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Abstract Vaccines that efficiently target severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent for coronavirus disease (COVID-19), are the best means for controlling viral spread. This study evaluated the efficacy of the COVID-19 vaccine S-268019-b, which comprises the recombinant full-length SARS-CoV-2 spike protein S-910823 (antigen) and A-910823 (adjuvant). In addition to eliciting both Th1-type and Th2-type cellular immune responses, two doses of S-910823 plus A-910823 induced anti-spike protein IgG antibodies and neutralizing antibodies against SARS-CoV-2. In a SARS-CoV-2 challenge test, S-910823 plus A-910823 mitigated SARS-CoV-2 infection-induced weight loss and death and inhibited viral replication in mouse lungs. S-910823 plus A-910823 promoted cytokine and chemokine at the injection site and immune cell accumulation in the draining lymph nodes. This led to the formation of germinal centers and the induction of memory B cells, antibody-secreting cells, and memory T cells. These findings provide fundamental property of S-268019-b, especially importance of A-910823 to elicit humoral and cellular immune responses.

Background/Aims During endoscopy, white spots (WS) are sometimes observed around benign or malignant colorectal tumors; however, few reports have investigated WS, and their significance remains unknown. Therefore, we investigated the significance of WS from clinical and pathological viewpoints and evaluated its usefulness in endoscopic diagnosis. Methods Clinical data of patients with lesions diagnosed as epithelial tumors from January 1, 2019, to December 31, 2020, were analyzed (n=3,869). We also performed a clinicopathological analysis of adenomas or carcinomas treated with endoscopic resection (n=759). Subsequently, detailed pathological observations of the WS were performed. Results The positivity rates for WS were 9.3% (3,869 lesions including advanced cancer and non-adenoma/carcinoma) and 25% (759 lesions limited to adenoma and early carcinoma). Analysis of 759 lesions showed that the WS-positive lesion group had a higher proportion of cancer cases and larger tumor diameters than the WS-negative group. Multiple logistic analysis revealed the following three statistically significant risk factors for carcinogenesis: positive WS, flat lesions, and tumor diameter ≥5 mm. Pathological analysis revealed that WS were macrophages that phagocytosed fat and mucus and were white primarily because of fat. Conclusions WS are cancer-related findings and can become a new criterion for endoscopic resection in the future.

Abstract A portable, battery‐powered, multi‐purpose readout system for combined optical and thermal measurements is presented. The system is modular with four independent input channels for different measurement schemes, allowing simultaneous multi‐parameter measurements to detect analytes of interest. Combined optical and thermal readout for spectroscopy is implemented by installing two different analog front‐end modules in the four input channels equipped with a micro spectrometer and a high‐resolution temperature sensor, respectively. The readout system is utilized to measure fluorescence signals of a common dye functionalized on gold nanoparticle‐DNA conjugates as a function of the temperature. Gold nanoparticles are modified with Guanine‐rich DNA sequences to perform Förster Resonance Energy Transfer (FRET) measurements. Elongation of DNA sequences at higher temperatures resulted in stronger fluorescence signals, accurately recorded by the portable system. The precision electronic components are chosen for a precise, battery‐powered operation. The size of this versatile, compact, and portable instrument is only 15.6 × 10.6 cm2. An interactive graphical‐user‐interface developed for this system supports point‐of‐care usage. The measurements carried out with the portable system showed a very close match with a commercial set‐up, with deviations less than 1 nm in the optical spectra and less than 0.5 °C in temperature.

Background/Aims Vedolizumab (VDZ) is a gut-selective agent with a favorable safety profile. We aimed to assess the feasibility of elective switch from other advanced therapies to VDZ and subsequent live-attenuated vaccination while continuing VDZ in patients with inflammatory bowel diseases (IBD). Methods We measured antibody titers specific for measles, rubella, mumps, and varicella viruses in IBD patients under immunosuppressive therapy. Those with negative titers and without vaccination history were judged unimmunized. Patients were administered vaccines while continuing VDZ or switched to VDZ if receiving other advanced therapies and then administered vaccines. Co-primary outcomes were the rate of maintaining disease severity after vaccination and the rate without vaccine-induced infection. Results Among 107 unimmunized patients, 37 agreed to receive live-attenuated vaccines while continuing VDZ (17 patients) or after switching to VDZ (20 patients). In the 20 patients who electively switched to VDZ, disease severity was maintained except for 1 patient who developed intestinal infection. After 54 weeks, 18 patients (90%) continued to receive VDZ, excluding 2 patients who reverted to their originally administered biologics. In all 37 patients administered live-attenuated vaccines under VDZ treatment, disease severity was maintained after vaccination. Antibody titers became positive or equivocal in 34 patients (91.9%). There were no cases of vaccine-induced infection during a median observation period of 121 weeks. Conclusions While live-attenuated vaccines are contraindicated under immunosuppressive therapy, they may be safely administered while receiving VDZ immunotherapy. Switching from other advanced therapies to VDZ and subsequently receiving live-attenuated vaccines may be a safe alternative in unimmunized patients.

