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We analyzed the utility for a clot waveform analysis (CWA) of small tissue factor induced FIX activation (sTF/FIXa) assay in patients with major orthopedic surgery (including total hip arthroplasty [THA] and total knee arthroplasty [TKA]) receiving edoxaban for the prevention of venous thromboembolism (VTE). The sTF/FIXa assay using recombinant human TF in platelet-rich plasma (PRP) and platelet-poor plasma (PPP) was performed using a CWA in the above patients to monitor the efficacy of edoxaban administration. Of 147 patients (109 THA and 38 TKA), 21 exhibited deep vein thrombosis (DVT), and 15 had massive bleeding. Increased peak heights of the CWA-sTF/FIX were observed in almost patients after surgery and prolonged peak heights of the CWA-sTF/FIX were observed in almost patients treated with edoxaban. The peak heights and times of the CWA-sTF/FIX were significantly higher and shorter, respectively, in PRP than in PPP. There were no significant differences in parameters of the CWA-sTF/FIXa between the patients with and without DVT or between those with and without massive bleeding. The peak time of CWA-sTF/FIXa were significantly longer in TKA patients than in THA patients on day 1 after surgery. The second derivative peak height of the CWA-sTF/FIXa was significantly lower in TKA patients than in THA patients on day 4. The CWA-sTF/FIX reflected hemostatic abnormalities after surgery and the administration of edoxaban, and the results were better in PRP than PPP. Further studies separately analyzing the THA and TKA subgroups should be conducted.

The fracture toughness and fracture process of second generation acrylic (SGA) adhesive joints were investigated in detail using tapered double cantilever beam (TDCB) tests. The distribution of granular elastomer with a size of ca. 150 nm in the bulk specimen by transmission electron microscopy (TEM) observation was similar to the distribution of cavitation determined by scanning electron microscopy (SEM) observation of the fracture surface. A mechanism was proposed for the role of the elastomer and acrylic phase in the cohesive failure process of SGA. A dimple, which is evidence of ductile fracture, was observed on the fracture surface. The relationships between the size of dimples, their number and energy release rate were clarified. An understanding of the proposed failure mechanisms is useful for constructing a numerical model for stress analysis and explaining the fracture phenomenon.

Objective Although the definitive diagnosis of atypical hemolytic uremic syndrome (aHUS) depends on a genetic analysis for the complement factors, such a genetic analysis is time-consuming and expensive. We examined the usefulness of a diagnostic scoring system for aHUS. Methods The thrombotic microangiopathy (TMA) scoring system consists of hemoglobin, the platelet count, creatinine levels and organ failure, and the aHUS scoring system consists of past history and family history of TMA, age at onset, prodromal symptoms and “red or brownish urine”, and these scoring system were both evaluated in patients with aHUS, thrombotic thrombocytopenic purpura or secondary TMA. Results In a receiver operating characteristics analysis, an adequate cut-off value for diagnosing aHUS, TTP, other TMA or all TMA versus patients without TMA was 7 points for both TMA screening scores. The area under the curve was 0.965 for the TMA screening score and 0.966 for the aHUS score. An adequate cut-off value for diagnosing aHUS was 2 points for a positive aHUS score, - 3 points for an exclusion aHUS score and 0 points for the total aHUS score. Conclusion The TMA screening and aHUS score systems are useful for making a diagnosis of aHUS without performing specific laboratory tests.

Concentrations of vitamin B2 in milk were evaluated based on photoluminescence (PL) peak intensities at around λ = 545 nm. PL was measured in a back-scattering configuration using a 3.2 mm diameter optical fibre bundle irradiated by ultra-violet LEDs, violet LEDs or a blue LED as the excitation light. The tip of the optical fibre bundle was dipped into commercially available whole milk, low-fat milk and non-fat milk. PL peaking at 545 nm was observed under LED irradiation. Vitamin B2 concentrations were measured using a standard addition method and a calibration curve method. Deviation between the vitamin B2 concentration measured by PL using a standard addition method and those by HPLC technique varied with wavelength of excitation light and was smallest with violet LED (405 nm) excitation. The standard deviation of results measured by PL using a calibration curve method was better than those using a standard addition method.

Optical back-scattering from milk with various fat and protein concentrations were evaluated in a back-scattering configuration using white, violet, blue, green, red or near infrared (NIR, λ = 850 and 940 nm) LEDs as the light source. The tip of the optical fibre bundle was dipped into the milk with fat and protein concentrations from 8.2 to 39 g L−1 and 32 to 37.7 g L−1, respectively. The back-scattering intensities varied linearly with the fat and protein concentrations of the milk. The slope (G) of calibration lines varied with the wavelength of the incident light. The G of the fat concentrations became zero at wavelength around λ = 520 nm and that of the protein concentrations was much smaller than that of the fat concentrations at NIR wavelengths. The fat and protein concentrations can therefore be measured separately based on the scattering intensities by selecting the wavelength for measurement.

