Enantioselectivity of discretized helical supramolecule consisting of achiral cobalt phthalocyanines via chiral-induced spin selectivity effect.

Enantioselectivity of helical aggregation is conventionally directed either by its homochiral ingredients or by introduction of chiral catalysis. The fundamental question, then, is whether helical aggregation that consists only of achiral components can obtain enantioselectivity in the absence of chiral catalysis. Here, by exploiting enantiospecific interaction due to chiral-induced spin selectivity (CISS) that has been known to work to enantio-separate a racemic mixture of chiral molecules, we demonstrate the enantioselectivity in the assembly of mesoscale helical supramolecules consisting of achiral cobalt phthalocyanines. The helical nature in our supramolecules is revealed to be mesoscopically incorporated by dislocation-induced discretized twists, unlike the case of chiral molecules whose chirality are determined microscopically by chemical bond. The relevance of CISS effect in the discretized helical supramolecules is further confirmed by the appearance of spin-polarized current through the system. These observations mean that the application of CISS-based enantioselectivity is no longer limited to systems with microscopic chirality but is expanded to the one with mesoscopic chirality.

Highly Durable Spin Filter Switching Based on Self-Assembled Chiral Molecular Motor.

Chiral molecules have recently received renewed interest as highly efficient sources of spin-selective charge emission known as chiral-induced spin selectivity (CISS), which potentially offers a fascinating utilization of organic chiral materials in novel solid-state spintronic devices. However, a practical use of CISS remains far from completion, and rather fundamental obstacles such as (i) external controllability of spin, (ii) function durability, and (iii) improvement of spin-polarization efficiency have not been surmounted to date. In this study, these issues are addressed by developing a self-assembled monolayer (SAM) of overcrowded alkene (OCA)-based molecular motor. With this system, it is successfully demonstrated that the direction of spin polarization can be externally and repeatedly manipulated in an extremely stable manner by switching the molecular chirality, which is achieved by a formation of the covalent bonds between the molecules and electrode. In addition, it is found that a higher stereo-ordering architecture of the SAM of OCAs tailored by mixing them with simple alkanethiols considerably enhances the efficiency of spin polarization per a single OCA molecule. All these findings provide the creditable feasibility study for strongly boosting development of CISS-based spintronic devices that can simultaneously fulfill the controllability, durability, and high spin-polarization efficiency.

Viral eradication by direct-acting antivirals does not decrease the serum myostatin level in patients infected with hepatitis C virus.

OBJECTIVES: Myostatin has been assumed to be involved in the development of sarcopenia in patients with chronic liver disease, but the effect of hepatitis C virus (HCV) elimination on myostatin is unclear. The aim of this study was to assess the effect of a sustained virologic response at 24 wk (SVR24) after direct-acting antiviral (DAA) therapy on serum myostatin levels in patients infected with HCV. METHODS: In this single-center retrospective study based on data collected from a university hospital, we analyzed patients infected with HCV who were treated with DAA between 2014 and 2017. We compared the serum myostatin level before and after DAA treatment and evaluated the correlation between myostatin and laboratory data. RESULTS: In the 91 participants, the median myostatin level at the start of DAA and after achieving an SVR24 were 3042 (924-10177) and 3349 (498-7963) pg/mL, respectively. There was no significant difference in the myostatin level between the start of DAA treatment and after achieving an SVR24 (P = 0.79). The serum myostatin levels were significantly higher in men than in women and in patients with cirrhosis than in patients with chronic hepatitis both at the start of DAA and after achieving an SVR24. Serum myostatin levels showed a significant positive correlation with the skeletal muscle index and liver fibrosis markers (e.g., type Ⅳ collagen 7S, aspartate aminotransferase-platelet ratio index score, and fibrosis-4 index). CONCLUSIONS: Viral eradication by DAA treatment did not decrease the serum myostatin level in patients infected with HCV.

Both fecal calprotectin and fecal immunochemical tests are useful in children with inflammatory bowel disease.

