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Background and aim of the study: Coronary artery fistula (CAF) is a relatively rare cardiac anomaly. We investigated long-term outcomes following surgical repair of CAF in adults. Methods: We retrospectively investigated 13 consecutive patients undergoing surgical repair of CAF in our institution between 2008 and 2019 (67.3±10.4 years old, 38% male). CAF types were coronary artery-pulmonary artery fistula (77%), coronary artery-coronary sinus fistula (15%), and both (8%). CAFs originated from the left coronary artery (38%), right coronary artery (8%), and bilateral coronary arteries (38%). Pulmonary and systemic flow (Qp/Qs) was measured in seven patients (54%), with a mean value of 1.52. Seven patients underwent surgery for CAFs alone, and others simultaneously underwent surgery for comorbid cardiac diseases. Results: All procedures were conducted under cardiopulmonary bypass. Surgical procedures were direct epicardial ligation of fistula (92%), direct closure of CAF through pulmonary artery incision (38%), direct closure of CAF through coronary sinus incision (8%), or patch closure of CAF through coronary artery incision (8%). Myocardial perfusion scintigraphy showed asymptomatic myocardial ischemia in the right coronary area after surgery in one patient. There were no deaths perioperatively or during follow-up (mean 66.6 months). There were no coronary or other CAF-related events. Conclusions: Several anatomical variations in CAF were observed which coexist with cardiac disease. Long-term outcomes following surgical repair were satisfactory, and the concurrent intervention of CAFs during surgery for comorbid cardiac disease is useful to prevent future complications related CAFs in adults.

Objectives The aim is to clarify the differences in magnetic resonance imaging (MRI) findings between rheumatoid arthritis (RA) patients treated with certolizumab pegol (CZP) and infliximab (IFX). Methods The study included RA patients who received CZP or IFX and were examined with low-field MRI (compacTscan; compact magnetic resonance imaging) at the beginning and again within 6 months of treatment initiation. Comparisons were made regarding background, clinical course, and differences in MRI findings following initiation of tumour necrosis factor inhibitors between the CZP and IFX treatment groups. MRI findings were evaluated by scoring erosion, bone marrow oedema (BME), and synovitis. Results Ten cases in CZP and 18 cases in IFX group were compared. The biologic disease-modifying antirheumatic drug–naïve rate in the IFX group was significantly higher than that in the CZP group. After 6 months, disease activities were significantly decreased from baseline in both groups. Erosion score did not change significantly in both groups after 6 months. BME score was significantly decreased in the CZP group after 6 months, whereas in the IFX group, there was no significant change. Synovitis score was significantly decreased in both groups after 6 months. Conclusions The findings of our study suggest that, in patients with RA, CZP might improve BME more effectively than IFX.

Recent studies have suggested that the clinical features of elderly-onset adult-onset Still’s disease (AOSD) differ from those of young and middle-aged-onset patients, whereas the details remain unclear, and cytokine profiles of elderly-onset AOSD have not been reported. To clarify the clinical features and cytokine profiles of elderly-onset AOSD, we examined patients with AOSD who developed the disease between January 2006 and September 2021. We divided the patients into the young and middle-aged-onset group (aged

BackgroundOptimal treatment for aortic thrombus remains to be determined, but surgical treatment is indicated when there is a risk for thromboembolism. Case PresentationA 47-year-old male presented with weakness in his left arm upon awakening. Contrast-enhanced computed tomography and transesophageal echocardiography revealed a mobile pedunculated object suggestive of a thrombus arising from the ascending aorta and extending to the left common carotid artery. It was removed under hypothermic circulatory arrest and direct cannulation of the left carotid artery to avoid carotid thromboembolism. Histopathological examination revealed that the object was a thrombus. The patient had an uneventful postoperative course and was discharged 9 days after surgery. ConclusionWhen a thrombus in the aortic arch extends to the neck arteries, direct cannulation of the neck arteries with selective cerebral perfusion via cervical incision is a useful technique.

