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This study aimed to develop an effective VR locomotion technique for walking through virtual environments with sloped ground. Thus, this paper presents a novel method for inducing the sensation of walking on a slope in walking-in-place (WIP) using ankle tendon electrical stimulation (TES), which induces the body tilt sensation. We conducted two experiments to evaluate the effectiveness of the proposed method. In Experiment 1, we evaluated the sensation of ascending and descending slopes induced by the proposed method in a setup where electricity flows when the feet are grounded by comparing it to the sensation on a real slope. Experiment 1 demonstrated a marginally significant effect of electrical stimulation on the sensation of ascending or descending slopes. We attributed this to the short duration of ankle TES and the influence of the user’s interpretation of the ankle TES. Based on the findings, Experiment 2 was conducted in a setup where ankle TES was constantly applied. The results indicated that participants who focused on the subjective body tilt sensation elicited by TES and those unaware of the TES effect experienced an ascending sensation with an anterior ankle TES and a descending sensation with a posterior ankle TES. Conversely, those who focused on the tactile or force sensation induced by ankle TES experienced the opposite effect. Based on this finding, we have constructed an implementation guide for a WIP system that incorporates ankle TES to present the desired sensation of ascending or descending slopes in virtual environments.

For accomplishing the vision of building of a net-emission zero society, low-carbon fuels such as e-fuel, Sustainable Aviation Fuel (SAF), and chemical products generation, plays a significant role. Especially, among the low carbon fuels, SAF is the most crucial. Ammonia and electric aircraft are under way as alternatives to fossil-derived jet fuel (kerosene). However, none of these have yet found their way to commercialization. Among the SAF production technology, biomass gasification and Fischer-Tropsch (FT) synthesis technology are one of the lowest CO2 emission processes, according to Life Cycle Assessment (LCA) analysis. However, at present there are some issues about biomass grinding, tar, ash treatment, gas purification and wastewater. We, at Mitsubishi Heavy Industries (MHI) R&D laboratory have developed entrained bed gasification, adopting the fluidized bed concept in which biomass particles are recirculated in the gasifier without fluidizer. Principally desired outcomes of this development was to reduce the grinding power, simplify the structure by using atmospheric pressure process, and lower tar concentration while maintain suitable temperature to prevent ash from melting inside gasifier. Empirical and actual results showed that the developed gasifier can obtain high carbon conversion ratio and low tar as compared to the traditional gasification processes for low-carbon fuel production and produce reliably stable syngas for low-carbon fuel synthesis with single gasifier. Based on the pilot plant operation results, effectiveness of moderate (1223 – 1323 K) temperature gasification with this concept has been demonstrated too. As a conclusion, development needs and expectation of gasification technology for contributing to carbon neutral society are mentioned.

Objectives: This scoping review aims to examine the existing use of eye-tracking technologies being applied to measure negative mental health-related outcomes. The review was guided by the following questions: 1) What eye-tracking methods are currently in use?; and 2) What type of negative mental health-related outcomes are these methods being applied to for estimation? Results will be evaluated to determine their prospective implementation in remote work as a mental health indicator. Methods: A scoping review was conducted in order to collect data from a range of sources and evaluate many distinct research methodologies. A scoping review was chosen for this study to widely report on the research currently being conducted, rather than answer a specific question from a focused set of evidence. On May 26, 2022, a systematic search of the scientific literature was conducted to identify any eye-tracking methods that have been used to measure stress and anxiety. Results: Out of an initial 5,356 eligible articles, a total of 14 articles were included in this scoping review. Estimation outcomes also ranged from various mental health-related outcomes with the most common outcome relating to stress and fatigue. Other outcomes included sleepiness, drowsiness, arousal, frustration, hypervigilance, defensive state, peritraumatic dissociation, and anxiety. Conclusions: Preliminary results show a very promising connection between eye metrics and negative mental health-related outcomes, which are very relevant to workplace mental health as well.

