Abstract Papillary microcarcinoma (PMC) of the thyroid is defined as papillary thyroid carcinoma (PTC) measuring ≤1 cm. Many autopsy studies on subjects who died of non-thyroidal diseases reported ...latent small thyroid carcinoma in up to 5.2% of the subjects. A mass screening study for thyroid cancer in Japanese adult women detected small thyroid cancer in 3.5% of the examinees. This incidence was close to the incidence of latent thyroid cancer and more than 1000 times the prevalence of clinical thyroid cancer in Japanese women reported at that time. The question of whether it was correct to treat such PMCs surgically then arose. In 1993, according to Dr. Miyauchi's proposal, Kuma Hospital initiated an active surveillance trial for low-risk PMC as defined in the text. In 1995, Cancer Institute Hospital in Tokyo, Japan, started a similar observation trial. The accumulated data from the trials at these two institutions strongly suggest that active surveillance (i.e., observation without immediate surgery) can be the first-line management for low-risk PMC. Although our data showed that young age and pregnancy might be risk factors of disease progression, we think that these patients can also be candidates for active surveillance, because all of the patients who showed progression signs were treated successfully with a rescue surgery, and none of them died of PTC. In this review, we summarize the data regarding the active surveillance of low-risk PMC as support for physicians and institutions that are considering adopting this strategy.
Among the recently discovered iron-based superconductors, ultrathin films of FeSe grown on SrTiO3 substrates have uniquely evolved into a high-transition-temperature (Tc ) superconducting material. ...The mechanisms for the high-Tc superconductivity are under debate, with the superconducting gap mainly characterized with in situ analysis for FeSe films grown by molecular beam epitaxy. Here, we investigate the high-Tc superconductivity in ultrathin FeSe using an alternative top-down electrochemical etching technique in a three-terminal transistor configuration. In addition to the high-temperature superconductivity in FeSe on SrTiO3 , the electrochemically etched ultrathin FeSe transistor on MgO also exhibits superconductivity around 40 K, implying that the application of an electric field effectively contributes to the high-Tc superconductivity in ultrathin FeSe regardless of substrate material. Moreover, the observable critical thickness for the high-Tc superconductivity is expanded up to 10 unit cells under an applied electric field and the insulator-superconductor transition is electrostatically controlled. The present demonstration implies that the modification of charge imbalance of holes and electrons by the electric-field effect plays a crucial role in inducing high-Tc superconductivity in FeSe-based electric double-layer transistors.
On 11 March 2011, the devastating M9.0 Tohoku Earthquake occurred on the interface of the subducting Pacific plate, and was followed by a huge tsunami that killed about 20,000 people. Several ...geophysical studies have already suggested that the very shallow portion of the plate interface might have played an important role in producing such a large earthquake and tsunami. However, the sparsity of seafloor observations leads to insufficient spatial resolution of the fault slip on such a shallow plate interface. For this reason, the location and degree of the slip has not yet been estimated accurately enough to assess future seismic risks. Thus, we estimated the coseismic slip distribution based on terrestrial GPS observations and all available seafloor geodetic data that significantly improve the spatial resolution at the shallow portion of the plate interface. The results reveal that an extremely large (greater than 50 m) slip occurred in a small (about 40 km in width and 120 km in length) area near the Japan Trench and generated the huge tsunami. The estimated slip distribution and a comparison of it with the coupling coefficient distribution deduced from the analysis of the small repeating earthquakes suggest that the 2011 Tohoku Earthquake released strain energy that had accumulated over the past 1000 years, probably since the Jogan Earthquake in 869. The accurate assessments of seismic risks on very shallow plate interfaces in subduction zones throughout the world can be obtained by improving the quality and quantity of seafloor geodetic observations.
