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We have developed a Flexible Mono-tread Mobile-Track (FMT), which exhibits an inherent capability for flexed posture in three dimensions and can traverse over rough terrain, particularly in post-disaster scenarios. The flexion mechanism of the FMT passively adapts to irregular ground surfaces, reducing overall weight, degrees of freedom for operation, and the operator's workload. Rigorous testing of legacy prototypes confirmed the remarkable mobility, following the National Institute of Standards and Technology (NIST) guidelines. The FMT’s performance is notably influenced by the flexibility of the vertebral body structure and the shape of the track belt. For instance, the asymmetric track belt results in anisotropy of forward and backward movement, while the layered body cannot achieve uniform three-dimensional flexion. Additionally, the asymmetric or simple circular head shape poses challenges in ensuring consistent climbability over steps with overhang walls. This paper proposes a solution involving a new vertebral body structure and symmetric track belt for the FMT. The resulting prototype, MRT03-GEJIY, addresses these challenges and improves upon the performance of the legacy FMT prototypes in the following: 1) Establishing a reliable vertebra for achieving wide and uniform curvature, facilitating smooth track belt movement. 2) Implementing a symmetric track segment to enhance the isotropy in forward and backward movement. 3) Introducing a horizontally symmetrical head shape equipped with passive obstacle-crossing capability. Furthermore, we conducted performance evaluations of MRT03-GEJIY, including tests such as step-climbing.

In an aging society, it is important to visualize the conditions of people living with diseases or disabilities, such as frailty and sarcopenia, and determine the environmental and genetic factors underlying such conditions. Atherosclerosis and arterial stiffness are key conditions between these factors and noncommunicable diseases. In 2014, we launched a population-based prospective open-cohort study, the Nagasaki Islands Study (NaIS), which was conducted in Goto City, located in the remote islands of Nagasaki Prefecture, Japan, mostly involving middle-aged and older residents. We conducted our own health checkups along with the annual standardized checkups organized by the municipality; recruited study participants; and started to follow them for vital status (death), migration, and occurrence of diseases, such as myocardial infarction, stroke, fracture, and human T-cell leukemia virus type 1 (HTLV-1)-associated uveitis. Our checkups were conducted as baseline surveys in different areas of Goto City during the fiscal years 2014–2016, secondary surveys during 2017–2019, and tertiary surveys since 2021, consisting of medical interviews, physical examinations, blood and urine tests, body composition measurements, osteoporosis screening, arterial stiffness measurements, carotid ultrasonography, and dental examination. A total of 4,957 residents participated in either the baseline or secondary surveys and were followed; 3,594 and 3,364 residents (aged 27–96 and 28–98 years) participated in the baseline and secondary surveys, respectively. In conclusion, the NaIS has been undertaken to reveal the influence of aging and risk factors of noncommunicable diseases and disabilities, with an aim to contribute towards better healthcare in the future.

The authors present a patient with carotid dissection in a tortuous arterial segment who successfully underwent carotid artery stenting (CAS) by straightening the tortuosity using an inflated balloon guiding catheter (BGC) and a stent retriever (SR). A 56-year-old man was transferred to our institute with right hemiparesis and a National Institutes of Health Stroke Scale score of 9. Magnetic resonance imaging showed left internal carotid artery (ICA) occlusion and ischemic change in the parietal lobe. Emergent angiography revealed tapered extracranial ICA occlusion sugg carotid artery dissection (CAD). CAS was attempted for CAD due to a mismatch of the motor area on clinical imaging. However, several attempts to navigate the stent delivery system over a guidewire failed. Therefore, we deployed a Trevo NXT ProVue SR (3 × 32 mm) in the middle cerebral artery, inflated a BGC, and then pulled on both to straighten the tortuous carotid artery, which resulted in successful navigation of the stent delivery system. The patient's symptoms improved after the recanalization. This case demonstrates the utility of a technique for navigation of a stent delivery system through a tortuous carotid artery in which the tortuosity is straightened by pulling on an inflated BGC and the delivery wire of the SR.