Abstract Background To perform laparoscopic gastrectomy safely, we aimed to comprehensively re-evaluate perigastric vessel anatomies using a three-dimensional angiography reconstructed from enhanced multidetector-row computed tomography data. Methods Perigastric vessel anatomy was preoperatively analyzed using a multidetector-row computed tomography-based three-dimensional angiography reconstructed in 127 patients undergoing gastric surgery. Results Of the 67 left gastric veins that ran along the dorsal side of the arteries, 59 (88.1%) ran along the dorsal side of the common hepatic artery and flowed into the portal vein. In 18 cases, a common trunk of one to three left gastric arteries and the replaced left hepatic artery was observed. The left inferior phrenic artery ramified from the left gastric artery in 5.5% of the cases. The right gastric artery was classified into distal (73.2%), caudal (18.1%), and proximal (8.7%) types. The infra-pyloric artery was also classified into distal (64.6%), caudal (26.0%), and proximal (9.4%) types. The posterior gastric artery branched as a common trunk with the superior polar artery in the proximal (37.9%) and distal (18.4%) regions of the splenic artery. The left gastroepiploic artery ramified from the splenic (18.1%) and inferior terminal arteries (81.9%). No, one, and two gastric branches of the left gastroepiploic artery, which ramified between the roots of the left gastroepiploic artery and its omental branch, were found in 36.5%, 49.2%, and 14.3% of the cases, respectively. Conclusions Preoperative 3D angiography is useful for the precise evaluation of perigastric vessel anatomies, and may help us to perform laparoscopic gastrectomy and robotic surgery safely.

Social VR enables people to join a remote discussion by keeping a high social presence and physical proximity using embodied avatars. However, the missing nonverbal cues, such as mutual eye contact and nuanced facial expression, make it challenging for distributed members to manage turn-taking, which could lead to unequal participation and affect trust building. Therefore, we propose a virtual moderator to make distributed members feel included by seeing their nonverbal behavior. The virtual moderator was designed with a “prompt Q&A″ feature to enable users to share feedback and an “attention guidance” feature to encourage participation. The preliminary result of a controlled experiment in social VR with 30 participants showed that seeing the virtual moderator’s body orientation enhanced participants’ psychological safety. In contrast, the prompt Q&A feature enhanced the perceived co-presence of their remote counterparts. We discussed how nonverbal behavior could be designed using a virtual moderator to shape human perception of the group discussion in social VR. We also pointed out challenges when providing multiple supports simultaneously in social VR.

Abstract Peroral cholangioscopy‐guided lithotripsy is highly effective in clearing difficult bile duct stones. It can cause adverse events, such as cholangitis and pancreatitis; however, gallbladder perforation is extremely rare. Herein, we describe the case of a 77‐year‐old woman who developed gallbladder perforation following peroral cholangioscopy ‐guided lithotripsy. She was referred to our hospital to treat multiple large bile duct stones. She underwent peroral cholangioscopy‐guided lithotripsy because of conventional lithotripsy failure. After a cholangioscope was advanced into the bile duct, saline irrigation was used for visualization. Electronic hydraulic lithotripsy was performed, but it took time for fragmentation because the calculus was hard. The 2‐h endoscopic procedure did not completely remove the stone, and treatment was discontinued after placing a biliary plastic stent and nasobiliary tube. After the endoscopic procedure, she started experiencing right hypochondrial pain, which worsened the next day. Computed tomography showed a gallbladder wall defect in the gallbladder fundus with pericholecystic fluid. She was diagnosed with gallbladder perforation and underwent emergency surgery. A perforation site was found at the gallbladder fundus. Open cholecystectomy, choledochotomy, and extraction of residual bile duct stones were performed. The patient was discharged 9 days post‐surgery without any complications. The saline irrigation used for visualization may have caused a surge in intra‐gallbladder pressure, resulting in gallbladder perforation. Therefore, endoscopists may need to conserve irrigation water during peroral cholangioscopy‐guided lithotripsy.

Objectives To examine the national, 6-year trends in in-hospital clinical outcomes of patients with subarachnoid haemorrhage (SAH) who underwent clipping or coiling and the prognostic influence of temporal trends in the Comprehensive Stroke Center (CSC) capabilities on patient outcomes in Japan.Design Retrospective study.Setting Six hundred and thirty-one primary care institutions in Japan.Participants Forty-five thousand and eleven patients with SAH who were urgently hospitalised, identified using the J-ASPECT Diagnosis Procedure Combination database.Primary and secondary outcome measures Annual number of patients with SAH who remained untreated, or who received clipping or coiling, in-hospital mortality and poor functional outcomes (modified Rankin Scale: 3–6) at discharge. Each CSC was assessed using a validated scoring system (CSC score: 1–25 points).Results In the overall cohort, in-hospital mortality decreased (year for trend, OR (95% CI): 0.97 (0.96 to 0.99)), while the proportion of poor functional outcomes remained unchanged (1.00 (0.98 to 1.02)). The proportion of patients who underwent clipping gradually decreased from 46.6% to 38.5%, while that of those who received coiling and those left untreated gradually increased from 16.9% to 22.6% and 35.4% to 38%, respectively. In-hospital mortality of coiled (0.94 (0.89 to 0.98)) and untreated (0.93 (0.90 to 0.96)) patients decreased, whereas that of clipped patients remained stable. CSC score improvement was associated with increased use of coiling (per 1-point increase, 1.14 (1.08 to 1.20)) but not with short-term patient outcomes regardless of treatment modality.Conclusions The 6-year trends indicated lower in-hospital mortality for patients with SAH (attributable to better outcomes), increased use of coiling and multidisciplinary care for untreated patients. Further increasing CSC capabilities may improve overall outcomes, mainly by increasing the use of coiling. Additional studies are necessary to determine the effect of confounders such as aneurysm complexity on outcomes of clipped patients in the modern endovascular era.

