Epidemiology of child mortality and challenges in child death review in Japan: The Committee on Child Death Review: A Committee Report: The Committee on Child Death Review: A Committee Report.

We performed a retrospective survey and verification of the medical records of death cases of children (and adolescents; aged <18 years) between 2014 and 2016 in pediatric specialty training facilities in Japan. Of the 2,827 registered cases at 163 facilities, 2,348 cases were included. The rate of identified deaths compared with the demographic survey, was 18.2%-21.0% by age group. The breakdown of deaths was determined as follows: 638 cases (27.2%) were due to external factors or unknown causes, 118 (5.0%) were suspected to involve child maltreatment, 932 (39.7%) were of moderate or high preventability or were indeterminable. Further detailed verification was required for 1,333 cases (56.8%). Comparison of the three prefectures with high rates of identified deaths in Japan revealed no significant differences, such as in the distribution of diseases, suggesting that there was little selection bias. The autopsy rate of deaths of unknown cause was 43.4%, indicating a high ratio of forensic autopsies. However, sufficient clinical information was not collected; therefore, thorough evaluations were difficult to perform. Cases with a moderate or high possibility of involvement of child maltreatment accounted for 5%, similar to previous studies. However, more objective evaluation is necessary. Preventable death cases including potentially preventable deaths accounted for 25%, indicating that proposals need to be made for specific preventive measures. Individual primary verification followed by secondary verification by multiple organizations is effective. It is anticipated that a child death review (CDR) system with such a multi-layered structure will be established; however, the following challenges were revealed: The subjects of CDR are all child deaths. Even if natural death cases are entrusted to medical organizations, and complicated cases to other special panels, the numbers are very high. Procedures need to be established to sufficiently verify these cases. Although demographic statistics are useful for identifying all deaths, care must be taken when interpreting such data. Detailed verification of the cause of death will affect the determination of subsequent preventability. Verification based only on clinical information is difficult, so a procedure that collates non-medical information sources should be established. It is necessary to organize the procedures to evaluate the involvement of child maltreatment objectively and raise awareness among practitioners. To propose specific preventive measures, a mechanism to ensure multiprofessional diverse perspectives is crucial, in addition to fostering the foundation of individual practitioners. To implement the proposed measures, it is also necessary to discuss the responsibilities and authority of each organization. Once the CDR system is implemented, verification of the system should be repeated. Efforts to learn from child deaths and prevent deaths that are preventable as much as possible are essential duties of pediatricians. Pediatricians are expected to undertake the identified challenges and promote and lead the implementation of the CDR system. This is a word-for-word translation of the report in J. Jpn. Pediatr. Soc. 2019; 123 (11): 1736-1750, which is available only in the Japanese language.

Increase in the Intracellular Bulk Water Content in the Early Phase of Cell Death of Keratinocytes, Corneoptosis, as Revealed by 65 GHz Near-Field CMOS Dielectric Sensor.

While bulk water and hydration water coexist in cells to support the expression of biological macromolecules, how the dynamics of water molecules, which have long been only a minor role in molecular biology research, relate to changes in cellular states such as cell death has hardly been explored so far due to the lack of evaluation techniques. In this study, we developed a high-precision measurement system that can discriminate bulk water content changes of ±0.02% (0.2 mg/cm3) with single-cell-level spatial resolution based on a near-field CMOS dielectric sensor operating at 65 GHz. We applied this system to evaluate the temporal changes in the bulk water content during the cell death process of keratinocytes, called corneoptosis, using isolated SG1 (first layer of stratum granulosum) cells in vitro. A significant irreversible increase in the bulk water content was observed approximately 1 h before membrane disruption during corneoptosis, which starts with cytoplasmic high Ca2+ signal. These findings suggest that the calcium flux may have a role in triggering the increase in the bulk water content in SG1 cells. Thus, our near-field CMOS dielectric sensor provides a valuable tool to dissect the involvement of water molecules in the various events that occur in the cell.

Autofluorescence changes of tomato surface tissues during overripening.

