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We establish the boundedness of generalized fractional integral operators Iρ on variable exponent Morrey spaces of an integral form Lp(・),ω(G), where ρ(x, r) and ω(x, r) are general functions satisfying certain conditions.

According to the recently proposed diagnostic criteria for sarcopenic dysphagia, sarcopenic dysphagia can be classified as probable or possible based on tongue pressure. However, it is unclear whether patients with probable and possible sarcopenic dysphagia have different characteristics. Therefore, this study aimed to investigate whether patients with possible and probable sarcopenic dysphagia have different clinical characteristics. A cross-sectional study. Setting: A rehabilitation hospital. PARTICIPANTS: In total, 129 patients aged ≥65 years with sarcopenic dysphagia were included. A tongue pressure of

This study aimed to investigate whether inflammation affects the outcome of swallowing ability to improve treatment for sarcopenic dysphagia.A retrospective observational cohort study was performed using data from the Japanese sarcopenic dysphagia database.The database was constructed using data from 19 hospitals and one home visiting rehabilitation team.Patients with sarcopenic dysphagia with measurements of C-reactive protein (CRP) and serum albumin (Alb) were included.Patients were assigned to two groups using CRP, Alb, and the Japanese modified Glasgow Prognostic Score (mGPS). The Food Intake LEVEL Scale (FILS) was measured at the times of admission and follow-up (FILS follow-up) to assess swallowing function.A total of 197 patients were included. Mean or median values of each parameter were as follows: age: 83.8±8.7, Alb: 3.2 ± 0.6 g/dL, CRP: 8.0 [3.0, 29.0] mg/L, mGPS: 1 [1-2], FILS: 7 [6-8], FILS follow-up: 8 [7-8], and duration of follow-up: 57.0 [27.0, 85.0] days. The FILS score at follow-up was significantly lower in the high CRP group (≥ 5.0 mg/L) than in the low CRP group (5.0 mg/L) (p = 0.01). Further, the FILS score at follow-up was significantly lower in the high mGPS group (class; 2) than in the low mGPS group (class; 0 and 1) (p = 0.03). In the multiple linear regression analyses without FILS at baseline, CRP and mGPS were independent risk factors for FILS follow-up. When FILS at baseline was entered, CRP and mGPS were not an independent risk factors for FILS follow-up.Inflammation could modify the outcome of the patients with sarcopenic dysphagia. Inflammation may be an important risk factor in evaluating patients with sarcopenic dysphagia.

To investigate the prevalence of hoarseness and its association with the severity of dysphagia in patients with sarcopenic dysphagia.Cross-sectional study using the Japanese sarcopenic dysphagia database.19 hospitals including 9 acute care hospitals, 8 rehabilitation hospitals, 2 long-term care hospitals, and 1 home visit rehabilitation team.287 patients with sarcopenic dysphagia, aged 20 years and older.Sarcopenic dysphagia was diagnosed using a reliable and validated diagnostic algorithm for the condition. The presence and characteristics of hoarseness classified as breathy, rough, asthenic, and strained were assessed. The prevalence of hoarseness and the relationship between hoarseness and Food Intake LEVEL Scale (FILS) were examined. Order logistic regression analysis adjusted for age, sex, naso-gastric tube, and handgrip strength was used to examine the relationship between hoarseness and FILS at baseline and at follow-up.The mean age was 83 ± 10 years. Seventy-four (26%) patients had hoarseness, while 32 (11%), 20 (7%), 22 (8%), and 0 (0%) patients had breathy, rough, asthenic, and strained hoarseness, respectively. Median FILS at the initial evaluation was 7 (interquartile range, 5-8). Hoarseness (β=0.747, 95% confidence intervals= 0.229, 1.265, p=0.005), age, sex, naso-gastric tube, and handgrip strength were associated independently with baseline FILS, while hoarseness (β=0.213, 95% confidence intervals= -0.324, 0.750, p=0.438) was not associated independently with the FILS at follow-up.Hoarseness was associated with the severity of dysphagia at baseline, however not a prognostic factor for sarcopenic dysphagia. Resistance training of swallowing and respiratory muscles and voice training as part of rehabilitation nutrition might be useful for treating sarcopenic dysphagia.