Selective-area growth, which can be an alternative to ion implantation, is an important technology for processing diamond power devices. In conventional chemical vapor deposition (CVD), a portion of the metal mask (non-growing region) peels off and is unintentionally incorporated into the film; therefore, creating high-quality fine patterns is a great challenge. In this study, we developed a technique to fabricate fine structures on a submicron scale by employing hot-filament (HF) CVD. The mask pattern was kept intact during growth, and submicron-scale selective-area growth was realized. As a result, contamination-free metallic p + diamond films possessing a smooth surface morphology were successfully selectively grown.

We analyzed a cohort of 36 females with pregnancy loss. In addition to 11 patients with antiphospholipid antibody syndrome and 2 patients with congenital antithrombin (AT) or protein C deficiency, we identified 5 patients with low fibrinogen levels (median 110 mg/dL) prior to 10 weeks of gestation. Four of these 5 patients underwent a fibrinogen gene analysis, and all 4 were found to be heterozygotes for the α-fibrinogen (FGA) Thr321Ala polymorphism. One female without hypofibrinogenemia with a history of 8 pregnancy losses was found to be homozygous for the same polymorphism, and she also showed hypercoagulability without thrombosis. In conclusion, there was a relatively high frequency of pregnancy loss in the setting of hypofibrinogenemia and/or the FGA Thr312Ala polymorphism, and this may be an important risk factor for pregnancy loss and a hypercoagulable state in later pregnancy.

Dehydrogenation of anhydrous methanol is of great importance, given its ubiquity as an intermediate for the production of a large number of industrial chemicals. Since dehydrogenation of methanol is an endothermic reaction, heterogeneous or homogeneous precious-metal-based catalysts and high temperatures are usually required for this reaction to proceed. Here we report the photochemical dehydrogenation of anhydrous methanol at room temperature catalysed by o-aminophenol (apH2), o-aminophenolate (apH−) and the non-precious metal complex trans-[FeII(apH)2(MeOH)2]. Under excitation at 289±10 nm and in the absence of additional photosensitizers, these photocatalysts generate hydrogen and formaldehyde from anhydrous methanol with external quantum yields of 2.9±0.15%, 3.7±0.19% and 4.8±0.24%, respectively, which are the highest values reported so far to the best of our knowledge. Mechanistic investigations reveal that the photo-induced formation of hydrogen radicals triggers the reaction., Photochemical dehydrogenation of anhydrous methanol is a relatively low temperature hydrogen generation process. Here, the authors report a series of compounds for room temperature anhydrous methanol dehydrogenation, together with the mechanism for the photochemical generation of hydrogen radicals.

A chemical decomposition of polyurea (PUA) by hydrolysis under high pressure of carbon dioxide (CO2) was proposed. The hydrolysis of PUA was carried out at 190 °C for 2 h under 7.0 MPa of CO2 in the presence of water. The hydrolysis reaction gave white residual solid and water soluble compound. The white residual solid was characterized to be degraded PUA by FT-IR spectrum and elemental analysis. 1H-NMR spectra of the water soluble compound revealed that the hydrolysis of PUA produced diamine only from repeating unit of PUA, which was a component of PUA. This hydrolysis gave the corresponding diamine for quantitative yields., Polymer Bulletin, 74(3), pp.615?623; 2017

Diamond-based rectifiers are promising devices for the development of next-generation power electronics. However, presented device structures limit current operation as low as tens A, which hampers diamond from real industrial applications. One of the critical issues is poor availability of conductive (low-resistivity) substrates which can be used for vertical-type devices for high-output operations. Recently, we have successfully fabricated heavily boron-doped (p+) low-resistivity diamond by hot-filament chemical vapor deposition (HFCVD). Resistivity was monotonically decreased to 1.2 mOcm with amount of doped boron. In this study, to further investigate potentials for electric applications, contact resistance between metal/p+ diamond was evaluated by transmission line model (TLM). From the current-voltage characteristics, low specific contact resistance of ~10-7 Ocm2 was demonstrated.

Microalbuminuria is said to reflect systemic vascular damage and endothelial dysfunction and is an established indicator of cardiovascular morbidity and mortality. Patients with obstructive sleep apnea (OSA)-chronic obstructive pulmonary disease (COPD) overlap syndrome have worse survival than those with OSA or COPD alone.This study evaluated the association between overlap syndrome and microalbuminuria.Data on patients in whom OSA was suspected and who underwent polysomnography between January 2010 and December 2012 were reviewed. Microalbuminuria was defined as an albumin-creatinine ratio between 20 and 299 mg/g in men and between 30 and 299 mg/g in women.Of 740 consecutive patients, 344 were analyzed. Sixty-four were control participants, 248 had OSA only, 4 had COPD only, and 28 had OSA-COPD overlap syndrome. Prevalence of microalbuminuria significantly increased in the order of control, OSA, and overlap syndrome groups (3.1, 12.9, and 32.1%, respectively; P = 0.0006). After adjusting for age and sex, multivariate logistic regression analysis demonstrated a significant association of overlap syndrome with microalbuminuria compared with OSA (odds ratio, 2.61; 95% confidence interval, 1.02-6.38; P = 0.047), but after adjusting for other confounding factors, the difference in the association did not reach significance (odds ratio, 2.54; 95% confidence interval, 0.93-6.72; P = 0.070). Of 63 patients reevaluated after 3 months of continuous positive airway pressure therapy, the logarithm of the albumin-creatinine ratio in 36 patients with good compliance significantly decreased, but there was no difference in patients with poor compliance.OSA-COPD overlap syndrome was more prevalent than OSA alone in patients with microalbuminuria, but the difference might be mediated by conventional risk factors rather than the addition of COPD itself.