We investigated the autofluorescence of tomato surface tissues during overripening at 25 °C for 13 days. Microscopic images and fluorescence spectra of tissues, including the epidermis and cuticle, were examined (excitation at 360 nm), revealing that the autofluorescence changes were related to the epidermis, particularly the fluorophores in the cuticle.

Highly precise characterization of the hydration state upon thermal denaturation of human serum albumin using a 65 GHz dielectric sensor.

The biological functions of proteins depend on harmonization with hydration water surrounding them. Indeed, the dynamical transition of proteins, such as thermal denaturation, is dependent on the changes in the mobility of hydration water. However, the role of hydration water during dynamical transition is yet to be fully understood due to technical limitations in precisely characterizing the amount of hydration water. A state-of-the-art CMOS dielectric sensor consisting of 65 GHz LC resonators addressed this issue by utilizing the feature that oscillation frequency sensitively shifts in response to the complex dielectric constant at 65 GHz with extremely high precision. This study aimed to establish an analytical algorithm to derive the hydration number from the measured frequency shift and to demonstrate the transition of hydration number upon the thermal denaturation of human serum albumin. The determined hydration number in the native state drew a "global" hydration picture beyond the first solvation shell, with substantially reduced uncertainty of the hydration number (about ±1%). This allowed the detection of a rapid increase in the hydration number at about 55 °C during the heating process, which was in excellent phase with the irreversible rupture of the α-helical structure into solvent-exposed extended chains, whereas the hydration number did not trace the forward path in the subsequent cooling process. Our result indicates that the weakening of water hydrogen bonds trigger the unfolding of the protein structure first, followed by the changes in the number of hydration water as a consequence of thermal denaturation.

Chick Embryo Growth Modeling Using Near-Infrared Sensor and Non-Linear Least Square Fitting of Egg Opacity Values.

Non-destructive monitoring of chick embryonic growth can provide vital management insights for poultry farmers and other stakeholders. Although non-destructive studies on fertility, hatching time and gender have been conducted recently, there has been no available method for embryonic growth observation, especially during the second half of incubation. Therefore, this work investigated the feasibility of using near-infrared (NIR) sensor-based egg opacity values-the amount of light lost when passing through the egg-for indirectly observing embryo growth during incubation. ROSS 308 eggs were selected based on size, mass and shell color for this experiment. To estimate the embryo size precisely, we fit various mathematical growth functions during incubation, based on the opacity value of incubated eggs. Although all the growth models tested performed similarly in fitting the data, the exponential and power functions had better performances in terms of co-efficient of determination (0.991 and 0.994 respectively) and RMSE to explain embryo growth during incubation. From these results, we conclude that the modeling paradigm adopted provides a simple tool to non-invasively investigate embryo growth. These models could be applied to resolving developmental biology, embryonic pathology, industrial and animal welfare issues in the near future.

A Noise Tolerant Spread Spectrum Sound-Based Local Positioning System for Operating a Quadcopter in a Greenhouse.

Quadcopters are beginning to play an important role in precision agriculture. In order to localize and operate the quadcopter automatically in complex agricultural settings, such as a greenhouse, a robust positioning system is needed. In previous research, we developed a spread spectrum sound-based local positioning system (SSSLPS) with a 20 mm accuracy within a 30 × 30 m greenhouse area. In this research, a noise tolerant SSSLPS was developed and evaluated. First, the acoustic noise spectrum emitted by the quadcopter was documented, and then the noise tolerance properties of SSSounds were examined and tested. This was done in a greenhouse with a fixed quadcopter (9.75 N thrust) with the positioning system mounted on it. The recorded quadcopter noise had a broadband noise compared to the SSSound. Taking these SSSound properties into account, the noise tolerance of the SSSLPS was improved, achieving a positioning accuracy of 23.2 mm and 31.6 mm accuracy within 12 × 6 m for both Time-division Multiple Access (TDMA) and Frequency-division Multiple Access (FDMA) modulation. The results demonstrate that the SSSLPS is an accurate, robust positioning system that is noise tolerant and can used for quadcopter operation even within a small greenhouse.

