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BACKGROUND von Willebrand disease (VWD) is characterized by a bleeding tendency due to abnormalities in von Willebrand factor (VWF). Severe traumatic brain injury (TBI) can induce secondary coagulopathy and hemostatic disorders. We herein present a rare case of multiple trauma, including severe TBI, in a patient with VWD who was successfully treated with repeated factor VIII/VWF transfusion in addition to standard critical care. CASE REPORT A 22-year-old man with type 2A VWD sustained head and lower limb injuries in a traffic accident and was comatose. Computed tomography indicated multiple trauma, including severe TBI (left-sided traumatic epidural hematoma, left-sided traumatic subdural hematoma, traumatic subarachnoid hemorrhage, skull fracture, and skull base fracture). The patient underwent emergency craniotomy for hematoma removal, external decompression, and intracranial pressure monitoring along with massive transfusion and repeated perioperative transfusion of factor VIII/VWF concentrates according to the level of bleeding. He recovered consciousness and eventually survived without neurological deficits. CONCLUSIONS Multiple trauma including TBI in patients with VWD is a critical condition. The active transfusion of factor VIII/VWF is essential for controlling hemorrhage early and in the perioperative period.

BACKGROUND Secondary thrombotic microangiopathies (TMAs) are induced by several underlying conditions and most are resolved by treating the underlying disease. Eculizumab, a human monoclonal antibody, blocks the final stages of the complement system. Several studies have shown that complement C5 monoclonal antibodies are effective in treating secondary TMA. Systemic sclerosis (SSc) is one of the most common causes of secondary TMA, and early diagnosis is important because TMA secondary to SSc has a poor prognosis. We report a case of TMA secondary to SSc that did not respond to eculizumab, despite the presence of severe complement activation. CASE REPORT A 61-year-old previously healthy man was admitted for acute renal failure and thrombocytopenia. TMA was suspected because hemolytic anemia, thrombocytopenia, and organ damage were detected. Based on the physical findings, we suspected SSc as the underlying cause. All tests for specific antibodies, including Scl-70, were negative, and C5b-9 levels were markedly elevated (11 041 ng/mL). We initiated plasma exchange on day 3, followed by eculizumab therapy, but with limited improvement. SSc with secondary TMA was identified upon further testing. After completion of the plasma exchange, the platelet count was maintained above 30 000/μL. Creatinine levels gradually decreased, and the patient was weaned off dialysis. Steroid treatment for SSc was continued, and the patient was eventually discharged. CONCLUSIONS A case of SSc-TMA was ineffectively treated with eculizumab, despite abnormal activation of the complement system. Continuous monitoring and investigation are required, and discontinuation of eculizumab should be determined according to the final diagnosis.

In human sepsis, little is known about the relationships between complement activation and the clinical characteristics of sepsis, including disseminated intravascular coagulation (DIC), interventions, and prognosis.Adult patients with sepsis admitted from November 2016 to December 2018 were included. We used the plasma levels of soluble C5b-9 (SC5b-9) as a marker of complement activation. We compared the clinical characteristics and complement components between patients with and without DIC. We also compared the clinical characteristics and each DIC parameter across quartile groups for the SC5b-9 value.Forty-nine sepsis patients were eligible. Thirty-four patients developed DIC, and eight patients died. The median (interquartile range) SC5b-9 value was 342 (261-501) ng/mL. Compared with patients without DIC, patients with DIC showed lower C3 levels (mean, 95.7 vs. 70.4 mg/dL, P 0.01) and higher SC5b-9 levels (median, 287 vs. 400 ng/mL, P = 0.01). Patients were stratified by SC5b-9 quartile (ng/mL: low:260, moderate: 260-342, high: 343-501, highest:501). The mean Sequential Organ Failure Assessment score varied across these groups (P = 0.02). In the high and highest groups, many more patients received vasopressors and developed DIC. In the highest group, the coagulation parameters were severe, and thrombocytopenia was prolonged. In-hospital mortality tended to be high (33%) in the highest group.The degree of complement activation is related to DIC, severity, intensive interventions, and mortality. Further studies are needed to confirm the usefulness of SC5b-9 for stratifying sepsis patients.

