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Abstract Background Xeroderma pigmentosum (XP) is an extremely rare and severe form of photosensitivity. It is classified into types A–G or V according to the gene responsible for the disease. The progression and severity of symptoms vary depending on the type. Although dysphagia caused by decreased swallowing function and dental malposition due to stenosis of the dentition in the facial and oral regions is common, it has not been reported in detail. We report three cases of type A XP, in which central and peripheral neurological symptoms appeared early on and progressed rapidly. We describe the oral function of these patients, focusing on the swallowing function and dentition malposition. Case presentation Two males (27 and 25 years old) and one female (28 years old) presented with diverse neurological symptoms. We focused on the relationship between the changes in swallowing and oral functions and conditions due to decline in physical function. Some effects were observed by addressing the decline in swallowing and oral functions. In particular, a dental approach to manage the narrowing of the dentition, which was observed in all three patients, improved the swallowing and oral functions and maintained the current status of these functions. Conclusions In type A XP, early decline in oral and swallowing functions is caused by the early decline in physical function, and it is necessary to monitor the condition at an early stage.

Abstract Objective Perampanel is an oral anti‐seizure medication, which is approved in Japan for focal‐onset seizures, with/without focal to bilateral tonic–clonic seizures, as monotherapy/adjunctive therapy in patients aged 4 years and older. Treatment for generalized tonic–clonic seizures as adjunctive therapy in patients aged 12 years and older is approved as well. We evaluated the feasibility of intravenous (IV) administration of perampanel as an alternative to oral administration. Methods Study 240 (NCT03754582) was an uncontrolled, open‐label study of IV perampanel, conducted in 21 Japanese patients with epilepsy who received a stable dose of 8–12 mg/day of oral perampanel. Patients received 30‐minute IV infusions at equivalent daily doses of oral perampanel for 4 days, then were switched back to oral perampanel. Safety, tolerability, plasma concentration, and maintenance of efficacy throughout the transition between IV and oral dosing of perampanel were assessed. As supportive data, a subgroup analysis was also conducted using data from healthy Japanese subjects (n = 18) who were enrolled in Study 050 (NCT03376997) investigating the pharmacokinetics and safety of IV perampanel in healthy subjects who received an IV infusion (30‐, 60‐, or 90‐minute) of perampanel 12 mg and a single oral administration of perampanel 12‐mg tablet. Results In Study 240, the transition between 30‐minute IV and oral perampanel dosing was associated with a ≤1.4‐fold increase in the mean change in maximum observed concentration of perampanel. Seizure outcomes demonstrated no considerable changes in efficacy before, during, or after 30‐minute IV dosing of perampanel. The safety profiles were similar between IV and oral formulations. In Study 050, the pharmacokinetics of 30‐ or 60‐minute IV infusion of perampanel further support the interchangeability between oral and IV formulations in the Japanese subjects. Significance These results support that 30‐minute IV perampanel may be a potential short‐term alternative to oral formulations for patients with epilepsy.

Abstract In clinical practice, we encounter cases wherein older adults lacking occlusal support consume foods requiring mastication and adequate swallowing function. This study investigated the relationship between jaw-closing force (JCF) and dietary form in older adults without occlusal support requiring nursing care. This prospective cross-sectional study included 123 older adults requiring nursing care who lost their molar occlusal support and consumed food orally without dentures. JCF was defined as the force required for crushing food with the edentulous ridges or with the tooth and edentulous ridge while closing the mouth. Participants were classified into four groups based on the International Dysphagia Diet Standardization Initiative framework for recommended dietary forms. Basic information was collected, and tongue pressure and JCF were measured. Differences in JCF were analyzed using one-way analysis of variance, while factors related to dietary form were evaluated using ordinal logistic regression analysis. Significant differences in JCF were observed among the four groups. Factors such as the Barthel Index, tongue pressure, and JCF were dietary form-related. Our findings suggest that older adults requiring nursing care tend to have higher JCF when consuming meals requiring mastication. Therefore, JCF could serve as an index for determining appropriate dietary forms in this population.

Objectives: We analyzed the 2-year clinical outcomes of patients with de novo femoropopliteal (FP) lesions who underwent drug-coated balloon (DCB) angioplasty and the angiographic predictors of restenosis. Methods: This single-center, retrospective, and observational study evaluated 129 de novo FP lesions treated with DCB angioplasty without bailout stenting. Clinical outcomes and risk factors for loss of primary patency were analyzed using univariate and multivariate Cox proportional hazards regression models. Results: The participants were aged 48–93 (mean: 73.6 ± 9.8) years, and 31% were women. Approximately 33% of the patients were receiving regular dialysis, and 35% of the affected limbs had critical ischemia. The mean lesion length was 132 ± 96 mm, and the mean reference vessel diameter (RVD) was 4.7 ± 0.8 mm. Forty-three (33%) limbs had chronic total occlusion of the target artery segment. Fifty-seven (44%) and 72 (56%) lesions were treated with DCB angioplasty using IN.PACT Admiral and Lutonix, respectively. The primary patency and amputation-free survival at 2 years were 59.3% and 89.5%, respectively. RVD was found to be an independent predictor of loss of primary patency. Based on the receiver operating characteristic analysis, an RVD of 4.2 mm was the best predictor of loss of primary patency at 2 years. Conclusions: The short-term clinical outcome of DCB angioplasty for de novo FP lesions was acceptable. Moreover, an RVD of