BACKGROUND: Noninvasive biomarkers of intestinal inflammation can reduce the number of endoscopies in children with inflammatory bowel disease (IBD). This study aimed to prospectively investigate the usefulness of fecal calprotectin (FCP) and fecal immunochemical test (FIT) in pediatric IBD. METHODS: Patients aged 6-17 years who underwent ileocolonoscopy for established or suspected IBD were eligible for this study. Fecal samples for FCP and FIT were collected before colonoscopy. RESULTS: A total of 251 samples were analyzed: 88 from ulcerative colitis (UC), 74 from Crohn's disease (CD), 75 from healthy controls (HC), and 14 from children with functional gastrointestinal disorders and normal colonoscopy (NC). At IBD diagnosis, both FCP and FIT were significantly higher in the newly diagnosed UC/CD group than in the HC/NC group (P < 0.001). The optimal cutoffs of FCP and FIT to predict IBD diagnosis were 217 mg/kg and 87 ng/mL, respectively. Patients without mucosal healing (MH) showed higher FCP and FIT than those with MH in both UC and CD (P < 0.001). The FCP increased exponentially as the endoscopic activity score increased. The optimal cutoff values of FCP and FIT for predicting MH were 161 mg/kg and 106 ng/mL for UC and 367 mg/kg and 57 ng/mL for CD, respectively. FCP showed better specificity than the FIT. Patients with CD and normal ileocolonoscopy had elevated FCP during active small intestinal inflammation. CONCLUSIONS: Both FCP and FIT correlate well with endoscopic activity in pediatric patients with IBD. The FCP is a superior marker for predicting MH.

Over 3-Years Follow-Up of a Case of Primary Biliary Cholangitis With Autoimmune Hyperthyroidism: Factors Associated With Liver Dysfunction.

We present a rare case of a 50-year-old woman with simultaneous primary biliary cholangitis (PBC) and autoimmune hyperthyroidism in which the factors associated with liver dysfunction were evaluated over a 3-year follow-up period. Although serum thyroid hormone levels improved after the administration of thiamazole, thyroid dysfunction was not directly associated with liver dysfunction. During the follow-up period, anti-hyperlipidemic drug therapy and eradication therapy for Helicobacter pylori (HP) infection caused transient elevation of serum transaminase levels. It should be recognized that serum liver enzyme levels might be affected by various factors, including the therapies for the many complications of PBC.

Features and Outcomes of Children with Ulcerative Colitis who Undergo a Diagnostic Change: A Single-Center Experience.

PURPOSE: A change in diagnosis from ulcerative colitis (UC) to Crohn's disease (CD) has been reported in pediatric inflammatory bowel disease; however, only a few clinical characteristics and predictors of this diagnostic change have been reported. We aimed to describe the clinical characteristics of patients with UC who underwent a change in diagnosis to CD and identify variables associated with the change. METHODS: The medical records of pediatric patients with UC who were followed up at the National Center for Child Health and Development between 2006 and 2019 were retrospectively reviewed. Clinical data on disease phenotype, laboratory parameters, endoscopic findings, and treatment of patients whose diagnosis changed to CD (cCD) were compared to those of patients whose diagnosis remained UC (rUC). RESULTS: Among the 111 patients initially diagnosed with UC, 11 (9.9%) patients were subsequently diagnosed with CD during follow-up. There was no significant difference between the cCD and rUC groups in terms of sex, age at initial diagnosis, and the extent and severity of disease at initial diagnosis. Albumin and hemoglobin levels were significantly lower in the cCD group than in the rUC group. The proportion of patients who required biologics was significantly higher in the cCD group than in the rUC group (p<0.05). CONCLUSION: Approximately 10% children initially diagnosed with UC were subsequently diagnosed with CD. Hypoalbuminemia and anemia at initial diagnosis and use of biologics could be predictors of this diagnostic change.

