Asteroid (3200) Phaethon, a B-type asteroid, has been active during its perihelion passages. This asteroid is considered to be a source of the Geminid meteor stream. It is reported that this asteroid ...is spinning at a rotation period of 3.60 hr and has a top shape (an oblate body with an equatorial ridge) with a mean equatorial diameter of 6.25 km. Here, we report that Phaethon's rotation state may be close to or above its critical rotation period when the bulk density is (a typical bulk density of a B-type asteroid). We found that in this condition, the structure of Phaethon is sensitive to failure unless the cohesive strength is . This result implies that if there are some surface processes driven by, for example, thermal waves, large-scaled deformation may happen and cause mass shedding. From this interpretation, we propose the processes that produced the Geminid meteor stream in the past and dust tails recently. Phaethon initially rotated at a spin period shorter than the current period. The magnitude of structural deformation at this stage was higher than the present spin condition, and a large mass-shedding event, i.e., the Geminid meteor stream, occurred. After this deformation process, the body became more oblate, and its spin slowed down. At this point, while the spin was high enough for the body to have mass-shedding events, the magnitude of these events became small.
Amphetamine-type stimulants are abused worldwide, and methamphetamine (METH) accounts for a large majority of seized abused drug cases. Recently, the paternal origin of health and disease theory has ...been proposed as a concept wherein paternal factors influence descendants. Although METH abuse is more common among males, its effects on their descendants were not examined. Therefore, we investigated the effects of paternal METH exposure on F1 and F2 levels in a mouse model. Sires were administered METH for 21 days and mated with female mice to obtain F1 mice. Growth evaluations (number of births, survival rate, body weight, righting reflex, cliff avoidance tests, and wire-hanging maneuver) were performed on F1 mice. Upon reaching six weeks of age, the mice were subjected to spontaneous locomotion, elevated plus-maze, acute METH treatment, and passive avoidance tests. Additionally, RNA-seq was performed on the striatum of male mice. Male F1 mice were mated with female mice to obtain F2 mice. They were subjected to the same tests as the F1 mice. Paternal METH exposure resulted in delayed growth and decreased memory function in F1 mice, overweight in F2 mice, decreased METH sensitivity, and reduced anxiety-related behaviors in female F2 mice. Enrichment analysis revealed significant enrichment of terms related to behavior in F1 and protein folding in F2. These results indicated that the effects of paternal METH exposure vary across generations. The effects of paternal factors need to be examined not only in F1, but also in F2 and beyond.
Methylphenidate (MPH) is used as a first-line treatment for attention-deficit/hyperactivity disorder (ADHD). Because the onset of ADHD appears in early childhood and the incidence number is ...increasing, more patients could become adults with long-term use of MPH. In addition, few men would discontinue the medication during a fertile period. Recently, environmental factors such as diet and drug abuse have been reported to produce changes in the sperm epigenome and affect the health of the next generation. However, the effects of long-term administration of a psychostimulant such as MPH on the next generation is unknown. In this study, we examined the effects of paternal administration of MPH on the growth, behavior, and gene expression in offspring using a mouse model. Sires were subcutaneously administered MPH for 21 days and mated with naive dams. Upon reaching 6–7 weeks of age, offspring were subjected to spontaneous locomotor, elevated plus-maze, and passive avoidance tests. Additionally, RNA-seq and RT-qPCR were performed on the striatum. Paternal MPH exposure induced increased atomoxetine-sensitive impulsivity and decreased long-term memory function in the offspring. Enrichment analysis following RNA-seq revealed significant enrichment of terms involved in the nervous system. Gene expression levels of Snap25, Syt1, Drd2, Maoa, and Comt, which are associated with ADHD pathology, are altered in the striatum. These results suggest that continuous administration of MPH to male mice induces ADHD-like behavior and changes in the expression of genes involved in the nervous system in the brain of the next generation.
