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Abstract Background A decreased glomerular filtration rate (GFR), estimated using creatinine (Cr– eGFR), is often found at the initial presentation of anorexia nervosa (AN). Its pathophysiology has been explained mainly by dehydration, and chronic hypokalemia is also thought to be a cause. However, because we have often experienced cases of AN with decreased Cr-eGFR without these conditions, we must consider different etiologies. The focus of this paper is on low free triiodothyronine (FT3) syndrome. We also discuss the utility of eGFR, estimated using cystatin-C (CysC-eGFR), for these patients. Methods The data of 39 patients diagnosed with AN between January 2005 and December 2023 was available for study. The characteristics of patients at the lowest and highest body mass index standard deviation score (BMI-SDS) were examined. Data on the parameters Cr-eGFR, CysC-eGFR, dehydration markers, potassium (K), and hormonal data and BMI-SDS were assessed during the treatment course to evaluate the correlations in these parameters. Blood hematocrit, uric acid (UA), blood urine nitrogen (BUN) level, and urine specific gravity were adopted as dehydration markers; FT3, free thyroxine, thyroid stimulating hormone, and insulin-like growth factor were adopted as hormonal data. Cr-eGFR and simultaneously evaluated dehydration markers, K, or hormonal data were extracted and correlations associated with the changes in BMI-SDS were examined. Furthermore, Cr-eGFR and simultaneously assessed CysC-eGFR were compared. Results When the BMI-SDS was at the lowest value, low-FT3 syndrome was shown. Severe hypokalemia was not found in our study. A linear relation was not found between Cr-eGFR and BMI-SDS. A statistically significant correlation was found between Cr-eGFR and FT3 (p = 0.0025). Among the dehydration markers, statistically significant correlations were found between Cr-eGFR and BUN or UA. The difference between Cr-eGFR and CysC-eGFR was prominent, and CysC-eGFR showed much higher values. Conclusions Our data indicates that low-FT3 syndrome and dehydration were related to the renal function of our patients with AN. Furthermore, our data suggest that caution is needed in the interpretation of kidney function evaluation when using CysC-eGFR in cases of AN.

Abstract Background Evidence regarding the association between hyperuricemia and arrhythmia recurrence after catheter ablation for paroxysmal atrial fibrillation (AF) is scarce. We investigated whether hyperuricemia predicts arrhythmia recurrence after catheter ablation for paroxysmal AF and the relationship between hyperuricemia and alcohol consumption in AF recurrence. Methods Patients who underwent catheter ablation for paroxysmal AF were divided into the hyperuricemia (index serum uric acid [UA] >7.0 mg/dL; n = 114) and control (UA ≤7.0 mg/dL; n = 609) groups and were followed for a median of 24 (12–48) months after ablation. Results The hyperuricemia group had more patients with an alcohol intake of ≥20 g/day (33.3% vs. 22.7%, p = .017) and a lower incidence of AF‐free survival (p = .019). Similarly, those with an alcohol intake of ≥20 g/day had a lower incidence of AF‐free survival than other patients. Multivariate Cox regression analysis revealed the following independent predictors of AF recurrence (adjusted hazard ratio, 95% confidence interval): hyperuricemia (1.64, 1.12–2.40), female gender (1.91, 1.36–2.67), brain natriuretic peptide level >100 pg/mL (1.59, 1.14–2.22), and alcohol consumption ≥20 g/day (1.49, 1.03–2.15) (all p

IntroductionOsteogenesis imperfecta (OI) is a congenital skeletal disorder characterized by bone fragility. Bisphosphonates (BISs) have become the mainstream treatment in children with OI. However, an optimal treatment protocol has not yet been established, while BIS treatment tends to be administered to normalize bone mineral density (BMD). Bone quality is an important component of bone strength. The trabecular bone score (TBS) is a quantitative measure of the microstructure that affects bone quality. This study investigated the TBS during BIS treatment in children with OI.Materials and methodsTwenty-nine children with OI were enrolled and classified into two groups: mild (type 1) and moderate to severe (types 3 and 4). Dual-energy x-ray absorptiometry images were retrospectively analyzed for TBS calculation. The relationship between the areal BMD (aBMD), its Z-score, height-adjusted BMD (BMDHAZ) Z-score, TBS, and TBS Z-score with the treatment duration was assessed for each group.ResultsIn the mild group, the aBMD, its Z-score, and BMDHAZ Z-score showed a significant positive correlation with treatment duration (r = 0.68, 0.68, 0.72, respectively, p

