Assessing associated factors for failure of nonoperative management in pediatric blunt liver and spleen injuries: a secondary analysis of the SHIPPs study.

Purpose: The purpose of this study was to describe the characteristics of pediatric patients who underwent nonoperative management (NOM) for blunt splenic and hepatic injuries and to explore factors associated with NOM failure.

Methods: This was a secondary analysis of a multicenter cohort study of pediatric patients with blunt liver and spleen injuries in Japan. Participants included pediatric trauma patients aged 16 years or younger between 2008 and 2019 with NOM, which was defined as no surgery provided within 6 h of hospital arrival.

Configurationally Nonselective Aquation of a Mononuclear Ru(II) Chloro Complex to Aquo Complex Isomers with Distinctive Aspects in Photoisomerization, Redox, and Catalytic Water Oxidation.

-[Ru(EtOtpy)(pynp)Cl] (-) (EtOtpy = 4'-ethoxy-2,2':6',2″-terpyridine, pynp = 2-(2-pyridyl)-1,8-naphthyridine), and /-[Ru(EtOtpy)(pynp)OH] (/-) complexes were newly synthesized to investigate the synergistic influence of the geometric configuration coupled with substituent introduction of an ethoxy (EtO) group on the physicochemical properties and reactions of the Ru(II) complexes. Configurationally nonselective aquation of - was uniquely observed to form /- isomers in water, in contrast to configurationally selective aquation of -[Ru(tpy)(pynp)Cl] (-, tpy = 2,2':6',2″-terpyridine) without the EtO group [Yamazaki, H. .

Early restricted oxygen therapy after resuscitation from cardiac arrest (ER-OXYTRAC): protocol for a stepped-wedge cluster randomised controlled trial.

Introduction: Cardiac arrest is a critical condition, and patients often experience postcardiac arrest syndrome (PCAS) even after the return of spontaneous circulation (ROSC). Administering a restricted amount of oxygen in the early phase after ROSC has been suggested as a potential therapy for PCAS; however, the optimal target for arterial partial pressure of oxygen or peripheral oxygen saturation (SpO) to safely and effectively reduce oxygen remains unclear. Therefore, we aimed to validate the efficacy of restricted oxygen treatment with 94%-95% of the target SpO during the initial 12 hours after ROSC for patients with PCAS.

Temperature-Controlled Transformation of WO Nanowires into Active Facets-Exposed Hexagonal Prisms toward Efficient Visible-Light-Driven Water Oxidation.

A unique transformation of WO nanowires (NW-WO) into hexagonal prisms (HP-WO) was demonstrated by tuning the temperature of the (NH)WO precursor suspension prepared from tungstic acid and hydrazine as a structure-directing agent. The precursor preparation at 20 °C followed by calcination at 550 °C produced NW-WO nanocrystals ( <100 nm width, 3-5 μm length) with anisotropic growth of monoclinic WO crystals to (002) and (200) planes and a polycrystalline character with randomly oriented crystallites in the lateral face of nanowires. The precursor preparation at 45 °C followed by calcination at 550 °C produced HP-WO nanocrystals ( 500-1000 nm diameter) with preferentially exposed (002) and (020) facets on the top-flat and side-rectangle surfaces, respectively, of hexagonal prismatic WO nanocrystals with a single-crystalline character.

Horse-Derived Ceramide Accentuates Glucosylceramide Synthase and Ceramide Synthase 3 by Activating PPARβ/δ and/or PPARγ to Stimulate Ceramide Synthesis.

Horse-derived ceramide (HC), which contains galactosylceramides as its main component, significantly improves skin symptoms when applied topically to patients with atopic dermatitis. We speculated that efficacy resulted from the amelioration of epidermal ceramide metabolism, and we characterized those effects using reconstructed human epidermal equivalents. Lipid analysis, RT-PCR and Western blotting revealed that HC significantly increased the total ceramide content of the stratum corneum (SC), accompanied by significantly increased gene and/or protein expression levels of ceramide synthase (CERS) 3, fatty acid elongase (ELOVL) 4, glucosylceramide synthase (GCS), β-glucocerebrosidase, sphingomyelin synthase and acid sphingomyelinase.

Potential Therapeutic Approach of Melatonin against Omicron and Some Other Variants of SARS-CoV-2.

The Omicron variant (B.529) of COVID-19 caused disease outbreaks worldwide because of its contagious and diverse mutations. To reduce these outbreaks, therapeutic drugs and adjuvant vaccines have been applied for the treatment of the disease.

