Prolonged infective SARS-CoV-2 omicron variant shedding in a patient with diffuse large B cell lymphoma successfully cleared after three courses of remdesivir.

We report a case of prolonged shedding of the infective SARS-CoV-2 omicron variant BA.1.1.2 in a 79-year-old male patient with diffuse large B-cell lymphoma, after receiving chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). The patient was admitted to our hospital in late March 2022 for the sixth course of R-CHOP chemotherapy. Initially, the patient tested negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using an in-hospital loop-mediated amplification assay with a nasopharyngeal swab, both on the day of admission and three days later. However, the patient developed fever and was diagnosed with coronavirus disease (COVID-19) six days after admission and was suspected to have contracted the infection in the ward. Viral shedding continued for more than three months, with confirmed viral infectivity. As compared to the original Wuhan-Hu-1/2019 strain, amino acid substitutions including S36 N in non-structural protein (NSP)2, S148P, S1265del and L1266I in NSP3, G105D in NSP4, G496S, A831V, or V987F in spike protein, and I45T in open-reading frame (ORF)9b were randomly detected in isolated viruses. Although the patient had received two doses of the BNT162b2 vaccine approximately six months earlier and the third dose on day 127 after the infection, both serum anti-spike and anti-nuclear protein IgG and IgM tests were negative at day 92, 114, and 149 after the infection. The patient finally cleared the virus after the third course of remdesivir and did not have further recurrence.

High incidence of posterior glenoid dysplasia of the shoulder in young baseball players.

BACKGROUND: Rounding of the posterior glenoid rim is observed in young throwing athletes with internal shoulder impingement and is considered developmental dysplasia of the glenoid. The aim of our study was to determine the incidence rate of dysplastic changes of the glenoid within a group of 92 young baseball players. METHODS: The study group included 92 male baseball players, with a mean age of 14.63 years. Of these patients, 30 were diagnosed with Little Leaguer's shoulder and 62 with a painful baseball-throwing shoulder with no abnormal findings on x-ray. The posterior glenoid rim of the affected shoulder was compared with the contralateral nonpainful shoulder, with the 2 following outcomes measured on radiographs obtained using the modified Bernageau imaging method: the distance between the anterior and posterior glenoid rims and the presence or absence of dysplasia of the posterior glenoid rim. RESULTS: The mean distance between the anterior and posterior glenoid rims was significantly shorter in the painful shoulders (mean, 26 mm) than in the nonpainful shoulders (mean, 29 mm; P < .0001). Dysplasia of the posterior glenoid rim was identified in 89 painful shoulders (96.7%), with 9 cases (9.7%) identified on the unaffected contralateral side (P < .001). The presence of dysplasia was not correlated with the age at which baseball playing began. CONCLUSION: The incidence of dysplasia of the posterior glenoid rim is high (96.7%) among young baseball players with a painful shoulder. The identified dysplasia may be related to impaired development of the inferior peripheral secondary glenoid ossification center due to repetitive throwing.

Do small outdoor geoengineering experiments require governance?

Standardized and/or centralized proactive research governance can lessen tensions.

Soy peptides enhance yeast cell growth at low temperatures.

PURPOSE OF WORK: To elucidate the mechanisms of high performance by soy peptides during yeast fermentation in low temperature stress conditions and to identify a type of soy peptide that is suitable for yeast fermentation at low temperatures during brewing. The growth of a tryptophan auxotrophic yeast strain in a medium containing soy peptide (SP) was compared with that in a medium containing an equivalent composition of free amino acid mixture. At low temperature (10 °C), the cells grew in the medium containing SP but not in the medium containing the free amino acid mixture. Free tyrosine and phenylalanine inhibited the uptake of free tryptophan at low temperatures whereas most of the tyrosine and phenylalanine were present as oligopeptides in SP. The cells could transport free tryptophan without being inhibited by free tyrosine and phenylalanine at low temperatures in the medium containing SPs. Soy peptide-AM that lacks free tyrosine and phenylalanine was more effective in promoting cell growth compared with a highly hydrolyzed version.

Precipitation extreme changes exceeding moisture content increases in MIROC and IPCC climate models.

