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The electromagnetic form factors of the proton and neutron encode information on the spatial structure of their charge and magnetization distributions. While measurements of the proton are relatively straightforward, the lack of a free neutron target makes measurements of the neutron's electromagnetic structure more challenging and more sensitive to experimental or model-dependent uncertainties. Various experiments have attempted to extract the neutron form factors from scattering from the neutron in deuterium, with different techniques providing different, and sometimes large, systematic uncertainties. We present results from a novel measurement of the neutron magnetic form factor using quasielastic scattering from the mirror nuclei ^{3}H and ^{3}He, where the nuclear effects are larger than for deuterium but expected to largely cancel in the cross-section ratios. We extracted values of the neutron magnetic form factor for low-to-modest momentum transfer, 0.6

Thrombus migration is a well-known clinical condition that occurs before mechanical thrombectomy and after intravenous thrombolysis in patients with anterior circulation strokes. Although thrombus migration from the vertebral artery (VA) can result in life-threatening basilar artery (BA) occlusion, its occurrence in the posterior circulation has rarely been discussed. Two patients with secondary BA occlusion caused by spontaneous thrombus migration from the VA are presented. A 60-year-old man with a left cerebellar infarction secondary to ipsilateral VA occlusion was admitted to our hospital 8 hours after onset, with a National Institute of Health Stroke Scale (NIHSS) score of 4. The patient became comatose 3.5 hours after arrival owing to subsequent BA occlusion. He was successfully treated with mechanical thrombectomy. A 74-year-old man with right cerebellar infarction secondary to ipsilateral VA occlusion was admitted to our hospital 26 hours after onset, with an NIHSS score of 3. He became comatose 1 hour after arrival owing to BA occlusion and was treated with thrombectomy, followed by internal and external decompression. Despite the mild symptoms of VA occlusion and consequently delayed admission to the hospital, stroke physicians should be aware that spontaneous thrombus migration from the VA to the BA can result in a life-threatening presentation.

Abstract Background The combination of laparoscopic and endoscopic approaches to neoplasia with a non-exposure technique (CLEAN-NET) is a laparoscopic and endoscopic cooperative surgery (LECS). It combines laparoscopic gastric resection and endoscopic techniques for local resection of gastric tumors, such as gastrointestinal stromal tumors (GIST), with minimal surgical margins. A conventional CLEAN-NET surgical procedure is complex, requiring careful techniques to preserve the cardia, particularly in case of nearby lesions. We describe the case of a patient who underwent a modified CLEAN-NET approach with a semi-circular seromuscular layer incision surrounding the base of the tumor, different from a circular shape seromuscular layer in the conventional CLEAN-NET: around the tumor to preserve mucosal continuity, which acts as a barrier to avoid intraoperative tumor dissemination. Case presentation A 43-year-old woman was referred to our hospital because of a gastric submucosal tumor near the cardia, detected on medical examination. The patient was diagnosed with gastric GIST based on the results of endoscopic ultrasound-guided fine-needle aspiration. Modified CLEAN-NET was performed with a semicircular incision of the seromuscular layer on the opposite side of the cardia, making the surgical procedure simple and minimizing partial resection of the gastric wall, including the tumor, while preserving the cardia. The operative time was 147 min, preoperative blood loss volume was 3 mL, and postoperative hospital stay was 9 days. The resected specimen revealed a minimal resection of the gastric wall, including the tumor. The cardia and gastric nerves were preserved, and the postoperative food intake was good. Conclusions The modified CLEAN-NET with semicircular seromuscular layer dissection is a simple and reliable surgical procedure for GIST near the cardia.