This study explores Human Activity Recognition (HAR) using smartphone sensors to address the challenges posed by position-dependent datasets. We propose a position-independent system that leverages data from accelerometers, gyroscopes, linear accelerometers, and gravity sensors collected from smartphones placed either on the chest or in the left/right leg pocket. The performance of traditional machine learning algorithms (Decision Trees (DT), K-Nearest Neighbors (KNN), Random Forest (RF), Support Vector Classifier (SVC), and XGBoost) is compared against deep learning models (Gated Recurrent Unit (GRU), Long Short-Term Memory (LSTM), Temporal Convolutional Networks (TCN), and Transformer models) under two sensor configurations. Our findings highlight that the Temporal Convolutional Network (TCN) model consistently outperforms other models, particularly in the four-sensor non-overlapping configuration, achieving the highest accuracy of 97.70%. Deep learning models such as LSTM, GRU, and Transformer also demonstrate strong performance, showcasing their effectiveness in capturing temporal dependencies in HAR tasks. Traditional machine learning models, including RF and XGBoost, provide reasonable performance but do not match the accuracy of deep learning models. Additionally, incorporating data from linear accelerometers and gravity sensors led to slight improvements over using accelerometer and gyroscope data alone. This research enhances the recognition of passenger behaviors for intelligent transportation systems, contributing to more efficient congestion management and emergency response strategies.

Key Clinical Message This case of non‐nodal mantle cell lymphoma (MCL) showcases atypical hairy cell‐like features, distinguishing it via next‐generation sequencing. Despite a TP53 mutation indicating poor prognosis, our case followed an indolent course, highlighting the importance of genetic testing and phenotypical examination in MCL.

Introduction: As inhibitors of advanced glycation end products (AGEs), such as pyridoxamine, significantly inhibit the development of retinopathy and neuropathy in rats with streptozotocin-induced diabetes, treatment with AGE inhibitors is believed to be a potential strategy for the prevention of aging, age-related diseases, and lifestyle-related diseases, including diabetic complications. In the present study, the MeOH extract of Epimedii Herba (EH; aerial parts of Epimedium spp.) was found to inhibit the formation of Nε-(carboxymethyl)lysine (CML) and Nω-(carboxymethyl) arginine (CMA) during the incubation of collagen-derived gelatin with ribose.Materials and methods: EH was purchased from Uchida Wakan-yaku Co., and a MeOH extract was prepared. Several steps of column chromatography purified the extract. Each fraction was tested for inhibitory activity by ELISA using monoclonal antibodies for CML and CMA.Results: After activity-guided fractionation and purification by column chromatography, three new prenylflavonoids [named Koreanoside L (1), Koreanoside E1 (2), and Koreanoside E2 (3)] and 40 known compounds (4–43) were isolated from EH, and their inhibitory effects against CML and CMA formation were tested. Among these, epimedokoreanin B (8), epimedonin E (21), epicornunin B (22), and epicornunin F (24) inhibited the formation of both CML and CMA, with epimedokoreanin B (8) having the most potent inhibitory effect among the isolated compounds. To obtain the structure–activity relationships of 8, the phenolic hydroxy groups of 8 were methylated by trimethylsilyl-diazomethane to afford the partially and completely methylated compounds of 8. Prenyl derivatives of propolis (artepillin C, baccharin, and drupanin) were used in the assay.Discussion: As only 8 showed significant activity among these compounds, the catechol group of the B ring and the two prenyl groups attached to the flavanone skeleton were essential for activity. These data suggest that 8 could prevent the clinical complications of diabetes and age-related diseases by inhibiting AGEs.

