High-rise housing is being built in increasingly densely populated urban residential areas in Tokyo,Japan.On the other hand,detached houses are built on small,subdivided sites.In urban residential areas where detached...High-rise housing is being built in increasingly densely populated urban residential areas in Tokyo,Japan.On the other hand,detached houses are built on small,subdivided sites.In urban residential areas where detached houses are lined up,many elements related to daily life are located near roadside space and spill out onto the road.This is a distinctive modern urban residential landscape.The purpose of this study is to get closer to the reality of urban residential life.For that,we will consider the characteristics and roles of elements related to daily life that can be observed in many areas around roadside space in an urban residential area lined with detached houses,in urban living environments.This study focuses on the detached residential area of Bunkyo Ward.A field survey will be conducted to investigate the amount of elements related to daily life that can be observed from the road.In addition,we will conduct a questionnaire survey of residents in the survey area regarding their use of and awareness of the roadside space.Finally,we will investigate the relationship between lifestyle factors and urban residential life from both quantitative and qualitative perspectives.展开更多
To investigate the influencesof non-plastic silt and soil aging on the re-liquefaction resistance of sands,a series of undrained triaxial tests was performed on sand-silt mixtures with finescontent ranging from 0%to 1...To investigate the influencesof non-plastic silt and soil aging on the re-liquefaction resistance of sands,a series of undrained triaxial tests was performed on sand-silt mixtures with finescontent ranging from 0%to 100%,as well as on undisturbed and reconstituted non-plastic sandy soils retrieved from earth structures with a history of earthquake-induced damage.The specimens on sand-silt mixtures were produced under an initial degree of compaction of 95%.In these tests,liquefaction histories were applied three times to a single specimen under the same cyclic stress ratio after the respective consolidation stages with the measurements of the shear wave velocities.The following conclusions can be obtained from the test results:(1)The liquefaction resistance obtained in the firstto third cyclicloading stages decreased initially with increasing finescontent up to about 45%,while it increased afterward.Therefore,the susceptibility of sands containing a relatively large amount of non-plastic silt to reliquefaction may be more significantthan that of clean sands;(2)The liquefaction resistance and the shear wave velocity decreased significantlyduring the second cyclic-loading stage and after the second consolidation,respectively,despite an increase in the specimen density caused by the first liquefaction history,while they increased in the third stage.The possible reason for this change would be the disturbance of soil structures due to liquefaction,which may be partially evaluated by the volumetric strain during the respective consolidation stages,and the stress-induced anisotropy formed in the previous liquefaction stage;and(3)The liquefaction resistance and the shear wave velocity of the undisturbed specimens,which were measured in the firstto third stages,were larger than those of the reconstituted ones due to the aging effects,respectively.That is,the aging effects may not necessarily be eliminated by the subsequent liquefaction history and may remain partially in some cases.展开更多
Progranulin(PGRN),encoded by the GRN gene,is a secreted glycoprotein that undergoes proteolytic cleavage to generate individual granulin peptides(granulin A-G)capable of exerting distinct biological functions.PGRN is ...Progranulin(PGRN),encoded by the GRN gene,is a secreted glycoprotein that undergoes proteolytic cleavage to generate individual granulin peptides(granulin A-G)capable of exerting distinct biological functions.PGRN is widely expressed in multiple tissues,including the central nervous and immune systems.Within the central nervous system,PGRN is highly expressed in the hippocampus,cerebral cortex,and hypothalamus,and has been detected in various neuronal subtypes,including Purkinje cells and motor neurons,where it plays a crucial role in neuronal functions,such as neurite outgrowth and synaptic plasticity.In addition to neurons,PGRN is expressed in glial cells,particularly in microglia,where it regulates phagocytosis.Furthermore,PGRN is presented in peripheral immune cells,including macrophages,and contributes to the regulation of inflammatory responses.PGRN exerts its diverse functions via binding partners,including receptors such as sortilin,EphA2,Notch,death receptor 3,and toll-like receptor 9(Chitramuthu et al.,2017).展开更多
As a closed-loop learning control method,repetitive control has been widely used in a variety of areas from appliances to aviation.A repetitive control system features perfect reference tracking and disturbance reject...As a closed-loop learning control method,repetitive control has been widely used in a variety of areas from appliances to aviation.A repetitive control system features perfect reference tracking and disturbance rejection in the steady state for periodic signals with a fixed period.This characteristic is important not only for conventional technologies and conventional industries but also for advanced technologies and emerging industries.This paper first explains the concept of repetitive control from its original idea.Next,it describes the structure of a repetitive controller as an internal model and shows the respective points of continuous-and discrete-time repetitive control.It presents a categorized list of practical applications of repetitive control.Moreover,two concrete applications,namely the control of a robotic manipulator and a rotating system,demonstrate the validity of the method with experimental results.Several current studies in this field are also reviewed,and some challenges and future studies for repetitive control are provided.展开更多
The lateral transport of labile organic carbon represents a critical pathway for soil organic carbon(SOC) loss,reducing organic carbon sequestration and increasing the risk of waterbody pollution.Livestock manure appl...The lateral transport of labile organic carbon represents a critical pathway for soil organic carbon(SOC) loss,reducing organic carbon sequestration and increasing the risk of waterbody pollution.Livestock manure application on croplands serves as a common fertilizer reduction practice to sustain crop yields,enhance SOC sequestration,and reduce water erosion.However,limited quantitative assessments have examined the effects of livestock manure substitution on labile organic carbon lateral loss and fluxes in long-term experiments.This study conducted a three-year field investigation on subtropical sloping croplands to assess the impact of livestock manure substitution on dissolved organic carbon(DOC) and particulate organic carbon(POC) loss via surface runoff,interflow and eroded sediments.There are four treatments:no fertilization(CK);chemical nitrogen fertilizer(SF),40% nitrogen substitution with pig manure(PMF),and 100% nitrogen substitution from pig manure(PM).Compared to SF treatment,long-term livestock manure substitution in PMF and PM treatments significantly(P<0.05) reduced annual cumulative surface runoff fluxes by 13.5 and 21.6%,respectively.Manure applications decreased annual sediment fluxes by 12.9 and 19.1%,respectively.Soil water stable aggregates for mean weight diameter(MWD) increased significantly by 37.7 and 73.6%.Annual cumulative POC loss flux via eroded sediment under PMF and PM treatments increased significantly(P<0.05) by 61.1 and 47.9%,respectively.The labile organic carbon loss fluxes,including DOC and POC losses,under PMF and PM treatments increased significantly(P<0.05) by 11.9 and 31.4%,respectively.These results demonstrate that while water erosion intensity decreases due to enhanced soil aggregate stability,the risk of labile organic carbon loss increases after long-term livestock manure substitution in subtropical sloping croplands.Future research should examine labile organic carbon lateral migration under various soil types and slope gradients for livestock manure application in subtropical agricultural ecosystem croplands to better understand extreme rainfall effects.展开更多