Anti-Xa assays are useful for monitoring the effects of selective anti-Xa drugs, such as fondaparinux, in the prophylaxis of deep vein thrombosis. In the present study, anti-Xa activity was measured using three different assays, Testzym(®) Heparin S, STA(®)-Liquid Anti-Xa and HemosIL(®) Liquid Heparin. Anti-Xa activity in each assay gradually increased from day one after administration to day eight, and still remained on day 15. Although there were significant differences in anti-Xa activity among the three assays, the activity showed significant correlation across assays. There were no significant differences in the anti-Xa activity between patients with and without DVT or between patients with and without massive bleeding on day one before and after administration, day four, day eight and day 15. Anti-Xa activity in each assay was weakly correlated with antithrombin (AT) activity. The AT activity in patients were significantly higher on days four, eight and 15 compared with day one before and after administration, suggesting that AT activity increases following the administration of fondaparinux. The three anti-Xa assay kits tested are useful for monitoring fondaparinux treatment in orthopedic surgery patients.

Venous thromboembolism (VTE) is a common complication in patients who have undergone major orthopedic surgery, but there are few predictors of VTE after major orthopedic surgery treated with an anticoagulant. We measured levels of fibrin-related markers (FRMs), such as D-dimer, soluble fibrin (SF), and fibrinogen and fibrin degradation products (FDPs) in 66 patients with acute-phase VTE, and 367 patients undergoing major orthopedic surgery. Plasma FDP, D-dimer, and SF levels were significantly higher in patients with acute VTE, but only FDP and D-dimer levels were significantly higher in subclinical VTE. Adequate cut-off levels of D-dimer were 2.2 μg/ml for diagnosing acute VTE and 1.5 μg/ml for diagnosing subclinical VTE. D-dimer of less than 1.9 or 0.7 μg/ml ruled out acute VTE or subclinical VTE. D-dimer of more than 1.3 μg/ml preoperatively showed a moderate risk for postoperative VTE. Measurement of FRMs is useful for evaluating the risk of subclinical or postoperative VTE in patients with major orthopedic surgery. In particular, FDP is the most valuable marker for diagnosing acute VTE, whereas D-dimer is the most valuable for diagnosing subclinical VTE or predicting VTE.

This study was designed to determine the effectiveness of whole-body vibration (WBV) and intermittent parathyroid hormone (iPTH) in combination against estrogen deficiency-induced osteoporosis. Female C57BL/6J mice were bilaterally ovariectomized (OVX, n = 40) or sham-operated (sham-OVX, n = 8) at 9 weeks of age. Two weeks later, the OVX mice were randomly divided into four groups (n = 10 each): the control group (c-OVX) and groups treated with iPTH (p-OVX), WBV (w-OVX) and both (pw-OVX). The p-OVX and pw-OVX groups were given human PTH (1-34) at a dose of 30 µg/kg/day. The w-OVX and pw-OVX groups were exposed to WBV at an acceleration of 0.3 g and 45 Hz for 20 min/day. All mice were euthanized after the 18-day treatment, and the left tibiae were harvested. The proximal metaphyseal region was µCT-scanned, and its cortical bone cross-section was analyzed by Fourier transform infrared microspectroscopy and nanoindentation testing. A single application of iPTH or WBV to OVX mice had no effect on bone structure or material properties of cortical bone, which were compromised in comparison to those in sham-OVX mice. The combination of iPTH and WBV improved trabecular bone volume, thickness, and connectivity in OVX mice. Although the combined treatment failed to improve cortical bone structure, its mineral maturity and hardness were restored to the levels observed in sham-OVX mice. There was no evidence of interaction between the two treatments, and the combined effects seemed to be additive. These results suggest combining WBV with iPTH has great potential for treating postmenopausal osteoporosis.

