Okinawa Prefecture

Background: Shaoyao Gancao Decoction (SGD) has demonstrated a broad spectrum of analgesic effects and has found application in the management of trigeminal neuralgia (TN). Nonetheless, the underlying molecular mechanisms of this therapeutic intervention remain poorly understood. Objective: This study is designed to elucidate the molecular mechanism of SGD in treating TN by employing an integrated approach that combines network pharmacology, molecular docking, and molecular dynamics simulation. Methods: The active ingredients and associated targets within SGD were screened from the TCMSP database. TN-related targets were extracted from GeneCards, OMIM, CTD, and DisGeNET databases. Subsequently, we constructed a comprehensive TN-SGD-herbs-ingredients-targets network by employing Cytoscape software for visualization. A protein-protein interaction (PPI) network was constructed using the STRING database and further analyzed with Cytoscape, from which we identified pivotal hub genes using three distinct Cytoscape plugins. GO and KEGG enrichment analyses were carried out utilizing R software. Then, molecular docking was executed using AutoDock Vina, and docking results were visualized and augmented with molecular dynamics simulations utilizing BIOVIA Discovery Studio software. Finally, in vitro experiments verified the anti-inflammatory effect of SGD on LPS-treated BV2 cells. Results: A total of 103 active ingredients within SGD, 332 targets associated with TN, and 68 potential therapeutic targets were obtained. We constructed a TN-SGD-herbs-ingredients-targets network and obtained a PPI network of potential therapeutic targets. Then, we extracted seven hub genes from the potential therapeutic targets, including ESR1, JUN, TP53, STAT3, BCL2, AKT1, and ESR2. GO enrichment analyses indicated that SGD affected multiple biological processes and functions, such as responses to xenobiotic stimuli, membrane rafts, DNA binding, and transcription factor binding. KEGG pathway analyses revealed that lipid and atherosclerosis, the AGE-RAGE signaling pathway in diabetic complications, and chemical carcinogenesis-receptor activation were mainly involved in the therapeutic effects of SGD on TN. Importantly, molecular docking analysis demonstrated substantial binding affinities between the top eight ranked active ingredients and the seven identified hub genes. Furthermore, molecular dynamics simulations validated the binding activity between shinpterocarpin and ESR2. Finally, SGD decreased the levels of TNF-α, IL-1β, and IL-6 and regulated protein expression of ESR1 and ESR2 on LPS-treated BV2 cells, indicating that SGD exerted anti-inflammatory effect on microglia. Conclusion: This study offers valuable insights into the active ingredients of SGD and elucidates their potential molecular mechanisms in the treatment of TN. The findings presented herein lay the groundwork for the development of anti-TN agents rooted in the constituents of SGD.

BackgroundAdvancing antimicrobial stewardship programs (ASP) has led to various metrics for assessing antimicrobial consumption. Since introducing the antimicrobial spectrum index (ASI) in 2017, similar metrics, such as days of antibiotic spectrum coverage (DASC), have emerged to better evaluate antimicrobial use, particularly considering de-escalation process. This study assessed antimicrobial consumption with a de-escalation process using DASC in 12 hospitals across three regions in Japan.Table 1.Characteristics of participating hospitalsFigure 1.Trend of monthly DASC/DOT and DOT per 1,000 patient-days stratified by hospital types.MethodsIntravenous antimicrobial consumption data from 12 Japanese hospitals (April 2016–March 2024) were collected. The participating hospitals were located in three regions: West (Okinawa, n=6), East (Tokyo, n=5), and Midwest (Aichi, n=1). Monthly antimicrobial consumption was expressed as days of therapy (DOT) and then converted to DASC per 1,000 patient-days (PD). Hospital-wide de-escalation was evaluated using DASC/DOT. The correlation between DASC/DOT (a new metric) and DOT per 1,000 PD (a conventional metric) was assessed using Spearman’s rank-order correlation test. Hospital characteristics, including ASP availability, and infectious disease consultation, were also collected.Figure 2.Trends of DOT per 1,000 PD, DASC per 1,000 PD and DASC/DOT stratified by hospital regionsResultsA total of 96 months of data were analyzed. Monthly median DOT, DASC, and DASC/DOT were 303.4, 2107.0, and 7.2, respectively. There was little correlation between DASC/DOT and DOT per 1,000 PD (rho=0.11; P< 0.73). University hospitals (median 7.7) and a cancer center (median 8.0) had higher DASC/DOT than the remaining 9 community hospitals (median 6.9), likely owing to the availability of transplant services and a larger number of ICU beds (Figure 1 and Table 1). A substantial decrease in DASC/DOT at one university hospital since August 2022 was observed, likely due to implementing a hospital-wide restriction of carbapenem use. Median DASC/DOTs in East and West were 6.9 and 7.2, respectively, suggesting that the de-escalation process has progressed more at hospitals in Tokyo than at hospitals in Okinawa (Figure 2).ConclusionDASC/DOT, showing little correlation with traditional DOT per 1,000 PD, is a useful metric to assess antimicrobial use and de-escalation process. A regional-level and hospital type-level comparisons can help identify facilities needing further ASP promotion.DisclosuresAll Authors: No reported disclosures

