Mie University

Technology mapping is a process in logic synthesis for designing logic circuits. It converts an internal graph representation of logic functions into a gate-level netlist. This study proposes a method that involves introducing clockless gates proactively into resultant netlists of RSFQ logic circuits. Ordinary RSFQ circuits consist of clocked gates and necessitate path balancing. The usage of clockless gates working without clock inputs reduces the number of clocked gates and logic stages, which leads to a smaller clock distribution network. The capability of reducing the number of stages is essential to improve flexibility in the number of logic stages of designed circuits. The method introduces more clockless gates into the resultant netlist compared with our previous method instead of a longer clock period. It utilizes a specific library of supergates, that is, small single-output circuits with several logic gates, used in technology mapping. The library is generated by adding supergates that utilize clockless gates, except for their output parts, to an original library with no clockless gates. The method reduces the number of clocked gates to a greater extent than our previous method and gives designers a higher degree of flexibility in the number of logic stages. The evaluation results indicate that the number of clocked gates in netlists and logic stages is reduced by over 40% when compared with netlists without clockless gates.

2H‐1,4‐Oxazin‐3(4H)‐One Derivatives Are Known to Exhibit a Wide Range of Biological Activities Such as Antifungal, Anticancer, as Receptor Antagonists and Potassium Channel Modulators. In This Report, We Describe That α‐Hydrazonoketone Is an Appropriate Substrate for the Umpolung Reaction and a Promising Candidate for the Synthesis of 2H‐1,4‐Oxazine‐3(4H)‐Ones. Notably, Umpolung N‐Methylation for α‐Hydrazonoketone Proceeded Quantitatively in a Mild and Extremely Short Reaction Time, Which Has Been Difficult to Achieve in the Conventional Reactions. Moreover, We Also Developed Tandem Umpolung Reaction/Reduction/N‐Acyl‐O‐Alkylation to Afford 2H‐1,4‐Oxazin‐3(4H)‐Ones in High Yield in the Presence of Chloroacetyl Chloride.

Deep learning in combination with fluorescence excitation-emission spectroscopy was studied to quantitatively analyze vitamin A (retinol) in cattle blood. The neural network model being obtained with the deep learning predicted the vitamin-A levels with a coefficient of determination (R²) of 0.93 with respect to the experimental values. The combination of the deep learning and fluorescence excitation-emission spectroscopy has a potential to predict the vitamin-A level in the cattle blood accurately, rapidly and inexpensively and to improve production of marbled beef with maintaining cattle health. It could also be applied to quantitative vitamin-A assays of various biological tissues, foods and so on as well as to those of blood samples besides cattle. Fullsize Image

Objectives: In digital image diagnosis using medical displays, it is crucial to rigorously manage display devices to ensure appropriate image quality and diagnostic safety. The aim of this study was to develop a model for the efficient quality control (QC) of medical displays, specifically addressing the measurement items of contrast response and maximum luminance as part of constancy testing, and to evaluate its performance. In addition, the study focused on whether these tasks could be addressed using a multitasking strategy. Methods: The model used in this study was constructed by fine-tuning a pretrained model and expanding it to a multioutput configuration that could perform both contrast response classification and maximum luminance regression. QC images displayed on a medical display were captured using a smartphone, and these images served as the input for the model. The performance was evaluated using the area under the receiver operating characteristic curve (AUC) for the classification task. For the regression task, correlation coefficients and Bland–Altman analysis were applied. We investigated the impact of different architectures and verified the performance of multi-task models against single-task models as a baseline. Results: Overall, the classification task achieved a high AUC of approximately 0.9. The correlation coefficients for the regression tasks ranged between 0.6 and 0.7 on average. Although the model tended to underestimate the maximum luminance values, the error margin was consistently within 5% for all conditions. Conclusion: These results demonstrate the feasibility of implementing an efficient QC system for medical displays and the usefulness of a multitask-based method. Thus, this study provides valuable insights into the potential to reduce the workload associated with medical-device management the development of QC systems for medical devices, highlighting the importance of future efforts to improve their accuracy and applicability.

