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To evaluate the usefulness of synthetic magnetic resonance imaging (MRI) performed before the initiation of neoadjuvant chemotherapy (NAC) in predicting whether breast cancers can achieve a pathological complete response (pCR) after the completion of NAC.This retrospective study investigated 37 consecutive patients with 39 breast cancers (pCR: 14, and non-pCR: 25) who underwent dynamic contrast-enhanced (DCE)-MRI and synthetic MRI before the initiation of NAC. Using synthetic MRI images, quantitative values (T1 and T2 relaxation times, proton density [PD] and their standard deviations [SD]) were obtained in breast lesions, before (Pre-T1, Pre-T2, Pre-PD, SD of Pre-T1, SD of Pre-T2, SD of Pre-PD) and after (Gd-T1, Gd-T2, Gd-PD, SD of Gd-T1, SD of Gd-T2, SD of Gd-PD) contrast agent injection. The aforementioned quantitative values and several morphological features that were identified on DCE-MRI were compared between pCR and non-pCR.Multivariate analyses revealed that the SD of Pre-T2 (p=0.038) was significant and was an independent predictor of pCR, with an area under the receiver operating characteristics curve of 0.829. The sensitivity, specificity, and accuracy of the SD of Pre-T2 with an optimal cut-off value of 11.5 were 71.4%, 80%, and 76.3%, respectively.The SD of Pre-T2 obtained from synthetic MRI was used successfully to predict those breast cancers that would achieve a pCR after the completion of NAC; however, these results are preliminary and need to be verified by further studies.

Objective: To describe the personal features, as well as the management activities related to cattle welfare in Loma Bonita, Oaxaca, Mexico. Design/Methodology/Approach: This is a cross-sectional, descriptive, and quantitative study. The sampling was non-probabilistic for convenience. Between December 2019 and March 2020, a questionnaire was applied to 27 farmers. Results: The average age of the ranchers is 44.6 years; 55.6% have more than 20 years of experience; 25.9% herd their cattle using a stick; 48.1% do not disinfect the udders; and 25.1% do not wash their hands during milking. Study Limitations/Implications: The results and conclusions are limited to the sample used in the present study. Therefore, extending them to all livestock farmers in the municipality would require a broader study that considers statistical techniques of probabilistic sampling. Findings/Conclusions: There are management activities outside the parameters established by the appropriate sanitary and welfare practices of cattle. However, the personal features indicate the existence of conditions related to the livestock activity in Mexico, that encourage participants to propose and carry out programs, plans, and strategies aimed at promoting and applying practices on animal welfare, thereby improving the productive, reproductive and profitability parameters.

The newly developed low-cost micro-electro-mechanical system (MEMS)-based acceleration sensors exhibit sufficient accuracy and stability to monitor the shaking of structures caused by an earthquake. We have developed a practical shaking-monitoring system using MEMS-based acceleration sensors and a 920 MHz multi-hop radio communication method that offers reliable radio wave communication, even within buildings. In this system, the base clock of each sensor unit must be closely synchronized to the master clock to minimize acceleration-induced phase synchronization error. In the proposed system, this error can be limited to three milliseconds in a system of multiple sensor units.

