Protocolized oxytocin infusion for elective cesarean delivery: a retrospective before-and-after study.

PURPOSE: To elucidate the clinical impact of the novel oxytocin protocol using a syringe pump with a stratified dose compared with the conventional practice of putting oxytocin into the bag. METHODS: This is a retrospective cohort study. We collected the data of the patients who underwent elective cesarean delivery under neuraxial anesthesia between June 2019 and May 2020. The patients were allocated to two groups according to oxytocin administration methods; the control group (the attending anesthesiologist put oxytocin 5-10 units in the infusion bag and adjusted manually after childbirth) and the protocol group (the oxytocin protocol gave oxytocin bolus 1 or 3 units depending on the PPH risk, followed by 5 or 10 unit h-1 via a syringe pump). We compared the total amount of oxytocin within 24 h postpartum, estimated blood loss, and adverse clinical events within 24 h postpartum between the two groups. RESULTS: During the study period, 262 parturients were included. Oxytocin doses of intraoperative and postoperative were significantly lower in the protocol group (9.7 vs. 11.7 units, intraoperative, 15.9 vs. 18 units, postoperative). The subgroup analyses showed that the impact was more remarkable in the low PPH risk than in the high PPH risk. The multivariate linear regression analyses also confirmed the difference. The groups had no significant difference in blood loss, requirement of additional uterotonics, and other adverse events. CONCLUSIONS: Our oxytocin infusion protocol significantly reduced oxytocin requirements in elective cesarean delivery under neuraxial anesthesia without increasing blood loss. However, we could not find other clinical benefits of the novel protocol.

Postpartum recovery of nulliparous women following scheduled cesarean delivery and spontaneous vaginal delivery: a prospective observational study.

BACKGROUND: Inpatient postpartum recovery trajectories following cesarean delivery and spontaneous vaginal delivery are underexplored. OBJECTIVE: This study primarily aimed to compare recovery following cesarean delivery and spontaneous vaginal delivery in the first postpartum week, and secondarily to evaluate psychometrically the Japanese version of the Obstetric Quality of Recovery-10 scoring tool. STUDY DESIGN: Following institutional review board approval, the EQ-5D-3L (EuroQoL 5-Dimension 3-Level) questionnaire and a Japanese version of the Obstetric Quality of Recovery-10 measure were used to evaluate inpatient postpartum recovery in uncomplicated nulliparous parturients delivering via scheduled cesarean delivery or spontaneous vaginal delivery. RESULTS: A total of 48 and 50 women who delivered via cesarean delivery and spontaneous vaginal delivery, respectively, were recruited. Women delivering via scheduled cesarean delivery experienced significantly worse quality of recovery on days 1 and 2 compared with those who had spontaneous vaginal delivery. Quality of recovery significantly improved daily, plateauing at days 4 and 3 for cesarean delivery and spontaneous vaginal delivery groups, respectively. Compared with cesarean delivery, spontaneous vaginal delivery was associated with prolonged time to analgesia requirement, decreased opioid consumption, reduced antiemetic requirement, and reduced times to liquid/solid intake, ambulation, and discharge. Obstetric Quality of Recovery-10-Japanese is a valid (correlates with the EQ-5D-3L including a global health visual analog scale, gestational age, blood loss, opioid consumption, time until first analgesic request, liquid/solid intake, ambulation, catheter removal, and discharge), reliable (Cronbach alpha=0.88; Spearman-Brown reliability estimate=0.94; and intraclass correlation coefficient=0.89), and clinically feasible (98% 24-hour response rate) measure. CONCLUSION: Inpatient postpartum recovery is significantly better in the first 2 postpartum days following spontaneous vaginal delivery compared with scheduled cesarean delivery. Inpatient recovery is largely achieved within 4 and 3 days following scheduled cesarean delivery and spontaneous vaginal delivery, respectively. Obstetric Quality of Recovery-10-Japanese is a valid, reliable, and feasible measure of inpatient postpartum recovery.

Long-term heat-storage materials based on λ-Ti3O5 for green transformation (GX).

