Computational role of sleep in memory reorganization.

Sleep is considered to play an essential role in memory reorganization. Despite its importance, classical theoretical models did not focus on some sleep characteristics. Here, we review recent theoretical approaches investigating their roles in learning and discuss the possibility that non-rapid eye movement (NREM) sleep selectively consolidates memory, and rapid eye movement (REM) sleep reorganizes the representations of memories. We first review the possibility that slow waves during NREM sleep contribute to memory selection by using sequential firing patterns and the existence of up and down states. Second, we discuss the role of dreaming during REM sleep in developing neuronal representations. We finally discuss how to develop these points further, emphasizing the connections to experimental neuroscience and machine learning.

Hospital pharmacist interventions for the management of oral mucositis in patients with head and neck cancer receiving chemoradiotherapy: a multicenter, prospective cohort study.

PURPOSE: Oral mucositis is a severe adverse event in patients with head and neck cancer (HNC) receiving chemotherapy and radiotherapy that may cause the termination of cancer treatment. In this study, we aimed to reveal the benefits of pharmacist interventions in oral health care for patients with HNC receiving concurrent chemoradiotherapy (CCRT). METHODS: We conducted a multicenter, prospective cohort study on 173 patients from September 2019 to August 2022. We evaluated the association between the occurrence of oral mucositis during CCRT and various factors in the absence or presence of direct medication instructions from hospital pharmacists. RESULTS: Sixty-eight patients received medication instructions from pharmacists (the pharmacist intervention group), whereas 105 patients did not receive instructions (the control group). Logistic regression analysis showed that grade 2 (Gr 2) oral mucositis was significantly lower in patients receiving pharmacist interventions than in patients in the control group (adjusted odds ratio [aOR], 0.42; 95% confidence interval [CI], 0.18-0.96; P = 0.04). The time to onset of Gr 2 oral mucositis was significantly longer in the pharmacist intervention group than in the control group (hazard ratio, 0.53; 95% CI, 0.29-0.97; P = 0.04). CONCLUSION: Direct intervention, especially when provided by hospital pharmacists, can have a real effect in supporting patients with HNC experiencing severe side effects of treatments. Moreover, the integration of pharmacists into the oral healthcare team is becoming even more essential to reduce the severity of side effects.

Information maximization explains state-dependent synaptic plasticity and memory reorganization during non-rapid eye movement sleep.

Slow waves during the non-rapid eye movement (NREM) sleep reflect the alternating up and down states of cortical neurons; global and local slow waves promote memory consolidation and forgetting, respectively. Furthermore, distinct spike-timing-dependent plasticity (STDP) operates in these up and down states. The contribution of different plasticity rules to neural information coding and memory reorganization remains unknown. Here, we show that optimal synaptic plasticity for information maximization in a cortical neuron model provides a unified explanation for these phenomena. The model indicates that the optimal synaptic plasticity is biased toward depression as the baseline firing rate increases. This property explains the distinct STDP observed in the up and down states. Furthermore, it explains how global and local slow waves predominantly potentiate and depress synapses, respectively, if the background firing rate of excitatory neurons declines with the spatial scale of waves as the model predicts. The model provides a unifying account of the role of NREM sleep, bridging neural information coding, synaptic plasticity, and memory reorganization.

[Comparison between Single and Three Times Pre-operative Administration of Amoxicillin in the Prophylactic Effects for Surgical Site Infections in Japanese Patients with Mandibular Third Molars Extraction].