BackgroundCurrently, five types of Janus kinase inhibitors (JAKis) are used for rheumatoid arthritis (RA) treatment. The number of cases in which multiple JAKis have been prescribed is increasing. However, the real-world efficacy and safety of JAKis and related factors require further evaluation.ObjectivesThe primary objective of this study was to elucidate the impact of past use of disease-modifying anti-rheumatic drugs on RA treatment using JAKis. The secondary objective was to investigate the safety profiles of these agents in a real-world setting.MethodsOf the 303 JAKi-treated patients in the Fukui Ishikawa Toyama Database of RA included in this study, 30 had switched from one JAKi to another (JJ group), 214 switched from a biologic agent to a JAKi (BJ group), and 47 were naïve to either biologics or JAKis (NJ group). We compared baseline factors, treatment response, and JAKi continuation rates among the three groups. Factors related to JAKi discontinuation were assessed using Cox regression analysis. Furthermore, we investigated adverse events and reported them using exposure-adjusted incidence rates (EAIR; incidence rates per 100 patient-years).ResultsData from the 303 cases were analyzed (mean age = 63.6 years; female, 82%; mean RA duration, 176 months). Of the 303 patients, 118, 106, 50, and 29 were treated with tofacitinib, baricitinib, peficitinib, and upadacitinib, respectively, on initial observation. Rate of concomitant use with methotrexate and prednisolone was 52% and 49%, respectively.Regarding efficacy, no significant differences were observed among the three groups in terms of treatment response and JAKi continuation rates, except for the 6-month treatment response between the JJ and NJ groups. Cox regression analysis of the 303 cases revealed that only past use of JAKis during the disease history was significantly associated with JAKi discontinuation. The Kaplan–Meier method showed that patients who previously used JAKis had significantly shorter median JAKi treatment duration than those without such a history (20.9 vs. 54.7 months; p = 0.012). Treatment response was significantly poor in patients who had previously used JAKis, especially 6 months after treatment initiation.In terms of safety, the total exposure period for the 303 cases was 495 person-years, and the total number of adverse events was 161 (EAIR, 32.5). There were 12 cases (EAIR, 2.5) of serious infections, 23 cases (EAIR, 5.1) of herpes zoster, 7 cases (EAIR, 1.4) of malignant tumors, and 4 cases (EAIR, 0.8) of MACE. Adverse events led to JAKi discontinuation in 34 patients (EAIR, 6.9); the main causes of adverse events leading to treatment discontinuation were infectious diseases in 10 cases (EAIR, 2) and neoplasms in 4 cases (EAIR, 0.8). Within 1 year of initiating JAKi therapy, 21 patients discontinued treatment owing to adverse events, which accounted for 27% of the reasons for treatment discontinuation.We also investigated cases of JAKi dose reduction, observed in 42 of the 303 cases. Among them, 10 patients required a re-increase in the JAKi dose, and 13 patients (56.5%) were able to maintain the reduced dose for more than 1 year. The remaining 19 patients were excluded from the analysis because the treatment duration at the lower dose had not exceeded 1 year at the time of data extraction. No difference in disease activity at the time of dose reduction was observed between those who maintained the new dose and those who did not (mean DAS28-CRP: 1.48 ± 0.26 vs. 1.89 ± 0.62).ConclusionPast use of JAKis may contribute to decreased response and continuation rates for JAKi treatment. In this study, conducted in Japan, development of herpes zoster was found to the most frequent adverse event among the priority survey items.AcknowledgementsI have no acknowledgements to declare.Disclosure of InterestsNone declared

AIM To evaluate the effect of augmented training datasets in a deep convolutional neural network (DCNN) used for detecting abnormal chest radiographs. MATERIALS AND METHODS Chest radiographs were corrected to conform to a DCNN dataset, with 288 abnormal and 447 normal radiographs. The radiographic images were divided into training and validation sets (441, 60%), and a test set (294, 40%). The training and validation sets were augmented to generate a total of 12,789 training and validation images. The augmentation consisted of operations such as rotation, horizontal and vertical flipping, Gaussian blur, and brightness variation, either alone or combined. The DCNN performed binary classification of the images as being abnormal or normal chest radiographs, and accuracy was used as measure to assess the model performance. RESULTS The accuracy of the DCNN trained with the augmented dataset tended to be higher than that of the DCNN trained with the non-augmented dataset. The augmented datasets combining rotation and horizontal flipping had a high accuracy of 0.91, showing the highest accuracy among the applied augmentation techniques and combinations. CONCLUSION Augmentation of training datasets can improve the performance of DCNN for radiographic image classification depending on the applied augmentation technique.

A potential factor dominating the obstacle strength of second phase precipitate particles in dispersion strengthening is the crystallographic mismatch between the matrix phase and the second phase; however, yet this concept has not been fully assessed by experiments and simulations. In the present study, we experimentally investigated the obstacle strength of body centered cubic (bcc) Nb particles and nanometric Nb clusters embedded in hexagonal close packed (hcp) Zr matrix. The bcc Nb is softer than the hcp Zr in terms of shear modulus, whereas from a crystallographic viewpoint, the bcc Nb particles can be nonshearable, strong obstacles because the slip plane inside the particles is not parallel with that in the matrix. Although the bcc Nb is thermodynamically the stable configuration for Nb atoms precipitating from the Zr matrix, in the very early stage of solute agglomeration, the crystal structure of Nb nanoclusters is possibly hcp rather than bcc. The obstacle strength ( α ) was no greater than 0.5 for the Nb nanoclusters, whereas 0.85 ≤ α ≤ 1 for the coarse bcc Nb particles; α = 1 was obtained with the Taylor factor ( M ) of 5.5 and α = 0.85 with M = 6.5, respectively. These results indicate that the bcc Nb particles are strong obstacles, and that the Nb nanoclusters are weak obstacles.