BACKGROUND Medical research for processing medical data is required to incorporate a governance system. Health data governance includes various elements. Among the values of governance, this study focuses on accountability and transparency. OBJECTIVE This paper proposes the system requirements for a communication platform to help medical researchers be accountable and transparent about medical data processing in medical research. METHODS We first examined accountability and transparency to find their shared bases and confirmed their importance by visiting medical research practices. Subsequently, we explored legal syllogism as the representative of rule compliance analysis to determine the system requirements to achieve the bases. RESULTS By examining accountability and transparency, we confirmed that these values were inherently vague but had two shared features– "organizing information" and "effective communication." Next, by analyzing the actual research process, we found that researchers needed to communicate effectively with legal and ethical experts to obtain appropriate support at the research planning phase. From these findings, the concept of a communication platform was derived. Through the analysis of the syllogism, we found three system requirements for the platform: (1) covering the entire chain of data processing activities; (2) being capable of recording relevant information for rule compliance analysis; and (3) being able to record compliance analysis results. CONCLUSIONS We introduced an example of a user interface in line with the discovered system requirements and discussed how our design can facilitate patients' and society's interests by empowering researchers to be accountable and transparent for their research. To support medical researchers to be accountable and transparent for their research, we proposed system requirements for a communication platform. CLINICALTRIAL N/A

OBJECTIVES To determine the incidence of bioprosthetic structural valve deterioration in dialysis patients undergoing aortic valve replacement compared to that in patients without dialysis. METHODS This single-centre retrospective observational study included 1159 patients who underwent aortic valve replacement using bioprosthetic valves for aortic stenosis and/or regurgitation at our institution between 2007 and 2017 [patients with dialysis (group D, n = 134, 12%) or without dialysis (group N, n = 1025, 88%)]. To adjust for potential differences between groups in terms of initial preoperative characteristics or selection bias, a propensity score analysis was conducted. The final sample that was used in the comparison included 258 patients, as follows: 129 patients with dialysis (group D) and 129 patients without dialysis (group N). The cumulative incidences of all-cause death, cardiac death and moderate or severe structural valve deterioration were estimated using the Kaplan–Meier method. RESULTS Operative mortality was significantly higher in group D than group N (9% vs 0%, P = 0.001). Kaplan–Meier analysis revealed that in group D, the incidence was significantly higher for all-cause death (P CONCLUSIONS The incidence of structural valve deterioration in dialysis patients undergoing aortic valve replacement was higher than that in patients without dialysis. Bioprosthetic valves should be carefully selected in dialysis patients undergoing aortic valve replacement.

SMI (SPICA Mid-infrared Instrument) is one of the three focal-plane science instruments for SPICA. SMI is the Japanese-led instrument proposed and managed by a university consortium. SMI covers the wavelength range from 10 to 36 μm with four separate channels: the low-resolution (R = 60 – 160) spectroscopy function for 17 – 36 μm, the broad-band (R = 5) imaging function at 34 μm, the mid-resolution (R = 1400 – 2600) spectroscopy function for 18 – 36 μm, and the high-resolution (R = 29000) spectroscopy function for 10 – 18 μm. In this presentation, we will show the latest design and specifications of SMI as a result of feasibility studies.

The aggregation behaviour of Au(I) complexes in condensed phases can affect their emission properties. Herein, aggregation-induced room-temperature phosphorescence (RTP) is observed from the crystals of trinuclear Au(I) complexes. The RTP is highly sensitive to the crystal structure, with a slight difference in the alkyl side chains causing not only a change in the crystal structure but also a shift in the RTP maximum. Furthermore, in nanocrystals, reversible RTP colour changes are induced by phase transitions between crystal polymorphs during crystal growth from solution or the pulverisation of bulk crystals. The colour change mechanism is discussed in terms of intermolecular interactions in the crystal structure of the luminescent aggregates. The results suggest that the behaviour in nanocrystals may differ from that in bulk crystals. These insights will advance the fundamental understanding of crystallisation mechanisms and may aid in the discovery of new materials properties for solids with nano- to micrometre sizes. The properties of nano-crystalline materials depend heavily on their size, therefore, understanding early crystallization processes is crucial. Here, the relationship between phosphorescence and crystal structures of three crystallizing Au(I) complexes bearing n-alkyl chains of different lengths is studied.

We examined the effect of X-ray irradiation on the magnetic properties of REBa2Cu3Oy (REBCO; RE = Y, Nd, or Gd). In all the samples, Tc0, which is defined as the temperature below which the magnetic susceptibility is lower than zero, did not change significantly after irradiation within the measurement accuracy. On the other hand, the magnetic susceptibilities after irradiation were lower than those before irradiation in all the samples. These results, which are consistent with those observed under light irradiation, indicate that X-ray irradiation enhances the superconductive properties of these materials. This enhancement results from hole doping in the CuO2 plane via the generation of electron–hole pairs by X-ray irradiation and subsequent trapping of the electrons at oxygen vacancies. Relaxation of the irradiation effect and the electron behavior after irradiation were studied by analyzing the magnetic properties and Raman spectra.