We successfully developed a novel time-resolved synchrotron-radiation X-ray diffraction (t-SXRD) measurement system with high temporal resolution (minimum time: 50 ms) at the BL02B2 facility at SPr...

Anti-vascular endothelial growth factor (VEGF) therapy is the first-choice treatment for neovascular age-related macular degeneration (nvAMD); however, patients often are burdened physically, financially, and mentally. We investigated the relationship between mental status and feasibility of an intravitreal ranibizumab treat-and-extend (TAE) regimen for nvAMD.In this prospective, multicenter study, 75 patients with nvAMD received ranibizumab intravitreally in a TAE regimen. After two monthly injections, the injection intervals were extended step-by-step to 6, 8, 12, and 16 weeks in eyes with dry maculas on optical coherence tomography (OCT) and, if exudation persisted or relapsed, shortened by one step. The best corrected visual acuity (BCVA) measurement and OCT were performed at baseline and on the same days of the scheduled injections. At baseline, all patients completed a survey, the Hospital Anxiety and Depression Scale (HADS), regarding mental burden. At week 52, patients on the TAE regimen for 1 year completed the HADS and a questionnaire designated to assess treatment-associated mental status.Fifty-one patients (68%) completed the 1-year TAE regimen; 24 eyes (32%) discontinued the TAE regimen because of the rescue treatment, difficulty in completing clinical visits, or financial burden. In 51 eyes on the TAE regimen for 1 year, the mean BCVAs improved from 64.3 letters at baseline to 71.6 letters at week 52. The mean anxiety and depression scores on HADS decreased significantly (p 0.01) after the 1-year treatment. Women tended to have higher anxiety scores, possibly associated with fear of injection and recurrence, while some men had higher depression scores potentially associated with financial burden, difficulty in completing clinical visits, and subsequent interruption of the TAE regimen especially in eyes with low treatment efficacy.A TAE regimen of intravitreal ranibizumab injections preserves vision in eyes with nvAMD and reduces mental burden associated with disease relapse.This clinical study was registered retrospectively on December 22, 2014 with the ClinicalTrials.gov identifier NCT02321839.

Intestinal sodium-dependent phosphate transport protein 2b (SLC34A2, NaPi2b) inhibitors are expected to be potential new candidates for anti-hyperphosphatemia drugs. However, a risk of on-target side effects based on the inhibition of NaPi2b in the lung and testis has been reported. To identify gut-selective (minimally systemic) NaPi2b inhibitors, we prepared and evaluated 1H-pyrazole-4-carbonyl-4,5,6,7-tetrahydrobenzo[b]thiophene derivatives with highly polar functional groups to reduce systemic exposure. As a result, compounds 36a and 36b showed a good activity in vitro and a low bioavailability in Sprague-Dawley (SD) rats. However, these compounds did not suppress phosphate absorption in SD rats. This lack of in vivo efficacy could be due to the high hydrophobicity of these compounds. The results of further investigations of other classes of compounds with appropriate physical properties will be reported in due course.

We study the early kinetic decoupling effect in a pseudo-Nambu-Goldstone (pNG) dark matter (DM) model. The pNG DM scattering processes with particles in the thermal bath in the early Universe are suppressed by the small momentum transfer. As a result, kinetic equilibrium is not maintained, and the temperature of DM is different from the temperature of the thermal bath at the freeze-out era. This temperature difference affects the thermal relic abundance of DM. We investigate the early kinetic decoupling in the Higgs resonance region, 50 GeV $\lesssim m_\chi \lesssim m_h/2$, where $m_\chi$ is the mass of the DM, and $m_h/2 \simeq$ 62.5 GeV. We find that the DM-Higgs coupling determined to obtain the measured value of the DM energy density is underestimated in the literature. The enhancement in the coupling leads larger value of the Higgs invisible decay rate. It enlarges the capability to discover the DM signals from the decay of the Higgs bosons at collider experiments., Comment: 20 pages, 3 figures, version accepted by PRD