Although the dosage of oral antibiotics (OA) for the mandibular third molar extraction (MTME) varies among the administration periods according to the current guideline, our previous reports suggested that it might be possible to further shorten the administration period without increasing the incidence of surgical site infection (SSI). In the present study, we retrospectively evaluated the relationship between the incidence of SSI and the administration period of OA in patients who underwent the MTME in our hospital. This retrospective cohort study included 348 patients who underwent the MTME in our dental outpatient clinic from June 2020 to March 2022. The administrated antibiotic was amoxicillin (AMPC) in all patients. Patients were divided into two groups based on the administration period of AMPC single and three times before the surgery. The following information was collected: (1) patient factors (age, gender, body mass index, diagnosis, mandibular third molar status); (2) surgical factors (operation time, presence/absence of wound closure, presence/absence of hemostat, experience of surgeons); (3) relationship between administration period of OA and SSI occurrence; and (4) details of SSI. There were 217 cases in the single group and 131 cases in the three times group. The incidence of SSI was 1.1% (4/348), with 1.4% (3/217) in the single group and 0.8% (1/131) in the three times group; there was no significant difference between the two groups. Our result suggests that single administration of AMPC before the MTME would be sufficient for the prevention of SSI in Japanese patients without risk factors.

Sublinear diffusion in the generalized triangle map.

Diffusion of the orbits in a nonchaotic area-preserving map called a generalized triangle map (GTM) is numerically and analytically investigated. We provide accurate empirical evidence that the mean-squared displacement of the momentum for generic perturbation parameter settings increases sublinearly in time, and that the distribution of the momentum obeys a time-fractional diffusion equation. We show that the diffusion properties in the GTM do not follow any of the known stochastic processes generating sublinear diffusion since two seemingly incompatible features, non-Markovian yet stationary, coexist in the dynamics.

Salivary inflammatory mediators as biomarkers for oral mucositis and oral mucosal dryness in cancer patients: A pilot study.

Oral mucositis (OM) is a common side effect in patients with cancer receiving chemotherapy and radiotherapy; however, no salivary mediator is known to be associated with OM. We aimed to determine candidate salivary inflammatory mediators potentially associated with OM in patients with cancer. To this end, we compared the relationships between OM grade, oral mucosal dryness, and inflammatory mediators (Interleukin (IL)-1ß, IL-6, IL-10, IL-12p70, tumor necrosis factor (TNF), prostaglandin E2, and vascular endothelial growth factor) in patients with cancer and in healthy volunteers (HV). We collected saliva samples from 18 patients with cancer according to the following schedule: 1) within 14 days of treatment initiation, 2) within 3 days of OM occurrence, 3) when OM was improved or got worsened, and 4) within 7 days after chemotherapy completion. The oral care support team determined the OM grade at each sample collection point based on CTCAE version 5.0. Salivary inflammatory mediator concentrations were detected using cytometric bead array or enzyme-linked immunoassay. We compared oral mucosal dryness in pre- and post-index patients with cancer to that in HV (n = 33) using an oral moisture-checking device. Fourteen of eighteen patients experienced OM (four, grade 3 OM; four, grade 2 OM; six, grade 1 OM). IL-6, IL-10, and TNF salivary concentrations were significantly increased in the post-index group compared to those in the pre-index group (p = 0.0002, p = 0.0364, and p = 0.0160, respectively). Additionally, salivary IL-6, IL-10, and TNF levels were significantly higher in the post-index group than in the HV group (p < 0.0001, p < 0.05, and p < 0.05, respectively). Significant positive correlations were observed between OM grade and salivary IL-6, IL-10, and TNF levels (p = 0.0004, r = 0.4939; p = 0.0171, r = 0.3394; and p = 0007, r = 0.4662, respectively). Oral mucosal dryness was significantly higher in the HV than in the pre- and post-index groups (p < 0.001). Our findings suggest that salivary IL-6, IL-10, and TNF levels may be used as biomarkers for OM occurrence and grade in patients with cancer. Furthermore, monitoring oral mucosal dryness and managing oral hygiene before cancer treatment is essential.

Pharmacist involved education program in a multidisciplinary team for oral mucositis: Its impact in head-and-neck cancer patients.