Objective Antiphospholipid syndrome (APS) is a well-known complication of habitual abortion and/or thrombosis and is frequently associated with autoimmune diseases. Methods We retrospectively investigated the relationships between the presence of antiphospholipid antibodies (aPLs) and the incidence of thrombotic events (THEs) in 147 patients with various connective tissue diseases (CTD) suspected of having APS and 86 patients with idiopathic thrombocytopenic purpura (ITP). THEs were observed in 41 patients, including 14 cases of venous thrombosis, 21 cases of arterial thrombosis and eight cases of complications of pregnancy. Results The prevalence of THE was significantly high in the systemic lupus erythematosus (SLE) patients compared with the other CTD patients and ITP patients. The frequency of lupus anticoagulant (LA), anticardiolipin antibodies (aCL)-β2-glycoprotein (GPI) complex IgG and aPL was significantly high in the SLE patients compared with the ITP patients. Subsequently, the rate of development of THE was significantly high in the patients with aPLs. In particular, the incidence of THE was significantly high in the SLE or ITP patients with LA, aCL-β2GPI IgG or aPL. The optimal cut-off values for LA, aCL IgG and aCL-β2GPI complex IgG for the risk of THEs were higher in the SLE patients in comparison to the values obtained when using the kit provided by the manufacturer. Conclusion Although aPLs is frequently associated with SLE and is a causative factor for thrombosis, the optimal cut-off value for aPL for predicting the occurrence of THEs varies among different underlying diseases.

Cyclobutenes with 2-pyridylmethylene groups at the 3 position underwent an intermolecular alkyne insertion reaction in the presence of a rhodium(i) catalyst at 170 °C to afford substituted benzenes. Among the different 2-pyridylmethylene groups examined, 3-methyl-2-pyridyl derivatives showed superior activity and readily coupled with various alkynes, including sterically demanding, heteroaromatic and terminal alkynes.

A novel platinum(II)-diimine complex, [Pt(CN)2 (H2 dcphen)] (1; H2 dcphen=4,7-dicarboxy-1,10- phenanthroline), was synthesized and its vapochromic shape-memory behavior was evaluated. The as-synthesized amorphous purple solid, [Pt(CN)2 (H2 dcphen)]⋅2 H2 O (1 P), exhibited vapochromic behavior in the presence of alcoholic vapors through transformation to a red, crystalline, porous, vapor-adsorbed form, 1 R⊃vapor. The obtained 1 R⊃vapor complex released the adsorbed vapors upon heating without collapse of the porous structure. The vaporfree, porous 1 R⊃open could detect water or n-hexane vapor, although these vapors could not induce 1 P-to-1 R⊃vapor transformation, and 1 R⊃open could easily be converted to the initial 1 P by manual grinding. These results indicate that 1 is a new shape-memory material that functions through formation and collapse of the porous framework with an emission change upon vapor-adsorption and grinding; this enables it to exhibit vapor history and ON-OFF switching sensing functions.

Efficacy of recombinant human soluble thrombomodulin (rhTM), which is frequently used to treat patients with disseminated intravascular coagulation (DIC), was compared with that of gabexate mesilate (GM), which was previously used routinely in the treatment of DIC patients in Japan. Although there was no significant difference in the resolution rates of the patients who were treated with rhTM and GM, the results of our analysis revealed that the mortality rate was significantly higher among infectious disease patients treated with GM than in those treated with rhTM. Levels of fibrinogen and fibrin degradation products (FDP), antithrombin (AT) activity, and thrombin AT complex (TAT) were significantly lower in the DIC patients with infectious diseases, while fibrinogen levels were high. FDP level, D-dimer, platelet count, PT ratio, and DIC score all showed significant improvement following rhTM treatment. There were no significant difference between survivors and non-survivors in terms of DIC score, FDP level, platelet count, AT activity, or in TAT, SF and PPIC levels before rhTM treatment. However, fibrinogen levels were significantly lower in non-survivors than in survivors. These results indicate that rhTM may be superior to GM for the treatment of DIC.

Mycobacterium fortuitum is a rapidly growing nontuberculous mycobacterium. This microorganism is an uncommon etiological agent of lung lesions; among lung lesions caused by M. fortuitum, thoracic empyema is particularly rare. A 61-year-old man who had been treated for chronic hypercapnic respiratory failure with noninvasive ventilation was admitted because of breathing difficulty and was found to have M. fortuitum thoracic empyema. He improved after the administration of amikacin, imipenem/cilastatin, and clarithromycin following sulfamethoxazole/trimethoprim and clarithromycin. This is the first report of M. fortuitum thoracic empyema in a patient without human immunodeficiency virus infection. The thoracic empyema may have developed via a pulmonary fistula in this case. This case highlights the fact that we must be aware of the possibility of M. fortuitum thoracic empyema, especially in patients with M. fortuitum lung infection and treatment with noninvasive ventilation. Multidrug therapy may be effective and important to the resolution of M. fortuitum thoracic empyema.