Precipitation extreme changes are often assumed to scale with, or are constrained by, the change in atmospheric moisture content. Studies have generally confirmed the scaling based on moisture content for the midlatitudes but identified deviations for the tropics. In fact half of the twelve selected Intergovernmental Panel on Climate Change (IPCC) models exhibit increases faster than the climatological-mean precipitable water change for high percentiles of tropical daily precipitation, albeit with significant intermodel scatter. Decomposition of the precipitation extreme changes reveals that the variations among models can be attributed primarily to the differences in the upward velocity. Both the amplitude and vertical profile of vertical motion are found to affect precipitation extremes. A recently proposed scaling that incorporates these dynamical effects can capture the basic features of precipitation changes in both the tropics and midlatitudes. In particular, the increases in tropical precipitation extremes significantly exceed the precipitable water change in Model for Interdisciplinary Research on Climate (MIROC), a coupled general circulation model with the highest resolution among IPCC climate models whose precipitation characteristics have been shown to reasonably match those of observations. The expected intensification of tropical disturbances points to the possibility of precipitation extreme increases beyond the moisture content increase as is found in MIROC and some of IPCC models.

Cases presenting to orthopedists with manifestations of lung cancer on skeletal radiographs.

The value of cervical spine or shoulder radiography has been established for the detection of Pancoast tumors. However, for the detection of lung cancers other than Pancoast tumors, the value of these skeletal radiographies has not been assessed. The aim of our study was to determine how many patients first presented to orthopedists with manifestations of lung cancer on skeletal radiographs and to present several cases for illustration. From the registry of the pathology department of our hospital, we identified 345 lung cancer patients diagnosed histologically over 10 years. From these patients, we selected 310 who had no previous history of malignancies at histological diagnosis of lung cancer. The study population consisted of individuals from the selected patients who had presented once or more to orthopedists at our hospital for any reason, at up to 2 years prior to histological diagnosis of lung cancer. For the study population, all radiological examinations performed by the orthopedists were reviewed by radiologists. The study population included 46 patients constituting 14.8 % (46/310) of the selected patients. Of these 46 patients, 37 (80.4 %) received 97 skeletal radiographies. Reviewing these skeletal radiographies disclosed lung tumors on 13 in 11 (11/46, 23.9 %) of the patients. We found that more than 10 % of lung cancer patients with no previous history of malignancies had presented to orthopedists on one or more occasions, at up to 2 years before histological diagnosis, and that approximately 25 % of these patients had manifestations of lung cancer on skeletal radiographs.

Fine-Tuning the Performance of Ultraflexible Organic Complementary Circuits on a Single Substrate via a Nanoscale Interfacial Photochemical Reaction.

Flexible electronics has paved the way toward the development of next-generation wearable and implantable healthcare devices, including multimodal sensors. Integrating flexible circuits with transducers on a single substrate is desirable for processing vital signals. However, the trade-off between low power consumption and high operating speed is a major bottleneck. Organic thin-film transistors (OTFTs) are suitable for developing flexible circuits owing to their intrinsic flexibility and compatibility with the printing process. We used a photoreactive insulating polymer poly((±)endo,exo-bicyclo[2.2.1]hept-ene-2,3-dicarboxylic acid, diphenylester) (PNDPE) to modulate the power consumption and operating speed of ultraflexible organic circuits fabricated on a single substrate. The turn-on voltage (V on) of the p- and n-type OTFTs was controlled through a nanoscale interfacial photochemical reaction. The time-of-flight secondary ion mass spectrometry revealed the preferential occurrence of the PNDPE photochemical reaction in the vicinity of the semiconductor-dielectric interface. The power consumption and operating speed of the ultraflexible complementary inverters were tuned by a factor of 6 and 4, respectively. The minimum static power consumption was 30 ± 9 pW at transient and 4 ± 1 pW at standby. Furthermore, within the tuning range of the operating speed and at a supply voltage above 2.5 V, the minimum stage delay time was of the order of hundreds of microseconds. We demonstrated electromyogram measurements to emphasize the advantage of the nanoscale interfacial photochemical reaction. Our study suggests that a nanoscale interfacial photochemical reaction can be employed to develop imperceptible and wearable multimodal sensors with organic signal processing circuits that exhibit low power consumption.

Are we ignoring a black elephant in the Anthropocene? Climate change and global pandemic as the crisis in health and equality.

Climate change and coronavirus pandemic are the twin crises in the Anthropocene, the era in which unsustainable growth of human activities has led to a significant change in the global environment. The two crises have also exposed a chronic social illness of our time-a deep, widespread inequality in society. Whilst the circumstances are unfortunate, the pandemic can provide an opportunity for sustainability scientists to focus more on human society and its inequalities, rather than a sole focus on the natural environment. It opens the way for a new normative commitment of science in a time of crises. We suggest three agendas for future climate and sustainability research after the pandemic: (1) focus on health and well-being, (2) moral engagement through empathy, and (3) science of loss for managing grief.

Industrial decarbonization under Japan's national mitigation scenarios: a multi-model analysis.