Methods for enhancing perceived piquancy are expected to improve eating satisfaction and reduce health hazards such as reflux esophagitis caused by the excessive consumption of piquant ingredients. In this study, based on the differences in receptors, we classified the perceived piquancy into three types: HOT, MINTY, and SPICY. We particularly focused on the HOT sensation, which primarily contributes to the negative health effect of eating piquant foods. We proposed a novel method to enhance the intensity of piquancy by single-pole electrical stimulation. Our proposed method uses metal cutlery as an electrode to stimulate the part of the trigeminal nerve of the tongue related to piquancy. To evaluate whether the proposed method selectively enhances the HOT sensation, we conducted psychophysical experiments and demonstrated that ${\mathrm {1.5~ \text {m} \text {A} }}$ anodal single-pole electrical stimulation enhanced the HOT sensation and the SPICY sensation induced by chili peppers or wasabi. To our knowledge, this is the first study to establish a method for enhancing the perceived piquancy using only electrical stimulation.

Abstract Background A comprehensive understanding of DNA adducts, one of the most plausible origins of cancer mutations, is still elusive, especially in human tissues in clinical settings. Recent technological developments have facilitated the identification of multiple DNA adducts in a single experiment. Only a few attempts toward this “DNA adductome approach” in human tissues have been reported. Geospatial information on DNA adducts in human organs has been scarce. Aim Mass spectrometry of human gastric mucosal DNA was performed to identify DNA adducts associated with environmental factors. Materials and methods From 59 subjects who had received gastrectomy for gastric cancer, 306 samples of nontumor tissues and 15 samples of tumors (14 cases) were taken for DNA adductome analysis. Gastric nontumor tissue from autopsies of 7 subjects without gastric cancer (urothelial cancer, hepatocellular carcinoma, lung cancer each; the other four cases were without any cancers) was also investigated. Briefly, DNA was extracted from each sample with antioxidants, digested into nucleosides, separated by liquid chromatography, and then electrospray-ionized. Specific DNA adducts were identified by mass/charge number and column retention time compared to standards. Information on lifestyle factors such as tobacco smoking and alcohol drinking was taken from the clinical records of each subject. Results Seven DNA adducts, including modified bases, C5-methyl-2′-deoxycytidine, 2′-deoxyinosine, C5-hydroxymethyl-2′-deoxycytidine, N6-methyl-2′-deoxyadenosine, 1,N6-etheno-2′-deoxyadenosine, N6-hydroxymethyl-2′-deoxyadenosine, and C8-oxo-2′-deoxyguanosine, were identified in the human stomach and characterized. Intraindividual differences according to the multiple sites of these adducts were noted but were less substantial than interindividual differences. N6-hydroxymethyl-2′-deoxyadenosine was identified in the human stomach for the first time. The amount of C5-hydroxymethyl-2′-deoxycytidine was higher in the stomachs of subjects without gastric cancer than in the nontumor and tumor portions of the stomach in gastric cancer patients. Higher levels of 1,N6-etheno-2′-deoxyadenosine were detected in the subjects who reported both smoking and drinking than in those without these habits. These DNA adducts showed considerable correlations with each other. Conclusions We characterized 7 DNA adducts in the nontumor portion of the human stomach in both gastric cancer subjects and nongastric cancer subjects. A reduction in C5-hydroxymethyl-dC even in the nontumor mucosa of patients with gastric cancer was observed. Smoking and drinking habits significantly influenced the quantity of one of the lipid peroxidation-derived adducts, etheno-dA. A more expansive DNA adductome profile would provide a comprehensive understanding of the origin of human cancer in the future.