Shooting precision is a fundamental characteristic in soccer, yet the probabilistic structure and magnitude of precision in soccer shooting remain quantitatively unexplored. This study aimed to quantify shooting precision using measures derived from the bivariate normal distribution for both preferred and non-preferred feet. Sixteen right-footed collegiate soccer players participated by performing instep kicks aiming at targets which are placed close to the left and right top corners of the soccer goal. We used bivariate normal distribution modeled the ball positions, revealing an ellipsoidal distribution, and the area of the 95% confidence ellipses served as an index of precision. Repeated measures ANOVAs revealed a significant main effect of the kicking foot. For shots aimed at the same side as the kicking foot, the area of the 95% confidence ellipse was 6.17 ± 1.93 m2 (mean ± SD) for the preferred foot and 10.22 ± 3.53 m2 for the non-preferred foot. Similar results were observed for shots aimed at the opposite side of the kicking foot. These quantitative findings hold promise for advancing soccer research and enhancing practical applications in soccer skill assessment.

Abstract Background and Aim The number of older patients with ulcerative colitis is increasing; however, limited data exist regarding the differences between elderly‐ and non‐elderly‐onset ulcerative colitis. We aimed to compare the clinical practice and course of elderly‐onset ulcerative colitis with those of non‐elderly‐onset ulcerative colitis. Methods We selected older patients with ulcerative colitis and divided them into the elderly‐ and non‐elderly‐onset ulcerative colitis groups according to their age at onset. We compared the cumulative systemic steroid‐free, molecular targeting drug‐free, and surgery‐free rates between the two groups. We performed a multivariate analysis to identify the clinical factors related to systemic steroid administration, the use of molecular targeting drugs, surgery, and death. Results We collected data of 2669 and 277 elderly and non‐elderly‐onset ulcerative colitis patients, respectively. The cumulative systemic steroid‐free rate of elderly‐onset ulcerative colitis was significantly lower than that of non‐elderly‐onset ulcerative colitis. However, no difference was observed in the cumulative molecular targeting drugs and surgery‐free rates between the two groups. Elderly‐onset ulcerative colitis significantly increased the risk of systemic steroid administration and death but not the use of molecular targeting drugs and surgery. Conclusion The disease severity of ulcerative colitis and clinical practice may not differ between the elderly‐ and non‐elderly‐onset groups. However, elderly‐onset ulcerative colitis was associated with increased mortality risk. Thus, we need to pay attention to the patients' condition and appropriate timing of surgery for patients with elderly‐onset ulcerative colitis.

As exoskeletal assistive devices are directly attached to a person, coordination must be improved. However, existing exoskeletal assistive devices have difficulty coordinating with human behavior. Existing exoskeletal assistive devices are driven by estimating the wearer’s movement intention based on predetermined movement time and device angle data. If the wearer does not move as expected, a gap in the command signal occurs, making it difficult to provide the appropriate assistance. Therefore, an assistive method is required to reduce such deviations. In a previous study, comparing the assist method using constant viscosity with other methods, it was confirmed that the viscous commands were less likely to cause command signal misalignment. However, even at constant viscosity, deviations from the target knee joint torque values obtained from the motion analysis were observed. Therefore, by focusing on the variable viscosity property, this study aims to output commands that are closer to the target torque value. In this study, the seated motion was used as the target motion for assistance and the viscosity coefficients of the variable viscosity were obtained for each of the three motion sections based on the motion analysis results. Subsequently, constant and variable viscosities were compared by measuring the command signal and amount of muscle activity. The results showed that the command signal was close to the target value and that the variable viscosity assist reduced the EMG potential in the majority of subjects. Even when the timing of the viscosity coefficient change deviated from the target, most actual deviation of subjects from the command peak timing was small.

