Hirose Electric (Japan)

Several Ephedra Herb-containing Kampo medicines are common initial treatments for various infections; however, the ephedrine alkaloids in Ephedra Herb can cause side effects by stimulating adrenergic receptors. Accordingly, an ephedrine alkaloids-free Ephedra Herb Extract (EFE) has been developed. This study aimed to evaluate whether EFE can be used effectively and safely in patients with mild coronavirus disease 2019 (COVID-19). We randomized patients with mild COVID-19 to receive EFE equivalent to 6 g of Ephedra Herb per day or a placebo for 14 days. The primary efficacy endpoint was the non-aggravation rate up to Day 15. We allocated 41 and 40 patients to the EFE and placebo groups, respectively. All participants were included in the mITT and safety analysis populations [male ratio, mean age: 31.7%, 42.0 years (EFE); 17.5%, 43.2 years (placebo)]. The non-aggravation rate up to Day 15 for the primary endpoint was 100.0% and 94.6% in the EFE and placebo group, respectively, with no between-group difference. The number of days to the improvement in nausea symptoms was significantly shorter in the EFE group. One patient in the placebo group discontinued the trial due to a side effect. Although EFE demonstrated safety in patients with mild COVID-19, it did not show superior efficacy compared to placebo for symptoms other than nausea.

Limited data are available on COVID-19 outcomes in the Japanese population. During the Wuhan strain-dominant period, we investigated factors associated with clinical deterioration of COVID-19 despite inpatient medical care in Japan. This retrospective, multicenter cohort study used data from the Japanese Association for Infectious Diseases (JAID) COVID registry to identify risk factors for progression to severe disease after hospital admission. The study population included Japanese patients with a confirmed diagnosis of COVID-19 between January 2020 and March 2021. Baseline data included demographics, symptoms at disease onset and admission, and laboratory findings. Univariate and multivariate logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for each explanatory variable associated with disease aggravation. Multiple imputation was used to handle missing data. The predictive performance of two multivariate models-Model I (based on measurable clinical findings) and Model II (based on interview data)-was assessed using the area under the receiver operating characteristic curve (AUC). A total of 2,884 patients were enrolled across 36 institutions in Japan. After excluding 25 ineligible cases and 45 protocol deviations, 2,814 patients were included in the analysis. Multivariate analysis identified several independent risk factors for disease aggravation despite inpatient care, including admission early in the pandemic, older age, impaired consciousness, respiratory distress, elevated BMI, high body temperature, anemia, cholestasis, dehydration, and elevated γ-GTP and LDH levels. The AUCs were 0.8928 for Model I and 0.8862 for Model II, indicating strong discriminatory power. This study identified key risk factors for COVID-19 progression despite inpatient medical care among Japanese patients. These findings underscore the importance of early risk stratification for patients at high risk of deterioration despite treatment and may inform preparedness strategies for future respiratory pandemics.

The coking coal mine at the research site is in the Pamaluan formation East Kalimantan. The condition of the mine has many complexities and challenges, such as natural slope condition (30º-35º), narrow pit area and low out pit dump capacity limited by land compensation issue, overburden material, geological structure, coal with very thin layers (<1 m) and consist multiple products in a layer, small number of strips and large number of blocks and high SR pit and SR balance in short range. In mine planning at the research location, many improvements need to be made so that all aspects, starting with mine planning and operations, can run smoothly and profits can be as expected. Some of the improvements that have been made at the mine such as build mine planning concepts, build fleet allocation rules, structural and stratigraphical geology modelling and improve drill & blast plan, implementation dynamic mine planning and optimize mining digital product. By implementing these improvements, significant positive impacts have been achieved, such as Consistently maintain mine planning compliance (accuracy) >97%, Maintain fleet productivity performance in range of 95% - 110%, Consistently achieving production targets >97%, Able to maintain SR balance by achieving weekly coal plan with the range of 94 - 103%, Achieving blasting performance results with a value of >97% and Maintain work safety aspects with no accidents and loss time injury.

Abstract Recently, temporary bridges have been developed to facilitate rescue operations and minimize damage to affected areas. High‐strength bolts are preferred for end‐plate connections to expedite construction, reducing the bolt count. Regarding parts reusability, we propose an I‐girder designed with an L‐shaped notch and a novel support block as a structural member. Finite Element Method (FEM) analysis was conducted to investigate the girder end's buckling behavior and failure mode and to verify the effect of the support block's geometry and bolt arrangement on load‐bearing capacity. The findings indicate that the load‐bearing capacity of the girder end with the support block is equivalent to that of a standard I‐girder end, despite reducing the area of the support block's effective compression area by 40% under shear force and bending moment.

