the surgical management of catamenial haemothorax due to thoracic endometriosis syndrome.

We propose $D$ mesons as probes to investigate finite-volume effects for chiral symmetry breaking at zero and finite temperature. By using the $2+1$-flavor linear-sigma model with constituent light quarks, we analyze the Casimir effects for the $\sigma$ mean fields: The chiral symmetry is rapidly restored by the antiperiodic boundary for light quarks, and the chiral symmetry breaking is catalyzed by the periodic boundary. We also show the phase diagram of the $\sigma$ mean fields on the volume and temperature plane. For $D$ mesons, we employ an effective model based on the chiral-partner structure, where the volume dependence of $D$ mesons is induced by the $\sigma$ mean fields. We find that $D_s$ mesons are less sensitive to finite volume than $D$ mesons, which is caused by the insensitivity of $\sigma_s$ mean fields. An anomalous mass shift of $D$ mesons at high temperature with the periodic boundary will be useful in examinations with lattice QCD simulations. The dependence on the number of compactified spatial dimensions is also studied., Comment: 15 pages, 13 figures, 3 tables; published version

1. We investigated whether bergamottin would be useful for evaluating CYP3A-mediated intestinal metabolism in rats utilising its characteristics as a mechanism-based inhibitor of CYP3A.2. Buspirone and fexofenadine, probe substrates of CYP3A and P-glycoprotein (P-gp), respectively, were orally co-administered to rats with bergamottin (2.5 mg/kg) or orally administered 2 h after bergamottin pre-treatment. The effect of bergamottin pre-treatment on hepatic CYP3A specifically was investigated with intravenous administration of buspirone. The

Background The usefulness of the activated partial thromboplastin time (APTT) waveform has been reported in hemophilia, acquired hemophilia and monitoring for anticoagulants. Material and methods The APTT waveform was examined in patients suspected of having disseminated intravascular coagulation (DIC) to analyze its usefulness for the diagnosis of DIC or the prediction of the outcome or bleeding risk. Results DIC with fibrinogen

Mucosal-associated invariant T (MAIT) cells are a type of innate lymphocyte and recognize riboflavin (vitamin B2) synthesis products presented by MHC-related protein 1. We investigated long-term reconstitution of MAIT cells and its association with chronic graft-versus-host disease (cGVHD) in a cross-sectional cohort of 173 adult patients after allogeneic hematopoietic cell transplantation. According to donor source, the number of MAIT cells significantly correlated with time after cord blood transplantation (CBT) but not with time after bone marrow transplantation or peripheral blood stem cell transplantation. The number of MAIT cells was significantly lower in patients with cGVHD compared with patients without cGVHD. We also examined the association between MAIT cell reconstitution and gut microbiota as evaluated by 16S ribosomal sequencing of stool samples 1 mo post-CBT in 27 adult patients undergoing CBT. The diversity of gut microbiota was positively correlated with better MAIT cell reconstitution after CBT. Phylogenetic Investigation of Communities by Reconstruction of Unobserved States analysis indicated that amounts of ribB and ribA genes were significantly higher in the microbiomes of patients with subsequent MAIT cell reconstitution after CBT. In conclusion, long-term MAIT cell reconstitution is dependent on the type of donor source. Our data also unveiled an important role for the interaction of circulating MAIT cells with gut microbiota in humans.

While lung cancer screening improves cancer-specific mortality and is recommended for high-risk patients, barriers to screening still exist. We sought to determine our institution's (an urban safety net hospital) screening rate and to identify socioeconomic barriers to lung cancer screening.We identified 8935 smokers 55 to 80 years of age evaluated by a primary care physician between March 2015 and March 2017 at our institution. We randomly selected one-third of these (n = 2978) to review for eligibility using the U.S. Preventive Services Task Force criteria for lung cancer screening. Using our institution's Lung Cancer Screening Program clinical tracking database, we identified patients who were screened from March 2015 to March 2017. We collected demographic information (race, primary language, education status, and median income) and evaluated possible associations with screening.Among our institution population, 99 patients meeting U.S. Preventive Services Task Force screening criteria underwent screening computed tomography, whereas 516 eligible patients were not screened, making our institution's estimated screening rate 16.1%. Comparing the unscreened population with those who received screening at our institution, the unscreened population was significantly older (median age of screened patients was 63 years, of unscreened patients was 66 years; P.001). African Americans had a lower screening rate (37.6% of the screened population and 47.5% of the unscreened population; P.001). Unscreened patients had a lower annual household income.The lung cancer screening rate at our hospital is 16.1%. Unscreened patients were older, were more likely to be African American, and had a lower median income. These findings highlight possible screening barriers and potential areas for targeted strategies to decrease disparities in lung cancer screening.