Preventive interventions are expected to substantially improve the prognosis of patients with primary liver cancer, predominantly hepatocellular carcinoma (HCC) and cholangiocarcinoma. HCC prevention is challenging in the face of the evolving etiological landscape, particularly the sharp increase in obesity-associated metabolic disorders, including metabolic dysfunction-associated steatotic liver disease (MASLD). Next-generation anti-HCV and HBV drugs have substantially reduced, but not eliminated, the risk of HCC and have given way to new challenges in identifying at-risk patients. The recent development of new therapeutic agents and modalities has opened unprecedented opportunities to refine primary, secondary, and tertiary HCC prevention strategies. For primary prevention (before exposure to risk factors), public health policies, such as universal HBV vaccination, have had a substantial prognostic impact. Secondary prevention (after or during active exposure to risk factors) includes regular HCC screening and chemoprevention. Emerging biomarkers and imaging modalities for HCC risk stratification and detection may enable individual risk-based personalized and cost-effective HCC screening. Clinical studies have suggested the potential utility of lipid-lowering, anti-diabetic/obesity, and anti-inflammatory agents for secondary prevention, and some of them are being evaluated in prospective clinical trials. Computational and experimental studies have identified potential chemopreventive strategies directed at diverse molecular, cellular, and systemic targets for etiology-specific and/or agnostic interventions. Tertiary prevention (in conjunction with curative-intent therapies for HCC) is an area of active research with the development of new immune-based neo/adjuvant therapies. Cholangiocarcinoma prevention may advance with recent efforts to elucidate risk factors. These advances will collectively lead to substantial improvements in liver cancer mortality rates.

Annular pancreas is a rare congenital anatomical anomaly, in which the pancreatic parenchyma surrounds the descending duodenum. Generally, annular pancreas is diagnosed on the basis of symptoms associated with complications of peptic ulcer, pancreatitis, cholelithiasis, and rarely, malignant tumors. Herein, we report an 84‐year‐old man for whom, during hospitalization for a urinary tract infection, pancreatic cystic lesions and an annular pancreas were noted incidentally on computed tomography. These findings led to a diagnosis of intraductal papillary mucinous neoplasms on further examination. He safely underwent robot‐assisted pylorus‐preserving pancreatoduodenectomy, with an operative time of 478 min and blood loss of 37 g. He was discharged on postoperative day 8 without postoperative complications. In conclusion, it is important to note that, in this case, intraductal papillary mucinous neoplasms were detected before they became malignant, and minimally invasive surgery was performed safely despite the anatomical anomaly of an annular pancreas.

Objectives For older adults, spending time out of bed is important for preventing functional decline, but its relationship to mortality is not clear. In this study, we aimed to investigate the association between mortality and time spent out of bed in Japanese older-adult nursing home residents. Design We conducted a cohort study using data from the Long-term Care Information System for Evidence database. Setting and Participants We used data collected between April 2022 and March 2024 from older-adult nursing home residents who required assistance with the activities of daily living. Methods We compared outcome data between residents who spent 6 or more hours per day out of bed (group L) and those who spent less than 6 hours per day out of bed (group S). The outcome was all-cause mortality. Data were analyzed using Kaplan-Meier curves and Cox regression models. Results Data from 185 older-adult nursing home residents (median age: 89 years; 141 women) were analyzed. Group L included 144 residents (77.8% of all participants). Of the 185 participants, 40 died during the observation period. Mortality in group L was significantly lower than in group S (16.7% vs 39.0%, P = .002). Kaplan-Meier curve analysis after the log-rank test revealed a significantly higher mortality in group S than group L. Univariate and multivariate Cox regression analyses with robust (Huber-White) standard errors identified the factor of time spent out of bed (≥6 h) as a significant and independent risk factor for mortality. Conclusion and Implications More time spent out of bed is associated with lower mortality in older-adult nursing home residents who require assistance with the activities of daily living.