Reconsideration of the relaxational and vibrational line shapes of liquid water based on ultrabroadband dielectric spectroscopy.

The Debye relaxation function is widely used to describe the large dielectric dispersion of ambient water around 20 GHz. However, from a theoretical point of view, this function is supposed to give incorrect predictions at high frequencies owing to the inappropriate assumption that inertial effects and intermolecular interactions do not affect the relaxation dynamics. Our ultrabroadband spectroscopy investigation of liquid water ranging from 500 MHz to 400 THz did demonstrate that the Debye function is inaccurate far above the microwave region. As an alternative, we tried a stochastic frequency modulation (SFM) model assuming instantaneous modification of the line shapes by the correlation with the surrounding system. The SFM relaxation model reproduced the experimental dielectric spectra up to 400 THz, showing that the hydrogen-bond dynamics are associated with the inertial effect that causes the non-exponential relaxation behaviour in a very short time (typically 25 fs). Within the framework of this relaxation model, the hindered translation modes are able to be approximated as fast modulation (homogeneous) line shapes because the interaction time with frequency modulation is too short. Compared with them, the libation mode is found to have a relatively slow modulation (inhomogeneous) origin, where disturbance of water hydrogen bonds induced by the hindered translations leads to fluctuations in the libration frequency.

Longterm renal allograft survival after sequential liver-kidney transplantation from a single living donor.

Combined liver-kidney transplantation (CLKT) is well established as a definitive therapy with the potential to provide complete recovery for certain liver-kidney diseases, although the results might be contingent on the cause of transplantation. The purposes of the present study were to review the longterm outcome of renal allografts in CLKT patients from single living donors and to investigate the beneficial factors, compared with solitary renal transplantation. Thirteen patients underwent sequential liver transplantation (LT) and kidney transplantation (KT) from single living donors. The indications for KT were oxaluria (n = 7), autosomal recessive polycystic disease (n = 3), and others (n = 3). The same immunosuppressive regimen used after LT was also used after KT. KT was performed between 1.7 and 47.0 months after the LT. The overall patient survival rate was 92.3% at 10 years. In 12 of the 13 surviving patients, the renal allografts were found to be functioning in 11 patients after a mean follow-up period of 103.6 months. The death-censored renal allograft survival rate at 10 years was 100%, which was better than that of KT alone (84.9%) in Japan. Immunological protection conferred by the preceding liver allograft may have contributed to the longterm outcomes of the renal allografts. In addition, the donation of double organs from a single living and related donor may have a favorable impact on the graft survival rate. In the future, investigations of factors affecting the longterm outcome of renal allografts, including details of the involvement of de novo donor-specific antibody, will be needed. Liver Transplantation 23 315-323 2017 AASLD.

Characterization of the hydrogen-bond network of water around sucrose and trehalose: Microwave and terahertz spectroscopic study.

Modification of the water hydrogen bond network imposed by disaccharides is known to serve as a bioprotective agent in living organisms, though its comprehensive understanding is still yet to be reached. In this study, aiming to characterize the dynamical slowing down and destructuring effect of disaccharides, we performed broadband dielectric spectroscopy, ranging from 0.5 GHz to 12 THz, of sucrose and trehalose aqueous solutions. The destructuring effect was examined in two ways (the hydrogen bond fragmentation and disordering) and our result showed that both sucrose and trehalose exhibit an obvious destructuring effect with a similar strength, by fragmenting hydrogen bonds and distorting the tetrahedral-like structure of water. This observation strongly supports a chaotropic (structure-breaking) aspect of disaccharides on the water structure. At the same time, hydration water was found to exhibit slower dynamics and a greater reorientational cooperativity than bulk water because of the strengthened hydrogen bonds. These results lead to the conclusion that strong disaccharide-water hydrogen bonds structurally incompatible with native water-water bonds lead to the rigid but destructured hydrogen bond network around disaccharides. Another important finding in this study is that the greater dynamical slowing down of trehalose was found compared with that of sucrose, at variance with the destructuring effect where no solute dependent difference was observed. This discovery suggests that the exceptionally greater bioprotective impact especially of trehalose among disaccharides is mainly associated with the dynamical slowing down (rather than the destructuring effect).