The usefulness of NUDT15 genotyping as a pharmacogenomic test for thiopurine has been established. The first such test developed to date, NUDT15 genotyping was approved for reimbursement in Japan in February 2019 for all indicated patients. We retrospectively examined claims data in Japan and confirmed that the proportion of patients who undergo genotyping before initiating a new thiopurine regimen has increased; furthermore, genotyping has improved the rate of treatment continuation and reduced on-treatment hospitalization. However, the genotyping rate before thiopurine induction was >50% for patients with inflammatory bowel disease and

Abstract Background and Aim There is a scarcity of data on long‐term outcomes in patients with new‐onset ulcerative colitis (UC) in the era of biologics. We aimed to clarify the long‐term prognosis of UC and the clinical practice of prescriptions for UC. Methods We collected 6689 new‐onset UC cases using a medical claim database provided by DeSC Healthcare, Inc. We investigated the surgery‐free, systemic steroid‐free, and molecular targeting drug‐free rates and compared their differences based on UC‐onset age. We used multivariate analysis to identify clinical factors affecting long‐term prognosis and investigated the transition of prescriptions for UC. Results The surgery‐free, systemic steroid‐free, and molecular targeting drug‐free rates at 5 years post‐UC diagnosis were 98.5%, 61.0%, and 88.7%, respectively. Pediatric patients had higher surgery‐free rates compared with elderly patients and non‐pediatric/non‐elderly patients (P = 0.022), whereas the systemic steroid‐free and molecular targeting drug‐free rates were significantly lower (P

Abstract Because exoskeletal assistive devices are worn directly by a person, enhancing cooperation is important. However, existing assistive devices have problems in terms of their cooperation with human behaviors. This is because existing assistive devices are driven by estimating the wearer’s movement intention based on predetermined movement time and device angle information. Although these methods are expected to work as expected, in practice, it is difficult to achieve the expected behavior. Therefore, an assistance method is required to reduce such misalignment with time and misalignment between the device and wearer. Therefore, this study focused on the viscoelastic properties that generate force in response to movement and are expected to enhance coordination. In a previous study, the authors confirmed the effects of viscoelastic properties or an assistive device with variable stiffness. However, viscous characteristics during movement have not been considered. In this study, we aimed to improve the coordination by focusing on the viscous characteristics. The viscous torque outputs in response to the angular velocity are expected to be driven in response to actual human motion. In this study, the viscous torque was calculated as the product of the command viscosity coefficient and the joint angular velocity and was applied to a lower-limb exoskeleton-type assist device equipped with a magneto-viscous fluid brake and a planetary gear mechanism. In addition, a viscous command that changes the torque according to speed (proposed method), a time command that changes the output value according to the passage of time, and an angle command that changes the command value according to the angle information of the device were applied to the assist device, and surface EMG measurements and command signals were compared. The target movement was a seated movement, and the left and right vastus medialis and semimembranosus muscles were measured. More than half of the subjects showed a decrease in myopotential for five subjects for all three command methods, confirming the effectiveness of the viscous command.

Rapid and continuous synthesis of metal nanoparticles using green solvent system is still a serious challenge for both fundamental and practical research. In this work, we report a new flow process using water in supercritical CO2 (w/scCO2) emulsion and applied it to the synthesis of silver nanoparticles (AgNPs). To investigate the performance of our system, AgNPs were synthesized by batch, flow and w/scCO2 emulsion flow system at 40 ºC while using AgNO3, NaBH(OAc)3, trisodium citrate and Aerosol-OT as precursor, reducer, stabilizer and emulsifier. As a result, we demonstrated that water droplets in w/scCO2 emulsion significantly contribute to a rise in the size controllability and productivity (product yield). Additionally, w/scCO2 emulsion flow process allowed the control of mean size from 4.0 to 36.6 nm and yield from 25% to 65% by changing the CO2 pressure and Aerosol-OT concentration. Furthermore, synthesized AgNPs successfully gave citrate-modified surface with high zeta potential of –54 mV and the transparent water dispersion with unimodal size distribution, showing promising potential to allow various practical applications.