Energy-intensive industries are difficult to decarbonize. They present a major challenge to the emerging countries that are currently in the midst of rapid industrialization and urbanization. This is also applicable to Japan, a developed economy, which retains a large presence in heavy industries compared to other developed economies. In this paper, the results obtained from four energy-economic and integrated assessment models were utilized to explore climate mitigation scenarios of Japan's industries by 2050. The results reveal that: (i) Japan's share of emissions from industries may increase by 2050, highlighting the difficulties in achieving industrial decarbonization under the prevailing industrial policies; (ii) the emission reduction in steelmaking will play a key role, which can be achieved by the implementation of carbon capture and expansion of hydrogen technologies after 2040; (iii) even under mitigation scenarios, electrification and the use of biomass use in Japan's industries will continue to be limited in 2050, suggesting a low possibility of large-scale fuel switching or end-use decarbonization. After stocktaking of the current industry-sector modeling in integrated assessment models, we found that such limited uptake of cleaner fuels in the results may be related to the limited interests of both participating models and industry stakeholders in Japan, specifically the interests on the technologies that are still at the early stage of development but with high reduction potential. It is crucial to upgrade research and development activities to enable future industry-sector mitigation as well as to improve modeling capabilities of energy end-use technologies in integrated assessment models. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11625-021-00905-2.

Heterogeneous Functional Dielectric Patterns for Charge-Carrier Modulation in Ultraflexible Organic Integrated Circuits.

Flexible electronics have gained considerable attention for application in wearable devices. Organic transistors are potential candidates to develop flexible integrated circuits (ICs). A primary technique for maximizing their reliability, gain, and operation speed is the modulation of charge-carrier behavior in the respective transistors fabricated on the same substrate. In this work, heterogeneous functional dielectric patterns (HFDP) of ultrathin polymer gate dielectrics of poly((±)endo,exo-bicyclo[2.2.1]hept-ene-2,3-dicarboxylic acid, diphenylester) (PNDPE) are introduced. The HFDP that are obtained via the photo-Fries rearrangement by ultraviolet radiation in the homogeneous PNDPE provide a functional area for charge-carrier modulation. This leads to programmable threshold voltage control over a wide range (-1.5 to +0.2 V) in the transistors with a high patterning resolution, at 2 V operational voltage. The transistors also exhibit high operational stability over 140 days and under the bias-stress duration of 1800 s. With the HFDP, the performance metrics of ICs, for example, the noise margin and gain of the zero-VGS load inverters and the oscillation frequency of ring oscillators are improved to 80%, 1200, and 2.5 kHz, respectively, which are the highest among the previously reported zero-VGS -based organic circuits. The HFDP can be applied to much complex and ultraflexible ICs.

EMF 35 JMIP study for Japan's long-term climate and energy policy: scenario designs and key findings.

In June, 2019, Japan submitted its mid-century strategy to the United Nations Framework Convention on Climate Change and pledged 80% emissions cuts by 2050. The strategy has not gone through a systematic analysis, however. The present study, Stanford Energy Modeling Forum (EMF) 35 Japan Model Intercomparison project (JMIP), employs five energy-economic and integrated assessment models to evaluate the nationally determined contribution and mid-century strategy of Japan. EMF 35 JMIP conducts a suite of sensitivity analyses on dimensions including emissions constraints, technology availability, and demand projections. The results confirm that Japan needs to deploy all of its mitigation strategies at a substantial scale, including energy efficiency, electricity decarbonization, and end-use electrification. Moreover, they suggest that with the absence of structural changes in the economy, heavy industries will be one of the hardest to decarbonize. Partitioning of the sum of squares based on a two-way analysis of variance (ANOVA) reconfirms that mitigation strategies, such as energy efficiency and electrification, are fairly robust across models and scenarios, but that the cost metrics are uncertain. There is a wide gap of policy strength and breadth between the current policy instruments and those suggested by the models. Japan should strengthen its climate action in all aspects of society and economy to achieve its long-term target. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11625-021-00913-2.

A Case of Post-trauma Dysphagia: Peculiar Swallowing Dynamics Due to Associated Laryngeal Paralysis.

