Survey on Sports-Related Concussions among Japanese University Students.

In recent years, head injuries in sports have garnered attention, and in particular, international discussions have been held on the prevention of and response to sports-related concussions (SRCs). The purpose of this study is to investigate past SRCs experienced by university students in Japan, clarify the state and mechanism of such injuries in each sport, and consider the creation of an environment for future SRC prevention and responses. A questionnaire survey on past SRC experience was conducted among 1731 students who belonged to Fukuoka University in Japan and took "sports medicine" classes in 2020. Responses from 1140 students (collection rate: 65.9%) were obtained. According to this survey, it was revealed that 39 students (3.7%) had experienced SRC. The male-female ratio of those who had experienced SRC was 31 males (79.5%) and 8 females (20.5%). Two males had experienced SRC twice. In this study, SRCs were recognized in a variety of sports, not just in a few contact sports. It is necessary to further disseminate education on head injury prevention and SRCs among both athletes and coaches, because SRCs have been frequently recognized in various sports.

Generative-adversarial-network-based dimensional measurement of optical waveguides.

We propose a high-throughput and precise waveguide-dimensional-measurement method consisting of a generative adversarial network (GAN) and curve-fitting-based dimensional calculator using sidewall functions. The GAN can learn the differences between low-magnification (LM) and high-magnification (HM) optical microscope images taken with different objective lenses at different magnifications over the same area. The LM and HM images of the waveguides are captured using an optical microscope at magnifications of 500× and 2000×, respectively. We obtained a standard deviation of the waveguide widths of approximately 0.8 pixels (∼ 42 nm), and confirmed precise width measurement using super-resolution images at the same imaging throughput as with an LM microscope.

Catheter Ablation Energy Sources and Myocardial Injury and Coagulation Biomarkers During Uninterrupted Periprocedural Edoxaban Use　- A Subanalysis of KYU-RABLE.

BACKGROUND: The effects of catheter ablation (CA) energy sources on myocardial injury and coagulation biomarkers among Japanese non-valvular atrial fibrillation patients receiving uninterrupted periprocedural edoxaban are unclear. This KYU-RABLE exploratory subanalysis compared the effects of CA using radiofrequency energy vs. cryoballoon on: (1) myocardial injury; and (2) plasma edoxaban and coagulation biomarker concentrations measured before and after CA.Methods and Results:Plasma creatine kinase (CK), edoxaban, D-dimer, and prothrombin fragment 1+2 (F1+2) concentrations within 1 h before CA were compared with concentrations the day after. All biomarkers increased after CA, regardless of the energy source, but especially with cryoballoon. Significantly higher increases in CK concentrations from before to the day after CA were seen with cryoballoon compared with radiofrequency energy (P<0.0001). Edoxaban concentrations were similar in both groups. Concentrations of D-dimer and F1+2 increased in both groups, but were significantly higher in the cryoballoon group (P<0.0001 and P=0.006, respectively). There were no significant between-group differences in the incidence of thrombotic or bleeding events. CONCLUSIONS: Uninterrupted edoxaban concentrations were similar in both groups. Both myocardial injury and coagulation biomarkers increased after CA, especially with cryoballoon, but there was no difference in the incidence of thrombotic or bleeding events. These findings suggest the efficacy of uninterrupted edoxaban, regardless of the CA energy source. Periprocedural anticoagulation, particularly with cryoballoon, should be undertaken with care.

Mirogabalin treatment of postoperative neuropathic pain after thoracic surgery: study protocol for a multicenter, randomized, open-label, parallel-group, interventional trial.

BACKGROUND: Intercostal nerve damage due to thoracotomy or thoracoscopic manipulation is a major contributor to chronic postsurgical pain after pulmonary resection. Chronic postsurgical pain may last for months or years and can negatively impair physical functioning and daily activities. Global consensus on severe postoperative pain management is lacking, and chronic pain incidence after thoracic surgery remains high. Many patients report neuropathic pain, which can be difficult to treat with currently available therapies. The efficacy and safety of mirogabalin have been demonstrated for other types of neuropathic pain; thus, this study was planned to investigate the efficacy and safety of mirogabalin to treat neuropathic pain after thoracic surgery. METHODS: In this multicenter, randomized, open-label, parallel-group, interventional study, patients who are diagnosed with neuropathic pain following removal of a chest drain after lung resection will receive conventional therapy (non-steroidal anti-inflammatory drugs and/or acetaminophen) with or without the addition of a clinical dose of mirogabalin for 8 weeks. For patient stratification, a visual analog scale pain intensity score at baseline of <60 vs. ≥60 mm will be used. Treatment efficacy and safety with and without the addition of mirogabalin will be assessed using a questionnaire evaluating postoperative changes in pain severity and activity. The primary study endpoint is the change in pain intensity from baseline to Week 8, measured by the visual analog scale. Additionally, the presence of chronic pain at 12 weeks after enrollment in each treatment group will be recorded. DISCUSSION: This protocol has been reviewed and approved by the Clinical Research Review Board of Nagasaki University. Study data will be published in the Japan Registry of Clinical Trials database and peer-reviewed journals. Mirogabalin is already approved for the treatment of other types of neuropathic pain. It is anticipated that this study will provide data to elucidate the impact of mirogabalin treatment, in combination with conventional therapy, to benefit patients with neuropathic pain following thoracic surgery. TRIAL REGISTRATION: Japan Registry of Clinical Trials Identifier: jRCTs071200053.