Key Points
Slip of the 2011 Tohoku earthquake is estimated from land and seafloor geodetic data
Maximum slip (85 m) released strain energy accumulated since the 869 Jogan earthquake
Distributions of estimated slip and the seismic activities are consistent
Summary
We investigated the incidence of fragility fractures from 2010 to 2012 in Sakaiminato, Japan. The incidence rates of limb fractures in Sakaiminato were lower than in Caucasian populations but ...had increased relative to data obtained in Japan in the 1990s. Clinical vertebral fractures occurred at higher rates in Sakaiminato than in Caucasian populations.
Introduction
To elucidate the incidence and prognosis of fragility fractures in Sakaiminato, Japan.
Methods
A survey of all hip, distal radius, proximal humerus, and clinical vertebral fractures was performed from 2010 to 2012 in patients aged 50 or older in Sakaiminato city, Tottori prefecture, Japan. The age- and gender-specific incidence rates (per 100,000 person-years) were calculated based on the population of Sakaiminato city each year. The incidence rates of hip, distal radius, and proximal humerus fractures were compared with previous reports. We conducted a follow-up study assessing patients within 1 year following their initial treatment at two Sakaiminato hospitals.
Results
The age-adjusted incidence rates in population aged 50 years or older (per 100,000 person-years) of hip, distal radius, proximal humerus, and clinical vertebral fractures were, respectively, 217, 82, 26, and 412 in males and 567, 432, 96, and 1229 in females. Age-specific incidence rates of hip, distal radius, and proximal humerus fractures all increased since the 1990s. Our study also revealed that anti-osteoporotic pharmacotherapy was prescribed 1 year post-fracture at rates of 29, 20, 30, and 50 % for patients with hip, distal radius, proximal humerus, and clinical vertebral fractures, respectively.
Conclusions
The incidence rates of limb fractures in Sakaiminato were substantially lower than Caucasian populations in northern Europe but had increased relative to data obtained in Japan in the 1990s. Unlike upper and lower limb fractures, clinical vertebral fractures occurred at higher rates in our study population than in other Asian and North European countries.
The present work demonstrates that vertically aligned graphene (VG)/diamond heterojunctions can function as optoelectronically-controllable synapses, which are connection parts of neurons and key ...elements for the memory functions of human brain. These junctions mimic several of the fundamental characteristics of biological synapses, including producing an excitatory postsynaptic current (EPSC), exhibiting a transition from short-term memory (STM) to long-term memory (LTM) states, and paired pulse facilitation (PPF), all of which are optically controllable. These junctions also exhibit photo-sensing properties and photo-controllable synaptic plasticity, meaning that they have similar functions as occur in the human brain and retina. Arrays fabricated from these junctions were found to function as image sensors that could provide an optical memory function and selectively memorize information depending on the relative importance of the data. These results are expected to assist in the realization of neuromorphic optical computers simulating human visual memory systems that are modulated by specific interests.
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Habitat loss and habitat fragmentation caused by anthropogenic activities are the main factors that constrain long-distance movement of ungulates. Mongolian gazelles (Procapra gutturosa) and Asiatic ...wild asses (Equus hemionus) in Mongolia are facing habitat fragmentation and loss. To better understand how their movements respond to potential anthropogenic and natural barriers, we tracked 24 Mongolian gazelles and 12 wild asses near the Ulaanbaatar-Beijing Railroad and the fenced international border between Mongolia and China between 2002 and 2012. None of the tracked gazelles crossed the railroad, even though gazelles were captured on both sides of the tracks at the start of the study. Similarly, we did not observe cross-border movements between Mongolia and China for either species, even though some animals used areas adjacent to the border. The both species used close areas to the anthropogenic barriers more frequently during winter than summer. These results suggest strong impacts by the artificial barriers. The construction of new railroads and roads to permit mining and other resource development therefore creates the threat of further habitat fragmentation, because the planned routes will divide the remaining non-fragmented habitats of the ungulates into smaller pieces. To conserve long-distance movement of the ungulates in this area, it will be necessary to remove or mitigate the barrier effects of the existing and planned roads and railroads and to adopt a landscape-level approach to allow access by ungulates to wide ranges throughout their distribution.