OBJECTIVES: This retrospective study examined how a pharmacist-involved education program in a multidisciplinary team (PEMT) for oral mucositis (OM) affected head-and-neck cancer (HNC) patients receiving concurrent chemoradiotherapy (CCRT). MATERIALS AND METHODS: Total samples data of 53 patients during the stipulated timeframe were retrospectively collected from electronic medical records from February 2017 to January 2019. We compared the presence/absence of OM (OM: yes/no) between patients with and without PEMT (PEMT: yes/no) as the primary endpoint and OM severity as the secondary endpoint. The following information was surveyed: age, gender, weight loss, steroid or immunosuppressant use, hematological values (albumin, white blood cell count, blood platelets, and neutrophils), cancer grade, primary cancer site, type and use of mouthwash and moisturizer, opioid use (yes/no, days until the start of opioid use, and dose, switch to tape), and length of hospital day (LOD). The two groups were compared using Fisher's exact test for qualitative data and the Mann-Whitney U test for quantitative data, and a significance level of p<0.05 was set. RESULTS: The group managed by PEMT had significantly lower weight loss and a significantly lower incidence of local anesthetic and opioid use and switch to tape compared with the group not managed by PEMT (p<0.05). The two groups showed no significant difference in OM (yes/no) or OM severity. The PEMT group had significantly shorter LOD at 57 (53-64) days compared with the non-PEMT group at 63.5 (57-68) days (p<0.05). CONCLUSIONS: Our results showed that PEMT did not improve OM (yes/no) or OM severity in HNC patients undergoing CCRT. However, the PEMT group had a lower incidence of grades 3 and 4 OM than the non-PEMT group, although not significantly. In addition, PEMT contributed to oral pain relief and the lowering of the risk for OM by reduction in weight loss.

Computational roles of intrinsic synaptic dynamics.

Conventional theories assume that long-term information storage in the brain is implemented by modifying synaptic efficacy. Recent experimental findings challenge this view by demonstrating that dendritic spine sizes, or their corresponding synaptic weights, are highly volatile even in the absence of neural activity. Here, we review previous computational works on the roles of these intrinsic synaptic dynamics. We first present the possibility for neuronal networks to sustain stable performance in their presence, and we then hypothesize that intrinsic dynamics could be more than mere noise to withstand, but they may improve information processing in the brain.

Scarring in classical chaotic dynamics with noise.

We report the numerical observation of scarring, which is enhancement of probability density around unstable periodic orbits of a chaotic system, in the eigenfunctions of the classical Perron-Frobenius operator of noisy Anosov ("perturbed cat") maps, as well as in the noisy Bunimovich stadium. A parallel is drawn between classical and quantum scars, based on the unitarity or nonunitarity of the respective propagators. For uniformly hyperbolic systems such as the cat map, we provide a mechanistic explanation for the classical phase-space localization detected, based on the distribution of finite-time Lyapunov exponents, and the interplay of noise with deterministic dynamics. Classical scarring can be measured by studying autocorrelation functions and their power spectra.

Comparison between the prophylactic effects of amoxicillin 24 and 48 hours pre-operatively on surgical site infections in Japanese patients with impacted mandibular third molars: A prospective cohort study.

INTRODUCTION: According to the guidelines, the dosage for mandibular wisdom tooth extraction (MWTE) varies within the administration period. There is a 24-fold difference between the minimum and maximum doses. If an appropriate antimicrobial can be administered without increasing incidence of surgical site infection (SSI), it may lead to a global action plan on antimicrobial resistance (AMR). Therefore, we prospectively surveyed incidence of SSI post-operatively and use of oral antibiotics (OA) for MWTE. METHODS: Subjects were patients who underwent MWTE in our dental outpatient clinic from May 2019 to April 2020. Two groups were formed depending on type of administration period they received: 24 h and 48 h after surgery. The following information was collected: (1) patient factors (age, gender, body mass index, presence/absence of preoperative medication, diagnosis, impacted wisdom tooth status; (2) surgical factors (operative time, presence/absence of closure, presence/absence of hemostat, doctor career, type and frequency of painkiller); (3) relationship between administration period of OA and SSI occurrence; and (4) details of SSI. RESULTS: Three hundred forty subjects were analyzed, all of which used amoxicillin. There were 106 cases in 24 h group and 234 cases in 48 h group. The total incidence of SSI was 1.1% (4/340 cases), with 0.9% (1/106 cases) in 24 h group and 1.3% (3/234 cases) in 48 h group; there was no difference between the two groups. CONCLUSION: Our study suggests that amoxicillin (250 mg/dose every 8 h x 3 doses beginning 1 h before surgery) might be sufficient in preventing SSI in Japanese dental patients without SSI risk factors.