Factors associated with bleeding events during catheter ablation with uninterrupted periprocedural edoxaban for atrial fibrillation: a subanalysis of the KYU-RABLE study.

BACKGROUND: Data are limited on patient background characteristics associated with catheter ablation (CA)-related bleeding events in Japanese patients with non-valvular atrial fibrillation receiving uninterrupted periprocedural edoxaban. This subanalysis of the KYU-RABLE study focused on univariate and multivariate analyses to identify correlations between bleeding events and baseline patient demographics and CA-related characteristics. METHODS: Patients with non-valvular atrial fibrillation (NVAF) enrolled from the KYU-RABLE study were included in the study. We performed univariate and multivariate analyses to investigate the correlation of major, minor, and clinically relevant non-major bleeding events with the patient baseline data at enrollment, and with CA procedures. RESULTS: A total of 513 NVAF patients were included in the full analysis set. Univariate analysis showed that the incidence of the bleeding events was higher in patients with HAS-BLED score ≥ 3 compared with those with a score < 3 (odds ratio [OR]: 9.48, 95% CI: 2.36-38.01; p = 0.002), in those with creatinine clearance (CrCL) ≤50 mL/min compared with those with CrCL > 50 mL/min (OR: 10.59, 95% CI: 3.65-30.79; p < 0.0001), and in those receiving edoxaban 30 mg compared with those receiving edoxaban 60 mg (OR: 3.49, 95% CI: 1.18-10.38; p = 0.025). Multivariate analysis showed that HAS-BLED score ≥ 3 (OR: 7.93, 95% CI: 1.66-37.88; p = 0.0094) and CrCl ≤ 50 mL/min (OR: 7.78, 95% CI: 2.17-27.90; p = 0.0016) were significant predictors of bleeding events among KYU-RABLE patients. CONCLUSIONS: These predictors of CA-related bleeding events may allow informed decision-making and better AF patient selection for CA with uninterrupted periprocedural edoxaban. TRIAL REGISTRATION: KYU-RABLE, UMIN000029693 . Registered 1 December 2017.

Plasma Concentration and Pharmacodynamics of Edoxaban in Patients with Nonvalvular Atrial Fibrillation and Acute Heart Failure.

OBJECTIVE: The objective of this study was to assess the pharmacokinetic and pharmacodynamic profiles and safety of edoxaban in patients with nonvalvular atrial fibrillation (NVAF) who were hospitalized with acute heart failure (AHF). METHODS: The trough plasma concentrations of edoxaban, and the coagulation biomarkers prothrombin fragments 1 and 2 (F1+2) and D-dimer, were determined. Twenty-six patients received edoxaban 60 mg (30 mg when dose adjustment was required) and blood samples were collected immediately before oral edoxaban administration for 7 consecutive days after hospitalization and on the day of discharge. RESULTS: The mean observation period was 13 (range 7-46) days. Trough plasma concentrations of edoxaban were constant from day 2 onwards. On day 1, the variation was greater owing to the differing intervals between the last edoxaban dose and day 1 blood collection. Trough plasma concentrations were higher in patients with reduced creatinine clearance (≤ 50 mL/min). Median values for F1+2 and D-dimer remained within normal ranges throughout the study. There were no drug discontinuations, and no serious adverse events were reported. CONCLUSIONS: This is the first study of edoxaban pharmacokinetics and pharmacodynamics in patients with NVAF and AHF, and shows that the pharmacokinetic and pharmacodynamic profiles of edoxaban were constant during hospitalization. Thus, even in patients with NVAF and AHF, edoxaban anticoagulation therapy with guided dose adjustment is considered to be a safe and appropriate intervention. In particular, patients with reduced creatinine clearance should adhere to dose adjustment criteria. CLINICAL TRIAL REGISTRATION: jRCTs031190006 (Japan Registry of Clinical Trials), 5 April, 2019 retrospectively registered.

Changes in plasma concentrations of edoxaban and coagulation biomarkers according to thromboembolic risk and atrial fibrillation type in patients undergoing catheter ablation: Subanalysis of KYU-RABLE.