Abstract The purpose of this study is to clarify the metabolic dependence of ovarian clear cell carcinoma (CCC) by comparing normal tissues and to examine the applicability of fluorescence imaging probe to exploit these metabolic differences. Enhanced glutathione synthesis was supported by the increased uptake of related metabolites and elevated expression levels of genes. Accumulation of intracellular iron and lipid peroxide, induction of cell death by inhibition of the glutathione synthesis pathway indicated that ferroptosis was induced. The activation of γ-glutamyl hydroxymethyl rhodamine green (gGlu-HMRG), a fluorescent imaging probe that recognizes γ-glutamyl transferase, which is essential for the synthesis of glutathione, was investigated in fresh-frozen surgical specimens. gGlu-HMRG detected extremely strong fluorescent signals in the tumor lesions of CCC patients, compared to normal ovaries or endometrium. These results revealed that CCC occurs in the stressful and unique environment of free radical-rich endometrioma, and that glutathione metabolism is enhanced as an adaptation to oxidative stress. Furthermore, a modality that exploits these metabolic differences would be useful for distinguishing between CCC and normal tissues.

Abstract Objectives This study aimed to investigate the relationship between postoperative reconstructed tongue flap volume (RTFV) and body mass index (BMI) and identify factors affecting the flap volume in patients with tongue squamous cell carcinoma. Methods Thirty‐two patients were evaluated for RTFV from computed tomography images and BMI. The first and second evaluations were done at 6 months and 1.5 years after surgery respectively. RTFV rate changes and BMI differences from the first and second evaluations were calculated. The correlation between RTFV rate change and BMI difference was assessed using Spearman's rank correlation coefficient. Multiple regression analysis evaluated the relationship between the flap volume rate change and age, sex, flap type, and BMI difference to identify influencing factors. Results The flap volume rate change and BMI difference correlated significantly (r = .594, p

Objective: To assess the pregnancy outcomes, including live birth rate and pregnancy loss for women aged 45–49 years at the time of oocyte retrieval, who underwent frozen autologous transfer of embryos. Methods: Among frozen-thawed embryo transfers (ET) performed at our clinic from September 2013 to March 2021, 1,114 cycles of women aged 45–49 years at the time of oocyte retrieval were examined retrospectively. Positive pregnancy test, clinical pregnancy, pregnancy loss, and live birth rates per transfer among each age group were analyzed using one-way analysis of variance or the Fisher’s exact test. Results: The mean age at the time of oocyte retrieval and ET was 45.8 and 46.5 years, respectively. Positive pregnancy test rate was 7.6%, of which 72.9% resulted in pregnancy loss. The clinical pregnancy and live birth rates were 5.1% and 2.0%, respectively, with a live birth rate of 3.0% for women with oocytes retrieved at 45 years of age. Multivariate analysis revealed that younger oocyte retrieval age was associated with biochemical and clinical pregnancy; however, no such association was observed for cases with live birth. The oocyte retrieval age of patients with live births was 45 years in 16 cases, 46 years in six cases, and 47 years in one case. In one case of live birth (46 years old), 21 trisomy was observed in the child; however, congenital abnormalities were not observed in other cases. Chorionic tests were performed on the fetuses in 12 of the 33 clinical abortions, of which 11 showed chromosomal abnormalities. Conclusions: Fertility treatment with autologous oocytes in advanced-age women has a low success rate. Although prognosis is poor above 45 years of age, these results can help in providing information to aid patients in their decisions regarding whether or not to pursue treatment.

Abstract Objective Videoendoscopic evaluation of swallowing is an objective swallowing function evaluation method used in dysphagia rehabilitation. However, it is anatomically difficult to detect the entry of foreign substances through the posterior tracheal wall using a conventional endoscope (CE). In this study, we developed an endoscope that can observe the posterior tracheal wall and investigated its reliability and validity in healthy adults. Methods Twenty healthy adults were included. The trachea was observed from inside the larynx using a CE and a portable, flexible two‐step angulation endoscope (two‐AE) with a two‐step curved shaft tip. The visibility of the anterior and posterior walls was recorded. The time from the endoscope tip entering the larynx to the posterior tracheal wall was measured. Additionally, discomfort events were assessed after the examination. McNemar's test and a paired t‐test were used for statistical analysis. Kappa coefficients and concordance rates were calculated. Results The anterior tracheal wall was observed using both endoscopes. The posterior tracheal wall was significantly observed in 18 participants with the two‐AE (p

Abstract Objective Patients lose their voice after laryngectomy for laryngeal cancer or aspiration prevention surgery for severe dysphagia. To assist such patients, we developed and verified the utility of a novel vocalization method using a device termed the voice retriever (VR), in which the sound source is placed in the mouth. Methods We investigated the effectiveness of the VR in patients. The VR consists of a mouthpiece with a built‐in speaker and a dedicated application that serves as the sound source. We compared the speech intelligibility and naturalness in normal participants using VR and an electrolarynx (EL) for the first time as well as the voice‐related quality of life (V‐RQOL) in patients with dysphonia before and after using the VR. Results The VR produced significantly higher 100‐syllable test scores as well as fluency, amount of additional noise, intonation, intelligibility and overall long reading test ratings in the first‐time VR and EL users. Furthermore, the VR use significantly improved the V‐RQOL of participants with dysphonia. Conclusion Compared to EL, VR allows more effective speech improvement in participants without experience using an alternative vocalization method and improves the V‐RQOL in patients with dysphonia. Level of Evidence Step 4.

