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Introduction: While chronic kidney disease (CKD) is one of the most important contributors to mortality from non-communicable diseases, the number of nephrologists is limited worldwide. Medical cooperation is a system of cooperation between primary care physicians and nephrological institutions, consisting of nephrologists and multidisciplinary care teams. Although it has been reported that multidisciplinary care teams contribute to the prevention of worsening renal functions and cardiovascular events, there are few studies on the effect of a medical cooperation system. Methods: We aimed to evaluate the effect of medical cooperation on all-cause mortality and renal prognosis in patients with CKD. One hundred and sixty-eight patients who visited the one hundred and sixty-three clinics and seven general hospitals of Okayama city were recruited between December 2009 and September 2016, and one hundred twenty-three patients were classified into a medical cooperation group. The outcome was defined as the incidence of all-cause mortality, or renal composite outcome (end-stage renal disease or 50% eGFR decline). We evaluated the effects on renal composite outcome and pre-ESRD mortality while incorporating the competing risk for the alternate outcome into a Fine–Gray subdistribution hazard model. Results: The medical cooperation group had more patients with glomerulonephritis (35.0% vs. 2.2%) and less nephrosclerosis (35.0% vs. 64.5%) than the primary care group. Throughout the follow-up period of 5.59 ± 2.78 years, 23 participants (13.7%) died, 41 participants (24.4%) reached 50% decline in eGFR, and 37 participants (22.0%) developed end-stage renal disease (ESRD). All-cause mortality was significantly reduced by medical cooperation (sHR 0.297, 95% CI 0.105–0.835, p = 0.021). However, there was a significant association between medical cooperation and CKD progression (sHR 3.069, 95% CI 1.225–7.687, p = 0.017). Conclusion: We evaluated mortality and ESRD using a CKD cohort with a long-term observation period and concluded that medical cooperation might be expected to influence the quality of medical care in the patients with CKD.

Highlights • Study of wetland sediment in the easternmost Asian monsoon affected region. • Sediment on the Konsen Plateau has continuously deposited since ∼4.0 ka. • C/N and C/S ratios suggest environmental changes during the late Holocene. Abstract Wetland soils are among the largest carbon reservoirs in terrestrial ecosystems and are vulnerable to climate change. Here we elucidate the developmental history of a wetland soil located on the Konsen Plateau in Hokkaido, Japan, during the Holocene. Through radiocarbon dating of sediment samples, we revealed that continuous sedimentation persisted over the past 4000 years. This onset of peat sedimentation was simultaneous with those reported in other wetlands in eastern Hokkaido. We hypothesized that cooling associated with the end of climatic optimal may have contributed to peat preservation. Elemental analyses also confirmed the formation of a stable wetland condition during the late Holocene. The C/N ratios were approximately 15–25 throughout the core, indicating that the organic materials in the sediments were steadily derived from terrestrial plants. The C/S ratios of the core varied between 43 and 97, suggesting that the sediments are free from marine influences. Our results provided continuous and stable record of wetland sedimentary environment in eastern Hokkaido over the past 4000 years.

This letter reports the successful demonstration of large-current and high-voltage (001) vertical-type two-dimensional hole gas (2DHG) diamond trench metal-oxide-semiconductor field-effect transistors (MOSFETs) with a p--drift layer. The fabricated transistor demonstrated a maximum drain current density of 210 mA/mm, a field-effect-mobility of 61 cm2V-1s-1, and a specific on-resistance of 23 mΩ cm2. Moreover, a high breakdown voltage of 580 V with a gate-drain length of 10 μm was obtained, which is the highest value reported for a vertical-type diamond MOSFET to date. These characteristics indicate that a vertical-type diamond MOSFET using a p--drift layer may be used to realize a pchannel power device with a high breakdown voltage and low on-resistance.