Long-term climate changes related with urbanization in Tokyo, Japan, and recent temperature and heavy rainfall distribution in the Tokyo metropolitan area are reviewed. A relatively high temperature increase in annual...Long-term climate changes related with urbanization in Tokyo, Japan, and recent temperature and heavy rainfall distribution in the Tokyo metropolitan area are reviewed. A relatively high temperature increase in annual mean temperature at the rate of 3.0°C/century was detected in Tokyo for the period 1901–2015. Some observational evidence showed the existence of both thermal and mechanical effects of urbanization on recent heavy rainfall occurrences, and modeling studies also support precipitation enhancement. Urban influences were recognized in other climatological elements, such as number of fog days, relative humidity, and wind circulation.展开更多
Purpose: This study was to clarify the association of sexual awareness of high school students with cognitive social capital (SC) in Tokyo, Japan. Method: In September 2017, we conducted a survey of 1073 third-grade h...Purpose: This study was to clarify the association of sexual awareness of high school students with cognitive social capital (SC) in Tokyo, Japan. Method: In September 2017, we conducted a survey of 1073 third-grade high school students who were the same students who had participated in the same questionnaire survey at the prior academic year when they were second-grade students. A total of 1073 students were surveyed and 956 students responded. From six to eight weeks prior to this September 2017 survey, we implemented an educational intervention in the students. Then we compared the results of this survey with the previous survey of February 2017. We used logistic regression to assess sexual awareness and sex knowledge, sexually experienced surrounding peers and Self-Esteem score. The study was approved by the Ethical Review Board. Result/Discussion: Sexual awareness of high school students was significantly associated with SC both before and after the intervention. The higher SC one had, the higher sexual awareness was shown and the greater the sexual caution among both boys and girls was indicated. The study clarified the Determinants of Sexual Awareness of High School Students in Tokyo before and after the educational intervention. Conclusion: SC was found to be significantly associated with sexual awareness. SC should be emphasized in promoting adolescent reproductive health for the future.展开更多
Purpose: The study aimed to clarify the relationship between cognitive social capital and sexual awareness in high school students in Tokyo, Japan. Method: The self-administered questionnaire survey was administered t...Purpose: The study aimed to clarify the relationship between cognitive social capital and sexual awareness in high school students in Tokyo, Japan. Method: The self-administered questionnaire survey was administered to 1073 high school junior students in Tokyo in Feb. 2017 (collection rate 94.5%). Final analysis subjects totaled 1011 boys and girls (94.2%). True/false questions on timing to wear condom for sex knowledge, acceptability to sexual behavior of high school students for sexual awareness, sense of community belonging for social capital, existence of sexually experienced peers, and Rosenberg Self-Esteem Scale score (binarized with the mean value) were verified. Multiple logistic regression analysis assigning sexual awareness for dependent variable and sex knowledge, sexually experienced peers and Self-Esteem score for independent variable [model 1], including social capital for independent variable [model 2] was performed. The study was approved by Ethical Review Board of sub-organ. Results and Discussion: Out of subjects, 52.6% answered correctly questions on sex knowledge, 33.2% showed tolerance to sexual behavior of high school students, 68.6% had many peers with sex experience, and 75.9% had a sense of community belonging. In model 1, in both genders, having sex knowledge, high Self-Esteem score, and existence of sexually experienced peers was associated with a sense of intolerance to sexual behavior of high school students. In model 2, in both genders, having a sense of community belonging was associated with a sense of intolerance to sexual behavior of high school students [OR (95% CI): boy 1.11 (0.81 - 1.53), girl 1.14 (0.72 - 1.79)]. Persons with high cognitive social capital were likely to have a cautious sense toward sexual behavior. Conclusion: Cognitive social capital was found to be associated with sexual awareness. Cognitive social capital should be emphasized in promoting adolescent reproductive health for the future.展开更多
Background: This study aimed to identify the predictors of LGBT recognition by health sciences university students in Japan. Methods: This is a cross-sectional study that used quantitative data collected from 481 retu...Background: This study aimed to identify the predictors of LGBT recognition by health sciences university students in Japan. Methods: This is a cross-sectional study that used quantitative data collected from 481 returned self-report questionnaires distributed to 866 health sciences undergraduate and graduate students. The following survey item and scales were used for measuring the main outcomes: Thoughts about sexual identity, Empathy scale, Objectivity scale, and LGBT recognition scale. Data were analyzed using descriptive statistics, two-sample t-test, one-way analysis of variance, and multiple regression analyses. SPSS ver. 23.0 (SPSS, Chicago, IL, USA) was used for data analysis at a 5% significance level. Results: The number of returned questionnaires was 481 (55.5%). There was no significant difference in the LGBT recognition and the participant’s characteristics (e.g., age and medical history). The 5 significant predictors of LGBT recognition were: 1) Empathy (β = 0.19, p LGBT learning experience (β = 0.18, p Objectivity (β = 0.15, p Sexual problem with a close person (β = 0.13, p Suffering from gender identity (β = 0.09, p Conclusions: The predictive factors of LGBT recognition were Empathy, LGBT learning experience, Objectivity, Sexual problem with a close person, and Suffering from gender identity. Careful development and implementation of LGBT educational programs are needed to better understand the situations and ideas of LGBT parties to enhance their recognition.展开更多
<p style="text-align:justify;margin-left:10pt;"> <span style="font-family:;" "=""><span>This study examined the validity of the differentiation-of-self hypothesis f...<p style="text-align:justify;margin-left:10pt;"> <span style="font-family:;" "=""><span>This study examined the validity of the differentiation-of-self hypothesis for Japanese university students, and its mechanism in relation to negative life event aversion. Although </span><span>the differentiation-of-self hypothesis is accepted as one of the basic hypothes</span><span>es in the clinical field of family therapy in Japan</span><span><span>, empirical studies on the subject are scarce. Further, there are few studies, internationally, on its mechanism. A questionnaire survey was conducted with university students (</span><i><span>n </span></i><span>= 250) to measure their differentiation of self, maladaptive states, and negative life event aversion. </span><span>Compared to the better-differentiated group, the less-differentiated group had higher scores both for maladaptive </span></span><span><span>states—somatic symptoms (</span><i><span>t</span></i><span>(223) = -</span></span></span><span><span style="font-family:;" "=""><span><span>2.70, </span><i><span>p</span></i><span> = </span></span></span></span><span><span>0</span></span><span><span style="font-family:;" "=""><span>.008), social dysfunction</span><span><span> (</span><i><span>t</span></i><span>(211.00) = -</span></span></span></span><span><span style="font-family:;" "=""><span><span>3.30, </span><i><span>p</span></i><span> = </span></span></span></span><span><span>0</span></span><span><span style="font-family:;" "=""><span>.001), and severe depression (</span><i><span>t</span></i><span>(208.78) = -</span></span></span><span><span style="font-family:;" "=""><span><span>4.08, </span><i><span>p</span></i><span> <</span></span></span></span><span><span> 0</span></span><span><span style="font-family:;" "=""><span>.001)—and negative life event aversion—interpersonal domain (</span><i><span>t</span></i><span>(223) = -</span></span></span><span><span style="font-family:;" "=""><span><span>3.96, </span><i><span>p</span></i><span> <</span></span></span></span><span><span> 0</span></span><span><span style="font-family:;" "=""><span>.001) and achievement domain (</span><i><span>t</span></i><span>(223) = -</span></span></span><span><span style="font-family:;" "=""><span><span>3.83, </span><i><span>p</span></i><span> <</span></span></span></span><span><span> 0</span></span><span><span>.001). </span></span><span>The results supported the validity of the differentiation-of-self hypothesis for Japanese university students, and that cognitive tendencies toward negative life events may be part of the mechanism for less-differentiated individuals’ subsequent vulnerability. This suggests the effectiveness of cognitive interventions.</span> </p>展开更多
