Search

Several vaccines have been approved worldwide for the prevention of morbidity and mortality against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the development of these vaccines has raised concerns regarding their adverse effects. Herein, we report the first case of intracerebral hemorrhage (ICH) due to vasculitis after the first dose of mRNA vaccine (BNT162b2, Pfizer/BioN-Tech). Although this case cannot demonstrate a direct relationship between COVID-19 vaccination and vasculitis, the clinical and histological features of this patient are highly consistent with the adverse effects of COVID-19 vaccine.

Dominant interpretations of Plato'sCritoattempt to reconstruct the text deductively, taking the arguments in the famous Laws’ speech as consisting solely in the application of general principles to facts. It is thus conceived that the principles and facts are grasped independently of each other, and then the former are applied to the latter, subsequently reaching the conclusion that Socrates must not escape. Following the lead of Cora Diamond, who argues against this ‘generalist interpretation’, I argue that the Laws’ speech essentially involves an exercise of our moral imagination through which both principles and the facts to which they apply are grasped. This is not to say that a deductive argument is absent from the Laws’ speech. Rather, for the first time, we understand how the deductive arguments in the Laws’ speech can function through imagining a life in which these arguments make sense. TheCritois an attempt to exercise the readers’ imagination, thereby presenting ethics that is both personal and objective. Understanding the Laws’ arguments essentially requires the readers’ imaginative involvement with Socrates’ personal story, but they still have objective import.

Background It is unclear whether molnupiravir has a beneficial effect on vaccinated patients infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We here evaluated the efficacy of molnupiravir in patients with mild-to-moderate coronavirus disease 2019 (COVID-19) during the Omicron variant surge in Fukushima Prefecture, Japan. Methods We enrolled patients with mild-to-moderate COVID-19 who were admitted to hospitals between January and April, 2022. Clinical deterioration after admission was compared between molnupiravir users (n = 281) and non-users (n = 1,636). Results The molnupiravir users were older (P

Highlights • In our case report, we suggested that reduced port laparoscopic surgery using an umbilical zigzag incision is comparable to conventional multiport laparoscopic surgery. • This method is associated with improved cosmesis and decreased wound pain. • We herein report a case involving interval resection of Meckel’s diverticulum using a transumbilical approach with a zigzag incision, which was performed three months after the appearance of symptoms., Introduction Reduced port laparoscopic surgery using an umbilical zigzag incision is comparable to conventional multiport laparoscopic surgery. This method is associated with improved cosmesis and decreased wound pain. Presentation of case A 67-year-old man visited our hospital. He presented emergency room with a chief complaint of right lower abdominal pain by walking. The patient was diagnosed Meckel’s diverticulitis by computed tomography (CT). At first, antibiotics therapy and fasting were performed. Three months later, the patient underwent resection of Meckel’ diverticulum with zigzag transumbilical laparoscopic surgery. The patient’s postoperative course was good, and he rarely felt wound pain. The patient started oral intake three days after surgery, and was discharged 10 days after surgery. Discussion Zigzag transumbilical laparoscopic surgery is very useful for resection of the small intestine. This method is associated with improved cosmesis and decreased wound pain. In the case of Meckel’s diverticulitis, we suggest that interval resection of Meckel’s diverticulum was very useful as it was an operation that could be performed easily. Conclusion Reduced port laparoscopic surgery using an umbilical zigzag incision is considered to be an excellent technique in terms of operability and aesthetic outcomes.

The lingering mystery of John Rawls’s reflective equilibrium is that its nature is unclear. Rawls at times suggests he is merely describing people’s conceptions of justice, whereas at other times he implies that his reflective equilibrium is a way to justify his conception of justice. Faced with seemingly conflictual passages, most scholars privilege the justificatory ones. However, I argue that this is not an effective strategy because understanding how the descriptive and justificatory aspects of reflective equilibrium fit together is the key to unlocking its nature and actual force. This paper compares Rawls’s method to the philosophical method of later Wittgenstein in his so-called private language argument to argue how the descriptive and justificatory aspects of Rawls’s reflective equilibrium fit together. In my view, both philosophers’ methods are descriptive clarifications of our unclear conceptions. However, their clarification is not just descriptive; they also aim at their readers achieving enlightenment. Importantly, I argue, that enlightenment offers us justification of the conception resulting from their clarification. Hence, their methods are justificatory as well. Finally, I claim that this way of understanding reflective equilibrium makes us realise how Rawls could respond to a prominent objection to it.

