A Common Diagnosis Delayed by Three “Wrong Footing” Anchoring Errors – it is Difficult to Remember What You Have Forgotten

Very often in clinical practice, an inflamed pelvic appendix shows left lower quadrant abdominal pain as the primary painful area. The clinicians are anchored to the most prominent symptom, thereby taking an unnecessary detour in reaching an accurate diagnosis. A 40-year-old man presented to our emergency department with persistent lower left abdominal pain with a fever of 38 oC from a day earlier. He had a good appetite and repeatedly complained of severe constipation at the time of his visit. Physical examination revealed tenderness in the lower left abdomen without a peritoneal sign. Abdominal ultrasound and non-contrast-enhanced computed tomography revealed a left hydroureter. The next day, a radiologist pointed out the possibility of appendicitis. An urgent laparoscopic appendectomy was performed.  The intriguing point of this case is the diagnostic delay because of three anchoring biases. First, the typical right lower abdominal pain of appendicitis was shielded by the intense left lower abdominal pain. Moreover, the presence of a left hydroureter distracted the physicians from the actual location of the pain. Furthermore, the presence of constipation anchored the physicians to constipation as the cause of abdominal pain. In overcoming these biases, specific diagnostic strategies to avoid biases should be implemented

Carbon Monoxide Poisoning in a Psychiatric Patient Mistaken for Indefinite Complaints

Introduction: Carbon monoxide (CO) binds to haemoglobin with a much higher affinity than oxygen, forming carboxyhaemoglobin (COHb), which impairs oxygen transport and utilization. As CO concentrations can easily peak in closed environments, non-fire-related CO poisoning can also occur. However, because CO poisoning is often a nonspecific clinical finding, it can result in a diagnostic error. This report details the misdiagnosis of a 42-year-old male patient with psychiatric disorders.Case description: The patient presented to the hospital with dizziness, abdominal pain and nausea on multiple occasions. His symptoms were ascribed to his psychiatric conditions. On his fifth visit, we diagnosed the patient with CO poisoning. Discussion: It is apparent that this patient was misdiagnosed because of his medical history, and standard analysis was overlooked. When patients with psychiatric disorders have nonspecific symptoms, it is important to check for urgent underlying conditions during diagnosis

Genetic Factors Associated with Heading Responses Revealed by Field Evaluation of 274 Barley Accessions for 20 Seasons

Heading time is a key trait in cereals affecting the maturation period for optimal grain filling before harvest. Here, we aimed to understand the factors controlling heading time in barley (Hordeum vulgare). We characterized a set of 274 barley accessions collected worldwide by planting them for 20 seasons under different environmental conditions at the same location in Kurashiki, Japan. We examined interactions among accessions, known genetic factors, and an environmental factor to determine the factors controlling heading response. Locally adapted accessions have been selected for genetic factors that stabilize heading responses appropriate for barley cultivation, and these accessions show stable heading responses even under varying environmental conditions. We identified vernalization requirement and PPD-H1 haplotype as major stabilizing mechanisms of the heading response for regional adaptation in Kurashiki

Sn-1位に多価不飽和脂肪酸を結合する2-0-methoxyethoxymethylglycerolの立体配置決定

A correlation of optical rotation, optical purity and configuration of the asymmetric center was done for 2-0-methoxyethoxymethylglycerol bearing polyunsaturated fatty acyl group at sn-1 position. This compound was enzymatically prepared and is an important starting material for the syntheses of optical active glycerophospholipids naving polyunwaturated fatty acyl groups.自然界に広く存在し，重要な生理機能を担っている多価不飽和脂肪酸結合リン脂質の化学的合成に必要な出発原料としての2-0-methoxyethoxymethylglycerolの立体配置と光学純度を，立体配置・光学純度既知の物質に化学的に誘導し，それらの比旋光度をお互いに比較する事により決定した

Narrowing Down the Mapping of Plant Sex-Determination Regions Using New Y-Chromosome-Specific Markers and Heavy-Ion Beam Irradiation-Induced Y-Deletion Mutants in Silene latifolia

