Availability of death review of children using death certificates and forensic autopsy results.

The Model Project for Child Death Review (CDR) was initiated in Japan, but parental consent is required for detailed investigations. We proposed an alternative method to review child deaths using death certificates and forensic autopsy results when parental consent is not provided. We extracted and reviewed death certificates for the deceased younger than 18 years from among all certificates submitted in Shiga Prefecture between 2015 and 2017. In addition, we analyzed autopsy records in cases that underwent forensic autopsy. The prevalence of each cause of death was compared among age groups. The situation and circumstances of unnatural deaths were analyzed in detail. Of 131 certificates, unnatural deaths accounted for 29.7 %. The prevalence of each cause of death significantly differed among age groups. Malignant disease and suicide were most common in school-aged children and congenital disease was most common in infants. Suicide was the leading cause of unnatural death, followed by suffocation, which was most common in infants. Situations where suffocation was reported included co-sleeping with the mother and breastfeeding. Despite parental consent not being obtained, the trends of regional child deaths and the circumstances of accidental deaths were clarified by the present method. However, the results of detailed investigation were lacking. This study provided basic information for implementing detailed methods and procedures for CDR at the governmental level. To perform optimal CDR, legislation for collecting detailed information without parental consent is required.

Virus Particle Detection by Convolutional Neural Network in Transmission Electron Microscopy Images.

A new computational method for the detection of virus particles in transmission electron microscopy (TEM) images is presented. Our approach is to use a convolutional neural network that transforms a TEM image to a probabilistic map that indicates where virus particles exist in the image. Our proposed approach automatically and simultaneously learns both discriminative features and classifier for virus particle detection by machine learning, in contrast to existing methods that are based on handcrafted features that yield many false positives and require several postprocessing steps. The detection performance of the proposed method was assessed against a dataset of TEM images containing feline calicivirus particles and compared with several existing detection methods, and the state-of-the-art performance of the developed method for detecting virus was demonstrated. Since our method is based on supervised learning that requires both the input images and their corresponding annotations, it is basically used for detection of already-known viruses. However, the method is highly flexible, and the convolutional networks can adapt themselves to any virus particles by learning automatically from an annotated dataset.

Late esophageal wall injury after mesh repair for large esophageal hiatal hernia: a case report.

BACKGROUND: Plication of an esophageal hiatus during surgery for esophageal hiatal hernia is a common practice; however, a mesh may be used if the hiatus is markedly enlarged. Recently, various late complications occurring as a result of mesh-induced esophageal and/or gastric wall injuries have been reported. CASE PRESENTATION: A 71-year-old woman presented at a neighborhood clinic in November 2010 with chief complaints of respiratory distress on exertion and heartburn. She was diagnosed as having a large esophageal hiatal hernia and was treated at our hospital using a laparoscopic Toupet fundoplication with mesh repair of the esophageal hiatus. Two years and 1 month after the operation, the patient complained of a bowel obstruction. An upper gastrointestinal endoscopy revealed that part of the mesh had extruded into the esophageal lumen, resulting in ulceration and stricture of the esophageal wall. Endoscopic balloon dilatation failed to improve the esophageal stricture. In July 2012, the patient underwent a lower esophagectomy with proximal gastrectomy and was discharged on the 25th hospital day. CONCLUSIONS: We experienced a rare case requiring surgical treatment for a mesh-induced esophageal wall injury after surgery for a giant esophageal hiatal hernia. The selection of a soft, durable mash and its firm securement at a position distant from the gastrointestinal wall may be important to avoid late esophageal wall injury.

Photovoltaic Rudorffites: Lead-Free Silver Bismuth Halides Alternative to Hybrid Lead Halide Perovskites.