Abstract Swallowing function is associated with systemic factors. Whether trunk or appendicular skeletal muscle mass is a better indicator of swallowing-related muscle characteristics in community-dwelling older adults is not clear. Hence, we investigated the association between the characteristics of swallowing-related muscles (e.g., mass and quality) and trunk muscle mass. Community-dwelling older adults aged ≥ 65 years (n = 141; men: n = 45, women: n = 96) were recruited for this cross-sectional observational study via a health survey conducted in 2018. Trunk muscle mass index (TMI) and appendicular skeletal muscle mass index (SMI) were measured using bioelectrical impedance analysis. Cross-sectional areas (CSAs) and echo intensity (EI) of the geniohyoid muscle (GHM) and tongue were evaluated using an ultrasonic diagnostic apparatus. Multiple regression analysis was used to examine the relationship of the characteristics of swallowing-related muscle with TMI and SMI. Multiple regression analysis showed that CSA of the GHM was positively associated with both TMI (B = 24.9, p

Abstract Background Small cell carcinoma of the uterine cervix (SCCC) is a rare and highly malignant human papillomavirus (HPV)‐associated cancer in which human genes related to the integration site can serve as a target for precision medicine. The aim of our study was to establish a workflow for precision medicine of HPV‐associated cancer using patient‐derived organoid. Methods Organoid was established from the biopsy of a patient diagnosed with HPV18‐positive SCCC. Therapeutic targets were identified by whole exome sequencing (WES) and RNA‐seq analysis. Drug sensitivity testing was performed using organoids and organoid‐derived mouse xenograft model. Results WES revealed that both the original tumor and organoid had 19 somatic variants in common, including the KRAS p.G12D pathogenic variant. Meanwhile, RNA‐seq revealed that HPV18 was integrated into chromosome 8 at 8q24.21 with increased expression of the proto‐oncogene MYC. Drug sensitivity testing revealed that a KRAS pathway inhibitor exerted strong anti‐cancer effects on the SCCC organoid compared to a MYC inhibitor, which were also confirmed in the xenograft model. Conclusion In this study, we confirmed two strategies for identifying therapeutic targets of HPV‐derived SCCC, WES for identifying pathogenic variants and RNA sequencing for identifying HPV integration sites. Organoid culture is an effective tool for unveiling the oncogenic process of rare tumors and can be a breakthrough for the development of precision medicine for patients with HPV‐positive SCCC.

Abstract The effectiveness of the tongue right positioner (TRP) use on oral and swallowing functions remains unclear. To investigate the effects of TRP use on tongue function in patients with dysphagia. This interventional study included eight participants with dysphagia who visited a university dental hospital. The measurement variables included tongue pressure (TP) as the primary outcome and lip and tongue movements, peak nasal inspiratory flow, and changes in the tongue and suprahyoid muscle regions on ultrasonography as the secondary outcomes. Each participant was asked to use a TRP for at least 8 h every night for 2 months. The measurement variables before and after the intervention were compared using the paired t test and Wilcoxon signed-rank test. TP after intervention (31.5 ± 13.1 kPa) was significantly higher than that before intervention (23.0 ± 13.4 kPa), while other measurement variables did not significantly improve. Numerous exercises have been suggested to improve TP; however, most require patients’ adherence to instructions. In contrast, although participants did not perform active exercises, most participants in this study observed an improved TP. Our findings show that TRP can greatly improve TP after 2 months of usage. Trial registration number: University Hospital Medical Information Network Clinical Trials Registry (UMIN000040253, date of first registration: 27/04/2020).

Abstract Carbonated beverages initiate the swallowing reflex earlier than water and have a shorter pharyngeal transit time. However, the effects of carbonation in thickened beverages of the same flavor on swallowing dynamics have not been reported. Therefore, we investigated the effects of thickened carbonated beverages on swallowing in patients with dysphagia by comparing the swallowing dynamics between thickened carbonated and thickened non-carbonated beverages. We enrolled 38 patients with dysphagia and divided them into two groups. Thickened carbonated and thickened non-carbonated beverages were used. Videoendoscopic swallowing evaluations were performed. Aspiration, penetration, pharyngeal residue, and initiation position of the swallowing reflex were evaluated. The reduction in the amount of residue in both the vallecula (p = 0.007) and pyriform sinus (p = 0.004) was greater after ingestion of thickened carbonated cola than thickened non-carbonated cola. The onset of the swallowing reflex was significantly earlier after ingestion of thickened carbonated cola than thickened non-carbonated cola (p = 0.007). There were no significant differences in the extent of penetration. Thickened carbonated beverages positively affected swallowing compared with thickened non-carbonated beverages. Thus, the use of thickened carbonated beverages may be helpful for patients with dysphagia.