Introduction Individuals with mental illness and their families often undergo their recovery process in their communities. This study explored the long-term outcome trajectories of individuals and families who received case management services provided by multidisciplinary outreach teams in a community setting. The primary objective of this study was to determine whether trajectories of subjective quality of life (QoL) related to personal recovery were linked to those clinical and societal outcomes and changes in outreach service frequency.Methods and analysis The protocol of this 10-year multisite cohort study was collaboratively developed with individuals with lived experience of psychiatric disorders who had received services from participating outreach teams, and with family members in Japanese family associations. The participants in the study include patients and their key family members who receive services from 23 participating multidisciplinary outreach teams. The participant recruitment period is set from 1 October 2023 to 30 September 2025. If necessary, the recruitment period may be extended and the number of participating teams may be increased. The study will annually evaluate the following outcomes after participants’ initial utilisation of services from each team: QoL related to personal recovery, personal agency, feelings of loneliness, well-being and symptom and functional assessments. The family outcomes encompass QoL, well-being, care burden and family relationships. Several meetings will be held to monitor progress and manage issues during the study. Multivariate analyses with repeated measures will be performed to investigate factors influencing changes in the patients’ QoL scores as the dependent variable.Ethics and dissemination The study protocol was approved by the ethical committee of the National Center of Neurology and Psychiatry (no. A2023-065). The study findings will be reported in peer-reviewed publications and presented at relevant scientific conferences.Trial registration number UMIN-CTR, No. UMIN000052275.

Urgent carotid artery stenting (CAS) is effective for treatment-resistant cervical internal carotid artery dissection (CICAD). We experienced a 37-year-old woman who presented with sudden onset of cervical pain, blurred vision in the right eye, and numbness in the left upper and lower extremities. Due to neurological deterioration resulting from hemodynamic impairment, urgent CAS was performed under general anesthesia. Brain perfusion single-photon emission computed tomography performed immediately after CAS showed increased blood flow in the right hemisphere despite no evidence of hemorrhage or ischemic lesion on brain computed tomography (CT). Systolic blood pressure was therefore strictly controlled below 110 mm Hg perioperatively. However, the day after CAS, a follow-up CT showed intracerebral hemorrhage in the right temporal lobe. Urgent CAS in patients with progressive deterioration of hemodynamic impairment caused by CICAD may induce intracerebral hemorrhage due to cerebral hyperperfusion. Care should be taken to recognize and manage this phenomenon during the perioperative period.

The structure of electrolyte solutions under pressure at a molecular level is a crucial issue in the fundamental science of understanding the nature of ion solvation and association and application fields, such as geological processes on the Earth, pressure-induced protein denaturation, and supercritical water technology. We report the structure of an aqueous 2 m (=mol kg−1) MgCl2 solution at pressures from 0.1 MPa to 4 GPa and temperatures from 300 to 500 K revealed by X-ray- and neutron-scattering measurements. The scattering data are analyzed by empirical potential structure refinement (EPSR) modeling to derive the pair distribution functions, coordination number distributions, angle distributions, and spatial density functions (3D structure) as a function of pressure and temperature. Mg2+ forms rigid solvation shells extended to the third shell; the first solvation shell of six-fold octahedral coordination with about six water molecules at 0 GPa transforms into about five water molecules and one Cl− due to the formation of the contact ion pairs in the GPa pressure range. The Cl− solvation shows a substantial pressure dependence; the coordination number of a water oxygen atom around Cl− increases from 8 at 0.1 MPa/300 K to 10 at 4 GPa/500 K. The solvent water transforms the tetrahedral network structure at 0.1 MPa/300 K to a densely packed structure in the GPa pressure range; the number of water oxygen atoms around a central water molecule gradually increases from 4.6 at 0.1 MPa/298 K to 8.4 at 4 GPa/500 K.

