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T1 mapping is a recently developed imaging analysis method that allows quantitative assessment of myocardial T1 values obtained using MRI. In children, MRI is performed under free-breathing. Thus, it is important to know the changes in T1 values between free-breathing and breath-holding. This study aimed to compare the myocardial T1 mapping during breath-holding and free-breathing.
Thirteen patients and eight healthy volunteers underwent cardiac MRI, and T1 values obtained during breath-holding and free-breathing were examined and compared. Statistical differences were determined using the paired t-test.
The mean T1 values during breath-holding were 1211.1 ± 39.0 ms, 1209.7 ± 37.4 ms, and 1228.9 ± 52.5 ms in the basal, mid, and apical regions, respectively, while the mean T1 values during free-breathing were 1165.1 ± 69.0 ms, 1103.7 ± 55.8 ms, and 1112.0 ± 81.5 ms in the basal, mid, and apical regions, respectively. The T1 values were lower during free-breathing than during breath-holding in almost all segments (basal: p = 0.008, mid: p < 0.001, apical: p < 0.001). The mean T1 values in each cross section were 3.1, 7.8, and 7.7% lower during free-breathing than during breath-holding in the basal, mid, and apical regions, respectively.
We found that myocardial T1 values during free-breathing were about 3–8% lower in all cross sections than those during breath-holding. In free-breathing, it may be difficult to assess myocardial T1 values, except in the basal region, because of underestimation; thus, the findings should be interpreted with caution, especially in children.
The occurrence of anorectal malformations (ARM) is thought to be reduced with sufficient folate intake. However, there is no apparent evidence. We focused on enzyme cofactors for one-carbon metabolism, including folate (vitamin B9), vitamin B6 and vitamin B12, and explored the association between maternal combined intake of these B vitamins and the risk of ARM. Using baseline data from a Japanese nationwide birth cohort study between 2011 and 2014, we analysed data of 89 235 women (mean age at delivery = 31·2 years) who delivered singleton live births without chromosomal anomalies. Information on dietary intake was obtained via a FFQ focused on early pregnancy and used to estimate B vitamin intake. We also collected information on the frequency of folic acid supplement use. ARM occurrence was ascertained from medical records. We identified forty-three cases of ARM diagnosed up to the first month after birth (4·8 per 10 000 live births). In terms of individual intake of the respective B vitamins, high vitamin B6 intake was non-significantly associated with reduced odds of ARM. Compared with women in the low combined B vitamin intake group, the OR of having an infant with ARM was 0·4 (95 % CI 0·2, 1·0) in the high intake group (folate ≥400 μg/d, and upper half of vitamin B6 and/or vitamin B12). In conclusion, our cohort analysis suggested an inverse association between the combined intake of one-carbon metabolism-related B vitamins in early pregnancy and ARM occurrence.
The pathogenesis of congenital diaphragmatic hernia (CDH) is largely unknown; however, vitamin A seems to play a role in diaphragmatic development. Previous case–control studies reported that maternal dietary vitamin A intake was inversely associated with the risk of CDH. To our knowledge, however, there is no prospective evidence regarding this association. Our aim was to examine whether maternal intake of vitamin A was associated with CDH occurrence. Baseline data, from the Japan nationwide birth cohort study (2011–2014) of 89 658 mothers (mean age at delivery = 31·2 years) who delivered singleton live births, were analysed. We assessed dietary habits using an FFQ focused on the first trimester and estimated the daily intake of total vitamin A (retinol activity equivalents), retinol, provitamin A carotenoids and vegetables. The occurrence of CDH was ascertained from medical records. A total of forty cases of CDH were documented. The adjusted OR of CDH occurrence for the high total vitamin A intake category (median = 468 μg/d) was 0·6 (95 % CI 0·3, 1·2) with reference to the low intake category (230 μg/d). When we restricted to mothers with a prepregnancy BMI of 18·5–24·9 kg/m2, vitamin A intake was inversely associated with the risk of their children being born with CDH (OR 0·5, 95 % CI 0·2, 1·0). Even given the limited number of cases in the study, our findings provide additional evidence to link vitamin A with CDH.