Abstract Purpose To compare the impact of Chocolate and conventional balloons on vessel preparation in percutaneous transluminal angioplasty. Materials and methods This single-center retrospective study included 111 endovascular therapy consecutive cases of femoropopliteal lesions using drug-coated balloon strategy with a 1:1 pre-dilation balloon diameter between February 2020 and August 2021, divided into the Chocolate percutaneous transluminal angioplasty (n = 48) and conventional (n = 63) groups. Before the availability of Chocolate balloons in Japan (December 2020), a standard semi-compliant or non-compliant balloon was used for vessel preparation. The primary endpoint was rate of severe dissection after pre-dilatation. Secondary endpoints were angiographic percent diameter stenosis, bailout stent rate, primary patency rate, and freedom from target-lesion-revascularization rate at six months. Results There was no significant difference in patient and lesion characteristics. The procedural characteristics comprised balloon length 90 ± 37 and 149 ± 95 mm (P = 0.004) and inflation pressure 11 ± 3 and 16 ± 7 atm (P

The older adult population in Japan is expected to increase. Therefore, long-term care and frailty prevention are important. However, the relationship between masticatory performance, nutritional intake, and frailty remains unclear. This cross-sectional study aimed to examine energy, protein, and vitamin D intake and its association with frailty and masticatory performance in older adults. Patients between January 2022 and January 2023 were recruited and divided into robust and frail groups. Masticatory performance, nutrition, frailty, and other data, such as age and sex, were evaluated through onsite measurements and a questionnaire. Logistic regression analysis was conducted with frailty as a dependent variable and masticatory performance as an independent variable, adjusting for age, sex, skeletal muscle mass, living alone, energy intake, protein–energy ratio, and vitamin D intake. No significant differences were observed between the groups regarding age or sex. The robust group showed significantly better results for protein–energy ratio, vitamin D intake, and subjective and objective masticatory performance than the frail group. Logistic regression analysis revealed a significant correlation between skeletal muscle mass, protein–energy ratio, and objective masticatory performance with frailty. Masticatory performance was associated with frailty, independent of the intake of nutrients such as energy, protein, and vitamin D.

Vocabulary acquisition and retention is an essential part of learning a foreign language and many learners use flashcard applications to repetitively increase vocabulary retention. However, it can be difficult for learners to remember new words and phrases without any context. In this paper, we propose a system that allows users to acquire new vocabulary with media which gives context to the words. Theoretically, this use of multimedia context should enable users to practice with interest and increased motivation, which has been shown to enhance the effects of contextual language learning. An experiment with 46 English as foreign language learners showed better retention after two weeks with the proposed system as compared to ordinary flashcards. However, the impact was not universally beneficial to all learners. An analysis of participant attributes that were gathered through surveys and questionnaires shows a link between personality and learning traits and affinity for learning with this system. This result indicates that the proposed system provides a significant advantage in vocabulary retention for some users, while other users should stay with traditional flashcard applications. The implications of this study indicate the need for the development of more personalized learning applications.

Abstract Background Patients with congenital heart disease (CHD) are associated with an increased incidence of scoliosis, often with severe progression. We report a case of hemoptysis caused by rapid scoliosis progression subsequent to surgery for CHD that was successfully managed by surgical curve correction following coil embolization. Case presentation A 14-year-old girl with scoliosis had undergone open heart surgery for CHD at the age of 1 year. She was first noted to have scoliosis at 12 years of age, which began to progress rapidly. At age 13, her main thoracic curve Cobb angle was 46°, and hemoptysis with high pulmonary vein pressure due to vertebral rotation was detected. Nine months after coil embolization, she received posterior spinal fusion from T5 to L2 for scoliosis correction. Postoperatively, her pulmonary vein diameter was enlarged, with no detectable signs of hemoptysis. Conclusions We encountered a case of hemoptysis caused by advanced scoliosis after cardiac surgery that was successfully treated by correction of the scoliotic curve following coil embolization. Patients with secondary scoliosis after surgery for CHD should be carefully monitored for the possibility of cardiovascular system deterioration.

Physical performance shows approximately 30% diurnal variation; however, diurnal variation in oral function remains unclear. This study aimed to determine the diurnal variation in oral and swallowing function in older adults requiring long-term care. The participants included 13 adults aged >60 years (3 men and 10 women, mean age: 77.2 ± 6.3 years, age range: 62–90 years) requiring long-term care. Tongue strength (TS) and oral mucosal moisture were measured as indices of oral and swallowing function, while hand grip strength was measured as an index of general muscle strength. The patients were asked to participate in a “test” after breakfast, lunch, and dinner on the same day. Multilevel linear regression analysis was used to examine diurnal differences in each item. Multilevel linear regression analysis with adjustment for age and sex revealed that TS was significantly higher at noon (p = 0.001) than in the morning. Therefore, caregivers who provide support during meals to older people requiring long-term care should consider the possibility of swallowing function differing according to the time of the day. In conclusion, it may be beneficial to establish a nutritional therapy that accounts for the diurnal variation in TS.

