The air discharge phenomenon, characterized by its rapid and transient nature, is inherently unpredictable, emphasizing the need for a comprehensive understanding of its physical interactions. Our ...experimental setup involved voltage generators producing both positive and negative impulse voltages (±100 kV, ±125 kV, and ±150 kV) at a 3.5 cm gap distance in a needle-to-plane geometry. This setup facilitated the study of individual spectral lines of impulse voltage discharges, with a specific emphasis on examining oxygen transitions through spectroscopy analysis. To explore the influence of photon emission on the breakdown rate, we examined the correlation between decay time, excitation temperature, and peak intensity during the transition from an upper state to a lower state. Our findings reveal that positive impulse voltage discharges more rapidly than negative impulse voltages. This heightened discharge rate is attributed to the higher peak intensities of O II at 313.421 and 241.162 nm, as well as O IV at 337.806 nm, observed in the excited state, as opposed to O I at 777.417 nm in the combination state. The inference drawn from the larger peak intensity suggests that energetic photon emission plays a pivotal role in initiating and expediting electron discharge in positive voltages.
This study aimed to evaluate the difference between binocular and monocular vision and eye movements during the competition using video-oculography (VOG). Experiment 1 included 14 participants to ...evaluate differences in arrow convergence. Then, seven participants in Experiment 1 were randomly selected and included in Experiment 2, which evaluated eye movements during archery using VOG. The target used an 80-cm waterproof target face and was set at a distance of 30 m. All players shot the target 36 times using their bows and arrows. Experiments 1 and 2 evaluated the distribution of arrows in each score and the number of focus points, respectively, between binocular and monocular conditions. The arrows, which include the area of 9 points, were significantly greater in the binocular condition (11.85 ± 5.04 shots) than in the monocular condition (9.36 ± 5.41 shots) in Experiment 1 (P = 0.047). The players focused on the target under both binocular and monocular conditions, although the players were switching off fixation between the target and shooting sight under the binocular condition in Experiment 2. These behaviors indicated that the players were trying to accurately shoot the target by exploring the distance between themselves and the target as a cue for depth perception.
Objectives This study sought to establish a model for grading lesion difficulty in interventional chronic total occlusion (CTO) treatment. Background Owing to uncertainty of success of the procedure ...and difficulties in selecting suitable cases for treatment, performance of interventional CTO remains infrequent. Methods Data from 494 native CTO lesions were analyzed. To eliminate operator bias, the objective parameter of successful guidewire crossing within 30 min was set as an end point, instead of actual procedural success. All observations were randomly assigned to a derivation set and a validation set at a 2:1 ratio. The J-CTO (Multicenter CTO Registry of Japan) score was determined by assigning 1 point for each independent predictor of this end point and summing all points accrued. This value was then used to develop a model stratifying all lesions into 4 difficulty groups: easy (J-CTO score of 0), intermediate (score of 1), difficult (score of 2), and very difficult (score of ≥3). Results The set end point was achieved in 48.2% of lesions. Independent predictors included calcification, bending, blunt stump, occlusion length >20 mm, and previously failed lesion. Easy, intermediate, difficult, and very difficult groups, stratified by J-CTO score, demonstrated stepwise, proportioned, and highly reproducible differences in probability of successful guidewire crossing within 30 min (87.7%, 67.1%, 42.4%, and 10.0% in the derivation set and 92.3%, 58.3%, 34.8%, and 22.2% in the validation set, respectively). Areas under receiver-operator characteristic curves were comparable (derivation: 0.82 vs. validation: 0.76). Conclusions This model predicted the probability of successful guidewire crossing within 30 min very well and can be applied for difficulty grading.
•Venous thromboembolism (VTE) is becoming a common issue in Japan.•The management strategies of VTE have changed dramatically in the past decade.•Direct oral anticoagulants could provide unique ...treatment strategies for VTE.•There are still a number of uncertain issues for VTE.•Future research is needed especially for cancer-associated VTE and minor VTE.
Clinicians have been more and more often encountering patients with venous thromboembolism (VTE), including pulmonary embolism and deep vein thrombosis, leading to the increased importance of VTE in daily clinical practice. VTE is becoming a common issue in Asian countries including Japan. The management strategies of VTE have changed dramatically in the past decade including the introduction of direct oral anticoagulants (DOACs). In addition, there have been several landmark clinical trials assessing acute treatment strategies including thrombolysis and inferior vena cava (IVC) filter. The current VTE guidelines do not recommend the routine use of thrombolysis or IVC filters based on recent evidence; Nevertheless, the prevalence of thrombolysis and IVC filter use in Japan was strikingly high. The novel profiles of DOACs with rapid onset of action and potential benefit of a lower risk for bleeding compared with vitamin K antagonist could make home treatment feasible and is safer even with extended anticoagulation therapy. One of the most clinically relevant issues for VTE treatment is optimal duration of anticoagulation for the secondary prevention of VTE. Considering recent evidence, optimal duration of anticoagulation should be determined based on the risk for recurrence as well as the risk for bleeding in an individual patient. Despite the recent advances for VTE management, there are still a number of uncertain issues that challenge clinicians in daily clinical practice, such as cancer-associated VTE and minor VTE including subsegmental pulmonary embolism and distal deep vein thrombosis, warranting future research. Several clinical trials are now ongoing for these issues, globally as well as in Japan. The current review is aimed to overview the recent advances in VTE management, describe the current status including some domestic issues in Japan, and discuss the future perspective of VTE.