In the International Consensus Guidelines 2017 for the management of intraductal papillary mucinous neoplasms (IPMNs), high risk stigmata (HRS) and worrisome features (WF) were revised to be more ...clinically relevant. However, the specificity and positive predictive value to establish a malignant diagnosis remain insufficient. Patients with IPMNs are often elderly with comorbidities. Even for patients with high-risk IPMNs with HRS or WF, follow-up is often chosen instead of surgery. Recently, a few reports on the medium- to long-term outcomes of patients with unresected high-risk IPMNs have shown that progression to IPMN-derived invasive cancer is rare, and disease-specific survival rates are relatively high. However, patients with mural nodules ≥10mm, main pancreatic duct diameter ≥15mm, and multiple HRS factors have lower disease-specific survival rates and should be followed carefully. Further elucidation of the clinical course of patients with unresected high-risk IPMNs and the development of predictive models based on disease-specific mortality and surgery-associated mortality and morbidity is expected in the future.
Cancer associated abdominal pain, as typified by pancreatic cancer, has conventionally been treated with narcotic drugs, but often the severe abdominal pain is difficult to control. Endoscopic ...ultrasound-guided celiac plexus neurolysis (EUS-CPN) is commonly performed for abdominal pain that is difficult to control. EUS-CPN can be performed more safely and reliably than other conventional procedures on the celiac plexus, and good outcomes of pain relief have been reported. Although a variety of endoscopic techniques are available for EUS-CPN, the choice varies among institutions, and evidence on the efficacy and safety of each procedure is limited. In this review, we summarize the indications for treatment, specific endoscopic techniques, therapeutic efficacy for pain relief, and complications from previous reports on EUS-CPN.
In recent years, Paddy Field Dams have received recognition as a measure to alleviate flooding due to torrential rains. Paddy Field Dams have been in practice in several prefectures of Japan, namely ...Niigata, Hyogo, and Nara Prefectures. Various issues have come to attention when introducing Paddy Field Dams to rural communities, such as the discrepancy in valuation between beneficiaries (downstream communities of paddy fields) and practitioners (farmers and irrigation administrators), the framework for supporting farmers in their installation, operation and maintenance, and identification of strategic locations in the context of river basin management. The purpose of this study was to clarify perceptions and valuations of Paddy Field Dam functions by rural communities in Nara Prefecture, Japan, under the above-mentioned issues. Analysis was performed using the results of a questionnaire survey conducted in three districts of Nara Prefecture. In addition, a Contingent Valuation Method (CVM) was applied to estimate the economic value of a Paddy Field Dam. The results indicated that awareness of Paddy Field Dams was lower than expected. However, it was found that many respondents value their practice and expect them to reduce the risk of flood damage effectively. In addition, the results of the CVM analysis showed that the annual willingness to pay (WTP) per household was estimated at a median value of 2200 yen to 3000 yen, with an average value of 3600 yen to 5600 yen. The WTP tended to be higher for districts that had experienced flooding in the past.
: The geriatric nutritional risk index (GNRI) is an easily calculable index that can be determined using three common clinical variables. The GNRI is suggested to be related to sarcopenia in ...cirrhotic patients. However, the relationship between the GNRI and the prognosis in patients with liver cirrhosis (LC) has not been reported. The aim of the present research is to study the association of the GNRI with the nutritional status, hepatic function reserve, and prognosis in patients with liver cirrhosis (LC).
: A total of 370 cirrhotic patients whose nutritional statuses were evaluated using anthropometric measurements and bioimpedance analysis were studied. The associations between the GNRI and nutritional status and the GNRI and hepatic function reserve were analyzed. We also investigated the GNRI and prognosis of patients with LC.