BACKGROUND: Associated laryngeal paralysis (ALP) is defined as vagus nerve impairment combined with other lower cranial nerve paralysis. Traumatic ALP is reported infrequently. CASE: A 72-year-old man was injured on the back of the head when a large tree fell on him; he was admitted to a general hospital, where he was diagnosed with brain concussion and Guillain-Barre syndrome (GBS). The patient developed aspiration pneumonia due to severe dysphagia. Although he underwent treatment and rehabilitation for 6 months, some disabilities persisted, and a percutaneous endoscopic gastrostomy tube was placed. Six months after the accident, the patient was transferred to our rehabilitation hospital. Videoendoscopic examination and videofluoroscopy revealed persistent upper esophageal sphincter (UES) opening, left dominant bilateral IX and X nerve paralysis, and left XII nerve paralysis; moreover, these examinations showed that the swallowing reflex was absent, although a bolus could pass through the UES. We suspected that the patient's condition was not GBS and performed head computed tomography and magnetic resonance imaging; these revealed a bone fracture at the skull base. Consequently, the patient's diagnosis was changed to bilateral ALP. He received swallowing rehabilitation for 2 months and could orally consume alternative nutrition. Finally, the patient was able to eat orally texture-modified foods (Food Intake LEVEL Scale level 8). DISCUSSION: While post-trauma dysphagia due to bilateral ALP might be severe, patients can regain the ability to eat orally if clinicians understand the etiology of dysphagia and provide appropriate swallowing rehabilitation techniques, including patient position adjustment while eating and selection of food textures.

Evaluation of 3'-deoxy-3'-18F-fluorothymidine for monitoring tumor response to radiotherapy and photodynamic therapy in mice.

UNLABELLED: 3'-Deoxy-3'-18F-fluorothymidine (18F-FLT) has been suggested as a new PET tracer for imaging tumor proliferation. We investigated the use of 18F-FLT to monitor the response of tumors to radiotherapy and photodynamic therapy (PDT) in mice. METHODS: C3H/He mice bearing an SCCVII tumor were treated with single-dose x-ray irradiation of 20 Gy. Tumor uptake was examined for 18F-FLT, 3H-thymidine (3H-Thd), 18F-FDG, and 14C-deoxyglucose (14C-DG) at 6 h, 12 h, 24 h, 3 d, and 7 d after radiotherapy. BALB/c nu/nu mice bearing a HeLa tumor were treated with PDT. Tumor uptake was examined for the 4 tracers at 24 h after PDT. Expression of proliferating cell nuclear antigen (PCNA) was determined in untreated and treated tumors. RESULTS: In the biodistribution study, considerable uptake of 18F-FLT was observed in both tumor types. Tumor volumes decreased to 39.3% +/- 22.4% at 7 d after radiotherapy. The PCNA labeling index was reduced in x-ray-irradiated tumors (control, 53.2% +/- 8.7%; 6 h, 38.5% +/- 5.3%; 24 h after radiotherapy, 36.8% +/- 5.3%). 18F-FLT uptake in tumor expressed as the percentage of the injected dose per gram of tumor (%ID/g) decreased significantly at 6 h and remained low until 3 d after radiotherapy (control, 9.7 +/- 1.2 %ID/g; 6 h, 5.9 +/- 0.4 %ID/g; 24 h, 6.1 +/- 1.3 %ID/g; 3 d after radiotherapy, 6.4 +/- 1.1 %ID/g). 18F-FDG uptake tended to gradually decrease but a significant decrease was found only at 3 d (control, 12.1 +/- 2.7 %ID/g; 6 h, 13.3 +/- 2.3 %ID/g; 24 h, 8.6 +/- 1.8 %ID/g; 3 d after radiotherapy, 6.9 +/- 1.2 %ID/g). PDT resulted in a reduction of the PCNA labeling index (control, 82.0% +/- 8.6%; 24 h after PDT, 13.5% +/- 12.7%). Tumor uptake of 18F-FLT decreased (control, 11.1 +/- 1.3 %ID/g; 24 h after PDT, 4.0 +/- 2.2 %ID/g), whereas 18F-FDG uptake did not decrease significantly after PDT (control, 3.5 +/- 0.6 %ID/g; 24 h after PDT, 2.3 +/- 1.1 %ID/g). Changes in the uptake of 18F-FLT and 18F-FDG were similar to those of 3H-Thd and 14C-DG, respectively. CONCLUSION: In our model system, changes in 18F-FLT uptake after radiotherapy and PDT were correlated with those of 3H-Thd and the PCNA labeling index. The decrease in 18F-FLT uptake after treatments was more rapid or pronounced than that of 18F-FDG. Therefore, 18F-FLT may be a feasible PET tracer for monitoring response to therapy in oncology.

18F-FDG PET in the detection of extrahepatic metastases from hepatocellular carcinoma.