The objective of this protocol was to compare the Airway ScopeTM(AWS) and the Macintosh laryngoscope (ML) for their performance in tracheal intubations (TIs) performed by emergency medical technicians (EMTs) using mannequin models with liquids in the airway. Rice gruel and mock blood were used to fill the upper airways of mannequins to create mock vomit and hematemesis models, respectively. TIs were performed by certified EMTs after visualizing the glottis using an AWS with an 18-Fr suction catheter and a ML with an 18-Fr suction catheter. TIs with AWS and ML were performed in random order in a comparative crossover trial. The TI success rate was evaluated based on the following: (a) the time taken from laryngoscope insertion into the oral cavity to glottis visualization, tracheal tube passage through the glottis, until the initiation of ventilation and (b) the subjective level of difficulty, which was assessed using a visual analog scale (VAS).

The purpose of this study was to assess the impact of number of lymph nodes examined on survival in patients with esophageal adenocarcinoma who underwent neoadjuvant chemoradiation.The National Cancer Database was queried for patients who underwent neoadjuvant chemoradiation followed by surgery for esophageal adenocarcinoma. Propensity scores were created predicting the odds of undergoing resection of ≥ 25 nodes. Patients were matched on propensity score. Overall survival analyses were performed using the Kaplan-Meier method. Sensitivity analyses were performed using various nodal cutoffs.In total, 3953 patients who underwent neoadjuvant chemoradiation were identified. The median number of resected nodes was 14 nodes (IQR, 8-20 nodes). Resection of ≥ 15 (vs. 15 nodes: 32 vs. 26 months; p 0.001), ≥ 20 (vs. 20 nodes: 36 vs. 28 months; p = 0.001), and ≥ 25 (vs. 25 nodes: 37 vs. 29 months; p = 0.015) nodes was associated with higher median survival, but resection of ≥ 30 nodes was not (vs. 30 nodes: 41 vs. 33 months; p = 0.367). Resection of ≥ 25 lymph nodes remained predictive for improved survival on subset analysis in patients with negative nodes and who underwent treatment at high-volume centers.After neoadjuvant chemoradiation, resection of 25 or more lymph nodes was associated with longer median survival. Prospective trials are warranted to determine the optimal nodal yield after neoadjuvant chemoradiation.

INTRODUCTION AND OBJECTIVES:In urology, renal mass biopsy among patients with an image-detected small renal mass (i.e. ≤ 4 cm) is currently not the standard of care; instead, most urologists procee...

Objective: To determine if induction chemotherapy with concurrent high-dose radiation followed by resection is associated with improved survival in patients with nonsuperior sulcus lung cancer with chest wall invasion. Methods: We performed a retrospective review of clinical T3 (chest wall invasion) N0/N1 patients with non-small cell lung cancer who underwent surgical resection between January 1, 1992, and January 31, 2017. Exclusion criteria included superior sulcus tumors and resection performed for palliation/recurrence. Patients undergoing induction chemoradiation followed by surgical resection were compared to those undergoing resection first or those receiving induction radiation followed by resection. Overall survival was calculated using the Kaplan-Meier method. Results: Thirty-four patients were included in the analysis, with 5-year overall survival (OS) of 30%. By clinical stage, 31 (91%) were IIB (T3N0) and 3 (9%) were IIIA (T3N1). Sixteen patients (47%) received induction chemoradiation before surgery. Of the remaining 18 patients, 5 (15%) received induction radiation followed by surgery, and 13 (38%) underwent surgery as the first treatment. Three patients belonging to the group not receiving induction chemoradiation died within 30 days after surgery and were excluded from survival analysis. In the remaining 31 patients, induction chemoradiation was associated with improved 5-year OS (53% for induction chemoradiation vs 7% for others; PConclusion: In patients with nonsuperior sulcus lung cancer with chest wall invasion, induction chemoradiation therapy followed by resection is associated with improved OS.