Abstract Background Neuropathological diagnosis of argyrophilic grain disease (AGD) is currently based primarily on the combination of argyrophilic grain (AG) visualized using Gallyas–Braak silver staining, phosphorylated tau-positive pretangles, coiled bodies, and ballooned neuron detection. Although AGD is common in patients with dementia and/or prominent psychiatric symptoms, whether it is a distinct neurological disease entity or a by-product of the aging process remains unclear. Methods In 1449 serial forensic autopsy cases > 40 years old (823 males and 525 females, aged 40–101 years, mean age 70.0 ± 14.1 years), we examined the frequency and comorbid pathology of AGD cases and investigated the clinical appearance by comparing those with non-AGD cases using the propensity score. Results Of the 1449 cases, we detected 342 AGD cases (23.6%; mean age 79.7 years; 177 males and 165 females). The AGD frequency and stage increased with age (P

Aqueous Na-ion batteries are attracting attention as candidates for large-scale rechargeable batteries with a high safety level. We proposed a novel electrolyte composed of NaClO4 dissolved in water, along with ethylene glycol, to serve as an innovative solution for aqueous Na-ion batteries. The potential window of NaClO4 aqueous-based electrolyte expanded as the ethylene glycol concentration increased. Specifically, when incorporating ethylene glycol into a 7 m (= mol kg−1) NaClO4 aqueous electrolyte, we observed a favorable cyclability pattern in the context of the NaTi2(PO4)3 anode, akin to that exhibited by a 17 m NaClO4 aqueous electrolyte. Moreover, the irreversible capacity of NaTi2(PO4)3 decreased as the ethylene glycol concentration increased. This effect was evident even at low rates such as 0.2 mA cm−2. Notably, the NaTi2(PO4)3 anode’s capacity, when utilizing a 7 m NaClO4 solution with a higher fraction of ethylene glycol (XE = 0.5), remained stable at 120 mAh g−1 even after the completion of 15 cycles. On the other hand, the Na2MnP2O7 cathode properties 7 m NaClO4 aqueous electrolyte could not be improved by adding a small amount of ethylene glycol.

Abstract Background The Japanese version of the individualized Supported Employment Fidelity scale (JiSEF) was developed by modifying the 25‐item Individual Placement and Support Fidelity Scale (IPS‐25). While a preliminary study partly confirmed the concurrent validity with vocational outcomes, this replication study aimed to examine the stability of the concurrent validity and the inter‐rater reliability of the JiSEF and to test its convergent validity with IPS‐25. Methods Fidelity assessments were conducted in 2016 (n = 17), 2017 (n = 13), and 2018 (n = 18) to examine the employment rate and the fidelity scores at the agency level. We also evaluated the fidelity scores for the IPS‐25 in 2018. We examined the associations between the fidelity scale scores and vocational outcomes for the concurrent validity and between the fidelity scales for convergent validity. The inter‐rater reliability was examined in the 2016 and 2017 assessments. Results High intraclass correlation coefficients (0.93 in 2016 and 0.92 in 2017) were obtained for the inter‐rater reliability. The JiSEF score in each year was associated with the agency employment rate (r = 0.710, P = 0.001 in 2016; r = 0.722, P = 0.005 in 2017; and r = 0.665, P = 0.003 in 2018). A supplementary longitudinal data analysis also confirmed the association between the JiSEF score and the employment outcomes. Additionally, the JiSEF was significantly correlated with the IPS‐25 (r = 0.760, P

Cancer‐associated fibroblasts (CAFs) regulate cancer progression through the modulation of extracellular matrix (ECM) and cancer cell adhesion. While undergoing a series of phenotypic changes, CAFs control cancer–stroma interactions through integrin receptor signaling. Here, we isolated CAFs from patients with non‐small‐cell lung cancer (NSCLC) and examined their gene expression profiles. We identified collagen type XI α1 (COL11A1), integrin α11 (ITGA11), and the ITGA11 major ligand collagen type I α1 (COL1A1) among the 390 genes that were significantly enriched in NSCLC‐associated CAFs. Increased ITGA11 expression in cancer stroma was correlated with a poor clinical outcome in patients with NSCLC. Increased expression of fibronectin and collagen type I induced ITGA11 expression in CAFs. The cellular migration of CAFs toward collagen type I and fibronectin was promoted via ERK1/2 signaling, independently of the fibronectin receptor integrin α5β1. Additionally, ERK1/2 signaling induced ITGA11 and COL11A1 expression in cancer stroma. We, therefore, propose that targeting ITGA11 and COL11A1 expressing CAFs to block cancer–stroma interactions may serve as a novel, promising anti‐tumor strategy.