To have a fully first-principles description of the moiré pattern in transition-metal dichalcogenide heterobilayers, we have carried out density functional theory calculations on a MoTe

Aim: An educational program delivered through e-learning was conducted, focusing on nursing for primary breast cancer patients. This paper investigates the results of the program, clarifying changes in levels of understanding before and after the program, and evaluations of the program by nurses who participated. Methods: The content of the education program, which consisted of 24 lessons, each lasting 15-20 minutes, including case studies, covered concerns raised in questions by patients and families about diagnosis, multimodal treatment and nursing for primary breast cancer. Instructors were Certified Nurses in Breast Cancer Nursing and Certified Nurse Specialists in Cancer Nursing, and PowerPoint presentations with video and audio material were created. A dedicated website was created, and 1417 participants took the on-demand program, which was provided from September 2015 to March 2016. Survey participants were the first 500 nurses registered for the course to respond. A questionnaire created by the researchers was sent by post to respondents. Responses were anonymous with identifying information code, and questionnaires were sent with a return envelope before the program (within 2 weeks of registration) and after the program (within 1 month of the end of the program), with return of the questionnaire signifying consent to participate. The questionnaire comprised 24 items on level of understanding of breast cancer nursing, aligned to program content, plus 11 items on evaluation of the program. Responses were selected from a 5-point scale, where 1 meant “strongly disagree” and 5 meant “strongly agree”. Analysis: Responses were quantified, and mean scores for each item were calculated. In addition, respondents were divided into two groups, namely, those with less than 3 years of breast cancer nursing experience (Group A) and those with 3 or more years' experience (Group B), and were compared using the Mann-Whitney U test. SPSS Statistics V22.0 was used. Ethical considerations: The study went through Research Ethics approval at the researchers' institute of affiliation. Results: A total of 126 people replied to both the pre-program and post-program questionnaire, and of these, the responses of 106 nurses (Group A: 34 nurses, Group B: 72 nurses) who were not qualified as Certified Nurses or Certified Nurse Specialists were used for analysis. Median age was 41.0 years (Group A: 38.5 years, Group B: 42 years), and median number of years of breast cancer nursing was 4.6 years. In terms of program evaluation, “I could study when it was convenient for me” scored 4.63, while “It will be useful for breast cancer nursing from now on” scored 4.57. In terms of comparison of level of understanding before and after the program, understanding improved on all 24 items, and was significant on 19 items. Comparison of the 2 groups showed significant difference on 2 items, “support for changes in body image” and “communication with the patient”, with changes in level of understanding in Group A being greater. Discussion: The study suggests that participants' understanding of breast cancer nursing increased and improvements in clinical practice can be expected through e-learning materials that facilitate effective learning. Citation Format: Abe K, Iseki C, Suzuki M, Kokufu H, Arahori Y, Ohno T, Kanazawa M, Takeishi Y. Results of an educational program delivered through e-learning, focused on nursing for primary breast cancer patients [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-20-06.