<span style="font-family:Verdana;">We are confronting a new threat in the prevalence of antibiotic-resistant bacteria followed by epidemic spread in aquatic environments in metropolitan areas because d...<span style="font-family:Verdana;">We are confronting a new threat in the prevalence of antibiotic-resistant bacteria followed by epidemic spread in aquatic environments in metropolitan areas because damage from river floods is increasing remarkably in Japan due to global extreme weather. The sewer penetration rate is about 100% in Tokyo and reclaimed water from sewage treatment plants accounts for over 50% of all water in both the down- and mid-stream areas of local rivers. The water quality of these rivers, which contain microflora, seems to be seriously affected by reclaimed water. In this study, we collected water samples on July 17, 2018 and examined the behavior of antibiotic-resistant fecal coliforms in the stream of a sewage treatment plant in Tokyo. Extended-spectrum </span><i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">-lactamase (ESBL)</span><span style="font-family:Verdana;">-producing fecal coliforms with encoding genes were found;the CTX-M-1, CTX-M-9, TEM, and SHV groups were found to have survived in the final effluent to the river after sterilization with sodium hypochlorite.展开更多
<strong>Background: </strong>The aim of this study was to investigate Japanese students and employed adults’ characteristic features, and sexual situation, and to find the correlated factors of lesbi...<strong>Background: </strong>The aim of this study was to investigate Japanese students and employed adults’ characteristic features, and sexual situation, and to find the correlated factors of lesbian, gay, bisexual, transgender (LGBT) recognition in order to obtain suggestions for improved relationships with sexual minorities in a diversifying society. <strong>Methods:</strong> This quantitative cross-sectional descriptive correlational study occurred during 2018 to 2019 when 2210 questionnaires were distributed to a purposive sample of eligible participants. A total of 1534 completed questionnaires (69.4%) were returned, of which 1439 (65.1%) were suitable for analyses. The survey included respondents’ 1) characteristics, 2) sexual situation, and 3) LGBT recognition scale. Data were analyzed with descriptive statistics, factor analysis, reliability analysis, and structural equation modeling. SPSS ver. 26.0 (SPSS, Chicago, IL, USA) was used for data analysis at a 5% significance level. <strong>Results:</strong> The LGBT recognition score was significantly affected by suffering from gender identity (standardized partial regression coefficient: β = 0.17, p < 0.001), age (β = <span style="white-space:nowrap;">−</span>0.19, p < 0.001), learning about LGBT experience (β = 0.29, p < 0.001), experience of disclosure from LGBT person (β = 0.14, p < 0.001), sexual problems with intimate relationship (β = 0.07, p < 0.001), and diversity penetration (β = 0.14, p < 0.05). <strong>Conclusions:</strong> Suffering from gender identity, learning about LGBT experience, experience of disclosure from LGBT person, sexual problem with intimate relationship, and diversity penetration had a positive effect, whereas age had negative effects on the LGBT recognition score.展开更多
This study has been carried out to examine the development of an “elderly tele-nursing model” for care provided in-homeby family members and through remote nursing systems in a super-aging society. The time required...This study has been carried out to examine the development of an “elderly tele-nursing model” for care provided in-homeby family members and through remote nursing systems in a super-aging society. The time required for elderly tele-nursing wasinfluenced by whether or not the visitor uses the Shinkansen or the Express train. Based on 40 questionnaires, clear differences wereobserved according to whether visits were “every two weeks” or “once per month”. And finally, comparing the trends andcharacteristics of remote care for the elderly in the TMA (Tokyo Main Area) and Kansai region clarified regional characteristic.展开更多
Dear Editor,This letter presents an improved repetitive controller(IRC) that uses a complex-coefficient filter to enhance the tracking performance of a system for periodic signals. Compared with the low-pass filter us...Dear Editor,This letter presents an improved repetitive controller(IRC) that uses a complex-coefficient filter to enhance the tracking performance of a system for periodic signals. Compared with the low-pass filter used in the conventional repetitive controller(CRC), the complex-coefficient filter causes less change in the phase and amplitude of a signal at the frequencies of the periodic signal, especially at the fundamental frequency, when the two filters have the same cutofffrequency.展开更多
Some of the most interesting areas in aerospace science and technologies are on either higher,faster,and larger systems or lower,slower,and smaller flying capabilities.In this paper,we present our perspectives on the ...Some of the most interesting areas in aerospace science and technologies are on either higher,faster,and larger systems or lower,slower,and smaller flying capabilities.In this paper,we present our perspectives on the aerodynamics related to small,fixed-wing as well as flapping-wing flight vehicles.From an evolutionary viewpoint,flyers have gone through many iterations,adaptations,and optimizations to balance their biological functions,including flight.In the low-Reynolds-number regime,the aerodynamic characteristics around a solid object differ from those observed at the scale of passenger-airplanes.Consequently,the optimal airfoil and wing shapes vary with vehicle size.As vehicle dimensions vary,non-proportional scaling between surface areas and weight shifts the dominance of physical mechanisms,leading to distinct operational parameters and technical requirements.With smaller flight vehicles,structural flexibility as well as anisotropic material properties become more pronounced,which causes qualitative changes in aerodynamics.The flapping motion of the wings,the interactions between wings,the synergistic characteristics of wing and tail,and the development of soft structures for better agility and flight performance are discussed.Low-Reynolds-number aerodynamics require collaborative innovation to optimize shape,motion,and structure of vehicles in accordance with the scaling laws.Together,progress on these fronts is reshaping the design paradigm of air vehicles and other types of robots with shrinking physical dimensions and more versatile capabilities to meet wider ranges of missions.展开更多