Elevated serum uric acid is a cardiovascular risk factor in patients with hypertension, even when blood pressure (BP) is well controlled. Xanthine oxidoreductase inhibitors (XORi) reduce serum uric acid levels and have several other potential effects. This multicenter, randomized, open‐label study compared the effects of two XORi, topiroxostat and febuxostat, on arterial stiffness, uric acid levels, and BP in hypertensive patients with hyperuricemia. Patients received topiroxostat 40–160 mg/day or febuxostat 10–60 mg/day, titrated to maintain serum uric acid, This multicenter, randomised, open‐label study compared the effects of two xanthine oxidoreductase inhibitors, topiroxostat and feboxostat, on arterial stiffness, uric acid levels and blood pressure (BP) in hypertensive patients with hyperuricemia. Neither topiroxostat nor feboxostat had any significant effects on arterial stiffness (measured using the cardio‐ankle vascular index) over 24 weeks' treatment; but both agents significantly reduced serum uric acid levels and morning home systolic BP compared with baseline.

Introduction Pancreatic acinar cell carcinoma (ACC) is a relatively rare neoplasm. Furthermore, tumor rupture is extremely rare. Only 1 case of ruptured pancreatic ACC has been reported, and the long-term outcome of the case is unknown. Here, we present a case of spontaneously ruptured ACC with long-term survival after successful resection. Case Presentation A 67-year-old man was brought to our hospital by ambulance, presenting with progressive left abdominal pain. Laboratory data showed an increased inflammatory response, and contrast-enhanced computed tomography showed a mass in the pancreas tail with nonuniform enhancement in the early phase. Fluid collection was detected around the spleen to the left kidney. Spontaneous rupture of a pancreatic tumor was strongly suspected. After improvement of his general condition, the patient underwent resection of the pancreas and adjacent organs. The resected tumor was surrounded by organs and adipose tissue, so obvious exposure was not observed in the surgical margins. Pathologically, neither exposure of tumor cells at the surgical margins nor lymph node involvement was detected. The patient has survived 80 months since initial diagnosis without any evidence of recurrence. Conclusion Although ruptured pancreatic ACC has the potential for dissemination, surgical resection including adjacent organs remains an option for curative treatment.

A 71-year-old man was admitted to our institution complaining of abdominal pain and constipation. Barium enema examination revealed narrowing, cobble stoning, and longitudinal ulcerations in the sigmoid colon and upper rectum. Conventional colonoscopy, magnifying narrow-band imaging endoscopy, and magnifying chromoendoscopy revealed edematous mucosa, longitudinal ulcerations with luminal narrowing, and multiple pseudopolyps. The histologic examination of the biopsy specimens showed thick-walled (arterialized) capillaries and subendothelial fibrin deposits in the mucosa and submucosa. Based on a preoperative diagnosis of idiopathic myointimal hyperplasia of mesenteric veins (IMHMV), he underwent a laparoscopic resection of the sigmoid colon and upper rectum. The histologic examination of the resected specimens showed marked proliferation of venous walls with marked myointimal thickening and luminal occlusion from the submucosa to the mesentery throughout the entire resected tissue section. The final diagnosis was IMHMV.

This study investigated the effect of hydrogen on the substructure of martensite in Fe-31Ni alloy. In both the hydrogen-charged and uncharged specimens, typical lenticular martensite plates formed after subzero cooling. However, we found that the fraction of twinned region (including the area of midrib) in lenticular martensite plate increased with increasing hydrogen content. In addition, the width of individual twins in the hydrogen-charged specimen was slightly smaller than that in the uncharged specimen. These results indicated that the existence of hydrogen facilitated twinning deformation as a lattice invariant deformation. We presented a comprehensive discussion about the reason why hydrogen enhanced twinning deformation. Even though tetragonality of martensite in the hydrogen-charged specimen could not be confirmed by X-ray diffraction, the transmission electron microscopy observations and the first-principles calculations suggested that hydrogen might increase the tetragonality of martensite. We proposed that solid solution hardening and an increase in the tetragonality of martensite by the existence of hydrogen were the possible reasons for facilitating twinning deformation as a lattice invariant deformation in martensitic transformation.