How do animals coordinate their motion during migration? Traditional models of movement coordination, for example, describing bird flocks or fish schools, rely on visual interactions. However, many animals are blind, requiring movement coordination through the maintenance of physical contact. The risks and cost of becoming accidentally separated may encourage the evolution of compensatory strategies. Here, we study tandem running in blind termites. We quantitatively investigate how these animals use their appendages to maintain stable pair movements. During tandem runs, male followers use their palps and antennae to maintain physical contact with female leaders. Our posture-tracking analysis revealed that termites dynamically change their antennal movements. Males stabilize their antennae to maintain contact with their partners while their palps are in contact. When the male palps lost contact with a female, males started swinging antennae while increasing movement speed. Antenna removal experiments revealed that antennal swinging contributes to pair maintenance, and males compensate for single antenna loss by increasing the swinging of the remaining one. By providing detailed information on contact-based movement coordination, our results contribute to understanding the diversity of animal collective motion.

Summary:Oncoplastic breast-conserving surgery aims to achieve oncological safety and aesthetic preservation. Here, we report a novel hybrid oncoplastic breast-conserving surgical technique that combines volume displacement and replacement using hatchet and anterior intercostal artery perforator (AICAP) flaps. A 71-year-old woman with centrally located breast cancer extending to the lower inner quadrant underwent wide local excision, incorporating the nipple–areolar complex, resulting in a 90-mm cylindrical defect. Reconstruction was planned using a hatchet flap elevated from the inferolateral breast and extended laterally along the inframammary fold. An AICAP flap harvested from the upper abdomen was preoperatively designed to ensure adequate central volume restoration and address the anticipated volume deficiency. The flap included a crescent-shaped skin paddle with an attached tongue-shaped fat pad that was de-epithelialized, folded, and used to fill the central defect. Subsequently, the hatchet flap was advanced over the folded intercostal flap to restore the contour and symmetry. Both flaps demonstrated satisfactory perfusion, as confirmed using intraoperative indocyanine green angiography. The patient recovered uneventfully and was discharged on postoperative day 6. Three months later, the reconstructed breast exhibited good projection and a soft tissue quality. This case highlights the utility of combining the hatchet and AICAP flaps in hybrid oncoplastic breast-conserving surgery. Importantly, this technique provides a reliable and aesthetically favorable solution for reconstructing large central-to-lower breast defects.

Translating network operational requirements into device configurations makes it difficult to predict overall system behavior. Hardware-based network testing is limited by time and resource constraints. We model production configurations into multi-layer topology data and develop simulation- and emulationbased verification systems for early-phase, low-overhead validation of multi-node networks. We examine the scalability and practical viability of both approaches.