The presence of vomit, blood, or other foreign liquid materials in the upper airway is a major obstacle in difficult tracheal intubations (TIs) especially in prehospital care. However, the usefulness of video laryngoscopes (VLs) in these situations has not been investigated. The objective of this study was to compare the Airway Scope (AWS) and the Macintosh laryngoscope (ML) for their performance in TIs performed by emergency medical technicians (EMTs) using mannequin models with liquids in the airway. Rice gruel and mock blood were used to fill the upper airways of mannequins to create mock vomit and hematemesis models, respectively. TIs were performed by certified EMTs after visualizing the glottis using an AWS with an 18-Fr suction catheter and a ML with an 18-Fr suction catheter. TIs with AWS and ML were performed in random order in a comparative crossover trial. The TI success rate was evaluated based on the following: (a) the time taken from laryngoscope insertion into the oral cavity to glottis visualization, tracheal tube passage through the glottis, until the initiation of ventilation and (b) the subjective level of difficulty, which was assessed using a visual analog scale (VAS). TIs in vomiting and hematemesis scenarios were performed by 25 and 26 EMTs, respectively. The TI success rates for these scenarios were 100% with both AWS and ML. The median time required until successful ventilation was significantly shorter with AWS than with ML in both the vomiting (42 vs. 58 s) and hematemesis models (33 vs. 39 s), respectively. In the hematemesis scenarios, difficulty assessed using a VAS was lower with AWS than with ML (13 vs. 38 in median), respectively. Compared to the ML, the AWS was capable of faster and easier TIs, in a simulated model of liquid foreign material in the upper airway.

We propose a novel mechanism of the Kondo effect driven by a chirality imbalance (or chiral chemical potential) of relativistic light fermions. This effect is realized by the mixing between a right- or left-handed fermion and a heavy impurity in the chirality imbalanced matter even at zero density. This is different from the usual Kondo effect induced by finite density. We derive the Kondo effect from both a perturbative calculation and a mean-field approach. We also discuss the temperature dependence of the Kondo effect. The Kondo effect at nonzero chiral chemical potential can be tested by future lattice simulations., Comment: 15 pages, 8 figures

We review the Hadronic Paschen-Back effect in charmonium systems, which is a new phenomenon caused when hadrons with finite orbital angular momenta are exposed to a strong magnetic field. The mass spectra, shapes of wave functions, and mixing ratios are numerically evaluated by the constituent quark models with a magnetic field and the cylindrical Gaussian expansion method. As a detectable effect, we discuss anisotropic quarkonium decays induced from the wave function deformation. Such decays would be useful to measure the strength of the magnetic field in high-energy heavy-ion collisions at LHC and RHIC, which has not been measured experimentally.

Properties of QCD matter change significantly around the chiral crossover temperature, and the effects on $U(1)_A$ and topological susceptibilities, as well as the meson spectrum have been studied with much care. Baryons and the effect of parity doubling in this temperature range have been analyzed previously by various other groups employing different setups. Here we construct suitable operators to investigate chiral and axial $U(1)_A$ symmetries in the baryon spectrum. Measurements for different volumes and quark-masses are done with two flavors of chirally symmetric domain-wall fermions at temperatures above the critical one. The possibility of emergent $SU(4)$ and $SU(2)_{CS}$ symmetries is discussed., Comment: 7 pages, 4 figures, talk presented at the 37th International Symposium on Lattice Field Theory (Lattice 2019), 16-22 June 2019, Wuhan, China. Updated numerical data in Fig. 1 and Fig. 2