Clinico-statistical survey of oral antimicrobial prophylaxis and surgical site infection regarding ordinary tooth extraction and mandibular wisdom tooth extraction in the dental outpatient clinic.

INTRODUCTION: We investigated the use of oral antibiotics (OA) and surgical site infection (SSI) related to extractions of ordinary teeth and mandibular wisdom teeth in a dental outpatient clinic from January 2015 to December 2019. METHODS: The following information were surveyed: (1) presence/absence of OA, (2) timing, (3) type, (4) administration period, and (5) SSI rates. RESULTS: The use of OA during ordinary tooth extraction decreased from 68.3% to 41.3%, but SSI rate did not change during this period of time. Total SSI rate was 0.8% (122/14,832) on average. For mandibular wisdom tooth extraction, preoperative administration of third-generation cephalosporins decreased from 70.4% to 0.3% while that of penicillin (AMPC) increased from 0% to 98%. SSI rate was not changed after these improvements. Total SSI rate was 3.5% (180/5106) on average. The duration of OA was slightly decreased to two days in 2018 and 2019, and it was found that there was no significant difference in SSI rates between 2- and 3-day durations. Preoperative administration had 0.37 odds ratio (OR) (95% confidence interval (95%CI): 0.22-0.63) of SSI compared with postoperative administration. AMPC had 0.76 OR (95% CI: 0.55-1.04) of SSI compared with Third-generation cephalosporins and others. Timing of OA was P < 0.01. CONCLUSIONS: SSI rates did not change over time, administration period of OA decreased and the use of AMPC increased. Therefore, it seems necessary to continue to investigate the effects of SSI risk factors proactively in the future and to make efforts in the advocacy of appropriate antimicrobial use.

A case of severe hepatotoxicity induced by cisplatin and 5-fluorouracil.

Severe hepatotoxicity from combination chemotherapy with cisplatin and 5-fluorouracil is a rare adverse effect. In this case report, we present a case with severe hepatotoxicity immediately following chemotherapy with cisplatin and 5-fluorouracil. This female patient had previously been treated with this combination with no hepatotoxicity. The elevated liver enzymes quickly normalized after chemotherapy was stopped. There were no specific changes in liver imaging. As hepatotoxicity occurred after repeated administration of cisplatin, we suggest that this hepatotoxicity might represent a case of allergic hepatitis caused by cisplatin. Severe hepatotoxicity should be watched for with repeated administration of cisplatin.

Leak potassium channels regulate sleep duration.

A primary goal of sleep research is to understand the molecular basis of sleep. Although some sleep/wake-promoting circuits and secreted substances have been identified, the detailed molecular mechanisms underlying the regulation of sleep duration have been elusive. Here, to address these mechanisms, we developed a simple computational model of a cortical neuron with five channels and a pump, which recapitulates the cortical electrophysiological characteristics of slow-wave sleep (SWS) and wakefulness. Comprehensive bifurcation and detailed mathematical analyses predicted that leak K+ channels play a role in generating the electrophysiological characteristics of SWS, leading to a hypothesis that leak K+ channels play a role in the regulation of sleep duration. To test this hypothesis experimentally, we comprehensively generated and analyzed 14 KO mice, and found that impairment of the leak K+ channel (Kcnk9) decreased sleep duration. Based on these results, we hypothesize that leak K+ channels regulate sleep duration in mammals.

The efficacy of a lip balm containing pseudo-ceramide on the dry lips of sensitive skin-conscious subjects.