To examine the diagnostic capabilities of feature-tracking cardiovascular magnetic resonance (FT-CMR), tagged cine magnetic resonance (MR), and wall thickening (WT) analyses to detect infarcted segments in patients with established myocardial infarction (MI).Twenty patients with established MI were selected retrospectively and the peak endocardial circumferential strain (CS) was quantified based on the 16-segment model. According to CMR with late gadolinium enhancement, segments were categorised as transmural MI, subendocardial MI, and no MI.A total of 320 segments (62 transmural MI, 50 subendocardial MI, and 208 no MI) were analysed. Peak endocardial CS was significantly lower for transmural MI compared with subendocardial MI (p0.05) and no MI (p0.001). Cut-off values of -11.2% for CS by FTCMR, -10.9% for CS by tagged MR, and 23.8% for %WT, differentiated between infarcted and non-infarcted segments with a sensitivity of 72%, 71%, and 56%; specificity of 71%, 75%, and 67%; accuracy of 72%, 73%, and 63%; positive predictive value of 57%, 60%, and 48%; negative predictive value of 83%, 83%, and 74%; and an area-under-the-curve of 0.77, 0.79, and 0.64, respectively.FT-CMR was diagnostically superior to %WT, and could differentiate between subendocardial and transmural MI. Unlike tagged MR, FT-CMR did not require the acquisition of additional sequences.

The Japan Arteriosclerosis Longitudinal Study-Existing Cohorts Combine (JALS-ECC) is a pooled study based on individual participant data from existing prospective cohort studies in Japan. Its purpose was to consider associations between risk factors and cardiovascular disease (CVD) outcomes, as well as differences between subgroups, defined by age, gender or geographical region, which could not be detected in the smaller samples.Individual records for 66,691 participants in 21 cohort studies were pooled, accounting for a total of 575,628 person-years. From this data, there were 409 deaths attributed to stroke and 169 deaths attributed to coronary heart disease (CHD). Total stroke and CHD events were 1,478 and 178, respectively. Of the 1,424 total stroke events with a reported stroke subtype, 975 were classified as ischemic, 267 as hemorrhagic, and 178 as subarachnoid hemorrhage.The JALS-ECC collected data from existing cohort studies covering a diverse Japanese population, which has provided information about the effects of modifiable factors on the risks of the CVD. Such information should provide a reliable basis for establishing prevention strategies.

Background Extended thymectomy is indicated for children with myasthenia gravis (MG) when drug-resistance or dependence is seen. We have employed a technique for mediastinoscopic extended thymectomy (MET) on children with MG. Method A total of 14 children underwent MET at Kanagawa Children's Medical Center between 2005 and 2013. A mediastinal operation field was made by a V-shaped hook infrasternally to extirpate the thymus with adipose tissue around the thymus. Results The operation time and the amount of blood loss were 182±44minutes and 34±43ml, respectively. Postoperative complications, in the form of transient paralysis of the right recurrent nerve, occurred in 2 patients. The median length of postoperative hospital stay was 4.5days. After MET, 6 patients achieved complete remission and 7 patients achieved steroid dose reduction, but no improvement was seen in 1 patient. Conclusions This procedure offers the advantage of good surgical access for dissection around the bilateral phrenic nerves in extended total thymectomy, while achieving good cosmetic results.

Purpose: To identify features useful for differentiation between malignant and benign breast neoplasms using multivariate analysis of findings by MR imaging. Material and Methods: In a retrospective analysis, 61 patients with 64 breast masses underwent MR imaging and the time-signal intensity curves for precontrast dynamic postcontrast images were quantitatively analyzed. Statistical analysis was performed using a logistic regression model, which was prospectively tested in another 34 patients with suspected breast masses. Results: Univariate analysis revealed that the reliable indicators for malignancy were first the appearance of the tumor border, followed by the washout ratio, internal architecture after contrast enhancement, and peak time. the factors significantly associated with malignancy were irregular tumor border, followed by washout ratio, internal architecture, and peak time. for differentiation between benignity and malignancy, the maximum cut-off point was to be found between 0.47 and 0.51. In a prospective application of this model, 91% of the lesions were accurately discriminated as benign or malignant lesions. Conclusion: Combination of contrast-enhanced dynamic and postcontrast-enhanced MR imaging provided accurate data for the diagnosis of malignant neoplasms of the breast. the model had an accuracy of 91% (sensitivity 90%, specificity 93%).

