Yamagata University

Building-integrated photovoltaics (BIPVs) require both high power conversion performance and an aesthetically acceptable appearance, particularly near-white façades that are widely used in architecture. However, conventional whitening methods based on surface-textured glass or highly scattered pigment layers can cause considerable optical losses. In this study, we proposed a scattering layer using nanosized smectite clay and investigated its potential for realizing near-white solar cells with reduced power loss. Organically modified smectite was dispersed in a thermoplastic acrylic resin and spin-coated onto glass to form clay films with controlled clay volume fractions. When applied to Si heterojunction (SHJ) cells, the clay films provide high haze through volume scattering, while maintaining a hemispherical transmittance close to that of flat glass, resulting in very low optical loss. In particular, a 50 vol% clay film achieved a near-white appearance comparable to that of commercial textured glass diffusers, while maintaining an optical loss below 1% with a lightness of 32. We also designed and fabricated hybrid films combining clay with dielectric multilayer films (DMFs), optimized by multi-objective Bayesian optimization. The optimized clay–DMF hybrid films achieved a lightness of approximately 60 with an optical loss of approximately 11%, exhibiting a color tone closer to white. These results demonstrate that nanoclay-based scattering layers and their hybridization with DMFs could offer a promising approach for producing near-white BIPV modules with enhanced aesthetic quality while retaining acceptable power performance. • BIPVs require high power conversion and an aesthetically acceptable appearance. • However, conventional whitening methods can cause considerable optical losses. • Hybrid films that combined nanoclay with dielectric multilayer films were studied. • 50 vol% clay film exhibited near-white appearance with optical loss <1% in SHJ cells. • Optimized clay–DMF hybrid films exhibited L∗ ≈60 at ∼11% optical loss.

Porphyrias are rare metabolic disorders caused by decreased or increased activity of one of the nine enzymes involved in the heme biosynthetic pathway, resulting in the accumulation of porphyrins or their precursors. Although nine subtypes are currently recognized, substantial overlap in clinical manifestations often makes diagnosis challenging. This article presents the English version of the first national clinical practice guidelines for porphyrias in Japan, originally published in 2025 by the Japanese Dermatological Association. The guidelines were developed by the Clinical Practice Guideline Committee, established as part of the Research Project on Intractable Diseases of the Ministry of Health, Labour and Welfare of Japan. Diagnostic and severity assessment criteria were based on those proposed by the Ministry research group. Clinical questions (CQs) were formulated, and recommendations were developed according to the principles of evidence-based medicine, incorporating both domestic and international evidence. The guidelines provide diagnostic criteria, severity classification, and evidence-based recommendations for the management of porphyrias. Although causative genes have been identified, the pathophysiology remains incompletely understood, and no curative therapy is currently available, and liver transplantation may be required in severe cases with liver failure. These guidelines aim to provide practical guidance for clinicians managing porphyrias in Japan. Future revisions will be necessary in response to advances in diagnostic technologies and therapeutic strategies.

In the version of the article initially published, the scale bar in Fig. 3d was labelled "Proton density (10 -5 -3 )" and read (from top to bottom) "1.0, 0.5, 0" but should have been labelled "Proton density (10 -1 -3 )" and have read (from top to bottom) "1.7, 0.7, 0".In the Fig.

Accurate clinical staging of upper tract urothelial carcinoma (UTUC) remains challenging, and discrepancies between clinical and pathological T stages may result in missed opportunities for appropriate treatment. This study aimed to elucidate real-world discrepancies between clinical and pathological T staging in UTUC, emphasizing the diagnostic uncertainty associated with clinical T2 (cT2) disease. A retrospective analysis was conducted involving 739 patients with cTa–4N0M0 UTUC who underwent radical nephroureterectomy (RNU) at multiple institutions. Patients who received neoadjuvant therapy or had missing pathological T stage data were excluded. Discrepancies between clinical and pathological staging, treatment patterns, and survival outcomes were evaluated. Among 739 patients, substantial discrepancies between clinical and pathological T stages were observed, with an overall diagnostic concordance rate of 44.7%. Only 16% of cT2 cases were pathologically confirmed as pathological T2 (pT2), whereas most were either down-staged to ≤pT1 or up-staged to ≥pT3, indicating marked diagnostic uncertainty. Clinical heterogeneity within the cT2 group resulted in marked survival differences based on pathological stage, as pT3 patients had significantly worse outcomes than pT2 patients. Within the pT3 subgroup, lymphovascular invasion independently correlated with poor prognosis, whereas adjuvant therapy improved survival. However, only approximately one-third of patients with pT3 disease received adjuvant therapy, indicating a treatment gap in this high-risk population. This multicenter study identified real-world discrepancies between clinical and pathological staging in UTUC. cT2 disease represents a heterogeneous and diagnostically uncertain category, requiring careful interpretation for appropriate treatment planning.