We reexamine the inverse Primakoff scattering of axions, whose scattering cross section depends on the distribution of electrons in target atoms. We evaluate it using a form factor computed with a relativistic Hartree-Fock wave function and compare it with the previous results obtained with those based on the screened Coulomb potential for the electrostatic field in the atom. We take xenon as an example for the target atom and show that the scattering cross section was overestimated by more than an order of magnitude for axions with $\lesssim O(10)$ keV energies, like solar axions. It is also found that inelastic scattering processes, in which the final state contains an excited or ionized atom, can be comparable or even be dominant when the size of momentum transfer is $\lesssim 1$ keV. For more energetic axions, on the other hand, the total scattering cross section is found to be well approximated by a simple expression and has little dependence on the atomic structure. As an application of this result, we consider supernova axions, whose energy is 10-100 MeV, and show that $O(1)$ inverse Primakoff events are expected for axions from a nearby supernova in the future neutrino experiments, which may warrant a more detailed study on the search strategy of this process., Comment: 15 pages, 3 figures; published version

Objective: Nitroglycerin is a first-line treatment for hypertensive acute heart failure syndrome (AHFS). However, nicardipine is frequently used to treat hypertensive emergencies, including AHFS. In this study, we compared the effectiveness of nicardipine and nitroglycerin in patients with hypertensive AHFS. Patients and Methods: This single-center, retrospective, observational study was conducted at the intensive care unit of a Japanese hospital. Patients diagnosed with AHFS and systolic blood pressure 140 mmHg on arrival between April 2013 and March 2021 were included. The outcomes were the time to optimal blood pressure control, duration of continuous infusion of antihypertensive agents, duration of positive pressure ventilation, need for additional antihypertensive agents, length of hospital stay, and body weight changes. Outcomes were compared between the nicardipine and nitroglycerin groups. We also compared these outcomes between the groups after excluding patients who received renal replacement therapy. Results: Fifty-eight patients were enrolled (26 and 32 patients were treated with nitroglycerin and nicardipine, respectively). The nicardipine group had a shorter time to optimal blood pressure control (2.0 [interquartile range, 2.0–8.5] h vs. 1.0 [0.5–2.0] h), shorter duration of continuous anti-hypertensive agent infusion (3.0 [2.0–5.0] days vs. 2.0 [1.0–2.0] days), less frequent need for additional anti-hypertensive agents (1 patients [3.1%] vs. 11 patients [42.3%]), and shorter length of hospital stay (17.5 [10.0–33.0] days vs. 9.0 [5.0–15.0] days) than the nitroglycerin group. The duration of positive pressure ventilation and body weight changes were similar between the groups. The outcomes were similar after excluding patients who received renal replacement therapy. Conclusion: Nicardipine may be more effective than nitroglycerin for treating hypertensive AHFS.

Patient: Female, 57-year-old Final Diagnosis: Acquired thrombocytopenic purpura • influenza A virus infection Symptoms: Hypoxemia Medication:— Clinical Procedure: Plasma exchange Specialty: Critical Care Medicine • Hematology Objective: Rare disease Background: Thrombotic microangiopathy, characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ damage by microvascular thrombosis, has a high mortality rate; therefore, early diagnosis and treatment are important. Thrombotic thrombocytopenic purpura is caused by a deficiency of a disintegrin-like and metalloproteinase with thrombospondin type 1 motifs 13 (ADAMTS13), and results in thrombotic microangiopathy. Influenza virus causes thrombotic thrombocytopenic purpura by inducing immunoglobulin G autoantibodies against ADAMTS13. We report a rare case of thrombotic thrombocytopenic purpura caused by influenza A without anti-ADAMTS13 antibody that was treated by plasma exchange. Case Report: A 57-year-old woman was admitted to our hospital because of hypoxemia. We diagnosed pneumonia and disseminated intravascular coagulation. Despite treatment, she developed thrombocytopenia, and we diagnosed thrombotic microangiopathy and started plasma exchange. With a PLASMIC score of 6 points and neuropsychiatric symptoms, we strongly suspected thrombotic thrombocytopenic purpura and started rituximab. However, ADAMTS13 activity by FRETS-VWF73 assay was 65%, and anti-ADAMTS13 antibody was negative. After 4 plasma exchanges and 2 rounds of rituximab, platelet numbers and lactate dehydrogenase and creati-nine concentrations normalized on the 16th day of hospitalization. Subsequently, influenza A (H1N1) was identified in a nasopharyngeal swab collected on admission. Plasma enzyme-linked immunosorbent assay testing for chromogenic ADAMTS13 activity showed a significant decrease (