Tc-99m GSA scintigraphy within the first 3 days after admission as an early predictor of outcome in severe acute liver injury.

Patients with severe acute liver injury (SLI) usually recover spontaneously. However, some SLI patients progress to acute liver failure with varying degrees of hepatic encephalopathy. Acute liver failure is associated with high mortality and can be substantially reduced by liver transplantation. Therefore, distinguishing SLI patients who might progress to acute liver failure and are at a risk of death is important when evaluating patients needing liver transplantation. The present study aimed to determine whether technetium-99m-diethylenetriaminepentaacetic acid galactosyl human serum albumin (Tc-99m GSA) scintigraphy can predict the prognosis of patients with SLI. This prospective observational study included 69 SLI patients. The accuracy of Tc-99m GSA for predicting death or liver transplantation for 6 months was assessed. Between the two groups of patients stratified based on the cut-off values from the receiver operating characteristic curves, 6-month transplant-free survival was compared. Sixteen (23.2%) patients died or underwent liver transplantation from admission (poor outcome). The hepatic accumulation index was calculated by dividing the radioactivity of the liver region of interest by that of the liver-plus-heart region of interest at 15 min (i.e., LHL15). The LHL15 in the 16 patients (0.686) was significantly lower than that in survivors (0.836; P < 0.0001). The optimal LHL15 cut-off for distinguishing poor outcome and survival was 0.737 with a sensitivity of 81.3%, specificity of 88.7%, and area under the curve of 0.907 (95% CI, 0.832-0.981). When patients were divided into two groups based on the LHL15 cut-off value, the 6-month transplant-free survival was significantly lower in patients with an LHL15 level ≤ 0.737. Tc-99m GSA scintigraphy may help predict the prognosis of patients with SLI.

Ustekinumab for children and adolescents with inflammatory bowel disease at a tertiary children's hospital in Japan.

BACKGROUND AND AIM: Ustekinumab is a human monoclonal antibody targeting the p40 subunit of both interleukin-12 and interleukin-23 with reported efficacy to treat Crohn's disease. However, few studies have reported the use of ustekinumab for pediatric inflammatory bowel disease. This study aimed to assess the clinical efficacy and safety of ustekinumab in children and adolescents with inflammatory bowel disease. METHODS: Medical records of patients aged under 20 years with Crohn's disease or Crohn's disease-like inflammatory bowel disease who had received ustekinumab at a Japanese pediatric inflammatory bowel disease center were retrospectively reviewed for efficacy and safety. The primary outcome was the steroid-free clinical remission rate at weeks 26 and 52. The steroid-free remission rate beyond week 52 was also evaluated. Weighted pediatric Crohn's disease activity index and simple endoscopic score for Crohn's disease were used to assess disease activity. RESULTS: Seventeen patients were included (male : female = 8:9, A1a [diagnosed < 10 years old]:A1b [diagnosed ≥ 10 years old] = 8:9). All patients were on ustekinumab at week 26, and 9/10 continued treatment over 1 year. The steroid-free clinical remission rates were 59% at week 26, 50% at week 52, and 70% over 1 year. Three of eight children who underwent endoscopy after ustekinumab introduction achieved endoscopic remission. No serious adverse events were recorded during the study period. CONCLUSIONS: Ustekinumab may be an effective and safe treatment option for pediatric and adolescent Crohn's disease and Crohn's disease-like inflammatory bowel disease patients having nonresponse or adverse reactions to anti-tumor necrosis factor agents.

Calf and arm circumference as simple markers for screening sarcopenia in patients with chronic liver disease.

