Search Results (84)

Adrenomedullin (AM) is a bioactive peptide that is strongly induced during severe inflammation, including pneumonia and sepsis, and serves as an organ-protective factor. The plasma concentration of AM is markedly increased in the novel coronavirus disease COVID-19 and is closely related to the severity of the disease and prognosis of patients. We performed two investigator-initiated trials to evaluate the efficacy and safety of AM in patients with moderate-to-severe COVID-19. This multicenter, double-blind, placebo-controlled phase-2a trial evaluated COVID-19 patients with severe (n = 33) and moderate (n = 31) pneumonia in Japan. Patients were randomly assigned to receive either 15 ng/kg/min AM or placebo. The primary endpoint was the duration of mechanical ventilation (MV) for severe pneumonia and oxygen support for moderate pneumonia. The main secondary endpoint was clinical status up to 30 days after the intervention. No differences in primary or secondary endpoints were observed between the AM and placebo groups in patients with severe or moderate pneumonia. In the severe pneumonia group, three patients in the placebo group died due to respiratory failure, and one patient in the AM group died due to respiratory failure. The respiratory function test at 30 days in the moderate pneumonia group tended to be better than that in the AM group and approached significance (p = 0.073). Although mild adverse events caused by the vasodilatory effects of AM were noted, the safety of AM for treating pneumonia was confirmed. In these trials, we did not observe a definitive efficacy of AM in moderate to severe pneumonia. Alternative strategies for the treatment of AM in pneumonia require further research. Full article

Background/Objectives: Lasmiditan is a newly developed drug for the acute treatment of migraine attacks, but factors associated with its efficacy remain unclear. This study aimed to confirm the efficacy of lasmiditan started at 50 mg under various dosing conditions and identify factors associated with its efficacy. Methods: There are four reasons for prescribing lasmiditan: as an add-on to triptan, if triptan is ineffective, if triptan produces side effects, and when triptan is contraindicated. Lasmiditan was administered at a dose of 50 mg. The efficacy of lasmiditan was defined as the disappearance of headache or a 50% or greater reduction in headache intensity within two hours after dosing. This study included 108 patients with migraines who took lasmiditan. Results: The results for efficacy and the side effects of lasmiditan were as follows: effective without side effects (22), effective with mild side effects (32), ineffective (14), and severe side effects (40). The efficacy rate of lasmiditan 50 mg was 50.0% (54/108). The following factors were found to be associated with lasmiditan’s efficacy: sex, migraine classification, calcium channel blockers, and anti-calcitonin gene-related peptide monoclonal antibody (CGRP-mAb) treatment. The overall incidence of side effects was 66.7%, and the dropout rate was 37.0%. Somnolence was more prevalent in the effective group, and other side effects were more prevalent in patients who dropped out due to the side effects of lasmiditan. Conclusions: Lasmiditan is likely to be effective in males with severe migraine classification and receiving CGRP-mAb treatment. If mild somnolence is a side effect, the drug can be continued and may be effective. Full article

Background: Formalin is widely used as a standard fixative in histopathological analysis; however, its high toxicity and strict regulatory restrictions create challenges for the safe transport and external evaluation of specimens. In translational research utilizing large animal models, establishing a reliable transport protocol that preserves both tissue structure and antigenicity remains essential. Objective: This study aimed to develop and validate a protocol for the safe transport of formalin-fixed renal specimens while maintaining their histopathological and immunohistochemical integrity. Methods: Using a porcine model, renal specimens were fixed in formalin and subsequently substituted with physiological saline or 70% ethanol before transport. These were compared with specimens transported in formalin without substitution. Following transportation, hematoxylin and eosin (HE) staining and immunohistochemistry (Nephrin, E-cadherin, CD3) were performed to assess tissue integrity, antigenicity, and structural preservation. Additionally, sample degradation, antigen loss, and potential leakage were evaluated. Results: Specimens substituted with saline or ethanol retained cellular structure and antigenicity comparable to those transported in formalin, with no significant deterioration in histological or immunohistochemical quality. Furthermore, no leakage or sample damage was observed during transport, demonstrating the feasibility of this replacement protocol for routine pathological assessments. Conclusions: These findings suggest that formalin substitution with saline or ethanol provides a viable alternative for specimen transport, ensuring both biosafety and analytical integrity. This protocol may enhance specimen handling in preclinical research, regulatory compliance, and international collaboration in pathology and regenerative medicine. Full article