This study uses first-principles calculations to investigate the effect of hydrogen on the chemical driving force of the transformation of iron from the face centered cubic (FCC) to hexagonal close packed (HCP) phase. The minimum energy path from FCC to HCP phases shows that FCC becomes stable with increasing hydrogen content. Furthermore, the energy difference between the FCC and HCP phases is observed to be smaller in Fe2H than in Fe throughout the temperature region. These results clearly explain the observed anomalous suppression of the martensitic transformation in the hydrogen-charged steel.

This paper provides new tools for philosophical argument analysis and fresh empirical foundations for ‘critical’ ordinary language philosophy. Language comprehension routinely involves stereotypical inferences with contextual defeaters. J.L. Austin’sSense and Sensibiliafirst mooted the idea that contextually inappropriate stereotypical inferences from verbal case-descriptions drive some philosophical paradoxes; these engender philosophical problems that can be resolved by exposing the underlying fallacies. We build on psycholinguistic research on salience effects to explain when and why even perfectly competent speakers cannot help making stereotypical inferences which are contextually inappropriate. We analyse a classical paradox about perception (‘argument from illusion’), suggest it relies on contextually inappropriate stereotypical inferences from appearance-verbs, and show that the conditions we identified as leading to contextually inappropriate stereotypical inferences are met in formulations of the paradox. Three experiments use a forced-choice plausibility-ranking task to document the predicted inappropriate inferences, in English, German, and Japanese. The cross-linguistic study allows us to assess the wider relevance of the proposed analysis. Our findings open up new perspectives for ‘evidential’ experimental philosophy.

The effects of Mn, Cr, and Ni addition on the hydrogen diffusion behavior in BCC, FCC, and HCP Fe was investigated by means of first-principles calculations. Diffusion coefficients were estimated quantitatively from the migration energy calculated by the nudged elastic band method and the vibrational energy at every stable and metastable site. The addition of Mn, Cr, and Ni to a BCC lattice has a blocking effect on hydrogen diffusion and decreases the diffusion coefficient of hydrogen. Crystal orbital Hamilton population (COHP) analysis revealed that the weakened bonding between the added element and hydrogen is the origin of the blocking effect. On the other hand, the addition of Mn, Cr, and Ni to FCC and HCP lattices resulted in the formation of hydrogen trap sites. In the FCC case, the diffusion coefficients of Fe31MnH, Fe31CrH, and Fe32H, showed similar values, while that of Fe31NiH was lower. In the HCP case, the diffusion coefficients of the three additional elements showed a decreasing trend. Based on the results of the COHP analysis, we conclude that the octahedral interstitial sites around the additional elements become trap sites in FCC and HCP Fe due to the strengthened bonding between Fe and H.

Inhibitors of vascular endothelial growth factor (VEGF)-VEGF receptor 2 (VEGFR2) signaling, such as bevacizumab (Bmab), are used for the treatment of various advanced cancers. However, these inhibitors induce renal thrombotic microangiopathy (TMA). Recently, two European cohort studies showed a distinctive histopathological pseudothrombotic pattern different from TMA in Bmab-treated patients. We analyzed 9 renal biopsies from proteinuric cancer patients treated with VEGF-VEGFR2 inhibitors in our Japanese cohort. Clinical and laboratory features were also assessed in these patients. All 9 patients had moderate to heavy proteinuria with normal or slightly elevated serum creatinine levels. On light microscopy, a patchy pattern of hemispherical/spherical lesions along glomerular capillary walls was a characteristic finding. On immunofluorescence microscopy, staining for immunoglobulins (IgM dominant) at varying intensities was observed mainly along glomerular capillary walls. Especially, hemispherical/spherical positive staining for immunoglobulins was a characteristic pattern. Immunohistochemical studies showed positive staining for immunoglobulins and negative staining for CD61-positive platelets in capillary hemispherical/spherical lesions and positive VEGF staining in podocytes. On electron microscopy, variably electron-dense material in dilated glomerular capillaries and partial effacement of podocyte foot processes were observed. After the withdrawal of VEGF-VEGFR2 inhibitors, proteinuria improved without any specific treatment in 8 patients. Histopathological findings in our patients treated with VEGF-VEGFR2 inhibitors were consistent with those observed in the recently described new form of Bmab-associated hyaline occlusive glomerular microangiopathy. This form should be considered in proteinuric cancer patients treated with VEGF-VEGFR2 inhibitors. Discontinuing VEGF-VEGFR2 inhibitors may lead to improvement of glomerular microangiopathy induced by these drugs.