Current evidence suggests that the aetiology of congenital gastrointestinal (GI) tract atresia is multifactorial, and not based solely on genetic factors. However, there are no established modifiable risk factors for congenital GI tract atresia. We used data from a Japanese nationwide birth cohort study launched in 2011, and examined whether fish consumption in early pregnancy was associated with congenital GI tract atresia. We analysed data of 89 495 women (mean age at delivery=31·2 years) who delivered singleton live births without chromosomal anomalies. Based on the results of the FFQ, we estimated the daily intake of fish and n-3 PUFA consumption in early pregnancy. We defined a composite outcome (oesophageal atresia, duodenal atresia, jejunoileal atresia and/or anorectal malformation) as congenital GI tract atresia. In this population, median fish intake was 31·9 g/d, and seventy-four cases of congenital GI tract atresia were identified. Fish consumption in early pregnancy was inversely associated with the composite outcome (multivariable-adjusted OR for the high v. low consumption category=0·5, 95 % CI 0·3, 1·0). For all the specific types of atresia, decreased OR were observed in the high consumption category, although not statistically significant. Reduced atresia occurrence was observed even beyond the US Food and Drug Administration’s recommended consumption of no more than 340 g/week. Also, n-3 PUFA-rich fish and n-3 PUFA consumptions tended to be inversely associated with atresia. Fish consumption in early pregnancy may be a preventive factor for congenital GI tract atresia.
Wernicke encephalopathy (WE) is a neuropsychiatric disorder caused by thiamine deficiency. It is recognized in various stages of the cancer trajectory but has not previously been recognized during nivolumab treatment.
From a series of WE patients with cancer, we report a lung cancer patient who developed WE during treatment with nivolumab.
A 78-year-old woman with lung cancer was referred to our psycho-oncology clinic because of depressed mood. Psychiatric examination revealed disorientation to time, date, and place, which had not been recognized 1 month previously. Her symptoms fulfilled the diagnostic criteria for delirium. No laboratory findings or drugs explaining her delirium were identified. WE was suspected as she experienced a loss of appetite lasting 4 weeks. This diagnosis was supported by abnormal serum thiamine and the disappearance of delirium after intravenous thiamine administration.
Significance of results
We found WE in an advanced lung cancer patient receiving treatment with nivolumab. Further study revealed the association between nivolumab and thiamine deficiency. Oncologists should consider thiamine deficiency when a patient experiences a loss of appetite of more than 2 weeks regardless of the presence or absence of delirium.
We aimed to elucidate the accuracy and optimal cut-off point of the self-diagnosis of influenza and the associated clinical symptoms of children by their guardians, compared with those of the rapid influenza diagnostic test (RIDT).
Seasonal influenza is a common outpatient problem during the winter season. A paediatric influenza epidemic has socio-economic impacts like temporary school closure, school event cancellations, and unscheduled work absences among parents. Hence, early identification and assessment of influenza to prevent its spread is important from a societal perspective.
We performed a cross-sectional observational study in a rural clinic in Japan every winter season from December 2013 to March 2016. We retrospectively extracted information from the medical records and pre-examination checklists of 24 patients aged <12 years (mean age, 5.4 years; men, 54.2%). The data extracted from the medical records and pre-examination checklist included the baseline characteristics (age, sex and past medical history of influenza), clinical signs and symptoms, diagnosis by guardians (%) and RIDT results.
The optimal cut-off point of the self-diagnosis of influenza by guardians was 80%, with a sensitivity and specificity of 63.6% (95% confidence interval: 30.8–89.1) and 92.3% (64.0–99.8). At a 50% cut-off point, the sensitivity and specificity were 90.9% (58.7–99.8) and 53.8% (25.1−80.8). The accuracy of feeling severely sick, as estimated by the guardians showed a sensitivity and specificity of 90.9% (58.7–99.8) and 69.2% (38.6–90.9). Our study indicates that the diagnosis of seasonal influenza by guardians to their children would be useful in the establishment of both confirmatory diagnoses when it has high probability above the optimal cut-off point (80%), and exclusion diagnosis when it has low probability (50%). Not feeling severely sick, estimated by the guardians might be a useful indicator for the exclusion of paediatric influenza.