BACKGROUND: Catheter ablation (CA) for atrial fibrillation (AF) can be associated with a risk of thromboembolism and bleeding. We recently demonstrated that uninterrupted edoxaban with one dose delayed on the CA procedural day is associated with a low risk of periprocedural complications. Previous reports have indicated that some specific subgroups of patients undergoing CA have an increased risk of bleeding and thromboembolic complications. This subanalysis of the KYU-RABLE study assessed the changes in plasma concentrations of edoxaban and coagulation biomarkers during the periprocedural period of CA in subgroups stratified by the risk of thromboembolism assessed by CHADS2 score (<2 or ≥2) and AF type (paroxysmal AF [PAF] or non-PAF). METHODS: We evaluated changes in plasma concentrations of edoxaban and coagulation biomarkers (D-dimer and prothrombin fragment F1+2), by subgroup, during the periprocedural period of CA. Measurements were made prior to CA (procedure day). RESULTS: This subanalysis evaluated data from 343 patients with CHADS2 score <2 and 134 patients with CHADS2 score ≥2, and from 280 patients with PAF and 197 patients with non-PAF. Plasma edoxaban concentration decreased with time on the day of CA, while plasma concentrations of coagulation biomarkers remained unchanged. No significant differences were observed according to CHADS2 score or type of AF. CONCLUSIONS: The changes in plasma concentrations of edoxaban and coagulation biomarkers in each subgroup were similar to those of the whole analysis, regardless of the thromboembolic risk (CHADS2 <2 or ≥2) or AF type (PAF or non-PAF).

Superresolved image reconstruction in FZA lensless camera by color-channel synthesis.

The Fresnel-zone-aperture lensless camera using a fringe-scanning technique allows non-iterative well-conditioned image reconstruction; however, the spatial resolution is limited by the mathematical reconstruction model that ignores diffraction. To solve this resolution problem, we propose a novel image-reconstruction algorithm using the wave-optics-based design of the deconvolution filter and color-channel image synthesis. We verify a two-fold improvement of the effective angular resolution by conducting numerical simulations and optical experiments with a prototype.

Efficacy and Safety of Uninterrupted Periprocedural Edoxaban in Patients Undergoing Catheter Ablation for Atrial Fibrillation　- The Prospective KYU-RABLE Study.

BACKGROUND: The KYU-RABLE study, a prospective, multicenter, single-arm interventional study, evaluated the efficacy and safety of uninterrupted oral edoxaban in patients undergoing catheter ablation (CA) for atrial fibrillation (AF).Methods and Results:We enrolled patients with AF from 23 centers in Japan. Edoxaban 60 mg (30 mg in patients indicated for dose adjustment) was administered uninterrupted, once daily in the morning for ≥4 weeks before CA and 4 weeks ±7 days after CA with one dose delayed on the procedural day. The primary endpoint was a composite of thromboembolism and major bleeding during 4 weeks from the procedural day. Among the 513 eligible patients who underwent CA, 63.5% received edoxaban 60 mg/day and 36.1% received 30 mg/day. For the primary endpoint, no thromboembolism and 1 major bleeding event (0.2%, cardiac tamponade) were observed. The plasma edoxaban concentration decreased depending on the time from the last administration to the CA procedure. However, plasma levels of coagulative biomarkers were within appropriate ranges regardless of the interval from the last administration of edoxaban. CONCLUSIONS: The present study provided evidence of the efficacy and safety of uninterrupted edoxaban administered once daily in the morning, with one dose delayed on procedural day, in patients with AF undergoing CA. Edoxaban was associated with a low risk of periprocedural thromboembolic and bleeding complications.

Proposal and experimental demonstration of SDM node enabling path assignment to arbitrary wavelengths, cores, and directions.

We propose a novel simple space division multiplexing (SDM) node which is rearrangeble nonblocking, and effectively utilizes enhanced network resources through SDM. The proposed node can reduce a number of ports of wavelength selective switches (WSSs) and a number of WSS modules by modifying conventional multi-stage switches and employing integrated multiple arrayed WSSs. We experimentally actualized the newly proposed node, and demonstrate wavelength, core, and direction switching functions based on 127-Gbps Dual Polarization Quadrature Phase Shift Keying (DP-QPSK) signals. We also confirm the feasibility of the proposed SDM node through SDM transmission experiments using a 40-km multicore fiber and a multicore amplifier.

Terahertz time-domain observation of spin reorientation in orthoferrite ErFeO3 through magnetic free induction decay.

Terahertz time domain spectroscopy was performed on orthoferrite ErFeO3. Through the emission from the two magnetic resonance modes, we succeeded in observing the spin reorientation transition. Depending on the orientation of the single crystal, the reorientation can be detected as either mode switching between the two modes or polarization change of the emission. This method enables picosecond resolved observation of the reorientation without disturbances such as electronic excitation and heating, and it is expected to open the doorway to observe ultrafast reorientation with the terahertz pulse.

Coherent control of spin precession motion with impulsive magnetic fields of half-cycle terahertz radiation.

Coherent control of the precession motion of magnetizations in a single crystal YFeO3 with double half-cycle pulse terahertz waves was demonstrated. Quasiferromagnetic (0.299 THz) and quasiantiferromagnetic (0.527 THz) precession modes were selectively excited by choosing an appropriate interval of two pulses and were observed as free induction decay (FID) signals from the spin system. By observing the circularly polarized FID signals due to ferromagnetic resonance, we also succeeded in confirming directly the energy storage in the spin system and recovery from that to the electromagnetic radiation.