Fujiidera Technical High School

Background and AimsOzanimod is a once-daily, oral, selective sphingosine 1-phosphate receptor 1 and 5 modulator. The objective of the randomized, phase 2/3 J-True North study (NCT03915769) was to assess the efficacy and safety of ozanimod in Japanese patients with moderately to severely active ulcerative colitis.MethodsIn the 12-week induction period (IP), patients were randomized 1:1:1 to receive placebo, ozanimod 0.46 mg, or ozanimod 0.92 mg. Patients who completed the IP with a clinical response at week (w) 12 were eligible to enter a 40-week maintenance period where they received the same treatment as they did in the IP. The primary endpoint was clinical response (complete Mayo score) at w12; clinical and mucosal secondary endpoints were assessed at w12 and w52.ResultsOf 198 patients randomized, 176 completed the IP. Of these patients, 97 entered and 77 completed the maintenance period. A significantly higher proportion of patients receiving ozanimod achieved clinical response at w12 versus placebo (ozanimod 0.46 mg: 52.9%, P = .0158; ozanimod 0.92 mg: 61.5%, P = .0006; vs placebo: 32.3%). Similar results were observed in the secondary endpoints where patients receiving ozanimod achieved higher rates of clinical remission, endoscopic improvement, and mucosal healing at w12 than those receiving placebo. Efficacy was maintained at w52 for all endpoints. Both doses of ozanimod were well tolerated, with no unexpected safety signals.ConclusionThis large-scale clinical trial demonstrated the efficacy and safety of once-daily oral ozanimod in Japanese patients with moderately to severely active ulcerative colitis. This is the first time that the efficacy and safety of ozanimod were verified in a large number of patients in Asia.

Abstract As part of the first author's expert testimony at a court trial, we investigated hindsight bias in perceptions of the predictability of a real flash flood. Participants were presented with pictures taken before the flash flood and asked to rate the muddiness of the water and judge the likelihood of flooding in Experiment 1. Participants who were informed that a flash flood had occurred perceived the river as muddier and judged a flood to be more likely than control participants. Their judgment was biased by hindsight. The results of Experiment 2 revealed that when the causality from muddiness to flooding was instructed, participants judged the river as muddier. These results were interpreted as top‐down perception being implicitly adjusted by outcome information and causality information. The judges decided that the defendants had no responsibility to predict the flash flood, taking the hindsight bias into consideration.

血液透析患者20例に対し透析中の運動療法を6か月間施行した．身体運動機能，栄養評価を介入前，3，6か月後に行い，統計解析はHolmの多重比較検定を用いた．Quality of life（QOL）は介入前後に評価し，Wilcoxon符号付順位和検定を用い比較した．いずれもp＜0.05を有意差ありと判定した．身体運動機能は介入3か月後に握力（非シャント肢），膝伸展筋力，足趾把持力，外転筋力，30秒立ち上がり試験，6分間歩行が向上し6か月後も維持または向上した．血中ヘモグロビン濃度を含む栄養評価項目に有意な変化は示さなかった．QOL評価は身体機能，心の健康，全体的健康観，活力が有意に上がった．身体機能の向上が日常的な疲労感を緩和させ，活動意欲が生まれたことで日常活動量が増加したと推察される．透析中の運動療法は身体機能の向上とともに精神心理的QOLを高めることが示唆された．

This study aimed to develop a detection scale for intimate partner violence (DS-IPV), excluding physical and sexual violence, and to validate the scale. A cross-sectional survey was undertaken using an anonymous 26-item self-administered questionnaire with volunteer women aged 18-59 residing in one prefecture in Japan. A total of 1,937 responses were obtained, and 1,915 were valid. The responses of the 1,277 women who had a partner at the time were included in the analysis. Statistical analysis examined exploratory/confirmatory factor analysis, internal consistency, and construct validity. A four-factor scale with 22 items was extracted for the DS-IPV. In the confirmatory factor analysis, the indices of fitness supported these results. Prior to the factor analysis, the Kiser-Mayer-Olkin measurement (.936) and Bartlett's sphericity test (p < .001) showed that all samples met the statistical criteria. Cronbach's alpha coefficient was .92 for total score and varied between .70 and .90 for each of the four factors, and internal consistency was confirmed. The following four factors emerged from an oblique factor analysis, with a cumulative variance of 58.1%: "arousing anxiety"; "controlling behavior"; "coercion and threat"; and "daily emotions". These four factors had a moderate correlation (.23-.48, p < .01) with each other, which indicated construct validity. Confirmatory factor analysis showed the indices of fitness supported these results. The DS-IPV scale, a concise scale to detect and screen for potential intimate partner violence, was developed. The DS-IPV scale showed good internal consistency and construct validity.