Abstract A 69‐year‐old woman, a long‐term survivor of subtotal stomach‐preserving pancreatoduodenectomy with the splenic vein resection for pancreatic cancer, visited our hospital with a chief complaint of bloody stools. Previously, she was diagnosed with varices in the ascending colon due to left‐sided portal hypertension after pancreatoduodenectomy by computed tomography and colonoscopy. After emergency hospitalization, she went into shock, and blood tests showed acute progression of severe anemia. Computed tomography showed a mosaic‐like fluid accumulation from the ascending colon to the rectum. She was diagnosed with ruptured varices in the ascending colon. Emergency colonoscopy was performed, and treatment with endoscopic injection sclerotherapy using N‐butyl‐2‐cyanoacrylate was successful. Ectopic varices occur at any location other than the esophagus and stomach, and colonic varices are rare among them. They are mostly caused by portal hypertension due to liver cirrhosis. However, with the trend of improving the prognosis for patients with pancreatic cancer, we should occasionally pay attention to the development of ectopic varices including colonic varices in patients who have undergone pancreatoduodenectomy with superior mesenteric and splenic veins resection. Treatment methods for colonic varices varied from case to case, including conservative therapy, interventional radiology, and endoscopic procedure. In this case, endoscopic injection sclerotherapy was successfully performed without any complications. To the best of our knowledge, this is the first study to report successful treatment with endoscopic injection sclerotherapy for varices in the ascending colon caused by left‐sided portal hypertension after pancreatoduodenectomy. Colonic varices should be considered in patients with obscure gastrointestinal bleeding after pancreatoduodenectomy.

Conclusion: Our findings support the safe and effective use of EBD for both ileal and colonic strictures associated with CD. The clinical practice and safety outcomes of EBD for CD-related strictures were comparable to those for strictures stemming from other etiologies.

Introoduction: Primary sclerosing cholangitis (PSC) is a rare disease, especially in Asian countries. PSC often develops during ulcerative colitis (UC). Little is known about the severity of PSC in patients with UC. Thus, this study aimed to investigate the impact of concomitant UC on the clinical course of patients with PSC using a nationwide database in Japan. Methods: We collected data on patients who were admitted for PSC using a nationwide database and divided eligible admissions according to concomitant UC (PSC-UC group vs. PSC-alone group). We conducted propensity score matching and compared the rates of liver transplantation, biliary drainage, and other clinical events between the two groups. We also conducted a multivariate analysis to identify the clinical factors that affect biliary drainage, cholangiocarcinoma, and liver transplantation. Results: We enrolled 672 patients after propensity score matching. The rate of liver transplantation in the PSC-UC group was lower than that in the PSC-alone group (2.2 vs. 5.4%, p = 0.002), whereas the rate of biliary drainage did not differ between the two groups (38.1 vs. 33.8%, p = 0.10). On multivariate analysis, concomitant UC was identified as a clinical factor that decreased the risk of liver transplantation (odds ratio = 0.40, 95% confidence interval: 0.23–0.68, p = 0.0007). Discussion: Concomitant UC in patients with PSC may decrease the risk of liver transplantation. The milder disease activity of PSC with UC is more likely compared to that of PSC without UC.

Abstract Background and Aim Acute pancreatitis (AP) is a rare extraintestinal manifestation of inflammatory bowel disease (IBD). Several studies from Western countries have reported that the severity of AP in patients with IBD is similar to that in the general population; however, its severity in patients from Eastern countries in the era of biologics remains unclear. This study aimed to investigate the severity of AP in patients with IBD and the effect of biologics on the severity of AP using a nationwide database. Methods We divided 1138 eligible AP admissions from the Diagnosis Procedure Combination database system into IBD and non‐IBD groups after propensity score matching, and compared the severity of AP. We divided the IBD group into ulcerative colitis (UC) and Crohn's disease (CD) subgroups and compared each with the non‐IBD group. Logistic regression analysis was conducted to identify the clinical factors affecting acute pancreatitis. Results IBD and UC groups had lower rate of severe AP compared to the non‐IBD group (13.7% vs 28.3%, P

