Quantum-based Mechanical Force Realization in Pico-Newton Range

We propose mechanical force realization based on flux quantization in the pico-Newton range. By controlling the number of flux quantum in a superconducting annulus, a force can be created as integer multiples of a constant step. For a 50 nm-thick Nb annulus with the inner and outer radii of 5 $\mu$m and 10 $\mu$m, respectively, and the field gradient of 10 T/m the force step is estimated to be 184 fN. The stability against thermal fluctuations is also addressed.Comment: 5 pages; 4 figure

Arctic-North Pacific Coupled Impacts on the Late Autumn Cold in North America

The Pacific Decadal Oscillation (PDO) is known to bring an anomalously cold (warm) period to southeastern (northwestern) North America during the cold season of its positive phase through a Rossby wave linkage. This study provides evidence that the remote connection between the North Pacific and the downstream temperature over central North America is strengthened by the warm arctic conditions over the Chukchi and East Siberian Sea, especially in the late autumn season. The modulation effect of the Arctic manifests itself as an altered Rossby wave response to a transient vorticity forcing that results from an equatorward storm track shift, which is induced collaboratively by the PDO and the warm Arctic. This observational finding is supported by two independent modeling experiments: 1) an idealized coupled GCM experiment being nudged toward the warm arctic surface condition and 2) a simple stationary wave model (SWM) experiment forced by transient eddy forcing

Heterogeneous amplification of ERBB2 in primary lesions is responsible for the discordant ERBB2 status of primary and metastatic lesions in gastric carcinoma

Aims: To determine the extent of HER2 homogeneity/heterogeneity in primary versus metastatic gastric carcinoma ( GC). Materials and results: The human epidermal growth factor receptor 2 ( HER2) status in primary and metastatic lesions was evaluated by immunohistochemistry ( IHC) and fluorescence in-situ hybridization ( FISH). Four separate cohorts consisting of primary GC alone or primary GC paired with metastatic lesions were examined. In the FISH analysis of 325 primary GCs, eight cases ( 2.5%) showed amplification with a heterogeneous pattern, whereas 27 cases ( 8.3%) showed amplification with a homogeneous pattern, and in this cohort the discordant: concordant FISH ratio based on examination of three different areas in each primary lesion was 0.30: 1. FISH testing using 250 paired primary and metastatic lesions revealed seven cases (2.8%) with discordant amplification. In metastatic disease positive conversion occurred in six cases (2.4%), whereas negative conversion happened in one case (0.4%). The discordant: concordant ratio of primary versus secondary lesions was 0.23: 1. When the seven discordant cases were re-evaluated using whole sections of primary GCs, six showed a heterogeneous pattern of amplification. Conclusions: These findings suggest that the discordant HER2 amplification observed in metastatic lesions is explained substantially by heterogeneity within primary tumours

Patient Perception of Natural Orifice Transluminal Endoscopic Surgery in an Endoscopy Screening Program in Korea

Purpose Natural orifice transluminal endoscopic surgery (NOTES) is a new method of accessing intracavitary organs in order to minimize pain by avoiding incisions in the body wall. The aim of this study is to determine patients' acceptance of NOTES in Korea and to compare their views about laparoscopic surgery and NOTES for benign and malignant diseases. Materials and Methods The target number of total subjects was calculated to be 540. The subjects were classified into 18 sub-groups based on age groups, gender, and history of prior surgery. The questionnaire elicited information about demographic characteristics, medical check-ups, diseases, endoscopic and surgical histories, marital status and childbirth, the acceptance of NOTES, and the preferred routes for NOTES. In addition, the subjects chose laparoscopic surgery or NOTES for a hypothetical cholecystectomy and rectal cancer surgery, and responded to questions regarding the acceptable complication rate of NOTES, the appropriate cost of NOTES, and the reason(s) why they did not select NOTES. Results: 486 of 540 patients (90.0%) who agreed to participate in this study completed the questionnaire. NOTES was preferred by the following patients: elderly; a history of treatment due to a disease; having regular check-ups; and a history of an endoscopic procedure (p<0.05). The most preferred route for NOTES was the stomach (67.1%). Eighty-four percent of the patients choosing NOTES responded that the complication rate of the new surgical method should be the same or lower than laparoscopic surgery. Vague anxiety over a new surgical method was the most common reason why NOTES was not selected in benign and malignant diseases (64% and 73%), respectively. Conclusion: Patients appear to be interested in the potential benefits of NOTES and would embrace it if their concerns about safety are met. We believe that qualified surgical endoscopists can meet these safety concerns, and that NOTES development has the potential to flourish