Since a large amount of sewage sludge (WSS) is generated daily, exploring effective methods for utilizing WSS is necessary. Although a photo-fermentation system sometimes alters the characteristics of microbial functions, there have been no attempts to perform photo-fermentation using WSS, which is regularly treated via dark fermentation. In this study, the effect of photo-fermentation (photo-irradiation) on anaerobic digestion using WSS was revealed. Photo-irradiation during the anaerobic digestion of WSS significantly reduced the amount of methane and hydrogen sulfide. Methane production was also reduced 5.6-fold at 13 days under light conditions, whereas hydrogen sulfide was consumed almost completely at 6 days. However, it was shown that the activity of sulfate-reducing bacteria in WSS under light treatment increased. Photo-irradiation also stimulated the growth of green sulfur bacteria and induced anoxygenic photosynthesis, via which process the fermented samples turned green in a manner that was correlated with their consumption of hydrogen sulfide. The production of organic acids was lowered in the samples that were irradiated using light. Finally, dark/light switching fermentation was only able to reduce hydrogen sulfide while methane production remained the same. The amounts of methane and hydrogen sulfide were 35 mmol/g VS, and they were undetected at 58 days in photo-irradiated samples compared to the control samples that produced 37 mmol/g VS of methane and 15 ppm/g VS of hydrogen sulfide.

To deal with the flexibility in the electric aircraft design, this study develops a structural parameter optimization method. The quad tilt-wing aircraft exhibits rotary-wing flight and fixed-wing flight modes by tilting its wings. This study focuses on the domain of attraction, which is a class of state vectors that converge to a static equilibrium point after infinite time. The method indirectly estimates the size of domain of attraction of an aircraft by calculating the radius of a sphere that is encompassed by the domain. In addition, after investigating the relationship between change in structural parameters and the size of the domain of attraction, the structural parameters that maximize the size of the domain are surveyed. The effectiveness of the proposed method is demonstrated for the optimization of the quad tilt-wing aircraft. The quad tilt-wing aircraft exhibits rotary-wing flight and fixed-wing flight modes by tilting its wings. As the characteristics of the dynamics of the quad tilt-wing aircraft demonstrate a significant nonlinear change depending on the tilt angle of the wing, we propose a method to optimize the structural parameters for an easy control of the aircraft. Simulation results show that the optimization scheme identifies the parameters that enable the aircraft to perform agile control to address a disturbance moment. Further, although the same controller is used in the original and optimized aircraft, the optimized aircraft can handle a disturbance in a shorter time when compared with the original aircraft.

Factors influencing oral problems, such as malocclusion and oral motor dysfunction, in patients with prolonged disorders of consciousness (DOC) remain unclear. This study aimed to clarify the relationship between oral problems and physical function, communication, respiration, and oral intake status, as well as related factors in patients with DOC receiving long-term care at home. A cross-sectional study was conducted in October 2018; 127 patients who developed DOC > 5 years ago were analyzed. The differences between patients with and without oral problems were examined, and a binomial logistic regression analysis was performed to examine factors associated with oral problems, with the presence of oral problems as the dependent variable, and age, the number of years since onset, drooling, oral intake status, and the presence of a family dentist as explanatory variables. A post hoc power analysis of the binomial logistic regression analysis for oral problems (odds ratio: 2.05, alpha value: 0.05, incidence of oral problems: 0.80, and total sample size: 127) demonstrated an observed power of 93.09%. Oral intake status (p = 0.010) and the number of years since onset (p = 0.046) were significantly related to oral problems. Preventive oral management and rehabilitation from the early stage after onset may be effective for oral problems in patients with DOC.

Abstract Maintaining oral function in older individuals with missing teeth is important for leading a healthy and independent life. This study aimed to evaluate whether simple isometric exercises can maintain and improve the oral function [maximum occlusal force (MOF) and masticatory ability (MA)] and the masticatory muscle properties [masseter muscle thickness (MMT) and echo intensity (MMEI)] in older adults during the maintenance phase of removable prosthetic treatment. Participants were randomly categorized into the intervention and control groups. The mouthpieces were distributed, and participants were instructed to use them for exercising. The intervention group was instructed to perform maximum clenching for 10 s, whereas the control group was instructed to tap the teeth at an arbitrary speed for 10 s. Both were repeated five times at an interval of 5 s between each activity and twice daily for 4 weeks. The outcomes were measured after a month of exercise. The intervention group showed a significant improvement in the MOF, MMT during contraction, MMT at rest and MMEI during contraction. There were no significant differences in the MA and MMEI at rest. In the control group, no improvement was observed in any of the parameters. When the isometric exercises were performed using a mouthpiece, there was an improvement in the oral function and masseter muscle properties in older individuals with Eichner B status who used dentures.

