Tumors developed in 2 old women presented with pathological findings similar to seborrheic keratosis, although the clinical feature of tumor showed typical keratoacanthoma. In addition to these two cases, we compared the pathological findings of a total of four cases, one case each of keratoacanthoma and seborrheic keratosis, which were clinically and histopathological typical. These two cases and the typical keratoacanthoma showed cell apoptosis by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining and infiltration of cytotoxic T cells. The keratoacanthoma in the decompensated stage may be histologically similar to seborrheic keratosis. TUNEL staining can help in the diagnosis of fading keratoacanthoma.
Background Phase-contrast cine cardiovascular magnetic resonance (CMR) quantifies global coronary flow reserve (CFR) by measuring blood flow in the coronary sinus (CS), allowing assessment of the entire coronary circulation. However, the complementary prognostic value of stress perfusion CMR and global CFR in long-term follow-up has yet to be investigated. This study aimed to investigate the complementary prognostic value of stress myocardial perfusion imaging and global CFR derived from CMR in patients with suspected or known coronary artery disease (CAD) during long-term follow-up. Methods Participants comprised 933 patients with suspected or known CAD who underwent comprehensive CMR. Major adverse cardiac events (MACE) comprised cardiac death, non-fatal myocardial infarction, unstable angina, hospitalization for heart failure, stroke, ventricular arrhythmia, and late revascularization. Results During follow-up (median, 5.3 years), there were 223 MACE. Kaplan–Meier curve analysis revealed a significant difference in event-free survival among tertile groups for global CFR (log-rank, p < 0.001) and between patients with and without ischemia (p < 0.001). The combination of stress perfusion CMR and global CFR enhanced risk stratification (p < 0.001 for overall), and prognoses were comparable between the subgroup with ischemia and no impaired CFR and the subgroup with no ischemia and impaired CFR (p = 0.731). Multivariate Cox proportional hazard regression analysis showed that impaired CFR remained a significant predictor for MACE (hazard ratio, 1.6; p = 0.002) when adjusted for coronary risk factors and CMR predictors, including ischemia. The addition of impaired CFR to coronary risk factors and ischemia significantly increased the global chi-square value from 88 to 109 (p < 0.001). Continuous net reclassification improvement and integrated discrimination with the addition of global CFR to coronary risk factors plus ischemia improved to 0.352 (p < 0.001) and 0.017 (p < 0.001), respectively. Conclusions During long-term follow-up, stress perfusion CMR and global CFR derived from CS flow measurement provided complementary prognostic value for prediction of cardiovascular events. Microvascular dysfunction or diffuse atherosclerosis as shown by impaired global CFR may play a role as important as that of ischemia due to epicardial coronary stenosis in the risk stratification of CAD patients.
The yield surface, the mechanical properties and our experimental methods for Zr55Al10Cu30Ni5 metallic glass are explained. The deformation behavior and the yield stress of this material changes for environmental temperature because of its obvious temperature dependency. The effect of normal stress on its yield can be revealed with increasing temperature and the yield surface closes a typical shape based on the Mohr-Coulomb yield criterion. This material also has an obvious strain rate dependency. The experimental study of the influence of deformation speed on the yield surface and function of this material will be important for a practical application of this material under dynamic load in hot environment.
The influence of thermo-mechanical loading on the mechanical behavior of Zr55Al10Cu30Ni5 bulk metallic glass was investigated experimentally. Pre-stressed specimen like loaded mechanical parts was subject to external and thermal load by heating. When pre-stress was lower than about 900MPa~1000MPa, during heating, this material showed plastic deformation with softening so that the mechanical tester cannot keep and control constant stress. A higher pre-stress than 1000MPa caused its brittle fracture to Zr55Al10Cu30Ni5 bulk metallic glass by heating. The temperatures to show these failures induced by heating under prestress to specimen were lower than the glass transition temperature of Zr55Al10Cu30Ni5 metallic glass measured by differential scanning calorimetry. Therefore, the interaction of the mechanical and thermal load such as external force and environmental temperature appears to decide the yield stress and the thermal properties of Zr55Al10Cu30Ni5 metallic glass, complementarily. From the result of this study, the direction for the strength design of applications made of this material subjected to various temperature conditions is indicated, and an effective machining method will be suggested.