Abstract Background and Aim The incidence and prevalence of psychiatric disorders are elevated in patients with inflammatory bowel disease (IBD). Whether psychiatric disorders could affect the clinical course of IBD is uncertain and controversial. We aimed to evaluate the impact of psychiatric disorders, particularly depression, on the clinical course of IBD using a nationwide database in Japan. Methods We collected data on admissions with IBD using the Diagnosis Procedure Combination database system introduced in Japan. We divided eligible admissions into IBD with and without depression groups using propensity score matching and compared the rates of surgery, use of molecular targeted drugs and biologics, systemic steroid administrations, and in‐hospital death. We also conducted a logistic regression analysis to identify clinical factors affecting surgery, the use of molecular targeted drugs and biologics, and systemic steroid administrations. Results The rates of surgery, use of two or more molecular targeted drugs, systemic steroid administrations, and in‐hospital deaths in the ulcerative colitis (UC) with depression group were higher than in the UC without depression group. Multivariate analysis of UC showed that depression increased the odds of systemic steroid administrations, use of two or more molecular targeted drugs, and surgery. However, analysis of Crohn's disease showed that only steroid administrations were associated with depression. Conclusion Our study demonstrated an association between a worse clinical course of UC and depression. Although this result indicates that depression might be associated with increased disease activity in patients with UC, the causal relationship is still unclear. Further prospective studies are warranted.

Introduction: Limited data exist regarding the prevalence and clinical practice involving generic drugs and biosimilars for treating ulcerative colitis (UC) in Japan. We aimed to clarify the clinical usage of these generic drugs and biosimilars for UC treatment in Japan using a nationwide database. Methods: We collected data from 30,675 UC cases, along with their prescriptions for both generic drugs or biosimilars and their original counterparts, using a medical claim database provided by DeSC Healthcare, Inc. We calculated the prescription and penetration rates of generic drugs and biosimilars and demonstrated the transition of these rates. Additionally, the cumulative retention rates between infliximab originator and biosimilar were compared using the Kaplan-Meier method. Results: The prescription rate of generic mesalazine increased from approximately 10% in 2015 to over 30% in 2021. Although the prescription rate of generic molecular targeting drugs (MTDs) also increased from approximately 0.15% in 2014 to 2.5% in 2021, the increment was lower than that of generic mesalazine. The penetration rates of generic 5-aminosalicylic acid and tacrolimus ranged from over 30% to approximately 50%. Infliximab biosimilar achieved an approximate 20% penetration rate, whereas adalimumab achieved

Abstract Background Small benign intestinal stenosis is usually treated by endoscopic balloon dilation (EBD) or surgery. Although EBD and surgery are able to resolve the stenosis in most cases, they are associated with several problems such as insufficient dilation and surgical stress, respectively. On the contrary, a novel approach called radial incision and cutting (RIC) is reported to have several benefits when compared to EBD and surgery. We can currently adopt RIC only for the strictures in the colon or terminal ileum and not for those stenotic lesions present further in the small intestine where balloon-assisted endoscopy is utilized, because the long-type electric knife is currently not approved for use in Japan. We will herein conduct a pilot study to investigate the safety and feasibility of RIC for treating the benign stenoses of the small intestine using the long-type electric knife. Methods This will be a single-center, single-arm, interventional trial. The major criteria for inclusion will be age ranging from 20 to 80 years and the presence of benign stenosis in the small intestine. We will perform RIC on 10 participants. The primary outcome is the safety of this procedure, which will be assessed by measuring the frequency of adverse events of special interest. The secondary outcomes will be technical success rate, improvement in subjective symptoms, procedure time, and duration of hospitalization. Discussion This pilot study will provide useful information that will aid in adopting RIC for treating the benign strictures present in the small intestine. Trial registration jRCT Identifier, jRCTs022200040 . Registered on 1 March 2021.

The role of liposomes as drug carriers has been investigated. Ultrasound-based drug release methods have been developed for on-demand drug delivery. However, the acoustic responses of current liposome carriers result in low drug release efficiency. In this study, CO2-loaded liposomes were synthesized under high pressure from supercritical CO2 and irradiated with ultrasound at 237 kHz to demonstrate their superior acoustic responsiveness. When liposomes containing fluorescent drug models were irradiated with ultrasound under acoustic pressure conditions that are safe for the human body, CO2-loaded liposomes synthesized using supercritical CO2 had 17.1 times higher release efficiency than liposomes synthesized using the conventional Bangham method. In particular, the release efficiency of CO2-loaded liposomes synthesized using supercritical CO2 and monoethanolamine was 19.8 times higher than liposomes synthesized using the conventional Bangham method. These findings on the release efficiency of acoustic-responsive liposomes suggest an alternative liposome synthesis strategy for on-demand release of drugs by ultrasound irradiation in future therapies.