Hybrid CPbX3 (C: Cs, CH3 NH3 ; X: Br, I) perovskites possess excellent photovoltaic properties but are highly toxic, which hinders their practical application. Unfortunately, all Pb-free alternatives based on Sn and Ge are extremely unstable. Although stable and non-toxic C2 ABX6 double perovskites based on alternating corner-shared AX6 and BX6 octahedra (A=Ag, Cu; B=Bi, Sb) are possible, they have indirect and wide band gaps of over 2 eV. However, is it necessary to keep the corner-shared perovskite structure to retain good photovoltaic properties? Here, we demonstrate another family of photovoltaic halides based on edge-shared AX6 and BX6 octahedra with the general formula Aa Bb Xx (x=a+3 b) such as Ag3 BiI6 , Ag2 BiI5 , AgBiI4 , AgBi2 I7 . As perovskites were named after their prototype oxide CaTiO3 discovered by Lev Perovski, we propose to name these new ABX halides as rudorffites after Walter Rüdorff, who discovered their prototype oxide NaVO2 . We studied structural and optoelectronic properties of several highly stable and promising Ag-Bi-I photovoltaic rudorffites that feature direct band gaps in the range of 1.79-1.83 eV and demonstrated a proof-of-concept FTO/c-m-TiO2 /Ag3 BiI6 /PTAA/Au (FTO: fluorine-doped tin oxide, PTAA: poly[bis(4-phenyl)(2,4,6-trimethylphenyl)amine], c: compact, m: mesoporous) solar cell with photoconversion efficiency of 4.3 %.

Development of rhabdomyolysis in a child after norovirus gastroenteritis.

BACKGROUND: In children, the most significant cause of rhabdomyolysis or muscle breakdown is viral infection. However, there are no reports that norovirus, a gastroenteric virus that commonly infects children, specifically causes rhabdomyolysis. Here, we report the first pediatric case of norovirus-associated rhabdomyolysis. CASE PRESENTATION: The patient, a 2-year-old boy with fever, diarrhea, and vomiting, was referred to our hospital with dysstasia and transaminitis. He was diagnosed with rhabdomyolysis. Additionally, norovirus genogroup GII was detected from stool samples by real-time quantitative reverse transcription Polymerase Chain Reaction, and thereafter, the norovirus GII.4 variant was identified. CONCLUSION: However, the association between rhabdomyolysis and the isolated norovirus variant was not clarified. After treatment the patient recovered without renal failure or disseminated intravascular coagulation. Rhabdomyolysis is a disease for which there is a need for early detection and treatment. If abnormal posture or muscle weakness is observed during the course of gastroenteritis, blood and urinary tests should be performed to rule out rhabdomyolysis.

Formation of Ordered 4-Fluorobenzenethiol Self-Assembled Monolayers on Au(111) from Vapor Phase Deposition.

Self-assembled monolayers (SAMs) were formed by the spontaneous adsorption of 4-fluorobenzenethiol (4-FBT) on Au(111) using both solution and ambient-pressure vapor deposition methods at room temperature. The surface structure and thermal desorption properties of 4-FBT SAMs were examined by scanning tunneling microscopy (STM) and thermal desorption spectroscopy (TDS). STM imaging showed that 4-FBT SAMs formed in solution at room temperature mainly contained disordered phase with gold adatom islands, while those formed by ambient-pressure vapor deposition had well-ordered phase, which can be described as a (2 x 2√13)R45 degrees structure. In addition, thermal desorption spectroscopy (TDS) measurements showed that strong desorption peak for parent mass fragment (m/z = 128, FC6H5SH+) for 4-FBT SAMs on Au(111) was observed at 460 K, as a result of hydrogen abstract reaction of chemisorbed thiolates during desorption.

Effect of Solution Concentration on the Formation of Ordered Domains in Pentachlorobenzenethiol Self-Assembled Monolayers on Au(111).

The surface structures of self-assembled monolayers (SAMs) formed by the adsorption of pentachlorobenzenethiol (PCBT) molecules on Au(111) as a function of solution concentration were examined by means of scanning tunneling microscopy (STM) to understand the effect of concentration on the formation of ordered domains. STM imaging revealed that PCBT SAMs formed in a 0.01 or 1 mM ethanol solution at room temperature for 20 min contained small ordered domains in the range of several to 20 nm2 and disordered phases, while PCBT SAMs formed in a 0.1 mM ethanol solution were composed of long-range ordered domains in the range of 20 to 50 nm2, which can be assigned as a (4 x √3)R45 degrees packing structure. Interestingly, the bright aggregated domains stacked by π-π interactions between PCBT rings were usually observed around boundary regions of ordered domains. In addition, X-ray photoelectron spectroscopy measurements revealed that ordered PCBT SAMs on Au(111) were formed via the chemical interactions between the sulfur atom of PCBT and gold surface. Our results obtained here will be very useful in understanding the formation and structure of PCBT SAMs on gold surfaces.