We report 2 cases with hemorrhagic complications following percutaneous transluminal angioplasty (PTA) for carotid stenosis. Computed tomography (CT) scanning of these cases demonstrated diffuse subarachnoid hemorrhage in 1 case, and intracerebral hemorrhage in the other case on the day after PTA. In the latter case, we measured cerebral blood flow velocity and mean transit time with transcranial doppler (TCD) and dynamic CT scan, and TCD and dynamic CT demonstrated a remarkable increase in blood flow velocity and peak height respectively. From these results, postoperative hyperperfusion was supposed to have caused the hemorrhagic complication.

We reviewed the MRI studies of 25 patients with occipital lobe infarcts to clarify the distribution of infarcts in the posterior cerebral arterial territory, focussing on their relationship to the striate cortex. Visual field defects and MRI findings were also correlated in 16 patients. On coronal and/or sagittal images, the distribution of the infarct and its relationship to the striate cortex were classified. Involvement of the cortex of both upper and lower lips of the calcarine fissure was observed in 10 patients, and involvement of the lower lip alone in 15. The upper cortical lesions were always accompanied by lower cortical lesions. The visual field defects were complete hemianopia in nine patients, superior quadrantanopia in six and hemianopia with a preserved temporal crescent in one. All patients with superior quadrantanopia had involvement of the lower cortex alone; there were no cases of inferior quadrantanopia. The characteristic vascular anatomy, and poor development of the collateral circulation in the lower cortical area, may explain the vulnerability of this area to infarcts.

By using self-assembly molecules as a template, nanometer-sized plate-like metal oxide and semiconductor particles can be obtained by confined growth inside the lamellar bilayers of microemulsion systems. It was found that a strong chemical affinity between the metal salt and the polar head group of amphiphilic molecules and the anisotropic structure of microemulsion systems play a premier role in the anisotropic growth. Nanometer-sized composite particles (nano-composites) with a core-shell structure have been prepared by arrested precipitation of metal or semiconductor clusters in reverse micelles, followed by hydrolysis and condensation of organometallic precursors in the microemulsion matrices. Temporally discrete nucleation and growth at elevated temperature (70 °C) give the resulting particles a narrow size distribution and defined crystallinity. Both the size of the core particles and the thickness of the coating layers can be varied by controlling processing parameters such as the ratio of water to surfactant and the ratio of water to organometallic precursors. By controlling the pH conditions and aging temperatures, a transparent gel composing the nanometer-sized inorganic clusters has been obtained. Optical properties of nanometer-sized composite particles are reviewed. For silver metal clusters and nano-composites, the shift of the absorption peak at the surface-plasmon resonance frequency due to the classical limited mean-free path of the conduction electrons or quantum size effects has been observed. The enhanced third-order non-linear susceptibility of the silver nano-composites results from the local-field enhancement and size effects, which has been experimentally demonstrated by the optical phase-conjugation technique.

We report on the results of intra-arterial thrombolysis in 11 patients with vertebrobasilar artery occlusion treated within 6 hours after onset of symptoms. Urokinase (5 patients) or recombinant tissue plasminogen activator (t-PA) (6 patients) was injected through a microcatheter conducted to the thrombus. Eight patients showed recanalization of the thrombus. The outcome was excellent in 5 patients, good in 2 patients, and poor in one patient. Recanalization could not be achieved in 3 of the 11 procedures; all patients in whom recanalization failed died. There were no hemorrhagic complications after thrombolysis. Two patients with residual stenosis after thrombolysis underwent successful percutaneous transluminal angioplasty (PTA) to prevent re-occlusion. Intra-arterial thrombolysis for vertebrobasilar artery occlusion is a safe and effective treatment if it is performed within 6 hours.

The causes of accelerated corrosion of Zircaloy-4 fuel cladding at high burnups in PWRs have been reviewed and, among these causes, the effect of hydriding has been investigated using out-of-pile corrosion test results and quantitative analyses. The review shows that the lithium effect and the microstructural change of Zircaloy-4 have potential to accelerate the corrosion rate. However, consistent data base applicable to quantitative analyses of PWR corrosion is not enough. On the other hand, the out-of-pile corrosion data shows that hydriding could accelerate the corrosion rate by a factor of up to 4. A new corrosion model which can take account of hydrogen movement showed hydriding is a plausible factor to determine the high burnup corrosion behavior.

