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Satoshi Tanida, Keiji Ozeki, Tsutomu Mizoshita, Hironobu Tsukamoto, Takahito Katano, Hiromi Kataoka, Takeshi Kamiya, Takashi Joh Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Aichi Prefecture, Japan Abstract: The goals of treatment for active Crohn's disease (CD) are to achieve clinical remission and improve quality of life. Conventional therapeutics for moderate-to-severe CD include 5-aminosalicylic acid, corticosteroids, purine analogs, azathioprine, and 6-mercaptopurine. Patients who fail to respond to conventional therapy are treated with tumor necrosis factor (TNF)-α inhibitors such as infliximab and adalimumab, but their efficacy is limited due to primary nonresponse or loss of response. It is suggested that this requires switch to another TNF-α inhibitor, a combination therapy with TNF-α blockade plus azathioprine, or granulocyte and monocyte adsorptive apheresis, and that other therapeutic options having different mechanisms of action, such as blockade of inflammatory cytokines or adhesion molecules, are needed. Natalizumab and vedolizumab are neutralizing antibodies directed against integrin a4 and a4ß7, respectively. Ustekinumab is a neutralizing antibody directed against the receptors for interleukin-12 and interleukin-23. Here, we provide an overview of therapeutic treatments that are effective and currently available for CD patients, as well as some that likely will be available in the near future. We also discuss the advantages of managing patients with refractory CD using a combination of TNF-α inhibitors plus azathioprine or intensive monocyte adsorptive apheresis. Keywords: adalimumab, granulocyte and monocyte adsorptive apheresis, combination therapy, complete remission

Ryo Takahashi, Sakiko Isojima, Masayu Umemura, Yoko Miura, Nao Oguro, Syo Ishii, Shinya Seki, Takahiro Tokunaga, Hiroyuki Tsukamoto, Hidekazu Furuya, Ryo Yanai, Tsuyoshi KasamaDivision of Rheumatology, Department of Medicine, Showa University School of Medicine,Tokyo, Japan Abstract: Anticyclic citrullinated protein antibody (ACPA) is known as an important indicator for diagnosis of rheumatoid arthritis (RA). Our aim was to examine the relationship between the serum ACPA titer at baseline and responsiveness to biological agents (antagonists of either tumor necrosis factor or interleukin 6) in patients with RA. ACPA was measured using second-generation chemiluminescent enzyme immunoassay. Disease activity was assessed using disease activity scores 28. Fifty-seven RA patients with biological agents were enrolled, and the median ACPA titer at baseline was 110.0 U/mL. The median ACPA titer was 23.3 U/mL and 183.0 U/mL in the good and moderate response groups, respectively, which were significantly lower than in the no response group (404.0 U/mL). In addition, 69.2% and 26.9% of patients with low (

Hidekazu Furuya,1 Tsuyoshi Kasama,1 Takeo Isozaki,1,2 Masayu Umemura,1 Kumiko Otsuka,1 Sakiko Isojima,1 Hiroyuki Tsukamoto,1 TakehiroTokunaga,1 Ryo Yanai,1 Ryo Takahashi11Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan; 2Department of Rheumatology,University of Michigan Medical School, Ann Arbor, MI, USAAbstract: Rheumatoid arthritis (RA) is a significant cause of work disability and job loss. The resulting economic burden experienced by patients has received considerable research attention. This research assesses the effect of tumor necrosis factor (TNF) antagonists (infliximab, etanercept) on the ability of RA patients living in Japan to work and participate in society. A total of 42 patients with active RA were enrolled and given biological therapy for 12 months (mo). Of these patients, 14 were employed full-time, 6 were employed part-time, and 22 were not employed. Twenty-six patients were given infliximab, and sixteen were given etanercept. The amount of domestic labor performed before the biologics served as a baseline and was assigned a value of 0%. After treatment with biologics, the productivity was evaluated using the visual analog scale (VAS; −100 to +100 mm). The administration of TNF antagonists to RA patients who exhibited an insufficient response to medical treatment significantly improved the Disease Activity Score 28 (DAS 28) after both 6 mo and 12 mo (P < 0.0001). A significant correlation was found between the improvement in their DAS 28 and improvements in their work situation (Productivity VAS) (P < 0.05). Of particular interest is the significant correlation between the values of baseline mHAQ and the percent changes of Productivity VAS that was observed after 6 mo and 12 mo (P < 0.05). Our findings indicate that medical treatment of RA with TNF antagonists improves the patients' ability to perform their jobs and housekeeping. Because loss of productivity is an important contributor to the indirect costs of RA, our findings are relevant for the pharmacoeconomic assessment of treatments.Keywords: rheumatoid arthritis, infliximab, etanercept, productivity, DAS28, mHAQ