Facing the escalating global challenge of frequent and severe heatwaves, this study meticulously assesses heatwave dynamics across urban and nonurban areas in central Thailand. It introduces a novel workflow integrating ground-based observations with satellite-derived land surface temperature data over 39 years (1981–2019). Our findings reveal a significant increase in daytime heatwaves in urban and peri-urban areas, with notable rises in the number, frequency, duration, and amplitude of heatwaves. Conversely, nighttime heatwaves intensify mainly in rural areas. Land surface temperature data show distinct patterns: peri-urban regions experience significant daytime increases in heatwave magnitude, amplitude, and frequency, contrasting with varied trends in urban and rural settings. The annual pattern of heatwave characteristics across specific regions reveals that daytime occurrences are more frequent and intense in peri-urban zones such as Pathum Thani and eastern Bangkok, with annual episodes ranging from 2 to 9 and durations of 10 to 39 days. In contrast, urban areas such as downtown Bangkok are more prone to nighttime heatwaves, with a wider occurrence range of 3 to 12 events and longer durations, lasting from 13 to 62 days annually. Overall, this research advances traditional methods by offering a nuanced view of heatwave dynamics and highlighting the potential of remote sensing to identify risk areas. The study demonstrates how this precise technique can identify extreme weather events and support sustainable climate practices, government policy, and decision-making, all of which are crucial for enhancing resilience and addressing the growing threat of heat-related health risks.

Urban planning and management increasingly depend on accurate building and population data. However, many regions lack sufficient resources to acquire and maintain these data, creating challenges in data availability. Our methodology integrates multiple data sources, including aerial imagery, Points of Interest (POIs), and digital elevation models, employing Light Gradient Boosting Machine (LightGBM) and Gradient Boosting Decision Tree (GBDT) to classify building uses and morphological filtration to estimate heights. This research contributes to bridging the gap between data needs and availability in resource-constrained urban environments, offering a scalable solution for global application in urban planning and population mapping.

In response to the urgent global threat posed by human-induced extreme climate hazards, heatwaves are still systematically under-reported and under-researched in Thailand. This region is confronting a significant rise in heat-related mortality, which has resulted in hundreds of deaths, underscoring a pressing issue that needs to be addressed. This research article is one of the first to present a solution for assessing heatwave dynamics, using machine learning (ML) algorithms and geospatial technologies in this country. It analyzes heatwave metrics like heatwave number (HWN), heatwave frequency (HWF), heatwave duration (HWD), heatwave magnitude (HWM), and heatwave amplitude (HWA), combining satellite-derived land surface temperature (LST) data with ground-based air temperature (Tair) observations from 1981 to 2019. The result reveals significant marked increases in both the frequency and intensity of daytime heatwaves in peri-urban areas, with the most pronounced changes being a 0.45-day/year in HWN, a 2.00-day/year in HWF, and a 0.27-day/year in HWD. This trend is notably less pronounced in urban areas. Conversely, rural regions are experiencing a significant escalation in nighttime heatwaves, with increases of 0.39 days/year in HWN, 1.44 days/year in HWF, and 0.14 days/year in HWD. Correlation analysis (p<0.05) reveals spatial heterogeneity in heatwave dynamics, with robust daytime correlations between Tair and LST in rural (HWN, HWF, HWD, r>0.90) and peri-urban (HWM, HWA, r>0.65) regions. This study emphasizes the importance of considering microclimatic variations in heatwave analysis, offering insights for targeted intervention strategies. It demonstrates how enhancing remote sensing with ML can facilitate the spatial–temporal analysis of heatwaves across diverse environments. This approach identifies critical risk areas in Thailand, guiding resilience efforts and serving as a model for managing similar microclimates, extending the applicability of this study. Overall, the study provides policymakers and stakeholders with potent tools for climate action and effective heatwave management. Furthermore, this research contributes to mitigating the impacts of extreme climate events, promoting resilience, and fostering environmental sustainability.