Hydrogen Bond Network of Water around Protein Investigated with Terahertz and Infrared Spectroscopy.

The dynamical and structural properties of water at protein interfaces were characterized on the basis of the broadband complex dielectric constant (0.25 to 400 THz) of albumin aqueous solutions. Our analysis of the dielectric responses between 0.25 and 12 THz first revealed hydration water with retarded reorientational dynamics extending ∼8.5 Å (corresponding to three to four layers) out from the albumin surface. Second, the number of nonhydrogen-bonded water was decreased in the presence of the albumin solute, indicating protein inhibits the fragmentation of the water hydrogen-bond network. Finally, water molecules at the albumin interface were found to form a distorted hydrogen-bond structure due to topological and energetic disorder of the protein surface. In addition, the intramolecular O-H stretching vibration of water (∼100 THz), which is sensitive to hydrogen-bond environment, pointed to a trend that hydration water has a larger population of strongly hydrogen-bonded water molecules compared with that of bulk water. From these experimental results, we concluded that the "strengthened" water hydrogen bonds at the protein interface dynamically slow down the reorientational motion of water and form the less-defective hydrogen-bond network by inhibiting the fragmentation of water-water hydrogen bonds. Nevertheless, such a strengthened water hydrogen-bond network is composed of heterogeneous hydrogen-bond distances and angles, and thus characterized as structurally "distorted."

Broadband dielectric spectroscopy of glucose aqueous solution: Analysis of the hydration state and the hydrogen bond network.

Recent studies of saccharides' peculiar anti-freezing and anti-dehydration properties point to a close association with their strong hydration capability and destructuring effect on the hydrogen bond (HB) network of bulk water. The underlying mechanisms are, however, not well understood. In this respect, examination of the complex dielectric constants of saccharide aqueous solutions, especially over a broadband frequency region, should provide interesting insights into these properties, since the dielectric responses reflect corresponding dynamics over the time scales measured. In order to do this, the complex dielectric constants of glucose solutions between 0.5 GHz and 12 THz (from the microwave to the far-infrared region) were measured. We then performed analysis procedures on this broadband spectrum by decomposing it into four Debye and two Lorentz functions, with particular attention being paid to the ß relaxation (glucose tumbling), δ relaxation (rotational polarization of the hydrated water), slow relaxation (reorientation of the HB network water), fast relaxation (rotation of the non-HB water), and intermolecular stretching vibration (hindered translation of water). On the basis of this analysis, we revealed that the hydrated water surrounding the glucose molecules exhibits a mono-modal relaxational dispersion with 2-3 times slower relaxation times than unperturbed bulk water and with a hydration number of around 20. Furthermore, other species of water with distorted tetrahedral HB water structures, as well as increases in the relative proportion of non-HB water molecules which have a faster relaxation time and are not a part of the surrounding bulk water HB network, was found in the vicinity of the glucose molecules. These clearly point to the HB destructuring effect of saccharide solutes in aqueous solution. The results, as a whole, provide a detailed picture of glucose-water and water-water interactions in the vicinity of the glucose molecules at various time scales from sub-picosecond to hundreds of picoseconds.

Quantification of resistant starch content in rice after hydrothermal treatments using terahertz spectroscopy.

Since hydrothermal treatments can enhance resistant starch (RS) content in rice and provide health benefits when consumed, a less laborious and non-destructive method to determine RS content is needed. Terahertz (THz) spectroscopy is hypothesized as a suitable method to quantify RS content in rice after hydrothermal treatment with its sensitivity for the intermolecular forces increase in the formation of RS. In this study, we first used the traditional in vitro hydrolysis method to determine the content of RS in rice. Then, the potential of starch absorbance peaks to quantify RS content after three commonly used hydrothermal methods, soaking, mild heat-moisture treatment, and parboiling, was investigated. The second derivative intensities of the peak at 9.0, 10.5, 12.1, and 13.1 THz were confirmed as being correlated with RS content and showed the high accuracy to predict RS content in samples (R2 > 0.96). Our results indicate the RS content of hydrothermally treated rice can be accurately quantified using these peaks.