Superconducting split magnets are developed for a high-resolution NMR spectrometer. An advanced superconducting shim system and negative current are adopted in the inner-most coils in order to improve the inhomogeneous magnetic field caused by the coil configurations.

The design and construction of superconducting shim coils for highly sensitive NMR spectrometer with a superconducting split magnet is described. Superconducting inner shim coils, superconducting periodically wavy coils and superconducting matrix shim system are adopted for achieving high correction capability for the split NMR spectrometer.

The differential 3[omega] method at room temperature is applied to analyze the thermal conductivity of n-type nanocrystalline bismuth-telluride-based thin films, grown on a glass substrate by a flash evaporation method followed by hydrogen annealing at 250 degree Celsius. It is inferred that protons and electrons are scattered or trapped at the grain boundaries in the nanocrystalline thin films.

Experimental and computational study was developed for unsteady hydrodynamic forces on a diffuser pump impeller excited by the interaction between the impeller and the vaned diffuser with the same number of vanes as impeller. Unsteady flow calculations are made using commercially available CFD software, CFX-TASC flow, as well as the two-dimensional vortex method. Calculated pressure and fluid forces on the impeller show good agreement with measured ones. It has been demonstrated that the fluid forces on the impeller with the same number of vanes as the vaned diffuser are smaller compared with other combinations of vane numbers. However, the pressure fluctuations are found to be greater than other cases. [DOI: 10.1115/1.1949640]

A two-dimensional unsteady flow was calculated within a whole stage of a diffuser pump to investigate pressure fluctuations due to the interaction between impeller and diffuser vanes by using the vortex method, in which vortices shedding from solid boundary were determined by the basic governing equation. The Petrov-Galerkin Method was applied to yield the solutions that satisfy the boundary conditions in an integral sense, and it improved the stability and accuracy of the numerical solutions greatly. A new scheme was also proposed to improve the unsteady pressure evaluation by a boundary integration method in the rotor-stator interaction problem. Moreover, for a more realistic prediction of the pressure fluctuations, the inlet flow was supposed to change with time so that pumping system may balance. The calculated time-varying flow rate, total hydraulic head rise and pressure fluctuations in the vaned diffuser passage, were compared with the measured and calculated ones by other methods. Calculated unsteady pressure fluctuations in the vaned diffuser passage showed good agreement with the experimental data and the CFD calculated ones. [DOI: 10.1115/1.1413242]

In the 1st report, the dynamic behavior of a cavitating centrifugal pump was related to the transient phenomena at the sudden opening/closure of the discharge valve. In this paper, the experimental study was extended to the transient behavior of the cavitating centrifugal pump at rapid starting/stopping of the pump. Unsteady pressures and flowrate were related to time-dependent cavitation behavior in a similar manner as for the rapid operation of the discharge valve. As a result of the present study, pressure fluctuations were found to occur due to water column separation at the sudden stop of the pump similarly to pressure oscillations associated with the sudden closure of the discharge valve. Moreover, the experimental results on the transient behavior at pump startup indicated that the transient fluctuations of delivery pressure and discharge flowrate are caused by oscillating cavitation similarly to the ones occurring at the opening of the discharge valve.