Rho-associated kinases play an important role in a variety of cellular functions. Although Rho-associated kinase activity has been shown to be an independent predictor for future cardiovascular events in a general population, there is no information on Rho-associated kinase activity in patients with acute coronary syndrome. We evaluated leukocyte Rho-associated kinase activity by Western blot analysis in 73 patients with acute coronary syndrome and 73 age- and gender-matched control subjects. Rho-associated kinase activity within 2 hours of acute coronary syndrome onset was higher in patients with acute coronary syndrome than in the control subjects (0.95±0.55 versus 0.69±0.31; P P =0.03 and P =0.03, respectively) and then gradually decreased to 0.83±0.52 after 7 days, 0.78±0.42 after 14 days, and 0.72±0.30 after 6 months ( P =0.22, P =0.29, and P =0.12, respectively). During a median follow-up period of 50.8 months, 31 first major cardiovascular events (death from cardiovascular causes, myocardial infarction, ischemic stroke, and coronary revascularization) occurred. After adjustment for age, sex, cardiovascular risk factors, and concomitant treatment with statins, increased Rho-associated kinase activity was associated with increasing risk of first major cardiovascular events (hazard ratio, 4.56; 95% confidence interval, 1.98–11.34; P

Aims As the glucose tolerance of patients with diabetes worsens, autonomic nervous system (ANS) function decreases. Only a few studies, using plasma glucose, have reported on this relationship in large general populations that include people with wide range of glycemia. This study aimed to examine correlates of ANS function with special reference to HbA1c which is more stable than plasma glucose among community residents. Methods Spectral analysis was performed to assess heart rate variability (HRV) using 1-minute electrocardiogram RR interval data recordings from 7690 residents aged 35–79 years in Nagahama City, Japan. HRV parameters were log-transformed. Multiple regression analysis was performed using potential correlates. Results lnLF decreased with age (regression coefficient, −0.025; P Conclusions Although the associations were weak, age, BMI and HbA1c were inversely correlated with parasympathetic activity, while positively correlated with sympathetic activity among general residents.

A paradoxical reaction (PR) is an excessive immune response occurring during antitubercular therapy (ATT), but is rare in patients with miliary tuberculosis. A 78-year-old woman complained of general malaise, loss of appetite, and fever for 10 days. Chest computed tomography (CT) showed diffuse, bilateral, discrete miliary nodules. The patient was treated with ATT for miliary tuberculosis. Nine days after starting the treatment, she developed a spiking fever and worsening malaise. Repeat CT showed new localized ground-glass opacity (GGO) in the right upper lobe. After excluding possible etiologies, she was diagnosed with PR due to ATT. She was successfully managed with oral prednisolone while continuing ATT. The GGO diminished and did not recur after discontinuation of the steroids. We reviewed 28 reported cases of miliary tuberculosis with a PR in patients not infected with human immunodeficiency virus. Those not on immunosuppressive therapy were likely to develop a PR early. This case illustrates that a PR may present as localized GGO in miliary tuberculosis in the lung of patients treated with ATT. In cases of a PR with marked symptoms, steroid therapy may be valuable. Keywords: Paradoxical reaction, Miliary tuberculosis, Mycobacterium tuberculosis

We aimed to analyze associations of sleep disturbance, including sleep disordered breathing, sleep fragmentation, and sleep efficiency, with abnormal nocturnal blood pressure (BP) profiles that may be risk factors for adverse cardiovascular outcomes.The study included 5854 community residents with 20,725 multi-day measurements. Sleep fragmentation and efficiency were evaluated using a wrist-worn activity monitor. Sleep disordered breathing was assessed using the 3% oxygen desaturation index corrected for actigraphy-determined sleep duration. A timer-equipped standard cuff-oscillometric device was used for home and sleep BP monitoring.Mean nocturnal systolic BP (SBP) change was -8.6 ± 9.7% (-11.1 ± 12.6 mmHg), and inter-day correlation coefficient of the nocturnal SBP change was 0.443. Results of a linear mixed model analysis using daily measured values identified lower sleep efficiency (coefficient = -0.130, p 0.001) as a determinant for decreased nocturnal SBP dipping beyond the interday variations of these parameters. Number of nocturnal urinations was another strong determinant (coefficient = 1.191, p 0.001), although the association of sleep efficiency was independent of nocturnal urination, awake SBP, and sleep disordered breathing (coefficient = -0.102, p 0.001). Sleep efficiency was also independently associated with sleep SBP level (coefficient = -0.138, p 0.001). Estimated differences in nocturnal SBP dipping and sleep SBP level as a function of the degree of sleep efficiency (less than 80%) reached 1.63% (1.09-2.17%) and 2.16 mmHg (1.49-2.82%), respectively.More attention should be paid to sleep efficiency as a factor in maintaining circadian BP rhythm.

Introduction Moxibustion, along with acupuncture, is an important therapeutic approach in traditional East Asian medicine. As such, the burning of moxa floss on the skin to thermally stimulate body surfaces. Presently, moxa floss is manufactured from mugwort leaves mainly in Japan, China, and South Korea. The genus Artemisia, to which the mugwort belongs, reportedly includes more than 250 wild species in the world and more than 30 in Japan. This study was conducted to characterize Japanese moxa floss by identifying various varieties of moxa floss mugwort (MFM) material collected from leading places of moxa floss production in the world by DNA-based phylogenetic analysis. Methods DNA was extracted from Japanese mugwort (9 families), South Korean dry mugwort (1 family), and Chinese dry moxa floss (4 types), and the nuclear DNA ITS and chloroplast DNArpl32-trnL, trnQ-5′rps16, and trnH-psbA regions were sequenced. Results All Japanese mugwort samples were found to have the same DNA sequence in the ITS region; there were no location-specific sequences. Chinese and South Korean mugwort samples were found to have species-specific mutations, and their mutated sequence was found to be identical to the sequence ofA. argyi, a species remote from Japanese Artemisia. Discussion/conclusions By identifying the various MFM varieties in Japan as the same species, this study showed that Japanese moxa floss can be characterized not only by manufacturing process, but also by raw material. The identification is also believed to provide basic information to understand the historical changes of places of MFM production.