Background Pulmonary arterial hypertension (PAH) is prominent as a vascular involvement in systemic sclerosis (SSc), which remains a leading cause of death in spite of current best treatments. Although recent studies focused on early diagnosis of established PAH, it is known that more than a half of the pulmonary circulation is impaired before early PAH is detected. However, there is little study about the changes of vascular functions or the underlying gene expressions during its subclinical stage. Objectives I. To detect the pathological changes in pulmonary arterial pressure (PAP) and vascular functions before PAH is manifested. II. To explore the changes in its underlying gene expressions of peripheral blood. Methods Total of 103 cases without PAH symptoms (NYHA I) with either Raynaud phenomenon (RP: n=87), skin sclerosis (n=65) or SSc-related autoantibody (n=68) were enrolled. To detect the pathological change of PAP, exercise Doppler echocardiography was carried out, and exercise induced pulmonary hypertension (exPH) group was segregated from normal response group (exN) with using the definition described in R. Naeije et al. 1) Vascular function was evaluated with thermography after 0°C-stress and determination of ankle-brachial index (ABI) and cardio-ankle vascular index (CAVI). Furthermore, reactive hyperemic index (RHI), augmentation index (AI) and second derivative of photoplethsmogram ageing index (SDPTGAI) were assessed with using EndoPAT. Micro-vascular changes were also recorded with nailfold videocapillaroscopy. Meanwhile, genome-wide gene expression analysis was performed with using whole peripheral blood. The genes correlated with each vascular function tests were analysed by weighted gene co-expression network analysis (WGCNA) and pathway enrichment analysis (PathVisio). Results There were significant differences between exPH and exN group in the result of thermography after 0°C-stress test, CAVI and AI normalised to heart rate of 75bpm (AI@75bpm). As the CAVI and AI are known to correlate positively with age, careful interpretation was necessary because the mean age of exPH group was higher as compare with exN group (69.05±11.04 vs. 60.23±14.73). However, the fact that recovery of blood-flow from RP was significantly delayed in exPH group suggested the additional pathological changes of vascular and endothelial functions. Gene expression analysis revealed that several mutual pathways such as “type2 interferon signalling”, “oxidative damage” and “fatty acid omega oxidation” seemed to underlie some vascular changes. Conclusions The results of vascular function tests including thermography after 0°C-stress, CAVI and AI@75bpm were significantly different between exPH and exN group. On the other hand, gene expression analysis showed that many factors such as ageing, arteriosclerotic and immunological mechanisms were involved in the changes of these vascular functions. Although further prospective study is required to select appropriate set of the tests, it is possible that evaluation of these vascular functions may be useful as a non-invasive test to assess the pulmonary vascular disease before PAH is manifested. Reference [1] . R. Naeije, et al., Am J Respir Crit Care Med187, 576–583 (2013). Disclosure of Interest None declared

Background In Japan, S-1 plus cisplatin has been used as first-line therapy for advanced gastric cancer (AGC). Patients with no response to first-line treatment with S-1 often receive a taxane-alone or irinotecan-alone as second-line treatment. However, second-line treatment with S-1 plus irinotecan is widely used in patients with AGC resistant to first-line S-1-based chemotherapy. The goal of this trial was to determine whether the consecutive use of S-1 plus irinotecan improves survival when compared with irinotecan-alone as second-line treatment for AGC. Patients and methods Patients who had disease progression during first-line S-1-based chemotherapy were randomly assigned to receive S-1 plus irinotecan or irinotecan-alone. The S-1 plus irinotecan group received oral S-1 (40–60 mg/m2) on days 1–14 and intravenous irinotecan (150mg/m2) on day 1 of a 21-day cycle. The irinotecan-alone group received the same dose of irinotecan intravenously on day 1 of a 14-day cycle. The primary end point was overall survival (OS). Results From February 2008 to May 2011, a total of 304 patients were enrolled. The median OS was 8.8 months in the S-1 plus irinotecan group and 9.5 months in the irinotecan-alone group. This difference was not significant (hazard ratio for death, 0.99; 95% confidence interval 0.78–1.25; P = 0.92). Grade 3 or higher toxicities were more common in the S-1 plus irinotecan group than in the irinotecan-alone group. Conclusion The consecutive use of S-1 plus irinotecan is not recommended as second-line treatment in patients who are refractory to S-1-based first-line chemotherapy. Clinical Trials.gov NCT00639327.