Background: COVID-19 cutaneous manifestations were first reported in February 2020, after a rash was listed as a sign of the virus. [1] In 2020, an article emphasized the absence of images among skin of color with respect to COVID-19 skin manifestations.[2] Without detection and treatment, individuals with skin of color may experience a disproportionate incidence of morbidity and mortality.[3] Discussion of cutaneous findings in skin of color remains limited to reviews and individual studies, and although there are meta-analyses that assess systemic manifestations among different races, investigation of various symptoms among people with skin of color, and overall comparison of systemic manifestations to cutaneous manifestations remains unreported to our knowledge. [4] Objectives: The objective of this meta-analysis was to quantify the frequency of reported cutaneous and systemic manifestations among different races. Methods: A search for studies on dermatologic and systemic manifestations associated with COVID-19 published before February 2022 was run on PubMed and Embase. Two independent reviewers screened abstracts and full manuscripts for eligibility based on the following criteria: studies included children or adult patients diagnosed with COVID-19 or temporal association to COVID-19, studies included assessment of cutaneous and systemic manifestations of individuals, studies identified cutaneous and systemic manifestations among different races, and studies were peer-reviewed case reports, original studies, systematic reviews, meta-analyses, and letters to the editor. Race and the most common systemic and dermatologic manifestations were extracted from included studies. Event rates for each outcome by race were pooled using a single-arm meta-analysis and the random-effects model to account for heterogeneity. Results: Seventeen studies, involving 2,525 patients, were selected. Pooled estimates for multisystem inflammatory syndrome (MIS) for Black, White, and Asian cases were 28% (95% CI, 18.8-40.7, p=0.001), 40.1% (95% CI, 23.0-60.1, p=0.332), and 20% (95% CI, 13.2-29.2, p=0.000), respectively. The most common manifestations were pyrexia, elevated inflammatory markers, cardiac dysfunction, and gastrointestinal symptoms. The frequency of elevated inflammatory markers within Black cases surpassed White and Asian cases (30.9%, 28.7%, and 19.6%). The percentage of Black cases for cardiac dysfunction exceeded White and Asian cases (38.8%, 25%, and 21.2%,). The frequency of pyrexia reported among Asian and Black cases exceeded White cases (26.7%, 24.3%, and 15.3%). The prevalence of dermatologic manifestations in Black cases was 4.2% (95% CI, 0.8-19.8, p=0.000) compared to White and Asian cases, 70.7% (95% CI, 42.9-88.6, p=0.139) and 11.7% (95% CI, 9.0-15.1, p=0.000). Conclusion: This meta-analysis highlights the discordance in reporting systemic manifestations compared to dermatologic manifestations by race in COVID-19 patients. Further investigation is needed to determine the underlying cause. REFERENCES:

BackgroundWe conducted a multicenter study to evaluate the performance of a novel fully automated molecular point-of-care test using transcription-reverse transcription concerted reaction that can detect influenza A and B within 15 min in nasopharyngeal swabs and gargle samples (TRCsatFLU).MethodsPatients who visited or were hospitalized at eight clinics and hospitals with influenza-like illnesses between December 2019 and March 2020 participated in this study. We collected nasopharyngeal swabs from all patients and gargle samples from patients whom the physician judged fit to perform gargling. The result of TRCsatFLU was compared to a conventional reverse transcription-polymerase chain reaction (RT-PCR). If the results of TRCsatFLU and conventional RT-PCR were different, the samples were analyzed by sequencing.ResultsWe evaluated 233 nasopharyngeal swabs and 213 gargle samples from 244 patients. The average age of the patients was 39.3 ± 21.2. Of the patients, 68.9% visited a hospital within 24 h of symptom onset. The most common symptoms were fever (93.0%), fatigue (79.5%), and nasal discharge (64.8%). All patients in whom the gargle sample was not collected were children. Influenza A or B was detected in 98 and 99 patients in nasopharyngeal swabs and gargle samples using TRCsatFLU, respectively. Four and five patients in nasopharyngeal swabs and gargle samples, respectively, with different TRCsatFLU and conventional RT-PCR results. Influenza A or B was detected using sequencing in all samples with different results. Based on the combined conventional RT-PCR and sequencing results, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of TRCsatFLU for influenza detection in nasopharyngeal swabs were 0.990, 1.000, 1.000, and 0.993, respectively. In the gargle samples, the sensitivity, specificity, PPV, and NPV of the TRCsatFLU for detecting influenza were 0.971, 1.000, 1.000, and 0.974, respectively.ConclusionsThe TRCsatFLU showed great sensitivity and specificity for the detection of influenza in nasopharyngeal swabs and gargle samples.Trial registration: This study was registered in the UMIN Clinical Trials Registry (reference number: UMIN000038276) on October 11, 2019. Before sample collection, written informed consent for the participation and publication of this study was obtained from all participants.