Abstract Aim To clarify the usefulness of intraoperative lavage cytology in patients undergoing curative resection for pStage II‐III colorectal cancer in a prospective multicenter study. Methods Patients preoperatively diagnosed with stage II‐III colorectal cancer between 2013 and 2017 from 20 hospitals were enrolled. Lavage cytology was performed twice during the surgery. The primary endpoint was the effect of lavage cytology on the 5‐year relapse‐free survival (RFS) in patients with pStage II‐III colorectal cancer. The secondary endpoint was the effect of lavage cytology on the 5‐year overall survival (OS) and peritoneal recurrence. Results A total of 1378 patients were eligible for analysis. The number of patients with pStage II‐III colorectal cancer was 670 and 708, respectively. Fifty‐four patients (3.9%) had positive cytological results. In pStage II patients, the 5‐year RFS rates with positive and negative cytology were 61.1% and 81.6%, respectively (p = 0.023). The 5‐year OS rates were 67.1% and 91.7%, respectively (p = 0.0083). However, there was no difference in RFS or OS between pStage III patients with positive and negative cytology results. The peritoneal recurrence rates were 11.8% and 1.5% in pStage II patients with positive and negative cytology results, respectively (p = 0.032). These rates were 10.5% and 2.5% in patients with stage III disease, respectively (p = 0.022). Conclusion Stage II colorectal cancer patients with negative cytology had better outcomes than those with positive cytology. Peritoneal lavage cytology is useful for predicting peritoneal recurrence after curative resection of stage II‐III colorectal cancer.

Abstract Background Intensive localized therapy is promising for the treatment of rectal cancer. In Japan, chemoradiotherapy (CRT) and neoadjuvant chemotherapy (NAC) are used as preoperative treatments for this disease. Magnetic resonance imaging (MRI) is used to diagnose lateral pelvic node (LPN) metastases, but the changes in LPN findings on MRI following preoperative treatment are unclear. Furthermore, there may be patients in whom LPN dissection can be omitted after CRT/NAC. Methods Patients who underwent total mesorectal excision with LPN dissection after CRT/NAC at 13 Japanese Society for Cancer of the Colon and Rectum member institutions between 2017 and 2019 were included. Changes in the short diameter of the LPNs after CRT/NAC and the reduction rate were examined. Results A total of 101 LPNs were examined in 28 patients who received CRT and 228 in 47 patients who received NAC. Comparison of LPNs before and after CRT/NAC showed that most LPNs shrank after CRT but that the size reduction was variable after NAC. Although some LPNs with a short diameter of

Abstract Aim To examine the potential negative effects of the COVID‐19 pandemic on short‐term postoperative outcomes of emergency surgery for gastroduodenal perforation in Japan. Methods A total of 7973 cases of gastroduodenal perforation from 2019 to 2021 were retrieved from the National Clinical Database (NCD), which includes >95% of surgical cases in Japan. Data were analyzed nationally and in subgroups for subjects in areas with high infection levels (HILs). Postoperative 30‐d mortality, surgical mortality, and complications (Clavien–Dindo (CD) grade ≥3) were examined. Months were considered to have significantly high or low mortality or complication rates, if the 95% confidence interval (CI) of the standardized mortality (morbidity) ratio (SMR) does not contain 1. Results Nationally, data from 2019 vs 2020 and 2021 showed 30‐d mortality of 175 (6.7%) vs 398 (7.4%), surgical mortality of 250 (9.5%) vs 537 (10.1%), and complications (CD ≥3) of 558 (21.2%) vs 1163 (21.8%). Among these data, the only significantly high SMR was found for complications in July 2020 (1.36 [95% CI: 1.001–1.80]). In areas with HILs, data from 2019 vs 2020 and 2021 indicated 30‐d mortality of 91 (6.3%) vs 215 (7.3%), surgical mortality of 135 (9.4%) vs 294 (10.0%), and complications (CD ≥3) of 304 (21.1%) vs (23.1%). In these data, no month had a significantly high SMR. Conclusion The COVID‐19 pandemic had few negative effects on outcomes after surgery for gastroduodenal perforation. These findings suggest that the emergency system for gastroduodenal perforation in Japan was generally maintained during the pandemic.

