Purpose
This study aimed to determine whether continual electronic patient-reported outcome (ePRO) measurements at home can capture the fluctuations in health-related quality of life (HRQOL) scores ...between visits.
Methods
We performed a randomized controlled trial to compare the scores obtained by standard practice (paper-based measurements in the hospital) to scores by continuous measurement of ePRO at home. Metastatic cancer patients were randomly assigned to either the paper-based (n = 50) or the ePRO group (n = 52). EQ-5D-5L and EORTC QLQ C-30 scores were obtained on 3 different chemotherapy days in the paper-based group. Meanwhile, scores were obtained on the chemotherapy day and on days 3, 7, 10, and 14 in the ePRO group during 2 cycles. The first hypothesis of our study was that both scores at the same time points would be equivalent despite different measurement frequency, place, or mode of measurement. The second hypothesis was that PRO score–adjusted time would be different between the groups. For equivalence, the endpoint was the mean EQ-5D-5L index value on the chemotherapy day before the outpatient treatment. Only if equivalence was shown, quality-adjusted life-days (QALDs) were considered using all the data.
Results
The adjusted mean difference in the EQ-5D-5L index was determined to be −0.013 (95% confidence interval CI: −0.049 to 0.022); the 95% CI did not exceed the equivalence margin. Similarly, the mean difference in global health status (2.28 95% CI: −2.55 to 7.11) also showed equivalence. However, the QALD by EQ-5D-5L was significantly lower in the ePRO group by 1.36 per 30 d (95% CI: −2.22 to −0.51; P = 0.0021).
Conclusions
Continual measurements of the HRQOL at home by ePRO may yield more detailed profiles of the HRQOL.
Objectives
The aim of this study was to identify whether diffusion-weighted magnetic resonance imaging (DW-MRI) can predict the malignant behavior of preoperative well-differentiated pancreatic ...neuroendocrine tumors (PanNETs).
Method
Forty patients with PanNETs who underwent pancreatectomy were enrolled in this study. The apparent diffusion coefficient (ADC) values were measured. Clinicopathological factors were compared in patients with high ADC and low ADC values and in patients with and without lymph node metastasis (LNM).
Result
The low ADC group was significantly associated with higher Ki-67 index, higher mitotic count, larger tumor size, higher rate of LNM, and venous invasion. In patients with low ADC values, the incidence of LNMs was 33.3%. In patients with high ADC values, there were no patients with LNM being 0%. A significant negative correlation was found between the mean ADC values and the Ki-67 index and between the mean ADC values and the mitotic count. In multivariate analysis, neural invasion and mean ADC values ≤ 1458 were independent predictors of LNM.
Conclusion
ADC values obtained using DW-MRI in the preoperative assessment of patients with PanNETs might be a useful predictor of malignant potential, especially LNM.
Physical reservoir computing is a promising solution for accelerating artificial intelligence (AI) computations. Various physical systems that exhibit nonlinear and fading-memory properties have been ...proposed as physical reservoirs. Highly-integrable physical reservoirs, particularly for edge AI computing, has a strong demand. However, realizing a practical physical reservoir with high performance and integrability remains challenging. Herein, we present an analogue circuit reservoir with a simple cycle architecture suitable for complementary metal-oxide-semiconductor (CMOS) chip integration. In several benchmarks and demonstrations using synthetic and real-world data, our developed hardware prototype and its simulator exhibit a high prediction performance and sufficient memory capacity for practical applications, showing promise for future applications in highly integrated AI accelerators.
Autophagy is primarily activated by cellular stress, such as starvation or mitochondrial damage. However, stress-independent autophagy is activated by unclear mechanisms in several cell types, such ...as thymic epithelial cells (TECs). Here we report that the mitochondrial protein, C15ORF48, is a critical inducer of stress-independent autophagy. Mechanistically, C15ORF48 reduces the mitochondrial membrane potential and lowers intracellular ATP levels, thereby activating AMP-activated protein kinase and its downstream Unc-51-like kinase 1. Interestingly, C15ORF48-dependent induction of autophagy upregulates intracellular glutathione levels, promoting cell survival by reducing oxidative stress. Mice deficient in C15orf48 show a reduction in stress-independent autophagy in TECs, but not in typical starvation-induced autophagy in skeletal muscles. Moreover, C15orf48
mice develop autoimmunity, which is consistent with the fact that the stress-independent autophagy in TECs is crucial for the thymic self-tolerance. These results suggest that C15ORF48 induces stress-independent autophagy, thereby regulating oxidative stress and self-tolerance.