Using lattice QCD simulations with $N_f = 2$ dynamical fermions, we study the axial $U(1)$ symmetry, topological charge, and Dirac eigenvalue spectra in the high-temperature phase in which the chiral symmetry is restored. Our gauge ensembles are generated with M\"obius domain-wall fermions, but the measurements such as susceptibilities are reweighted to those for the overlap fermions by using overlap/domain-wall reweighting technique. We find that the $U(1)_A$ and topological susceptibilities are strongly suppressed in the small quark mass region, which is related to the reduction of chiral-zero and low-nonzero modes on the Dirac spectra. We also examine their volume dependence., Comment: 10 pages, 4 figures, 1 table; Proceedings of The 9th International Workshop on Chiral Dynamics (CD18), 17-21 September, 2018, Durham, NC, USA. arXiv admin note: text overlap with arXiv:1812.06621

e18640 Background: Delays in diagnosis and treatment have been identified as practice gaps in lung cancer management. At our large safety-net hospital, 2016-2018 data provided by the Commission on Cancer (CoC) indicated that 58-66% of lung cancer patients began treatment > 30 days after their diagnosis, compared to a median of 30 days for CoC-accredited hospitals. A quality improvement (QI) project was performed to identify causes for treatment delays, and to implement changes to reduce the median time from diagnosis to treatment to < 30 days. Methods: Root cause analysis was performed on a cohort of lung cancer patients identified and abstracted by the CoC Registry with diagnosis in October 2018-September 2019, to provide more recent data on treatment delays and to identify actionable interventions. Subsequently, a multidisciplinary QI initiative through Thoracic Surgery, Hematology Oncology, and Radiation Oncology was implemented using the Plan-Do-Study-Act (PDSA) tool. The initiative was tracked for 6 months starting in August 2020, with time from referral to consult and time from diagnosis to treatment calculated via chart review. Results: For the root cause analysis, 36 patients were identified. Eleven cases were excluded as they did not receive treatment at our institution. For the remaining 25 patients, the median time from referral to consult across all three oncology specialties was 13 days. The most common barriers to initiating treatment were appointment scheduling delays (37.5%), patient factors including synchronous malignancies or insurance, geographic or cultural barriers (31.3%), and multiple factors including appointment scheduling delays (25%). Median time from diagnosis to treatment was 31 days, with 36% (N = 9) starting treatment in < 30 days. While appointment scheduling delays included both work-up (imaging, procedures) and consults as well as follow-ups, multidisciplinary discussions identified time from referral to consult as the most actionable QI initiative. With support from Patient Navigation, the three oncology specialties jointly implemented a system whereby suspected or confirmed new lung cancer patients were scheduled for consult ideally in < 7 days, and no more than 14 days from the referral date. Of 28 new lung cancer patients who started treatment after the QI intervention, median time from referral to consult decreased to 7 days. Median time from diagnosis to treatment decreased to 26.5 days, with 53.6% (N = 15) of patients starting treatment in < 30 days. Conclusions: By decreasing time from referral to consult, this multidisciplinary QI intervention facilitated earlier initiation of treatment for lung cancer patients. Similar actions to decrease other scheduling delays and mitigate the impact of social determinants of health could further promote improvements in timely patient care.

In human emotion estimation using an electroencephalogram (EEG) and heart rate variability (HRV), there are two main issues as far as we know. The first is that measurement devices for physiological signals are expensive and not easy to wear. The second is that unnecessary physiological indexes have not been removed, which is likely to decrease the accuracy of machine learning models. In this study, we used single-channel EEG sensor and photoplethysmography (PPG) sensor, which are inexpensive and easy to wear. We collected data from 25 participants (18 males and 7 females) and used a deep learning algorithm to construct an emotion classification model based on Arousal–Valence space using several feature combinations obtained from physiological indexes selected based on our criteria including our proposed feature selection methods. We then performed accuracy verification, applying a stratified 10-fold cross-validation method to the constructed models. The results showed that model accuracies are as high as 90% to 99% by applying the features selection methods we proposed, which suggests that a small number of physiological indexes, even from inexpensive sensors, can be used to construct an accurate emotion classification model if an appropriate feature selection method is applied. Our research results contribute to the improvement of an emotion classification model with a higher accuracy, less cost, and that is less time consuming, which has the potential to be further applied to various areas of applications.