Layered double hydroxides (LDHs) are promising compounds in a wide range of fields. However, exchange of CO32– anions with other anions is necessary, because the CO32– anions are strongly affixed i...

A series of sequence-regulated vinyl copolymers with high-order and long vinyl monomer sequences were constructed via a combination of iterative single vinyl monomer additions, which were mediated by radical and cationic intermediates, and subsequent metal-catalyzed step-growth radical polymerization. The construction of vinyl monomer sequences was attained by iterative single monomer radical and cationic additions between a dichloride, having a similar substituent to that of vinyl monomers, and vinyl monomers such as styrenes, acrylates, and acrylonitrile. The resulting products were converted into sequence-regulated ab-type monomers that have embedded vinyl monomer sequences between an unconjugated C═C bond and reactive C–Cl bond via selective allylation of one of the two C–Cl bonds at their terminals. The synthesized sequence-regulated ab-type monomers were polymerized via metal-catalyzed step-growth radical polymerization, which resulted in vinyl chloride units via repetitive intermolecular addition reactions between the C═C and C–Cl terminals. Alternatively, aa- and bb-type sequence-regulated monomers, which have two unconjugated C═C and two reactive C–Cl bonds, respectively, were prepared by similar iterative single monomer additions and were subsequently polymerized via metal-catalyzed step-growth radical polymerization. The repeating vinyl monomer sequence codes in the resulting polymers, such as ABCC, ABCD, ABBAC, ABDBAC, and ABDBACAEEAC, varied from 4 to 11 monomer units in which the embedded vinyl monomer units were styrenes, acrylates, acrylamides, acrylonitrile, vinyl chloride, vinylidene chloride, and ethylene.

Intestinal sodium-dependent phosphate transport protein 2b (SLC34A2, NaPi2b) inhibitors are expected to be potential new candidates for anti-hyperphosphatemia drugs. However, a risk of on-target side effects based on the inhibition of NaPi2b in the lung and testis has been reported.In this article, we report on our identification of novel indole derivatives as gut-selective NaPi2b inhibitors with good activity, low systemic exposure and moderate hydrophobicity.In particular, gut-selective compound 27, with even lower bioavailability and lower systemic exposure as compared to previously reported pyridine derivatives, demonstrated excellent phosphate absorption-inhibitory effect in SD rats. Compound 27 has an ideal profile and appears to offer promise as a candidate drug for the treatment of hyperphosphatemia, with minimal risk of side effects due to systemic exposure.

We previously reported thiophene derivatives as gut-selective (minimally systemic) and potent sodium-dependent phosphate transport protein 2b (SLC34A2, NaPi2b) inhibitors. However, these derivatives did not suppress phosphate absorption form the intestinal tract in Sprague-Dawley (SD) rats. The lack of efficacy in vivo could be due to the high hydrophobicity of these compounds. In this report, we identified novel pyridine derivatives as gut-selective NaPi2b inhibitors with good activity in vitro and relatively low hydrophobicity. Especially, gut-selective compound 20b suppressed phosphate absorption in SD rats. These results suggest that physical properties, such as the hydrophobicity of the compounds, might affect the in vivo efficacy.

A 67-year-old female with a history of autoimmune hepatitis was admitted for fever, acute hepatic dysfunction, and acute kidney injury. She was diagnosed with multiple duodenal ulcers. Despite the administration of proton pump inhibitor and red blood cells, her black stool and anemia progressed, and she was therefore transferred to our hospital. Despite hemostatic treatments, she continued to bleed. On the 21st day of admission, an endoscopic examination showed the oozing of blood from the duodenal mucosa. A low factor XIII (FXIII) activity level was detected, and she was administered FXIII concentrate. The bleeding stopped and she was thereafter discharged.