A plastic molding technique for SQUIDs has been developed to protect the chip from moisture damage. A 1.5-mm-thick layer of molding compound (epoxy resin, elastic resin, and silica powder) was poured over Ketchen-type DC-SQUID that has Nb/AlO/sub x//Nb Josephson junctions. The moisture resistance of these plastic-molded SQUIDs was examined by subjecting them to temperature and humidity storage tests (60/spl deg/C, 90% relative humidity, 1,000 hours), and then measuring their performance characteristics. The results showed that the plastic packaging protected the chip from moisture damage, while not affecting the noise performance of the SQUIDs. The plastic molding therefore improved reliability and ease in handling of such SQUIDs.

A SQUID-based MEG measurement system cooled by a GM/JT cryocooler have been developed. The system consists of 61 channels of axial gradiometers arranged on a spherical surface, and thus can conform to a human head. The white noise level of the system is in a range between 12 and 18 fT/Hz/sup 1/2/. The noise from the cryocooler controlled to a level of 15 pT by several improvements to the cryostat (e.g., using low electrical conductivity material). Since the latter noise have a periodic characteristics, it can be reduced by using a "noise template" (i.e., a digital process using a computer). The system is described here, and its performance demonstrated by using it to measuring the faint biomagnetic fields from a human brain.

Improved methods for testing thin-film transistor (TFT) arrays are becoming increasingly Important as TFT liquid-crystal flat-panel displays become the first choice for many applications. The optical charge-sensing method for testing TFT arrays described in this paper uses interface reflections to sense accumulative free carriers and to generate maps showing the type and location of line and point defects. The method is nondestructive and provides data which can be used to repair certain types of array defects. It can also be used to measure such parameters as threshold voltage and channel conductance of TFT's, and frequency response of driver circuits. Optical charge sensing depends not only on charge density but also on the structure of the TFT arrays. Charge-sensing sensitivity is reduced by reflections from the metal interconnects. An improvement in the net reflectance change is obtained by using polarized and angled incident light in spite of reduced reflectance changes compared with normal incidence.

The fragmentat+-ion cross sections of He isotopes are analyzed microscopically in the Glauber theory. Simple model wave functions for 6 He and 8 He are introduced to investigate the importance of neutron correlations in these nuclei. It is shown that the momentum distribution of 4 He in the ( 6 He, 4 He) two-neutron removal reaction is quite sensitive to the description of the neutron correlation. A microscopic wave function for 6 He is found to reproduce successfully all the data on the fragmentation reaction together with the recent data on the beta-delayed particle emission.

The traditional Japanese medicine rikkunshito ameliorates the nitric oxide-associated delay in gastric emptying. Whether rikkunshito affects gastric motility associated with 5-hydroxytryptamine (serotonin: 5-HT) receptors or dopamine receptors is unknown. We examined the effects of rikkunshito on the delay in gastric emptying induced by 5-HT or dopamine using the phenol red method in male Wistar rats. 5-HT (0.01–1.0 mg kg−1, i.p.) dose dependently delayed gastric emptying, similar to the effect of the 5-HT3receptor agonist 1-(3-chlorophenyl) biguanide (0.01–1.0 mg kg−1, i.p.). Dopamine also dose dependently delayed gastric emptying. The 5-HT3receptor antagonist ondansetron (0.04–4.0 mg kg−1) and rikkunshito (125–500 mg kg−1) significantly suppressed the delay in gastric emptying caused by 5-HT or 1-(3-chlorophenyl) biguanide. Hesperidin (the most active ingredient in rikkunshito) suppressed the 5-HT-induced delayed gastric emptying in a dose-dependent manner, the maximum effect of which was similar to that of ondansetron (0.4 mg kg−1). The improvement obtained by rikkunshito or ondansetron in delaying gastric emptying was completely blocked by pretreatment with atropine. Rikkunshito appears to improve delay in gastric emptying via the antagonistic action of the 5-HT3receptor pathway.

This paper will overview our results of endovascular therapy (PTA or stenting) for cervical ICA stenosis and discuss the advantages and disadvantages of each treatment. 60 cases with 62 lesions were treated with PTA 68 times, while 36 cases with 37 lesions were treated with stenting 37 times. A total of 99 lesions were treated with PTA or stenting 105 times. In the PTA group arterial stenosis improved from 76.4% to 21%. In the stent group the stenosis improved from 82.3% to 8.3%. The morbidity rate was 2/60 (3.3%) in PTA group, although two cases had minor neurological deficits, while in stent treated group, morbidity rate was 1/36 (2.8%), although it showed one major neurological deficit. Mortality was 0% in each group. The restenosis rate in PTA group was 15/58 (26%), while it was 0/20 (0%) in stent treated group. Stenting brings significant reduction of stenosis and reduces the rate of restenosis compared to PTA. However, stenting has its own disadvantages such as hypotension and distal kinks when deployed in tortuous ICA stenosis.

