Active Gaits Generation of Quadruped Robot Using Pulse-Type Hardware Neuron Models

In this chapter, the authors will propose the active gait generation of a quadruped robot. We developed the quadruped robot system using self-inhibited pulse-type hardware neuron models (P-HNMs) as a solution to elucidate the gait generation method. We feedbacked pressures at the robot system’s each foot to P-HNM and varied the joints’ angular velocity individually. We experimented with making the robot walk from an upright position on a flat floor. As a result of the experiment, we confirmed that the robot system spontaneously generates walk gait and trot gait according to the moving speed. Also, we clarified the process by which the robot actively generates gaits from the upright state. These results suggest that animals may generate gait using a similarly simple method because P-HNM mimics biological neurons’ function. Furthermore, it shows that our robot system can generate gaits adaptively and quite easily

Characterization of Aquimarina hainanensis isolated from diseased mud crab Scylla serrata larvae in a hatchery

Mass mortality due to necrosis signs occurred in hatchery‐reared zoea stage larvae of the mud crab Scylla serrata in Okinawa, Japan, and a causative bacterium was isolated. In this study, we identified and characterized the bacterium by genome analysis, biochemical properties and pathogenicity. The bacterium was a Gram‐negative, non‐motile, long rod, forming yellow colonies on a marine agar plate. It grew at 20–33°C (not at 37°C) and degraded chitin and gelatin. Phylogenetic analysis of the 16S rRNA gene sequence identified the bacterium as Aquimarina hainanensis. Genome sequence data obtained from Illumina MiSeq generated 29 contigs with 3.56 Mbp in total length and a G + C content of 32.5%. The predicted 16 chitinase genes, as putative virulence factors, had certain homologies with those of genus Aquimarina. Experimental infection with the bacterium conducted on larvae of four crustacean species, brine shrimp Artemia franciscana, freshwater shrimp Caridina multidentata, swimming crab Portunus trituberculatus and mud crab S. serrata, revealed that this bacterium was highly virulent to these species. The present study suggests that the bacterium caused mass mortality in mud crab seed production was A. hainanensis and can be widely pathogenic to crustaceans

Tactile Hypoesthesia Associated with Myofascial Trigger Points in Patients with Persistent Post-Mastectomy Pain: A Close Observation Study in A Case Series

Purpose: Numbness is frequently seen at or near the operated site in patients with persistent post-mastectomy pain (PPMP). Numbness including tactile hypoesthesia can be also seen in patients with myofascial pain. The purpose of this study was to observe relation between such tactile hypoesthesia and myofascial trigger points in patients with PPMP. Methods: We studied five female patients from 43 to 74 years old who consulted at our pain clinic for treatment of PPMP. The areas of tactile hypoesthesia and anesthesia, myofascial trigger points, as well as diffuse tenderness, were marked on the skin surface with delineating such areas and putting X mark on the site of myofascial trigger points using aqueous markers and recorded in photographs at every visit. Results: Tactile hypoesthesia and anesthesia were observed in five and four patients, respectively. Myofascial trigger points were identified in all the five patients and were located within, in the vicinity or near the same dermatomal levels of the hypoesthesia. A series of trigger point injections reduced NRS scores by more than 50% in all patients. The size of the area of tactile hypoesthesia was significantly reduced in association with the decrease of NRS scores in four patients. Conclusions: Our findings indicate that tactile hypoesthesia is closely associated with myofascial pain, and myofascial pain is one potential pathophysiological cause of prolongation and exacerbation of PPMP. Our results also indicate that treating them with trigger point injections are useful for alleviating PPMP

ガッコウ ニオケル キツエン ヨボウ オ モクテキ トシタ ユニバーサル キョウイク : キョウイク モクヒョウ ノ コウセイ ト ソノ エビデンス

TOP SELF, that is, Trial of Prevention School Education for Life and Friendship, has been developed by Yamasaki, Sasaki, Uchida, Katsuma, & Matsumoto（in press）. The present paper aims to depict how the program purposes have been developed and constructed. Firstly, the characteristics of TOP SELF and the partial optional education are explained, and then the construction of the hierarchical purposes of smoking?preventive is specified as starting with the literature review. Theorists have argued that knowledge?focused preventive education is not effective and that social and psychological components in preventive education should be considered to improve outcomes. The construction of the purposes includes constituent, intermediate, subordinate and operational purposes. The higher?order purposes are more likely related to the realization of primary purposes, whereas operational purposes directly relate to educational methods. Those purposes are derived from evidence based outcomes in the literature. Challenges and the future direction are discussed at the end