Background Endovascular treatment is used for traumatic arterial injuries in the torso. However, the effectiveness of endovascular covered stent‐graft treatment for peripheral artery injury is unclear. We present a case of superficial femoral artery (SFA) injury successfully treated with a covered stent‐graft. Case Report A 68‐year‐old man presented with traumatic lower limb injury and shock. Computed tomography angiography revealed left subtrochanteric fracture and hematoma with extravasation. Digital subtraction angiography revealed extravasation from a left SFA branch, and a pseudoaneurysm at the SFA trunk. We coil embolized the SFA branch, and treated the pseudoaneurysm with a covered stent‐graft. Computed tomography carried out 22 days later showed complete pseudoaneurysm exclusion and sufficient stent patency. Conclusion We successfully used a covered stent‐graft to treat SFA injury due to blunt trauma. A covered stent‐graft could be effective for peripheral artery injury., A 68‐year‐old man presented with lower limb injury and shock after a fall, and digital subtraction angiography revealed extravasation from a proximal branch of the left superficial femoral artery and a pseudoaneurysm at the superficial femoral artery trunk. We used a coil to embolize the superficial femoral arterial branch, and a covered stent graft to treat the pseudoaneurysm. A covered stent graft could be effective for peripheral artery injury; however, the long‐term complications are unclear.

We study gamma-ray line signatures from electroweakly interacting non-abelian spin-1 dark matter (DM). In this model, $Z_2$-odd spin-1 particles including a DM candidate have the SU(2)$_L$ triplet-like features, and the Sommerfeld enhancement is relevant in the annihilation processes. We derive the annihilation cross sections contributing to the photon emission and compare with the SU(2)$_L$ triplet fermions, such as Wino DM in the supersymmetric Standard Model. The Sommerfeld enhancement factor is approximately the same in both systems, while our spin-1 DM predicts the larger annihilation cross sections into $\gamma \gamma/ Z \gamma$ modes than those of the Wino by $\frac{38}{9}$. This is because a spin-1 DM pair forms not only $J=0$ but also $J=2$ partial wave states where $J$ denotes the total spin angular momentum. Our spin-1 DM also has a new annihilation mode into $Z_2$-even extra heavy vector and photon, $Z' \gamma$. For this mode, the photon energy depends on the masses of DM and the heavy vector, and thus we have a chance to probe the mass spectrum. The latest gamma-ray line search in the Galactic Center region gives a strong constraint on our spin-$1$ DM. We can probe the DM mass for $\lesssim 25.3~$TeV by the Cherenkov Telescope Array experiment even if we assume a conservative DM density profile., Comment: 31 pages, 6 figures, 2 tables, the version published in JHEP

Background: Nitroglycerin is considered a first-line agent for hypertensive acute heart failure syndromes (AHFS). In this study, we compared the effectiveness of nicardipine and nitroglycerin in patients with hypertensive AHFS. Methods: We conducted a single-center, retrospective, observational study at the intensive care unit of a Japanese hospital. Patients diagnosed with AHFS and systolic blood pressure exceeding 140 mmHg on arrival between April 2013 and August 2019 were included. The outcomes were the time to optimal blood pressure control, duration of the continuous infusion of anti-hypertensive agents, duration of positive pressure ventilation, need for additional anti-hypertensive agents, length of hospital stay, and body weight changes. Outcomes were compared between the nicardipine and nitroglycerin groups. We also compared these outcomes between the groups after excluding patients who received renal replacement therapy. Results: Forty-five patients were enrolled (25 and 20 were treated with nitroglycerin and nicardipine, respectively). The nicardipine group had a shorter time to optimal blood pressure control (1.0 [interquartile range, 1.0–3.0] h vs. 0.5 [0.5–1.0] h), shorter duration of the continuous infusion of anti-hypertensive agents (65.5 [32.5–127.5] h vs. 31.0 [18.5–61.0] h), less frequent need for additional anti-hypertensive agents (0 patients vs. 10 patients [40.0%]), and shorter length of hospital stay (19.0 [10.0–33.0] days vs. 8.0 [5.0–12.3] days) than the nitroglycerin group. The duration of positive pressure ventilation and body weight changes were similar between the groups. These outcomes were similar after excluding patients who received renal replacement therapy. Conclusions: Nicardipine may be more effective than nitroglycerin for treating hypertensive AHFS.