Several topics on purely organic MV systems are highlighted after brief explanation on the basic concepts that are essential to understand the details of organic MV chemistry. Charge localization and delocalization on π‐conjugated organic molecular systems are discussed in terms of key parameters: electronic coupling, reorganization energy, and activation barrier. In particular, correlation between bridging units and electronic coupling, topology of bridging pattern, through‐bond and through‐space pathway, and control of spin states through MV states are described while citing intriguing examples of organic MV molecular systems.
Supplemental interlighting is a technique to improve horticultural light conditions. However, optimal methods for energy-efficient supplemental lighting are not yet established. Therefore, this study investigated the influence of supplemental light canopy position during the tomato fruit enlargement stage on photosynthetic function and aboveground dry-matter weight. A supplementary interlighting module was fixed at the initial irradiation position, then the irradiation position for three other modules were raised to 10 cm above each fruit truss at different developmental stages. These stages were the early enlargement stage (ES), from flowering until the first fruit reached a diameter of 10 mm, then the vigorously enlarging stage (VES), with tomato fruit diameter from 10 to 30 mm, and the late enlargement stage (LS) with a tomato fruit diameter greater than 30 mm. Cultivation was carried out using a D-tray system with a planting density of 5.5 plants·m⁻². The LED supplemental interlighting reduced specific leaf area (SLA), altering the plant canopy structure. This increased the canopy light transmittance from 40% to 70% at 20 cm from the canopy and from 20% to 40% at 40 cm from the canopy, especially during the ES. The total chlorophyll (Chl) content of leaves was higher under all irradiated treatments compared to the untreated control. However, Chl a/b ratios decreased for all treatments except in leaves under continuous LED irradiation. The maximum photosynthetic rate was higher in leaves closer to the supplemental interlighting exposure, but was lower in the 17th and 13th leaves at 6 μmol·m²·s⁻¹ and 4 μmol·m²·s⁻¹, respectively. Fruit dry-matter weight increased significantly to 143.2–156.5 g in all supplemental interlighting treatments compared with 119.6 g for the control. Interlighting treatment during VES achieved the highest yield and the greatest increase in fruit and total dry-matter weight. Therefore, VES-irradiation is most efficient to increase dry-matter weight.
Asparaginase is an essential drug for acute lymphoblastic leukaemia (ALL) treatment, but has several side effects, and its discontinuation often compromises patient outcomes. In the prospective Japan Association of Childhood Leukaemia Study ALL-02 protocol, two major changes were made: (1) additional chemotherapies to compensate for the reduction of treatment intensity when asparaginase was discontinued and (2) more intensive concomitant corticosteroid administration, relative to our previous ALL-97 protocol. In ALL-02 study, 1192 patients were included and L-asparaginase was discontinued for 88 (7.4%). Discontinuation due to allergy was markedly decreased relative to the ALL-97 protocol (2.3% vs 15.4%). Event-free survival (EFS) among patients with T-ALL was compromised when L-asparaginase was discontinued, as well as among patients with high-risk B-cell ALL, especially when discontinued before maintenance therapy. Moreover, multivariate analysis identified discontinuation of L-asparaginase as an independent poor prognostic factor for EFS. In the current study, additional chemotherapies failed to fully compensate for L-asparaginase discontinuation, illustrating the difficulty of replacing asparaginase with other classes of drugs, although this study was not designed to evaluate the effect of these modifications. Concomitant intensive corticosteroid treatment may help to reduce allergy to asparaginase. These results will assist in further optimization of asparaginase use.
We herein report a three-year-old boy with septic pulmonary embolism caused by Tsukamurella paurometabola bacteremia during chemotherapy for rhabdomyosarcoma. During the interval of chemotherapy, the patient was temporarily discharged with a peripherally inserted central venous catheter but was readmitted to the hospital with a fever on the same day. A blood culture taken at the time of re-admission showed T. paurometabola. The patient had a persistent fever, and computed tomography performed on the ninth day showed septic pulmonary embolism. We stress the importance of being aware of the possibility of septic pulmonary embolism in patients with Tsukamurella bacteremia.