Background: Prescribing antiviral agents for severe acute respiratory syndrome coronavirus 2 requires careful consideration based on the patient’s risk factors for severe disease progression and their vaccination status. However, effective interventions ensuring the appropriate use of antiviral agents by physicians have yet to be fully established. Thus, this study evaluated the impact of an educational film on antiviral prescription rates for coronavirus disease 2019 (COVID-19). Methods: This prospective, nationwide, web-based survey enrolled 1500 physicians. They were instructed to view a short educational film and assess the necessity of prescribing antiviral agents in 16 fictitious scenarios featuring adult patients with COVID-19 with varying risk factors for severe disease and vaccination statuses. We compared the antiviral prescription rates before and after viewing the educational film. Results: There was a significant increase in the antiviral prescription rates after viewing the educational film, particularly nirmatrelvir/ritonavir prescribed in cases involving immunocompromised patients (from 31.3% to 49.4%) and those with obesity (from 15.1% to 33.7%) who were unvaccinated and had no risk of drug interactions. However, viewing the educational film made little to no impact on the prescription rates for the patients with hypertension and hyperlipidemia or those with no underlying conditions. Conclusions: Short educational films may promote the appropriate use of antiviral agents for COVID-19. However, their impact on altering prescription behavior appears limited and varies according to the clinical context. Full article

Corticosterone, an end product of the hypothalamic–pituitary–adrenal (HPA) axis, is a crucial stress hormone. A dysregulated HPA axis and corticosterone release play pivotal roles in the onset and persistence of symptoms of stress-related psychiatric disorders, such as anxiety. The intake of nutrients, probiotics, and prebiotic supplements decreases blood corticosterone levels. The dipeptide L-carnosine is composed of beta-alanine and L-histidine and is commercially available as a nutritional supplement for recovery from fatigue. L-carnosine is involved in stress-induced corticosterone responses and anxiety behaviors in rodents. Here, we assessed the effect of L-carnosine in CD157 knockout (KO) mice, a murine model of autism spectrum disorder (ASD). The uptake of L-carnosine suppressed the increase in plasma corticosterone levels in response to acute stress and attenuated anxiety-like behaviors in CD157 KO mice. These results suggest that L-carnosine supplementation may relieve anxiety by suppressing excessive stress responses in individuals with ASD. Full article

Current mRNA vaccines against SARS-CoV-2 effectively induce systemic and cell-mediated immunity and prevent severe disease. However, they do not induce mucosal immunity that targets the primary route of respiratory infection, and their protective effects wane after a few months. Intranasal vaccines have some advantages, including their non-invasiveness and the additional ability to activate mucosal immunity. In this study, we aimed to explore the effectiveness of an intranasally inoculated spike protein of SARS-CoV-2 mixed with a carboxy-vinyl polymer (S–CVP), a viscous agent. Intranasally inoculated S–CVP strongly induced antigen-specific IgG, including neutralizing antibodies, in the mucosal epithelium and serum and cellular immunity compared to the spike protein mixed with aluminum potassium sulfate. Furthermore, IgA production was detected only with S–CVP vaccination. S–CVP-inoculation in mice significantly suppressed the viral load and inflammation in the lung and protected mice against SARS-CoV-2 challenges, including an early circulating strain and the Omicron BA.1 variant in a manner dependent on CD8⁺ cells and monocytes/neutrophils. Surprisingly, high antibody responses and protective effects against multiple variants of SARS-CoV-2, including Omicron BA.5, persisted for at least 15 months after the S–CVP immunization. Hence, we propose intranasal inoculation with S–CVP as a promising vaccine strategy against SARS-CoV-2. Full article

222 nm far-ultraviolet (F-UV) light has a bactericidal effect similar to deep-ultraviolet (D-UV) light of about a 260 nm wavelength. The cytotoxic effect of 222 nm F-UV has not been fully investigated. DLD-1 cells were cultured in a monolayer and irradiated with 222 nm F-UV or 254 nm D-UV. The cytotoxicity of the two different wavelengths of UV light was compared. Changes in cell morphology after F-UV irradiation were observed by time-lapse imaging. Differences in the staining images of DNA-binding agents Syto9 and propidium iodide (PI) and the amount of cyclobutane pyrimidine dimer (CPD) were examined after UV irradiation. F-UV was cytotoxic to the monolayer culture of DLD-1 cells in a radiant energy-dependent manner. When radiant energy was set to 30 mJ/cm², F-UV and D-UV showed comparable cytotoxicity. DLD-1 cells began to expand immediately after 222 nm F-UV light irradiation, and many cells incorporated PI; in contrast, PI uptake was at a low level after D-UV irradiation. The amount of CPD, an indicator of DNA damage, was higher in cells irradiated with D-UV than in cells irradiated with F-UV. This study proved that D-UV induced apoptosis from DNA damage, whereas F-UV affected membrane integrity in monolayer cells. Full article

