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We investigated the evaporation and condensation coefficients of vapor, which represent evaporation and condensation rates of vapor molecules, under high gas pressure (high gas density) conditions in a system of a vapor/gas-liquid equilibrium state. The mixture gas is composed of condensable gas (vapor) and non-condensable gas (NC gas) molecules. We performed numerical simulations of vapor/gas–liquid equilibrium systems with the Enskog–Vlasov direct simulation Monte Carlo (EVDSMC) method. As a result of the simulations, we found that the evaporation and condensation fluxes decrease with increasing NC gas pressure, which leads to a decrease in the evaporation and condensation coefficients of vapor molecules. Especially, under extremely high gas pressure conditions, the values of these coefficients are close to zero, which means the vapor molecules cannot evaporate and condensate at the interface. Moreover, we found that the vapor molecules behave as NC gas molecules under high gas pressure conditions. We also discussed the reason why NC gas molecules interfere with evaporation and condensation of vapor molecules at the vapor/gas–liquid interface.

The kinetic boundary condition (KBC) represents the evaporation or condensation of molecules at the vapor–liquid interface for molecular gas dynamics (MGD). When constructing the KBC, it is necessary to classify molecular motions into evaporation, condensation, and reflection in molecular-scale simulation methods. Recently, a method that involves setting the vapor boundary and liquid boundary has been used for classifying molecules. The position of the vapor boundary is related to the position where the KBC is applied in MGD analyses, whereas that of the liquid boundary has not been uniquely determined. Therefore, in this study, we conducted molecular dynamics simulations to discuss the position of the liquid boundary for the construction of KBCs. We obtained some variables that characterize molecular motions such as the positions that the molecules reached and the time they stayed in the vicinity of the interface. Based on the characteristics of the molecules found from these variables, we investigated the valid position of the liquid boundary. We also conducted an investigation on the relationship between the condensation coefficient and the molecular incident velocity from the vapor phase to the liquid phase. The dependence of the condensation coefficient on the incident velocity of molecules was confirmed, and the value of the condensation coefficient becomes small in the low-incident-velocity range. Furthermore, we found that the condensation coefficient in the non-equilibrium state shows almost the same value as that in the equilibrium state, although the corresponding velocity distribution functions of the incident velocity significantly differ from each other.

BackgroundVonoprazan is a potassium competitive acid blocker used to treat erosive gastroesophageal reflux disease (GERD) with stronger, more stable acid-suppressing effects than proton pump inhibitors (PPIs). This study clarified the usefulness and superiority of vonoprazan administered every second day over PPIs in the maintenance therapy of erosive GERD.MethodsThis is a prospective, multicenter, open-label, two-period randomized cross-over study. Patients were randomized to either the vonoprazan-lansoprazole (VP-LZ) group, who were given vonoprazan 10 mg for the first 4 weeks and then lansoprazole 15 mg for the next 4 weeks both administered once every second day, or the lansoprazole-vonoprazan (LZ-VP) group, who were treated in reverse. GERD symptoms were compared using symptom diaries, the frequency scale for symptoms of GERD (FSSG), and the gastrointestinal symptom rating scale (GSRS).ResultsWe enrolled 122 patients between December 2017 and May 2019. Symptoms were well controlled in vonoprazan administration and lansoprazole administration were 93.6% and 82.1%, respectively, with a significant difference on McNemar’s test (P = 0.003). During the second 4 weeks, 94.4% and 76.7% of patients in the VP-LZ and LZ-VP groups, respectively, were well controlled following for ≥ 6 consecutive days a week (P = 0.009). During the first 4 weeks, 96.7% and 80.0% of patients were well controlled with < 1 weekly in the VP-LZ and LZ-VP groups, respectively, during the first 4 weeks (P = 0.007). GERD symptoms, assessed via FSSG and GSRS, significantly decreased with vonoprazan administration once every second day.ConclusionsVonoprazan administered once every second day could be an effective alternative to PPIs in the maintenance treatment of erosive GERD (UMIN000030393).

