We propose an angle-measurement method involving ultrasound imaging of a transmitter for a thin medical devices used in minimally invasive surgery. We fabricated a fiber-optic ultrasound transmitter ...with multiple ultrasound sources for angle-measurement. The angles can be measured by an image of multiple ultrasound sources. To form ultrasound sources not only at the tip but also in the middle of an optical fiber, gap structures are formed by connecting fibers with adhesive that contains micrometer-sized particles to scatter light. A portion of the propagating laser light is taken out at the connected point by light scattering and converted to an ultrasound pulse. We fabricated a two-source transmitter and confirmed that they have the patterns in an ultrasound image. We conducted angle-measurement with our two-source ultrasound transmitter and a one-dimensional array probe. The error of measurement was less than 2° and 10° for polar and azimuth angles, respectively.
Desflurane is one of the most frequently used inhalational anesthetics in clinical practice. A circadian rhythm phase-shift after general anesthesia with sevoflurane or isoflurane has been reported ...in mice, but few studies have reported this effect with desflurane. In the present study, we examined the rest/activity rhythm of mice by counting the number of running wheel rotations, and we found that desflurane anesthesia caused a phase shift in the circadian rhythm that was dependent on the time of day of anesthesia. We also found that desflurane anesthesia altered the relative mRNA expression of four major clock genes (Per2, Bmal, Clock, and Cry1) in the suprachiasmatic nucleus (SCN). These results are important for elucidating the effects of desflurane on the SCN, which is the master clock for the mammalian circadian rhythm. Further studies on the relationship between anesthesia and circadian rhythm may lead to the prevention and treatment of postoperative complications related to circadian rhythms.
Purpose
Postoperative delirium is one of the most common complications after cardiovascular surgery in older adults. Benzodiazepines are a reported risk factor for delirium; however, there are no ...studies investigating remimazolam, a novel anesthetic agent. Therefore, we prospectively investigated the effect of remimazolam on postoperative delirium.
Methods
We included elective cardiovascular surgery patients aged ≥ 65 years at Hamamatsu University Hospital between August 2020 and February 2022. Patients who received general anesthesia with remimazolam were compared with those who received other anesthetics (control group). The primary outcome was delirium within 5 days after surgery. Secondary outcomes were delirium during intensive care unit stay and hospitalization, total duration of delirium, subsyndromal delirium, and differences in the Mini-Mental State Examination scores from preoperative to postoperative days 2 and 5. To adjust for differences in the groups’ baseline covariates, we used stabilized inverse probability weighting as the primary analysis and propensity score matching as the sensitivity analysis.
Results
We enrolled 200 patients; 78 in the remimazolam group and 122 in the control group. After stabilized inverse probability weighting, 30.3% of the remimazolam group patients and 26.6% of the control group patients developed delirium within 5 days (risk difference, 3.8%; 95% confidence interval −11.5% to 19.1%;
p
= 0.63). The secondary outcomes did not differ significantly between the groups, and the sensitivity analysis results were similar to those for the primary analysis.
Conclusion
Remimazolam was not significantly associated with postoperative delirium when compared with other anesthetic agents.
Echo-guided intervention is a promising minimally invasive surgery in the ultrasound (US) image guide because of its non-invasiveness and the high visuality of blood vessels. However, detecting the ...position of an intervascular device is difficult under an echo-guided intervention. To overcome this problem, we proposed a novel position detection method for an echo-guided intervention with a small photoacoustic transmitter. The method detects the position of the intervascular device by receiving the US that the transmitter at the device tip emits. Because its accuracy decreases under weak signal conditions, this paper proposes a Kalman filter-based filtering method to improve the accuracy of the position detection. The proposed filter reduces the detection error based on a linear approximation of the system. Our experiment shows the filter reduces 52% of the root mean squared error during position detection in an elevation direction.
Background:Pulmonary embolism (PE) is a potentially fatal form of venous thromboembolism (VTE). This study compares the mortality, incidence of recurrent VTE, and incidence of major bleeding between ...non-cancer and cancer-associated PE patients treated with direct oral anticoagulants (DOACs).Methods and Results:This was a retrospective, observational, single-center study involving 130 consecutive patients (87 with active cancer; 43 without cancer) who received DOAC treatment for PE between January 2016 and December 2019. Kaplan-Meier analysis showed significantly higher mortality in cancer-associated PE patients than in non-cancer patients (35/87 40% vs. 1/43 2%, P<0.001, log-rank test, HR 18.6 95% CI: 2.5–136.0). In contrast, the cumulative incidences of recurrent VTE and major bleeding were comparable between the 2 groups. Among the cancer-associated PE patients, the incidence for the composite outcome of recurrent VTE or major bleeding was significantly higher in patients undergoing chemotherapy than in those not undergoing chemotherapy (9/37 24% vs. 2/50 4%, P=0.004, log-rank test, HR 6.9 95% CI: 1.5–32.0).Conclusions:Although cancer-associated PE patients treated with DOACs showed higher mortality compared with non-cancer patients, presumably because of the presence of cancer, the risk of recurrent VTE or major bleeding was comparable between the 2 groups. Thus, DOAC is an important treatment option for cancer-associated PE, although underlying cancer-related risks (e.g., chemotherapy) remain.