AIM: To prevent the progression of sarcopenia, early identification is important. We investigated the usefulness of sarcopenia screening tests using the arm and calf circumferences in patients with chronic liver disease. METHODS: This was a single-center cross-sectional study based on data collected from a university hospital. We analyzed simple anthropometric data and sarcopenia-related chemical data or imaging data between April and December 2019. Sarcopenia was defined according to the Japan Society of Hepatology guidelines. RESULTS: In total, 661 patients participated. Low muscle mass and low muscle strength were found in 245 (37.1%) and 153 (23.1%) patients, respectively. Ultimately, 90 (13.6%) patients were diagnosed with sarcopenia. The sarcopenia group was significantly older and had a higher cirrhosis ratio and poorer liver function than the non-sarcopenia group. The sarcopenia group had a significantly lower body mass index, arm circumferences and calf circumferences than the non-sarcopenia group. A receiver operating characteristics analysis for diagnosing sarcopenia by arm and calf circumferences showed respective areas under the curve of 0.89 and 0.91 for men and 0.84 and 0.89 for women. The optimal cut-off values of arm and calf circumferences were respectively determined to be 25.0 and 32.6 cm for men (sensitivity 88.4% and 83.7%; specificity 74.0% and 84.7%) and 22.7 and 32.1 cm for women (sensitivity 66.0% and 85.1%; specificity 90.0% and 81.3%). CONCLUSIONS: The arm and calf circumferences seem useful as simple surrogate markers for screening sarcopenia in patients with chronic liver disease.

Anomalous 2D-Confined Electronic Transport in Layered Organic Charge-Glass Systems.

To get insight into the nature of the electronic fluid in the frustration-driven charge glasses, we investigate in-plane and out-of-plane charge transport for several quasitriangular-lattice organic systems: θ-(BEDT-TTF)_{2}X [X=RbZn(SCN)_{4}, CsZn(SCN)_{4}, and I_{3}]. These compounds host a charge order, charge glass, and Fermi liquid, depending on the strength of the charge frustration. We find that the resistivity exhibits extreme 2D anisotropy and contrasting temperature dependence between the in-plane and out-of-plane directions in the charge-glass phase, unlike in the charge order and metallic states. The experimental features indicate that the frustration-induced charge glass carries an anomalous 2D-confined electronic fluid with possible charge excitations other than conventional quasiparticles.

Impact of Grip Strength in Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib.

Although sarcopenia is characterized by a loss of muscle strength and skeletal muscle mass, few studies have evaluated the effect of muscle strength on hepatocellular carcinoma (HCC) patients. We evaluated the impact of sarcopenia-related factors (grip strength (GS) and the skeletal muscle index (SMI)) on the survival among lenvatinib-treated unresectable HCC (u-HCC) patients. This single-center cohort study was conducted at a university hospital. The study population included 63 lenvatinib-treated u-HCC patients managed between April 2018 and April 2020. A decreased GS and decreased SMI were found in 21 (33.3%) and 22 (34.9%) patients, respectively. The overall survival (OS) of the normal GS group was significantly higher than that of the decreased GS group, while that of the normal and decreased SMI groups did not differ markedly. There were no significant differences in the progression-free survival between the normal GS and decreased GS groups or the normal SMI and decreased SMI groups. A multivariate Cox proportional hazards model showed that modified albumin-bilirubin-grade (mALBI) 2b (hazard ratio (HR) 4.39) and a decreased GS (HR 3.55) were independently associated with an increased risk of poor prognosis. In addition to the hepatic functional reserve, a decreased GS was a poor prognostic factor in lenvatinib-treated u-HCC patients.

Sustained virologic response by direct-acting antivirals suppresses skeletal muscle loss in hepatitis C virus infection.