Highly efficient (&asymp, 75% quantum yield), aggregation-induced phosphorescence is reported. The phosphorescence is emitted at room temperature and in the presence of air from crystals of trinuclear Au(I) complexes, accompanied by an extremely large Stokes shift of 2.2 &times, 104 cm&minus, 1 (450 nm). The mechanism of the aggregation-induced room-temperature phosphorescence from the Au complex crystals was investigated in terms of the crystal packing structure and the primary structure of the molecules. It was found that two kinds of intermolecular interactions occurred in the crystals, and that these multiple dual-mode intermolecular interactions in the crystals play a crucial role in the in-air room-temperature phosphorescence of the trinuclear Au(I) complexes.

Gold(I) complexes are some of the most attractive materials for generating aggregation-induced emission (AIE), enabling the realization of novel light-emitting applications such as chemo-sensors, bio-sensors, cell imaging, and organic light-emitting diodes (OLEDs). In this study, we propose a rational design of luminescent gold complexes to achieve both high thermochemical stability and intense room temperature phosphorescence, which are desirable features in practical luminescent applications. Here, a series of gold(I) complexes with ligands of N-heterocyclic carbene (NHC) derivatives and/or acetylide were synthesized. Detailed characterization revealed that the incorporation of NHC ligands could increase the molecular thermochemical stability, as the decomposition temperature was increased to ~300 &deg, C. We demonstrate that incorporation of both NHC and acetylide ligands enables us to generate gold(I) complexes exhibiting both high thermochemical stability and high room-temperature phosphorescence quantum yield (&gt, 40%) under ambient conditions. Furthermore, we modified the length of alkoxy chains at ligands, and succeeded in synthesizing a liquid crystalline gold(I) complex while maintaining the relatively high thermochemical stability and quantum yield.

Tangeretin and nobiletin are polymethoxylated flavonoids in citrus peel. Both tangeretin and nobiletin are bitter; however, their bitterness has not been evaluated using human bitter taste receptors (hTAS2Rs). We screened 25 kinds of hTAS2Rs and found that hTAS2R14 and hTAS2R46 received both compounds.

To control contamination resistance of polymer surfaces, the surface hydrophobization and hydrophilization were attempted by atmospheric pressure plasma jet (APPJ)-coating with hexamethyldisiloxane (HMDSO) and APPJ-oxidation, respectively. The APPJ-coating remarkably prevented the deposition of the particulate contaminants in air. The granular morphology was observed on the film surfaces after the APPJ-coating, which resulted in superior contamination resistance via the decrease in the contact area with the contaminant. On the other hand, the APPJ-oxidation promoted the contamination removal in the aqueous detergent system.

Non-photorealistic rendering is one of the digital art techniques. It generates digital images resembling artistic representation. The main contribution of this paper is to show a non-photorealistic rendering for high quality pointillism image generation with squares by pasting square patterns on canvas. Our technique is inspired by the characteristic of the human visual system to optimize generated images. Although it can generate high quality pointillistic images, a lot of time is necessary. Hence, we have implemented our technique in a graphics processing unit (GPU) to accelerate the computation. The experimental results show that the GPU implementation can achieve a speed-up factor of 160 over the sequential CPU implementation.

We report a case of 39-year-old man who developed tricuspid valve infective endocarditis with a complication of pulmonary embolism. He was transferred to our institution because of intermittent fever and enlargement of the vegetation of the tricuspid valve in spite of optimal antibiotics treatment. Computed tomography revealed pulmonary embolism, and transesophageal echocardiography showed a large and mobile vegetation (22×10 mm) on the tricuspid valve with moderate regurgitation. In addition, Streptococcus agalactiae was identified in blood cultures. The patient underwent surgical resection of the vegetation followed by tricuspid valve repair including De Vega's annuloplasty. Antibiotic therapy was continued for 4 weeks after surgery, and he was discharged on the 31st postoperative day. No endocarditis nor tricuspid valve dysfunction has re-occurred.