Abstract Purpose We investigated the clinical results of Japanese men with Y chromosome microdeletions. Methods This study retrospectively examined 2163 azoospermic or severe oligozoospermic patients. We investigated the frequency of azoospermia factor (AZF) deletions and sperm retrieval rate (SRR) by microTESE in patients with these deletions, then analyzed the ICSI outcomes. Results Azoospermia factor deletions were found in 201 patients. SRR was significantly higher than that of the control group (74.0% vs 20.4%, P

This paper proposes an experience-based lecture style that offers dual-scale experiments in combination. Lectures for vibration engineering were designed based on the proposed style and offered to undergraduate students. In the proposed style, experiments on free vibration on a seismic building for second-year students and advanced vibration control using an effective device for fourth-year students are examined in combination. The lecture style trials were repeated twice, once each in 2015 and 2016, with about two hundred second-year students; the students felt the free vibration of the five-story building which had a 6,100 ton weight inside and witnessed the mechanism of the base-isolated layer. To follow the demonstration steps, we developed an experimental device. The experimental device is composed of a vibration component corresponding to a building, and a motor cart with a handle corresponding to the ground. These are connected via a linear actuator that can exert one-dimensional force on the vibration component as a function of the input voltage. In the lectures conducted in 2017 and 2018, the students oscillate the cart and observe the motion of the vibration component. In addition, the virtual reality cameras for offering students a visually rich experience attracted students' interest. The questionnaire results showed that almost all of the students valued the lectures as useful. Since most of the students answered that the combination of the large-scale demonstration and scale-down experiment was useful, the proposed lecture style achieved the expected overall goals.

Abstract Purpose To assess the clinical efficacy of personalized embryo transfer (pET) guided by a new endometrial receptivity test, ERPeakSM, in patients with recurrent implantation failure (RIF). Methods Recurrent implantation failure patients of all ages at two private Japanese clinics from April 2019 to June 2020 were retrospectively analyzed. The intervention group (n = 244) received pET in accordance with endometrial receptivity testing results and was compared to control group (n = 306) receiving standardized timing, non‐personalized embryo transfer (npET). In propensity score matching analysis, the clinical pregnancy rate (CPR) and live birth rate (LBR) were compared between groups, and a subanalysis of advanced maternal age (AMA) (≥38 years old) versus non‐AMA (

We prototyped a new device with a soft and flexible pressure sensor to measure the force to close the mandible with or without occlusal support (jaw-closing force, JCF). This study aimed to clarify the practicality of this instrument. Healthy young and older adults with occlusal support were recruited. Intra- and inter-rater reliability of the JCF meter was examined using data from younger participants. Data regarding age, sex, body mass index, remaining teeth, and dentures of the older adults were obtained. Furthermore, the right and left JCFs were measured using a JCF meter; occlusal force was measured using an existing occlusal force-measuring device. Intra- and inter-rater correlation coefficients were significantly reproducible (0.691–0.811, p < 0.05). JCF was correlated with occlusal force (p < 0.05). Multiple regression analysis revealed that factors significantly associated with JCF included denture status (p < 0.001), age (p = 0.038), and occlusal force (p = 0.043). The prototyped JCF meter can measure JCF with high reproducibility, reliability, and validity. Further, association with occlusal force, which is an existing index, was observed. This device could be used to measure the JCF with or without occlusal support as a new method of evaluating oral function in older adults.

Aims. To evaluate the vascular response after directional coronary atherectomy (DCA) for left main (LM) bifurcation lesion. Methods. This study was a retrospective, single-center study enrolling 31 patients who underwent stentless therapy using DCA followed by drug-coated balloon (DCB) angioplasty for LM bifurcation lesion. We compared intravascular ultrasound (IVUS) findings before and after DCA. Results. After DCA, the lumen and vessel areas significantly increased, whereas the plaque area (PA) and %PA were significantly reduced. When the lesions were divided into small vessel and large vessel groups using the median value of the vessel area, the maximum balloon pressure of the DCA catheter was greater in the large vessel group. Changes in the lumen and vessel areas were also significantly greater in the large vessel group. On the other hand, the changes in PA and %PA were similar between groups. Conclusions. The main vascular responses associated with lumen enlargement after DCA were plaque reduction and vessel expansion. Contribution of vessel expansion to lumen enlargement was larger than the effect of plaque reduction in large vessel lesions.

The precise correlations among tongue function and characteristics remain unknown, and no previous studies have attempted machine learning-based classification of tongue ultrasonography findings. This cross-sectional observational study aimed to investigate relationships among tongue characteristics and function by classifying ultrasound images of the tongue using a K-means clustering algorithm. During 2017–2018, 236 healthy older participants (mean age 70.8 ± 5.4 years) were enrolled. The optimal number of clusters determined by the elbow method was 3. After analysis of tongue thickness and echo intensity plots, tongues were classified into three groups. One-way ANOVA was used to compare tongue function, tongue pressure, and oral diadochokinesis for /ta/ and /ka/ in each group. There were significant differences in all tongue functions among the three groups. The worst function was observed in patients with the lowest values for tongue thickness and echo intensity (tongue pressure [P = 0.023], /ta/ [P = 0.007], and /ka/ [P = 0.038]). Our results indicate that ultrasonographic classification of tongue characteristics using K-means clustering may aid clinicians in selecting the appropriate treatment strategy. Indeed, ultrasonography is advantageous in that it provides real-time imaging that is non-invasive, which can improve patient follow-up both in the clinic and at home.