Summary
Background
A predisposition to exacerbations is being recognized as a distinct phenotype with “previous exacerbations” representing the strongest clinical factor associated with future ...exacerbation. Thus, to identify additional novel biomarkers associated with asthma exacerbations, “past exacerbation status” must be included as a confounding factor.
Objective
This study aimed to characterize the clinical and biomarker features associated with asthma exacerbations in severe asthma.
Methods
We evaluated clinical parameters from 105 severe asthmatics yearly for 3 years, as well as their exacerbation status. We classified the subjects into 3 groups: (i) consistent non‐exacerbators (CNE, subjects who did not experience any exacerbation over the 3‐year period); (ii) consistent frequent exacerbators (CFE, subjects with frequent exacerbation, defined as those who had 2 or more exacerbations within 1 year, throughout the 3‐year period); and (iii) intermittent exacerbators (IE). We conducted multivariate analysis for comparisons among the groups for multiple factors, including several Th2‐related biomarkers, in addition to the “past exacerbation status.”
Results
Thirty‐nine subjects were classified as CNE, 15 as CFE, and 51 as IE. Frequent exacerbations in the previous year predicted exacerbations for the following year (P < .001). Among the several Th2‐related biomarkers, only FeNO was associated with exacerbation status. When we analysed the data after the second visit, the impact of FeNO on predicting future exacerbation remained significant, even after considering the exacerbation status during the first year (P < .05).
Conclusions and Clinical Relevance
Measurement of FeNO has a significant potential to predict future asthma exacerbation, which is independent of the “past exacerbation history.”
Abstract Conventional atmospheric retrieval codes are designed to extract information, such as chemical abundances, thermal structures, and cloud properties, from fully “reduced” spectra obtained ...during transit or eclipse. Reduced spectra, however, are assembled by fitting a series of simplified light curves to time-series observations, wavelength by wavelength. Thus, spectra are postprocessed summary statistics of the original data, which by definition do not encode all the available information (i.e., astrophysical signal, model covariance, and instrumental noise). Here, we explore an alternative inversion strategy where the atmospheric retrieval is performed on the light curve directly, i.e., closer to the data. This method is implemented in EXoplanet Panchromatic Light curve Observation and Retrieval (E x PLOR), a novel atmospheric retrieval code inheriting from the T au RE x project. By explicitly considering time in the model, E x PLOR naturally handles transits, eclipses, phase curves, and other complex geometries for transiting exoplanets. In this paper, we have validated this new technique by inverting simulated panchromatic light curves. The model was tested on realistic simulations of a WASP-43 b-like exoplanet as observed with the James Webb Space Telescope (JWST) and Ariel telescope. By comparing our panchromatic light-curve approach against conventional spectral retrievals on mock scenarios, we have identified key breaking points in information and noise propagation when employing past literature techniques. Throughout the paper, we discuss the importance of developing “closer-to-data” approaches such as the method presented in this work, and highlight the inevitable increase in model complexity and computing requirements associated with the recent JWST revolution.
Strength and ductility of ultrafine grained (UFG) aluminum and iron fabricated by ARB and annealing were clarified in the grain sizes ranging from 200 nm to 20 μm. Strength held Hall–Petch ...relationship, while uniform elongation of the UFG materials was limited below a few percents. The limited uniform elongation in the UFG materials could be explained in terms of plastic instability.
Background
A survival benefit of extensive intraoperative peritoneal lavage (EIPL) has been reported in patients with gastric cancer with positive peritoneal cytology. The hypothesis of this study ...was that EIPL may reduce peritoneal recurrence in patients with advanced gastric cancer who undergo surgery with curative intent.
Methods
This was an open‐label, multi‐institutional, randomized, phase 3 trial to assess the effects of EIPL versus standard treatment after curative gastrectomy for resectable gastric cancer of T3 status or above. The primary endpoint was disease‐free survival (DFS); secondary endpoints were overall survival, peritoneal recurrence‐free survival and incidence of adverse events.