Analog memory presents a promising solution in the face of the growing demand for energy-efficient artificial intelligence (AI) at the edge. In this study, we demonstrate efficient deep neural network transfer learning utilizing hardware and algorithm co-optimization in an analog resistive random-access memory (ReRAM) array. For the first time, we illustrate that in open-loop deep neural network (DNN) transfer learning for image classification tasks, convergence rates can be accelerated by approximately 3.5 times through the utilization of co-optimized analog ReRAM hardware and the hardware-aware Tiki-Taka v2 (TTv2) algorithm. A simulation based on statistical 14 nm CMOS ReRAM array data provides insights into the performance of transfer learning on larger network workloads, exhibiting notable improvement over conventional training with random initialization. This study shows that analog DNN transfer learning using an optimized ReRAM array can achieve faster convergence with a smaller dataset compared to training from scratch, thus augmenting AI capability at the edge.

Consciousness is thought to be regulated by bidirectional information transfer between the cortex and thalamus, but the nature of this bidirectional communication - and its possible disruption in unconsciousness - remains poorly understood. Here, we present two main findings elucidating mechanisms of corticothalamic information transfer during conscious states. First, we identify a highly preserved spectral channel of cortical-thalamic communication that is present during conscious states, but which is diminished during the loss of consciousness and enhanced during psychedelic states. Specifically, we show that in humans, mice, and rats, information sent from either the cortex or thalamus via δ/θ/α waves (∼1–13 Hz) is consistently encoded by the other brain region by high γ waves (52–104 Hz); moreover, unconsciousness induced by propofol anesthesia or generalized spike-and-wave seizures diminishes this cross-frequency communication, whereas the psychedelic 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) enhances this low-to-high frequency interregional communication. Second, we leverage numerical simulations and neural electrophysiology recordings from the thalamus and cortex of human patients, rats, and mice to show that these changes in cross-frequency cortical-thalamic information transfer may be mediated by excursions of low-frequency thalamocortical electrodynamics toward/away from edge-of-chaos criticality, or the phase transition from stability to chaos. Overall, our findings link thalamic-cortical communication to consciousness, and further offer a novel, mathematically well-defined framework to explain the disruption to thalamic-cortical information transfer during unconscious states.

Background. Autoimmune hemolytic anemia (AIHA) associated with solid tumors such as mature cystic teratomas is rare and poorly understood. Here, we report a successfully treated case of secondary AIHA in a mature cystic teratoma containing antibodies against red blood cells. Case description. A 22-year-old woman was referred to our hospital with progressive anemia. Laboratory findings revealed hemolysis with a positive direct and indirect antiglobulin test. Imaging studies identified a left ovarian mass, suspected to be a mature cystic teratoma, which was later confirmed by histopathology after laparoscopic oophorocystectomy. The patient was treated with prednisolone, resulting in improved anemia. To examine the relationship between the tumor and AIHA, an indirect antiglobulin test was performed on the tumor contents. Stronger aggregations were observed at any concentration diluted by 10 times from 10 to 10,000 times of the tumor contents compared to the patient’s serum. Additionally, immunofixation electrophoresis of the tumor contents revealed the presence of monoclonal immunoglobulin G-κ. Conclusion. The presence of monoclonal IgG-κ in the tumor suggests intratumoral antibody production as a possible mechanism. Further research is necessary to elucidate the pathogenic relationship between such tumors and AIHA. The report also highlights the importance of considering secondary AIHA in patients with unexplained anemia and solid tumors.

This review addressed the recent progress of sintered reaction‐bonded Si3N4 (SRBSN) ceramics which are expected to be used as ceramic substrates of the next-generation power devices. Following an overview of thermal conductivities of Si3N4 ceramics and their improvement strategies, we described the advantages of the SRBSN routes. Because of the low content of lattice oxygen, the SRBSN ceramics possess significantly high thermal conductivities, compared to Si3N4 ceramics prepared by conventional methods. This material also showed exceptionally high fracture toughness and the strong rising R-curve behavior. The properties of the SRBSN ceramics are largely affected by the nitridation conditions, including the temperature, pressure and heating rate, and the sintering additive ratios. The thermal fatigue tests revealed the excellent thermal fatigue resistance of the SRBSN substrates, compared with those of other ceramic substrates. The strength retention ratio after thermal fatigue was clearly proportional to the fracture toughness. The dielectric breakdown strength (DBS) of the SRBSN ceramics with large fibrous grains showed a thickness dependency reverse to the normal (lower DBS in thinner substrates).