Background Mobile phones used by healthcare workers (HCWs) are contaminated with bacteria, but the posterior surface of smartphones has rarely been studied. The aim of this study was to compare the prevalence of microbial contamination of touchscreens and posterior surfaces of smartphones owned by HCWs. Methods A cross-sectional study of smartphones used by HCWs employed at two intensive care units at a Japanese tertiary care hospital was performed. Bacteria on each surface of the smartphones were isolated separately. The primary outcomes were the prevalence of microbial contamination on each surface of smartphones and associated bacterial species. Fisher’s exact test was used to compare dichotomous outcomes. Results Eighty-four HCWs participated in this study. The touchscreen and posterior surface were contaminated in 27 (32.1%) and 39 (46.4%) smartphones, respectively, indicating that the posterior surface was more frequently contaminated ( p  = 0.041). Bacillus species and coagulase-negative staphylococci were isolated from each surface of the smartphones. Conclusions The posterior surface of a smartphone was more significantly contaminated with bacteria than the touchscreen, regardless of having a cover. Therefore, routine cleaning of the posterior surface of a smartphone is recommended.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Although studies have reported various patterns of atherosclerotic aortic plaques (AAPs) detected by non-obstructive aortic angioscopy (NOA), the long-term outcomes associated with AAPs such as puff-chandelier rupture atheromatous plaque (PCR), remain unclear. This study investigated the long-term prognostic significance of AAPs detected by NOA in patients who underwent percutaneous coronary intervention (PCI). This retrospective multicenter cohort study included 167 patients who underwent PCI and NOA. The association between AAPs and the incidence of major adverse cardiac events (MACE) were assessed. MACE was categorized into: MACE1, including cardiac death, myocardial infarction, stroke, and ischemia-driven unplanned revascularization; and MACE2, including cardiac death, myocardial infarction, and stroke. There were no NOA-related complications. Of all AAPs, only PCR showed a significant prognostic value during the follow-up period (mean follow-up period: 6.3 years [range 5.9–6.6]). In multivariable Cox proportional hazards analysis, PCR was an independent predictor of MACE (MACE1; HR 1.91, 95% CI 1.04–3.49, P = 0.04, MACE2; hazard ratio [HR] 4.52, 95% confidence interval [CI] 1.23–16.57, P = 0.02). Kaplan–Meier analysis revealed that PCR was significantly associated with MACE. NOA during PCI is safe and feasible. Detecting PCR by NOA may provide reliable information for identifying patients at high risk of subsequent long-term adverse events after PCI.

IntroductionThis real-world study evaluated whether long-term use of eldecalcitol (ELD) increases the risk of adverse events (AEs), namely, hypercalcemia, acute kidney injury (AKI), and urolithiasis, and analyzed the ELD-induced risk of rare AEs such as osteonecrosis of the jaw (ONJ) and atypical femoral fracture (AFF).Materials and methodsPatient records were retrieved from Medical Data Vision (MDV) and Japan Medical Data Center (JMDC) databases. The ELD-treated osteoporosis patient cohort (ELD cohort) was analyzed to determine the incidence rate of the aforementioned AEs. The patient cohort that was prescribed active vitamin D3 other than ELD (AVD cohort) was analyzed as the reference.ResultsIncidence rates of hypercalcemia, AKI, and urolithiasis in the ELD cohort were 0.942, 0.517, 2.465 events per 100 person-years, respectively, in the MDV dataset, and 0.687, 0.155, 3.785, respectively, in the JMDC dataset. The incidence rates of these AEs in the ELD cohort remained relatively constant throughout ELD treatment. A small number of patients experienced ONJ or AFF during ELD or AVD treatment. The number of ONJ and AFF cases in the both cohorts decreased over time. The two cohorts showed no difference in the concomitant use of anti-bone resorptive agents such as bisphosphonates and denosumab.ConclusionThe risk of hypercalcemia and AKI associated with ELD use observed in this retrospective analysis is similar to that reported previously in the Japanese post-marketing surveillance of ELD. Furthermore, ELD, similar to AVD, may not increase the risk of ONJ and AFF.

