The great East Japan earthquake and out-of-hospital cardiac arrest

From N Engl J Med, Kitamura, T., Kiyohara, K., Sakai, and Iwami, T., The Great East Japan Earthquake and Out-of-Hospital Cardiac Arrest., 369, 22 Copyright ? 2013 Massachusetts Medical Society. Reprinted with permission.Correspondenc

Thermal Hall responses in frustrated honeycomb spin systems

We study geometrical responses of magnons driven by a temperature gradient in frustrated spin systems. While Dzyaloshinskii-Moriya (DM) interactions are usually incorporated to obtain geometrically nontrivial magnon bands, here we investigate thermal Hall responses of magnons that do no rely on the DM interactions. Specifically, we focus on frustrated spin systems with sublattice degrees of freedom and show that a nonzero Berry curvature requires breaking of an effective $PT$ symmetry. According to this symmetry consideration, we study the $J_1$-$J_2$-$J_2^\prime$ Heisenberg models on a honeycomb lattice as a representative example, and demonstrate that magnons in the spiral phase support the thermal Hall effect once we introduce a magnetic field and asymmetry between the two sublattices. We also show that driving the magnons by a temperature gradient induces spin current generation (i.e., magnon spin Nernst effect) in the $J_1$-$J_2$-$J_2^\prime$ Heisenberg models.Comment: 16 pages, 8 figure

Analysis of prostate cancer localization toward improved diagnostic accuracy of transperineal prostate biopsy

PurposeDelineating the precise localization of prostate cancer is important in improving the diagnostic accuracy of prostate biopsy.MethodsIn Juntendo University Nerima Hospital, initial 12-core or repeat 16-core biopsies were performed using a transrectal ultrasound guided transperineal prostate biopsy method. We step-sectioned prostates from radical prostatectomy specimens at 5-mm intervals from the urethra to the urinary bladder and designated five regions: the (1) Apex, (2) Apex-Mid, (3) Mid, (4) Mid-Base, and (5) Base. We then mapped prostate cancer localization on eight zones around the urethra for each of those regions.ResultsProstate cancer was detected in 93 cases of 121 cases (76.9%) in the Apex, in 115 cases (95.0%) in the Apex-Mid, in 101 cases (83.5%) in the Mid, in 71 cases (58.7%) in the Mid-Base, and in 23 cases (19.0%) in the Base. In 99.2% of all cases, prostate cancers were detected from the Apex to Mid regions. For this reason, transperineal prostate biopsies have routinely been prioritized in the Apex, Apex-Mid, and Mid regions, while the Base region of the prostate was considered to be of lesser importance. Our analyses of prostate cancer localization revealed a higher rate of cancer in the posterior portion of the Apex, antero-medial and postero-medial portion of the Apex-Mid and antero-medial and postero-lateral portion of the Mid. The transperineal prostate biopsies in our institute performed had a sensitivity of 70.9%, a specificity of 96.6%, a positive predictive value (PPV) of 92.2% and a negative predictive value (NPV) of 85.5%.ConclusionsThe concordance of prostate cancer between prostatectomy specimens and biopsies is comparatively favorable. According to our study, the diagnostic accuracy of transperineal prostate biopsy can be improved in our institute by including the anterior portion of the Apex-Mid and Mid regions in the 12-core biopsy or 16-core biopsy, such that a 4-core biopsy of the anterior portion is included

Effect of different trunk postures on scapular muscle activities and kinematics during shoulder external rotation

[Background]Shoulder external rotation at abduction (ER) is a notable motion in overhead sports because it could cause strong stress to the elbow and shoulder joint. However, no study has comprehensively investigated the effect of different trunk postures during ER. This study aimed to investigate the effect of different trunk postures on scapular kinematics and muscle activities during ER. [Methods]Fourteen healthy men performed active shoulder external rotation at 90° of abduction with the dominant arm in 15 trunk postures. At maximum shoulder external rotation in 15 trunk postures, including 4 flexion-extension, 6 trunk rotation, and 4 trunk side-bending postures, as well as upright posture as a control, scapular muscle activities and kinematics were recorded using surface electromyography and an electromagnetic tracking device, respectively. The data obtained in the flexion-extension, trunk rotation, and trunk side-bending postures were compared with those obtained in the upright posture. [Results]In the flexion-extension condition, scapular posterior tilt and external rotation significantly decreased, but the muscle activities of the lower trapezius and infraspinatus significantly increased in maximum trunk flexion. Moreover, scapular upward rotation and the activity of the serratus anterior significantly increased in maximum trunk extension. In the rotation condition, scapular posterior tilt and external rotation significantly decreased, but the activity of the serratus anterior significantly increased in the maximum contralateral trunk rotation posture. In the trunk side-bending condition, scapular posterior tilt and the external rotation angle significantly decreased. [Conclusio]Trunk postures affected scapular kinematics and muscle activities during ER. Our results suggest that different trunk postures activate the lower trapezius and serratus anterior, which induce scapular posterior tilt