BACKGROUND: Many people use lip care products daily to prevent dry lips. However, some people, especially those with sensitive skin-consciousness, complain of various skin problems on their lips including contact dermatitis caused by lip care products. Dry lips have decreased water holding capacity and cutaneous barrier function as well as reduced stratum corneum ceramide levels. In this study, we investigated the usefulness of a newly formulated lip balm containing pseudo-ceramide for the dry lips of subjects with sensitive skin. METHOD: Thirty subjects with dry lips and sensitive skin-consciousness used the test lip balm more than twice a day for 4 weeks. Lip conditions were evaluated before and after 2 and 4 weeks. RESULT: Visual evaluation by a dermatologist showed that overall improvements were observed in all subjects as early as week 2. After 4 weeks of usage, 27% of the subjects were objectively judged as "markedly improved" and 60% of the subjects were judged as "improved". No adverse event developed throughout the test period, and all subjects were able to use the lip balm safely for 4 weeks. Usefulness was judged based on all evaluation items, and 27%, 70%, and 3% of the subjects were judged as "very useful," "useful," and "slightly useful," respectively. Ninety percentage of the subjects expressed improvement and acceptance of the lip balm. CONCLUSION: Based on these results, the newly formulated lip balm containing pseudo-ceramide is very useful for the lip care of sensitive skin-conscious subjects as well as for daily use by healthy subjects.

High-space resolution imaging plate analysis of extreme ultraviolet (EUV) light from tin laser-produced plasmas.

With the advent of high volume manufacturing capabilities by extreme ultraviolet lithography, constant improvements in light source design and cost-efficiency are required. Currently, light intensity and conversion efficiency (CE) measurments are obtained by charged couple devices, faraday cups etc, but also phoshpor imaging plates (IPs) (BaFBr:Eu). IPs are sensitive to light and high-energy species, which is ideal for studying extreme ultraviolet (EUV) light from laser produced plasmas (LPPs). In this work, we used IPs to observe a large angular distribution (10°-90°). We ablated a tin target by high-energy lasers (1064 nm Nd:YAG, 1010 and 1011 W/cm2) to generate the EUV light. The europium ions in the IP were trapped in a higher energy state from exposure to EUV light and high-energy species. The light intensity was angular dependent; therefore excitation of the IP depends on the angle, and so highly informative about the LPP. We obtained high-space resolution (345 µm, 0.2°) angular distribution and grazing spectrometer (5-20 nm grate) data simultaneously at different target to IP distances (103 mm and 200 mm). Two laser systems and IP types (BAS-TR and BAS-SR) were also compared. The cosine fitting values from the IP data were used to calculate the CE to be 1.6% (SD ± 0.2) at 13.5 nm 2% bandwidth. Finally, a practical assessment of IPs and a damage issue are disclosed.

Biological Antioxidant Potential Negatively Correlates With Carotid Artery Intima-Media Thickness.

Oxidative stress is a crucial factor in the pathogenesis and development of cardiovascular disease. Recently, simplified methods for the detection of reactive oxygen species (ROS) using the derivatives of reactive oxygen metabolites (d-ROMs) test as an index of ROS products and the biological antioxidant potential (BAP) test as an index of antioxidant potential have been utilized. These methods are easy to perform, quick, inexpensive since they use small equipment, and provide reliable results compared with established oxidative stress and antioxidant markers. Because oxidative stress has been shown to represent the balance of production of ROS and antioxidant capacity, it is more appropriate to evaluate ROS and antioxidant capacity simultaneously. However, no study has examined the associations among d-ROMs, BAP values, and carotid artery intima-media thickness (IMT) concurrently. Therefore, we studied the associations among d-ROMs, BAP values, and the carotid artery IMT. Carotid artery IMT, blood pressure (BP), fasting circulating d-ROMs, BAP, glucose metabolism, lipid, and C-reactive protein levels were measured in 95 subjects (age: 49.5 ± 13.8 years; men: 41; women: 54), including 42 healthy subjects and 53 patients with hypertension, dyslipidemia, and diabetes mellitus who were not on medication. The results of multiple regression analysis revealed that dependent carotid artery IMT determinants remained significantly associated with age, systolic BP, total cholesterol, and BAP, whereas dependent BAP determinants remained significantly associated with body mass index and carotid artery IMT. BAP was strongly correlated with carotid artery IMT in our cohort. Our results suggest that BAP may be a useful risk marker for carotid atherosclerosis.