A 69-year-old man with refractory lung adenocarcinoma was treated with gemcitabine and vinorelbine. Dyspnea and hypertension developed after the 17th cycle of chemotherapy. Laboratory findings revealed intravascular hemolysis and renal dysfunction. Thrombotic microangiopathy (TMA) was confirmed by renal biopsy. Antihypertensive and steroid therapies were ineffective. After plasmapheresis, intravascular hemolysis and renal dysfunction gradually improved. However, the disease progressed, and he died 6 months after TMA diagnosis. Autopsy revealed similar pathological findings to those of the renal biopsy. It is important to discontinue gemcitabine at the onset of TMA and consider TMA when using gemcitabine for long periods.

Diamonds are highly favored materials in high-temperature and high-power operations owing to their excellent characteristics, and diamond p-channel field-effect transistors (p-FETs) considerably aid in the improvement of CMOS technology, providing high performance, which is essential for inverter operations. This study demonstrates a low ON-resistance (001) vertical-type two-dimensional hole gas (2-DHG) diamond metal–oxide–semiconductor field-effect transistor (MOSFET) with a trench gate structure. The active area of the device reduced after introducing a trench gate structure that can significantly improve the device integration and high-current operation. The maximum drain current density ( ${I}_{\text{D}}$ ) exceeds 20 kA/cm2 at ${V}_{\text{DS}} = -50$ V and ${V}_{\text{GS}} = -20$ V, which is the highest value obtained for (001) vertical-type diamond MOSFETs. This vertical-type diamond trench MOSFET can obtain the lowest ON-resistance ( ${R}_{\mathrm{\scriptstyle{ON}}}\text{S}$ ) of 2.5 $\text{m}\Omega \cdot \text{cm}^{2}$ , which is comparable to that of SiC and GaN vertical-type n-channel FETs (n-FETs). It can be potentially used as a p-channel power FET in a complementary inverter. Furthermore, this study demonstrates that the trench contact depth to the p+ diamond substrate significantly impacts the static characteristics of a device using the ATLAS device simulation. This result significantly contributes to the improvement of the rising drain current in the low-voltage region of the vertical-type diamond FET, which can be used in the future as p-channel power devices for the next generation of complementary inverters using GaN or SiC MOSFETs as n-channels.

TGF-β-Smad pathway participates in various biological processes such as development, differentiation, growth regulation, and cancer progression including epithelial-mesenchymal transition (EMT). Long non-coding RNAs (lncRNAs) also involved in carcinogenesis and cancer malignancies. To identify lncRNAs regulating TGF-β-Smad pathway, we comprehensively identified lncRNAs induced by TGF-β and found and reported a lncRNA ELIT-1 (EMT-associated lncRNA induced by TGF-β-1) which was induced by TGF-β and promoted EMT by facilitating TGF-β-Smad signaling. ELIT-1 bound to Smad and participated in expression of TGF-β target genes including Snail. Prognosis of lung adenocarcinoma and gastric cancer patients with high expression of ELIT-1 was poor suggesting that ELIT-1 may be useful as a novel prognostic and therapeutic target. Recently, we found that lincNMR (long intergenic noncoding RNA-nucleotide metabolism regulation) was induced via TGF-β-Smad pathway in various cell lines. Moreover, RNA-seq analysis using lincNMRs-depleted cells indicated that lincNMRs was involved in expression of APOBEC3B, a cytidine deaminase, promoting C to U mutation and highly expressed in various human cancers. Although, regulatory mechanisms of APOBEC3B expression have not been fully elucidated, we proved that lincNMRs bound to Smad and promoted the activity of APOBEC3B promoter. These data suggest that lincNMRs participate in APOBEC3B expression by collaborating with TGF-β-Smad pathway. Additionally, high expression of lincNMRs was positively correlated with high expression of APOBEC3B in various cancer cell lines. The high expression of APOBEC3B as well as lincNMR was significantly associated with their poor prognosis in liver and lung cancer patients, suggesting that lincNMR may contribute to tumor malignancy by enhanced expression of APOBEC3B via TGF-β-Smad pathway. Citation Format: Masatoshi Kitagawa, Kosuke Ota, Tatsuya Ohhata, Satoshi Sakai. Identification and functional characterization of long noncoding RNAs that regulate TGF--Smad pathway as Smad co-factors. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3723.