To assess the extent and coverage of ecosystem services, we need to know their geographic distributions. These are typically estimated using environmental data such as land cover. But as biodiversity is closely linked with ecosystem functions, variables describing different dimensions of biodiversity should provide essential information to predict and map services produced by these functions. One persistent problem is that most of the organisms primarily responsible for services are invertebrates that suffer from data shortfalls. For example, we still lack estimates of ranges and aggregate biodiversity patterns for most described insect species. But perhaps more importantly, we are missing information on insect functional diversity, or the variation in species’ functional traits, which is most closely linked with the provision of services. The proliferation of open biodiversity data and development of robust modeling methods now make it possible to predict and map species’ distributions even for those with limited data, but the mapping of insect biodiversity patterns is just getting underway. Here, we mapped taxonomic and functional diversity for bumblebees at the country scale for Japan to assess pollination service potential. Specifically, we used citizen science data on bumblebee occurrences and species distribution models to predict bumblebee richness patterns for Japan, then used multivariate trait data to model the functional hypervolumes of bumblebee communities, and finally mapped these values to compare them with richness. We also ran extinction simulations to map functional resilience, or the ability of communities to retain functional diversity after the loss of resident species. Results showed congruences between taxonomic and functional diversity in the central Japanese Alps, also the most resilient region, but mismatch for Hokkaido in Japan’s far north with high richness yet low functional diversity. Such maps can show how dimensions of insect biodiversity differ over space and can lead to different conservation actions depending on whether species or functions are prioritized. An important next step is to integrate these results with ecosystem service models that link functional diversity estimates with actual service provision.

Existing XR simulators for enteral feeding rely mainly on self-reported learning outcomes and procedural checklists. As a result, they offer limited opportunities to capture objective behavioral data or to present dynamic patient reactions. This two-stage pilot study evaluated an XR-based gastrostomy tube-feeding simulator (ESTE-TF) that integrates sensor-derived performance metrics and two biological-reaction presentation modalities (projection mapping and tablet display). In Experiment 1, nursing students completed pre- and post-experience questionnaires assessing perceived learning across seven domains, alongside sensor-based measurements of feeding-start timing, dosing-rate characteristics, and total procedure time. Experiment 2 employed a tablet-based version with four learning items assessed for students and post-experience evaluations collected from registered nurses. Participants also compared the two XR presentation methods. Students demonstrated perceived learning gains of small-to-large magnitude across both experiments (Experiment 1: d = 0.455-0.974; Experiment 2: d = 0.014-0.886), with wide 95% confidence intervals reflecting the exploratory nature of this pilot work. Sensor-derived data showed greater dosing-rate variability and longer procedure times among students than nurses. Participants reported that projection mapping offered a more embodied experience, whereas tablet displays provided clearer visibility. These findings indicate the feasibility and preliminary educational potential of integrating sensing technologies with XR-based biological-reaction presentation for gastrostomy-feeding training. Given the small samples and non-validated measures, results should be interpreted as exploratory. Future research will refine sensor accuracy, establish standardized performance metrics, and evaluate learning outcomes using validated instruments and controlled study designs.

Suicidal ideation is reported in approximately 4% of patients with progressive supranuclear palsy (PSP); however, only three cases of PSP-related suicide attempts have been reported. Here, we report the case of a patient with early-stage PSP who attempted suicide using an organophosphorus agent. An 81-year-old man with no medical history of severe depression impulsively attempted suicide by consuming an organophosphate. After improvement of the symptoms of organophosphate poisoning, the patient exhibited mild depressive mood, insomnia, mild amnesia, attention deficit, and frontal lobe dysfunction. In addition, he exhibited neck rigidity and postural instability, but no disturbance in ocular motility. Neuroradiological examination revealed findings characteristic of PSP, such as midbrain atrophy, third ventricle enlargement, and remarkably decreased dopamine transporter availability on single-photon emission computed tomography. Based on the clinical symptoms and neuroradiological findings, he was diagnosed with early-stage PSP. In line with previous clinical reports and a forensic study regarding suicide and PSP, our case indicates that suicide may occur before the onset or in the early phases of PSP. Larger neuroradiological studies among older adults with signs of depression may be needed to clarify the involvement of PSP pathology in suicide.

Objective.The LET trilemma-an inherent conflict between target dose homogeneity, range robustness, and high dose-averaged linear energy transfer (LETd)-poses a major challenge in treatment optimization. To ensure accurate beam delivery in multi-ion therapy, this study evaluated the effects of range and setup uncertainties on LETd-optimized treatment plans and explored strategies to overcome this trilemma, framed within the phase I LETdescalation trial for head and neck cancers.Approach.Six head and neck cancer patients representing diverse tumors were selected. Multi-ion therapy plans using carbon-, oxygen-, and neon-ion beams were optimized to achieve a target LETdof 90 keV μm-1(the final LETdlevel of the phase I trial). These plans were recalculated to incorporate systematic range uncertainty (±2.5%) and random daily setup variations (mean, 0.45 mm; standard deviation, 0.23 mm) across the 16 fractions, and their combined effects on the dose and LETddistributions were evaluated. Additionally, to explore strategies to enhance plan robustness, five modified plans were evaluated for one patient identified as particularly susceptible to these uncertainties.Main Results.Range uncertainty was the dominant contributor to degraded plan quality, substantially outweighing setup uncertainty. A small, centrally located tumor was most susceptible, exhibiting dose inhomogeneity of approximately 11%, while LETdvariations were approximately 3 keV μm-1. The most effective mitigation strategy involved replacing the original carbon-oxygen combination with oxygen ions for two beam ports, reducing dose inhomogeneity by more than 7% while maintaining normal tissue sparing adjacent to the target.Significance.Optimization toward achieving higher LETdmakes treatment plans susceptible to range uncertainty, leading to dose degradation within small, deep-seated tumors. Employing heavier ions is an effective strategy to overcome this challenge, enabling robust target coverage by leveraging their inherently higher LETdwhile sparing normal tissues. These findings provide a key rationale for ion selection in the design of robust multi-ion therapy.