Background: The semiquantitative Clinical Frailty Scale (CFS) is a simple tool to assess patients’ frailty and has been shown to correlate with mortality in elderly patients even when evaluated by nongeriatricians. The aim of the current study was to determine the prognostic value of CFS in patients who underwent transcatheter aortic valve replacement. Methods: We utilized the OCEAN (Optimized Catheter Valvular Intervention) Japanese multicenter registry to review data of 1215 patients who underwent transcatheter aortic valve replacement. Patients were categorized into 5 groups based on the CFS stages: CFS 1-3, CFS 4, CFS 5, CFS 6, and CFS ≥7. We subsequently evaluated the relationship between CFS grading and other indicators of frailty, including body mass index, serum albumin, gait speed, and mean hand grip. We also assessed differences in baseline characteristics, procedural outcomes, and early and midterm mortality among the 5 groups. Results: Patient distribution into the 5 CFS groups was as follows: 38.0% (CFS 1-3), 32.9% (CFS4), 15.1% (CFS 5), 10.0% (CFS 6), and 4.0% (CFS ≥7). The CFS grade showed significant correlation with body mass index (Spearman’s ρ=−0.077, P =0.007), albumin (ρ=−0.22, P P P P P Conclusions: In addition to reflecting the degree of frailty, the CFS was a useful marker for predicting late mortality in an elderly transcatheter aortic valve replacement cohort.

In reacent years, studies on reducing the diameter of microcapsules for practical application to self-healing FRP have been conducted. This study clarifies how filler grain diameter and strength and filler volume fraction affect the interlaminar fracture toughness of FRP. The reinforcement material used in this experiment was carbon fiber fabric sheets. Acrylic particles were used as filler; the mechanical properties were similar to those of microcapsules of self-healing FRP. The filler volume fraction was confirmed to affect the interlaminar fracture toughness. The grain diameters of the hollow particles were smaller, and the Young's modulus of the filler is larger, confirming that the interlaminar fracture toughness increased. High rigidity and small-grain diameter microcapsules are considered to be appropriate microcapsules (enclosing repair agents) for self-healing of CFRP.

Recently, multi-car elevator (MCE) system has captured attention as an effective mean for the improvement of transportation capability in a high-rise building. The MCE has two or more cars in one shaft. In this paper, we propose an algorithm for group controllers of MCE system, and show the effectiveness of our algorithm through computer simulation.

Highly effective power supply system has been developed to achieve eco-conscious server machines in data center. The number of conversion steps between AC and DC are decreased and power supply efficiency of PSU at low load is improved to increase the power supply efficiency. To develop these approaches, the built-in rack UPS method, dynamic operation number control method of PSU, and power assistance method are described in this paper. The power supply efficiency was improved 13% or more by implementing the proposed method keeping the function of UPS. In addition, a function was achieved to withstand a rapid load rising by the battery's power supply in the condition of small number of operating PSU.

To evaluate the effectiveness of episcleral ¹⁰⁶ruthenium plaque therapy (RPT) in the management of retinoblastoma.One hundred one RPTs were retrospectively analyzed that were performed in 90 eyes of 85 patients with retinoblastoma at National Cancer Center Hospital between 1998 and 2008. Each RPT had a corresponding tumor and 101 tumors were considered in the analysis of local control. Median follow-up length was 72.8 months. Median patient age at the RPT was 28 months. Median prescribed doses at reference depth and outer surface of the sclera were 47.4 Gy and 162.3 Gy, respectively.Local control rate (LCR) and ocular retention rate (ORR) at 2 years were 33.7% and 58.7%, respectively. Unilateral disease, International Classification of Retinoblastoma group C or more advanced at the first presentation or at the time of RPT, vitreous and/or subretinal seeding, tumor size greater than 5 disc diameter (DD), reference depth greater than 5 mm, dose rate at reference depth lower than 0.7 Gy/hour, dose at the reference depth lower than 35 Gy, and (biologically effective dose with an α/β ratio of 10 Gy) at the reference depth lower than 40 Gy(10) were associated with unfavorable LCR. Two patients died of metastatic disease. Radiation complications included retinal detachment in 12 eyes (13.3%), proliferative retinopathy in 6 (6.7%), rubeosis iris in 2 (2.2%), and posterior subcapsular cataract in 23 (25.6%).RPT is an effective eye-preserving treatment for retinoblastoma.