We determined the usefulness and prognostic ability of the renal risk score (RRS), proposed in Europe, for Japanese patients with antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (AAGN) and high myeloperoxidase (MPO)-ANCA positivity; these aspects remain to be verified.This retrospective study was conducted on 86 Japanese patients with new, biopsy-confirmed AAGN. We calculated the RRS and analyzed the relationship between this classification, and clinicopathological features and prognosis. We also compared the predictive values between RRS for endpoints including renal death and conventional prognostic tools for patients with AAGN.There were 33, 37, and 16 patients in the low-, medium-, and high-risk groups, respectively. All patients were MPO-ANCA positive. The median follow-up period was 33 months; 16 (18.6%) patients progressed to end-stage renal disease (ESRD). In the high-risk group, 9/16 (56.3%) patients progressed to ESRD, and renal prognosis was significantly poorer than that in other groups (low-risk group, P 0.001; medium-risk group, P = 0.004). In Cox multivariate regression analysis, RRS was an independent, poor renal prognostic factor (hazard ratio 5.22; 95% confidence interval 2.20-12.40; P 0.001). The receiver-operating characteristic curves of the RRS for each endpoint were comparable with those of the 2010 histological classification and those of the severity classification of Japanese rapidly progressive glomerulonephritis.This is the first study to report the usefulness of the RRS for predicting renal outcomes among Japanese patients with AAGN. Our predictive value of the RRS was comparable with that of conventional prognostic tools.

A 69-year-old woman, who complained of appetite loss, was diagnosed with Type 3 gastric cancer, and a biopsy resulted in the diagnosis of adenocarcinoma(tub2-por), Group 5. Abdominal computed tomography (CT) revealed bulky metastatic lymph nodes around the stomach and the aorta. The diagnosis was cT4a, cN2, cM1(LYM), cStage ⅣB, and SP therapy(a combination of S-1 and cisplatin) was immediately administered. On the completion of 3 courses of SP therapy, both the primary tumor and lymph nodes markedly decreased in size. Based on this finding, D2 total gastrectomy, No. 16 lymph node dissection, splenectomy, and right adrenal tumor resection were performed. Histopathology showed no residual tumor cells in the stomach or lymph nodes. Postoperatively, she received S-1 therapy, which was discontinued on completion of the first course due to its side effects. She survived for over 7 years postoperatively without receiving chemotherapy and showed no recurrence.

Results from DFT calculations are in many cases equivalent to experimental data. They describe a set of properties of a phase at a well-defined composition and temperature, T, most often at 0 K. In order to be practically useful in materials design, such data must be fitted to a thermodynamic model for the phase to allow interpolations and extrapolations. The intention of this paper is to give a summary of the state of the art by using the Calphad technique to model thermodynamic properties and calculate phase diagrams, including some models that should be avoided. Calphad models can decribe long range ordering (LRO) using sublattices and there are model parameters that can approximate short range ordering (SRO) within the experimental uncertainty. In addition to the DFT data, there is a need for experimental data, in particular, for the phase diagram, to determine the model parameters. Very small differences in Gibbs energy of the phases, far smaller than the uncertainties in the DFT calculations, determine the set of stable phases at varying composition and T. Thus, adjustment of the DFT results is often needed in order to obtain the correct set of stable phases.