Effective reuse of waste heat energy is an important energy savings issue for green transformation. In general, phase-change heat storage materials cannot store energy for a prolonged period. If a solid material could conserve the accumulated thermal energy and release it only on demand, then its heat-storage application potential is considerably widened. From this angle, in 2015, we proposed the concept of a long-term heat-storage material, in which latent heat is preserved until the material is triggered by an external stimulus. This feature article describes long-term heat-storage ceramics composed of lambda-trititanium-pentoxide (λ-Ti3O5) from their discovery to heat-storage properties and future applications.

Ethanol Enhances Astaxanthin Production by Aurantiochytrium sp. O5-1-1.

Two-percent ethanol increased the astaxanthin productivity of heterotrophic microalgae Aurantiochytrium sp. O5-1-1 to 2.231 mg/L, 45-fold higher than under ethanol-free condition. Ethanol in the medium decreased at the same rate as spontaneous volatilization, suggesting that it was not a transient signaling factor but a continuous stress on the cells. The triply mutated strain OM3-3 produced 5.075 mg/L astaxanthin under 2% ethanol conditions. Furthermore, the astaxanthin accumulation of the mutant OM3-9 was 0.895 mg/g, which was 150-fold higher than that of strain O5-1-1 in ethanol-free condition. These results are beneficial for the commercial exploitation of carotenoids producing Aurantiochytrium spp.

Combined ALT, Estlander, and Upper Lip Flap for Defects Involving the Oral Commissure.

Lip defects (including the corners of the mouth) are a reconstructive challenge in terms of both aesthetic and functional outcomes. When oral cancer resection results in defects that extend beyond the corners of the mouth to the buccal mucosa and buccal skin, it is difficult to perform reconstructive surgery using only a local flap, and a free flap must be used in combination. In this report, we present a case of reconstructive surgery of the corners of the mouth, buccal mucosa, and buccal skin after tumor resection for buccal mucosal squamous cell carcinoma in a 70-year-old man. The patient presented with a change in an oral mucosal ulcer for a period of 1 year. After biopsy of the ulcerated area, he was pathologically diagnosed with squamous cell carcinoma. After tumor resection, including the corners of the mouth, lips, and cheek skin, and neck dissection, the patient underwent reconstructive surgery using an extended upper lip flap combined with an Estlander flap and a free anterolateral thigh flap. Two months after surgery, the patient was able to consume regular food. At 24 months of follow-up, the patient was able to speak normally without any restrictive symptoms such as fluid leakage from the corner of the mouth. Lip sensation restoration was optimal. This method using the combination of an anterolateral thigh flap and extended Estlander flap is a markedly useful option for reconstructive surgery of defects around the corner of the mouth caused by wide excision of invasive cancer.

Does different timing of hip and knee joint extension during take-off affect backstroke start performance?

This study investigated how the difference in the timing of the extension of the joints of the lower limbs during take-off affects the backstroke start performance. Eleven backstroke swimmers performed three lower-limb joint extension sequences of backstroke start: knee extension after hip extension (KAH), simultaneous hip and knee extension (SHK), and knee extension before hip extension (KBH). The shortest 5-m time was performed at KAH (1.90 ± 0.26 s), followed by a performance at SHK (2.12 ± 0.52 s) and KBH (2.47 ± 0.61 s). The greater trochanter (GT) vertical positions at toe-off were higher at KAH and SHK than at KBH. KAH had a shorter entry range, defined as the horizontal distance from the fingertip (FT) to the GT entry in the water, than KBH and SHK. A positive correlation was noted between the entry range and the 5-m time at KAH (r = 0.79). In addition, a negative correlation was observed between the GT vertical position at toe-off and the entry range at KAH (r = -0.65). The results suggested that KAH makes it easier to take the arched-back posture after toe-off, allowing the performance of a hole-entry technique that reduces the entry range and the 5-m time.

Relationship between dolphin kick movement in humans and velocity during undulatory underwater swimming.