Genome-Based Construction of the Metabolic Pathways of Orientia tsutsugamushi and Comparative Analysis within the Rickettsiales Order

Orientia tsutsugamushi, the causative agent of scrub typhus, is an obligate intracellular bacterium that belongs to the order of Rickettsiales. Recently, we have reported that O. tsutsugamushi has a unique genomic structure, consisting of highly repetitive sequences, and suggested that it may provide valuable insight into the evolution of intracellular bacteria. Here, we have used genomic information to construct the major metabolic pathways of O. tsutsugamushi and performed a comparative analysis of the metabolic genes and pathways of O. tsutsugamushi with other members of the Rickettsiales order. While O. tsutsugamushi has the largest genome among the members of this order, mainly due to the presence of repeated sequences, its metabolic pathways have been highly streamlined. Overall, the metabolic pathways of O. tsutsugamushi were similar to Rickettsia but there were notable differences in several pathways including carbohydrate metabolism, the TCA cycle, and the synthesis of cell wall components as well as in the transport systems. Our results will provide a useful guide to the postgenomic analysis of O. tsutsugamushi and lead to a better understanding of the virulence and physiology of this intracellular pathogen

Effects of Rhythmic Auditory Stimulation During Hemiplegic Arm Reaching in Individuals with Stroke: An Exploratory Study

SummaryObjective/BackgroundThis study investigated the effects of rhythmic auditory stimulation (RAS) on muscle activity and elbow motion during arm reaching with hemiplegic arm in participants with stroke.MethodsSixteen adults with stroke who resided in a community were recruited in this study. The RAS consisted of sound emitted from a digital metronome. While sitting upright in a chair, participants reached their arms towards a target (a switch on a table) both with and without RAS. The three-dimensional motion analysis system and surface electromyography system were used for measurements during the reaching tasks.ResultsWe found that RAS elicited better performance in reaching movements than those movements performed without RAS. RAS shortened the movement time (p = .002), reduced the change in acceleration (p = .001), increased the elbow extension range of motion (p = .001), increased muscle activation of the triceps brachii (p = .024), and reduced the co-contraction ratio (p = .015) of the affected arm.ConclusionRAS might be a useful technique to facilitate improvements in motor function of the affected arm in patients with stroke

Sex differences in the factors that affect medical lethality in elderly suicide attempters

ObjectivesThis study aimed to identify sex differences in the factors that affect medical lethality in elderly suicide attempters.MethodsA total of 253 elderly suicide attempters and 351 middle-aged attempters (comparison group) who visited the emergency room at a general hospital were included. The sociodemographic and clinical characteristics of the patients were investigated. The Chi-squared test and logistic regression analysis were performed. And Spearman’s correlation coefficient was calculated.ResultsIn older males, the risk of high lethality was lower when attempting suicide due to the loss of family members [adjusted odds ratio (AOR): 0.08]. The risk increased as the intent to die became more certain (some AOR: 11.31, certain AOR: 28.75), and this association became more pronounced with age (rho middle-aged: 0.329; young-old: 0.387; old-old: 0.415). In older females, the risk was lower when employed (AOR: 0.28). The method of suicide attempt also affected lethality (agricultural chemicals AOR: 3.71; psychiatric medication AOR: 0.31).ConclusionSex differences in the factors that affect medical lethality were identified among elderly suicide attempters. In particular, medical lethality can be predicted by the degree of suicide intention in older males. These findings will help to establish more efficient preventive strategies with specific targets