In this study,we investigated improving the performance of a layered double hydroxide(LDH)for the adsorption of As(III)and As(V)by controlling the morphology of LDH crystals.The LDH was synthesized via a simple coprec...In this study,we investigated improving the performance of a layered double hydroxide(LDH)for the adsorption of As(III)and As(V)by controlling the morphology of LDH crystals.The LDH was synthesized via a simple coprecipitation method using barely soluble MgO as a precursor and succinic acid(SA)as a morphological control agent.Doping the LDH crystals with carboxylate ions(RCOO−)derived from SA caused the crystals to develop in a radial direction.This changed the pore characteristics and increased the density of active surface sites.Subsequently,SA/MgFe-LDH showed excellent affinity for As(III)and As(V)with maximum sorption densities of 2.42 and 1.60 mmol/g,respectively.By comparison,the pristine MgFe-LDH had sorption capacities of 1.56 and 1.31 mmol/g for As(III)and As(V),respectively.The LDH was effective over a wide pH range for As(III)adsorption(pH 3-8.5)and As(V)adsorption(pH 3-6.5).Using a combination of spectroscopy and sorption modeling calculations,the main sorption mechanism of As(III)and As(V)on SA/MgFe-LDH was identified as inner-sphere complexation via ligand exchangewith hydroxyl group(-OH)and RCOO−.Specifically,bidentate As-Fe complexeswere proposed for both As(III)and As(V)uptake,with the magnitude of formation varying with the initial As concentration.Importantly,the As-laden adsorbent had satisfactory stability in simulated real landfill leachate.These findings demonstrate that SA/MgFe-LDH exhibits considerable potential for remediation of As-contaminated water.展开更多
Background:Scutellaria root(root of Scutellaria baicalensis),which has potent anti-inflammatory effects,is a component of useful traditional formulaes.Albeit a low frequency,it has been reported to cause severe inters...Background:Scutellaria root(root of Scutellaria baicalensis),which has potent anti-inflammatory effects,is a component of useful traditional formulaes.Albeit a low frequency,it has been reported to cause severe interstitial pneumonia and liver dysfunction.Importantly,the hepatotoxicity induced by Scutellaria root can be controlled by the baicalin content,one of its major constituents.This study aimed to clarify the role of MRP2 in modulating baicalin-induced cytotoxicity in HepG2 cells,providing insights that inform safer use and assessment of baicalin.Methods:Cytotoxicity of HepG2 and MDCK cells was assessed using a cell counting kit-8 assay in the presence and absence of MK571,an MRP2 inhibitor.MRP2 expression levels were confirmed using agarose gel electrophoresis,and intracellular baicalin concentrations were measured using LC/MS.Results:Baicalin exhibited concentration-dependent cytotoxicity,with higher toxicity observed in MRP2-negative MDCK cells than in MRP2-positive HepG2 cells.Pre-treatment with MK571 increased baicalin-induced cytotoxicity in HepG2 cells and doubled the intracellular baicalin concentration.Conclusion:Our results indicated that MRP2 plays an important role in reducing baicalin-induced hepatocyte toxicity by decreasing intracellular baicalin levels.Monitoring MRP2 activity could serve as a critical predictive biomarker to identify individuals at higher risk of baicalin-induced hepatotoxicity,enabling personalized dosing strategies and minimizing adverse effects associated with Scutellaria root-containing formulae.展开更多
In this paper,a nonlinear control approach for an unstable networked plant in the presence of actuator and sensor limitations using robust right coprime factorization is proposed.The actuator is limited by upper and l...In this paper,a nonlinear control approach for an unstable networked plant in the presence of actuator and sensor limitations using robust right coprime factorization is proposed.The actuator is limited by upper and lower constraints and the sensor in the feedback loop is subjected to network-induced unknown time-varying delay and noise.With this nonlinear control method,we first employ right coprime factorization based on isomorphism and operator theory to factorize the plant,so that bounded input bounded output(BIBO)stability can be guaranteed.Next,continuous-time generalized predictive control(CGPC)is utilized for the unstable operator of the right coprime factorized plant to guarantee inner stability and enables the closed-loop dynamics of the system with predictive characteristics.Meanwhile,a second-Do F(degrees of freedom)switched controller that satisfies a perturbed Bezout identity and a robustness condition is designed.By using the CGPC controller that possesses predictive behavior and the second-Do F switched stabilizer,the overall stability of the plant subjected to actuator limitations is guaranteed.To address sensor limitations that exist in networked plants in the form of delay and noise which often cause system performance degradation,we implement an identity operator definition in the feedback loop to compensate for these adverse effects.Further,a pre-operator is designed to ensure that the plant output tracks the reference input.Finally,the effectiveness of the proposed design scheme is demonstrated by simulations.展开更多
Rationale:Advances in sleep research have introduced medications like lemborexant,a dual orexin receptor antagonist.While effective for regulating sleep,overdoses are a concern,especially in suicide attempts.However,l...Rationale:Advances in sleep research have introduced medications like lemborexant,a dual orexin receptor antagonist.While effective for regulating sleep,overdoses are a concern,especially in suicide attempts.However,limited data exist on lemborexant overdose,prompting this case report to elucidate its clinical course.Patient’s Concern:A 91-year-old Japanese woman with multiple comorbidities,including insomnia and chronic kidney disease,was admitted after ingesting 315 mg of lemborexant in a suicide attempt.Diagnosis:Lemborexant overdose.Interventions:Supportive care with 500 mL of Ringer’s acetate solution at the emergency room.Outcomes:She gradually regained full consciousness with no residual deficits.Due to persistent suicidal ideation,she was transferred to a psychiatric hospital after seven days of supportive care.Lessons:A review of four lemborexant overdose cases managed at our hospital revealed that overdoses primarily induce altered consciousness and are unlikely to cause organ dysfunction.Supportive care is generally sufficient for management.However,given the limited data,further case accumulation is needed to enhance clinical understanding.展开更多
Rationale:Abdominal pain is a common complaint with a broad differential diagnosis,including both intra-abdominal and abdominal wall pathologies.While visceral causes are frequently considered,abdominal wall condition...Rationale:Abdominal pain is a common complaint with a broad differential diagnosis,including both intra-abdominal and abdominal wall pathologies.While visceral causes are frequently considered,abdominal wall conditions are often overlooked,leading to diagnostic delays.Among them,umbilical abscesses are rare but require distinction from urachal abscesses due to differences in management.Patient’s concern:A 46-year-old woman presented with a one-week history of periumbilical pain unresponsive to analgesics.Diagnosis:Physical examination revealed localized tenderness and a positive Carnett’s sign.Computed tomographic images identified an umbilical abscess without evidence of urachal remnants,ruling out a urachal abscess.Interventions:The patient underwent abscess drainage and received cefalexin(1500 mg/day)for 28 days.Outcomes:The abscess resolved completely without recurrence.Lessons:Umbilical abscesses are rare and may be mistaken for urachal abscesses.A thorough clinical evaluation,including Carnett’s sign and imaging studies,is crucial for accurate diagnosis.Prompt differentiation facilitates appropriate management and prevents unnecessary interventions.展开更多
文摘High-rise housing is being built in increasingly densely populated urban residential areas in Tokyo,Japan.On the other hand,detached houses are built on small,subdivided sites.In urban residential areas where detached houses are lined up,many elements related to daily life are located near roadside space and spill out onto the road.This is a distinctive modern urban residential landscape.The purpose of this study is to get closer to the reality of urban residential life.For that,we will consider the characteristics and roles of elements related to daily life that can be observed in many areas around roadside space in an urban residential area lined with detached houses,in urban living environments.This study focuses on the detached residential area of Bunkyo Ward.A field survey will be conducted to investigate the amount of elements related to daily life that can be observed from the road.In addition,we will conduct a questionnaire survey of residents in the survey area regarding their use of and awareness of the roadside space.Finally,we will investigate the relationship between lifestyle factors and urban residential life from both quantitative and qualitative perspectives.