Halorhodospira (Hlr.) halophila strain BN9622 is an extremely halophilic and alkaliphilic purple phototrophic bacterium and has been widely used as a model for exploring the osmoadaptive and photosynthetic strategies employed by phototrophic extreme halophiles that enable them to thrive in hypersaline environments. Here we present the cryo-EM structures of (1) a unique native Hlr. halophila triple-complex formed from light-harvesting (LH1), the reaction center (RC), and high-potential iron–sulfur protein (HiPIP) at 2.44 Å resolution, and (2) a HiPIP-free LH1–RC complex at 2.64 Å resolution. Differing from the LH1 in the Hlr. halophila LH1–LH2 co-complex where LH1 encircles LH2, the RC-associated LH1 complex consists of 16 (rather than 18) αβ-subunits circularly surrounding the RC. These distinct forms of LH1 indicate that the number of subunits in a Hlr. halophila LH1 complex is flexible and its size is a function of the photocomplex it encircles. Like LH1 in the LH1–LH2 co-complex, the RC-associated LH1 complex also contained two forms of αβ-polypeptides and both dimeric and monomeric molecules of bacteriochlorophyll a. The majority of the isolated Hlr. halophila LH1–RC complexes contained the electron donor HiPIP bound to the surface of the RC cytochrome subunit near the heme-1 group. The bound HiPIP consisted of an N-terminal functional domain and a long C-terminal extension firmly attached to the cytochrome subunit. Despite overall highly negative surface-charge distributions for both the cytochrome subunit and HiPIP, the interface between the two proteins was relatively uncharged and neutral, forming a pathway for electron tunneling. The structure of the Hlr. halophila LH1–RC–HiPIP complex provides insights into the mechanism of light energy acquisition coupled with a long-distance electron donating process toward the charge separation site in a multi-extremophilic phototroph.

This study discusses disseminated intravascular coagulation (DIC) associated with solid cancers and various vascular abnormalities, both of which generally exhibit chronic DIC patterns. Solid cancers are among the most significant underlying diseases that induce DIC. However, the severity, bleeding tendency, and progression of DIC vary considerably depending on the type and stage of the cancer, making generalization difficult. Moreover, during the process of creating these guidelines, it became apparent that despite solid cancers being a major underlying condition for DIC, there is a lack of high-quality research on DIC associated with solid cancers. Nevertheless, we developed recommendations for clinical questions (CQs) regarding the use of heparin and recombinant thrombomodulin. Additionally, statements concerning these five questions were provided. DIC associated with various vascular abnormalities, is characterized by hyperfibrinolytic activity and linked to underlying conditions such as aortic aneurysm, aortic dissection, vasculitis syndromes, and vascular malformations. These conditions must always be considered differential diagnoses when unexplained thrombocytopenia or bleeding tendencies are observed. Although no evidence was found to support the assignment of recommendation levels, three statements were made. However, traumatic vascular abnormalities have not been discussed in this context.

A bis(triarylamine) (BTA) radical cation, bridged by two o‐terphenylene moieties, was prepared and characterized to explore the impact of the double‐π‐bridge on the intramolecular charge/spin transfer process in the 2‐site organic mixed‐valence (MV) compound. Spectroscopic analyses on optically and thermally assisted intervalence charge‐transfer (IVCT) processes revealed that the doubly π‐bridging enhanced the charge delocalization between two nitrogen redox‐active centers, whereas the electronic coupling was not so strengthened, in comparison with the singly π‐bridging reference compound.

Purpose: This study investigated the frequency with which nursing support for constipation is provided for patients with cancer during the prognostic months and weeks. Methods: An online cross-sectional survey was conducted anonymously among registered nurses in palliative care units across Japan. The frequencies of providing six types of nursing support (abdominal massage with essential oils, abdominal acupressure, auricular acupressure, self-management education, abdominal massage, and warm compresses) were surveyed. Results: Data were obtained from 539 nurses (response rate: 22.3%) from 162 facilities. The most frequently provided support was warm compression; the least frequently provided supports were auricular acupressure, abdominal massage with essential oils, and abdominal acupressure. In the prognostic weeks only, self-management education followed these support types. Conclusion: The investigation found that the six types of support were rarely implemented for relieving constipation in patients with cancer. Future research should investigate the factors hindering the provision of these supports.

Powdery mildew is an economically important disease caused by c. 1000 different fungal species. Erysiphe vaccinii is an emerging powdery mildew species that is impacting the blueberry industry. Once confined to North America, E. vaccinii is now spreading rapidly across major blueberry‐growing regions, including China, Morocco, Mexico, and the USA, threatening millions in losses. This study documents its recent global spread by analyzing both herbarium specimens, some over 150‐yr‐old, and fresh samples collected world‐wide. Our findings were integrated into a ‘living phylogeny’ via T‐BAS to simplify pathogen identification and enable rapid responses to new outbreaks. We identified 50 haplotypes, two primary introductions world‐wide, and revealed a shift from a generalist to a specialist pathogen. This research provides insights into the complexities of host specialization and highlights the need to address this emerging global threat to blueberry production.