Introduction This study was designed to identify the minimal and necessary cell morphologies to be considered for high-precision diagnosis of high-grade urothelial carcinoma (HGUC) in a routine urinary cytology practice. Materials and methods We included 338 urine cytology specimens from 11 medical facilities in Japan. Six experts evaluated these Papanicolaou-stained specimens using their own diagnostic criteria to categorize them within an initial 4-tiered classification system. Of the 338 cases, 70 HGUC and 32 benign cases (with a complete consensus diagnosis of 6 experts) were included for the analysis. Two of the cytologists evaluated the specimens for 20 specific cellular features. The results were analyzed using a contingency table and by discriminant analysis. Results Of the original 338 cases, 165 were originally diagnosed as HGUC, but only 70 (42.4%) were scored as malignant by all participating cytologists; of the 101 benign cases, only 32 (31.7%) were classified as such in all examinations. These specimens were re-evaluated by 6 experts using a panel of 20 specific cellular features used to distinguish between HGUC and benign diseases; tests of significance and discriminant analyses identified 7 critical features that were most useful for cytological diagnosis. Statistical analysis revealed that a focus on these 7 features led to a diagnosis of HGUC with a probability of over 95%. Conclusions The accuracy of our presently used method to evaluate urinary cytology is not consistently high. This novel classification system, which focuses on 7 critical features, facilitates the high accurate diagnosis of HGUC in routine cytology practice.

An overview of the Seimei telescope, a 3.8 m optical infrared telescope located on Mt. Chikurinji in the Okayama prefecture of Japan, is presented. Seimei is a segmented-mirror telescope whose primary mirror consists of 18 petal-shaped segments. The telescope tube supporting the thin segmented mirrors is structurally incorporated within large arc-rails providing the elevation axis. The tube has a light-weight homologous structure designed with a genetic algorithm. The total weight of the telescope tube, including 1.4-ton optics, is only 8 tons. By virtue of its light weight, the telescope is able to point at an object anywhere in the observable sky within one minute. The telescope is operated by Kyoto University in collaboration with the National Astronomical Observatory of Japan (NAOJ). Half of the telescope time is used by Kyoto University. The remaining time is open to the Japanese astronomical community. NAOJ is responsible for the management of the open-use time, including handling of the observation proposals. The telescope is now regularly performing scientific observations on the basis of a variety of proposals.

Background Patients with some mutations in the lamin A/C (LMNA) gene are characterized by the presence of dilated cardiomyopathy (DCM), conduction abnormalities, ventricular tachyarrhythmias (VT), and sudden cardiac death (SCD). Various clinical features have been observed among patients who have the same LMNA mutation. Here, we show a family with cardiac laminopathy with a c.475G > T, p.E159* LMNA mutation, and a family history of conduction disorder, DCM, VT, and SCD. Case presentation A proband (female) with atrial fibrillation and bradycardia was implanted with a pacemaker in her fifties. Twenty years later, she experienced a loss of consciousness due to polymorphic VT. She had a serious family history; her mother and elder sister died suddenly in their fifties and sixties, respectively, and her nephew and son were diagnosed as having DCM. Genetic screening of the proband, her son, and nephew identified a nonsense mutation (c.475G > T, p.E159*) in the LMNA gene. Although the proband’s left ventricular ejection fraction remained relatively preserved, her son and nephew’s left ventricular ejection fraction were reduced, resulting in cardiac resynchronization therapy by implantation of a defibrillator. Conclusions In this family with cardiac laminopathy with a c.475G > T, p.E159* LMNA mutation, DCM, SCD, and malignant VT occurred. Clinical manifestation of various atrial and ventricular arrhythmias and heart failure with reduced ejection fraction occurred in an age-dependent manner in all family members who had the nonsense mutation. It appears highly likely that the E159* LMNA mutation is related to various cardiac problems in the family of the current report.

The hydrogen diffusion behavior in BCC, FCC, and HCP iron has been investigated by means of first-principles calculations. Diffusion coefficients were estimated quantitatively from the migration energy derived by the Nudged elastic band method, and phonon calculations including the vibrations of all atoms at every stable and metastable site. Our calculations on the BCC structure show good agreement with those in the previous report. In the FCC structure as well, the calculated diffusion coefficients are in good agreement with experimental data. Our results suggest that the consideration of the antiferromagnetic state in FCC is important for the reproduction of experimental results. For the HCP structure, although there was a lack of systematic experimental results, our calculations predict that the diffusion coefficient is smaller than that in the case of the FCC sample. In the HCP lattice, there are two diffusion paths: one parallel to the c-axis and the other in the c-plane. The direction and the diffusion coefficient can be controlled by the tuning of c/a, which is the ratio of the lattice constants.