Abstract Aims Renal dysfunction in patients with chronic heart failure predicts a poor prognosis. Tolvaptan has a diuretic effect in patients with chronic kidney disease and heart failure without adverse effects on renal function. We aimed to determine the effects of tolvaptan and predictors of worsening renal function in patients with heart failure. Methods and results This post hoc analysis was a sub‐analysis of a single‐centre prospectively randomized trial on the early and short‐term tolvaptan administration. We enrolled 201 participants with decompensated heart failure between January 2014 and March 2019 (early group, n = 104; age: 79.0 ± 12.8 years; late group, n = 97; age: 80.3 ± 10.8 years). Renal ultrasonography was performed before and after the administration of tolvaptan. Urine output and oral water intake significantly increased during tolvaptan administration. The difference between water intake and urine volume increased during tolvaptan administration. Changes in body weight, blood pressure, heart rate, and estimated glomerular filtration rate (eGFR) in both groups were comparable. The changes in peak‐systolic velocity (PSV), acceleration time (AT) of the renal arteries, and resistance index were comparable. The changes in PSV and end‐diastolic velocity (EDV) of the interlobar arteries increased following tolvaptan administration (Δmax PSV: 0.0 ± 14.8 cm/s before tolvaptan vs. 5.6 ± 15.7 cm/s after tolvaptan, P = 0.002; Δmean PSV: 0.4 ± 12.3 vs. 4.9 ± 12.7 cm/s, P = 0.002; Δmax EDV: −0.2 ± 3.5 vs. 1.4 ± 4.0 cm/s, P = 0.001; Δmean EDV: −0.0 ± 3.1 vs. 1.1 ± 3.4 cm/s, P = 0.003). The renal artery AT was negatively correlated with the eGFR (Δmax AT: beta = −0.2354, P = 0.044; Δmean AT: beta = −0.2477, P = 0.035). Conclusions Tolvaptan increased the PSV and EDV of the interlobar artery, which may mean tolvaptan increased renal blood flow. The renal artery AT may be a surrogate for worsening renal function.

Abstract Aim Possible negative effects of the COVID‐19 pandemic on short‐term postoperative outcomes for colorectal perforation in Japan were examined in this study. Methods The National Clinical Database (NCD) is a large‐scale database including more than 95% of surgical cases in Japan. We analyzed 13 107 cases of colorectal perforation from 2019 to 2021. National data were analyzed, and subgroup analyses were conducted for subjects in prefectures with high infection levels (HILs) and metropolitan areas (Tokyo Met. and Osaka Pref.). Postoperative 30‐day mortality, surgical mortality, and postoperative complications (Clavien–Dindo grade ≥3) were examined. Months were considered to have significantly high or low mortality or complication rates, if the 95% confidence interval (CI) of the standardized mortality (morbidity) ratio (SMR) does not contain 1. Results In the NCD, postoperative 30‐day mortality occurred in 1371 subjects (10.5%), surgical mortality in 1805 (13.8%), and postoperative complications in 3950 (30.1%). Significantly higher SMRs were found for 30‐day mortality in November 2020 (14.6%, 1.39 [95% CI: 1.04–1.83]) and February 2021 (14.6%, 1.48 [95% CI: 1.10–1.96]), and for postoperative complications in June 2020 (37.3%, 1.28 [95% CI: 1.08–1.52]) and November 2020 (36.4%, 1.21 [95% CI: 1.01–1.44]). The SMRs for surgical mortality were not significantly high in any month. In prefectures with HILs and large metropolitan areas, there were few months with significantly higher SMRs. Conclusions The COVID‐19 pandemic had limited negative effects on postoperative outcomes in patients with colorectal perforation. These findings suggest that the emergency system for colorectal perforation in Japan was generally maintained during the pandemic.

Membranous nephropathy (MN) recurs in some kidney allograft patients, and recurrence increases graft failure rates. We present a unique case of recurrent MN in first and second allografts showing glomerular capillary wall-positivity for complement receptor 1 (CR1) consistent with immunoglobulin G (IgG). A man in his late 20s developed MN and started hemodialysis. MN recurred and caused graft loss after the first transplantation and recurred again soon after the second transplantation. The IgG subclass staining was almost consistently negative for IgG4 and phospholipase A2 receptor (PLA2R)-staining was negative. Recurrent MN of unknown etiology was considered. Mass spectrometry demonstrated that CR1 had increased in the transplanted kidney biopsies. Immunohistochemistry and immunofluorescence studies demonstrated CR1 colocalized with IgG along glomerular capillaries in this case, whereas CR1 was localized in podocytes with no colocalization of IgG in a control case of PLA2R-associated MN. Correlative light and immunoelectron microscopy showed localization of CR1 at the interface between electron-dense deposits and podocytes. Collectively, this case demonstrated a unique enhancement and localization of CR1. MN with enhancement of CR1 has not been reported to date. CR1 may be a candidate causative antigen in this case of recurrent MN, although further study is needed to investigate the pathogenesis of CR1.