Objective We evaluated the modified diagnostic criteria for disseminated intravascular coagulation (DIC), which was published by the Japanese Society of Thrombosis and Hemostasis (JSTH), in 274 suspected DIC patients with hematopoietic injury. Materials and methods The diagnoses of the patients were as follows: DIC (n = 125); pre-DIC (n = 42) and non-DIC (n = 107). The efficacy of the diagnostic criteria for DIC was evaluated using a receiver operating characteristic (ROC) analysis. Results The area under the curve (ARC) and odd's ratio for the global coagulation test (GCT) scores in the diagnosis of “DIC” were high, while those for the diagnosis of “DIC and pre-DIC” were low, suggesting that the addition of antithrombin (AT) and soluble fibrin (SF)/thrombin antithrobin complex (TAT) was required to diagnose “DIC and pre-DIC”. Although the addition of the AT and SF/TAT values to the GCT did not increase its ability to predict a poor outcome, the JSTH's modified diagnostic criteria scores were correlated with the odds ratio for death. Discussion and conclusion The JSTH's modified diagnostic criteria for DIC, which included the GCT score, and the AT, and TAT/SF values, were useful for diagnosing DIC and pre-DIC, and predicting a poor outcome.

Microbial fuel cells equipped with SPEEK-MEA (SPEEK-MFC) and Nafion-MEA (Nafion-MFC) were constructed with organic waste as electron donor and lake sediment as inoculum and were then evaluated comprehensively by electrochemical and microbial analyses. The proton conductivity of SPEEK was several hundreds-fold lower than that of Nafion 117, whereas the oxygen mass and diffusion transfer coefficients of SPEEK were 10-fold lower than those of Nafion 117. It was difficult to predict which was better membrane for MFC based on the feature of membrane. Analyses of polarization curves indicated that the potential of electricity production was similar in both MFCs, as the SPEEK-MFC produced 50–80% of the practical current density generated by the Nafion-MFC. Chronopotentiometry analyses indicated that the Nafion-MEA kept the performance longer than the SPEEK-MEA for long period, whereas performance of both anodes improved on time. Multidimensional scaling analyses based on DGGE profiles revealed the anolytic and biofilm communities of the SPEEK-MFC had developed differently from those of the Nafion-MFC. Clone library analyses indicated that Geobacter spp. represented 6.3% of the biofilm bacterial community in the Nafion-MFC but not detected in the SPEEK-MFC. Interestingly, the clone closely related to Acetobacterium malicum strain HAAP-1, belonging to the homoacetogens, became dominant in both anolytic and biofilm communities of the SPEEK-MFC. It was suggested that the lower proton conductivity of SPEEK-MEA allowed the bacteria closely related to strain HAAP-1 to be dominant specifically in SPEEK-MFC. These results indicated that Nafion-MFC ranked with SPEEK-MFC and that MEAs had strong selective pressure for electricity-producing bacterial community.

Case Cortical blindness induced by hepatic encephalopathy is an extremely rare complication and its epidemiology has not been studied in great detail. We report a 63-year-old man with liver cirrhosis who developed sudden bilateral visual impairment. Outcome On arrival at hospital, the patient had orientation disturbance, slurred speech, and mild disturbance of consciousness with impaired vision (light sense). He had no focal neurological deficits except for bilateral blindness. Cerebral stroke was suspected, but imaging and ophthalmological examination did not reveal major abnormalities. An increased concentration of ammonia in blood suggested hepatic encephalopathy; a diagnosis of cortical blindness was proposed. His vision returned gradually with relief of hepatic encephalopathy. Conclusion Cortical blindness can be an initial symptom of hepatic encephalopathy without severe disturbance of consciousness, and can be misdiagnosed as cerebral stroke. Cortical blindness induced by hepatic encephalopathy has been reported in only 10 cases, including our patient, and merits further evaluation.

Leuconostocspecies are vancomycin-resistant Gram-positive cocci. Infections due toLeuconostocspecies have been reported in various immunocompromised patients, but little is known about such infection in patients with hematologic malignancies. We report a case ofLeuconostocinfection in a 44-year-old woman with acute lymphoblastic leukemia. The patient developed a high fever despite antimicrobial therapy with doripenem after induction chemotherapy. After an isolate from blood cultures was identified asL. pseudomesenteroides, we changed the antibiotics to piperacillin-tazobactam and gentamicin, after which the patient recovered from the infection. Physicians should be aware ofLeuconostocspecies as causative pathogen if they encounter Gram-positive cocci bacteremia resistant to standard antibiotics such as vancomycin and teicoplanin, especially in patients with hematologic malignancies.