We have mapped the results of large-scale search of SNPs for type 2 DM susceptibility genes in a Japanese population into a molecular interaction map for metabolic syndrome. This computer readable mapping may result in important insights in the ongoing endeavor to understand the complex web of SNPs and gene interactions in metabolic syndrome.

The electronic property of organic electroluminescent electro-luminescent electro-luminescent devices having a simple bi-layer structure of α-NPD and Alq 3 was investigated by impedance spectroscopy. We observed hole accumulation in the α-NPD layer and estimated hole mobility was 1.4x10-5cm2/Vs.

We developed a system that supports disease association studies to detect genes that may cause complex diseases. The main function of the system is to examine the possibility of each polymorphism being associated with a disease. Another important function is to perform linkage disequilibrium analysis and combine SNPs (single nucleotide polymorphisms) together into LDblocks (linkage-disequilibrium-blocks) to improve statistical power for association study. Those analyses can be efficiently performed using an analysis pipeline of the new system with handy tools for eliminating the inadequate data and so on. Consequently, the number of SNPs the system can analyze is about 30 to 50 times higher than by the standard manual procedures per unit of time. The new system also has a sophisticated visualization tool. The main viewer displays the genomic structure and is linked to another main viewer showing the in-depth analysis result. These viewers let the user easily check and make an interpretation of the results. The new system should provide significant assistance for the genome research of complex diseases.

Finding the causative genes for common diseases using SNP (single nucleotide polymorphism) markers is now becoming a real challenge. Although traditional statistical SNP association tests exist, these tests could not explain the effects of SNP combinations or probable recombination histories from ancestral chromosomes. Haplotype analysis of disease associated site provides more powerful markers than individual SNP analysis, and can help identify probable causative mutations. In this paper, we introduce a new method for effective haplotype pattern mining to detect disease associated mutations. Using this procedure, we can discover some of the new disease associated SNPs, which can not be detected by traditional methods. We will introduce a powerful tool for implementing this procedure with some worked examples.

To investigate the effect of shift work on long-term sickness absence (more than 7 calendar days), an 8-year follow-up study was carried out in a factory in Japan. The participants were male employees aged 18-54 years who were engaged in manufacturing sites. Shift patterns were classified by the number of non-daytime working days during the previous one-year. The causes of sickness absence were classified into three groups, 1) causes except injury, diseases of the musculoskeletal system and connective tissue, 2) injury, 3) diseases of the musculoskeletal system and connective tissue. The analysis of long-term sickness absences was based on the first occurrence. The age-adjusted incidence of sickness absence among shift workers who were on non-daytime shifts more than two-thirds of working days during the previous one year was significantly higher than that among other workers. After adjusting for confounding factors, a significant high risk still existed for this group of workers taking sickness absence for all causes and causes except for injury and the musculoskletal disorders. These findings suggest that shift workers who are engaged on a particular shift schedule are more likely to take leave due to sickness.

The satisfiability problem (SAT) of the propositional calculus is a well-known NP-complete problem. It requires exponential computation time as the problem size increases. We proposed a neural network, called LPPH, for the SAT. The equilibrium point of the dynamics of the LPPH exactly corresponds to the solution of the SAT, and the dynamics does not stop at any point that is not the solution of the SAT. Experimental results show the effectiveness of the LPPH for solving the SAT. In this paper we extend the dynamics of the LPPH to solve several variations of the SAT, such as, the SAT with an objective function, the SAT with a preliminary solution, and the MAX-SAT. The effectiveness of the extensions is shown by the experiments.

A 62-year old female patient in whom paradoxical right atrial to left atrial shunt flow through the foramen ovale was detected by transesophageal echocardiography during pneumoperitoneum for laparoscopic cholecystectomy was reported. This patient had a history of mitral valve replacement with residual tricuspid valve regurgitation. It was considered that the onset of paradoxical interatrial shunting through the foramen ovale might be caused not only by mechanical ventilation with positive end-expiratory pressure but also by pneumoperitoneum, especially in patients with heart disease, even if the intra-abdominal pressure was maintained at 12 mmHg.