Whether the association between metabolic syndrome (MetS) and functional disability differs depending on sex or age remains unknown. To determine the association between MetS and functional disability in older people separately by sex and age groups. A total of 11 083 participants (4407 men and 6676 women) aged 65 years or over without functional disability were enrolled. MetS was defined according to the revised NCEP ATP III guidelines. Functional disability was defined by a new certification in the long-term care insurance in Japan. Cox proportional hazards models were used to assess the risk of functional disability with adjustment for possible confounding factors. Over the mean observation period of 10.5 years, 1282 men and 2162 women experienced functional disability. For those aged 65 to 74 years, HRs (95% CIs) for functional disability in the MetS group were 1.33 (1.07-1.66) in men and 1.15 (1.000-1.32) in women. For those aged 75 years or older, there was no significant association in men or women. In subjects with a severe care need level, there was a marginal significant association in men aged 65 to 74 years. Among the MetS components that independently increased the risk of functional disability were glucose intolerance and elevated blood pressure (men and women aged 65-74 years), obesity (women aged 65-74 years), and glucose intolerance (women aged 75 years or older). MetS contributed to an increase in a high risk of future functional disability among individuals aged 65 to 74 years. In this age group, improvement of lifestyle, health promotion and interventions for MetS from middle age may prevent future functional disability.

Recent studies have highlighted the indispensable role of oxidized lipids in inflammatory responses, cell death, and disease pathogenesis. Consequently, inhibitors targeting oxidized lipids, particularly lipid-derived radicals critical in lipid peroxidation, which are known as radical-trapping antioxidants (RTAs), have been actively pursued. We focused our investigation on nitroxide compounds that have rapid second-order reaction rate constants for reaction with lipid-derived radicals. A novel screening system was developed by employing competitive reactions between library compounds and a newly developed profluorescence nitroxide probe with lipid-derived radicals to identify RTA compounds. A PubMed search of the top hit compounds revealed their wide application as repositioned drugs. Notably, the inhibitory efficacy of methyldopa, selected from these compounds, against retinal damage and bilateral common carotid artery stenosis was confirmed in animal models. These findings underscore the efficacy of our screening system and suggest that it is an effective approach for the discovery of RTA compounds.

Daijiro Haba,1,2 Mizuho Itabashi,1,3 Nao Tamai,2,4,5 Hiromi Tobe,2,6 Hiromi Sanada,1,2,6 Gojiro Nakagami1,2 1Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan; 2Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan; 3Department of Gerontological Nursing, Graduate School of Nursing Science, St. Luke’s International University, Chuo-ku, Tokyo, Japan; 4Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan; 5Department of Nursing, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan; 6Ishikawa Prefectural Nursing University, Kahoku, Ishikawa, JapanCorrespondence: Gojiro Nakagami, Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan, Tel/Fax +81-3-5841-341, Email gojiron@g.ecc.u-tokyo.ac.jpAbstract: Diminished peripheral blood flow at the wound site remains a key hindrance to effective wound healing. Hard-to-heal wounds are defined as wounds that fail to heal with standard therapy. Vibration therapy may help promote the healing of hard-to-heal wounds such as pressure injuries, diabetic foot ulcers, and venous leg ulcers by improving blood flow. However, evidence supporting its effectiveness on hard-to-heal wounds is inadequate. This scoping review focuses on studying the effectiveness of vibration therapy for healing hard-to-heal wounds by compiling all available research. The following databases were systematically reviewed from 1980 to 2023: MEDLINE, EMBASE, Cochrane Library, Ichu-shi-Web, IEEE, CINAHL, Scopus, Web of Science, and PEDro. The search terms included “wound”, “ulcer”, “hard-to-heal”, “vibration therapy”, and “wound healing”. Two authors independently screened the articles based on inclusion criteria, and the lead author performed data extraction and analysis. A total of 1036 articles were identified, and five articles were eligible to be included in this review. The results suggested that low-frequency and low-intensity vibration therapies helped effectively treat wounds (including pressure injuries, diabetic foot ulcers, and venous leg ulcers) by improving blood flow, relieving pain, reducing exudate, removing necrotic tissue, and increasing the expression of nitric oxide associated with wound healing. This study will inform the treatment choices of clinicians who manage patients with hard-to-heal wounds and researchers who plan to conduct clinical trials using vibration therapy. Further studies on vibration therapy must be performed to gather evidence to support the clinical application of vibration therapy to improve healing time and outcomes in individuals with hard-to-heal wounds.Keywords: vibration, physical therapy, hard-to-heal wound, chronic wound, wound healing