Biofilm Inhibiting Activity of Advanced Glycation Endproduct Crosslink Breaking and Glycation Inhibiting Compounds.

is a Gram-positive bacterium that plays a role in the pathogenesis of skin lesions in diabetes mellitus, atopic dermatitis, and psoriasis, all of which are associated with elevated non-enzymatic glycation biomarkers. The production of biofilm protects resident bacteria from host immune defenses and antibiotic interventions, prolonging pathogen survival, and risking recurrence after treatment. Glycated proteins formed from keratin and glucose induce biofilm formation in , promoting dysbiosis and increasing pathogenicity.

Optimal target blood pressure in elderly with septic shock (OPTPRESS) trial: study protocol for a randomized controlled trial.

Background: Hemodynamic stabilization is a core component in the resuscitation of septic shock. However, the optimal target blood pressure remains debatable. Previous randomized controlled trials suggested that uniformly adopting a target mean arterial pressure (MAP) higher than 65 mmHg for all adult septic shock patients would not be beneficial; however, it has also been proposed that higher target MAP may be beneficial for elderly patients, especially those with arteriosclerosis.

Distinctive Aspects in Aquation, Proton-Coupled Redox, and Photoisomerization Reactions between Geometric Isomers of Mononuclear Ruthenium Complexes with a Large-π-Conjugated Tetradentate Ligand.

Geometric isomers of mononuclear ruthenium(II) complexes, /-[Ru(tpy)(dpda)Cl] (/-, tpy = 2,2':6',2″-terpyridine, dpda = 2,7-bis(2-pyridyl)-1,8-diazaanthracene), were newly synthesized to comprehensively investigate the geometric and electronic structures and distinctive aspects in various reactions between isomers. The ultraviolet (UV)-visible absorption spectra of /- isomers show intense bands for metal-to-ligand charge transfer (MLCT) at close wavelengths of 576 and 573 nm, respectively. However, time-dependent density functional theory (TD-DFT) calculations suggest that the MLCT transition of - involves mainly single transitions to the π* orbital of the dpda ligand in contrast to mixing of the π* orbitals of the dpda and tpy ligands for -.

Effect of facial application of essence containing royal jelly extract on stratum corneum moisture content: A placebo-controlled, double-blind, parallel-group study.

Objectives: To evaluate the moisturizing function and other effects of royal jelly extract on the skin. The effects of applying an essence containing royal jelly extract on the skin of healthy Japanese males and females were examined.

Methods: Thirty-five healthy Japanese men and women who were aware of their skin dryness applied an essence containing royal jelly extract or placebo for 4 weeks using the split-face method in a placebo-controlled, double-blind, parallel comparative study.

Early intubation and decreased in-hospital mortality in patients with coronavirus disease 2019.

Background: Some academic organizations recommended that physicians intubate patients with COVID-19 with a relatively lower threshold of oxygen usage particularly in the early phase of pandemic. We aimed to elucidate whether early intubation is associated with decreased in-hospital mortality among patients with novel coronavirus disease 2019 (COVID-19) who required intubation.

Methods: A multicenter, retrospective, observational study was conducted at 66 hospitals in Japan where patients with moderate-to-severe COVID-19 were treated between January and September 2020.

Life-saving case of cardiopulmonary arrest by secondary aortoenteric fistula formed in the anastomotic site between the inferior mesenteric artery and aortic graft.

Background: Secondary aortoenteric fistula is a fatal cause of gastrointestinal bleeding after aortic reconstructive surgery with a prosthesis. In most cases, the proximal suture line is involved. We herein report a rare case in which the fistula formed between the suture line of inferior mesenteric artery reimplantation and the jejunum.

Highly Efficient and Durable Electrocatalysis by a Molecular Catalyst with Long Alkoxyl Chains Immobilized on a Carbon Electrode for Water Oxidation.

A dinuclear Ru complex, ,-[RuL(COtpy)(OH)(OH)] (COtpy = 4'-octyloxy-2,2'; 6',2″-terpyridine) () with long alkoxyl chains, was synthesized to be immobilized on a carbon paper (CP) electrode via hydrophobic interactions between the long alkoxyl chains and the CP surface. The /CP electrode demonstrated efficient electrocatalytic water oxidation with a low overpotential (η) of 0.26 V (based on the onset potential for water oxidation) in an aqueous medium at pH 7.

Serial Passaging of RAW 264.7 Cells Modulates Intracellular AGE Formation and Downregulates RANKL-Induced In Vitro Osteoclastogenesis.

The passage number of cells refers to the number of subculturing processes that the cells have undergone. The effect of passage number on morphological and phenotypical characteristics of cells is of great importance. Advanced glycation end products have also been associated with cell functionality and characteristics.

Inhibitory Effects of Astaxanthin on CML-HSA-Induced Inflammatory and RANKL-Induced Osteoclastogenic Gene Expression in RAW 264.7 Cells.