Background/aim: Currently, several ongoing prospective studies are investigating the safety of breast surgery omission in patients with breast cancer who are exceptional responders to neoadjuvant chemotherapy. However, there is little information about the preferences of these patients regarding omission of breast surgery. Patients and methods: We conducted a questionnaire survey to assess preferences regarding omission of breast surgery among patients with breast cancer who had human epidermal growth factor receptor 2-positive or estrogen receptor-negative tumors and good clinical response after neoadjuvant chemotherapy. Patients' estimation of the risk of ipsilateral breast tumor recurrence (IBTR) after definitive surgery or breast surgery omission was also assessed. Results: Of 93 patients, only 22 (23.7%) said they would omit breast surgery. Under the scenario of omitting breast surgery, the 5-year IBTR rate estimated by patients who said they would omit breast surgery was significantly lower (median, 10%) than the rate estimated by patients who preferred undergoing definitive surgery (median, 30%) (p=0.017). Conclusion: The proportion of our surveyed patients who were willing to omit breast surgery was low. Patients who said they preferred to omit breast surgery overestimated the 5-year IBTR risk.
Nimaviridae (class Naldaviricetes) is a family of double-stranded DNA viruses infecting crustaceans, with the only officially recognized representative being white spot syndrome virus (WSSV). Chionoecetes opilio bacilliform virus (CoBV) was isolated as the causative agent of milky hemolymph disease in the snow crab Chionoecetes opilio, an economically important crustacean in the northwestern Pacific. Here, we present the complete genome sequence of CoBV and show that it is unambiguously a nimavirus. The CoBV genome is a 240-kb circular DNA molecule with 40% GC content that encodes 105 proteins, including 76 WSSV orthologs. Phylogenetic analysis based on eight naldaviral core genes established that CoBV is a member of the family Nimaviridae. The availability of the CoBV genome sequence provides a deeper understanding of CoBV pathogenicity and nimavirus evolution.
Here, we investigated the differences in the characteristics of ultraviolet‐B (UV‐B) laser diodes (LDs) fabricated on AlGaN templates prepared using two types of fabrication methods: (1) spontaneous nucleation in which AlGaN is grown three‐dimensionally from spontaneously generated AlN crystal nuclei and (2) AlN nanopillar in which AlGaN is grown on AlN nanopillars formed by etching a mask created using a nanoimprinting method coupled with inductively coupled plasma etching method. The LD formed on the AlGaN fabricated using the AlN nanopillar method of slope efficiency and maximum peak light output power was improved 4 times and 6 times respectively, which were significantly better compared with the spontaneous nucleation method. The analysis also confirmed the differences in injection efficiency and internal loss in the semiconductor crystal. Furthermore, detailed analysis of the current‐voltage characteristics showed that the AlN nanopillar method has lower reverse leakage current and n value than the spontaneous nucleation method. Comparison of these differences with crystallographic properties suggests that these differences in device properties are manifested by differences in V‐shaped pits and dislocation density. The reduction of dislocations and V‐shaped pit density in an AlGaN template is important to realize high‐performance UV‐B LDs, and the AlN nanopillar method is found to be useful for the fabrication of a suitable AlGaN template. This article is protected by copyright. All rights reserved.
Primary ciliary dyskinesia (PCD) is a hereditary disease caused by pathogenic variants in genes associated with motile cilia. Some variants responsible for PCD are reported to be ethnic-specific or geographical-specific. To identify the responsible PCD variants of Japanese PCD patients, we performed next-generation sequencing of a panel of 32 PCD genes or whole-exome sequencing in 26 newly identified Japanese PCD families. We then combined their genetic data with those from 40 Japanese PCD families reported previously, for an overall analysis of 66 unrelated Japanese PCD families. We conducted Genome Aggregation Database and TogoVar database analyses to reveal the PCD genetic spectrum of the Japanese population and compare with other ethnic groups worldwide. We identified 22 unreported variants among the 31 patients in the 26 newly identified PCD families, including 17 deleterious variants estimated to cause lack of transcription or nonsense-mediated mRNA decay and 5 missense mutations. In all 76 PCD patients from the 66 Japanese families, we identified 53 variants on 141 alleles in total. Copy number variation in DRC1 is the most frequent variant in Japanese PCD patients, followed by DNAH5 c.9018C>T. We found 30 variants specific to the Japanese population, of which 22 are novel. Furthermore, 11 responsible variants in the Japanese PCD patients are common in East Asian populations, while some variants are more frequent in other ethnic groups. In conclusion, PCD is genetically heterogeneous between different ethnicities, and Japanese PCD patients have a characteristic genetic spectrum.