Comprehensive genomic profiling (CGP) is increasingly used as a clinical laboratory test and being applied to cancer treatment; however, standardization and external quality assessments (EQA) have not been fully developed. This study performed cost-effective EQA and proficiency tests (PT) for CGP testing among multiple institutions those belong to the EQA working group of Japan Association for Clinical Laboratory Science (JACLS). This study revealed that preanalytical processes, such as derived nucleic acids (NA) extraction from formalin fixed paraffine embedded (FFPE) samples, are critical. First, EQA with extracted DNA from cell lines showed a detection rate of 100% (9 out of 9) in KRAS (c.38G > A; p.G13D), PIK3CA (p.H1047R), and B-Raf proto-oncogene, serine/threonine kinase (BRAF) (c.1799 T > A; p.V600E) in cases of > 10% variant allele frequency (VAF). However, BRAF (c.1799 T > A; p.V600E) detection decreased to 67% (6 out of 9) for a VAF of 4.9%. Second, when DNA was extracted from FFPE samples, pathogenic variants and variants with companion diagnostic indications were detected in all 10 participating laboratories. Each variant had < 20% VAFs on average (8.1–19.1%) and wide variability among laboratories was observed (relative standard deviation, 13–60%). Nonetheless, BRAF (c.1798_1799delinsAA; p.V600K) of 8.1% VAF, EGFR (c.2235_2249del; p.E746_A750del) of 9.7% VAF, and EGFR (c.2254_2277del; p.S752_I759del) of 9.8% VAF were detected with 70% (7/10), 70% (7/10), and 60% (6/10) frequency, respectively. Therefore, 10% VAF in pre-analytic processing for DNA extraction from FFPE was critical for variant detection in CGP analysis. Further, incorrect results were reported in case independent variant calling of BRAF; c.1798_1799delinsAA (p.V600K) was mistakenly interpreted as c.1798G > A, and c.1799 T > A was on the other strand. In conclusion, the EQA/PT among 10 institutes with common samples revealed the importance of VAF in pre-analysis and helped us understand the significance of the pipeline and common pitfalls usually ignored by the internal quality control in a single institute.

Background Although extensive research has been conducted on early anastomotic leakage (AL) after sphincter‐sparing surgery, the status of late anastomotic complications (post‐30 days) has received limited attention. These late complications significantly affect a patient's quality of life and often lead to permanent stoma creation. Methods This study conducted a sub‐analysis of a phase II trial assessing the outcomes of laparoscopic surgery for cStage I lower rectal adenocarcinoma (the ultimate trial). This study included 278 patients who underwent intestinal anastomosis and investigated the frequency, timing, and risk factors of late anastomotic complications (stenosis, fistula, and intestinal prolapse). Results Anastomotic stenosis occurred in 27 patients (9.7%), and the median time of occurrence was 274 days (range, 70–1226 days). Only early AL (p = 0.004) was identified as an independent risk factor. A late anastomotic fistula was observed in five patients (1.8%), and 18 patients (6.4%) requiring permanent stomas. A short distance from the lower tumor margin to the anal verge (AV) (p = 0.004) and the presence of stenosis or fistula (p < 0.0001) were independent risk factors. Intestinal prolapse occurred in eight cases (3%), with a median occurrence of 221 days (range, 122–725 days). Intersphincteric resection (ISR) (p = 0.02) and splenic flexure takedown (p < 0.0001) were independent risk factors. Conclusion Anastomotic stenosis and late fistula formation frequently emerge as secondary consequences of early AL and represent significant complications linked to permanent stoma creation, often proving resistant to treatment. Intestinal prolapse is a characteristic anastomotic complication of ISR that can be caused by excessive intestinal mobilization.