In this proceeding paper, we introduce the recent results of Galactic maser astrometry by mainly focusing on those obtained with Japanese VLBI array VERA. So far we have obtained parallaxes for 86 sources including preliminary results, and combination with the data obtained with VLBA/BeSSeL provides astrometric results for 159 sources. With these most updated results we conduct preliminary determinations of Galactic fundamental parameters, obtaining R0 = 8.16 ± 0.26 kpc and Θ0 = 237 ± 8 km/s. We also derive the rotation curve of the Milky Way Galaxy and confirm the previous results that the rotation curve is fairly flat between 5 kpc and 16 kpc, while a remarkable deviation is seen toward the Galactic center region. In addition to the results on the Galactic structure, we also present brief overviews on other science topics related to masers conducted with VERA, and also discuss the future prospect of the project.
We have detected [C I] 3P1–3P0 emissions in the gaseous debris disks of 49 Ceti and β Pictoris with the 10 m telescope of the Atacama Submillimeter Telescope Experiment, which is the first detection of such emissions. The line profiles of [C I] are found to resemble those of CO(J=3–2) observed with the same telescope and the Atacama Large Millimeter/submillimeter Array. This result suggests that atomic carbon (C) coexists with CO in the debris disks, and is likely formed by the photodissociation of CO. Assuming an optically thin [C I] emission with the excitation temperature ranging from 30 to 100 K, the column density of C is evaluated to be (2.2 ± 0.2) × 1017 and (2.5 ± 0.7) × 1016 cm−2 for 49 Ceti and β Pictoris, respectively. The C/CO column density ratio is thus derived to be 54 ± 19 and 69 ± 42 for 49 Ceti and β Pictoris, respectively. These ratios are higher than those of molecular clouds and diffuse clouds by an order of magnitude. The unusually high ratios of C to CO are likely attributed to a lack of H2 molecules needed to reproduce CO molecules efficiently from C. This result implies a small number of H2 molecules in the gas disk; i.e., there is an appreciable contribution of secondary gas from dust grains.
We formulate and conduct the time-integration of time evolution equation for the giant molecular cloud mass function (GMCMF) including the cloud-cloud collision (CCC) effect. Our results show that the CCC effect is only limited in the massive-end of the GMCMF and indicate that future high resolution and sensitivity radio observations may constrain giant molecular cloud (GMC) timescales by observing the GMCMF slope in the lower mass regime.
We propose a new method to verify that a higher-order, tree-processing functional program conforms to an input/output specification. Our method reduces the verification problem to multiple verification problems for higher-order multi-tree transducers, which are then transformed into higher-order recursion schemes and model-checked. Unlike previous methods, our new method can deal with arbitrary higher-order functional programs manipulating algebraic data structures, as long as certain invariants on intermediate data structures are provided by a programmer. We have proved the soundness of the method and implemented a prototype verifier.
We consider a two-dimensional reflecting random walk on the non-negative integer quadrant. It is assumed that this reflecting random walk has skip-free transitions. We are concerned with its time-reversed process assuming that the stationary distribution exists. In general, the time-reversed process may not be a reflecting random walk. In this paper, we derive necessary and sufficient conditions for the time-reversed process also to be a reflecting random walk. These conditions are different from but closely related to the product form of the stationary distribution.
The 2011 Great East Japan Earthquake caused major disruptions in the provision of health care, including that for patients with sleep-disordered breathing (SDB) using a nasal continuous positive airway pressure (nCPAP) device. This study investigated the ability of SDB patients to continue using the nCPAP device in the weeks immediately following the earthquake, whether inability to use the nCPAP device led to symptom relapse, and measures that should be taken to prevent disruptions in nCPAP therapy during future disasters.
If nCPAP devices cannot be used during disasters, SDB patients’ health will be affected negatively.
Within 14 days of the disaster, 1,047 SDB patients completed a questionnaire that collected data regarding ability to use, duration of inability to use, and reasons for inability to use the nCPAP device; symptom relapse while unable to use the nCPAP device; ability to use the nCPAP device use at evacuation sites; and recommendations for improvement of the nCPAP device.