Abstract Background Several previous observational studies have reported the risk factors associated with readmission in people with mental illness. While patient-reported experiences and outcomes have become increasingly important in healthcare, only a few studies have examined these parameters in terms of their direct association with readmission in an acute psychiatric setting. This project will investigate multiple factors associated with readmission and community living in acute psychiatric patients in Japan. This study will primarily investigate whether patient-reported experiences at discharge, particularly quality of life (QoL), are associated with future readmission and whether readmission after the index hospitalization is associated with changes in patient-reported outcomes during the study period. Here, we describe the rationale and methods of this study. Methods This multicenter prospective cohort study is being conducted in 21 participating Japanese hospitals, with a target sample of approximately 600 participants admitted to the acute psychiatric ward. The study has four planned assessment points: time of index admission (T1), time of discharge (from the index admission) (T2), 6 months after discharge from the index admission (T3), and 12 months after discharge from the index admission (T4). Participants will complete self-reported measures including a QoL scale, a subjective disability scale, and an empowerment- and self-agency-related scale at each assessment point; additionally, service satisfaction, subjective view of need for services, and subjective relationships with family members will be assessed at T2 and T3. We will assess the participants’ hospitalization during the study period and evaluate several potential individual- and service-level factors associated with readmission and patient-reported experiences and outcomes. Multivariate analyses will be conducted to identify potential associations between readmission and patient-reported experiences and outcomes. Discussion The present study may produce evidence on how patient-reported experiences at discharge influence readmission and on the influence of readmission on the course of patient-reported outcomes from admission to community living after discharge. The study may contribute to improving care for both patients’ subjective views of their own health conditions and their community lives in an acute psychiatric setting. Trial registration University Hospital Medical Information Network—Clinical Trials Registry (UMIN-CTR) UMIN000034220. Registered on September 20, 2018.

Objective: The purpose of this study was to determine whether increased alkaline phosphatase (ALP) was associated with early neurological deterioration (END) in patients with atherothrombotic brain infarction (ATBI) attributable to intracranial atherosclerosis (ICAS) or not. Methods: We analyzed data derived from 70 patients (47 men; mean age, 72.4 ± 12.8 years) with symptomatic ICAS who were admitted within 3 days of ATBI onset between April 2013 and December 2018. We defined END as an increase of ≥2 in the National Institutes of Health Stroke Scale scores during the first 72 h of hospitalization. Results: Eleven (15.7%) patients had END. Serum ALP levels on admission were significantly higher among patients with, than without END (median [interquartile range], 296 [233–338] vs. 216 [187–262] U/L, p = .0081). Conclusion: Increased serum ALP levels on admission may be able to predict developing END in patients with symptomatic ICAS.

The force required to break a chemical bond is related both to the bond strength and the rate at which force is applied, however recent experiments on gold nanowires have challenged this view. Here, the authors perform breaking experiments on single gold-gold bonds and propose a solution to the apparent paradox.

TRIM21 is one of the autoantigens that reacts with an anti-SS-A antibody (Ab) present in patients with systemic lupus erythematosus (SLE) and Sjögren's syndrome. TRIM21 is thought to play a role in B-cell proliferation and apoptosis, among other activities. Here we examined a pathological role of TRIM21 in SLE. Trim21-deficient MRL/lpr mice were generated by backcrossing Trim21-deficient C57BL/6 mice to MRL/lpr mice. The levels of serum anti-dsDNA Ab and urine protein at 28 weeks of age were significantly higher in Trim21-deficient MRL/lpr mice as compared to wild-type MRL/lpr mice (p = 0.029 and 0.003, respectively). Resting B cells from Trim21-deficient mice showed significantly higher abilities to differentiate into plasmablasts and to produce Ab as compared with control mice. Due to the reduction of TRIM21-mediated ubiquitylation, IRF5 protein expression was increased in Trim21-deficient MRL/lpr mice (p = 0.021), which correlated with increased plasmablast generation and immunoglobulin production. B cells from SLE patients with anti-TRIM21 Ab seropositivity also showed a significantly higher ability to differentiate into plasmablasts as compared with those without anti-TRIM21 Ab or healthy controls. These results suggest that TRIM21 dysfunction contributes to SLE pathogenesis by promoting B-cell differentiation, for which anti-TRIM21 Ab may be partly responsible.