Results
Between July 2011 and January 2014, 314 patients were enrolled from 15 institutions and 295 patients were analysed (145 and 150 in the EIPL and no‐EIPL groups respectively). The 3‐year DFS rate was 63·9 (95 per cent c.i. 55·5 to 71·2) per cent in the EIPL group and 59·7 (51·3 to 67·1) per cent in the control group (hazard ratio (HR) 0·81, 95 per cent c.i. 0·57 to 1·16; P = 0·249). The 3‐year overall survival rate was 75·0 (67·1 to 81·3) per cent in the EIPL group and 73·7 (65·9 to 80·1) per cent in the control group (HR 0·91, 0·60 to 1·37; P = 0·634). Peritoneal recurrence‐free survival was not significantly different between the two groups (HR 0·92, 0·62 to 1·36; P = 0·676). No intraoperative complications related to EIPL were observed.
Conclusion
EIPL did not improve survival or peritoneal recurrence in patients who underwent gastrectomy for advanced gastric cancer. Registration number: 000005907 (http://www.umin.ac.jp/ctr/index.htm).
Antecedentes
Se ha descrito que un lavado peritoneal extenso intraoperatorio (extensive intraoperative peritoneal lavage, EIPL) proporciona un beneficio en la supervivencia en pacientes con cáncer gástrico con citología peritoneal positiva. La hipótesis de este estudio era que el EIPL podría disminuir la recidiva peritoneal en pacientes con cáncer gástrico avanzado sometidos a cirugía con intención curativa.
Métodos
Ensayo clínico fase 3, abierto, multicéntrico y aleatorizado para evaluar los efectos de un lavado peritoneal extenso intraoperatorio (EIPL) frente a tratamiento estándar tras gastrectomía curativa por cáncer gástrico ≥T3 resecable. La variable de resultado primaria fue la supervivencia libre de enfermedad (disease‐free survival, DFS), y las variables de resultado secundarias fueron la supervivencia global (overall survival, OS), la supervivencia libre de recidiva peritoneal y la incidencia de efectos adversos.
Resultados
Entre julio de 2011 y enero de 2014, se reclutaron 314 pacientes de 15 instituciones y se analizaron los datos de 295 pacientes (145 en el grupo con EIPL y 150 en el grupo sin EIPL). La DFS a los 3 años fue 63,9% (i.c. del 95% 55,5‐71,2) en el grupo con EIPL y 59,7% (i.c. del 95% 51,3‐67,1) en el grupo control (cociente de riesgos instantáneos, hazard ratio, HR 0,81 (i.c. del 95% 0,57‐1,16), P = 0,249). La OS a los 3 años fue 75,0% (i.c. del 95% 67,1‐81,3) en el grupo con EIPL y 73,7% (i.c. del 95% 65,9‐80,1) en el grupo control (HR 0,91 i.c. del 95% 0,60‐1,37), P = 0,634). No se observaron diferencias estadísticamente significativas entre los dos grupos en la supervivencia libre de recidiva peritoneal (P = 0,676, HR 0,92 (i.c. del 95% 0,62‐1,36). No se observaron complicaciones intraoperatorias relacionadas con EIPL.
Conclusión
El EIPL no mejoró la supervivencia o la recidiva peritoneal en pacientes sometidos a gastrectomía por cáncer gástrico avanzado.
This trial was conducted to clarify the effects of extensive intraoperative peritoneal lavage (EIPL) therapy after curative gastrectomy for resectable cT3 gastric cancer. The 3‐year DFS rate was slightly better in the EIPL group (63·9 per cent) than in the no‐EIPL group (59·7 per cent), but the difference was not statistically significant (hazard ratio 0·81, 95 per cent c.i. 0·57 to 1·16; P = 0·249). Superiority of EIPL therapy was not demonstrated.
No benefit
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