Optical scattering spectra and angular distribution of scattering intensities were evaluated using commercially available tomato juice for a non-destructive quality control. A halogen lamp, a red LED and NIR LEDs (λ = 850 nm and λ = 940 nm) can be used as the incident light for scattering evaluations of tomato because incident light with wavelengths shorter than 550 nm is absorbed by pigments in tomato. Scattering intensities and their angular distributions are found to depend on the sugar concentrations of tomato juice. The scattering intensities vary linearly with the sugar concentrations of the specimens irradiated with a halogen lamp, a red LED or NIR LEDs (λ = 850 nm and λ = 940 nm). Gradient of calibration lines, G, between the sugar concentrations and the scattering intensities varies with the scattering angles and the wavelength of light irradiated. G is large negative value with large scattering angles such as a back scattering configuration. While, G is small positive value with small scattering angles such as a forward scattering configuration.

It is hard to envision all possible use cases or environmental conditions that might happen to a VLSI system during its lifetime and could adversely affect its performance and/or dependability. The job of designing and testing a VLSI includes the challenge of being prepared even against problems hard to foresee, within the restrictions of practical cost and time. This chapter is intended to offer a perspective for unidentified future threats to dependability and provisions in design and test that could be taken to mitigate them. First of all, in Sect. 12.1, we look back on the trend in the fault causes experienced over time, and discuss unidentified future threats and technical challenges. Section 12.2 takes up the cloud data center that provides IaaS (Infrastructure as a Service) as a typical electronic system requiring high levels of dependability from a few different subsystem perspectives, i.e., server, storage, and communications, and discusses relevant emerging requirements. In Sect. 12.3, the concept of “patchable hardware and rectification for post-Silicon validation” is introduced. Section 12.4 deals with collecting the field test data for preventive maintenance and potentially for post-failure analysis and future study based on the technology called DART (Dependable Architecture with Reliable Testing). Section 12.5 deals with the fault detection and reconfiguration method for multiple-core processor is discussed. Finally, in 12.6, checkpoint-restart for heterogeneous multiple processor systems is proposed as a standard procedure for dependability.

Background The usefulness of vascular function tests for management of patients with a history of coronary artery disease is not fully known. Methods and Results We measured flow‐mediated vasodilation ( FMD ) and brachial–ankle pulse wave velocity (ba PWV ) in 462 patients with coronary artery disease for assessment of the predictive value of FMD and ba PWV for future cardiovascular events in a prospective multicenter observational study. The first primary outcome was coronary events, and the second primary outcome was a composite of coronary events, stroke, heart failure, and sudden death. During a median follow‐up period of 49.2 months, the first primary outcome occurred in 56 patients and the second primary outcome occurred in 66 patients. FMD above the cutoff value of 7.1%, derived from receiver‐operator curve analyses for the first and second primary outcomes, was significantly associated with lower risk of the first (hazard ratio, 0.27; 95% confidence interval, 0.06–0.74; P =0.008) and second (hazard ratio, 0.32; 95% confidence interval, 0.09–0.79; P =0.01) primary outcomes. ba PWV above the cutoff value of 1731 cm/s was significantly associated with higher risk of the first (hazard ratio, 1.86; 95% confidence interval, 1.01–3.44; P =0.04) and second (hazard ratio, 2.19; 95% confidence interval, 1.23–3.90; P =0.008) primary outcomes. Among 4 groups stratified according to the combination of cutoff values of FMD and ba PWV , stepwise increases in the calculated risk ratio for the first and second primary outcomes were observed. Conclusions In patients with coronary artery disease, both FMD and ba PWV were significant predictors of cardiovascular events. The combination of FMD and ba PWV provided further cardiovascular risk stratification. Clinical Trial Registration URL : www.umin.ac.jp . Unique identifier: UMIN 000012950.

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.

We report the photochemical carboxylation of o-phenylenedimamine in the absence of a base and an electron donor under an atmosphere of CO2, which afforded 2,3-diaminobenzoic acid (DBA) in 28% synthetic yield and 0.22% quantum yield (Φ(%)). The synthetic yield of DBA in this reaction increased to 58% (Φ(%) = 0.47) in the presence of Fe(II). The photochemical reaction described in this work provides an effective strategy to use light as the driving force for the direct carboxylation of organic molecules by CO2.