FoxO1 Gain of Function in the Pancreas Causes Glucose Intolerance, Polycystic Pancreas, and Islet Hypervascularization

Genetic studies revealed that the ablation of insulin/IGF-1 signaling in the pancreas causes diabetes. FoxO1 is a downstream transcription factor of insulin/IGF-1 signaling. We previously reported that FoxO1 haploinsufficiency restored β cell mass and rescued diabetes in IRS2 knockout mice. However, it is still unclear whether FoxO1 dysregulation in the pancreas could be the cause of diabetes. To test this hypothesis, we generated transgenic mice overexpressing constitutively active FoxO1 specifically in the pancreas (TG). TG mice had impaired glucose tolerance and some of them indeed developed diabetes due to the reduction of β cell mass, which is associated with decreased Pdx1 and MafA in β cells. We also observed increased proliferation of pancreatic duct epithelial cells in TG mice and some mice developed a polycystic pancreas as they aged. Furthermore, TG mice exhibited islet hypervascularities due to increased VEGF-A expression in β cells. We found FoxO1 binds to the VEGF-A promoter and regulates VEGF-A transcription in β cells. We propose that dysregulation of FoxO1 activity in the pancreas could account for the development of diabetes and pancreatic cysts

Characteristics and outcomes of emergency patients with self-inflicted injuries: A report from ambulance records in Osaka City, Japan

Background: Few studies have evaluated the actual situations of emergency patients with self-inflicted injuries treated by emergency-medical-service (EMS) personnel. Methods: This study retrospectively reviewed population-based ambulance records in Osaka City, Japan, between January 2010 and December 2012, and enrolled emergency patients who suffered from self-inflicted injuries such as poisoning by drugs or gas, cutting/piercing skin, jumping from heights, hanging, and drowning. The endpoint was the annual incidence per 100,000 populations in Osaka City of emergency patients who presented with self-inflicted injuries by age and sex. Their outcomes including deaths at the scene and hospital arrival were also evaluated. Results: During the study period, a total of 8,671 patients with 9,424 incidents of self-inflicted injuries were documented. The annual incidence of self-inflicted injuries was higher among women than men in the whole population and in the age group =50 years (49.0 versus 68.9, P < 0.001). The total number of self-inflicted deaths was 1,564 (16.6 %), and the overall proportion of self-inflicted deaths was greater among men than women (32.2 % [1075/3340] vs. 7.5 % [451/6027], P < 0.001). The proportion of self-inflicted hanging was 76.7 % [1142/1489], followed by poisoning by carbon monoxide at 57.1 % [56/98] and jumping to death at 47.6 % [254/534]. Discussion: Using large-scale EMS records, we investigated characteristics and outcomes of emergency patients with self-inflicted injuries treated by EMS personnel. Our findings suggested the gender paradox that the proportion of self-inflicted deaths was higher among men than women, while the proportion of non-fatal self-inflicted injuries was higher among women than among men, particularly in the group aged <=49 years. Our findings showing the importance of the prevention for self-inflicted injuries as well as the gender paradox of self-inflicted injuries will provide important epidemiological information to improve psychiatric cares in prehospital emergency settings. Conclusions: In the total population, the annual incidence of self-inflicted injuries responded to by EMS personnel was higher among women than among men. However, the proportion of self-inflicted deaths was greater among men than women, and the most frequent manner among deceased patients was by hanging.Matsuyama, T., Kitamura, T., Kiyohara, K. et al. Characteristics and outcomes of emergency patients with self-inflicted injuries: a report from ambulance records in Osaka City, Japan. Scand J Trauma Resusc Emerg Med 24, 68 (2016). https://doi.org/10.1186/s13049-016-0261-