Long non-coding RNAs (lncRNAs) participate in carcinogenesis and cancer malignancies. Transforming growth factor-β (TGF-β) is involved in various cellular processes including cancer progression. We performed comprehensive RNA sequencing analyses to identify lncRNAs regulated by TGF-β and found that lincNMR (long intergenic noncoding RNA–nucleotide metabolism regulator, also identified as MAP3K9-DT) was induced by TGF-β in various cell lines. There are several variants of lincNMR (hereafter lincNMRs) in the lincNMR/MAP3K9-DT locus, and their expression was increased by TGF-β. TGF-β-mediated induction of lincNMRs was decreased by depletion of Smad2/3 in Huh7, suggesting that the TGF-β–Smad pathway is involved in lincNMRs expression. We also found that APOBEC3B but not other APOBEC family members were a target gene of lincNMRs. APOBEC3B, a cytidine deaminase, promotes C to U mutation and highly expressed in various human cancers. Although it is associated with cancer progression, regulatory mechanisms of APOBEC3B expression have not been fully elucidated. We performed RNA immunoprecipitation assays and proved that lincNMRs bound to endogenous Smad2 in Huh7 cells. The increased activity of the promoter of APOBEC3B induced by overexpression of Smad2/3 was inhibited by depletion of lincNMRs. These data suggest that lincNMRs participate in APOBEC3B expression by collaborating with TGF-β–Smad pathway. High expression of lincNMRs was positively correlated with high expression of APOBEC3B in various cancer cell lines. Overexpression of APOBEC3B as well as lincNMR was found in human cancers such as hepatic and lung cancers and was associated with their poor prognosis, suggesting that lincNMR may contribute to tumor malignancy via enhanced expression of APOBEC3B.

Uniform, micron-sized SrTiO3 particles do not tend to aggregate, and the low surface area of larger particles can be improved by incorporating porous structures, thus offering superior performance for a range of applications. In this study, submicron-to micron-sized SrTiO3 particles were prepared using hot water or hydrothermal conversion of spherical hydrous titania (TiO2·nH2O) and porous hydrous titania. When spherical hydrous titania particles were employed as the starting material, spherical SrTiO3 particles of hydrous titania were obtained via treatment at 120 °C for 24 h. Similarly, the use of porous hydrous titania particles treated at 90 °C for 48 h resulted in spherical porous SrTiO3 particles with macropores of porous hydrous titania. These porous SrTiO3 particles have a specific surface area of ~115 m2/g, which is one of the largest among micron-sized SrTiO3 particles, thereby making them suitable for use as catalysts or photocatalysts.

A 63-year-old man with pulmonary adenocarcinoma was treated with nivolumab. High fever developed within several hours after the first administration of nivolumab; subsequently, serum creatinine levels kept increasing daily. We diagnosed acute kidney injury (AKI) as an immune-related adverse event; the patient was initially treated with 50 mg prednisolone, and the dose was then tapered. Renal biopsy pathologically revealed tubulointerstitial inflammation with strong infiltration of only T cells that were CD3+, CD4+, and CD8+. The infiltration of CD163+ M2 macrophage was also observed. AKI within 1 week after the administration of nivolumab seems to be rare; therefore, the present case provides important findings useful in daily clinical practice.