Small Intestinal Metastasis from Esophageal Squamous Cell Carcinoma Presenting with Perforated Peritonitis.

Metastatic tumors of the small intestinal tract from extra-abdominal sites are rare. We report herein a rare case of small intestinal metastasis from esophageal carcinoma that presented with perforated peritonitis. A 71-year-old man with dysphagia was referred to our hospital for further examination and treatment, and was diagnosed with type 3 advanced esophageal squamous cell carcinoma of the lower thoracic esophagus. Based on a diagnosis of Stage II cancer, a radical esophagectomy with three-field lymph node dissection was performed after neoadjuvant chemotherapy composed of 5-fluorouracil plus cisplatin. Pathological examination of the resected specimen revealed a moderately differentiated squamous cell carcinoma, extending into the adventitia with lymph node metastasis (T3, N2, M0, Stage III). During postoperative adjuvant chemotherapy, the patient complained of abdominal pain and was found to have perforated peritonitis. Emergency laparotomy was performed. A jejunal perforation with a submucosal nodule approximately 80 cm distal from the ligament of Treitz was detected, and completely resected by jejunal partial resection. Histopathology of the specimen showed a perforation of the small intestine due to metastasis of esophageal squamous cell carcinoma with mesenteric lymph node metastasis. The patient died of cancer 9 months after surgery. An extremely rare case of small intestinal metastasis from esophageal carcinoma presenting with perforated peritonitis was described.

The relationship between repolarization parameters and serum electrolyte levels in patients with J wave syndromes.

BACKGROUND: Intravenous administration of magnesium (Mg(2+)) is effective for polymorphic ventricular tachycardia via homogenization of transmural ventricular repolarization. Mg(2+) likely plays some role in the heterogeneity of repolarization in J wave syndromes. OBJECTIVE: To investigate the relationship between the repolarization parameters and serum Mg(2+), potassium (K(+)), and calcium (Ca(2+)) levels in J wave syndromes. METHODS: Thirteen J-wave syndrome patients (Brugada and early repolarization [ER] syndromes), with documented episodes of ventricular fibrillation (VF), and 13 ER pattern (ERP) or Brugada type ECG patients were enrolled (25 males, mean age 48 ± 15 years). The 12-lead ECG-derived parameters including the QT, QT dispersion (QTd), Tpeak-Tend (Tp-e) interval, Tp-e dispersion (Tp-ed), Tp-e/QT ratio, and activation recovery interval (ARI) dispersion were calculated; the correlations between these parameters and electrolytes including Mg(2+), K(+), and Ca(2+) were analyzed. RESULTS: Although there was no association between serum K(+) or Ca(2+) and QTd, there was a strong negative correlation between serum Mg(2+) and QTd in J wave syndrome patients with a history of VF (r = -0.715, p = 0.006). Also, there was a tendency for a negative correlation between Mg(2+) and Tp-ed or ARI dispersion in J wave syndrome patients with a history of VF (r = -0.513, p = 0.072 and r = -0.53, p = 0.063, respectively). On the other hand, in 13 patients with a Brugada type ECG or ERP, no correlation was observed between serum Mg(2+) and the QTd, Tp-ed or ARI dispersion. CONCLUSION: Serum Mg(2+) may play an important role in the cardiac repolarization process in J wave syndromes.

Formation and structure of ordered pentachlorobenzenethiol self-assembled monolayers on Au(111) studied by scanning tunneling microscopy.

Molecular-scale surface structures of self-assembled monolayers (SAMs) prepared by the adsorption of pentafluorobenzenethiols (PFBT) and pentachlorobenzenethiols (PCBT) on Au(111) were investigated by scanning tunneling microscopy (STM). High-resolution STM imaging revealed that PFBT SAMs on Au(111) have long-range ordered domains with a row structure at room temperature, whereas PCBT SAMs have small ordered domains, with disordered domains as the main phase. This may reflect the larger diffusion barriers of PCBT molecules on Au(111) surfaces compared to PFBT molecules during SAM formation. The structural transitions of PCBT SAMs from the mixed phase containing disordered and ordered domains to the uniform ordered domains were observed at 50 degrees C depending on immersion time. The ordered packing structure of PCBT SAMs is an incommensurate (square root of 3 x square root of 10)R45 degrees structure, which differs from that of PFBT SAMs with a (2 x 5 square root of 13)R30 degrees structure. We found that a small modification in the chemical structures of aromatic rings using a halo-substituent strongly affects the self-assembly mechanism and packing structure of aromatic thiol SAMs on Au(111). Moreover, we demonstrated that highly ordered PCBT SAMs can be obtained at a solution temperature of 50 degrees C after immersion for 60 min.