基金supported by JSPS KAKENHI(Grant Nos.JP22K04305 and JP19K15083).
文摘To investigate the influencesof non-plastic silt and soil aging on the re-liquefaction resistance of sands,a series of undrained triaxial tests was performed on sand-silt mixtures with finescontent ranging from 0%to 100%,as well as on undisturbed and reconstituted non-plastic sandy soils retrieved from earth structures with a history of earthquake-induced damage.The specimens on sand-silt mixtures were produced under an initial degree of compaction of 95%.In these tests,liquefaction histories were applied three times to a single specimen under the same cyclic stress ratio after the respective consolidation stages with the measurements of the shear wave velocities.The following conclusions can be obtained from the test results:(1)The liquefaction resistance obtained in the firstto third cyclicloading stages decreased initially with increasing finescontent up to about 45%,while it increased afterward.Therefore,the susceptibility of sands containing a relatively large amount of non-plastic silt to reliquefaction may be more significantthan that of clean sands;(2)The liquefaction resistance and the shear wave velocity decreased significantlyduring the second cyclic-loading stage and after the second consolidation,respectively,despite an increase in the specimen density caused by the first liquefaction history,while they increased in the third stage.The possible reason for this change would be the disturbance of soil structures due to liquefaction,which may be partially evaluated by the volumetric strain during the respective consolidation stages,and the stress-induced anisotropy formed in the previous liquefaction stage;and(3)The liquefaction resistance and the shear wave velocity of the undisturbed specimens,which were measured in the firstto third stages,were larger than those of the reconstituted ones due to the aging effects,respectively.That is,the aging effects may not necessarily be eliminated by the subsequent liquefaction history and may remain partially in some cases.
基金SENSHIN Medical Research Foundation,Takeda Science Foundation,Taiju Life Social Welfare Foundation,Mitsui Sumitomo Insurance Welfare Foundation,Research Foundation for Pharmaceutical Sciences,Tokyo Medical University Research Grant,JSPS KAKENHI(23K06369)to SKJSPS KAKENHI(24K02187)to KK.
文摘Progranulin(PGRN),encoded by the GRN gene,is a secreted glycoprotein that undergoes proteolytic cleavage to generate individual granulin peptides(granulin A-G)capable of exerting distinct biological functions.PGRN is widely expressed in multiple tissues,including the central nervous and immune systems.Within the central nervous system,PGRN is highly expressed in the hippocampus,cerebral cortex,and hypothalamus,and has been detected in various neuronal subtypes,including Purkinje cells and motor neurons,where it plays a crucial role in neuronal functions,such as neurite outgrowth and synaptic plasticity.In addition to neurons,PGRN is expressed in glial cells,particularly in microglia,where it regulates phagocytosis.Furthermore,PGRN is presented in peripheral immune cells,including macrophages,and contributes to the regulation of inflammatory responses.PGRN exerts its diverse functions via binding partners,including receptors such as sortilin,EphA2,Notch,death receptor 3,and toll-like receptor 9(Chitramuthu et al.,2017).
基金supported in part by the Japan Society for the Promotion of Science Grants-in-Aid for Scientific Research(B)(23K25252,24K03325)the National Natural Science Foundation of China(61873348)the Natural Science Foundation of Hubei Province,China(2020CFA031)。
文摘As a closed-loop learning control method,repetitive control has been widely used in a variety of areas from appliances to aviation.A repetitive control system features perfect reference tracking and disturbance rejection in the steady state for periodic signals with a fixed period.This characteristic is important not only for conventional technologies and conventional industries but also for advanced technologies and emerging industries.This paper first explains the concept of repetitive control from its original idea.Next,it describes the structure of a repetitive controller as an internal model and shows the respective points of continuous-and discrete-time repetitive control.It presents a categorized list of practical applications of repetitive control.Moreover,two concrete applications,namely the control of a robotic manipulator and a rotating system,demonstrate the validity of the method with experimental results.Several current studies in this field are also reviewed,and some challenges and future studies for repetitive control are provided.