Reconstructing past ocean currents in the coastal regions is necessary to better understand the relationship between oceanographic changes and coastal ecosystems. It is known that variations have occurred with large-scale climate changes such as ENSO (El Niño Southern Oscillations) and PDO (Pacific Decadal Oscillations). Thus, reconstruction of past seawater conditions in coastal regions is needed to better understand the relationship between oceanographic changes and coastal ecosystems. Seawater radiocarbon is a unique proxy to understand the properties of water masses. Reef-building corals have been employed extensively and successfully in conducting this type of research into past ocean circulation histories. However, their distribution is limited to the low latitudes and hence alternative archives are required for studies in mid to high-latitude locations. Here, we use abalone shell samples obtained from Otsuchi Bay located in the Tohoku region on the Pacific coast of Northern Japan. Radiocarbon in abalone shells was compared with dissolved inorganic carbon in two-year-long records of river water as well as seawater. The data indicate that abalone shells can be used to reconstruct past seawater radiocarbon variations in northern Japan where coral skeletons are not available for ocean mixing studies.

Lakes are sensitive recorders of anthropogenic activities, as human society often develops in their vicinity. Lake sediments thus have been widely used to reconstruct the history of environmental changes in the past, anthropogenic, or otherwise, and radiocarbon dating provides chronological control of the samples. However, specific values of radiocarbon in different carbon reservoirs due to the different pathways of radiocarbon from the upper atmosphere to the lake, called the radiocarbon reservoir age, is always difficult to evaluate because of dynamic processes in and around lakes. There are few systematic studies on radiocarbon reservoir ages for lakes owing to the complex radiocarbon transfer processes for lakes. Here, we investigate lake waters of the Fuji Five Lakes with monthly monitoring of the radiocarbon reservoir effects. Radiocarbon from dissolved inorganic carbon (DIC) for groundwater and river water is also measured, with resulting concentrations (Δ14C) at their lowest at Lake Kawaguchi in August 2018 (–122.4 ± 3.2‰), and at their highest at Lake Motosu in January 2019 (–22.4 ± 2.5‰), despite a distance of 25 km. However, winter values in both lakes show similar trends of rising Δ14C (about 20‰). Our lake water DIC Δ14C results are compared to previously published records obtained from sediments in Lake Motosu and Lake Kawaguchi. These suggest that total organic carbon and compound-specific radiocarbon found in sediments are heavily influenced by summer blooms of aquatic organisms that fix DIC in water. Thus, future studies to conduct similar analyses at the various lakes would be able to provide further insights into the carbon cycle around inland water, namely understanding the nature of radiocarbon reservoir ages.

Purpose Achieving cost-effectiveness while maintaining strict quality regulations is an emerging topic in pharmaceutical manufacturing. With a focus on the use process of excipients, e.g., reception, storage, testing, and actual usage, this paper presents a multiobjective design method for determining the optimal process setup.

We attempted to predict activity/dominance for soccer games, where activity is defined as the degree of activity of the game as perceived by the viewer, whereas dominance is the degree at which the viewer perceives a particular team to dominate over the other team. Such activity/dominance information would help a layman viewer understand the game. It would also enable construction of an automatic digest creation system that extracts scenes having high activity/dominance. There are two facets of this study: 1. The main part of the underlying prediction model consists of a Stick-Breaking Hidden Markov Model, where the data automatically estimates the number of states of the Markov process behind the data. 2. The data used in this paper is vector time-series data consisting of player, referee, and ball positions, together with team information, acquired by a set of fixed cameras. The problem was approached with a Bayesian framework where learning and prediction were implemented by three different methods: Markov Chain Monte Carlo, Expectation Maximization, and Variational Bayes. The proposed method was tested using a dataset consisting of 10 professional soccer games and was compared against standard regression methods.

Structures of cobalt oxide cluster cations have been investigated by ion mobility mass spectrometry. When the ions were injected into a drift cell with 250 eV kinetic energy, ( CoO ) n + and Co n O n - 1 + were observed. Collision cross sections were experimentally determined for ( CoO ) 2 - 7 + and Co n O n - 1 + (n = 5–7). Orientation-averaged collision cross sections were calculated for optimized structures of these ions obtained in quantum chemical calculations. By comparison between experimental and theoretical cross sections, ( CoO ) 3 - 5 + ions are found to have monocyclic-ring structures. By contrast, ( CoO ) 6 , 7 + have compact tower structures. Therefore, structural transition from the ring to compact structures occurs at ( CoO ) 6 + .