Analytical studies were developed on the transient behavior of a cavitating centrifugal pump during the transient operations, including the sudden opening/closure of the discharge valve and the pump startup/shutdown. In order to investigate the mechanism of the low cycle oscillations of both the pressure and the flowrate at a rapid change of the pump system conditions, an unsteady flow analysis was made for the cavitating pump-system by assuming the transient pump performance to be quasisteady. The calculated unsteady pressure and flowrate during the transient period agree with the corresponding measured time histories. It is shown that the fluctuations of delivery pressure and discharge flowrate at pump rapid startup or sudden valve opening are caused by peculiar oscillating cavitation dynamics inside the pump at rapid increase in flowrate, while the fluctuations at pump rapid shutdown or sudden valve closure are related to the collapse of cavitation bubbles or water column separation in the suction pipe at rapid decrease in flowrate. Moreover, the occurrence of transient fluctuations in pressure and flowrate was predicted by examining the critical condition which creates the occurrence of two different flow mechanisms i.e., (A) oscillating cavitation and (B) water column separation including also the collapse of the cavitation bubbles. These flow mechanisms were represented with two flow models i.e., (A) unsteady cavitating flow incorporating effects of cavitation compliance and mass flow gain factor and expressed by a set of ordinary differential equations solved with the Cardano Method and (B) water-hammer type model including Discrete Free Gas Model and solved with method of characteristics. The calculated critical conditions for. the occurrence of the oscillating cavitation and water column separation agree qualitatively with measured ones.

A series of studies on the dynamic characteristics of noncavitating centrifugal pumps were extended to the cavitating case. An experimental study was carried out on the transient behavior of a cavitating centrifugal pump at the sudden opening/closure of the discharge valve. Cavitation behavior in the centrifugal pump was visualized during the transient period by using high speed video camera, and instantaneous pressure and flowrate were measured at the pump suction and discharge section with rotational speed during the transient period. Unsteady pressure, as well as flowrate, was related to the time-dependent cavitation behavior. As a result of the present study, pressure and flowrate fluctuations were found to occur due to oscillating cavitation or water column separation at rapid transient operations.

An investigation of the microstructure of ZnSe/ZnTe multiple quantum well-based pseudo ohmic contacts to p-ZnSe has been conducted. The experiment used both high-resolution transmission electron microscopy and conventional transmission electron microscopy. Lomer dislocations are observed to be the dominant feature at the interface while 60 degree dislocations are dominant in the slope of the corrugations. The amount of ZnSe/ZnTe multiple quantum wells and the increasing total thickness tend to result in 60 degree dominant dislocation defects.

This paper describes a case in which no complete demolishment was observed in a geofoam (expanded polystyrene foam EPS) embankment. Used for local roads situated over active faults at a mountainous site in Mashiki Town, Kumamoto, Japan, the EPS withstood two successive strong earthquakes that struck Kumamoto and Oita prefectures in 2015. The EPS blocks of this EPS embankment were markedly shifted sideways both horizontally and vertically because earthquake-caused landslides occurred behind the EPS fills. Nevertheless, only a part of the EPS embankment collapsed, causing no damage to the temple nearby. Thereafter, the road surface was remediated temporarily immediately after the earthquakes and was maintained for the opening of traffic. This case demonstrates that EPS presents great benefits: most importantly, the partly collapsed EPS road was put into practical use as a temporary road supporting the daily life of local residents. This report describes an engineering perspective of why the road was not collapsed completely. Future issues to be considered by local governments and engineering institutions are explained for the preparation of great earthquake countermeasures. [ABSTRACT FROM AUTHOR]

An investigation was conducted using atomic force microscopy and transmission electron microscopy on surface morphological changes in ZnSe-related II-VI epitaxial films grown by molecular beam epitaxy. Results show that under group-II-rich conditions with c(2X2) surface reconstruction, the process of roughening gives rise to periodic elongated corrugations aligned in the [110] direction. A model is proposed to explain the changes in surface morphology under group-II-rich conditions and group-VI-rich conditions.