Government 2.0 activities have become very attractive and popular. Using the platforms to support the activities, anyone can anytime report issues in a city on the Web and share the reports with other people. Since a variety of reports are posted, officials in the city management section have to give priorities to the reports. However, it is not easy task for the officials to judge the importance of the reports because importance judgments vary depending on the officials, and consequently the agreement rate becomes low. To remedy the low agreement rate problem of human judgment, it is necessary to create an intelligent agent which supports finding reports with high priorities. Hirokawa et al. employed the Support Vector Machine (SVM) with a word Feature Selection method (SVM+FS) to detect signs of danger from posted reports because the signs of danger is one of high priority issues to be dealt with. However they did not compare the SVM+FS method with other conventional machine learning methods and it is not clear if the SVM+FS method has better performance than the other methods. This paper explores methods for detecting the signs of danger through comprehensive experiments to develop an intelligent agent which supports officials in the city management sections. We explores conventional machine learning methods: SVM, Random Forest, Naïve Bayse using conventional word vectors, an LDA-based document vector, and word embedding by Word2Vec and compared the best method with SVM+FS. Experimental results illustrate the superiority of SVM+FS and invoke the importance of using multiple data sets when evaluating the methods of detecting signs of danger.

Stroke is associated with multiple forms of disability, including dysphagia. Post-stroke dysphagia increases the risks of pneumonia and mortality and often results in cessation of oral feeding. However, appropriate rehabilitation methods can eventually lead to resumption of oral food intake. This study tried to clarify that re-initiating oral food intake could modify the composition of oral/gut microbial communities in patients with dysphagia. From 78 patients with sub-acute stage of stroke, 11 complete tube feeding subjects without taking antibiotics were enrolled and received rehabilitation for re-initiation of oral food intake, and 8 subjects were brought back to complete oral feeding. Oral and gut microbiota community profiles were evaluated using 16S rRNA sequencing of the saliva and feces samples before and after re-initiation of oral food intake in patients recovering from enteral nutrition under the same nutrient condition. Standard nutrition in the hospital was 1,840 kcal, including protein = 75 g, fat = 45 g, and carbohydrates = 280 g both for tube and oral feeding subjects. Oral food intake increased oral and gut microbiome diversity and altered the composition of the microbiome. Oral and gut microbiome compositions were drastically different; however, the abundance of family Carnobacteriaceae and genus Granulicatella was increased in both the oral and gut microbiome after re-initiation of oral food intake. Although oral microbiota showed more significant changes than the gut microbiota, metagenome prediction revealed the presence of more differentially enriched pathways in the gut. In addition, simpler co-occurrence networks of oral and gut microbiomes, indicating improved dysbiosis of the microbiome, were observed during oral feeding as compared to that during tube feeding. Oral food intake affects oral and gut microbiomes in patients recovering from enteral nutrition. Rehabilitation for dysphagia can modify systemic health by increasing the diversity and altering the composition and co-occurrence network structure of oral and gut microbial communities.

Abstract Background Previous studies have reported a relationship between masseter muscle thickness and tooth loss or limb muscle thickness. However, it is not yet known whether masseter muscle thickness is related to appendicular skeletal muscle mass, and grip strength. The purpose of this study was to determine which of the two variables—tooth loss or appendicular skeletal muscle mass index—is more strongly related to masseter muscle thickness, and to identify a suitable indicator of decreasing masseter muscle thickness in healthy elderly individuals. Methods Grip strength, walking speed, body weight, skeletal muscle mass index, tooth loss, and masseter muscle thickness at rest and during contraction were determined in 97 community-dwelling elderly individuals aged ≥65 years (men: 44, women: 53). Masseter muscle thickness was chosen as the dependent variable, while age, skeletal muscle mass index, body weight, grip strength, and tooth loss were chosen as the independent variables. Multiple regression analysis was conducted using the stepwise regression method. Results In men, grip strength was the only independent predictor of masseter muscle thickness at rest. Tooth loss and grip strength were independent predictor of masseter muscle thickness during contraction. In women, tooth loss was the independent predictor of masseter muscle thickness both at rest and during contraction, while grip strength and body weight were the independent predictor of masseter muscle thickness at rest only. Conclusions We confirmed that in healthy elderly individuals, tooth loss has a stronger relationship with masseter muscle thickness than aging and skeletal muscle mass index do. Masseter muscle thickness in both elderly men and women is also associated with grip strength, suggesting that grip strength can be used as an indicator of masseter muscle thickness in this population.