Influence of COVID-19 pandemic on bystander interventions, emergency medical service activities, and patient outcomes in out-of-hospital cardiac arrest in Osaka City, Japan

Background: The coronavirus disease (COVID-19) pandemic may have negatively affected bystander interventions, emergency medical service (EMS) personnel activities, and patient outcomes after out-of-hospital cardiac arrest (OHCA). This study assessed bystander interventions, EMS activities, and patient outcomes during the COVID-19 pandemic era and compared them with those during the non-COVID-19 pandemic era in Osaka City, Japan, where public-access automated external defibrillators (AEDs) are well established. Methods: We conducted this population-based cohort study that included all cases with non-traumatic OHCA treated by EMS personnel and excluded cases with no resuscitation attempt, traumatic cases, cases occurring in healthcare facilities, or cases witnessed by EMS personnel. Data were compared between the COVID-19 pandemic period (February 1, 2020 to July 31, 2020) and the non-COVID-19 pandemic period (February 1, 2019 to July 31, 2019). Results: During the study periods, 1687 patients were eligible for analyses (COVID-19: n = 825; non-COVID-19: n = 862). Patients with OHCA during the COVID-19 pandemic period were significantly less likely to receive bystander cardiopulmonary resuscitation (CPR) (COVID-19: 33.0%; non-COVID-19: 41.3%; p < 0.001) and public-access AED pad application (COVID-19: 2.9%; non-COVID-19: 6.1%; p = 0.002) compared with patients during the non-COVID-19 pandemic period. There were no significant differences in 1-month survival with favorable neurological outcomes between the two periods (COVID-19: 4.6%; non-COVID-19: 6.1%; p = 0.196). Conclusion: The COVID-19 pandemic period did not affect patient outcomes after OHCA but changed bystander behaviors in Osaka City, Japan

Synthesis of yellow and red fluorescent 1,3a,6a-triazapentalenes and the theoretical investigation of their optical properties

To expand the originally developed fluorescent 1,3a,6a-triazapentalenes as fluorescent labelling reagents, the fluorescence wavelength of the 1,3a,6a-triazapentalenes was extended to the red color region. Based on the noteworthy correlation of the fluorescence wavelength with the inductive effect of the 2-substituent, electron-deficient 2-(2-cyano-4-methoxycarbonylphenyl)-1,3a,6a-triazapentalene and 2-(2,6-dicyano-4-methoxycarbonylphenyl)-1,3a,6a-triazapentalene were synthesized. The former exhibited yellow fluorescence and the latter exhibited red fluorescence, and both compounds exhibited large Stokes shifts, and the 1,3a,6a-triazapentalene system enabled the same fluorescent chromophore to cover the entire region of visible wavelengths. The potential applications of the 1,3a,6a-triazapentalenes as fluorescent probes in the fields of the life sciences were investigated, and the 1,3a,6a-triazapentalene system was clearly proven to be useful as a fluorescent reagent for live cell imaging. Quantum chemical calculations were performed to investigate the optical properties of the 1,3a,6a-triazapentalenes. These calculations revealed that the excitation involves a significant charge-transfer from the 1,3a,6a-triazapentalene skeleton to the 2-substituent. The calculated absorption and fluorescence wavelengths showed a good correlation with the experimental ones, and thus the system could enable the theoretical design of substituents with the desired optical properties

Synthesis and Evaluation of 1,3a,6a-triazapentalene (TAP)-bonded system

A method of synthesizing a directly connected 1,3a,6a-triazapentalene (TAP) ring system as a linearly bonded aromatic system with a planar form was established. Various TAP-dimers and a 2-alkyl-TAP-trimer were synthesized and their fluorescence properties were evaluated. Although the direct connection of the TAP ring with other TAP rings did not affect the fluorescence properties in diluted solvent, TAP-dimers showed unique fluorescence properties derived from the aggregation state under highly concentrated conditions. In particular, TAP-dimer 5f showed aggregation-induced emission in highly concentrated solution, and 5b showed typical mechanochromic fluorescence in the solid state despite their compact molecular size