Of the 1,047 patients, 966 (92.3%) had been unable to use the nCPAP device in the days immediately following the earthquake. The most common reason for inability to use the nCPAP device was power failure, followed by anxiety about sleeping at night due to fear of aftershocks, involvement in disaster-relief activities, loss of the nasal CPAP device, and fear of being unable to wake up in case of an emergency. Among the 966 patients, 242 (25.1%) had experienced relapse of symptoms, the most common of which was excessive daytime sleepiness (EDS), followed by insomnia, headache, irritability, and chest pain.
Developing strategies for the continuation of nCPAP therapy during disasters is important for providing healthy sleeping environments for SDB patients in emergency situations.
MitoF, NishijimaT, SakuraiS, KizawaT, HosokawaK, TakahashiS, SuwabeA, AkasakaH, KobayashiS. Effects of CPAP Treatment Interruption Due to Disasters: Patients with Sleep-disordered Breathing in the Great East Japan Earthquake and Tsunami Area. Prehosp Disaster Med. 2013;28(6):547-555.
Crystal structure change with an applied electric field was investigated by Raman spectroscopy and X-ray diffraction (XRD) for the 1 μm-thick (100)/(001) one-axis oriented tetragonal Pb(Zr0.3Ti0.7)O3 films prepared on Pt-covered (100) Si substrates by chemical solution deposition technique. As-deposited films were under the strained condition in good agreement with the estimation from the thermal strain applied under the cooling process after the deposition from the Curie temperature to the room temperature. This strain was ascertained to be relaxed by an applied electric field in accompanying with the dramatic increase of the volume fraction of (001) orientation. These results demonstrate the importance of the crystal structure measurement not only as-deposited films, but also after applied electric field, such as after poling.
We present a distance measurement to the semi-regular variable star RX Bootis (RX Boo). Using the VLBI Exploration of Radio Astrometry (VERA) telescope, we conducted astrometric observations of a water maser spot associated with RX Boo, as well as of the continuum reference source J1419+2706. Based on monitoring observations covering a full year, the annual parallax of RX Boo was measured at 7.31 ± 0.50 mas, corresponding to a distance of 136+10−9 pc. This distance uncertainty is smaller by a factor of two than those previously published, allowing us to determine the object's stellar properties more accurately. Using our distance, we can determine the absolute magnitude and discuss more precisely the locus of RX Boo on the period–luminosity (PL) relation. RX Boo exhibits two simultaneous pulsation periods and is located on the fundamental and first overtone Mira sequences of the PL relation. In addition, we calculated the radius and mass of the star.
In general, twins have delayed language development early in childhood compared with singletons. The purpose of this study was to clarify the overall linguistic features of twins. A Japanese version of the Illinois Test of Psycholinguistic Abilities (ITPA) was administered in 24 twin pairs (aged 3 to 4 years) at their own homes. The overall language abilities of the twins were in the normal range (based on ITPA normative data: mean scale score 36.0 ± 6.0 points), and for the ITPA subtests only, Auditory Reception fell within the range of language disorder (mean scale score 24.9 ± 5.1 points). The findings suggest that in 3- to 4-year-old Japanese twins, overall language abilities are not delayed. However, there may be specific difficulties with auditory reception skills.
In 2011 February, a burst of the 22 GHz H2O maser in Orion KL was reported. In order to identify the bursting maser features, we have been carrying out observations of the 22 GHz H2O maser in Orion KL with VERA, a Japanese VLBI network dedicated for astrometry. The bursting maser turns out to consist of two spatially different features at 7.58 and 6.95 km s−1. We determine their absolute positions and find that they are coincident with the shocked molecular gas called the Orion Compact Ridge. We tentatively detect the absolute proper motions of the bursting features toward the southwest direction, perpendicular to the elongation of the maser features. It is most likely that the outflow from the radio source I or another young stellar object interacting with Compact Ridge is a possible origin of the H2O maser burst. We will also carry out observations with ALMA in the cycle 0 period to monitor the submillimeter H2O maser lines in the Orion Compact Ridge region. These follow-up observations will provide novel information on the physical and chemical properties of the mastering region.