BACKGROUND The aim of this study is to clarify associations between orthostatic blood pressure (BP) change, as well as possible physiological factors, and day-to-day home BP variability, a promising risk factor for cardiovascular outcomes. METHODS Study participants were 6,465 community residents (age 58.3 years). Home BP was measured every morning and evening for 7 days. Orthostatic BP was calculated as the maximum difference between BP measured while sitting and remeasured after 1 and 3 minutes standing. RESULTS Frequency of individuals who showed orthostatic BP decline was as follows: systolic BP (SBP) change ≥−20 mm Hg: 2.6%, ≥−10 mm Hg: 14.1%. These subgroups showed larger home SBP variability (average real variability: 11.3 ± 5.3, 8.7 ± 3.9 mm Hg) when compared with orthostatic normotensives (7.6 ± 3.7 mm Hg) (all P < 0.001). Multiple linear regression analysis adjusted for major covariates, including seated BP, identified orthostatic BP drop as an independent determinant for morning BP variability (≥−20 mm Hg: β = 0.037, P = 0.003; ≥−10 mm Hg: β = 0.026, P = 0.036) but not for evening BP variability. Carotid hypertrophy was significantly associated with home BP variability (morning: β = 0.052, P = 0.001; evening: β = 0.065, P < 0.001) and showed a U-shaped association with orthostatic BP change. Plasma B-type natriuretic peptide level, a previously suggested factor for BP variability, did not show significant association with morning and evening BP variability. CONCLUSION Orthostatic BP decline was significantly associated with morning BP variability. Large artery atherosclerosis was a common risk factor.

Study Objectives The individual prevalence of sleep-disordered breathing (SDB), short sleep duration, and obesity is high and increasing. The study aimed to investigate potential associations between SDB, objective sleep duration, obesity, diabetes and hypertension across genders, and the effect of pre- or post-menopausal status. Methods A cross-sectional study evaluated 7051 community participants with wrist actigraphy for a week, and nocturnal oximetry ≥ 2 nights. SDB was assessed by 3 per cent oxygen desaturation index (ODI) corrected for sleep duration obtained from wrist actigraphy. Moderate-to-severe SDB was defined as ODI3% levels ≥ 15 per hour. Results Both logODI3% and body mass index showed independent negative associations with sleep duration (β = -0.16, p < 0.001 and β = -0.07, p < 0.001, respectively). Moderate-to-severe SDB (men/premenopausal women/postmenopausal women; 23.7/1.5/9.5%, respectively) was associated with a higher risk of diabetes in premenopausal women (OR 28.1; 95%CI 6.35-124.6; p < 0.001) and postmenopausal women (OR 3.25; 95%CI 1.94-5.46; p < 0.001), but not in men (OR 1.47; 95%CI 0.90-2.40; p = 0.119). Moderate-to-severe SDB was associated with a higher risk of hypertension in men (OR 3.11; 95%CI 2.23-4.33; p < 0.001), premenopausal women (OR 3.88; 95%CI 1.42-10.6; p = 0.008), and postmenopausal women (OR 1.96; 95%CI 1.46-2.63; p < 0.001). Short sleep duration was not associated with diabetes or hypertension. The associations of obesity with diabetes or hypertension were indirectly mediated by SDB (24.0% and 21.5%, respectively), with possible sex differences emerging (men/women; 15.3/27.8% and 27.0/16.9%, respectively). Conclusions Notwithstanding the cross-sectional design, SDB and obesity, but not short sleep duration, were independently associated with diabetes and hypertension, with gender and menopausal status-related differences in risk emerging.

The gain-of-function variation p.I1157T in C3 was previously identified in 8 patients with atypical hemolytic uremic syndrome (aHUS) at Mie University Hospital. In the present study, we identified another 11 patients with aHUS with this variation, including 10 pediatric patients (onset age: 1-16 years). The variation seems to be geographically concentrated around Mie Prefecture in Japan. Fifteen of the 19 patients with aHUS experienced infection as probable triggering events. All 19 patients had renal dysfunction. Seven patients, including 2 from the previous study and 5 from the present study, were treated with eculizumab, with all showing a good response with hematological normalization. Among the 5 eculizumab-treated patients in the present study, 3 had an ambiguous diagnosis of aHUS due to low-grade hemolysis even with elevated levels of lactate dehydrogenase and bilirubin. In those cases, in-house targeted DNA sequencing identified the C3 p.I1157T variation carriers, which enabled the early initiation of treatment with eculizumab. The present study supports the early introduction of eculizumab in patients with aHUS, especially pediatric patients.