To explore the biology of lung adenocarcinoma (LUAD) and identify new therapeutic opportunities, we performed comprehensive proteogenomic characterization of 110 tumors and 101 matched normal adjacent tissues (NATs) incorporating genomics, epigenomics, deep-scale proteomics, phosphoproteomics, and acetylproteomics. Multi-omics clustering revealed four subgroups defined by key driver mutations, country, and gender. Proteomic and phosphoproteomic data illuminated biology downstream of copy number aberrations, somatic mutations, and fusions and identified therapeutic vulnerabilities associated with driver events involving KRAS, EGFR, and ALK. Immune subtyping revealed a complex landscape, reinforced the association of STK11 with immune-cold behavior, and underscored a potential immunosuppressive role of neutrophil degranulation. Smoking-associated LUADs showed correlation with other environmental exposure signatures and a field effect in NATs. Matched NATs allowed identification of differentially expressed proteins with potential diagnostic and therapeutic utility. This proteogenomics dataset represents a unique public resource for researchers and clinicians seeking to better understand and treat lung adenocarcinomas.

Objective: In the field of forensic science, sex discrimination of skeletons is an important identification item for personal identification. The individual sex discrimination method using skeletons includes a determination method using measurement values and a macroscopic form observation method. Both methods have advantage and disadvantage. In this study, we used the homologous model technique and principal component (PC) analysis to determine gender difference from morphology of the mandible. Methods and materials: 45 patients (23 males and 22 females) of CT imaging for tooth extraction from January 2018 to March 2019 at department of oral surgery, Osaka Medical College. The mean age was 43.1 ± 14.6. Patients with less than 14 remaining teeth were excluded because the number of remaining teeth may affect the shape of the mandible. 3D images were constructed, and 20 landmarks plotting on the 3D model surfaces. We generated template models of the mandible consisting of approximately 8434 polygons. The template model automatically fitted into the individually scanned point cloud of the mandible by minimising external and internal energy functions. As described above, the mandibles were constructed for each sample by using the Homologous Body Modeling software (HBM, Digital Human Technology, Inc.) and the mHBM-Rugle (Medic Engineering Corporation). The mandibles were analysed using the PCA. Results: The contribution of the most important PC was found to be 27.2%. 12 PCs explained over 75% of the total variance. That is, it was able to express 75% or more of the mandible expression with 12 PCs. A significant difference between male and female was observed in the first PCs (Wilcoxon test, p < 0.05). Visualising the result of the first PC showed that the mandibular branch of male was larger than that of female, and the mandible angle was overhanging outside. Conclusion: This method is a combination of the determination method using the previous measurement values and the determination using macroscopic observation, and is considered to be innovative method.

Recently, we have reported that the porous current collector could be produced with a pico-second pulse laser system and that graphite electrodes prepared with porous Cu current collectors improved the rate of Li+-pre-doping reaction in the laminated graphite electrodes [1-3]. In this study, in order to speed up the rate of the pre-doping reaction more, the porous graphite electrodes were prepared by directly opening the holes on the surface of graphite electrodes with a picosecond laser (Fig. 1). In the cell composed of laminated porous graphite electrodes (Fig. 2) and a lithium metal, the Li+-doping reaction proceeded much faster than in the cells of the graphite electrodes prepared with porous current collectors and a Li metal. In addition, the results of electrochemical impedance spectroscopy suggested that the transfer of Li+ ions though the holes on the graphite electrodes was a rate determining step of the doping reaction of Li+ to laminated graphite electrodes and that the decrease in the hole diameter at the constant of opening rate of holes on the graphite electrodes cased the reduction of resistance for Li+ ions, resulting in shortening the time for completing the doping reaction of Li+ ions. Figure 1

New-onset refractory status epilepticus (NORSE) is a rare neurological emergency condition with poor prognosis. A 30-year-old male suddenly had tonic-clonic convulsions seven days after a preceding fever and diarrhea. MRI showed a reversible splenial lesion, and he developed refractory multifocal and generalized seizures in spite of anticonvulsant medication. He was diagnosed with NORSE and received a combination treatment with immunotherapy and targeted temperature management (TTM), which effectively decreased his seizures. This case suggests that even for patients with reversible splenial lesions, NORSE should be considered, and that treatment with immunotherapy and TTM may be effective., Highlights • New-onset refractory status epilepticus (NORSE) can present with a reversible splenial lesion. • Targeted temperature management and immunotherapy are useful for the treatment of a patient with NORSE who has a high fever. • Arterial spin labeling on MRI showed increased blood flow, assumed to be due to the persistent seizure activity.