The corrosion degradation of the steel sheet pile material accelerates in recent years. The extremely accelerated corrosion induces the thickness loss and decreases the mechanical characteristics. It ...is essential to evaluate the corroded situations for the design and maintenance of the infrastructures. In this study, the spatial characteristics of the corrosion loss in service steel sheet pile canals were evaluated by the geostatistics with the variogram and kriging. In experimental procedures, steel sheet pile thicknesses were measured in service drainage canals. The thickness sampling was conducted in the air, tidal, water, sludge and soil zones. In analytical procedures, the variogram analysis is conducted for modeling of the spatial structures of the corrosion loss distribution. The ordinary kriging based on the theoretical variogram interpolates the no-sampling area. As a result, the thickness profile shows the largest corrosion loss in the tidal zone. The kriging interpolation shows the acceleration of the corrosion in the flanges of the tidal zone.
Invasive extraintestinal pathogenic Escherichia coli (ExPEC) disease (IED), characterised by sepsis and bacteraemia, is a major global healthcare concern worsened by emerging multidrug resistant ...(MDR) strains. The development of multivalent prophylactic vaccines targeting E. coli strains of IED-associated O-serotypes could address this. A better understanding of O-serotype distribution is required for this purpose. Here, we characterised O-serotype prevalence and drug resistance among ExPEC bacteraemia isolates in Japan.
E. coli blood isolates from patients aged ≥60 years with bacteraemia were obtained from a retrospective surveillance study in Japan (2015–2017). O-serotyping was performed by agglutination; for isolates non-typeable by agglutination, O-genotyping was performed. Antimicrobial susceptibility was evaluated by broth microdilution using a 21-antibiotic panel. The frequency of drug resistant (DR) isolates was evaluated by antimicrobial susceptibility testing.
Of 401 ExPEC bacteraemia isolates evaluated, the most prevalent O-serotype (≥1%) was O25 (28.7% n = 115), followed by O1 (14.2% n = 57), O2 (8.5% n = 34), O6 (5.5% n = 22), O75, O18, O13, O16, O15, O4, O46/O134, O86, O8 and O83 (each <5% prevalence). These 14 O-serotypes accounted for 81.5% of isolates collected. In total, 19% (n = 77) of isolates were DR ≥ 3, of which 59.7% were O25. Fluoroquinolone-resistance among all and O25 isolates was most prevalent (35.7% and 84.3%, respectively). Almost all (98%) isolates identified as O25 were of subtype O25B.
E. coli serotype O25B showed the highest prevalence and highest multidrug resistance among ExPEC bacteraemia isolates from patients ≥60 years in Japan. Our data may inform development of multivalent glycoconjugate vaccines to prevent IED.
Abstract
The human brain possesses an exceptional information processing capability owing to the 3D and dense network architecture of numerous neurons and synapses. Brain‐inspired neuromorphic ...hardware can also benefit from 3D architectures, such as high integration of circuits and acquisition of highly complex dynamical systems. In this study, for future 3D neuromorphic engineering, 3D conductive polymer networks consisting of poly(3,4‐ethylenedioxy‐thiophene) doped with poly(styrene sulfonate) anions (PEDOT:PSS) are successfully and stably fabricated between multiple electrodes from scratch in precursor solution by electropolymerization. The networks efficiently emulate the 3D local connections between neighboring neurons observed in the cortex. This novel technology, which allows 3D conductive wiring only between desired electrodes, is unprecedented and has potential as an underlying technology for 3D integration. Furthermore, the experimental results also conclusively prove that conductance modification can be performed by manipulating the physical and chemical properties of 3D branch‐wired conductive polymer wires, thus demonstrating for the first time the feasibility of neuromorphic wetware with enhanced biological plausibility in the subsequent post‐Moore era.