Silene latifolia is a well-studied model system for plant XY sex determination. Three maleness factors are thought to function on the Y chromosome, gynoecium suppression factor (GSF), stamen-promoting factor (SPF), and male fertility factor (MFF), and their deletions result in hermaphrodites, anther defects, and pollen defects, respectively. Although a framework map of the Y chromosome exists, the sex determination genes have not been identified, and no markers close enough to potentially be used for BAC library screening are yet available. The analysis of Y deletion mutants by Y-chromosome-specific STS markers is an efficient way to isolate sex determination regions, but more Y-specific STS markers are needed to accelerate the exploration of sex determination factors. Herein, we report a marker design method that uses simple sequence repeats, which is especially effective on the Y chromosome of S. latifolia because it contains many simple sequence repeats. Six new Y-chromosome-specific STS markers were obtained, SmicSy1–6. These were used to detect relatively small Y deletion sites in heavy-ion beam irradiation-induced mutants. The mapping of male sex determination regions was narrowed down by using more markers and smaller-sized Y deletion mutants. One new marker, SmicSy6, is a proximal marker to SPF and, thus, a second index for SPF. The region including SPF is thought to be located between two SPF proximal markers. The flower phenotype correlates with the deletion size of SPF using SPF proximal markers. These findings represent new progress in isolating the sex determination factor, which has been studied for more than 50 years

Machine Learning Assisted Characterization of Labyrinthine Pattern Transitions

We present a comprehensive approach to characterizing labyrinthine structures that often emerge as a final steady state in pattern forming systems. We employ machine learning based pattern recognition techniques to identify the types and locations of topological defects of the local stripe ordering to augment conventional Fourier analysis. A pair distribution function analysis of the topological defects reveals subtle differences between labyrinthine structures which are beyond the conventional characterization methods. We utilize our approach to highlight a clear morphological transition between two zero-field labyrinthine structures in single crystal Bi substituted Yttrium Iron Garnet films. An energy landscape picture is proposed to understand the athermal dynamics that governs the observed morphological transition. Our work demonstrates that machine learning based recognition techniques enable novel studies of rich and complex labyrinthine type structures universal to many pattern formation systems

Detection of the Far-infrared [O III] and Dust Emission in a Galaxy at Redshift 8.312: Early Metal Enrichment in the Heart of the Reionization Era

We present the Atacama Large Millimeter/submillimeter Array (ALMA) detection of the [O III] 88 $\mu$m line and rest-frame 90 $\mu$m dust continuum emission in a Y-dropout Lyman break galaxy (LBG), MACS0416_Y1, lying behind the Frontier Field cluster MACS J0416.1-2403. This [O III] detection confirms the LBG with a spectroscopic redshift of $z = 8.3118 \pm 0.0003$, making this object one of the furthest galaxies ever identified spectroscopically. The observed 850 $\mu$m flux density of $137 \pm 26$ $\mu$Jy corresponds to a de-lensed total infrared (IR) luminosity of $L_{\rm IR} = (1.7 \pm 0.3) \times 10^{11} L_{\odot}$ if assuming a dust temperature of $T_{\rm dust} = 50$ K and an emissivity index of $\beta = 1.5$, yielding a large dust mass of $4 \times 10^6 M_{\odot}$. The ultraviolet-to-far IR spectral energy distribution modeling where the [O III] emissivity model is incorporated suggests the presence of a young ($\tau_{\rm age} \approx 4$ Myr), star-forming (SFR $\approx 60 M_{\odot}$ yr$^{-1}$), moderately metal-polluted ($Z \approx 0.2 Z_{\odot}$) stellar component with a mass of $M_{\rm star} = 3 \times 10^8 M_{\odot}$. An analytic dust mass evolution model with a single episode of star-formation does not reproduce the metallicity and dust mass in $\tau_{\rm age} \approx 4$ Myr, suggesting a pre-existing evolved stellar component with $M_{\rm star} \sim 3 \times 10^9 M_{\odot}$ and $\tau_{\rm age} \sim 0.3$ Gyr as the origin of the dust mass.Comment: Accepted by ApJ. 18 pages, 10 figures, 5 table