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This study aimed to evaluate the associations between skin carotenoid measurements and fruit and vegetables intake among school children. We conducted a cross-sectional study for 10-y-old children in ...2020 in Japan. We compared the optical skin carotenoid score, measured using Veggie Meter®, and food intake, based on a self-administered questionnaire. Among the 328 children who were registered in the three primary schools, 321 (97.9%) agreed to undergo skin carotenoid measurements. None of the children were unable to undergo the examination or experienced any adverse events. Among the 321 children who underwent skin carotenoid measurements, 315 (96.0%) responded to the questionnaire. The baseline characteristics showed that 160 (50.8%) children were boys. The median (interquartile range) skin carotenoid score was 335 (277–407) points. The minimum and maximum scores were 138 and 822 points, respectively, and the mean score (standard deviation) was 349 (104) points. The multivariable model showed a higher intake of fruits and green-yellow vegetables and more exercises were independently associated with higher skin carotenoid scores. We showed positive associations between higher skin carotenoid scores and higher intake of fruits and green-yellow vegetables and more exercise. The skin carotenoid score could be used to promote better food intake among children.
Abstract
Background
Administration of dexmedetomidine has been reported to improve inflammatory response in animals. We explored the effects of administering dexmedetomidine on the levels of ...C-reactive protein (CRP) and procalcitonin, and thus on inflammation, in patients with sepsis enrolled in a randomized clinical trial.
Methods
The DESIRE trial was a multicenter randomized clinical trial in which adult patients with sepsis were sedated with (DEX group) or without (non-DEX group) dexmedetomidine while on mechanical ventilators. As a prespecified sub-analysis, we compared CRP and procalcitonin levels during the first 14 days of treatment between the two groups. The 14-day mortality rate, albumin level, and the number of patients with disseminated intravascular coagulation (DIC) were also assessed. We used generalized linear models to estimate the differences in these outcomes between groups. We also used the Kaplan-Meier method to estimate the 14-day mortality rate and the log-rank test to assess between-group differences.
Results
Our study comprised 201 patients: 100 in the DEX group and 101 in the non-DEX group. CRP and procalcitonin levels were lower in the DEX vs. non-DEX group during the 14-day treatment period CRP—range, 5.6–20.3 vs. 8.3–21.1 mg/dL (
P
= 0.03); procalcitonin—range, 1.2–37.4 vs. 1.7–52.9 ng/mL (
P
= 0.04). Albumin levels were higher in the DEX group (range, 2.3–2.6 g/dL) than in the non-DEX group (range, 2.1–2.7 g/dL;
P
= 0.01). The percentage of patients with DIC did not significantly differ between the groups (range, 21–59% and 17–56% for the DEX and non-DEX groups, respectively;
P
= 0.49). The 14-day mortality rates in the DEX and non-DEX groups were 13 and 21%, respectively (
P
= 0.16).
Conclusion
Sedation using dexmedetomidine reduced inflammation in patients with sepsis requiring mechanical ventilation.
Trial registration
ClinicalTrials.gov,
NCT01760967
. Registered on 4 January 2013.
Abstract
Nearly monocyclic terahertz waves are used for investigating elementary excitations and for controlling electronic states in solids. They are usually generated via second-order optical ...nonlinearity by injecting a femtosecond laser pulse into a nonlinear optical crystal. In this framework, however, it is difficult to control phase and frequency of terahertz waves. Here, we show that in a one-dimensional Mott insulator of a nickel-bromine chain compound a terahertz wave is generated with high efficiency via strong electron modulations due to quantum interference between odd-parity and even-parity excitons produced by two-color femtosecond pulses. Using this method, one can control all of the phase, frequency, and amplitude of terahertz waves by adjusting the creation-time difference of two excitons with attosecond accuracy. This approach enables to evaluate the phase-relaxation time of excitons under strong electron correlations in Mott insulators. Moreover, phase- and frequency-controlled terahertz pulses are beneficial for coherent electronic-state controls with nearly monocyclic terahertz waves.
BACKGROUND:Recently, the Academic Research Consortium for High Bleeding Risk (ARC-HBR) has been proposed to standardize the definition of HBR, which was arbitrarily defined as a Bleeding Academic ...Research Consortium 3 or 5 bleeding ≥4% at 1-year. However, the prevalence and the expected bleeding event rate of HBR patients defined by ARC-HBR criteria are currently unknown in the real-world percutaneous coronary intervention practice.
METHODS:We applied the ARC-HBR criteria in the CREDO-Kyoto (Coronary Revascularization Demonstrating Outcome Study in Kyoto) registry cohort-2, a multicenter registry that enrolled 13 058 consecutive patients who underwent their first percutaneous coronary intervention. The primary bleeding end point was defined as the Global Utilization of Streptokinase and Tissue plasminogen activator for Occluded coronary arteries moderate/severe bleeding. There were 5570 patients (43%) in the HBR group and 7488 patients in the no-HBR group.
RESULTS:Cumulative incidence of the primary bleeding end point was much higher in the HBR group than in the no-HBR group (10.4% versus 3.4% at 1-year, and 18.9% versus 6.6% at 5-year, P<0.0001). Presence of each ARC-HBR major or even minor criterion, in isolation, with the exception of liver cirrhosis and prior ischemic stroke, was also associated with major bleeding risk higher than 4% at 1-year. Cumulative 5-year incidence of the primary bleeding end point got incrementally higher as the number of the ARC-HBR major criteria increased (≥3 majors49.9%, 2 majors30.6%, 1 major18.5%, ≥2 minors14.7%, and no-HBR6.6%, P<0.0001).
CONCLUSIONS:ARC-HBR criteria successfully identified those patients with very HBR after percutaneous coronary intervention, who represented 43% of patients in this all-comers registry.
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