There is a growing demand for redirected walking (RDW) techniques and their application to various virtual and real environments. To apply appropriate RDW methods and manipulation according to the real and virtual environments, the RDW controllers are predominantly used. There are three types of RDW controllers: direct scripted controller, generalized controller, and predictive controller. The scripted controller type pre-scripts the mapping between the real and virtual environments. The generalized controller type employs the RDW method and manipulation quantities according to a certain procedure depending on the user’s position in relation to the real space. This approach has the potential to be reused in any environment; however, it is not fully optimized. The predictive controller type predicts the user’s future path using the user’s behavior and manages RDW techniques. This approach is highly anticipated to be very effective and versatile; however, it has not been sufficiently developed. This paper proposes a novel RDW controller using reinforcement learning (RL) with advanced plannability/versatility. Our simulation experiments indicate that the proposed method can reduce the number of reset manipulations, which is one of the indicators of the effectiveness of the RDW controller, compared to the generalized controller under real environments with many obstacles. Meanwhile, the experimental results also showed that the gain output by the proposed method oscillates. The results of a user study conducted showed that the proposed RDW controller can reduce the number of resets compared to the conventional generalized controller. Furthermore, no adverse effects such as cybersickness associated with the oscillation of the output gain were evinced. The simulation and user studies demonstrate that the proposed RDW controller with RL outperforms the existing generalized controllers and can be applied to users as it only causes cybersickness comparable to that in the case of conventional generalized controllers.

BackgroundEndovascular therapy has been shown to be effective in patients with acute cerebral large‐vessel occlusion, but real‐world efficacies are unknown. Methods and ResultsWe conducted a prospective registry at 46 centers between October 2014 and January 2017. Eligible patients were those who were aged 20 years or older, with acute cerebral large‐vessel occlusion, and who were hospitalized within 24 hours of the onset. We enrolled both consecutive patients who were treated with or without endovascular therapy. Endovascular therapy included thrombectomy, balloon angioplasty, stenting, local fibrinolysis, and piercing. The primary outcome was a favorable outcome as defined by a modified Rankin Scale of 0 to 2 at 90 days after onset. Secondary outcomes were modified Rankin Scale of 0 to 1 and mortality. Safety outcomes were intracerebral hemorrhage or a recurrence of ischemic stroke. We constructed the 2242 (1121 each) propensity score–matched patients cohort based on a propensity score for endovascular therapy and estimated the adjusted odds ratio, followed by sensitivity analyses on original 2399 (1278 in endovascular therapy versus 1121 in no endovascular therapy) patients. In the propensity score–matched cohort, favorable outcomes were observed in 35.3% and 30.7% of patients in the endovascular therapy and no endovascular therapy groups, respectively (P=0.02). The adjusted odds ratio for the favorable outcome was 1.44 (95% confidence interval, 1.10–1.86, P=0.007). The efficacy of endovascular therapy in achieving favorable outcomes did not differ between our subgroups and in the sensitivity analyses. ConclusionsEndovascular therapy decreased disabilities at 90 days in real‐world patients with acute cerebral large‐vessel occlusion. Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT02419794.

Background: Pituitary apoplexy (PA) is a rare clinical condition presenting with acute headache, visual disturbance, and disorientation. PA can cause strokes due to acute internal cervical artery occlusion (ICO), which is an extremely rare condition. Arterial spin labeling (ASL) on magnetic resonance imaging (MRI) is a popular technique, which is a quantitative perfusion imaging useful for the diagnosis of ischemia. We report a treatment with acute pseudo-ICO in which ASL on MRI was useful for the decision of surgery timing. Case Description: A 50-year-old male presented with a sudden headache and nausea. MRI and magnetic resonance angiography revealed a large pituitary tumor and left ICO. However, the left middle cerebral and anterior cerebral arteries were depicted due to a cross-flow through the anterior communicating artery. ASL on MRI showed decreased perfusion of the left hemisphere, suggesting acute ICO. As he had no neurological deficit, we treated him conservatively, following the guidelines. Two days after admission, he presented with sensory aphasia and incomplete right paralysis. Emergency head computed tomography revealed a low-density area in his left temporal lobe. We decided on emergency tumor decompression surgery to prevent ischemic progression. We performed endonasal transsphenoidal surgery. Postoperative MRI showed recanalization of the left internal carotid artery (ICA). His incomplete right paralysis improved immediately after surgery but remains mild sensory aphasia. Conclusion: ICO-related PA is a very rare occasion but there are few similar reports. Some cases of successful ICO treatment due to PA have been reported, but the question of whether emergency or elective surgery is better remains unanswered. Our case may have been no neurological deficit if we had decided to have surgery on admission. Hypoperfusion of the ICA area due to PA may be an adaptation of emergency surgery. Perfusion images like ASL could be a useful technique to decide on surgery or conservative treatment. [ABSTRACT FROM AUTHOR]