The present study was conducted to identify the kinematic variables associated with dolphin kick performance during the acceleration and deceleration phases. Nine male competitive swimmers performed 3-5 × 15-m dolphin kick swimming trials with maximum effort. The underwater motion of the dolphin kick was recorded using a digital video camera for a two-dimensional motion analysis. Upper-lower trunk and leg angles in addition to shoulder, hip, and knee joint angles were calculated as kinematic variables. The average horizontal velocity of the greater trochanter during two cycles of the dolphin kick correlated with the angular displacement of the lower trunk in the acceleration (r = -0.715, p < 0.05) and deceleration phases (r = 0.682, p < 0.05). Furthermore, greater angular displacement of the lower trunk was associated with smaller angular displacement of the upper leg and greater angular displacement of the hip, knee, and lower leg in both phases. These results suggest that the movement of the lower trunk is a key kinematic variable for dolphin kick performance, and also that swimming coaches and swimmers need to focus on the movement of the lower trunk as well as upper-lower legs in order to improve dolphin kick motion.

Usefulness of fluorescence visualization-guided surgery for early-stage tongue squamous cell carcinoma compared to iodine vital staining.

BACKGROUND: In the most cases of oral squamous cell carcinoma (OSCC), oral epithelial dysplasia (OED) is found adjacent to the primary tumor. The delineation of surgical margins for OSCC is critical to minimize the risk for local recurrence. The aim of this study is to demonstrate that the fluorescence visualization (FV)- device can delineated the lesion visualizes OED of adjacent primary tumors by histopathologically comparison to conventional iodine vital staining. MATERIAL AND METHODS: The study involved 40 patients with superficial tongue squamous cell carcinoma treated from July 2016 to July 2018 at the Oral Cancer Center, Tokyo Dental College. RESULTS: Cytokeratin 13 (CK13) expression rate in the area of fluorescence visualization loss (FVL) was significantly lower than that in the area of fluorescence visualization retention (FVR). In addition, CK17, Ki-67, and p53 expression rates were significantly higher in FVL than FVR. There was no significant difference in the delineation rate or area between FVL and iodine-unstained area. High-grade dysplasia was observed most frequently at the FV and iodine-unstained boundary, but no significant pathological differences were found. CONCLUSION: We strongly suggest the FV-guided surgery is a useful method for accurate resection in early-stage tongue squamous cell carcinoma.

Does ankle joint flexibility affect underwater kicking efficiency and three-dimensional kinematics?

Ankle flexibility is critical to obtain a high swimming velocity in undulatory underwater swimming (UUS). The present study investigated the Froude (propelling) efficiency and three-dimensional (3D) kinematics of human UUS following the extrinsic restriction of the ankle by tape application. In Experiment 1, swimmers (9 male and 8 female college swimmers) performed UUS trials involving normal swimming (Normal) and swimming with tape application at the ankle (Tape). Kicking frequency was controlled in both settings. UUS kinematics were obtained with a two-dimensional motion analysis. Swimming velocity significantly decreased during swimming with tape application compared with that during normal swimming (Normal, 1.33 m·s-1; Tape, 1.26 m·s-1, p < 0.05). The Froude efficiency was not affected (Normal, 0.77; Tape, 0.76), and ankle plantar angle did not decrease during swimming (Normal, 159.02°; Tape, 160.38°). In Experiment 2, lower limb rotations of a male swimmer were analysed using 3D motion analysis under the same conditions as Experiment 1. An insufficient forefoot rotation was observed during downstroke kicks (the phase of the highest acceleration to forward direction). These findings suggest that UUS velocity is affected by the mobility of end effector.

Fabrication of tunable diffraction grating by imprint lithography with photoresist mold.

We fabricated a deformable transmission silicone [poly(dimethylsiloxane)] grating using a two-beam interference method and imprint lithography and evaluated its optical characteristics during a compression process. The grating pattern with 0.43 µm depth and 1.0 µm pitch was created on a silicone surface by an imprinting process with a photoresist mold to realize a simple, low-cost fabrication process. The first-order diffraction transmittance of this grating reached 10.3% at 632.8 nm wavelength. We also measured the relationship between the grating period and compressive stress to the fabricated elements. The grating period changed from 1.0 µm to 0.84 µm by 16.6% compression of the fabricated element in one direction, perpendicular to the grooves, and the first-order diffraction transmittance was 8.6%.