To reconstruct the Cenozoic paleoceanographic evolution, in particular, temporal changes in nutrient levels, we studied calcareous nannofossil assemblages from Ocean Drilling Program holes 1210A, ...located in the northwestern Pacific Ocean, and 762B, situated in the eastern Indian Ocean. At each site we focused on the relationships among the nannofossil accumulation rate (NAR), relative abundance of Discoaster, and coccolith size of the genus Reticulofenestra. The co-occurrence of a low NAR, high Discoaster abundance and presence of large Reticulofenestra suggest a deep thermocline and nutricline, typical of oligotrophic conditions. Conversely, the co-occurrence of a high NAR, low Discoaster abundance and presence of small Reticulofenestra indicate a shallow thermocline and nutricline, typical of eutrophic conditions. The combination of these three parameters suggests that the gradual eutrophication and collapse of sea surface stratification occurred in the northwestern Pacific Ocean at 7.9, 6.4, and 5.0Ma. In contrast, abrupt eutrophication is indicated at 8.8Ma in the eastern Indian Ocean. Although the timing of eutrophication differs between the Pacific and Indian Ocean sites, it roughly coincides with tectonic and/or climatic events around the two oceans. This finding suggests that tectonic and climatic events are capable of causing an increase in the terrestrial input and/or coastal upwelling of nutrients that subsequently leads to the eutrophication of sea surface waters.
•High-resolution record of calcareous nannofossil assemblages during 2–14Ma•Gradual eutrophication during 7.9–5.0Ma in the northwestern Pacific Ocean•Abrupt eutrophication at 8.8Ma in the eastern Indian Ocean•Eutrophication caused by changes in tectonic and climate settings
Type 1 recombinant enterovirus G (EV-G), which carries the papain-like cysteine protease (PLCP) gene of torovirus between its 2C/3A regions, and type 2 recombinant EV-G, which carries the torovirus ...PLCP gene with its flanking regions having non-EV-G sequences in place of the viral structural genes, have been detected in pig farms in several countries. In a previous study, we collected 222 fecal samples from 77 pig farms from 2104 to 2016 and detected one type 2 recombinant EV-G genome by metagenomics sequencing. In this study, we reanalyzed the metagenomic data and detected 11 type 2 recombinant EV-G genomes. In addition, we discovered new type 2 recombinant EV-G genomes of the two strains from two pig farms samples in 2018 and 2019. Thus, we identified the genomes of 13 novel type 2 recombinant EV-Gs isolated from several pig farms in Japan. Type 2 recombinant EV-G has previously been detected only in neonatal piglets. The present findings suggest that type 2 recombinant EV-G replicates in weaning piglets and sows. The detection of type 1 recombinant EV-Gs and type 2 recombinant EV-Gs at 3-year and 2-year intervals, respectively, from the same pig farm suggests that the viruses were persistently infecting or circulating in these farms.
•High-resolution calcareous nannofossil biostratigraphy of the Shimajiri Group.•Eutrophication was caused by shallowing of the sedimentary basin.•Eutrophication occurred in the northwestern Pacific ...Ocean at 5Ma.
We investigated the calcareous nannofossil biostratigraphy and paleoceanography of the Shimajiri Group in two exploratory wells (depths, 1243 and 1800m) drilled on southern Okinawa-jima, Ryukyu Islands, southwestern Japan. Three late Miocene to Pliocene datum planes were identified: the first occurrence of Amaurolithus spp. (7.42Ma), the last occurrence of Discoaster quinqueramus (5.59Ma), and the first occurrence of Ceratolithus rugosus (5.12Ma). These datum planes were also identified in two other deep wells on southern Okinawa-jima. Nutrient levels (reconstructed from the relative abundances of small Reticulofenestra spp., and the relative abundances of Discoaster spp. plus Sphenolithus abies) suggest that deposition of the Shimajiri Group (<8.29–3.50Ma) occurred under conditions of increasing eutrophication. The eutrophication was likely caused by shallowing of the sedimentary basin, but a stepwise shift was associated with an abrupt eutrophication event that occurred in the northwestern Pacific Ocean at 5Ma.
We sequenced the complete genome of a porcine torovirus (PToV) strain from Japan for the first time. Whole-genome analysis revealed that this strain (Iba/2018) has a mosaic sequence composed of at ...least three genome backgrounds, related to US, Chinese and German PToV strains. Clear recombination breakpoints were detected in the M and HE coding regions. A similarity plot and structural analysis demonstrated that the HE coding region exhibits the highest diversity, and the most sequence variation was found in the lectin domain. PToVs were divided into two lineages in the HE region, whereas clear lineages were not found in other regions.
PDF