The role of thoracic surgeons in the management of pulmonary infection has evolved over time as the medical treatments have improved. We herein review historical and current management for surgically-treated pulmonary infections—lung abscesses, empyemas, and bronchopleural fistulas. In particular, we review when the surgeons need to be involved for infectious cases, our algorithm/approach to empyemas, and summary of post-operative bronchopleural fistula in tuberculosis cases.

We propose an efficient simulation method for clouds by using an adaptive grid structure to cloud simulation. We apply a grid structure proposed by Zhu et al. (ACM Trans Graph 32:63:1–63:2, 2012, [2]) to cloud simulation. This grid is an extension of a uniform grid and dynamically extends the cells surrounding a fine uniform grid while maintaining fine resolution about the regions of interest. Our method keeps track of the cloud distribution and automatically determines the region of interest to generate the optimal grid structure. Our method achieves two times faster computation on average compared to the simulation using a uniform grid.

Thrombotic microangiopathy (TMA) is caused by activated platelets. The plasma C-type lectin-like receptor 2 (CLEC2) levels in 58 patients with TMA were examined and compared with those in healthy volunteers and other diseases.The plasma levels of soluble platelet surface glycoprotein VI (GPVI) and CLEC2 were measured in patients with TMA.Plasma CLEC2 levels in patients with DIC and TMA were significantly higher (p 0.001) than those in thrombocytopenic patients with other hematological diseases, but no significant differences in the plasma CLEC2 levels were observed among patients with thrombotic thrombocytopenic purpura, hemolytic uremic syndrome (HUS), atypical HUS and other TMA. The plasma CLEC2 levels after the remission were significantly lower than those before treatment (p 0.001). The plasma CLEC2 levels were poorly correlated with the levels of soluble GPVI in the plasma of patients with TMA. The plasma CLEC2 levels were not significantly differ between survivor and non-survivor in TMA patients, but were significantly higher in non-survivor in overall population (p 0.001).The measurement of the plasma CLEC2 level is considered to be important for the diagnosis and evaluation of TMA.

Introduction Both disseminated intravascular coagulation (DIC) and thrombotic microangiopathy (TMA) cause microvascular thrombosis associated with thrombocytopenia, bleeding tendency and organ failure. Reports and discussion The frequency of DIC is higher than that of thrombotic thrombocytopenic purpura (TTP). Many patients with TMA are diagnosed with DIC, but only about 15% of DIC patients are diagnosed with TMA. Hyperfibrinolysis is observed in most patients with DIC, and microangiopathic hemolytic anemia is observed in most patients with TMA. Markedly decreased ADAMTS13 activity, the presence of Shiga-toxin-producing Escherichia coli (STEC) and abnormality of the complement system are useful for the diagnosis of TTP, STEC-hemolytic uremic syndrome (HUS)and atypical HUS, respectively. However, there are no specific biomarkers for the diagnosis of DIC. Conclusion Although DIC and TMA are similar appearances, all coagulation, fibrinolysis and platelet systems are activated in DIC, and only platelets are markedly activated in TMA.