Abstract CUX2 gene encodes a transcription factor that controls neuronal proliferation, dendrite branching and synapse formation, locating at the epilepsy-associated chromosomal region 12q24 that we previously identified by a genome-wide association study (GWAS) in Japanese population. A CUX2 recurrent de novo variant p.E590K has been described in patients with rare epileptic encephalopathies and the gene is a candidate for the locus, however the mutation may not be enough to generate the genome-wide significance in the GWAS and whether CUX2 variants appear in other types of epilepsies and physiopathological mechanisms are remained to be investigated. Here in this study, we conducted targeted sequencings of CUX2, a paralog CUX1 and its short isoform CASP harboring a unique C-terminus on 271 Japanese patients with a variety of epilepsies, and found that multiple CUX2 missense variants, other than the p.E590K, and some CASP variants including a deletion, predominantly appeared in patients with temporal lobe epilepsy (TLE). The CUX2 variants showed abnormal localization in human cell culture analysis. While wild-type CUX2 enhances dendritic arborization in fly neurons, the effect was compromised by some of the variants. Cux2- and Casp-specific knockout mice both showed high susceptibility to kainate, increased excitatory cell number in the entorhinal cortex, and significant enhancement in glutamatergic synaptic transmission to the hippocampus. CASP and CUX2 proteins physiologically bound to each other and co-expressed in excitatory neurons in brain regions including the entorhinal cortex. These results suggest that CUX2 and CASP variants contribute to the TLE pathology through a facilitation of excitatory synaptic transmission from entorhinal cortex to hippocampus.

Severe plastic deformation (SPD) is effective in producing bulk ultrafine-grained and nanostructured materials with large densities of lattice defects. This field, also known as NanoSPD, experienced a significant progress within the past two decades. Beside classic SPD methods such as high-pressure torsion, equal-channel angular pressing, accumulative roll-bonding, twist extrusion, and multi-directional forging, various continuous techniques were introduced to produce upscaled samples. Moreover, numerous alloys, glasses, semiconductors, ceramics, polymers, and their composites were processed. The SPD methods were used to synthesize new materials or to stabilize metastable phases with advanced mechanical and functional properties. High strength combined with high ductility, low/room-temperature superplasticity, creep resistance, hydrogen storage, photocatalytic hydrogen production, photocatalytic CO2 conversion, superconductivity, thermoelectric performance, radiation resistance, corrosion resistance, and biocompatibility are some highlighted properties of SPD-processed materials. This article reviews recent advances in the NanoSPD field and provides a brief history regarding its progress from the ancient times to modernity. Abbreviations: ARB: Accumulative Roll-Bonding; BCC: Body-Centered Cubic; DAC: Diamond Anvil Cell; EBSD: Electron Backscatter Diffraction; ECAP: Equal-Channel Angular Pressing (Extrusion); FCC: Face-Centered Cubic; FEM: Finite Element Method; FSP: Friction Stir Processing; HCP: Hexagonal Close-Packed; HPT: High-Pressure Torsion; HPTT: High-Pressure Tube Twisting; MDF: Multi-Directional (-Axial) Forging; NanoSPD: Nanomaterials by Severe Plastic Deformation; SDAC: Shear (Rotational) Diamond Anvil Cell; SEM: Scanning Electron Microscopy; SMAT: Surface Mechanical Attrition Treatment; SPD: Severe Plastic Deformation; TE: Twist Extrusion; TEM: Transmission Electron Microscopy; UFG: Ultrafine Grained

The authors show that fear-memory-related cell-ensembles in the amygdala, hippocampus, and prefrontal cortex are inter-regionally co-activated in post-learning sleep. The co-activations are hosted by fast network oscillations and re-appear during recall.