Extreme corrosion on steel sheet piles, which includes thickness loss and pitting corrosion, has been observed in service canal walls. This extreme corrosion decreases the durability of steel sheet ...piles and causes buckling phenomena. This study aims to detect strain concentration around pitting corrosion on a steel sheet pile sample in bending stress fields with acoustic emission (AE) and digital image correlation (DIC) methods. In experimental procedures, three types of test samples were used, which had different types of thickness loss and pitting corrosion, even thickness loss, and no thickness loss. A fourpoint bending test with AE and DIC methods was conducted for these samples. In analytical procedures, AE hits, AE energy, and AE source locations in each loading process are analyzed. The DIC method are used to detect strain distribution on surfaces of the test samples. As results, AE sources and maximum principal strain concentrate around the pitting corrosion. The timeseries of the strain concentration detected using the DIC method correspond to those of the AE hits. Thus, the AE and DIC methods can be used to detect the relationship between AE hits, AE sources, and strain concentration in the bending process.
Carbon quantum dots (CQDs; luminescent carbon nanoparticles, size < 10 nm) have attracted much attention with respect to their eco-friendliness and multi-functionality. The solvent-dependent ...photoluminescence of CQDs has been well investigated to optimize the synthesis process and homogeneous dispersion. Although some alkan-1-ol solvents, such as ethanol, have been well utilized empirically as good solvents when synthesizing highly photoluminescent CQDs, the role of alkan-1-ol solvents, particularly long-chain alkan-1-ols (
e.g.
, 1-nonanol, 1-decanol), has not yet been clarified. Herein, we demonstrate a method for the synthesis of strongly yellow emitting CQDs using solvothermal treatment and elucidate the role of alkan-1-ol solvents in the photoluminescence of CQDs. These CQDs have been characterized using theoretical calculations,
ex situ
morphological observations using transmission electron microscopy (TEM) and dynamic light scattering (DLS), and 500 MHz
1
H nuclear magnetic resonance (NMR) and
13
C NMR spectroscopy. A comparative study of alkan-1-ol solvents suggests a mechanism for the agglomeration and aggregation of carbon precursors, intermediates, and CQDs, which is expected to lead to further synthesis studies on highly luminescent CQDs.
Carbon quantum dots (CQDs; luminescent carbon nanoparticles, size < 10 nm) have attracted much attention with respect to their eco-friendliness and multi-functionality.
To evaluate the utility of the conventional lethal triad in current trauma care practice and to develop novel criteria as indicators of treatment strategy.
Retrospective observational study.
Fifteen ...acute critical care medical centers in Japan.
In total, 796 consecutive trauma patients who were admitted to emergency departments with an injury severity score of greater than or equal to 16 from January 2012 to December 2012.
None.
All data were retrospectively collected, including laboratory data on arrival. Sensitivities to predict trauma death within 28 days of prothrombin time international normalized ratio greater than 1.50, pH less than 7.2, and body temperature less than 35°C were 15.7%, 17.5%, and 15.9%, respectively, and corresponding specificities of these were 96.4%, 96.6%, and 93.6%, respectively. The best predictors associated with hemostatic disorder and acidosis were fibrin/fibrinogen degradation product and base excess (the cutoff values were 88.8 µg/mL and -3.05 mmol/L). The optimal cutoff value of hypothermia was 36.0°C. The impact of the fibrin/fibrinogen degradation product and base excess abnormality on the outcome were approximately three- and two-folds compared with those of hypothermia. Using these variables, if the patient had a hemostatic disorder alone or a combined disorder with acidosis and hypothermia, the sensitivity and specificity were 80.7% and 66.8%.
Because of the low sensitivity and high specificity, conventional criteria were unsuitable as prognostic indicators. Our revised criteria are assumed to be useful for predicting trauma death and have the potential to be the objective indicators for activating the damage control strategy in early trauma care.
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