Abstract Aims Primary sclerosing cholangitis (PSC) is a relatively common complication of ulcerative colitis (UC). Only a few studies have investigated the impact of PSC on the clinical course of UC, and their conclusions are contradictory. Therefore, we aimed to compare the disease activity of UC with and without PSC. Methods and Results We collected UC patient data using the Diagnosis Procedure Combination database system in Japan and classified eligible admissions into two groups based on their diagnosis of either UC alone or UC associated with PSC. We then compared therapeutic details (medical treatment and surgery) between the two groups. Multivariable logistic regression analysis and propensity score matching was also performed. The rates of systemic steroid injection and infliximab administration in patients with PSC were lower than those in patients without PSC (21% vs. 28%, P = 0.012, 9.6% vs. 16%, P = 0.01, respectively). The rates of surgery, colorectal cancer, duration of hospital stay, and in‐hospital mortality did not differ between the two groups. Multivariable analysis revealed that concomitant PSC was a clinical factor that reduced the odds of systemic steroid injection (odds ratio [OR] = 0.66, 95% confidence interval [CI]: 0.49–0.90, P = 0.008) and infliximab (OR = 0.48, 95% CI: 0.32–0.74, P = 0.0008) administration. Conclusion UC patients with PSC might have less UC disease activity than those with UC alone.

Introduction: Limited data exist on the efficacy of combination therapy with ustekinumab and budesonide in patients with Crohn’s disease. Our objective was to compare the clinical outcomes of ustekinumab and budesonide combination therapy with those of ustekinumab monotherapy. Methods: In this phase 2 single-center, double-blind, randomized controlled trial, we assigned 19 patients with Crohn’s disease with a Crohn’s disease activity index (CDAI) equal to or greater than 220 and less than 450 in a 1:1 ratio to receive ustekinumab and budesonide or ustekinumab for 32 weeks. The primary endpoint was the clinical remission rate at 8 weeks. The secondary endpoints were the clinical remission rate at 32 weeks and mucosal healing rates at 8 and 32 weeks. Results: Of 19 patients, the mean age was 37.8 years, and 42.1% were women (CDAI ≥220 and

Background: Perforated appendicitis without an associated abscess necessitates emergency surgery. However, it is difficult to predict the presence of perforation before surgery, and the predictive factors are still unclarified. Our purposes were to characterize a patient population with perforated appendicitis without an associated abscess to identify the preoperative predictive factors of appendiceal perforation. Methods: We retrospectively identified 150 patients who underwent appendectomy for acute appendicitis at our institution from June 2018 to November 2020. Logistic regression analysis was performed to analyze the concurrent effects of various factors on the prevalence of perforated appendicitis. Results: Forty (29%) of 150 patients had appendiceal perforation detected intraoperatively. Of these 40 patients, only 19 had appendiceal perforation detected on preoperative computed tomography. Multivariable analysis found that a higher C-reactive protein level, higher total bilirubin level, and the presence of an appendiceal fecalith were independent predictive factors for appendicitis with perforation. Conclusion: Our analysis suggests that the presence of an appendiceal fecalith, a total bilirubin level of more than 21.38 μmol/L, and a C-reactive protein level of more than 3.0 × 104 μg/L are predictive factors of perforated appendicitis.

Background: New therapeutic agents, including biologics and small-molecule drugs, are widely used to treat ulcerative colitis (UC). This study evaluates long-term prognosis in Japanese patients treated with these agents and the association between prognosis and genetic susceptibility to UC. Methods: We evaluated surgery-free rates using the Kaplan-Meier method in the total cohort and in patients treated with prednisolone and new therapeutic agents. Multivariate analysis was performed to identify clinical factors affecting surgical rates using Cox’s proportional hazard model. The rate of use of new therapeutic agents was compared using the Kaplan-Meier method, and multivariate analysis was conducted to investigate the correlation between the single-nucleotide polymorphism (SNP) rs117506082 and long-term prognosis. Results: Surgery-free survival decreased over time. There was no significant difference in this parameter between patients who were administered prednisolone and those who were administered new therapeutic agents. Poor response to prednisolone and treatment without topical 5-aminosalicylic acid were poor prognostic factors. Shorter time from diagnosis to initiation of treatment with new therapeutic agents was a risk factor for colectomy. The AA genotype of SNP rs117506082 was associated with a shorter time to surgery and increased use of new therapeutic agents. Conclusions: The use of new therapeutic agents might improve long-term prognosis in patients with more severe UC. Previously identified genetic risk factors were not significantly associated with a higher rate of colectomy.

