Preoperative Evaluation of Computed Tomography Perfusion: Its Significance for the Risk Assessment of Cerebrovascular Complications Perioperatively1

Neurological complications occur with an overall frequency of 2.8% perioperatively. Although ultrasound imaging is an excellent modality for the risk assessment of carotid arterial diseases, no comprehensive information can be obtained with respect to the intracranial cerebral blood flow. Recent advent of computed tomography perfusion (CTP) imaging has made it possible to directly measure the cerebral blood flow at any intracranial region of interest. We describe here an efficacy of CT perfusion imaging in the preoperative settings for the risk assessment of neurological complications, especially in cases with carotid arterial stenosis/occlusion

Feasibility Study of High-Efficiency Cooling of High-Temperature Superconducting Coils by Magnetic Refrigeration

As a high-efficiency cooling technology for high-temperature superconducting coils, we have begun research and development to examine the feasibility of a cooling assist technology that maintains a cryogenic state by combining the magnetic force generated by the superconducting coil with magnetic refrigeration technology. Magnetic refrigeration requires the magneto caloric material to change the magnetic field. In many cases, the magnetic field change is obtained by moving the magnetic source, but moving the superconducting coil is not a good idea. Although it is possible to generate a change in the magnetic field by turning on and off the power supply of the high-temperature superconducting coil, it is unlikely to be established as a system that assists cooling of the superconducting coil because the coil generates heat due to AC loss. Therefore, it was considered that the magnetic field change can be obtained if the magnetic force generated from the superconducting coil can be controlled by the magnetic shield. As a verification of the principle, it was clarified experimentally that a magnetic field change can be obtained by repeatedly inserting and removing the magnetic shield into and from the gap between the magnetic field generation source and the magneto caloric material, and the temperature change can be extracted by the magneto caloric effect. In the experiment, the temperature change obtained when a magnetic shield was inserted into the air gap was measured by a simple test device using an iron-based magneto caloric material having high magneto caloric effect performance at room temperature and a permanent magnet. The principle verification confirmation test was performed using several types of magnetic shielding materials such as Permalloy bulks and the electrical steel sheets. In addition, numerical analysis is performed on the magnetic shielding effect, and the shielding effect is improved by increasing the thickness of the shielding material and the possibility of using high temperature superconductors as magnetic shielding materials were also analyzed. In this study, we report the possibility of cooling the high-temperature superconducting coil with high efficiency by combining the magnetic field created by the superconducting coil and magnetic refrigeration

ABCA7 Gene Expression and Genetic Association Study in Schizophrenia

Introduction: Although ATP-binding cassette sub-family A member 7 gene (ABCA7) is known to be associated with Alzheimer’s disease, the relationship between ABCA7 and schizophrenia has been unknown. Methods: Schizophrenia patients (n = 50; 24 males, 62.1 ± 0.50 years old) and age- and sex-matched healthy controls (n = 50) were recruited for the mRNA analysis. Additionally, a case-control study for the rs3764650 genotypes was performed with 1308 samples (control subjects; n = 527, schizophrenia patients; n = 781). All participants were Japanese, unrelated to each other, and living in the same area. Results: The distributions of the rs3764650 genotypes in schizophrenia patients were not different from that of controls. However, the ABCA7 mRNA expression levels in schizophrenia patients were significantly higher than those in controls by a logistic regression analysis. Additionally, the ABCA7 mRNA expression levels in schizophrenia patients were correlated with the rs3764650 genotypes in a dose-dependent manner. Discussion: The ABCA7 mRNA expression levels in peripheral blood with the rs3764650 genotypes may be related to pathological mechanisms in schizophrenia and may be a biological marker for schizophrenia

A Multidisciplinary Approach to the Management of Chronic Pain through a Self-managed Behavioral Exercise Program : A Pilot Study in Japan