An infant with pancytopenia was born to a mother who used the common immunosuppressant azathioprine (AZA). Maternal and neonatal blood levels of 6-thioguanine nucleotides (6TGN; metabolite of AZA) were 1890 and 1480 pmol/8 × 108 red blood cells, respectively. Maternal 6TGN levels could be useful in predicting neonatal pancytopenia.

We report diffusing boron and phosphorus dopant atoms in silicon with impurity sources of BOx and POx layers formed on the top surfaces of n- and p-type crystalline silicon substrates. The silicon samples with impurity sources were subsequently covered with carbon powders to effectively absorb 2.45 GHz microwave power. Microwave irradiation at 1000 W for 27 s rapidly heated the carbon powders to 1265°C. The sheet resistivity of the samples decreased to 29 and 16 Ω/sq because of boron and phosphorus doping by 29-s-microwave heating. The photo-induced minority carrier lifetime increased to 2.0×10−5 and 3.5×10−5 s by 20- and 14-s-microwave heating for the boron- and phosphorus-doped samples. Boron atoms with a concentration above 1020 cm−3 diffused 150 nm deep by 26-s-microwave heating. Achievements of diode rectified characteristics and photovoltaic effect demonstrate pn junction formation at the top surface region by the present doping method.

A combination of the carbon-powder absorber with microwave irradiation is proposed as a rapid heat method. 2-μm-diameter carbon powders with a packing density of 0.08 effectively absorbed 2.45 GHz 1000-W-microwave and heated themselves to 1163 °C for 26 s. The present heat treatment recrystallized n-type crystalline silicon surfaces implanted with $$1.0 \times 10^{15}\hbox {-cm}^{-2}$$ -boron and phosphorus atoms with crystalline volume ratios of 0.99 and 0.93, respectively, by microwave irradiation at 1000 W for 20 s. Activation and carrier generation were simultaneously achieved with a sheet resistivity of $$62\, \Omega / \hbox {sq}$$ . A high photo-induced-carrier effective lifetime of $$1.0 \times 10^{-4}$$ s was also achieved. Typical electrical current-rectified characteristic and solar cell characteristic with an efficiency of 12.1 % under $$100\hbox{-mW/cm}^{2}\hbox{-air-mass-}1.5$$ illumination were obtained. Moreover, heat treatment with microwave irradiation at 1000 W for 22 s successfully crystallized silicon thin films with thicknesses ranging from 2.4 to 50 nm formed on quartz substrates. Nano-crystalline cluster structure with a high volume ratio of 50 % was formed in the 1.8-nm (initial 2.4-nm)-thick silicon films. Photoluminescence around 1.77 eV was observed for the 1.8-nm-thick silicon films annealed at 260 °C in $$1.3 \times 10^{6}$$ -Pa-H2O-vapor for 3 h after the microwave heating.

今回われわれは，破裂動脈瘤による重症くも膜下出血の症例で脳波上alpha comaと診断し，治療により回復のみられた症例を経験したので報告する．症例は突然の意識障害で搬送された60歳，男性．来院時より深昏睡状態で両側瞳孔散大傾向を示した．CTでは強いくも膜下出血を認め，3D-CTAで前交通動脈瘤が確認された．脳波検査では全体的に単調なα波がみられalpha comaと診断した．動脈瘤に対してコイル塞栓術を施行した．術後経過は良好で，意識レベルも改善し，簡単な日常会話が可能なまでに回復した．術後7週目の脳波では基礎波も正常化した．脳波上，alpha comaと診断された患者の予後は不良であることが報告されているが，近年予後の良い例も報告もある．病態として低酸素脳症が背景にあることが指摘されている．われわれの症例は，適切な呼吸器疾患の治療を行うことにより低酸素状態からの回復し，昏睡からの回復に応じた脳波所見の改善を示した．本例のような重症くも膜下出血例でalpha comaと診断された場合でも，入院時の他の電気生理検査の結果や，初期治療による臨床症状の変化を参考にしながら積極的な治療適応があるか決定することが勧められる．