Fasting serum insulin levels and insulin resistance are associated with blood rheology in Japanese young adults without diabetes.

OBJECTIVES: To evaluate fasting serum insulin levels and insulin resistance, and their association with blood rheology, in Japanese young adults without diabetes. METHODS: Blood samples were analysed and blood rheology was estimated using haematological parameters. Whole blood passage time was measured using a Hitachi MC-FAN(©) microchannel array flow analyser. RESULTS: Out of 151 subjects (mean age, 24.1 ± 1.5 years), fasting serum insulin levels and insulin resistance (using homeostasis model assessment-estimated insulin resistance [HOMA-IR]), were positively correlated with longer whole blood passage times and higher values for haematocrit (Hct), haemoglobin (Hb), fibrinogen, body weight, body mass index (BMI), triglycerides, and low-density lipoprotein cholesterol (LDL-C)/high-density lipoprotein cholesterol (HDL-C) ratio, and were negatively correlated with HDL-C. Whole blood passage time correlated with body weight, BMI, LDL-C/HDL-C ratio, Hct, Hb, white blood cell (WBC) count, platelet count, fibrinogen, fasting serum insulin levels, and HOMA-IR. Multiple regression analysis revealed that whole blood passage time was independently associated with Hct, fibrinogen levels, and WBC count. CONCLUSIONS: Fasting serum insulin levels and insulin resistance were associated with blood rheology, and may influence blood rheology by modulating haematological parameters and lipid parameters in young adults without diabetes.

High Th1/Th2 ratio in patients with multiple myeloma.

To determine the clinical significance of the T helper 1(Th1)/T helper 2 (Th2) ratio in multiple myeloma, the intracellular IFN-gamma and IL-4 were analyzed by flow cytometry in 56 patients with multiple myeloma. The mean Th1/Th2 ratio of cases in the initial diagnosis phase and the refractory phase were higher than that of the control group. The mean serum beta-2-microglobulin in the high Th1/Th2 subgroup was significantly higher than that in the normal Th1/Th2 subgroup (P < 0.05). In conclusion, the Th1/Th2 ratio was closely related to the disease status of multiple myeloma.

[Urinary 8-hydroxy-2'-deoxyguanosin (8-OHdG) in patients with chronic liver diseases].

Urinary 8-hydroxy-2'-deoxyguanosin(8-OHdG) has been reported as sensitive biomarker of oxidative DNA damage and also of oxidative stress. We measured the urinary 8-OHdG in patients with chronic liver diseases by competitive ELISA, and analyzed the relationship with clinical characteristics. Fifty patients (male/female: 22/28) with chronic liver disease were enrolled this study. The mean concentration of urinary 8-OHdG in healthy control and patients with liver cirrhosis, chronic hepatitis C, chronic hepatitis B, and autoimmune hepatitis were 10.40+/-3.14, 10.14+/-4.19, 11.79+/-5.58, 14.99+/-4.46, and 13.64+/-3.84 microg/gCr, respectively. There were no significant differences among the five group. The mean concentration of urinary 8-OHdG in inveterate drinker was significantly higher than that in non-drinker (16.67+/-4.29 vs. 11.19+/-4.80 microg/gCr, p<0.05). The smoking enhanced the elevation of urinary 8-OHdG in drinkers. In clinical characteristics, serum y-GTP, a marker of alcoholic liver disease, had significant positive correlation with urinary 8-OHdG on the drinker with chronic hepatitis. In addition, there was a positive correlation between serum ferritin levels and urinary 8-OHdG levels. Iron in the liver suggested oxidative damage of hepatocytes through the fenton reaction in patients with chronic liver disease. In conclusion, drinking and smoking induced liver damage by oxidative stress, and urinary 8-OHdG may be reliable marker of oxidative stress in patients with chronic liver disease.