This randomized, open-label, multicenter, parallel study imitating real-world clinical practice assessed the effect of switching to weekly teriparatide in patients with glucocorticoid-induced osteoporosis (GIO) with a lumbar spine/proximal femur bone mineral density (BMD) T-score ≤ -2.0 or ≤-1.0 and a fragility fracture. Forty-four patients were randomized. The mean durations of the corticosteroid and bisphosphonate administrations were 90.0 and 51.3 months. The baseline BMD at L1-L4 was 0.828 and 0.826 g/cm2 in Groups B (bisphosphonate) and T (teriparatide); at the femur (total), these values were 0.689 and 0.661 g/cm2. The mean change in BMD was numerically higher with teriparatide vs. bisphosphonate but not statistically significant. The mean percentage changes from baseline in BMD at L1-L4 after a 72-week treatment were 0.5% and 4.1% in Groups B and T. The incidence of new fractures was higher in the patients taking bisphosphonates vs. those receiving once-weekly teriparatide at 72 weeks (18.2% vs. 11.8%) and 144 weeks (22.7% vs. 17.6%). The mean percentage change in femur (trochanter) BMD (0.035 [0.007-0.063]; p = 0.02) was significantly greater with teriparatide vs. bisphosphonates. Adverse events (AEs) were more frequent with teriparatide vs. bisphosphonates. Switching to once-weekly teriparatide tended to increase lumbar spine BMD and reduce the occurrence of new fractures vs. bisphosphonates.

IntroductionAbatacept efficacy in older patients with rheumatoid arthritis (RA) has been primarily demonstrated via retrospective comparisons with younger patients. The objective of this study was to compare efficacy of abatacept in older vs. younger patients with RA, and efficacy of abatacept with that of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) in both age groups.MethodsThis prospective, multicenter, observational study (UMIN000014913) enrolled csDMARD-refractory patients without previous biological DMARD treatment. Abatacept (A) or csDMARDs (C) were administered at the treating physician’s discretion to older (O, ≥ 65 years) and younger (Y, 20–64 years) patients, producing AO, AY, CO, and CY groups. Clinical efficacy after 24 weeks was evaluated using European League Against Rheumatism (EULAR) erythrocyte sedimentation rate response criteria.ResultsOverall, 202 patients were evaluated. Compared with the CO group, more patients in the AO group achieved a EULAR good or moderate response (p < 0.0001). Compared with the CY group, more patients in the AY group achieved a EULAR good or moderate response (p < 0.01). Similar proportions of patients in the AO and AY groups achieved a EULAR good response or a good or moderate response. Few adverse events were reported.ConclusionsThis prospective study demonstrated that abatacept is efficacious and safe in older patients with RA and a history of being refractory to csDMARDs. Abatacept was shown to be more efficacious than adding or switching to a new csDMARD in both younger and older csDMARD-refractory patients with RA.Trial RegistrationUMIN000014913.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40744-021-00356-2.

Abstract The Japanese second deep ice coring project was carried out at Dome Fuji, Antarctica. Following the drilling of the pilot hole in 2001, deep ice core drilling led by the Japanese Antarctic Research Expedition (JARE) was conducted over four austral summer seasons, beginning with the 2003/04 season and reached a depth of 3035.22 m near the bedrock in January 2007. The new drill was designed and developed with the goals of (1) solving the problems encountered during the first JARE deep coring drill and (2) achieving more efficient drilling. In particular, the maximum core length that can be drilled at one time was increased from 2.30 m to 3.84 m and the chip storage efficiency was enhanced by a special pipe with many small holes. This paper gives an outline of the improved drilling system, the progress of drilling and various drilling data.