We describe herein 2 patients who developed Vogt-Koyanagi-Harada syndrome in the course of renal biopsy-proven immunoglobulin A (IgA) nephropathy. A 61-year-old man with an 11-year history of IgA nephropathy and a 16-year history of thyroiditis, and a 56-year-old man with a 5-year history of IgA nephropathy developed Vogt-Koyanagi-Harada syndrome. At the time of the eye disease presentation, IgA nephropathy was stable without corticosteroids in both patients. Vogt-Koyanagi-Harada syndrome was successfully treated with intravenous administration of prednisolone tapered from 200 mg daily. Vogt-Koyanagi-Harada syndrome is associated with IgA nephropathy, suggesting a similar autoimmune mechanism for both diseases.

A questionnaire survey was conducted to investigate the sleeping habits of young children in relation to their lifestyles and psychological state. The study revealed that, while they were not associated with the occupation of their parents, their sleeping habits correlated with their habits of watching TV, playing games, soporific actions or the habit of napping, among others. The results suggested that young children who have regular sleeping habits have been properly guided to get up and go to bed in their daily life. It was further suggested that young children with regular sleeping habits are emotionally more stable than those with irregular sleeping habits.

The silylation of various kinds of aryl iodides with 1,1,1,3,5,5,5-heptamethyltrisiloxane was achieved by a suitable transition-metal catalyst, such as Pd(0), Pt(0), and Rh(I). These -catalytic systems showed dramatically different substrate scope.

Radiation doses during computed tomography (CT) examinations are generally evaluated by CT dose index (CTDI). The CTDI is measured by means of a CTDI phantom, which is placed in the center of the CT gantry aperture. However, patients are not always positioned in the centered in clinical settings. In this study, dose distributions associated with patient setup errors and head size were evaluated using phantoms developed for pediatric patients. The phantoms were made using flexible acrylic sheets in a cylindrical shape [diameters of 6 (premature baby), 8 (neonate), 10 (infant), and 12 cm (child)] and placed on the end of the CT bed. The bed position was lowered from the center by up to a radius length for each phantom size. Dose distributions in the phantoms were measured using radiochromic film. By lowering the bed position, the surface doses at 0° increased and those at 180° and the center doses decreased. However, the other measurement positions exhibited complex changes depending on the phantom size. In addition, the shapes of the dose profile curves varied according to the distance from the X-ray tube (i.e. location in the gantry aperture). In this study, the surface doses became smaller with decreasing distance from the X-ray tube. Therefore, decreasing the distance from the lens to the X-ray tube would be an effective way to reduce the absorbed dose of the lens. However, the dose distributions in the phantoms varied in a complex manner depending on patient setup errors and phantom size. In addition, beam slice width and pitch were important factors in determining the amount of the CT dose.

Mesodermal-specific cDNA or transcript (MEST) was identified by suppression subtractive hybridization-PCR of cDNA isolated from embryonic day 13vs. newborn mice kidneys. At day 13 of mouse gestation, a high expression of MEST, with a single ∼2.7-kb transcript that was exclusively localized to the metanephric mesenchyme was observed. The MEST mRNA expression gradually decreased during the later stages and then abruptly decreased in the newborn kidneys and subsequent postnatal life, after which a very mild expression persisted in the glomerular mesangium. Regression in mRNA expression during embryonic renal development appears to be related to methylation of the MEST gene. Treatment of metanephroi, harvested at day 13 of gestation with MEST-specific antisense oligodeoxynucleotide resulted in a dose-dependent decrease in the size of the explants and the nephron population. This was associated with a selective decrease in MEST mRNA expression and accelerated apoptosis of the mesenchyme. These findings suggest that MEST, a gene with a putative mesenchymal cell-derived protein, conceivably plays a role in mammalian metanephric development.