基金funded by the Joint Funds of the National Natural Science Foundation of China (U20A20107 and U22A20562)the National Key Research and Development Program of China (2023YFD1900201-3)the International Cooperation Project,Ministry of Science and Technology of China (G2023019005L)。
文摘The lateral transport of labile organic carbon represents a critical pathway for soil organic carbon(SOC) loss,reducing organic carbon sequestration and increasing the risk of waterbody pollution.Livestock manure application on croplands serves as a common fertilizer reduction practice to sustain crop yields,enhance SOC sequestration,and reduce water erosion.However,limited quantitative assessments have examined the effects of livestock manure substitution on labile organic carbon lateral loss and fluxes in long-term experiments.This study conducted a three-year field investigation on subtropical sloping croplands to assess the impact of livestock manure substitution on dissolved organic carbon(DOC) and particulate organic carbon(POC) loss via surface runoff,interflow and eroded sediments.There are four treatments:no fertilization(CK);chemical nitrogen fertilizer(SF),40% nitrogen substitution with pig manure(PMF),and 100% nitrogen substitution from pig manure(PM).Compared to SF treatment,long-term livestock manure substitution in PMF and PM treatments significantly(P<0.05) reduced annual cumulative surface runoff fluxes by 13.5 and 21.6%,respectively.Manure applications decreased annual sediment fluxes by 12.9 and 19.1%,respectively.Soil water stable aggregates for mean weight diameter(MWD) increased significantly by 37.7 and 73.6%.Annual cumulative POC loss flux via eroded sediment under PMF and PM treatments increased significantly(P<0.05) by 61.1 and 47.9%,respectively.The labile organic carbon loss fluxes,including DOC and POC losses,under PMF and PM treatments increased significantly(P<0.05) by 11.9 and 31.4%,respectively.These results demonstrate that while water erosion intensity decreases due to enhanced soil aggregate stability,the risk of labile organic carbon loss increases after long-term livestock manure substitution in subtropical sloping croplands.Future research should examine labile organic carbon lateral migration under various soil types and slope gradients for livestock manure application in subtropical agricultural ecosystem croplands to better understand extreme rainfall effects.
基金supported by the KAKENHI Grant (No. 26220202) from the Japan Society for the Promotion of Science (JSPS)the Leading Project in Japanese Fiscal Year 2015 and 2016 of Tokyo Metropolitan University
文摘Long-term climate changes related with urbanization in Tokyo, Japan, and recent temperature and heavy rainfall distribution in the Tokyo metropolitan area are reviewed. A relatively high temperature increase in annual mean temperature at the rate of 3.0°C/century was detected in Tokyo for the period 1901–2015. Some observational evidence showed the existence of both thermal and mechanical effects of urbanization on recent heavy rainfall occurrences, and modeling studies also support precipitation enhancement. Urban influences were recognized in other climatological elements, such as number of fog days, relative humidity, and wind circulation.
文摘Purpose: This study was to clarify the association of sexual awareness of high school students with cognitive social capital (SC) in Tokyo, Japan. Method: In September 2017, we conducted a survey of 1073 third-grade high school students who were the same students who had participated in the same questionnaire survey at the prior academic year when they were second-grade students. A total of 1073 students were surveyed and 956 students responded. From six to eight weeks prior to this September 2017 survey, we implemented an educational intervention in the students. Then we compared the results of this survey with the previous survey of February 2017. We used logistic regression to assess sexual awareness and sex knowledge, sexually experienced surrounding peers and Self-Esteem score. The study was approved by the Ethical Review Board. Result/Discussion: Sexual awareness of high school students was significantly associated with SC both before and after the intervention. The higher SC one had, the higher sexual awareness was shown and the greater the sexual caution among both boys and girls was indicated. The study clarified the Determinants of Sexual Awareness of High School Students in Tokyo before and after the educational intervention. Conclusion: SC was found to be significantly associated with sexual awareness. SC should be emphasized in promoting adolescent reproductive health for the future.
文摘Purpose: The study aimed to clarify the relationship between cognitive social capital and sexual awareness in high school students in Tokyo, Japan. Method: The self-administered questionnaire survey was administered to 1073 high school junior students in Tokyo in Feb. 2017 (collection rate 94.5%). Final analysis subjects totaled 1011 boys and girls (94.2%). True/false questions on timing to wear condom for sex knowledge, acceptability to sexual behavior of high school students for sexual awareness, sense of community belonging for social capital, existence of sexually experienced peers, and Rosenberg Self-Esteem Scale score (binarized with the mean value) were verified. Multiple logistic regression analysis assigning sexual awareness for dependent variable and sex knowledge, sexually experienced peers and Self-Esteem score for independent variable [model 1], including social capital for independent variable [model 2] was performed. The study was approved by Ethical Review Board of sub-organ. Results and Discussion: Out of subjects, 52.6% answered correctly questions on sex knowledge, 33.2% showed tolerance to sexual behavior of high school students, 68.6% had many peers with sex experience, and 75.9% had a sense of community belonging. In model 1, in both genders, having sex knowledge, high Self-Esteem score, and existence of sexually experienced peers was associated with a sense of intolerance to sexual behavior of high school students. In model 2, in both genders, having a sense of community belonging was associated with a sense of intolerance to sexual behavior of high school students [OR (95% CI): boy 1.11 (0.81 - 1.53), girl 1.14 (0.72 - 1.79)]. Persons with high cognitive social capital were likely to have a cautious sense toward sexual behavior. Conclusion: Cognitive social capital was found to be associated with sexual awareness. Cognitive social capital should be emphasized in promoting adolescent reproductive health for the future.
文摘Background: This study aimed to identify the predictors of LGBT recognition by health sciences university students in Japan. Methods: This is a cross-sectional study that used quantitative data collected from 481 returned self-report questionnaires distributed to 866 health sciences undergraduate and graduate students. The following survey item and scales were used for measuring the main outcomes: Thoughts about sexual identity, Empathy scale, Objectivity scale, and LGBT recognition scale. Data were analyzed using descriptive statistics, two-sample t-test, one-way analysis of variance, and multiple regression analyses. SPSS ver. 23.0 (SPSS, Chicago, IL, USA) was used for data analysis at a 5% significance level. Results: The number of returned questionnaires was 481 (55.5%). There was no significant difference in the LGBT recognition and the participant’s characteristics (e.g., age and medical history). The 5 significant predictors of LGBT recognition were: 1) Empathy (β = 0.19, p LGBT learning experience (β = 0.18, p Objectivity (β = 0.15, p Sexual problem with a close person (β = 0.13, p Suffering from gender identity (β = 0.09, p Conclusions: The predictive factors of LGBT recognition were Empathy, LGBT learning experience, Objectivity, Sexual problem with a close person, and Suffering from gender identity. Careful development and implementation of LGBT educational programs are needed to better understand the situations and ideas of LGBT parties to enhance their recognition.