Abstract Objective The aim of the study was to assess the lower limits of midluteal plasma progesterone and estradiol concentrations in patients who achieved pregnancy with timed intercourse or intrauterine insemination without a human menopausal gonadotropin stimulation. Results We included 297 pregnant cycles of 297 women and assessed midluteal plasma progesterone and estradiol concentrations and pregnancy outcomes, retrospectively. These cycles were compared with the non-pregnant cycles (406 cycles) of the same women who became pregnant. Mean midluteal plasma P4 and E2 concentrations were significantly (P

If the excavated underground veins are not backfilled, they may be a factor in the continued outflow of acid mine drainage (AMD). The flow rate of AMD can be reduced by backfilling underground drifts from abandoned mines. In addition, the quality of AMD may be improved as the flow rate of AMD reduces. In this paper, the quality of the AMD after backfilling was evaluated by a three-dimensional geochemical analysis model when the groundwater level was recovered after backfilling. The measured dissolved iron (Fe) and sulfate ion (SO42−) concentrations and pH before backfilling the drift were reproduced by the calibration of the simulation. Using the calibrated model, the pH at the outlet of the drift was changed from about pH 3 before backfilling to about pH 4 to 5 after backfilling. When calcite was contained in the filling materials of the drift, the pH approached neutral. However, when gypsum was formed, the neutralization was inhibited. The Fe concentration discharged from the drift was calculated at approximately 0.002 mol/L before backfilling. The total Fe concentration was calculated at 0.0004 mol/L or less after backfilling, and the dissolved Fe concentration decreased by several orders of magnitude after backfilling. A geochemical model quantitatively evaluated the improvement in water quality after backfilling the drifts. This method can be applied to the other abandoned mines with similar hydrogeological conditions.

Abstract Background Copper-containing contraceptive devices may deposit copper ions in the endometrium, resulting in implantation failure. The deposition of copper ions in many organs has been reported in patients with untreated Wilson’s disease. Since these patients sometimes exhibit subfertility and/or early pregnancy loss, copper ions were also considered to accumulate in the uterine endometrium. Wilson’s disease patients treated with zinc successfully delivered babies because zinc interfered with the absorption of copper from the gastrointestinal tract. These findings led to the hypothesis that infertile patients with high serum copper concentrations may have implantation failure due to the excess accumulation of copper ions. The relationship between implantation (pregnancy) rates and serum copper concentrations has not yet been examined. The Japanese government recently stated that actual copper intake was higher among Japanese than needed. Therefore, the aim of the present study was to investigate whether serum copper concentrations are related to the implantation (pregnancy) rates of human embryos in vivo. Methods We included 269 patients (age

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Three-dimensional groundwater flow around an abandoned mine was simulated to evaluate the effects of backfilling the excavated underground space of the mine on reducing the acid mine drainage (AMD). The conceptual model of the groundwater flow consists of not only variable geological formations but also vertical shafts, horizontal drifts, and the other excavated underground space. The steady-state groundwater flow in both days with high and little rainfall was calculated to calibrate the model. The calculated groundwater levels and flow rate of the AMD agreed with the measured ones by calibrating the hydraulic conductivity of the host rock, which was sensitive to groundwater flow in the mine. This validated model was applied to predict the flow rate of the AMD when backfilling the excavated underground space. The results showed that the flow rate of the AMD decreased by 5% to 30%. This indicates that backfilling the excavated space is one of the effective methods to reduce AMD of abandoned mines.

This paper presents a novel nonprehensile manipulation method that uses the vibration of a plate, where the two degrees of freedom of a part on the plate are controlled by only one actuator. First, a manipulator whose end effector is a flat plate is introduced. By employing an underactuated joint mechanism, the shape and orientation of the vibrational orbit of the plate vary according to frequency and offset angle of the sinusoidal displacement input to an actuator. Then, simulation analyses reveal that the manipulator can omnidirectionally induce translational velocity to the part on the plate. There exists an orthogonality between the effects of the frequency and offset angle on the velocity map of the part. Based on this characteristic, a visual feedback control for manipulating the part is designed. Finally, the proposed method is validated via experiments using a prototype manipulator. A target-trajectory tracking task and a four-way part-feeding task are demonstrated.

Immune-mediated platelet transfusion refractoriness (PTR) is mainly caused by alloantibodies against human leukocyte antigen (HLA), and rarely by human platelet-specific antigen (HPA). Here, we report a case of acute myeloid leukemia (AML) associated with PTR caused by anti-HPA-5a antibody. The patient was a 38-year-old female who responded poorly to platelet transfusion since the initial transfusion. Only anti-HPA-5a antibody was detected, without any anti-HLA antibodies, leading to the diagnosis of PTR caused by anti-HPA-5a antibody. Patients with hematologic malignancy with PTR have a poor prognosis. HPA antigen testing revealed the patient to be HPA-5b/b, while the HLA-matched sibling was HPA-5a/a. Therefore, hematopoietic stem cell transplantation was not performed during the first remission setting. Complete remission was achieved after two cycles of induction therapy and managed with HPA-matched platelet transfusions and intravenous gammaglobulin without any bleeding complications. In patients with PTR caused by rare antibodies, finding compatible platelet transfusions can be very challenging and could potentially impact treatment decisions. Future development of HPA-matched platelet products derived from induced pluripotent stem (iPS) cells is desirable. [ABSTRACT FROM AUTHOR]