BACKGROUND: Positron emission tomography (PET) with 18F-fluoro-2-deoxy-D-glucose (18F-FDG) is useful in detecting distant metastases from a variety of malignancies. However, its efficiency in detecting distant metastases from hepatocellular carcinoma (HCC) has not been investigated. The aim of this study was to evaluate the usefulness of 18F-FDG PET for the detection of extrahepatic metastases from HCC. METHODS: Nineteen patients suspected of having extrahepatic HCC underwent 18F-FDG PET. Fourteen patients (group A) had extrahepatic lesions, which were detected by conventional studies. In five patients (group B), conventional imaging showed no extra- or intrahepatic lesions, but the tumor marker levels were elevated. The PET results were compared with those obtained by histopathology or by clinical follow-up. RESULTS: The detection rate of 18F-FDG PET was 83% (24 of 29 metastases) for extrahepatic metastases larger than 1 cm in greatest diameter and 13% (1 of 8 metastases) for lesions less than or equal to 1 cm. PET revealed two bone metastases not depicted by bone scan, and detected the nodal metastasis and intestinal metastases inconclusive on computed tomography. Extrahepatic lesions were resected in 5 patients of group A on the basis of PET findings. In all patients of group B, PET results were true negative for extrahepatic metastases, but HCCs were detected in the liver within 4 months in 4 patients. These were no false-positive lesions in either group. CONCLUSIONS: This preliminary study suggested that 18F-FDG PET could provide additional information and contribute to the management of HCC patients suspected of having extrahepatic metastases.

Effect of ultrasound application on fat mobilization.

The aim of this experimental trial was to study the effect of ultrasound application on the lipolysis in adipose tissue. Rats were administered to pentobarbital (Nembutal) anesthesia and their abdomens were shaved. Rat abdomen was subjected to 24 kHz-1 MHz ultrasound for 10 min to investigate frequency and power-intensity dependency for fat mobilization. Blood was taken from the tail vein to estimate plasma free fatty acids (FFA). For frequency dependency two regions around 100 kHz and 300-500 kHz were effective for fat mobilization. For power-intensity dependency, effective regions were found to be from 24 to 1090 kHz. In the effective regions on frequency and power-intensity, application of ultrasound caused increases in plasma FFA and norepinephrine concentration of extra-cellular fluid of perirenal adipose tissue. These results suggest that ultrasound application stimulates fat mobilization through a local increase in norepinephrine secretion under the conditions of effective frequency and intensity.

[Clinical effects of long-term administration of pranlukast, a leukotriene receptor antagonist, on adult patients with bronchial asthma].

Eighty-one adult patients with bronchial asthma who suffered asthmatic episodes in spite of treatment with 400 mg/day of BDP were placed on pranlukast therapy for 4 weeks. Group I, which showed a 5% or greater increase in PEFR, continued oral pranlukast medication for an additional two years. Those patients who did not show an increase of 5% or greater in PEFR after 4 weeks of pranlukast therapy were instructed to continue the medication for another year. Group II, which exhibited a 5% or greater increase in PEFR after a one-year period continued medication for one more year. Medication was suspended for Group III, which failed to show improvement in PEFR after one year, and the group was placed under observation for the following year. Group I improved significantly in PEFR and exhibited a reduction in the frequency of b2 inhalation, the number of night visits to a medical facility, the amount of steroids inhaled, and the quantity of oral steroids given at regular intervals; and the Group I peripheral eosinophil count, serum ECP level, and FEV1.0 ameliorated. After one year, Group II also showed significant improvement in PEFR and a reduction in both the peripheral eosinophil count and the serum ECP level. This group's PEFR continued to improve after two years. One year after medication was suspended, Group III showed a significant increase in the number of night visits to a medical facility and a rise in the serum ECP level. These findings indicated the efficacy of pranlukast.

Assessment of a potential tumor-seeking manganese metalloporphyrin contrast agent in a mouse model.

The performance of a newly developed potential tumor-seeking magnetic resonance (MR) contrast agent alpha-Aqua-13,17-bis(1-carboxypropionyl) carbamoylethyl-3,8-bis(1-phenethyloxyethyl)-beta-hydroxy-2,7,12,18-tetramethyl-porphyrinato manganese (III) (HOP-8P) was tested using a mouse model. Tumor-bearing (SCC-VII) mice were imaged using a 1.5T MR imager before and after intravenous administration of 0.1 mmol/kg of HOP-8P. A biodistribution analysis was performed using an optical emission spectrometer. Significant enhancement of the transplanted tumor was observed in MR images 24 h after intravenous injection of HOP-8P. The biodistribution assessment of manganese also correlated with the results of the imaging study. During the 24-h period following contrast administration, HOP-8P was consistently cleared from the circulation, liver, kidneys, and muscle; however, it was progressively accumulated within the tumor. HOP-8P is a promising tumor-seeking metalloporphyrin MR contrast agent with a wide imaging window.