BACKGROUND AND AIM: Although chronic liver disease is associated with secondary sarcopenia, the effect of primary disease treatment (hepatitis C virus elimination) on the skeletal muscle is unclear. This study aimed to determine the effect of a sustained virologic response at 24 weeks following direct-acting antiviral therapy on the skeletal muscle in hepatitis C virus-infected patients. METHODS: Hepatitis C virus-infected patients treated with direct-acting antivirals between 2014 and 2017 in our hospital were included. We evaluated the skeletal muscle index and intramuscular adipose tissue content at the third lumbar vertebra on abdominal computed tomography and compared the rate of change in the skeletal muscle index per year and intramuscular adipose tissue content per year before and after direct-acting antiviral treatment. RESULTS: Ninety-two patients participated. At sustained virologic response at 24 weeks, liver test results, including fibrosis marker levels, were significantly improved compared to those before direct-acting antiviral treatment. Skeletal muscle index measured before direct-acting antiviral treatment initiation was significantly lower than that at the first computed tomography scan. However, no significant change was found between the skeletal muscle index at the second computed tomography scan and final follow up. The rate of change in skeletal muscle index measured after direct-acting antiviral treatment was significantly higher than that before direct-acting antiviral treatment (-0.07 vs -0.99% per year). There was no significant difference between the change in intramuscular adipose tissue content before and after direct-acting antiviral treatment. CONCLUSIONS: Viral eradication by direct-acting antiviral treatment improved the liver function and suppressed skeletal muscle loss in hepatitis C virus-infected patients.

Using Linguistic Properties of Place Specification for Network Naming to Improve Mobility Performance.

By considering the definitions and properties from the field of linguistics regarding place specification, a questionnaire that can be used to improve naming in networks is obtained. The questionnaire helps introduce the idea of place specification from linguistics and the concept of metric spaces into network naming schemes. The questionnaire results are used to improve the basic Information-Centric Networking (ICN) architecture's notoriously lax network naming structure. The improvements are realized by leveraging components from the Named-Node Network Architecture, a minor ICN design, to supply the resulting network architecture with the properties the questionnaire highlights. Evaluation results from experiments demonstrate that modifying the network architecture so that the proposed questionnaire is satisfied results in achieving high mobility performance. Specifically, the proposed system can obtain mean application goodput at above 88 % of the ideal result, with a delay below 0.104 s and with the network time-out Interest ratio below 0.082 for the proposed single mobile push producer, single mobile consumer scenario, even when the nodes reach the maximum tested speed of 14 m/s.

Supramolecular Polymerization in Liquid Crystalline Media: Toward Modular Synthesis of Multifunctional Core-Shell Columnar Liquid Crystals.

Recently, we discovered a modular synthetic approach for constructing core-shell columnar liquid crystals (LCs) by supramolecular polymerization in LC media. In the present work, we successfully confirmed that our modular synthetic approach has the potential to be widely extended to the development of multifunctional columnar LCs. Herein, we constructed the first core-shell columnar LC that was proved to be orientable by both electric and magnetic fields by the supramolecular polymerization of NODiskNH* in a nematic LC medium of 4-cyano-4'-pentyloxybiphenyl (5OCB). NODiskNH* is a chiral benzenetricarboxamide derivative bearing 2,2,6,6-tetramethylpiperidine 1-oxyl termini, which is known to form a helical supramolecular polymer via a triple hydrogen-bonding array. NODiskNH* alone formed a hydrogen-bonded liquid phase without any long-range structural ordering. However, a nematic LC medium of 5OCB, when mixed with NODiskNH* at a molar ratio of 1:3, underwent a "structural order-increasing" mesophase transition, affording an optically active single LC phase with a hexagonally arranged core-shell columnar geometry in a temperature range from 113 to 51 °C. Unprecedentedly, this core-shell columnar LC can orient its columns both electrically and magnetically, resulting in unidirectional columnar ordering.

A Novel Four Single-Sideband M-QAM Modulation Scheme Using a Shadow Equalizer for MIMO System Toward 5G Communications.