Effect of molecular desorption on the electronic properties of self-assembled polarizable molecular monolayers.

We investigated the interfacial electronic properties of self-assembled monolayers (SAM)-modified Au metal surface at elevated temperatures. We observed that the work functions of the Au metal surfaces modified with SAMs changed differently under elevated-temperature conditions based on the type of SAMs categorized by three different features based on chemical anchoring group, molecular backbone structure, and the direction of the dipole moment. The temperature-dependent work function of the SAM-modified Au metal could be explained in terms of the molecular binding energy and the thermal stability of the SAMs, which were investigated with thermal desorption spectroscopic measurements and were explained with molecular modeling. Our study will aid in understanding the electronic properties at the interface between SAMs and metals in organic electronic devices if an annealing treatment is applied.

Selective aerobic oxidation of methanol in the coexistence of amines by nanoporous gold catalysts: highly efficient synthesis of formamides.

Holey gold: Highly selective aerobic oxidation of methanol over alkylamines was achieved with a reusable nanoporous gold (AuNPore) catalyst that was fabricated from a Au-Ag alloy. This excellent chemoselectivity enabled direct N-formylation of alkylamines from a mixture of methanol and amines. The remarkable catalytic activity was attributed to the synergistic effect between gold and the residual silver remaining in the AuNPore.

Growth, solvent effects, and thermal desorption behavior of octylthiocyanate self-assembled monolayers on Au(111).

The growth process, solvent effects, and thermal desorption behavior of octylthiocyanate [OTC, CH(3)(CH(2))(7)S-CN] self-assembled monolayers (SAMs) on Au(111) were characterized by scanning tunneling microscopy (STM), X-ray photoelectron spectroscopy (XPS), and thermal desorption spectroscopy (TDS). To investigate their growth processes, octanethiol [OT, CH(3)(CH(2))(7)S-H] and OTC SAMs were prepared in 0.5 µM ethanol solution at room temperature as a function of immersion time: 10 min, 1 h, 2 h, and 24 h. STM imaging revealed that OT SAMs underwent a phase transition from the liquid phase containing striped-phase domains to the closely packed c(4 × 2) phase. OTC SAMs underwent a different phase transition from the liquid phase containing aggregated molecules to the disordered phase containing striped-phase domains. The adsorption amounts of OTC SAMs formed after immersion for 10 min and 24 h were measured to be 16% and 30% smaller than those of OT SAMs under the same conditions. STM and XPS results show that the growth kinetics of OTC SAMs on Au(111) are much slower than those of OT SAMs. Hexane resulted in OTC SAMs of higher structural quality than ethanol, DMF, or toluene. TDS measurements revealed that the relative desorption intensities of octanethiolate (C8S(+), monomer) and dioctyl disulfide (C8SSC8(+), dimer) to octanethiol (C8SH(+)) fragments for OTC SAMs were much weaker than those of OT SAMs. This is because desorption of monomers and dimers is strongly suppressed by low surface coverage of OTC SAMs, as revealed by STM observations.

Spontaneous desorption and phase transitions of self-assembled alkanethiol and alicyclic thiol monolayers chemisorbed on Au(111) in ultrahigh vacuum at room temperature.