Background Delirium is a condition characterized by an acute and transient disturbance in attention, cognition, and consciousness. It is increasingly prevalent at the end of life in patients with cancer. While non-pharmacological nursing interventions are essential for delirium prevention, their effectiveness in terminally ill patients with cancer remains unclear. Objectives This study examined the nursing support practices employed to prevent delirium in terminally ill patients with cancer in palliative care units (PCUs) in Japan. Methods This cross-sectional study administered an online survey to 2448 nurses from 162 institutions with PCUs in Japan. Results Regarding nursing practices with patients with a prognosis of months and weeks, multi-component intervention, family support, and dehydration prevention were practiced frequently, whereas bright light therapy was practiced less frequently. The specialist team approach was practiced by approximately 50% of participants. Regarding multicomponent intervention in cases with a prognosis of months and weeks, adjustments in the sleep environment and pain management were practiced by more than 90% of the participants, whereas early exercise, vision or hearing assistance, and patient education on delirium were implemented by less than 50%. The management of intravenous injection routes and catheters was implemented by participants approximately 20% more frequently in cases with a prognosis of weeks than those with a prognosis of months. Conclusion The primary methods of nursing support for preventing delirium in patients with terminal cancer were multicomponent intervention, family support, and dehydration prevention. Further research is necessary to develop and implement appropriate nursing support strategies.

Japanese pear [Pyrus pyrifolia (Burm. F.) Nakai] has a S-RNase-based self-incompatibility system and inactivation of S-RNase causes self-incompatibility breakdown in this system. Copper ions (Cu⁺⁺) strongly inhibited the RNase activity of crude stylar proteins, but did not overcome self-incompatibility in the Japanese pear ‘Kosui’ (S4S5). To elucidate the cause of this phenomenon, the present study aimed to separate stylar RNases and clarify their responses to Cu⁺⁺ in ‘Kosui’. Using an anion exchange chromatograph equipped with a Mono-Q column, one strong non-S-RNase was separated, and at least six non-S-RNases together with 2 S-RNases were isolated, by cation exchange chromatography with the Mono-S column. S-RNases were identified by dot blot analysis using S-RNase antiserum, and hereafter, the seven non-S-RNases isolated are designated as NS1 to NS7 in eluting order. NS1 and NS2 were abundant RNases with strong activities, and their activities were reduced to 6.6 and 4.5% of the control by 1 mM CuSO4, respectively. NS3, NS4, NS5, NS6, and NS7 were weak RNases, and NS7 showed intermediate inhibition (31%) with Cu⁺⁺, whereas inhibition of other RNases was weak, from 44 to 74% of the control. Meanwhile, the degree of inhibition was quite low in S4- and S5-RNase (86 to 89%). Thus, RNase inhibition of crude stylar proteins by Cu⁺⁺ is due to strong repression of NS1 and NS2 activities. These results indicate that active S-RNase can cause a self-incompatibility reaction despite large decreases in non-S-RNase activities in the pear style.

Himawari-8/9 is a next-generation Japanese Geostationary Earth Orbit (GEO) meteorological satellite with an onboard sensor – the Advanced Himawari Imager (AHI). Because Himawari-8/9 AHI observe the Earth's hemispheres every 10 min with multiple spectral bands, AHI providing an unprecedented opportunity to facilitate its observation datasets are expected to be a new data source for terrestrial monitoring in terms of mitigating cloud contaminations. Estimation of land surface reflectance (LSR) is crucial in quantitative terrestrial monitoring. In this study, we aimed to develop a method for estimating the LSR and angular-adjusted LSR of the Himawari-8/9 AHI using the look-up table based Second Simulation of a Satellite Signal in the Solar Spectrum Vector (6SV) Radiative Transfer Model (RTM) and kernel-driven semi-empirical bidirectional reflectance distribution function (BRDF) model. The estimated LSR underwent evaluation and inter-comparison through two distinct approaches: ray-matching and estimating angular-adjusted LSR. Ray-matching of the obtained data pairs with the MODIS LSR product shows that the correlation coefficients (r) for all bands are greater than 0.86 at low latitudes. Angular-adjusted LSRs estimated using AHI time-series data at mid-latitudes also show good agreement with MODIS (r > 0.5), particularly the red and near-infrared bands (r > 0.9). The results obtained by our method are in high agreement with those calculated using the reference aerosol optical thickness (AOT) (r > 0.98). Our findings highlight the potential application of our methodology to other GEO satellites for high-frequency terrestrial monitoring at continental to global scales.