This study delineated definitive treatment patterns for Stage II non-small cell lung cancer (NSCLC) in the United States and evaluated survival by treatment approach.Patients with clinically-staged Stage II NSCLC treated with surgery-based therapy, chemoradiation, conventionally-fractionated radiation (CFR), or stereotactic body radiotherapy (SBRT) were identified using the National Cancer Database (NCDB). Median survival was estimated using Kaplan-Meier analysis. Crude and adjusted hazard ratios (HR) and 95% confidence intervals were computed using Cox regression modeling.Between 2004-2012, 19,749 patients met study criteria: 13,382 (67.8%) underwent surgery-based treatment, 4,310 (21.8%) received chemoradiation, 1,606 (8.1%) received CFR, and 451 (2.3%) received SBRT. Surgery and SBRT utilization increased over time while CFR and chemoradiation decreased (all p ≤ 0.002). Patients receiving radiation-based treatments were older, with more comorbidities, and higher T/N stage (all p 0.0001). With median follow-up of 25.2 months, median survival was 51.6, 23.3, 15.4, and 23.7 months for surgery-based treatment, chemoradiation, CFR, and SBRT, respectively (p 0.0001). On multivariate analysis, chemoradiation (HR 1.67 [1.59-1.75], p 0.0001), CFR (HR 2.38 [2.22-2.55], p 0.0001), and SBRT (HR 1.76 [1.53-2.01], p 0.0001) were associated with decreased survival versus surgery-based treatment. CFR was associated with decreased survival versus chemoradiation (HR 1.52 [1.41-1.63], p 0.0001) and SBRT (HR 1.39 [1.19-1.61], p 0.0001). SBRT was associated with similar survival versus chemoradiation (HR 1.10 [0.95-1.27], p = 0.212).NCDB data demonstrate increasing use of surgery-based treatments and SBRT for Stage II NSCLC over time. Radiation-based therapies were associated with decreased survival compared to surgery. CFR was associated with decreased survival compared to chemoradiation and SBRT.

Extracorporeal membrane oxygenation (ECMO) is an emerging tool for supporting cardiopulmonary function in patients with cardiorespiratory failure or arrest. The oxygenator of the ECMO circuit requires effective oxygenation and removal of carbon dioxide from the blood. Major problems that can occur with the oxygenator include plasma leakage, one of the late-onset serious complications necessitating device replacement. However, the rapid onset of plasma leakage is rare. We present a 1-year-old boy with acute respiratory failure due to Pneumocystis and Aspergillus pneumonia. He presented with tachypnea, tachycardia, and hypoxemia despite the ventilatory support, and was therefore placed on venoarterial ECMO with a drainage catheter from the right internal jugular vein (12 Fr) and a return catheter to the right internal carotid artery (10 Fr). Extracorporeal circulation was initiated at a blood flow of 1 L/min (145 mL/kg/min) and a sweep gas flow of 1 L/min with FiO2 of 0.7. Although he was successfully weaned from the venoarterial ECMO on day 15 with an improvement of cardiopulmonary function, he was later placed on venoarterial ECMO again because of the progression of pulmonary hypertension. Laboratory tests showed increased concentrations of hepatic enzymes and hyperbilirubinemia (total bilirubin 31.6 mg/dL). Six hours after starting ECMO circulation, plasma leakage from the oxygenator occurred. Although we replaced the oxygenator with a new one, the replacement showed plasma leakage after 6 h. Disassembly of the oxygenator revealed congestion from bilirubin in the membrane fibers. We described a case of repeated, rapid-onset plasma leakage after implementation of ECMO. Hyperbilirubinemia was likely associated with the plasma leakage of this patient.

The Siberian flying squirrel (Pteromys volans) produces up to two litters a year. To deliver second litters in breeding season, P. volans may have a postpartum estrus similarly to that of a variety of small mammals. If this were the case, females would have periods of elevated progesterone levels because of the formation of corpora lutea (CL) after postpartum ovulation. To test this hypothesis, fecal progesterone metabolite dynamics was investigated during lactation in this species using an enzyme immunoassay. In five of the six lactating females, periods of high fecal progesterone metabolite concentration were observed, and, furthermore, progesterone secretion patterns were periodic. Therefore, the source of progesterone during lactation could be arising CL from postpartum ovulation, indicating that ovarian activity was reinitiated after parturition and the CL that formed began secreting progesterone. This study thus showed that P. volans likely has the physiologic potential to mate during lacta...

The axial $U(1)$ symmetry in the high-temperature phase is investigated with $N_f = 2$ lattice QCD simulations. The gauge ensembles are generated with M\"obius domain-wall fermions, and the overlap/domain-wall reweighting is applied. We find that the $U(1)_A$ susceptibility evaluated from the spectrum of overlap-Dirac eigenvalues is strongly suppressed in the chiral limit. We also study its volume dependence., Comment: 7 pages, 2 figures, talk presented at the 36th International Symposium on Lattice Field Theory (Lattice 2018), 22-28 July, 2018, Michigan, USA