Health management in captive animals is difficult for various unknown reasons presumably related to physiological functions, disease, and diet. Generally, abnormal conditions are diagnosed based on body weight; however, zoos lack appropriate scales for megafauna. Body shape evaluation is often used to evaluate the nutritional status of breeding animals; however, this is inaccurate for zoo animals because of inter-observer variability, especially in megafauna. Previously, three-dimensional laser measurements were used to analyse body shape of reticulated giraffe, but further studies are required to examine its effectiveness in more individuals, and other species. Here, we applied this method to seven reticulated giraffe (Giraffa reticulata), five okapi (Okapia johnstoni), and three black rhinoceros (Diceros bicornis) individuals for which cross-sectional area, width, and height in transverse section were determined. Relative change rates of each variable in relation to measurements at the axillary region revealed changes in body shape for each individual. Further, scatter plots and corresponding fitted curves and correlation coefficients showed a correlation between body length and approximate volume. The accuracy of three-dimensional laser measurements was demonstrated in three animal species, whereby we propose its use as an alternative method to evaluate body shape in megafauna without the inter-observer variability. In addition, this handheld device may be applied for various zoos without the scale for megafauna.

When protons and neutrons (nucleons) are bound into atomic nuclei, they are close enough to feel significant attraction, or repulsion, from the strong, short-distance part of the nucleon-nucleon interaction. These strong interactions lead to hard collisions between nucleons, generating pairs of highly energetic nucleons referred to as short-range correlations (SRCs). SRCs are an important but relatively poorly understood part of nuclear structure1-3, and mapping out the strength and the isospin structure (neutron-proton (np) versus proton-proton (pp) pairs) of these virtual excitations is thus critical input for modelling a range of nuclear, particle and astrophysics measurements3-5. Two-nucleon knockout or 'triple coincidence' reactions have been used to measure the relative contribution of np-SRCs and pp-SRCs by knocking out a proton from the SRC and detecting its partner nucleon (proton or neutron). These measurements6-8 have shown that SRCs are almost exclusively np pairs, but they had limited statistics and required large model-dependent final-state interaction corrections. Here we report on measurements using inclusive scattering from the mirror nuclei hydrogen-3 and helium-3 to extract the np/pp ratio of SRCs in systems with a mass number of three. We obtain a measure of the np/pp SRC ratio that is an order of magnitude more precise than previous experiments, and find a marked deviation from the near-total np dominance observed in heavy nuclei. This result implies an unexpected structure in the high-momentum wavefunction for hydrogen-3 and helium-3. Understanding these results will improve our understanding of the short-range part of the nucleon-nucleon interaction.

A mass spectroscopy experiment with a pair of nearly identical high-resolution spectrometers and a tritium target was performed in Hall A at Jefferson Lab. Utilizing the (e,e′K+) reaction, enhancements, which may correspond to a possible Λnn resonance and a pair of ςNN states, were observed with an energy resolution of about 1.21 MeV (σ), although greater statistics are needed to make definitive identifications. An experimentally measured Λnn state may provide a unique constraint in determining the Λn interaction, for which no scattering data exist. In addition, although bound A=3 and 4 ς hypernuclei have been predicted, only an A=4 ς hypernucleus (Heς4) was found, utilizing the (K-,π-) reaction on a He4 target. The possible bound ςNN state is likely a ς0nn state, although this has to be confirmed by future experiments.

