Late-Onset Hypogonadism in a Male Patient with Long COVID Diagnosed by Exclusion of ME/CFS

After the acute phase of COVID-19, some patients have been reported to have persistent symptoms including general fatigue. We have established a COVID-19 aftercare clinic (CAC) to provide care for an increasing number of these patients. Here, we report the case of a 36-year-old man who developed post-COVID fatigue after acute infection with SARS-CoV-2. In the acute phase of COVID-19, the patient's fever resolved within four days; however, general fatigue persisted for three months, and he visited our CAC 99 days after the initial infection. Examination revealed a high Aging Male's Symptoms (AMS) score of 44 and low free testosterone (FT) level of 5.5 pg/mL, which meet the Japanese criteria of late-onset hypogonadism (LOH) syndrome. Imaging studies revealed an atrophic pituitary in addition to fatty liver and low bone mineral density. Anterior pituitary function tests showed a low follicle-stimulating hormonelevel and delayed reaction of luteinizing hormone (LH) after gonadotropin-releasing hormone (GnRH) stimulation, indicating the possibility of hypothalamic hypogonadism in addition to primary hypogonadism seen in patients with post-COVID-19 conditions. After the initiation of Japanese traditional medicine (Kampo medicine: hochuekkito followed by juzentaihoto), the patient's symptoms as well as his AMS score and serum FT level were noticeably improved. Furthermore, follow-up tests of GnRH stimulation revealed improvements in LH responsiveness. Although many patients have been reported to meet the criteria of ME/CFS such as our case, we emphasize the possibility of other underlying pathologies including LOH syndrome. In conclusion, LOH syndrome should be considered a cause of general fatigue in patients with post-COVID-19 conditions and herbal treatment might be effective for long COVID symptoms due to LOH (264 words)

Daptomycin-related Musculoskeletal Adverse Events and Statin Use

Background. There is a growing concern about the association between the combined use of daptomycin (DAP) and statins and the occurrence of musculoskeletal adverse events (MAEs), but this remains controversial. This study aimed to clarify the association between statin use and DAP-related MAEs. Methods. We used a mixed approach that combines 2 methodologies. First, we conducted a meta-analysis to examine the effects of statin use on DAP-related MAEs. Second, we conducted a disproportionality analysis using the US Food and Drug Administration Adverse Events Reporting System (FAERS) to further confirm the results of the meta-analysis and to examine the effect of each type of statin on DAP-related MAEs in a large population. Results. In the meta-analysis, statin use significantly increased the incidence of DAP-related rhabdomyolysis (odds ratio [OR]: 3.83; 95% confidence interval [CI]: 1.43–10.26) but not DAP-related myopathy (OR: 1.72; 95% CI: .95–3.12). In the disproportionality analysis using the FAERS, the use of statin significantly increased the reporting OR (ROR) for DAP-related myopathy (ROR: 5.69; 95% CI: 4.31–7.51) and rhabdomyolysis (ROR: 5.77; 95% CI: 4.33–7.68). Atorvastatin, rosuvastatin, and simvastatin all increased the incidence of DAP-related myopathy and rhabdomyolysis. Conclusion. The mixed approach combining a meta-analysis and disproportionality analysis showed that statin use was associated with the occurrence of DAP-related rhabdomyolysis. The appropriate use of statins and DAP should be performed with careful consideration of its safety

Grunbaum colorings of even triangulations on surfaces

A Grunbaum coloring of a triangulation G is a map c : E(G){1,2,3} such that for each face f of G, the three edges of the boundary walk of f are colored by three distinct colors. By Four Color Theorem, it is known that every triangulation on the sphere has a Grunbaum coloring. So, in this article, we investigate the question whether each even (i.e.,Eulerian) triangulation on a surface with representativity at least r has a Grunbaum coloring. We prove that, regardless of the representativity, every even triangulation on a surface F has a Grunbaum coloring as long as F is the projective plane, the torus, or the Klein bottle, and we observe that the same holds for any surface with sufficiently large representativity. On the other hand, we construct even triangulations with no Grunbaum coloring and representativity r=1,2, and 3 for all but finitely many surfaces. In dual terms, our results imply that no snark admits an even map on the projective plane, the torus, or the Klein bottle, and that all but finitely many surfaces admit an even map of a snark with representativity at least3

Microstructural Refinement of Hyper-Eutectic Al–Si–Fe–Mn Cast Alloys to Produce a Recyclable Wrought Material

Although the cascade of material flow is presently suitable for the aluminum recycling, a better utilization of secondary alloys is required. In order to establish an upgradeable recycling design for developing wrought products from secondary aluminum alloys, a fine distribution of the primary phases in hyper-eutectic Al?Si?Fe?Mn cast materials has been achieved. Two novel processes were adopted. One was repeated thermomechanical treatment (RTMT), which involves a repetition of a multi-step cold-working followed by heat treatment. The other was rapid solidification by high-speed twin-roll casting to develop a fine solidification structure in a thin sheet. By applying these processes, refined microstructures were successfully obtained. Microstructural refinement by RTMT resulted in the avoidance of early fracture that was detected in the cast material by a tensile test. The RTMT imparted good ductility; therefore, it was possible to allow greater flexibility in the cold working of Al?Si?Fe?Mn cast materials

Data on species list and the amount of macrophytes and mobile epi-benthic invertebrates in a subtropical seagrass-seaweed mixed bed in Ishigaki Island, Japan

In April 2014 and 2015, field samplings were conducted in a subtropical seagrass-seaweed mixed bed in Ishigaki Island, southwest Japan in order to collect macrophytes and mobile epi-benthic invertebrates. This article describes macrophyte biomass of 16 species or groups and invertebrate abundance of 66 species or groups. This data is associated with “Phylogenetically diverse macrophyte community promotes species diversity of mobile epi-benthic invertebrates” (Nakamoto et al., 2018) [1] Keywords: Seagrass, Seaweed, Mobile epi-benthic invertebrate, Seagrass-seaweed mixed be