Factors Influencing Spike Jump Height in Female College Volleyball Players.

Ikeda, Y, Sasaki, Y, and Hamano, R. Factors influencing spike jump height in female college volleyball players. J Strength Cond Res 32(1): 267-273, 2018-The purpose of this study was to examine factors influencing spike jump (SPJ) performance by female competitive volleyball players through comparisons of the kinematic data of SPJ with those of the standing long jump (SLJ) and vertical jump (VJ). Seventeen female competitive volleyball players were asked to perform SPJ, SLJ, and VJ. Motion data of SPJ including the approach phase were recorded. Regarding SLJ and VJ, jumping motion and ground reaction force were recorded during each performance. The results obtained showed that SPJ height correlated with vertical velocity at take-off, horizontal velocity at third step contact, and the deceleration of horizontal velocity from third step contact to take-off. Regarding the relationship among SPJ, SLJ, and VJ, the relationship between SPJ and SLJ was stronger than that with VJ. The contributions of the hip, knee, and ankle muscles to the propulsive phase of SLJ were 39.7%, 21.1%, and 39.2%, respectively, whereas their contributions to VJ were 36.2%, 30.2%, and 33.6%, respectively. The vertical velocity of SPJ at take-off correlated with hip work and ankle peak power in SLJ and knee peak power in VJ. These results suggest the importance of enhancing horizontal and vertical jumping abilities separately to improve the height of SPJ because the primary generator for power production seems to depend on jump direction.

Sol-gel zirconia diffraction grating using a soft imprinting process.

A zirconia diffraction grating with high diffraction efficiency was fabricated using a soft imprinting technique and a sol-gel method. The imprinting process involved dropping zirconia nanoparticle dispersion onto a silicone (polydimethylsiloxane) mold, which was transferred from the patterned photoresist grating through the molding process. The first-order diffraction transmittance of the fabricated zirconia gel grating with a 1.0-µm pitch and a depth of 0.58 µm reached 29.4% at a wavelength of 632.8 nm (zeroth-order transmittance: 18.1%). This high aspect ratio grating can be fabricated in a simpler manner and at lower cost compared to conventional gratings.

Does installation of the backstroke start device reduce 15-m start time in swimming?

The purpose of this study was to determine the installation of the backstroke start device reduces 15-m time. Thirteen college swimmers participated in this study. The aerial start and underwater motions were recorded with two digital video cameras. The center of mass (CM) of the swimmer, angular displacements and velocities of the shoulder, hip and knee joints were calculated. As an indicator of performance, the 5- and 15-m times were measured. The 5- and 15-m times in the backstroke start device condition were significantly shorter than in the non-backstroke start device condition. The vertical velocities of the CM at hand-off and toe-off in the backstroke start device condition were significantly greater than in the non-backstroke start device condition, while there was no significant difference in the CM horizontal velocity at toe-off. As a result, the height of the great trochanter at entry of the fingertips, with the backstroke start device, was 15 cm higher than in the non-backstroke start device condition. In addition, the CM horizontal velocities at 5 m in the backstroke start device condition were significantly greater than those of the non-backstroke start device. Thus, the use of the backstroke start device may reduce the 15-m time by diminution of the entry area.

Design of luciferase-displaying protein nanoparticles for use as highly sensitive immunoassay detection probes.

In this study, we developed a protein nanoparticle-based immunoassay to detect cancer biomarkers using a bioluminescent fusion protein. This method relies on the use of protein nanoparticles comprised of genetically-engineered elastin-like polypeptides (ELPs) fused with poly-aspartic acid tails (ELP-D), previously developed in our lab. The sizes of the self-assembled ELP-D nanoparticles can be regulated at the nanoscale by charged repulsion of the poly-aspartic acid chains. To improve the sensitivity of enzyme-linked immunosorbent assays (ELISAs), we herein demonstrate the multivalent display of NanoLuc® (Nluc) luciferase and a biotin acceptor peptide (BAP) on the surfaces of ELP-D nanoparticles, and demonstrate the sensitivity of these multivalent nanoparticles as detection probes. The fusion protein comprised of ELP-D and Nluc-BAP (ELP-D-Nluc-BAP) was found to form nanoparticles with Nluc and BAP displayed multivalently on their surfaces. Moreover, the use of the nanoparticles in ELISA resulted in a detection sensitivity for α-fetoprotein (AFP) about 10 times higher than that of an assay relying on the use of the monomeric version of the fusion protein. Taken together, ELP-D-based nanoparticles displaying multivalent luciferases on their surfaces enable the construction of an ELISA with enhanced sensitivity.