The small binding energy of the hypertriton leads to predictions of the non-existence of bound hypernuclei for isotriplet three-body systems such as nnΛ. However, invariant mass spectroscopy at GSI has reported events that may be interpreted as the bound nnΛ state. The nnΛ state was sought by missing-mass spectroscopy via the (e, e′K+) reaction at Jefferson Lab's experimental Hall A. The present experiment has higher sensitivity to the nnΛ-state investigation in terms of better precision by a factor of about three. The analysis shown in this article focuses on the derivation of the reaction cross-section for the 3H(γ∗, K+)X reaction. Events that were detected in an acceptance, where a Monte Carlo simulation could reproduce the data well (δ p/p| < 4), were analyzed to minimize the systematic uncertainty. No significant structures were observed with the acceptance cuts, and the upper limits of the production cross-section of the nnΛ state were obtained to be 21 and 31 nb sr-1 at the $90\%$ confidence level when theoretical predictions of (-BΛ, Γ) = (0.25, 0.8) MeV and (0.55, 4.7) MeV, respectively, were assumed. The cross-section result provides valuable information for examining the existence of nnΛ.

FePd, FePt, and CoPt alloy epitaxial films of 40 nm thickness are prepared on MgO(111) singlecrystal substrates by employing two different methods. One is a one-step method consisting of hightemperature deposition at 600 °C and the other is a two-step method consisting of low-temperature deposition at 200 °C followed by annealing at 600 °C. Although the preparation method is different, similar final crystal structures are realized for all the film materials. FePd and FePt alloy films grow on the substrates with six L10(111) variants, whose c-axes are about 35° canted from the substrate surface and rotated around the film normal by 60° each other. The order degrees of FePd and FePt films prepared by one- and two-step methods, (Sone-step, Stwo-step), are estimated to be (0.25, 0.33) and (0.08, 0.15), respectively. On the contrary, L10 ordered phase formation is not recognized for CoPt alloy films. The films prepared by one-step method have rough surfaces surrounded by side facets, whereas the films prepared by two-step method have very flat surfaces with the arithmetical mean roughness of 0.3 nm. The two-step method is useful for preparation of L10 ordered films with flat surface.

Magnetic relaxation of FePd alloy epitaxial thin films with very flat surfaces prepared on MgO(001) substrate are measured by in-plane broadband ferromagnetic resonance (FMR). Magnetic relaxation is investigated as Δω for FMR absorption peak by frequency sweep measurements. ΔH is calculated by using the measured Δω. Gilbert damping constant, α, is estimated by employing a straight line fitting of the resonant frequency dependence of ΔH. The α value for an FePd film deposited at 200 ˚C, which shows disordered A1 structure, is 0.010 and ΔH0, which is frequency independent part of ΔH, is 10 Oe. The α value for a film annealed at 400 ˚C, which shows partially L10 ordered structure (S=0.32), is 0.013, which is slightly larger than that for the disorder A1 structure film. However, ΔH0 for the annealed film is 85 Oe, which is much larger than that for the film with disordered structure. The results show that the magnetic relaxation of the 400 ˚C annealed film is mainly dominated by ΔH0, which is related with magnetic in-homogeneity caused by the appearance of perpendicular anisotropy of partially ordered phase.

Fe50Pt50–xPdx (at. %, x = 0, 12.5, 25, 37.5, 50) alloy epitaxial films are prepared on MgO(001) substrates at temperatures ranging from room temperature to 600 °C by radio-frequency magnetron sputtering. The effects of substrate temperature and Pd/Pt composition on the order degree, c-axis distribution, and magnetic property are investigated. With increasing the substrate temperature, L10 ordering is enhanced for all the compositions. The order degree of film deposited at 600 °C decreases from 0.37 to 0.23 as the x value increases from 0 to 12.5 at. %. With further increasing the x value, the order degree increases up to 0.69. The Fe50Pt50–xPdx films with x ≥ 25 consist of only an L10(001) single-crystal with the c-axis perpendicular to the substrate surface, whereas the films with x < 25 involve two types of L10(100) variant with the c-axis lying in the film plane in addition to L10(001) variant. The c-axis distribution is influenced by the Pd/Pt composition. The magnetic anisotropy is reflecting the c-axis distribution and the order degree.