ABSTRACT The barnacle genus Platylepas contains obligate epibionts of marine vertebrates, but the taxonomic status and evolutionary history of the sea-snake specialist, P. ophiophilus , has remained unclear. Here, we reassess the systematics of the genus through an integrative approach, combining morphological examinations with molecular phylogenetic analyses of mitochondrial COI and nuclear H3 genes from specimens collected from sea turtles, sea snakes, and a dugong. Our results unequivocally demonstrate that P. ophiophilus is a valid species, phylogenetically and morphologically distinct from the widespread turtle barnacle, P. hexastylos . Furthermore, we report the first record of P. ophiophilus from a sirenian host ( Dugong dugon ), a discovery that necessitates the re-examination of historical records of barnacles on sirenians worldwide. Our phylogeny places P. decorata , a turtle epibiont, as the earliest diverging lineage within the genus. This strongly suggests that the ancestor of Platylepas was associated with sea turtles, a conclusion supported by the ichnofossil record. The subsequent divergence of the P. ophiophilus clade represents a major macroevolutionary event: an ancient host shift from sea turtles to the taxonomically disparate but ecologically linked inhabitants—sea snakes and sirenians—of seagrass ecosystems. This study not only resolves a long-standing taxonomic problem but also provides a compelling narrative of host-switching that reconciles deep molecular divergence estimates with the sparse body fossil record for this fascinating group of marine symbionts.

IntroductionConditioning involves the regulation of psychological health, physical fitness, and overall well-being, all of which are essential for optimal athletic performance. While psychological aspects have been extensively studied, the relationship between muscle activity and psychological factors such as anxiety and depression remains underexplored.MethodsThis study investigated the relationship between anxiety, depression, and forearm muscle activity in amateur athletes (mean age: 28 ± 9 years; sports experience: 13 ± 5 years) who participate in sports requiring upper extremity use. Muscle activity was evaluated using autocorrelation coefficients derived from muscle deformation data collected via a sensor array. Anxiety and depression levels were assessed using validated questionnaires, and their associations with muscle deformation were analyzed.ResultsMuscle deformation suggested a task-dependent relationship with psychological factors. A significant correlation was observed between anxiety and Hand tasks (r = −0.57, p = 0.004, pfdr = 0.05) and a trend was found between depression and random tasks such as HPI randomness (r = 0.46, p = 0.04, pfdr = 0.15).DiscussionThese findings suggest that chronic psychological stress may impair sustained muscle contraction during cyclic movements and promote fixed motor patterns during random tasks. This study elucidates how anxiety and depression affect muscle activity under different task conditions, providing a basis for optimizing training protocols and psychological stress management strategies in athletic conditioning.

BackgroundAortic root replacement in patients with ventricular septal defect (VSD) requires a modified surgical technique.MethodsBetween 2000 and 2022, 12 patients with aortic regurgitation and VSD underwent an operation. Their age at operation was 31.8 (SD 19.9) years. The VSD was patent in 5 patients and spontaneously or surgically closed in 7 patients. The location of the VSD was subarterial in 6 patients, perimembranous in 5, and muscular in 1 patient. The aortic valve was tricuspid in 8 patients, bicuspid in 2, and unicuspid in 2. Eight patients also had annuloaortic ectasia.ResultsThe VSDs were closed using a patch in 4 patients and directly closed in 1 patient. The aortic root procedures were valve-sparing reimplantation in 7 patients, root remodeling in 1, basal ring annuloplasty in 1, basal ring annuloplasty with sinutubular junction annuloplasty in 1, and a Ross procedure in 1 patient. Additional cusp repair was required in 9 patients. No early deaths occurred. The postoperative follow-up periods were 5.3 (3.4) years. Two patients died, and 1 underwent aortic valve replacement 4 years postoperatively. Survival was 91.7 (8.0)% at 5 years and 68.8 (20.7)% at 10 years. Freedom from aortic valve reoperation was 88.9 (10.5)% at 10 years.ConclusionsValve-sparing root reimplantation in patients with annuloaortic ectasia and VSD may require a special first row suture line. Patients with prolapsed cusps may require resuspension or cusp extension. The Ross operation can be an alternative for patients with severely deformed aortic cusps.