Solid state 13 C nuclear magnetic resonance (NMR) spectroscopy is a common tool to study the structure of soil humic fractions; however, knowledge regarding carbon structural relationships in humic fractions is limited. In this study, mobile humic acid (MHA) and recalcitrant calcium humate (CaHA) fractions were extracted from eight soils collected from six US states and representing a variety of soils and ecoregions, characterized by this spectroscopic technique and analyzed for statistical significance at P = 0.05. We found that the abundances of COO and N-C=O functional groups in the MHA fractions were negatively correlated to soil sand content, but were positively correlated to silt, total N and soil organic carbon contents. In contrast, the abundances of the COO and N-C=O functional groups were only positively correlated to the content of clay in the CaHA fractions, indicating that the two humic fractions were associated with different soil components. The two 13 C NMR peaks representing alkyls and OCH 3 /NCH were negatively correlated to the peaks representing aromatics, aromatic C-O and N-C=O/COO. Comparison of the sets of data from 13 C NMR spectroscopy and ultrahigh resolution mass spectrometry revealed that the aromatic components identified by the two methods were highly consistent. The comparison further revealed that protein in MHA was associated with, or bound to, the nonpolar alkyl groups, but a component competitively against (or complementary to) aromatic groups in the MHA composition. These observations provided insight on the internal correlations of the functional groups of soil humic fractions.

In this paper, transmission characteristics affected by a relative position between a noise suppression sheet (NSS) placed on a periodic metal film and a transmission line are examined. A microstrip line (MSL) based on IEC standard (IEC62333-2) is fabricated, and transmission characteristics of the MSL placed on two types of NSS are measured.

This paper describes a method to heat a food uniformly by using a microwave oven which has two input ports. Different standing wave distribution appears when an in-phase or anti-phase electric power is excited in the two input ports. This means that the heated parts of a food are different. Therefore, it is possible to heat a food more uniformly when in-phase or anti-phase electric power is given from the two ports alternately.

This paper investigates transmission characteristics of a microstrip line (MSL) with a noise suppression sheet (NSS) when thickness and permittivity of an adhesive between the NSS and the MSL are changed. The MSL based on IEC standard (IEC62333-2) is fabricated, and a transmission characteristic of the MSL attached with a dielectric-adhesive-backed NSS is simulated by a software Agilent's EMpro.

In this paper, we show a low temperature neutral beam oxidation process to obtain a high quality metallic oxide film. After irradiation of a Ta metal film with a neutral oxygen beam, a nm-thick Ta 2 O 5 film with a high film density was obtained, and a fabricated Cu/Ta 2 O 5 /Pt resistive memory (ReRAM) structure showed a bipolar resistive switching characteristic. In addition, after the deposition of a 1-nm-thick Al film on a Ge substrate, the simultaneous oxidation of Al and Ge was carried out at 300 °C, and a fabricated Au/AlO x /GeO x /Ge/Al MOS gate structure showed a C-V characteristic. These results demonstrate the great potential of neutral beam oxidation for the development oxide-based nanodevices.

The PD-1/B7-H1 pathway regulates immune responses and maintains homeostasis. Here, we identified a unique expression of B7 homolog 1 (B7-H1) on masticatory mucosae in the oral cavity. B7-H1 was physiologically expressed on the dorsal surface of the tongue, gingiva, and hard palate. Other squamous epithelia and other structures of the epithelia did not express B7-H1 in the steady state. Physiological B7-H1 expression on masticatory mucosae was limited on prickle cells, and its expression on basal keratinocytes (KCs) was strictly regulated. B7-H1 on prickle cells was upregulated by external topical stimuli, but B7-H1 on basal KCs was induced only by internal stimuli via infiltrating cells. The blocking of KC-associated B7-H1 or the lack of programmed cell death-1 (PD-1) on tissue effector CD4

Direct binding of Grb2 has an important role in the development of myeloproliferative disease induced by ETV6/FLT3