Scanning tunneling microscopy (STM) and X-ray photoelectron spectroscopy (XPS) were used to examine the surface structure and adsorption conditions of hexanethiol (HT) and cyclohexanethiol (CHT) self-assembled monolayers (SAMs) on Au(111) as a function of storage period in ultrahigh vacuum (UHV) conditions of 3×10(-7) Pa at room temperature (RT). STM imaging revealed that after storage for 7 days, HT SAMs underwent phase transitions from c(4×2) phase to low coverage 4×√3 phase. This transition is due to a structural rearrangement of hexanethiolates that results from the spontaneous desorption of chemisorbed HT molecules on Au(111) surface. XPS measurements showed approximately 28% reduction in sulfur coverage, which indicates desorption of hexanethiolates from the surfaces. Contrary to HT SAMs, the structural order of CHT SAMs with (5×2√3)R35° phase completely disappeared after storage for 3 or 7 days. XPS results show desorption of more than 80% of the cyclohexanethiolates, even after storage for 3 days. We found that spontaneous desorption of CHT molecules on Au(111) in UHV at RT occurred quickly, whereas spontaneous desorption of HT molecules was much slower. Thermal desorption spectroscopy (TDS) results suggest CHT SAMs in UHV at RT can desorb more efficiently than HT SAMs due to formation of thiol desorption fragments that result from chemical reactions between surface hydrogen atoms and thiolates on Au(111) surfaces. This study clearly demonstrated that organic thiols chemisorbed on gold surfaces are desorbed spontaneously in UHV at RT and van der Waals interactions play an important role in determining the structural stability of thiolate SAMs in UHV.

Effect of the steric molecular structure of azobenzene on the formation of self-assembled monolayers with a photoswitchable surface morphology.

The growth processes of self-assembled monolayers (SAMs) of two azobenzene disulfides formed on flat gold surfaces were studied to confirm the effect of the intermolecular interactions between azobenzene molecules on the light-triggered surface morphologies of the SAMs. Scanning tunneling microscopy (STM), atomic force microscopy (AFM), thermal desorption spectroscopy (TDS), X-ray photoelectron spectroscopy (XPS), and ultraviolet-visible (UV-vis) absorption spectroscopy were employed to study the SAMs and their growth processes. The SAMs studied were of bulky-substituted azobenzene disulfide (Et-2S), and nonsubstituted azobenzene disulfide (Me-2S), formed on a gold-covered substrate, and had a twisted and a planar structure, respectively. STM-based imaging of the initial stage of the self-assembly of the Et-2S molecules revealed that cleavage of the disulfide bond occurred on the gold surface, and phase-separated domains composed of azobenzenethiolate and dodecanethiolate were formed. Time-dependent AFM-based imaging illustrated the mechanism through which the Et-2S SAM grew-it was through the formation of dendritic aggregates and islands-eventually resulting in phase-separated domains with a wormlike structure. This wormlike structure showed noticeable changes in its surface morphology upon irradiation with UV and visible light. On the other hand, while the growth process for the Me-2S SAM was similar to that of the Et-2S SAM, the final Me-2S SAM had smooth domains whose morphology did not exhibit photoswitchability. The TD and XP spectra of the SAMs showed that the number of adsorbed Et-2S molecules reached a point of saturation after a 24 h long immersion while the number of Me-2S molecules increased even after a 336 h long immersion. Furthermore, the area occupied by the azobenzene moiety in the Et-2S SAM was constant regardless of the immersion time, whereas that in the Me-2S SAM decreased with the immersion time. These results indicated that the strength of the interactions between the azobenzene molecules significantly influenced the aggregate-forming ability in SAMs.

Thoracoscopic esophagectomy while in a prone position for esophageal cancer: a preceding anterior approach method.

BACKGROUND: In 2009, the rate of thoracoscopic esophagectomy for esophageal cancer was about 20% in Japan. This low rate may be due to the difficulty in maintaining a good surgical field and the meticulous procedures that are required. The purpose of this study was to establish and evaluate a new procedure for performing a thoracoscopic esophagectomy while the patient is in a prone position using a preceding anterior approach to make the esophagectomy easier to perform. METHODS: We have performed thoracoscopic esophagectomy using our new procedure in 60 patients with esophageal cancer. Each patient was placed in a prone position and five trocars were inserted; only the left lung was ventilated and a pneumothorax was maintained. The esophagus was mobilized from the anterior structure during the first step and from the posterior structure during the second step. The lymph nodes around the esophagus were also dissected anteriorly and posteriorly. The patients were sequentially divided into two groups and their clinical outcomes were evaluated. RESULTS: The mean operative time for the thoracoscopic procedure for the latter 30 cases (203 min) was shorter than that for the former 30 cases (260 min) (P = 0.001). Among the 52 cases without pleural adhesion, the mean blood loss in the latter 26 cases (18 mL) was also less than that in the former 26 cases (40 mL) (P = 0.027). There were no conversions to a thoracotomy and no operative deaths in this series. Postoperative complications related to the thoracoscopic procedure occurred in 8 cases (27%) in the former group and in 4 cases (13%) in the latter group. CONCLUSIONS: Thoracoscopic esophagectomy with the patient in the prone position using a preceding anterior approach is a safe and feasible procedure. As experience performing the procedure increases, the performance of the procedure stabilizes. This method seems to make the esophagectomy easier to perform.