Abstract Background and Aim The number of elderly patients with ulcerative colitis (UC) is increasing worldwide. The clinical practice of associated treatment is still unclear. Therefore, we aimed to analyze clinical treatment realities and mortality in elderly and non‐elderly patients with UC. Methods We collected UC patients' data using the diagnosis procedure combination (DPC) database system and divided eligible patients into elderly (≥65 years) and non‐elderly (≤64 years) groups. We investigated and compared their therapeutic histories (medical treatments vs. surgery). Logistic regression analysis was conducted to identify clinical factors affecting surgery and in‐hospital death in each group. Results The rates of systemic steroid injection, molecular targeting drug usage, and surgery were not different between the two age groups. Meanwhile, the rate of in‐hospital death in elderly patients was higher than that in non‐elderly patients (2.7% vs. 0.19%, P

Abstract Immune response involving various immunoglobulin (Ig) isotypes and subtypes to microbiome is involved in the pathogenesis and disease activity of inflammatory bowel diseases (IBDs). To clarify the presence of Ig-coated bacteria in the intestine and its association with disease activity in ulcerative colitis (UC) and Crohn’s disease (CD), we extracted and classified Ig-coated bacteria from fecal samples of 42 patients with IBD and 12 healthy controls (HCs) using flow cytometry and 16S ribosomal RNA sequence analysis. The percentage of bacteria coated with IgA and IgM was higher in patients with IBD than in HCs, and IgG-coated bacteria were found only in patients with IBD. Moreover, the percentages of bacteria coated with IgG1, IgG2, IgG3, and IgM in UC samples and IgG3, IgG4, and IgM in CD samples were correlated with disease activities. The proportions of Bacteroides ovatus and Streptococcus increased during the active phase of CD. Hence, the detailed analysis of Ig-coated bacteria and Ig subtypes using flow cytometry could aid in developing useful indicators of disease activity and identifying more disease-related bacteria, which could become novel treatment targets for IBDs.

Endovascular thrombectomy (EVT) is the preferred treatment strategy for patients with acute ischemic stroke (AIS). However, clinical outcome and prognosis in patients who undergo EVT in response to AIS with concomitant malignancy have not been fully elucidated. Data of patients with malignancy who underwent EVT at participating institutions between January 2015 and April 2019 were retrospectively analyzed. Patient characteristics, treatment methods, posttreatment strategy, and long-term prognosis were evaluated in 12 patients with prediagnoses of malignancy. Good revascularization (TICI 2b or higher) was achieved in 10 of 12 patients. Among the eight patients who survived more than 2 weeks from onset, four patients showed good clinical outcome [modified Rankin Scale (mRS)

With the diversification of robots, modularization of robots has been attracting attention. In our previous study, we developed a robot that mimics the principle of human joint drive using a straight-fiber-type pneumatic rubber artificial muscle (“artificial muscle”) and a magnetorheological fluid brake (“MR brake”). The variable viscoelastic joints have been modularized. Therefore, this paper evaluates the basic characteristics of the developed Joint Module, characterizes the variable viscoelastic joint, and compares it with existing modules. As basic characteristics, we confirmed that the Joint Module has a variable viscoelastic element by experimentally verifying the joint angle, stiffness, viscosity, and tracking performance of the generated torque to the command value. As a characteristic evaluation, we verified the change in motion and response to external disturbances due to differences in driving methods through simulations and experiments and proved the strength of the variable viscoelastic joint against external disturbances, which is a characteristic of variable viscoelastic joints. Based on the results of the basic characterization and the characterization of the variable viscoelastic drive joint, we discussed what kind of device the Joint Module is suitable to be applied to and clarified the position of the variable viscoelastic joint as an actuator system.