Fluorine materials scavenge excess carbon dioxide and promote Escherichia coli growth.

Fluorinated solvents have been used as oxygen carriers in closed microbial cultures to sustain aerobic conditions. However, the growth-promoting effects of fluorinated solvents remain unclear. Therefore, this study aimed to elucidate the mechanism by which fluorinated solvents promote microbial growth and to explore alternative materials that can be easily isolated after culture. Escherichia coli and HFE-7200, a fluorinated solvent, were used to explore factors other than oxygen released by fluorinated solvents that promote microbial growth. E. coli growth was promoted in gas-permeable cultures, and HFE-7200 alleviated medium acidification. Gas chromatography confirmed that HFE-7200 functioned as a scavenger of carbon dioxide produced by E. coli metabolism. Because fluorinated solvents can dissolve various gases, they could scavenge metabolically produced toxic gases from microbial cultures. Furthermore, using polytetrafluoroethylene, a solid fluorine material, results in enhanced bacterial growth. Such solid materials can be easily isolated and reused for microbial culture, suggesting their potential as valuable technologies in food production and biotechnology.

Biotinylation of silicon and nickel surfaces and detection of streptavidin as biosensor.

The availability of metal mesh device sensors has been investigated using surface-modified nickel mesh. Biotin was immobilized on the sensor surfaces consisting of silicon and nickel via a thiol-ene click reaction, known as the Michael addition reaction. Biotinylation on the maleimidated surface was confirmed by X-ray photoelectron spectroscopy. The binding of streptavidin to the biotinylated surfaces was evaluated using a quartz crystal microbalance and a metal mesh device sensor, with both techniques providing similar binding constant value. The recognition ability of the biotin immobilized using the thiol-maleimide method for streptavidin was comparable to that of biotin immobilized via several other methods. The adsorption of a biotin conjugate onto the streptavidin-immobilized surface via the biotin-streptavidin-biotin sandwich method was evaluated using a fluorescent microarray, with the results demonstrating that the biological activity of the streptavidin remained.

Near-field sensor array with 65-GHz CMOS oscillators can rapidly and comprehensively evaluate drug susceptibility of Mycobacterium.

Multidrug-resistant tuberculosis (MDR-TB) is a major clinical problem. Because Mycobacterium, the causative agent of tuberculosis, are slow-growing bacteria, it takes 6-8 weeks to complete drug susceptibility testing, and this delay contributes to the development of MDR-TB. Real-time drug resistance monitoring technology would be effective for suppressing the development of MDR-TB. In the electromagnetic frequency from GHz to THz regions, the spectrum of the dielectric response of biological samples has a high dielectric constant owing to the relaxation of the orientation of the overwhelmingly contained water molecule network. By measuring the change in dielectric constant in this frequency band in a micro-liquid culture of Mycobacterium, the growth ability can be detected from the quantitative fluctuation of bulk water. The 65-GHz near-field sensor array enables a real-time assessment of the drug susceptibility and growth ability of Mycobacterium bovis (BCG). We propose the application of this technology as a potential new method for MDR-TB testing.

Determining changes in crystallinity of rice starch after heat-moisture treatment using terahertz spectroscopy.

To investigate the potential of Fourier-transform terahertz (FT-THz) spectroscopy to follow crystalline structure changes in rice starch after heat-moisture treatment (HMT), we measured the crystallinity by X-ray diffraction (XRD) spectra and found its correlation with THz spectra. According to A-type crystal structure and Vh-type crystalline structure of amylose-lipid complex (ALC) in rice starch, crystallinity is divided into A-type and Vh-type. The intensity of second derivative spectra peak at 9.0 THz was highly correlated with both A-type and Vh-type crystallinity. Additionally, other three peaks at 10.5 THz, 12.2 THz, and 13.1 THz were also sensitive to Vh-type crystalline structure. These results indicate that after HMT, the crystallinity of ALC (Vh-type) and A-type starch can be quantified using THz peaks.