: The median age of the enrolled patients was 66 years old, and 266 (71.9%) patients had viral hepatitis-related LC. The GNRI was shown to decrease with the progression of chronic liver disease, represented by an increased FIB-4 index and severe Child-Pugh and mALBI grades. In addition, a low GNRI (<92) was associated with severe cirrhosis-related metabolic disorders, including a low branched-chain amino acid-to-tyrosine ratio (BTR) and a low zinc value. The GNRI was positively correlated with two nutrition-related anthropometric variables (% arm circumference and % arm muscle circumference), and a low GNRI was related to a low skeletal muscle mass index (SMI) (<7.0 kg/m
for men or <5.7 kg/m
for women), as determined by using bioimpedance analysis. In addition, patients with a low GNRI (<92) had a poorer prognosis than those with a high GNRI (≥92) (log-rank test:
= 0.0161, and generalized Wilcoxon test,
= 0.01261).
: Our results suggest that a low GNRI is related to severe chronic liver disease, low muscle volume, and a poor prognosis of patients with cirrhosis.
Aim
Recently, a new technique using attenuation imaging (ATI) was developed to diagnose hepatic steatosis. The aim of this study was to investigate whether ATI for the evaluation of hepatic steatosis ...is influenced by liver fibrosis.
Methods
A total of 328 patients with chronic liver disease were enrolled to study the associations between histological hepatic steatosis or liver fibrosis and ATI findings. The interaction between liver fibrosis and ATI was also analyzed.
Results
Median ATI values according to steatosis grade and fibrosis stage increased in line with the progression of liver steatosis (p < 0.001) and fibrosis (p < 0.05). However, in each steatosis grade, ATI values according to fibrosis stage were not significantly increased. In multiple regression analyses for assessment of the effect of their interaction, the p values for fibrosis stage, steatosis grade, and fibrosis stage × steatosis grade were 0.096, <0.001, and 0.077, respectively. Variance inflation factor values for fibrosis stage, steatosis grade, and fibrosis stage × steatosis grade were 1.079, 1.094, and 1.074, respectively.
Conclusion
Attenuation imaging values are not influenced by liver fibrosis.
Endoscopic papillectomy (EP) for benign ampullary neoplasms could be a less-invasive alternative to pancreatoduodenectomy (PD). There are some problems and limitations with EP. The post-EP resection ...margins of ampullary tumors are often positive or uncertain because of the burning effect of EP. The clinical outcomes of resected margin positive or uncertain cases after EP remain unknown.
To investigate the clinical outcomes of resected margin positive or uncertain cases after EP.
Between January 2007 and October 2018, all patients with ampullary tumors who underwent EP at Kobe University Hospital were included in this study. The indications for EP were as follows: adenoma, as determined by preoperative endoscopic biopsy, without bile/pancreatic duct extension, according to endoscopic ultrasound or intraductal ultrasound. The clinical outcomes of resected margin positive or uncertain cases after EP were retrospectively investigated.
Of the 45 patients, 29 were male, and 16 were female. The mean age of the patients was 65 years old. Forty-one patients (89.5%) underwent
resection, and 4 patients (10.5%) underwent piecemeal resection. After EP, 33 tumors were histopathologically diagnosed as adenoma, and 12 were diagnosed as adenocarcinoma. The resected margins were positive or uncertain in 24 patients (53.3%). Of these cases, 15 and 9 were diagnosed as adenoma and adenocarcinoma, respectively. Follow-up observation was selected for all adenomas and 5 adenocarcinomas. In the remaining 4 adenocarcinoma cases, additional PD was performed. Additional PD was performed in 4 cases, and residual carcinoma was found after the additional PD in 1 of these cases. In the follow-up period, local tumor recurrence was detected in 3 cases. Two of these cases involved primary EP-diagnosed adenoma. The recurrent tumors were also adenomas detected by biopsy. The remaining case involved primary EP-diagnosed adenocarcinoma. The recurrent tumor was also an adenocarcinoma. All of the recurrent tumors were successfully treated with argon plasma coagulation (APC). There was no local or lymph node recurrence after the APC. The post-APC follow-up periods lasted for 57.1 to 133.8 mo. No ampullary tumor-related deaths occurred in all patients.
Resected margin positive or uncertain cases after EP could be managed by endoscopic treatment including APC, even in cases of adenocarcinoma. EP could become an effective less-invasive first-line treatment for early stage ampullary tumors.
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