文摘<p style="text-align:justify;margin-left:10pt;"> <span style="font-family:;" "=""><span>This study examined the validity of the differentiation-of-self hypothesis for Japanese university students, and its mechanism in relation to negative life event aversion. Although </span><span>the differentiation-of-self hypothesis is accepted as one of the basic hypothes</span><span>es in the clinical field of family therapy in Japan</span><span><span>, empirical studies on the subject are scarce. Further, there are few studies, internationally, on its mechanism. A questionnaire survey was conducted with university students (</span><i><span>n </span></i><span>= 250) to measure their differentiation of self, maladaptive states, and negative life event aversion. </span><span>Compared to the better-differentiated group, the less-differentiated group had higher scores both for maladaptive </span></span><span><span>states—somatic symptoms (</span><i><span>t</span></i><span>(223) = -</span></span></span><span><span style="font-family:;" "=""><span><span>2.70, </span><i><span>p</span></i><span> = </span></span></span></span><span><span>0</span></span><span><span style="font-family:;" "=""><span>.008), social dysfunction</span><span><span> (</span><i><span>t</span></i><span>(211.00) = -</span></span></span></span><span><span style="font-family:;" "=""><span><span>3.30, </span><i><span>p</span></i><span> = </span></span></span></span><span><span>0</span></span><span><span style="font-family:;" "=""><span>.001), and severe depression (</span><i><span>t</span></i><span>(208.78) = -</span></span></span><span><span style="font-family:;" "=""><span><span>4.08, </span><i><span>p</span></i><span> <</span></span></span></span><span><span> 0</span></span><span><span style="font-family:;" "=""><span>.001)—and negative life event aversion—interpersonal domain (</span><i><span>t</span></i><span>(223) = -</span></span></span><span><span style="font-family:;" "=""><span><span>3.96, </span><i><span>p</span></i><span> <</span></span></span></span><span><span> 0</span></span><span><span style="font-family:;" "=""><span>.001) and achievement domain (</span><i><span>t</span></i><span>(223) = -</span></span></span><span><span style="font-family:;" "=""><span><span>3.83, </span><i><span>p</span></i><span> <</span></span></span></span><span><span> 0</span></span><span><span>.001). </span></span><span>The results supported the validity of the differentiation-of-self hypothesis for Japanese university students, and that cognitive tendencies toward negative life events may be part of the mechanism for less-differentiated individuals’ subsequent vulnerability. This suggests the effectiveness of cognitive interventions.</span> </p>
文摘<span style="font-family:Verdana;">We are confronting a new threat in the prevalence of antibiotic-resistant bacteria followed by epidemic spread in aquatic environments in metropolitan areas because damage from river floods is increasing remarkably in Japan due to global extreme weather. The sewer penetration rate is about 100% in Tokyo and reclaimed water from sewage treatment plants accounts for over 50% of all water in both the down- and mid-stream areas of local rivers. The water quality of these rivers, which contain microflora, seems to be seriously affected by reclaimed water. In this study, we collected water samples on July 17, 2018 and examined the behavior of antibiotic-resistant fecal coliforms in the stream of a sewage treatment plant in Tokyo. Extended-spectrum </span><i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">-lactamase (ESBL)</span><span style="font-family:Verdana;">-producing fecal coliforms with encoding genes were found;the CTX-M-1, CTX-M-9, TEM, and SHV groups were found to have survived in the final effluent to the river after sterilization with sodium hypochlorite.
文摘<strong>Background: </strong>The aim of this study was to investigate Japanese students and employed adults’ characteristic features, and sexual situation, and to find the correlated factors of lesbian, gay, bisexual, transgender (LGBT) recognition in order to obtain suggestions for improved relationships with sexual minorities in a diversifying society. <strong>Methods:</strong> This quantitative cross-sectional descriptive correlational study occurred during 2018 to 2019 when 2210 questionnaires were distributed to a purposive sample of eligible participants. A total of 1534 completed questionnaires (69.4%) were returned, of which 1439 (65.1%) were suitable for analyses. The survey included respondents’ 1) characteristics, 2) sexual situation, and 3) LGBT recognition scale. Data were analyzed with descriptive statistics, factor analysis, reliability analysis, and structural equation modeling. SPSS ver. 26.0 (SPSS, Chicago, IL, USA) was used for data analysis at a 5% significance level. <strong>Results:</strong> The LGBT recognition score was significantly affected by suffering from gender identity (standardized partial regression coefficient: β = 0.17, p < 0.001), age (β = <span style="white-space:nowrap;">−</span>0.19, p < 0.001), learning about LGBT experience (β = 0.29, p < 0.001), experience of disclosure from LGBT person (β = 0.14, p < 0.001), sexual problems with intimate relationship (β = 0.07, p < 0.001), and diversity penetration (β = 0.14, p < 0.05). <strong>Conclusions:</strong> Suffering from gender identity, learning about LGBT experience, experience of disclosure from LGBT person, sexual problem with intimate relationship, and diversity penetration had a positive effect, whereas age had negative effects on the LGBT recognition score.
文摘This study has been carried out to examine the development of an “elderly tele-nursing model” for care provided in-homeby family members and through remote nursing systems in a super-aging society. The time required for elderly tele-nursing wasinfluenced by whether or not the visitor uses the Shinkansen or the Express train. Based on 40 questionnaires, clear differences wereobserved according to whether visits were “every two weeks” or “once per month”. And finally, comparing the trends andcharacteristics of remote care for the elderly in the TMA (Tokyo Main Area) and Kansai region clarified regional characteristic.
基金supported in part by the National Natural Science Foundation of China(61873348,6230 3266,62273200)JSPS(Japan Society for the Promotion of Science) KAKENHI(22H03998,23K25252)
文摘Dear Editor,This letter presents an improved repetitive controller(IRC) that uses a complex-coefficient filter to enhance the tracking performance of a system for periodic signals. Compared with the low-pass filter used in the conventional repetitive controller(CRC), the complex-coefficient filter causes less change in the phase and amplitude of a signal at the frequencies of the periodic signal, especially at the fundamental frequency, when the two filters have the same cutofffrequency.
基金supported by the Research Grants Council(RGC)of the Government of Hong Kong Special Administrative Region(HKSAR)with RGC/GRF Project(Grant Nos.16206321 and 14113824).
文摘Some of the most interesting areas in aerospace science and technologies are on either higher,faster,and larger systems or lower,slower,and smaller flying capabilities.In this paper,we present our perspectives on the aerodynamics related to small,fixed-wing as well as flapping-wing flight vehicles.From an evolutionary viewpoint,flyers have gone through many iterations,adaptations,and optimizations to balance their biological functions,including flight.In the low-Reynolds-number regime,the aerodynamic characteristics around a solid object differ from those observed at the scale of passenger-airplanes.Consequently,the optimal airfoil and wing shapes vary with vehicle size.As vehicle dimensions vary,non-proportional scaling between surface areas and weight shifts the dominance of physical mechanisms,leading to distinct operational parameters and technical requirements.With smaller flight vehicles,structural flexibility as well as anisotropic material properties become more pronounced,which causes qualitative changes in aerodynamics.The flapping motion of the wings,the interactions between wings,the synergistic characteristics of wing and tail,and the development of soft structures for better agility and flight performance are discussed.Low-Reynolds-number aerodynamics require collaborative innovation to optimize shape,motion,and structure of vehicles in accordance with the scaling laws.Together,progress on these fronts is reshaping the design paradigm of air vehicles and other types of robots with shrinking physical dimensions and more versatile capabilities to meet wider ranges of missions.