Analysis of anticancer immunity aids in assessing the prognosis of patients with breast cancer. From 250 operated breast cancers, we focused on serum levels of C‐C motif chemokine ligand 5 (CCL5), which is involved in cancer immune reactions. Serum levels of CCL5 were measured using a cytometric bead‐based immunoassay kit and CCL5 expression in cancer cells was determined using immunohistochemical staining. In addition, mRNA in cancer and stromal cells was analyzed by microdissection and comparison with the public dataset. Disease‐free survival (DFS) of patients with high CCL5 levels (cut‐off, 13.87 ng/mL; n = 192) was significantly better than those with low CCL5 levels (n = 58; hazard ratio, 0.20; 95% confidence interval, 0.10‐0.39; P < .0001). An improved overall survival was observed in patients with high CCL5 levels compared to those with low CCL5 levels (P = .024). On the contrary, high immunohistochemical expression of CCL5 in cancer cells was significantly associated with decreased DFS. As serum CCL5 levels did not correlate with CCL5 expression in cancer cells and the relative expression of mRNA CCL5 was elevated in stromal cells in relation to cancer cells, serum CCL5 might be derived not from cancer cells, but from stromal cells. Expression of CCL5 in serum, but not in cancer cells, might contribute to improved patient prognosis mediating through not only immune reaction, but through other mechanisms. Determination of circulating CCL5 levels could be useful for predicting patient prognosis.

BackgroundIn most patients, anemia is present when myelodysplastic syndrome is diagnosed. Although darbepoetin α is the first-choice supportive therapy for low-risk myelodysplastic syndrome, half of all patients develop a loss of response to darbepoetin α within 12 months. However, few reports have described supportive therapy after the loss of response to darbepoetin α.Case presentationWe herein present a case involving a 65-year-old Japanese woman with low-risk myelodysplastic syndrome whose erythropoiesis-stimulating agent treatment was switched from darbepoetin α to epoetin β pegol (continuous erythropoietin receptor activator) to treat transfusion-dependent anemia. The frequent transfusions required to treat the anemia resulted in transfusion-associated circulatory overload. The transfusion-dependent anemia was initially treated with darbepoetin α, which negated the requirement for transfusion. However, after 12 months of darbepoetin α therapy, the hemoglobin concentration sharply declined. We switched her therapy from darbepoetin α to continuous erythropoietin receptor activator to avoid transfusion. After initiation of continuous erythropoietin receptor activator therapy, the hemoglobin concentration gradually increased and transfusion was not required. At the time of writing, no progression of the anemia had occurred.ConclusionsAlthough darbepoetin α is the first-choice supportive therapy for low-risk myelodysplastic syndrome, continuous erythropoietin receptor activator might be considered the second-choice therapy.

Elastic optical networks (EONs) and space-division multiplexing (SDM) are promising technologies for future core optical networks with high transmission capacity. Traditional optical node architectures for SDM-EONs have two important problems: flexibility and power consumption. Architecture on demand (AoD) is a new concept for an optical node architecture, and an optical node based on this concept is called an AoD node. AoD nodes can be dynamically constructed according to the traffic request by interconnecting input/output ports and building modules with optical switches. Although AoD nodes have great flexibility, power consumption is still a serious problem for them. In this paper, we propose an energy-efficient network system that includes a novel energy-efficient AoD node architecture and resource assignment method cooperating with this node architecture. The proposed system solves the power-consumption problem by simplifying the implemented building modules based on spatial multiplicity of SDM-EONs. The proposed on-demand routing and spectrum allocation method efficiently satisfies the restricted spectrum arrangement that is required by energy-efficient AoD nodes. Finally, we evaluate the proposed system of node architecture and resource allocation method through computer simulations. The simulations show that the proposed network system can improve both the power consumption and the blocking probability of path setup requests in the entire network.

Background: Intra-abdominal free air is found frequently in patients undergoing peritoneal dialysis (PD). Some studies have investigated an association between intra-abdominal free air and peritonitis in PD patients. However, most used chest X-rays, which are of limited sensitivity, and the association was not made clear. We conducted a retrospective study of the association between peritonitis and intra-abdominal free air using computed tomography. Methods: The presence and volume of free air, and its relationship with other variables, were assessed on review of routine examinations in 108 patients. Correlations between the presence of free air and age, duration of PD, continuous ambulatory versus automated PD, presence or absence of a person who assisted in bag changes, exit-site infection, tunnel infection and peritonitis were assessed. Results: Free air was detected in 29 patients (27.1%). The prevalence of peritonitis was higher in the free air (+) group than in the free air (−) group: 1/40.2 patient-months for free air (+) versus 1/96.9 patient-months for free air (−). The risk ratio of free air for peritonitis was 2.41 (95% confidence interval: 2.28–2.55) and was similar when corrected for age, gender, albumin, diabetes mellitus and body mass index. Conclusion: Free air is an independent risk factor for peritonitis in PD patients. This suggests that bag change procedures should be re-evaluated, and patients re-educated, when necessary.