Single-sideband (SSB) modulation through Hilbert transformation has successfully transmitted data using only half the bandwidth of the traditional scheme for the same amount of contained information. Toward this end, the four single-sideband (4-SSB) approach for high order modulation is a promising approach for the next-generation communications by applying soft-input soft-output (SISO) equalizer algorithms over orthogonal frequency division multiplexing (OFDM). However, OFDM is challenging for realizing the feasible 5G communications, compared to the emerging techniques, e.g., non-orthogonal multiple access (NOMA), orthogonal multiple access (OMA) or multiple-input multiple-output (MIMO). Since the 4-SSB is an orthogonal modulation which was successfully applied over the traditional OFDM, in this article, we propose a novel 4-SSB modulation scheme over OFDM Guard Interval (GI) and massive MIMO. Besides the carrier signal, from the receiver side, we also apply the shadow equalizer algorithm in the uncoded and coded environment using turbo codes to achieve the 4-SSB with high efficiency from low complexity and energy consumption for 5G. The evaluation results validate that our system consumes lower energy due to low complexity gained from same number of iterations without the heavy decoding as of the 4-SSB SISO based on the turbo equalizer. In addition, the 4-SSB over the OFDM GI achieves the best performance among the relevant approaches conducted in 4-SSB. The proposal then acts as a practical communication system designed to solve the inter-symbol interference (ISI) induced by additional Hilbert transform in the wireless environment toward fifth generation (5G), given that turbo code is considered as a potential channel coding scheme for 5G radio specification.

A Lille model for predicting the response of severe alcoholic hepatitis to corticosteroid treatment in Japanese patients.

AIM: Corticosteroids are the most widely used agents for the treatment of severe alcoholic hepatitis (SAH). The therapeutic effectiveness of corticosteroids is assessed by the Lille model, which has been validated well in patient cohorts in North America and Europe; however, its usefulness has not yet been confirmed independently in Japanese patients. The present study aimed to determine whether the Lille model could predict the prognosis of SAH in Japanese patients. METHODS: This was a retrospective cohort study including 32 SAH patients who were admitted to our institute from April 2011 to February 2018. According to the previously validated Lille model cut-off value, patients who received corticosteroids were classified as corticosteroid responders or non-responders (with responders obtaining a Lille score ≥ 0.45), followed by assessment for the 6-month prognosis. RESULTS: Out of 32 patients, 26 were treated with corticosteroids. The 28-day and 6-month mortality rates in the corticosteroid-treated group were 23.1% and 46.2%, respectively. The median Lille score was significantly higher in patients who died or underwent liver transplantation (0.647) than in those who survived without undergoing transplantation (0.226; P < 0.0182). The 6-month transplant-free survival rate of non-responders (Lille score ≥ 0.45) was significantly lower (27.3%; 95% confidence interval, 9.0-58.6%) than that of responders (Lille score < 0.45, 73.3%; 95% confidence interval, 46.7-90.0%; P = 0.0149, log-rank test). CONCLUSIONS: The Lille score could be useful for predicting the 6-month prognosis of Japanese SAH patients after corticosteroid therapy.

PPCS: A Progressive Popularity-Aware Caching Scheme for Edge-Based Cache Redundancy Avoidance in Information-Centric Networks.

This article proposes a novel chunk-based caching scheme known as the Progressive Popularity-Aware Caching Scheme (PPCS) to improve content availability and eliminate the cache redundancy issue of Information-Centric Networking (ICN). Particularly, the proposal considers both entire-object caching and partial-progressive caching for popular and non-popular content objects, respectively. In the case that the content is not popular enough, PPCS first caches initial chunks of the content at the edge node and then progressively continues caching subsequent chunks at upstream Content Nodes (CNs) along the delivery path over time, according to the content popularity and each CN position. Therefore, PPCS efficiently avoids wasting cache space for storing on-path content duplicates and improves cache diversity by allowing no more than one replica of a specified content to be cached. To enable a complete ICN caching solution for communication networks, we also propose an autonomous replacement policy to optimize the cache utilization by maximizing the utility of each CN from caching content items. By simulation, we show that PPCS, utilizing edge-computing for the joint optimization of caching decision and replacement policies, considerably outperforms relevant existing ICN caching strategies in terms of latency (number of hops), cache redundancy, and content availability (hit rate), especially when the CN's cache size is small.