An alkyl spacer effect on the structure of 4-fluorobenzenethiol and 4-fluorobenzenemethanethiol self-assembled monolayers on Au(111).

Self-assembled monolayers (SAMs) formed by the adsorption of 4-fluorobenzenethiol (4-FBT) and 4-fluorobenzenemethanethiol (4-FBMT) on Au(111) were examined by scanning tunneling microscopy (STM) to understand the effect of a flexible methylene spacer between the sulfur head-group and phenyl group and the effect of solution temperature on the formation and structure of the SAMs. Although the adsorption of 4-FBT on Au(111) at room temperature for 24 h generated only disordered phase SAMs containing gold adatom islands, 4-FBT at 75 degrees C for 2 h formed mixed SAMs: disordered phases and ordered (2 x 12√(2))R10 degrees superlattice with a rectangular unit cell containing six adsorbed molecules. On the other hand, SAMs formed from 4-FBMT, with a methylene spacer, at room temperature for 24 h on Au(111) had irregularly ordered phases containing uniformly distributed VIs with lateral dimensions of 2-5 nm; SAMs formed from 4-FBMT at 75 degrees C for 2 h were composed of slightly improved ordered phases and larger VIs with lateral dimensions of 5-12 nm as a result of Ostwald ripening. From this study, we found that the methylene spacer plays an important role in controlling the structure of SAMs formed from p-substituted fluorinated aromatic thiols.

New invasive patterns as a prognostic factor for superficial esophageal cancer.

BACKGROUND: Prognostic factors for superficial esophageal cancer cannot be limited to such factors as lymph node metastasis (N factor), depth of tumor invasion (T factor), and genetic alterations. The purpose of this study was to examine whether invasive growth patterns of tumors, such as infiltrative growth pattern c (INFc) and budding, represent new useful prognostic factors for superficial esophageal cancer. METHODS: We investigated 87 cases of superficial esophageal cancer in patients treated with radical surgery. First, the invasive growth pattern of the tumor was pathologically evaluated based on the traditional infiltrative growth pattern (INF) classification. Next, new INF criteria were proposed, and the invasive pattern was re-evaluated. We also investigated budding (Bud) in the stroma of the invasive frontal lesion. RESULTS: When the patients were divided into two groups, with and without an INFc component, the group with an INFc component had a poorer outcome than the group without an INFc component. When the group with an INFc component was defined as "new INFc", new INFc was correlated with the T factor (p = 0.006) and the ly factor (lymphatic invasion) (p = 0.041). Bud was correlated with the T factor (p = 0.001), the N factor (p = 0.030), and new INFc (p < 0.001). An analysis of survival revealed new INFc (p = 0.002) and Bud (p = 0.006) to be prognostic factors. The survival of the group with new INFc(+)/Bud(+) was poorer than that with new INFc(-)/Bud(-) (p = 0.007). CONCLUSIONS: New INFc and Bud, which represent new invasive patterns, were prognostic factors for superficial esophageal cancer.

Electronic structure of the buried interface between an organic semiconductor, N,N'-bis(3-methylphenyl)-N,N'-diphenylbenzidine (TPD), and metal surfaces.

The electronic structures of buried interfaces between an organic semiconductor, N,N'-bis(3-methylphenyl)-N,N'-diphenylbenzidine (TPD) and metal surfaces of Au, Ag, Al and Ca were examined by the new experimental method that we have developed recently. In this method the energy levels at the organic/metal interface can be examined without changing the film thickness and related physical parameters e.g., the vacuum levels of the sample in contrast to the widely-used thickness-dependent photoemission experiments. The results were discussed in view of large interfacial dipole moment of the TPD and metal (Au and Ag) contacts.