The recent rapid growth in Internet of Things (IoT) technologies is enriching our daily lives but significant information security risks in IoT fields have become apparent. In fact, there have been large-scale botnet attacks that exploit undiscovered vulnerabilities, known as zero-day attacks. Several intrusion detection methods based on network traffic monitoring have been proposed to address this issue. These methods employ federated learning to share learned attack information among multiple IoT networks, aiming to improve collective detection capabilities against attacks including zero-day attacks. Although their ability to detect zero-day attacks with high precision has been confirmed, challenges such as autonomous labeling of attacks from traffic information and attack information sharing between different device types still remain. To resolve the issues, this paper proposes IDAC, a novel intrusion detection method with autonomous attack candidate labeling and federated learning-based attack candidate sharing. The labeling of attack candidates in IDAC is executed using information autonomously extracted from traffic information, and the labeling can also be applied to zero-day attacks. The federated learning-based attack candidate sharing enables candidate aggregation from multiple networks, and it executes attack determination based on the aggregated similar candidates. Performance evaluations demonstrated that IDS with IDAC within networks based on attack candidates is feasible and achieved comparable detection performance against multiple attacks including zero-day attacks compared to the existing methods while suppressing false positives in the extraction of attack candidates. In addition, the sharing of autonomously extracted attack candidates from multiple networks improves both detection performance and the required time for attack detection. Full article

Background: The utility of using indirect calorimetry (IC) to estimate energy needs and methods for its application to this purpose remain unclear. This systematic review investigated whether using IC to estimate energy expenditure in critically ill patients is more meaningful for improving survival than other estimation methods. Methods: Comprehensive searches were conducted in MEDLINE using PubMed, Cochrane Central Register of Controlled Trials, and Igaku-Chuo-Zasshi up to March 2023. Results: Nine RCTs involving 1178 patients were included in the meta-analysis. The evidence obtained suggested that energy delivery by IC improved short-term mortality (risk ratio, 0.86; 95% confidence interval [CI], 0.70 to 1.06). However, the use of IC did not appear to affect the length of ICU stay (mean difference [MD], 0.86; 95% CI, −0.98 to 2.70) or the duration of mechanical ventilation (MD, 0.66; 95% CI, −0.39 to 1.72). Post hoc analyses using short-term mortality as the outcome found no significant difference by target calories in resting energy expenditure, whereas more frequent IC estimates were associated with lower short-term mortality and were more effective in mechanically ventilated patients. Conclusions: This updated meta-analysis revealed that the use of IC may improve short-term mortality in patients with critical illness and did not increase adverse events. Full article

The formation of brittle intermetallic compounds (IMCs) at the interface between dissimilar materials causes considerable problems. In this study, a multi-material additive manufacturing technique that employs a diode laser and the hot-wire method was developed for stainless steel/aluminum alloys. An Al-Mg aluminum alloy filler wire (JIS 5183-WY) was fed on an austenitic stainless-steel plate (JIS SUS304) while varying the laser power and process speed and using paste-type flux and flux-cored wire. The effects of laser power and process speed on phenomena during manufacturing and IMC formation were investigated. Finally, the wall-type multilayer specimens were fabricated under optimized conditions. The suppression of IMC formation to a thickness of less than 2 μm was achieved in the specimens, along with a high interfacial strength of over 120 MPa on average. Full article

Background: Diffusion-weighted images (DWI) obtained by echo-planar imaging (EPI) are frequently degraded by susceptibility artifacts. It has been suggested that DWI obtained by fast advanced spin-echo (FASE) or reconstructed with deep learning reconstruction (DLR) could be useful for image quality improvements. The purpose of this investigation using in vitro and in vivo studies was to determine the influence of sequence difference and of DLR for DWI on image quality, apparent diffusion coefficient (ADC) evaluation, and differentiation of malignant from benign head and neck tumors. Methods: For the in vitro study, a DWI phantom was scanned by FASE and EPI sequences and reconstructed with and without DLR. Each ADC within the phantom for each DWI was then assessed and correlated for each measured ADC and standard value by Spearman’s rank correlation analysis. For the in vivo study, DWIs obtained by EPI and FASE sequences were also obtained for head and neck tumor patients. Signal-to-noise ratio (SNR) and ADC were then determined based on ROI measurements, while SNR of tumors and ADC were compared between all DWI data sets by means of Tukey’s Honest Significant Difference test. Results: For the in vitro study, all correlations between measured ADC and standard reference were significant and excellent (0.92 ≤ ρ ≤ 0.99, p < 0.0001). For the in vivo study, the SNR of FASE with DLR was significantly higher than that of FASE without DLR (p = 0.02), while ADC values for benign and malignant tumors showed significant differences between each sequence with and without DLR (p < 0.05). Conclusion: In comparison with EPI sequence, FASE sequence and DLR can improve image quality and distortion of DWIs without significantly influencing ADC measurements or differentiation capability of malignant from benign head and neck tumors. Full article