We study the effect of the early kinetic decoupling in a model of fermionic dark matter (DM) that interacts with the standard model particles only by exchanging the Higgs boson. There are two DM-Higgs couplings, namely CP-conserving and CP-violating couplings. If the mass of the DM is slightly below half of the Higgs boson mass, then the couplings are suppressed to obtain the measured value of the DM energy density by the freeze-out mechanism. In addition, the scattering processes of DM off particles in the thermal bath are suppressed by the small momentum transfer if the CP-violating DM-Higgs coupling is larger than the CP-conserving one. Due to the suppression, the temperature of the DM can differ from the temperature of the thermal bath. By solving coupled equations for the number density and temperature of the DM, we calculate the DM-Higgs couplings that reproduce the right amount of the DM relic abundance. We find that the couplings have to be larger than the one obtained without taking into account the difference in the temperatures. A consequence of the enhancement of the DM-Higgs couplings is the enhancement of the Higgs invisible decay branching ratio. The enhancement is testable at current and future collider experiments., Comment: 18 pages, 3 figures; typo corrected, updated the constraint from the Higgs invisible decay

We propose an electroweakly interacting spin-1 dark matter (DM) model. The electroweak gauge symmetry, SU(2)$_L\times$U(1)$_Y$, is extended into SU(2)$_0\times$SU(2)$_1 \times $SU(2)$_2 \times$U(1)$_Y$. A discrete symmetry exchanging SU(2)$_0$ and SU(2)$_2$ is imposed. This discrete symmetry stabilizes the DM candidate. The spin-1 DM particle ($V^0)$ and its SU(2)$_L$ partners ($V^\pm$) interact with the Standard Model (SM) electroweak gauge bosons without any suppression factors. Consequently, pairs of DM particles efficiently annihilate into the SM particles in the early universe, and the measured value of the DM energy density is easily realized by the thermal freeze-out mechanism. The model also predicts a heavy vector triplet ($W'^\pm$ and $Z'$) in the visible sector. They contribute to the DM annihilation processes. The mass ratio of $Z'$ and $V^0$ determines values of various couplings, and constraints on $W'$ and $Z'$ restrict regions of the parameter space that are viable for DM physics. We investigate the constraints from perturbative unitarity of scalar and gauge couplings, the Higgs signal strength, $W'$ search at the LHC, and DM direct detection experiments. It is found that the relic abundance of $V^0$ explains the right amount of the DM energy density for 3 TeV $\lesssim m_{V^0} \lesssim$ 19 TeV., 29 pages, 7 figures, 2 tables, the version published in JHEP

We investigate the maximum value of the spin-independent cross section (σ SI) in a dark matter (DM) model called the two-Higgs doublet model + a (2HDM+a). This model can explain the measured value of the DM energy density by the freeze-out mechanism. Also, σ SI is suppressed by the momentum transfer at the tree level, and loop diagrams give the leading contribution to it. The model prediction of σ SI highly depends on values of c 1 and c 2 that are the quartic couplings between the gauge singlet CP-odd state (a 0) and Higgs doublet fields (H 1 and H 2), c 1 a 0 2 H 1 † H 1 and c 2 a 0 2 H 2 † H 2 $$ {c}_1{a}_0^2{H}_1^{\dagger }{H}_1\kern0.33em and\kern0.33em {c}_2{a}_0^2{H}_2^{\dagger }{H}_2 $$ . We discuss the upper and lower bounds on c 1 and c 2 by studying the stability of the electroweak vacuum, the condition for the potential bounded from the below, and the perturbative unitarity. We find that the condition for the stability of the electroweak vacuum gives upper bounds on c 1 and c 2. The condition for the potential to be bounded from below gives lower bounds on c 1 and c 2. It also constrains the mixing angle between the two CP-odd states. The perturbative unitarity bound gives the upper bound on the Yukawa coupling between the dark matter and a 0 and the quartic coupling of a0. Under these theoretical constraints, we find that the maximum value of the σ SI is ∼ 5 × 10 −47 cm2 for m A = 600 GeV, and the LZ and XENONnT experiments can see the DM signal predicted in this model near future.