This article employs sawtooth twisted tapes to generate swirling flow and interrupted flowing disturbance in order to increase the level of heat transfer rate. The influences of the sawtooth twisted tape (S-TT) on enhanced heat transfer rate, friction factor and aerothermal performance index (API) behaviors are analyzed. The sawtooth twisted tapes (S-TTs) possessing constant pitch/twist ratio (y//W) of 3.0 and six sawtooth angles (α) of 20°, 30°, 40°, 50°, 60°, and 70° are assessed. Considering turbulent flow using air as the testing fluid, experiments were investigated at 6,000 < Re < 20,000 under boundary conditions of constant heat flux. According to the experimental findings, sawtooth twisted tape (S-TT) improves heat transfer rate and raises pressure loss with varying rates based on sawtooth angles (α). With the sawtooth twisted tape (S-TT) and 70° sawtooth angles, the optimum API of 1.33 is attained, while Nusselt number and friction factor are 32 and 0.135 at Re = 6,000. The recommended sawtooth twisted tape (S-TT) yields a highest Nusselt number of 78, which is 1.6 times greater than the typical twisted tape (TT) and 1.1 times greater than the plain tube. The combination of the TT and sawtooth patterns can be beneficial in terms of boosting heat transfer rate and API relating coupling of swirling flow and interrupted flowing disruption effects since the sawtooth twisted tape (S-TT) offers superior performance than the TT. Additionally, the heat exchanger tubes fitted with sawtooth twisted tape (S-TT) at sawtooth angles (α) of 20°, 30°, 40°, 50°, 60°, and 70° gain greater Nusselt number than the plain tube up to 158.3%, 162.2%, 166.1%, 171.7%, 179.7% and 186.2%, respectively.
The purpose of this paper is to examine the energy cost of strawberry cultivation in a controlled environment chamber. To determine the energy cost, a 2.25 × 5.05 × 2.2 m³ testing room for growing strawberries was set up for the experiment in Chiang Mai, Thailand. Light-emitting diode (LED) grow lighting and air conditioning were used to regulate the environment inside the room to satisfy the strawberry growing requirements. There were 180 strawberry plants in the room. The energy consumption of the room was recorded for about 20 weeks. A computer model of the controlled environment chamber was developed and validated using the TRaNsient SYStem simulation tool (TRNSYS). The validated model was then used to predict the energy cost for one strawberry crop. In addition, the TRNSYS model was used to predict the energy consumption and costs of the room using weather data from five Southeast Asian cities (Chiang Mai, Kuala Lumpur, Yangon, Ho Chi Minh City, and Vientiane). It was found that the energy cost of growing strawberries in the controlled environment chamber in Chiang Mai was 2170 USD/crop cycle (71,500 THB/crop cycle) which is equivalent to 12 USD/plant. It was assumed that the average yield of strawberries would be around 150–400 grams per plant under protected cultivation for about 35 days from the fertilisation of the first flower. Consequently, the predicted energy cost for growing strawberries in the controlled environment chamber in Vientiane was the lowest, at 906 USD per crop cycle (5 USD/plant or 14 USD/kg), because of the low ambient temperature and low electricity tariff.
Central air-conditioners are used to control environmental conditions inside plant factory. However, if the plant factory is large, there is a high demand for air-conditioner system. The main objective of this study was to control the local air temperature around a serpentine copper pipe, as well as to examine the temperature difference between the surrounding and local air temperatures. It is generally known that controlling air temperature for cooling or heating consumes a large amount of energy. Thus, practical techniques to reduce energy consumption while also providing the desired air temperature in a local area are very important. The local air temperature and thermal performance around a serpentine copper pipe were experimentally investigated. A serpentine copper pipe was designed and constructed as a small-scale experiment, and a mixture of water with ethylene glycol was circulated as the working fluid, with a varied temperature of -5.0 °C to 6.2 °C applied for cooling in the present study. Collected data such as room air temperature, flow rate of working fluid, and supply and return fluid temperatures were used to calculate heat flux. In addition, local air temperature distributions around the serpentine copper pipe were measured by thermocouple. The results demonstrated that a serpentine copper pipe can reduce local indoor temperature. Upon decreasing the supply water temperature, local air temperatures decreased compared with room air temperature. However, increasing the volume flow rate did not affect the change in local air distribution. It was observed that supply water temperature had a greater influence on local air temperature and heat flux than the flow rate of working fluid. In summary, a serpentine copper pipe is helpful for controlling local air temperature and reducing energy consumption compared to traditional air conditioning.