To investigate the stability of various Mg-based Laves phases, the formation enthalpy and phonon dispersion were obtained by first-principles calculation. The calculated formation enthalpy and phonon dispersion indicate that MgX2 (X = Al, Co, Ni, Cu, Zn) and Mg2X (X = Ca, Sr, Y, Ba, La) are stable both statically and dynamically. These results are consistent with the experimental results except for MgAl2 and Mg2La. These compounds are considered to be in a metastable state in each binary system. We also used the cluster expansion method to examine the possibility of adding a third element to MgZn2. Our theoretical investigations suggest attractive interaction between Zn and a third element such as Ag, Ca, and Zr in the MgZn2 lattice. However, Ca and Zr replace a small amount of Zn in MgZn2 owing to the instability of MgCa2 and MgZr2, in agreement with the experimental result. Furthermore, it is suggested that Zr becomes stable at the Mg site in the MgZn2 lattice owing to the stability of ZrZn2.

For the potential new permanent magnet materials, SmFe 12 -based compounds, Ti plays an important role in stabilizing the SmFe 12 -based structures. Thermodynamic properties of the systems relating to Sm–Fe–Ti ternary system become indispensable for the future development of the SmFe 12 -based magnets. In order to construct the multi-component thermodynamic database for SmFe 12 -based compounds, the thermodynamic properties and phase diagram of Sm–Ti binary system is necessary. In this work, we attempted to construct the Sm–Ti binary thermodynamic database using data obtained mainly from first-principles. First-principles calculations are performed to obtain the Gibbs energy of ordered and disordered structures within the binary system and used for parameterized the Gibbs energy descriptions of various phases in the Sm–Ti binary system through the CALPHAD methodology, the first Sm–Ti phase diagram has been calculated accordingly.

A thermodynamic analysis of the Fe-Ti-S ternary system was performed by incorporating first-principles calculations into the calculation of phase diagrams (CALPHAD) method. To evaluate the Gibbs energy, the Debye-Gruneisen model was applied for some sulfides of the Ti-S binary system. In addition, the cluster expansion and cluster variation methods were used for the solid solution phases in the Ti-S binary and (Fe,Ti)S phases. The calculated Ti-S binary phase diagram showed good agreement with the experimental results. The very low solubility of the Ti solid solution in the Ti-S system, as reported by Murray, agreed well with our calculated results. A binodal phase decomposition of the liquid phase was expected in the S-rich region. The Gibbs energy curve of (Fe,Ti)S between FeS and TiS was found to be convex downward. This is characteristic of an isomorphic solid solution, attributed to the attractive interaction between Fe and Ti in (Fe,Ti)S. The vertical phase diagram between FeS and TiS, obtained using the thermodynamic database, was in good agreement with the experimental results of Mitsui et al. The solubility products of (Fe,Ti)S have been experimentally estimated previously. The calculated solubility product agreed with the experimental value of TiS.

In the scholarship on Wittgenstein’s later philosophy of mathematics, the dominant interpretation is a theoretical one that ascribes to Wittgenstein some type of ‘ism’ such as radical verificationism or anti-realism. Essentially, he is supposed to provide a positive account of our mathematical practice based on some basic assertions. However, I claim that he should not be read in terms of any ‘ism’ but instead should be read as examining philosophical pictures in the sense of unclear conceptions. The contrast here is that basic assertions that frame philosophical ‘isms’ are propositional such that they are subject to normal argumentative evaluation, while pictures in Wittgenstein’s sense are non-propositional—they lack a clear truth condition. They, therefore, need clarification rather than argumentation. In this paper, I provide a detailed analysis of Wittgenstein’s treatment of philosophical pictures with special focus on his argument on contradiction. I begin by explaining the problem with this trend of theoretical interpretation, taking Steve Gerrard’s otherwise excellent interpretation as a representative example and pointing out why it is problematic. Next, I will argue that those problems do not arise if we take Wittgenstein’s task as the clarification of philosophical pictures. I do this, first, by explaining Wittgenstein’s method using his argument concerning the Augustinian Picture in Philosophical Investigations and then pointing out that the same method can be identified in the crucial arguments in his philosophy of mathematics. Finally, in order to connect my interpretation with the current scholarship, I will explain the relation of my interpretation with those of New Wittgensteinian scholars.