We conducted this study to determine the short-term treatment outcomes of multidisciplinary approaches to chronic pain management for outpatients in Japan. We evaluated pain reduction and improvement in quality of life (QOL) after treatment. We analyzed 32 patients who had experienced intractable chronic pain for > 3 months. The patients received multidisciplinary therapeutic self-managed exercise instructions and then underwent evaluations 1 and 3 months after the treatment. We used the Pain Disability Short Form-36 (SF-36), Pain Catastrophizing Scale (PCS), and Pain Disability Assessment Scale (PDAS) to evaluate QOL. Although the pain levels were the same before and after the physical exercise program, the patients showed significant improvements in physical function on the SF-36 (48.5 vs. 54.5, 3 months vs. 1 month; p=0.0124), the magnification subscale on the PCS (6.8 vs. 5.9, 1 month vs. before; p=0.0164) and the PDAS (29.2 vs. 23.4, 3 months vs. before; p=0.0055). Chronic pain should be treated with a biopsychosocial approach, but time constraints and costs have limited the implementation of multidisciplinary and behavioral approaches to chronic pain management. Our findings demonstrate that clinical improvements are possible for patients with chronic pain, using multidisciplinary team resources widely available in Japanese clinical practice

TREM2 Expression in Schizophrenia

TREM2 and TYROBP are causal genes for Nasu–Hakola disease (NHD), a rare autosomal recessive disease characterized by bone lesions and early-onset progressive dementia. TREM2 forms a receptor signaling complex with TYROBP, which triggers the activation of immune responses in macrophages and dendritic cells, and the functional polymorphism of TREM2 is reported to be associated with neurodegenerative disorders such as Alzheimer’s disease (AD). The objective of this study was to reveal the involvement of TYROBP and TREM2 in the pathophysiology of AD and schizophrenia. Methods: We investigated the mRNA expression level of the 2 genes in leukocytes of 26 patients with AD and 24 with schizophrenia in comparison with age-matched controls. Moreover, we performed gene association analysis between these 2 genes and schizophrenia. Results: No differences were found in TYROBP mRNA expression in patients with AD and schizophrenia; however, TREM2 mRNA expression was increased in patients with AD and schizophrenia compared with controls (P < 0.001). There were no genetic associations of either gene with schizophrenia in Japanese patients. Conclusion: TREM2 expression in leukocytes is elevated not only in AD but also in schizophrenia. Inflammatory processes involving TREM2 may occur in schizophrenia, as observed in neurocognitive disorders such as AD. TREM2 expression in leukocytes may be a novel biomarker for neurological and psychiatric disorders

Cross-Country Student Perceptions about Online Medical Education during the COVID-19 Pandemic

(1) Introduction: Most educational institutions around the world have shifted from traditional face-to-face to online education amid COVID-19. This change may particularly impact medical students, whose education is heavily influenced by clinical learning experiences. Accordingly, we investigated medical students’ perceptions about positive and negative aspects of online medical education in Japan and overseas during the COVID-19 pandemic. (2) Methods: In-depth online interviews were conducted among 13 Japanese medical students and five medical students from Slovakia, Norway, and Hungary. Interviews were conducted from 23rd September to 3rd October 2020 using the snowball sampling method. Questions were focused on five main areas: Q1 the type of online education; Q2 advantages and disadvantages of online education; Q3 any changes in the relationship with teachers, friends, and family; Q4 any opinions about further improvements in online education; and Q5 any needs for affiliation with a particular university. Then thematic analysis was conducted. (3) Results: The results of the thematic analysis revealed the following four themes that represent the positive and negative aspects of online medical education; Theme 1: Timesaving and Flexibility; Theme 2: Technical problems and lack of digital skills; Theme 3: Unstandardized teaching skills; Theme 4: Lack of experience beyond medical school lectures. (4) Conclusions: While online education was found useful in terms of saving time and creating a flexible learning environment, many important drawbacks were noted such as internet and computer problems and unstandardized teaching skills, and lack of quality assurance. In addition, experiences outside the classroom such as making relationships with faculty and friends, conducting research and participating in extracurricular activities were missed, which they normally enjoy in college life

Measurement of the Branching Fraction for B->eta' K and Search for B->eta'pi+

We report measurements for two-body charmless B decays with an eta' meson in the final state. Using 11.1X10^6 BBbar pairs collected with the Belle detector, we find BF(B^+ ->eta'K^+)=(79^+12_-11 +-9)x10^-6 and BF(B^0 -> eta'K^0)=(55^+19_-16 +-8)x10^-6, where the first and second errors are statistical and systematic, respectively. No signal is observed in the mode B^+ -> eta' pi^+, and we set a 90% confidence level upper limit of BF(B^+-> eta'pi^+) eta'K^+- decays is investigated and a limit at 90% confidence level of -0.20<Acp<0.32 is obtained.Comment: Submitted to Physics Letters