文摘In this study,we investigated improving the performance of a layered double hydroxide(LDH)for the adsorption of As(III)and As(V)by controlling the morphology of LDH crystals.The LDH was synthesized via a simple coprecipitation method using barely soluble MgO as a precursor and succinic acid(SA)as a morphological control agent.Doping the LDH crystals with carboxylate ions(RCOO−)derived from SA caused the crystals to develop in a radial direction.This changed the pore characteristics and increased the density of active surface sites.Subsequently,SA/MgFe-LDH showed excellent affinity for As(III)and As(V)with maximum sorption densities of 2.42 and 1.60 mmol/g,respectively.By comparison,the pristine MgFe-LDH had sorption capacities of 1.56 and 1.31 mmol/g for As(III)and As(V),respectively.The LDH was effective over a wide pH range for As(III)adsorption(pH 3-8.5)and As(V)adsorption(pH 3-6.5).Using a combination of spectroscopy and sorption modeling calculations,the main sorption mechanism of As(III)and As(V)on SA/MgFe-LDH was identified as inner-sphere complexation via ligand exchangewith hydroxyl group(-OH)and RCOO−.Specifically,bidentate As-Fe complexeswere proposed for both As(III)and As(V)uptake,with the magnitude of formation varying with the initial As concentration.Importantly,the As-laden adsorbent had satisfactory stability in simulated real landfill leachate.These findings demonstrate that SA/MgFe-LDH exhibits considerable potential for remediation of As-contaminated water.
基金supported by the JSPS KAKENHI(Grant Number:JP22K06676)。
文摘Background:Scutellaria root(root of Scutellaria baicalensis),which has potent anti-inflammatory effects,is a component of useful traditional formulaes.Albeit a low frequency,it has been reported to cause severe interstitial pneumonia and liver dysfunction.Importantly,the hepatotoxicity induced by Scutellaria root can be controlled by the baicalin content,one of its major constituents.This study aimed to clarify the role of MRP2 in modulating baicalin-induced cytotoxicity in HepG2 cells,providing insights that inform safer use and assessment of baicalin.Methods:Cytotoxicity of HepG2 and MDCK cells was assessed using a cell counting kit-8 assay in the presence and absence of MK571,an MRP2 inhibitor.MRP2 expression levels were confirmed using agarose gel electrophoresis,and intracellular baicalin concentrations were measured using LC/MS.Results:Baicalin exhibited concentration-dependent cytotoxicity,with higher toxicity observed in MRP2-negative MDCK cells than in MRP2-positive HepG2 cells.Pre-treatment with MK571 increased baicalin-induced cytotoxicity in HepG2 cells and doubled the intracellular baicalin concentration.Conclusion:Our results indicated that MRP2 plays an important role in reducing baicalin-induced hepatocyte toxicity by decreasing intracellular baicalin levels.Monitoring MRP2 activity could serve as a critical predictive biomarker to identify individuals at higher risk of baicalin-induced hepatotoxicity,enabling personalized dosing strategies and minimizing adverse effects associated with Scutellaria root-containing formulae.
文摘In this paper,a nonlinear control approach for an unstable networked plant in the presence of actuator and sensor limitations using robust right coprime factorization is proposed.The actuator is limited by upper and lower constraints and the sensor in the feedback loop is subjected to network-induced unknown time-varying delay and noise.With this nonlinear control method,we first employ right coprime factorization based on isomorphism and operator theory to factorize the plant,so that bounded input bounded output(BIBO)stability can be guaranteed.Next,continuous-time generalized predictive control(CGPC)is utilized for the unstable operator of the right coprime factorized plant to guarantee inner stability and enables the closed-loop dynamics of the system with predictive characteristics.Meanwhile,a second-Do F(degrees of freedom)switched controller that satisfies a perturbed Bezout identity and a robustness condition is designed.By using the CGPC controller that possesses predictive behavior and the second-Do F switched stabilizer,the overall stability of the plant subjected to actuator limitations is guaranteed.To address sensor limitations that exist in networked plants in the form of delay and noise which often cause system performance degradation,we implement an identity operator definition in the feedback loop to compensate for these adverse effects.Further,a pre-operator is designed to ensure that the plant output tracks the reference input.Finally,the effectiveness of the proposed design scheme is demonstrated by simulations.
文摘Rationale:Advances in sleep research have introduced medications like lemborexant,a dual orexin receptor antagonist.While effective for regulating sleep,overdoses are a concern,especially in suicide attempts.However,limited data exist on lemborexant overdose,prompting this case report to elucidate its clinical course.Patient’s Concern:A 91-year-old Japanese woman with multiple comorbidities,including insomnia and chronic kidney disease,was admitted after ingesting 315 mg of lemborexant in a suicide attempt.Diagnosis:Lemborexant overdose.Interventions:Supportive care with 500 mL of Ringer’s acetate solution at the emergency room.Outcomes:She gradually regained full consciousness with no residual deficits.Due to persistent suicidal ideation,she was transferred to a psychiatric hospital after seven days of supportive care.Lessons:A review of four lemborexant overdose cases managed at our hospital revealed that overdoses primarily induce altered consciousness and are unlikely to cause organ dysfunction.Supportive care is generally sufficient for management.However,given the limited data,further case accumulation is needed to enhance clinical understanding.
文摘Rationale:Abdominal pain is a common complaint with a broad differential diagnosis,including both intra-abdominal and abdominal wall pathologies.While visceral causes are frequently considered,abdominal wall conditions are often overlooked,leading to diagnostic delays.Among them,umbilical abscesses are rare but require distinction from urachal abscesses due to differences in management.Patient’s concern:A 46-year-old woman presented with a one-week history of periumbilical pain unresponsive to analgesics.Diagnosis:Physical examination revealed localized tenderness and a positive Carnett’s sign.Computed tomographic images identified an umbilical abscess without evidence of urachal remnants,ruling out a urachal abscess.Interventions:The patient underwent abscess drainage and received cefalexin(1500 mg/day)for 28 days.Outcomes:The abscess resolved completely without recurrence.Lessons:Umbilical abscesses are rare and may be mistaken for urachal abscesses.A thorough clinical evaluation,including Carnett’s sign and imaging studies,is crucial for accurate diagnosis.Prompt differentiation facilitates appropriate management and prevents unnecessary interventions.