Abstract Under normal conditions, fasting results in decreased protein disulfide isomerase (PDI) activity and accumulation of unfolded proteins, leading to the subsequent activation of the unfolded protein response (UPR)/autophagy signaling pathway to eliminate damaged mitochondria. Fasting also induces upregulation of thioredoxin-interacting protein (TXNIP) expression and mice deficient of this protein (TXNIP-KO mice) was shown to develop severe hypoglycemia, hyperlipidemia and liver steatosis (LS). In the present study, we aimed to determine the role of TXNIP in fasting-induced LS by using male TXNIP-KO mice that developed LS without severe hypoglycemia. In TXNIP-KO mice, fasting induced severe microvesicular LS. Examinations by transmission electron microscopy revealed mitochondria with smaller size and deformities and the presence of few autophagosomes. The expression of β-oxidation-associated genes remained at the same level and the level of LC3-II was low. PDI activity level stayed at the original level and the levels of p-IRE1 and X-box binding protein 1 spliced form (sXBP1) were lower. Interestingly, treatment of TXNIP-KO mice with bacitracin, a PDI inhibitor, restored the level of LC3-II after fasting. These results suggest that TXNIP regulates PDI activity and subsequent activation of the UPR/autophagy pathway and plays a protective role in fasting-induced LS.

The purpose of this study is to systematically relate research on effectuation with that on business models, and to propose a starting point for the derivation of marketing implications. The results show that possible connection of studies in these two areas can be examined by focusing on the hierarchy of corporate business processes and systems. Using interviews with three entrepreneurs obtained from practice-based research, this paper examines effectuation decision making of individual entrepreneurs in relation to frameworks used in business model research and development practice, such as value proposition, pivot, and product market fit. We discuss effectuation decision making by individual entrepreneurs in a company, and we show that effectuation decision making by such individuals can be connected to group decision making by utilizing the framework of business model research.

Objectives: We investigated the protection performance of whole gloves by developing a straightforward permeability resistance method and evaluating the permeation over 480 min. Methods: The permeation time for toluene was obtained for seven glove types according to the Japanese Industrial Standards. In addition, the permeability resistance of whole gloves was evaluated from the ratio of collected amount of toluene in the passive layered sampler attached to the inside and outside of the glove. Results: The permeation times of the two types of polyurethane gloves evaluated were less than 1 min each. However, the percentages of toluene that permeated through the whole gloves determined by the developed method were 32.5% and 6.8% for the thin and thick gloves, respectively, at 480 min and 71.8% and 24.1% for the thin and thick gloves, respectively, at 1,440 min. Permeation times for all three types of layered films were more than 1,440 min, but the whole glove tests showed differences of 1.7%, 3.1%, and less than 0.1% at 1,440 min. The causes of these differences were assumed to be related to variations in thickness, type of material, and differences in deposition state of the various gloves. Conclusions: It became possible to grasp the permeation performance throughout whole chemical resistant gloves, which could not be known only with material testing, using a straightforward permeability test method.

Background and aims Emergency endoscopic hemostasis for colonic diverticular bleeding is effective in preventing serious consequences. However, the low identification rate of the bleeding source makes the procedure burdensome for both patients and providers. We aimed to establish an efficient and safe emergency endoscopy system. Methods We prospectively evaluated the usefulness of a scoring system (Jichi Medical University diverticular hemorrhage score: JD score) based on our experiences with past cases. The JD score was determined using four criteria: CT evidence of contrast agent extravasation, 3 points; oral anticoagulant (any type) use, 2 points; C-reactive protein ≥1 mg/dL, 1 point; and comorbidity index ≥3, 1 point. Based on the JD score, patients with acute diverticular bleeding who underwent emergency or elective endoscopy were grouped into JD ≥3 or JD Results The JD ≥3 and JD Conclusion We established a safe and efficient endoscopic scoring system for treating colonic diverticular bleeding. The higher the JD score, the higher the bleeding source identification, leading to a successful hemostatic procedure. Elective endoscopy was possible in the JD