High-speed imaging of sound using parallel phase-shifting interferometry.

Sound-field imaging, the visualization of spatial and temporal distribution of acoustical properties such as sound pressure, is useful for understanding acoustical phenomena. This study investigated the use of parallel phase-shifting interferometry (PPSI) with a high-speed polarization camera for imaging a sound field, particularly high-speed imaging of propagating sound waves. The experimental results showed that the instantaneous sound field, which was generated by ultrasonic transducers driven by a pure tone of 40 kHz, was quantitatively imaged. Hence, PPSI can be used in acoustical applications requiring spatial information of sound pressure.

Functional Role of the Front and Back Legs During a Track Start with Special Reference to an Inverted Pendulum Model in College Swimmers.

This study investigated factors that determine the velocity of the center of mass (CM) and flight distance from a track start to devise effective technical and physical training methods. Nine male and 5 female competitive swimmers participated in this study. Kinematics and ground reaction forces of the front and back legs were recorded using a video camera and force plates. The track start was modeled as an inverted pendulum system including a compliant leg, connecting the CM and front edge of the starting block. The increase in the horizontal velocity of the CM immediately after the start signal was closely correlated with the rotational component of the inverted pendulum. This rotational component at hands-off was significantly correlated with the average vertical force of the back plate from the start signal to hands-off (r = .967, P < .001). The flight distance / height was significantly correlated with the average vertical force of the front plate from the back foot-off to front foot-off (r = .783, P < .01). The results indicate that the legs on the starting block in the track start play a different role in the behavior of the inverted pendulum.

Immobilization of immunoglobulin-G-binding domain of Protein A on a gold surface modified with biotin ligase.

Protein A from Staphylococcus aureus specifically binds to the Fc region of immunoglobulin G (IgG) and is widely used as a scaffold for the immobilization of IgG antibodies on solid supports. It is known that the oriented immobilization of Protein A on solid supports enhances its antibody-binding capability in comparison with immobilization in a random manner. In the current work, we developed a novel method for the oriented immobilization of the IgG-binding domain of Protein A based on the biotinylation reaction from archaeon Sulfolobus tokodaii. Biotinylation from S. tokodaii has a unique property in that the enzyme, biotin protein ligase (BPL), forms a stable complex with its biotinylated substrate protein, biotin carboxyl carrier protein (BCCP). Here, BCCP was fused to the IgG-binding domain of Protein A, and the resulting fusion protein was immobilized on the BPL-modified gold surface of the sensor chip for quartz crystal microbalance through complexation between BCCP and BPL. The layer of the IgG-binding domain prepared in this way successfully captured the antibody, and the captured antibody retained high antigen-binding capability.

Comparison of the snatch technique for female weightlifters at the 2008 Asian championships.

The purpose of this study was to compare the snatch techniques of Japanese and international female weightlifters. Two high-speed cameras operating at 250 Hz were used to record the snatch lifts of the 5 best weightlifters in the snatch and 5 Japanese weightlifters during the 2008 Asian Weightlifting Championships held in Japan. The results revealed that the forward velocity of the barbell for the Japanese weightlifters during the second pull was significantly greater than that for the best weightlifters and that barbell trajectories of Japanese weightlifters except for the 53-kg class crossed the vertical reference line with great forward displacement of the barbell. In addition, the best weightlifters extended the knee and hip joints during the second pull earlier than the Japanese weightlifters did. These findings indicate that it is important to improve the way of pulling the barbell during the second pull for Japanese female weightlifters.