Population pharmacokinetic modeling of GS‐441524, the active metabolite of remdesivir, in Japanese COVID‐19 patients with renal dysfunction

腎障害患者におけるレムデシビルの薬物動態モデルを構築 --新型コロナウイルス感染症治療薬の適正使用に向けて--. 京都大学プレスリリース. 2021-11-25.Remdesivir, a prodrug of the nucleoside analog GS-441524, plays a key role in the treatment of coronavirus disease 2019 (COVID-19). However, owing to limited information on clinical trials and inexperienced clinical use, there is a lack of pharmacokinetic (PK) data in patients with COVID-19 with special characteristics. In this study, we aimed to measure serum GS-441524 concentrations and develop a population PK (PopPK) model. Remdesivir was administered at a 200 mg loading dose on the first day followed by 100 mg from day 2, based on the package insert, in patients with an estimated glomerular filtration rate (eGFR) greater than or equal to 30 ml/min. In total, 190 concentrations from 37 Japanese patients were used in the analysis. The GS-441524 trough concentrations were significantly higher in the eGFR less than 60 ml/min group than in the eGFR greater than or equal to 60 ml/min group. Extracorporeal membrane oxygenation in four patients hardly affected the total body clearance (CL) and volume of distribution (Vd) of GS-441524. A one-compartment model described serum GS-441524 concentration data. The CL and Vd of GS-441524 were significantly affected by eGFR readjusted by individual body surface area and age, respectively. Simulations proposed a dose regimen of 200 mg on day 1 followed by 100 mg once every 2 days from day 2 in patients with an eGFR of 30 ml/min or less. In conclusion, we successfully established a PopPK model of GS-441524 using retrospectively obtained serum GS-441524 concentrations in Japanese patients with COVID-19, which would be helpful for optimal individualized therapy of remdesivir

An Evaluation of the Safety and Feasibility of Adenosine-assisted Clipping Surgery for Unruptured Cerebral Aneurysms: Study Protocol

The effectiveness of adenosine-induced flow arrest in surgical clipping for the cerebral aneurysms with difficulties in temporary clip placement to the proximal main trunk has been reported. This is the first clinical trial to evaluate the safety and feasibility of adenosine-assisted clipping surgery for unruptured cerebral aneurysms (UCAs) in Japan. The inclusion criteria are as follows: patients over 20 years old, patients who agree to be enrolled in this study after providing informed consent, patients who undergo clipping surgery for UCA in our institute, and patients in whom the surgeons (T.H. or I.D.) judge that decompression of the aneurysm is effective. The primary endpoint is a modified Rankin Scale (mRS) score 30 days after surgery. We plan to enroll 10 patients in this study. The original protocol of adenosine administration was established in this trial. Herein, we present the study protocol

Re-biopsy status among non-small cell lung cancer patients in Japan: A retrospective study

AbstractObjectiveDisease progression because of acquired resistance is common in advanced or metastatic epidermal growth factor receptor (EGFR)-mutation positive non-small cell lung cancer (NSCLC), despite initial response to EGFR-tyrosine kinase inhibitors (TKIs). In Japan, transbronchial tissue biopsy is the most common sampling method used for re-biopsy to identify patients eligible for treatment. We aimed to investigate the success rate of re-biopsy and re-biopsy status of patients with advanced or metastatic NSCLC completing first-line EGFR-TKI therapy.Patients and methodsThis was a retrospective, multi-center, Japanese study. The target patients in the study were EGFR mutation-positive NSCLC patients. The primary endpoint was the success rate (number of cases in which tumor cells were detected/total number of re-biopsies performed×100). Secondary endpoints included differences between the status of the first biopsy and that of the re-biopsy in the same patient population, and the details of cases in which re-biopsy could not be carried out. Re-biopsy-associated complications were also assessed.ResultsOverall, 395 patients were evaluated (median age 63 years), with adenocarcinoma being the most common tumor type. Re-biopsy was successful in 314 patients (79.5%). Compared with the sampling method at first biopsy, at re-biopsy, the surgical resection rate increased from 1.8% to 7.8%, and percutaneous tissue biopsy increased from 7.6% to 29.1%, suggesting the difficulty of performing re-biopsy. Approximately half of the patients had T790M mutations, which involved a Del19 mutation in 55.6% of patients and an L858R mutation in 43.0%. Twenty-three patients (5.8%) had re-biopsy- associated complications, most commonly pneumothorax.ConclusionsSuccess rate for re-biopsy in this study was approximately 80%. Our study sheds light on the re-biopsy status after disease progression in patients with advanced or metastatic NSCLC. This information is important to improve the selection of patients who may benefit from third-generation TKIs