Sarcopenia has been associated with several conditions relevant to obstructive sleep apnea (OSA), such as aging and obesity, but a direct relationship between OSA and skeletal muscle alterations has not been identified. This study investigated associations between computed tomography (CT)-measured skeletal muscle indices and OSA severity. Analyzed were 334 patients who underwent polysomnography to diagnose OSA. Lumbar skeletal muscles were assessed with CT for the skeletal muscle mass index (SMI, cross-sectional area, normalized for height squared) and skeletal muscle density (SMD, fat infiltration). The apnea-hypopnea index (AHI) correlated positively with the SMI and negatively with SMD in both men and women. The AHI was weakly associated with SMI only in men (β = 0.11, P = 0.017) after adjustment for the body mass index (BMI) (BMI: β = 0.61, P P P P

A 23-year-old man from Mie Prefecture, Japan, with past and family history of hematuria was diagnosed with influenza A and admitted to our hospital on the following day because of hemoglobinuria. He was diagnosed with thrombotic microangiopathy and was suspected of having atypical hemolytic uremic syndrome (aHUS). C3 p.I1157T missense mutation, which we had previously reported in eight aHUS patients from six families in Mie Prefecture, was identified. The laboratory findings and symptoms of our patient promptly improved after administering eculizumab. Little information is available on abnormalities of the complement system in aHUS or on mutation-specific outcomes of eculizumab therapy. Eculizumab was effective for treating our aHUS patient with C3 p.I1157T missense mutation.

Urinary liver-type fatty acid-binding protein (L-FABP) is a potential biomarker for acute kidney injury, and it in turn increases cardiovascular mortality. We tested whether the urinary L-FABP level predicted short- and mid-term outcomes in patients with acute heart failure.We enrolled consecutive patients with acute heart failure, and measured their urinary L-FABP levels before acute treatment. Worsening renal function (WRF), defined as both an absolute increase in the serum creatinine level of ≥0.3mg/dL and a ≥25% relative increase in its level from baseline, occurred in 37 (26.8%) of 138 patients. Patients with a urinary L-FABP level above the upper normal limit (8.4 µg/g creatinine) (n = 49; 35.5%) were more likely than those with a urinary L-FABP level within normal limits (n = 89; 64.5%) to develop WRF (n = 26 [53.1%] vs n = 11 [12.4%]; P.001). A urinary L-FABP level above the upper limit was independently associated with WRF (hazard ratio 1.8; P = .01). During 1 year of follow-up, 12 patients (8.7%) died, and urinary L-FABP level had no association with all-cause mortality. There was, however, a tendency toward a higher readmission rate in patients with a urinary L-FABP level above the upper normal limit who survived the index hospitalization (n = 46) than in those without an abnormal L-FABP level (n = 88; n = 13 [28.3%] vs n = 13 [14.8%]; log-rank P = .06).Increased urinary L-FABP level before treatment may predict WRF in patients with acute heart failure. Further investigation is warranted for its predictive ability of adverse outcomes.

We review the hybrid-integration of an InP semiconductor optical amplifier on a silicon photonics chip, and our in-line SOA integration using precise flip-chip bonding technology. We demonstrate the loss-less operation of a 4×4 switch with a 4ch-SOA array.

In this paper, a method of simple geometrical analysis method during ankle joint stretching treatment using numerical calculation was proposed, and the effect was examined in a developed system. The stretching of the ankle joint is an important medical treatment that physical therapist (PT’s) help their patients to recover their ability to walk and to prevent contracture. Since the ankle treatment requires a large amount of force (nearly equal to the subject’s weight) and precise angle control at the same time, manual treatment by PTs has not been replaced by mechanical treatment systems and the mechanism of the treatment has not been analyzed mathematically. In order to realize developing the effective mechanism of the treatment, the geometrical relationships between Ankle joint, Hip joint, Thenar and pushing device rotation center were analyzed mathematically by using numerical calculation during the treatment. In addition, the effectiveness of the numerical calculation was confirmed by developing the treatment device by using two of force sensors and DC motors. Key point of the PTs method of the ankle joint treatment was a position layout between the Ankle joint and the pushing device rotation center. The proposed numerical calculation method will effectively work to develop the mechanical systems of ankle joint stretching treatment.

Background No studies have addressed the relationship between obstructive sleep apnea (OSA) and abdominal aortic calcification (AAC), a marker for subclinical atherosclerosis and future cardiovascular events. Objectives To investigate 1) the association between OSA severity and AAC, and 2) whether OSA can impact the extent of AAC independent of comorbid atherogenic risk factors. Methods 390 participants aged 40–70 years underwent polysomnography and abdominal computed tomography. AAC was separately quantified in the upper and lower abdominal aorta using the modified Agatston scoring method, and the total AAC score was calculated as a sum of the two scores. OSA was defined as none/mild (apnea-hypopnea index [AHI] Results Log-transformed total AAC score adjusted for age and body mass index (BMI) was greater in participants with an elevated AHI (3.4 for none/mild OSA, 3.7 for moderate OSA, and 4.2 for severe OSA, p = 0.04). Multivariate linear regression analysis including age and BMI as covariates showed that severe OSA was associated with higher scores for the lower and total AAC (β = 0.15 and 0.14, p = 0.01 and 0.01, respectively). The association did not persist after additionally adjusting for traditional atherogenic risk factors including visceral fat, smoking, hypertension, dyslipidemia, and diabetes. Conclusions Severe OSA was associated with a greater extent of AAC, which was dependent on coexisting atherogenic risk factors. Comorbid cardiometabolic disorders may largely mediate the association of OSA with subclinical atherosclerosis.