Assessment of chalkiness index of Sake rice using transmission imaging.

The higher chalkiness level of the white core kernel is prone to breakage during the high degree polishing. So, grading white core kernel based on chalkiness level is crucial to making premium quality Sake (rice wine) in the brewing industry. The chalkiness level in the white core kernel is currently performed destructively. Thus, a chalkiness index is required to assess the level in the white core kernel. This research assesses the white core rice kernel based on the chalkiness index non-destructively. Here, the optical transmission property in the visible to near-infrared (VIS-NIR) region of rice was measured using a V-670 spectrophotometer equipped with an integrating sphere to investigate the variation of chalkiness level rice samples. The images were then acquired by transmission mode of four types of intact Sake rice kernel using blue light-emitting diodes (LEDs), green, red, and NIR LEDs in which the peak wavelength of the LEDs was 465 nm, 525 nm, 630 nm, and 830 nm, respectively. The result indicates that the rice samples were more penetrated and better visualized chalkiness by light in the NIR region. Therefore, the wavelength region in NIR showed better discrimination between transparent and opaque parts in white core's Sake rice. Furthermore, the proposed chalkiness index was inversely correlated with the gray-level intensity of the transmittance image. This gray value was significantly correlated (R2 = 0.89) with the chalkiness index in the NIR region. So, gray values of NIR transmittance images were identified as sensitive for chalkiness index, which would be applied for sorting the white core kernel with different levels of chalkiness in the Sake brewing industry.

Hydrogen-Bond Configurations of Hydration Water around Glycerol Investigated by HOH Bending and OH Stretching Analysis.

Toward a comprehensive understanding of the mechanism of glycerol as a moisturizer, studies on the hydrogen-bond (HB) structure of hydration water, which is known to be disordered by glycerol, are insufficient. To this aim, we evaluated the HB configurations based on the HOH bending and OH stretching spectra of the hydration water from those of glycerol/water mixtures by subtracting the contributions of bulk water and glycerol using dielectric relaxation spectroscopy. Analysis of the HOH bending band showed that hydration water-donating HBs lose the intermolecular bending coupling with increasing glycerol by replacing the water-water HBs with water-glycerol HBs. The OH stretching band provided more detailed insight into the HB configuration, indicating that the double-donor double-acceptor and double-donor single-acceptor configurations in bulk water change to a predominantly double-donor single-acceptor configuration in hydration water around glycerol. The formation of more donor HBs than acceptor HBs may be due to the steric constrains by glycerol and/or differences in the partial charge on the oxygen atom between water and glycerol.

Japanese dace (Tribolodon hakonensis) fish freshness estimation using front-face fluorescence spectroscopy coupled with chemometric analysis.

Although fish and its related products are good sources of protein and unsaturated fatty acids, like omega-3 in the human diet, their shelf-life is limited by biochemical and microbial changes. In this study, a front-face fluorescence spectroscopy technique was used to acquire Excitation-emission matrices (EEM) to monitor Japanese dace (Tribolodon hakonensis) fish freshness degradation during storage. EEM of Japanese dace fish parts (intact eyeball and surface-containing scales), excitation from 220 to 585 nm and emissions from 250 to 600 nm, were measured at different times during storage. To simplify the acquired complex spectra datasets from each fish part, the variables were reduced to those that were only significant/important (those with higher positive or negative correlation) for K value prediction, and as an index of freshness. Partial least square regression (PLSR) results demonstrated that combining the fluorescence EEM of the eyeball and surface-containing scales the best monitoring of fish freshness; excitation at 280 and 350 nm for both the eyeball and surface-containing scales, with 2.84 and 0.96 as RMSE and R2, respectively. These findings demonstrate that multiple excitation fluorescence approaches can be convenient for the freshness evaluation of fish.