ABO Blood Incompatibility Positively Affects Early Graft Function: Single-Center Retrospective Cohort Study

Background We investigated the association between ABO-incompatible (ABO-I) kidney transplantation and early graft function. Methods We retrospectively analyzed 95 patients who underwent living donor kidney transplantation between May 2009 and July 2019. It included 61 ABO-compatible (ABO-C) and 34 ABO-I transplantations. We extracted data on immunologic profile, sex, age, cold ischemic time, type of immunosuppression, and graft function. Two definitions were used for slow graft function (SGF) as follows: postoperative day (POD) 3 serum creatinine level >3 mg/dL and estimated glomerular filtration rate (eGFR) Results The characteristics between the ABO-C and ABO-I were not different. ABO-I received rituximab and plasma exchange. Patients also received tacrolimus and mycophenolate mofetil for 2 weeks and prednisolone for 1 week before transplantation as preconditioning. Of the 95 study patients, 19 (20%) and 21 (22%) were identified with SGF according to POD 3 serum creatinine level or eGFR, respectively. Multivariable analysis revealed that ABO-I significantly reduced the incidence of SGF (odds ratio, 0.15; 95% confidence interval, 0.03-0.7; P = .02), and cold ischemic time >150 min increased the incidence of SGF (odds ratio, 6.5; 95% confidence interval, 1.7-25; P = .006). Similar results were identified in POD 3 eGFR. Inferior graft function in patients with SGF was identified up to 6 months after transplantation. Conclusion ABO-I reduces the incidence of SGF, which is associated with an inferior graft function up to 6 months

Feasible kidney donation with living marginal donors, including diabetes mellitus

Objectives: To compare the donor outcomes of living donor kidney transplantation between standard donors (SDs) and marginal donors (MDs) including diabetic patients (MD + DM). Methods: MDs were defined according to Japanese guideline criteria: (a) age >70-years, (b) blood pressure 25 to = 70 to 6.2 or Results: No kidney function parameters were different between SDs and MDs. When comparing SD and MD + DM, MD + DM had a lower postoperative eGFR (48 vs. 41 (1 (month), p = .02), 49 vs. 40 (12, p = 2 risk factors. Conclusions: Although long-term observation of donor kidney function is necessary, careful MD + DM selection had the potential to expand the donor pool

Robotic Renal Autotransplantation: A Feasibility Study in a Porcine Model

We investigated the feasibility of robotic renal autotransplantation (RAT) in a porcine model to reduce invasiveness of RAT. Five pigs underwent robotic RAT using the da Vinci® robotic system. A robotic left nephrectomy was performed in all cases. Robotic RAT was performed on the left side in all but one case. Four ports were used. In 3 cases, the kidney was taken out through the GelPort® and irrigated on ice with Ringer’s solution. In 2 cases, a complete intracorporeal robotic RAT was performed. An end-to-side anastomosis was performed between the renal vein and the external iliac vein and between the renal artery and the external iliac artery. Ureteroneocystostomy was also performed in 2 cases. All cases were performed robotically without open conversion. The median (IQR) console time was 3.1 (0.7) h, and the operative time was 3.8 (1.1) h. The estimated blood loss was 30 (0) ml. The warm ischemia time was 4.0 (0.2) min, and the cold ischemia time was 97 (17) min. Intracorporeal transarterial hypothermic renal perfusion was feasible in the 2 complete intracorporeal robotic RAT cases by using a perfusion catheter through a laparoscopic port. Robotic RAT has the potential to be a new minimally invasive substitute for conventional open surgery