Twenty‐nine cases (55.7%) showed traumatic intracranial hemorrhagic injury progression during interventional radiology. Age (P = 0.029), Glasgow Coma Scale at admission (P = 0.001), Revised Trauma Score (P = 0.036), Trauma and Injury Severity Score probability of survival (P = 0.043), platelet count (P = 0.005), D‐dimer level (P = 0.046), fibrinogen level (P = 0.016), and hemoglobin level (P = 0.003) differed significantly between the enlarged and non‐enlarged groups., Aim To identify factors affecting the progression of traumatic intracranial hemorrhagic injury (t‐ICH) during interventional radiology (IVR) for the hemostasis of extracranial hemorrhagic injury. Methods This was a retrospective comparative study. Fifty‐two patients with t‐ICH who underwent hemostasis using IVR for extracranial trauma at our institute were included. Clinical and computed tomography scan data were collected to investigate factors associated with t‐ICH progression. Results Fifty‐two subjects (36 men/16 women) with a mean age of 70.9 ± 19.2 years were analyzed. The mean Injury Severity Score was 34.9 ± 11.2. In 29 patients (55.7%), t‐ICH progressed during IVR. Hematoma progression frequently occurred in patients with acute subdural hematoma (56.2%) and traumatic intracerebral hematoma/hemorrhagic brain contusion (66.6%). Factors associated with t‐ICH progression included age (P = 0.029), consciousness level at admission (P = 0.001), Revised Trauma Scale (P = 0.036), probability of survival (P = 0.043), platelet count (P = 0.005), fibrinogen level (P = 0.016), hemoglobin level (P = 0.003), D‐dimer level (P = 0.046), and red blood cell transfusion volume (P = 0.023). Conclusion Aggressive correction of anemia, thrombocytopenia, and low fibrinogen levels in severe consciousness disturbance patients with acute subdural hematoma and traumatic intracerebral hematoma/hemorrhagic brain contusion could improve the prognosis after IVR for hemostasis of extracranial hemorrhagic injuries.

The aim of this study was to investigate a failure criterion to predict flexural strengths of composite resins (CR) by three-dimensional finite element analysis (3D-FEA). Models of flexural strength for test specimens of CR and rods comprising a three-point loading were designed. Calculation of Young's moduli and Poisson's ratios of CR were conducted using a modified McGee-McCullough model. Using the experimental CR, flexural strengths were measured by three-point bending tests with crosshead speed 1.0 mm/min and compared with the values determined by in silico analysis. The flexural strengths of experimental CR calculated using the maximum principal strain significantly correlated with those obtained in silico amongst the four types of failure criteria applied. The in silico analytical model established in this study was found to be effective to predict the flexural strengths of CR incorporating various silica filler contents by maximum principal strain.

We report the improvement of an apparatus for Bragg coherent x-ray diffraction imaging (Bragg-CDI) at BL22XU in SPring-8 to expand the applicable particle size and the application of the Bragg-CDI technique for Pd and ferroelectric barium titanate (BaTiO3) fine crystals with particle sizes of 40–500 nm. Preparing a vacuum environment around the sample enabled us to obtain the high-contrast diffraction pattern of a 40-nm particle. The reconstructed three-dimensional image showed the outer shape, size, and internal phase (strain) for a single particle. A single 500-nm BaTiO3 particle showed a straight and sharp antiphase-boundary shape, whereas smaller BaTiO3 particles showed different phase boundary shapes. The present Bragg-CDI apparatus, thus, allows the observation of the outer shape, size, and inner phase distribution for a single particle with a size of 40–500 nm.