The presence of lymphatic vessels in dental pulp has recently been controversial, and no conclusion has been reached. In this study, we investigated the control of lymphangiogenesis with dental pulp development in the mouse mandibular molar using VEGF-C, VEGF-D, and VEGFR-3 as indices of lymphatic vessel-controlling factors. In addition, to distinguish blood and lymphatic vascular epithelial cells, we performed immunohistochemical analysis using von Willebrand factor (vWF) and statistical analysis. In dental papilla in the bell-stage non-calcified period, mesenchymal cells positive for VEGF-C, VEGF-D, and VEGFR-3 increased and lumen-forming endothelial cells were noted, but vWF was negative, suggesting that these were actively forming lymphatic vessels. Positive undifferentiated mesenchymal cells, an increase in endothelial cells in dental pulp, and lumen expansion were noted early after birth. Positivity was also detected in the odontoblast layer and sheath of Hertwig after birth, suggesting that these factors also play important roles in odontoblast differentiation and maturation and periodontal ligament and tooth root formation. We embryologically clarified lymphatic vessel formation in dental pulp and a process of lymphatic vessel formation from blood vessels, suggesting involvement of the surrounding tissue, odontoblasts, and sheath of Hertwig in vessel formation.

NdFeAs(O,F) superconducting thin films were grown on MgO, GaAs, CaF 2 , and LaAlO 3 single crystal substrates by molecular beam epitaxy. All thin films exhibited a clear superconducting transition, while the critical temperature T c showed a distinct substrate dependence, although the same growth condition was employed for all samples. The difference in T c can be attributed to the lattice strain effect and how susceptible the substrate is to fluorine. The thin film grown on CaF 2 substrate showed the highest T c with an onset T c of 56 K and zero resistance at 52 K. A correlation between T c and the lattice constant ratio c / a was observed similar to what was reported for other iron-based superconductors, suggesting an intimate relation between the crystal structure and the superconducting properties.

The transition between the two Zeeman sublevels of 2S1/2 in a single trapped 40Ca+ ion is directly excited by a radio-frequency magnetic field. A coherence time of 29.4±2.5 ms is measured by Ramsey interferometry. The ratio of the maximum Rabi frequency of the Zeeman transition (∼250 kHz) to the inverse of the coherence time is 7.3×103, which is considered to be a figure of merit for Zeeman states when they are used as a quantum bit. Several applications of the Zeeman qubit to quantum information processing are also discussed.

Unique properties of the N-acceptor in homo- and hetero-epitaxially grown ZnO by molecular beam epitaxy (MBE) are studied by means of microproving of surface sheet-resistance, Hall-effect measurement, persistent photoconduction (PPC) and thermally stimulated current (TSC). Rapid postanneal of N-doped ZnO is found to induce the change in the conduction type from n-type (as-grown) to p/n-type mixed conduction, forming island structure, and these properties are related to a structural instability of the N-acceptor.

There are several Fitness-For-Service (FFS) standards with evaluation rules in terms of plastic collapse for pres- sure equipment possessing a local metal loss simultaneously subjected to internal pressure and bending moment. The authors have already reported the results of a comparative study of FFS rules, including the remaining strength factor approach in API 579-1/ASME FFS-1 and the p-M (pressure and moment) diagram method, which pointed out that there could be signifi- cant differences in allowable flaw sizes. In this paper, acceptance criterion for plastic collapse assessment on local metal loss at high temperatures is proposed with taking into account the effect of decreasing yield strength of material at high tempera- tures, such as 350 ◦ C. The allowable flaw depth at high temperatures derived from API 579-1/ASME FFS-1 is larger than that obtained by the p-M diagram method. However, it is verified by finite element analysis that the allowable flaw size of the p-M diagram method is set on the stress state of general yielding near a local metal loss area if safety factor is not considered and it is possible to evade ratcheting due to cyclic bending moment in service such as that caused by earthquake if the proposed acceptance criterion is used.