Background: Data on the potential benefit of acute-phase rehabilitation initiation in very old (aged ≥90) patients with acute heart failure (AHF) have been scarce. Methods: We retrospectively analyzed data from the Diagnosis Procedure Combination database, which is a nationwide inpatient database. This study included patients hospitalized for heart failure (HF) from January 2010 to March 2018, those aged ≥90 years, who had a length of stay of ≥3 days, New York Heart Association (NYHA) class of ≥II, and had not undergone major procedures under general anesthesia. Propensity score matching and generalized linear models were used to compare in-hospital mortality, length of stay, 30-day readmission rate due to HF, all-cause 30-day readmission, and improvement in activities of daily living (ADL) between patients with and without an acute-phase rehabilitation initiation, which is defined as the rehabilitation initiation within 2 days after hospital admission. Results: Acute-phase rehabilitation was initiated in 8588 of 41,896 eligible patients. Propensity score matching created 8587 pairs. Patients with acute-phase rehabilitation initiation have lower in-hospital mortality (9.0% vs. 11.2%, p < 0.001). Acute-phase rehabilitation initiation was associated with lower in-hospital mortality (odds ratio, 0.778; 95% confidence interval, 0.704-0.860). Patients with acute-phase rehabilitation initiation have a shorter median length of stay (17 days vs. 18 days, p < 0.001), lower 30-day readmission rate due to HF (5.5% vs. 6.4%, p = 0.011) and all-cause 30-day readmission (10.2% vs. 11.2%, p = 0.036), and better ADL improvement (49.7% vs. 46.9%, p < 0.001). Subgroup analysis revealed consistent results (sex, body mass index, NYHA class, and Barthel Index). Conclusions: The acute-phase rehabilitation initiation was associated with improved short-term clinical outcomes in patients aged ≥90 years with AHF.
Xavier Hall was a timber structured building for auditorium and believers’ hall designed by Togo Murano Architect Office, built in 1949 in the property of Nobori-cho Catholic Church in Hiroshima, widely known as “Memorial Cathedral for World Peace.” The hall is important in inquiring the design process of the Cathedral, because it had a fundamental influence on site-composition of the religious complex as a whole. In this paper, based on the chronological order of sketches and drawings relevant to the hall, morphological analysis was performed through three problem-solving studies to reveal the architect’s design thinking and strategy.
The group definition for an animal population is important for building associations among individuals (i.e., social network). Indo-Pacific bottlenose dolphins (Tursiops aduncus) have a society with high fission–fusion dynamics that changes their group memberships over time, making it difficult to define groups clearly. In addition, current group definitions of small delphinid species are mainly related to boat-based or land-based surveys, and few definitions exist for underwater surveys. We propose a group definition for underwater observations after comparing 234 group transitions from 44 surveys of simultaneous boat-based and underwater observations targeting the resident Indo-Pacific bottlenose dolphins around Mikura Island, Japan. Our results highly matched group transitions between boat-based and underwater observations when all video-recorded dolphins during one encounter (from entering to exiting the water) were defined as a group, and groups with at least one shared individual during one survey were treated as the same group. This definition successfully produced highly similar association indices to boat observation. This is useful for underwater surveys of highly maneuverable delphinids, especially for commercial-tour-based studies in which researchers do not have the full decision-making authority for the observations.
In order to know the effect of varied grousers on the reaction of soil, the reaction of soil by a plate at different angles of inclination using the two-dimensional discrete element method (DEM) has been investigated. Either the simulation or the experiment, a flat iron plate with 5 × 77 × 100 (mm) was used, and the inclination angle between the plate and the soil surface ranged from 0 to 60 degrees with 15-degree intervals. According to the result, the cohesive soil model introduced in the 2D DEM could successfully replicate the experimental results considering the effects of different inclination angles of the plate and the values of the root mean square error between the simulation and the experiment were found as 6.62, 36.60, 58.63, 60.84, and 66.25 N for inclination angles from 0 to 60 degrees in the horizontal direction. Moreover, the RMSE values of 127.91, 216.06, 75.88, 110.40, and 25.49 N were obtained for the vertical direction. Overall, a minimal discrepancy was observed between the results of DEM simulation and those of experiments in the vertical component of reaction force when the inclination angle of the plate was increased.
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2-174 Edobashi, 514-8507, Tsu, Mie , Japan