Background: Treatment of oropharyngolaryngeal venous malformations (VMs) remains challenging. This study evaluated the effectiveness and safety of fluoroscopy- and endoscopy-guided transoral sclerotherapy for oropharyngolaryngeal VMs in a hybrid operation room (OR). Methods: Patients with oropharyngolaryngeal VMs who underwent transoral sclerotherapy in a hybrid OR were enrolled. Results: Fourteen patients (six females, eight males; median age of 26 years; range, 4–71 years) were analyzed. The symptoms observed were breathing difficulties (n = 3), snoring (n = 2), sleep apnea (n = 1), and swallowing difficulties (n = 1). Lesions were extensive in the face and neck (n = 9) and limited in the oropharyngolarynx (n = 5). A permanent tracheostomy was performed on two patients, while a temporary tracheostomy was performed on five patients. The treated regions were the soft palate (n = 8), pharynx (n = 7), base of the tongue (n = 4), and epiglottis (n = 1). The median number of sclerotherapy sessions was 2.5 (range, 1–9). The median follow-up duration was 81 months (range, 6–141). Treatment outcomes were graded as excellent (n = 2), good (n = 7), or fair (n = 5). The post-treatment complication was bleeding (n = 1), resulting in an urgent tracheostomy. Conclusions: Fluoroscopy- and endoscopy-guided transoral sclerotherapy in a hybrid OR can be effective and safe for oropharyngolaryngeal VMs. Full article

Nicotinamide adenine dinucleotide (NAD⁺) plays a pivotal role in various physiological processes within mammalian cells, including energy metabolism, redox homeostasis, and genetic regulation. In the majority of mammalian cellular contexts, NAD⁺ biosynthesis primarily relies on vitamin B3, including nicotinamide (NAM) and nicotinic acid (NA). The concept of NAD⁺ augmentation therapy has recently emerged as a promising strategy to mitigate aging-associated phenomena, termed rejuvenation. Despite the involvement of diverse enzymatic cascades in NAD⁺ biosynthesis, certain cellular environments exhibit deficiencies in specific enzymes, suggesting cell type-dependent variability in optimal NAD⁺ precursor selection. However, the optimization of NAD⁺ precursors for topical formulations has received scant attention thus far. In the present investigation, we sought to delineate the most efficacious precursor for augmenting NAD⁺ levels in human skin keratinocytes. Remarkably, NA supplementation led to a significant 1.3-fold elevation in intracellular NAD⁺ levels, even in the presence of nicotinamide phosphoribosyltransferase inhibition by FK866. Additionally, NA mononucleotide demonstrated a 1.5-fold increase (but not significant) in NAD⁺ levels following 100 μM application. Conversely, NAM and its derivatives failed to elicit a NAD⁺ response in keratinocytes. Notably, NA supplementation elicited up-regulation of mitochondrial superoxide dismutase (SOD2) and sirtuin 3 (SIRT3), indicative of its beneficial impact on mitochondrial function. Furthermore, NA mitigated rotenone-induced mitochondrial reactive oxygen species (ROS) accumulation. Collectively, these findings advocate for the potential utility of NA in topical applications aimed at skin rejuvenation. Full article

Lithium–air batteries (LABs) have a theoretically high energy density. However, LABs have some issues, such as low energy efficiency, short life cycle, and high overpotential in charge–discharge cycles. To solve these issues electrocatalytic materials were developed for oxygen reduction reaction (ORR) and oxygen evolution reaction (OER), which significantly affect battery performance. In this study, we aimed to synthesize electrocatalytic N-doped carbon-based composite materials with solution plasma (SP) using Co or Ni as electrodes from organic solvents containing cup-stacked carbon nanotubes (CSCNTs), iron (II) phthalocyanine (FePc), and N-nethyl-2-pyrrolidinone (NMP). The synthesized N-doped carbon-based composite materials were characterized by transmission electron microscopy (TEM), X-ray diffraction (XRD), Raman spectroscopy, and X-ray photoelectron spectroscopy (XPS). TEM observation and XPS measurements revealed that the synthesized carbon materials contained elemental N, Fe, and electrode-derived Co or Ni, leading to the successful synthesis of N-doped carbon-based composite materials. The electrocatalytic activity for ORR of the synthesized carbon-based composite materials was also evaluated using electrochemical measurements. The electrochemical measurements demonstrated that the electrocatalytic performance for ORR of N-doped carbon-based composite material including Fe and Co showed superiority to that of N-doped carbon-based composite material including Fe and Ni. The difference in the electrocatalytic performance for ORR is discussed regarding the difference in the specific surface area and the presence ratio of chemical bonding species. Full article