Lymphoepithelial carcinoma (LEC) is an uncommon neoplasm strongly associated with Epstein-Barr virus (EBV). LEC of the salivary glands (LECSG) is very rare: the most commonly affected site is the parotid gland, followed by the submandibular gland. This report describes the case of a 58-year-old man who presented with a left submandibular mass that had gradually increased in size over five years. On magnetic resonance imaging (MRI), the mass showed low apparent diffusion coefficient (ADC) values, rapid initial enhancement before reaching a plateau on dynamic contrast-enhanced MRI (DCE-MRI), and internal septal-like enhancement. Histopathologically, the tumor comprised polygonal or round tumor cells with atypical or pleomorphic nuclei and numerous lymphocytes, separated by heavy fibrosis. Immunohistological findings were positive for AE/AE3, CD20, and EBV-encoded small RNA in situ hybridization (EBER-ISH), consistent with LEC. A low ADC value with rapid initial enhancement before reaching a plateau on DCE-MRI was thought to reflect abundant cellular components with tumor neoangiogenesis, whereas internal septal-like enhancement reflects separating heavy fibrosis. To the best of our knowledge, this is the first case report describing ADC value and DCE-MRI findings of LECSG, and these findings can be considered characteristic MRI findings of LECSG.

We aimed to develop machine learning-based predictive models for identifying inappropriate implantable cardioverter-defibrillator (ICD) therapy. Our study included 182 consecutive cases (average age 62.2 ± 4.5 years, 169 men) and employed 14 non-deep learning models for prediction (hold-out method). These models utilized selected electrocardiogram parameters and clinical features collected after ICD implantation. From the feature importance analysis of the best ML model, we established easily calculable scores. Among the patients, 25 (13.7%) experienced inappropriate therapy, and we identified 16 significant predictors. Using recursive feature elimination with cross-validation, we reduced the features to six with high feature importance: history of atrial arrhythmia (Atr-arrhythm), ischemic cardiomyopathy (ICM), absence of diabetes mellitus (DM), lack of cardiac resynchronization therapy (CRT), V3 ST level at J point (V3 STJ), and V5 R-wave amplitudes (V5R amp). The extra-trees classifier yielded the highest area under receiver operating characteristics curve (AUROC; 0.869 on test data). Thus, the Cardi35 score was defined as [+ 5.5*Atr-arrhythm − 1.5*CRT + 1.0*V3STJ + 1.0*V5R − 1.0*ICM − 0.5*DM], which demonstrated a hazard ratio of 1.62 (P < 0.001). A cut-off value of the score + 5.5 showed high AUROC (0.826). The ML approach can yield a robust prediction model, and the Cardi35 score was a convenient predictor for inappropriate therapy.

PurposeTo investigate the ability of three-dimensional double-echo steady-state with water excitation sequence (3D-DESS-WE) in detecting the greater occipital nerve (GON) and the lesser occipital nerve (LON).Materials and methodsWe retrospectively reviewed 66 consecutive patients who underwent magnetic resonance imaging, including 3D-DESS-WE. Two readers evaluated the detectability [0 (poor) to 3 (excellent)] and thickness of the GON and LON. We calculated the average evaluation scores and interobserver variability for the detectability of the GON and LON. We also calculated the average nerve thickness for each of the two readers and the interobserver reproducibility for the thickness of the GON and LON. The interobserver variability was calculated using a weighted kappa analysis and the intraclass correlation coefficient (ICC) was used to evaluate the interobserver reproducibility of the nerve thickness.ResultsThe respective average score, interobserver variability, thickness and interobserver reproducibility were 3.00, excellent (κ = 1.00), 1.07 ± 0.12 mm, and almost perfect (ICC = 0.82) for the GON and 1.81, good (κ = 0.73), 0.84 ± 0.11 mm, and substantial (ICC = 0.78) for the LON. The GON was significantly thicker than the LON (p < 0.001).ConclusionThe 3D-DESS-WE demonstrated excellent visualization of the GON and relatively good visualization of the LON.