Objective: Elevated levels of serum -carboxymethyllysine (CML), a well-known advanced glycation end-product (AGE), were observed in patients with inflammation or osteoporosis. Astaxanthin was reported to possess anti-inflammatory and antioxidant effects. In the present study, we investigated the effects of commercially available dietary supplement AstaReal ACT (ASR) capsule content as astaxanthin on CML-HSA-induced inflammatory and receptor activator of nuclear factor-kappa-Β ligand (RANKL)-induced osteoclastogenic gene expression.

[Three Cases of No. 16 Lymph Node Metastasis-Positive Gastric Cancer Successfully Treated with Chemotherapy and Para-Aortic Lymph Node Dissection].

Chemotherapy is standard treatment for Stage Ⅳ advanced gastric cancer(AGC)positive for No. 16 lymph node(LN) metastasis, but the significance of conversion surgery remains unclear. S-1 plus CDDP(SP), primary lesion resection+ para-aortic LN dissection(PAND), and postoperative recurrence-free survival are reported.

Mechanism of H dissociation-induced O-O bond formation via intramolecular coupling of vicinal hydroxo ligands on low-valent Ru(III) centers.

The understanding of O-O bond formation is of great importance for revealing the mechanism of water oxidation in photosynthesis and for developing efficient catalysts for water oxidation in artificial photosynthesis. The chemical oxidation of the Ru(OH)(OH) core with the vicinal OH and OH ligands was spectroscopically and theoretically investigated to provide a mechanistic insight into the O-O bond formation in the core. We demonstrate O-O bond formation at the low-valent Ru(OH) core with the vicinal OH ligands to form the Ru(μ-OOH) core with a μ-OOH bridge.

Three millimeter needlescopic splenectomy using three-port technique: report of three cases.

We report our experience with needlescopic splenectomy (NS) for the surgical treatment of idiopathic thrombocytopenic purpura using a 3-mm needlescope with three ports. One patient was male and two were females, and their mean age was 58 years. The patient was placed in the right lateral decubitus position.

Facile Fabrication of a Highly Crystalline and Well-Interconnected Hematite Nanoparticle Photoanode for Efficient Visible-Light-Driven Water Oxidation.

Facile and scalable fabrication of α-FeO photoanodes using a precursor solution containing Fe ions and 1-ethylimidazole (EIm) in methanol was demonstrated to afford a rigidly adhered α-FeO film with a controllable thickness on a fluorine-doped tin oxide (FTO) substrate. EIm ligation to Fe ions in the precursor solution brought about high crystallinity of three-dimensionally well-interconnected nanoparticles of α-FeO upon sintering. This is responsible for the 13.

Vagus nerve stimulation modulates arachidonic acid production in the mesenteric lymph following intestinal ischemia-reperfusion injury.

Background: Inflammatory lipid mediators in mesenteric lymph (ML), including arachidonic acid (AA), are considered to play an important role in the pathogenesis of multiple-organ dysfunction after hemorrhagic shock. A previous study suggested that vagus nerve stimulation (VNS) could relieve shock-induced gut injury and abrogate ML toxicity, resulting in the prevention of multiple-organ dysfunction. However, the detailed mechanism of VNS in lymph toxicity remains unclear.

Evaluation of bleeding control course for health-care providers in Japan.

Aim: The Bleeding Control Basic (BCon) course was developed by the American College of Surgeons to teach laypeople and health-care providers (HCPs) how to stop life-threatening bleeding. The first BCon course in Japan was held for HCPs in July 2018. Our study aimed to evaluate the utility of the course, the satisfaction and confidence level of the HCPs that participated, and their experience with using vascular tourniquets.

Measurement of Vagus Nerve Response to Transcutaneous Electrical Ear Canal Stimulation in Anesthetized Rat.

Vagus nerve stimulation (VNS) administered to individuals following events such as severe trauma can be a potential therapy to attenuate gut injury and its sequelae. To determine the effective dose of transcutaneous electrical VNS (TE-VNS) and explore an effective method for performing TE-VNS, a measurement system was developed for the detection of vagus nerve response to TE-VNS. In addition, a noise-suppressed transcutaneous electrical stimulator (TES) was constructed for the same purpose.

A multi-stimuli responsive ruthenium complex for catalytic water oxidation.

A ruthenium complex showing multi-stimuli-responsive isomerization was synthesized. The catalytic activity of this complex toward water oxidation showed responses to visible-light irradiation and heat due to photoisomerization and thermal back-isomerization, respectively. DFT calculations suggested that a pendant moiety in the complex was key to controlling the catalytic activity.