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Acquired loss of hypothalamic orexin (hypocretin)-producing neurons causes the chronic sleep disorder narcolepsy-cataplexy. Orexin replacement therapy using orexin receptor agonists is expected as a mechanistic treatment for narcolepsy. Orexins act on two receptor subtypes, OX1R and OX2R, the latter being more strongly implicated in sleep/wake regulation. However, it has been unclear whether the activation of only OX2R, or both OX1R and OX2R, is required to replace the endogenous orexin functions in the brain. In the present study, we examined whether the selective activation of OX2R is sufficient to rescue the phenotype of cataplexy and sleep/wake fragmentation in orexin knockout mice. Intracerebroventricular [Ala 11 , D -Leu 15 ]-orexin-B, a peptidic OX2R-selective agonist, selectively activated OX2R-expressing histaminergic neurons in vivo, whereas intracerebroventricular orexin-A, an OX1R/OX2R non-selective agonist, additionally activated OX1R-positive noradrenergic neurons in vivo. Administration of [Ala 11 , D -Leu 15 ]-orexin-B extended wake time, reduced state transition frequency between wake and NREM sleep, and reduced the number of cataplexy-like episodes, to the same degree as compared with orexin-A. Furthermore, intracerebroventricular orexin-A but not [Ala 11 , D -Leu 15 ]-orexin-B induced drug-seeking behaviors in a dose-dependent manner in wild-type mice, suggesting that OX2R-selective agonism has a lower propensity for reinforcing/drug-seeking effects. Collectively, these findings provide a proof-of-concept for safer mechanistic treatment of narcolepsy-cataplexy through OX2R-selective agonism.

Purpose Pulmonary perfusion is an important factor for gas exchange. Chest digital dynamic radiography (DDR) by the deep‐breathing protocol can evaluate pulmonary perfusion in healthy subjects. However, respiratory artifacts may affect DDR in patients with respiratory diseases. We examined the feasibility of a breath‐holding protocol and compared it with the deep‐breathing protocol to reduce respiratory artifacts. Materials and methods A total of 42 consecutive patients with respiratory diseases (32 males; age, 68.6 ± 12.3 yr), including 21 patients with chronic obstructive pulmonary disease, underwent chest DDR through the breath‐holding protocol and the deep‐breathing protocol. Imaging success rate and exposure to radiation were compared. The correlation rate of temporal changes in each pixel value between the lung fields and left cardiac ventricles was analyzed. Results Imaging success rate was higher with the breath‐holding protocol vs the deep‐breathing protocol (97% vs 69%, respectively; P < 0.0001). The entrance surface dose was lower with the breath‐holding protocol (1.09 ± 0.20 vs 1.81 ± 0.08 mGy, respectively; P < 0.0001). The correlation rate was higher with the breath‐holding protocol (right lung field, 41.7 ± 9.3%; left lung field, 44.2 ± 8.9% vs right lung field, 33.4 ± 6.6%; left lung field, 36.0 ± 7.1%, respectively; both lung fields, P < 0.0001). In the lower lung fields, the correlation rate was markedly different (right, 15.3% difference; left, 14.1% difference; both lung fields, P < 0.0001). Conclusion The breath‐holding protocol resulted in high imaging success rate among patients with respiratory diseases, yielding vivid images of pulmonary perfusion.

Background Although development of immune checkpoint inhibitors and various molecular target agents has extended overall survival time (OS) in advanced non-small cell lung cancer (NSCLC), a complete cure remains rare. We aimed to identify features and treatment modalities of complete remission (CR) cases in stages III and IV NSCLC by analyzing long-term survivors whose OS exceeded 3 years. Methods From our hospital database, 1,699 patients, registered as lung cancer between 1 st Mar 2004 and 30 th Apr 2011, were retrospectively examined. Stage III or IV histologically or cytologically confirmed NSCLC patients with chemotherapy initiated during this period were enrolled. A Cox proportion hazards regression model was used. Data collection was closed on 13 th Feb 2017. Results There were 164 stage III and 279 stage IV patients, including 37 (22.6%) and 51 (18.3%) long-term survivors and 12 (7.3%) and 5 (1.8%) CR patients, respectively. The long-term survivors were divided into three groups: 3 ≤ OS < 5 years, 5 years ≤ OS with tumor, and 5 years ≤ OS without tumor (CR). The median OS of these groups were 1,405, 2,238, and 2,876 days in stage III and 1,368, 2,503, and 2,643 days in stage IV, respectively. The mean chemotherapy cycle numbers were 16, 20, and 10 in stage III and 24, 25, and 5 in stage IV, respectively. In the stage III CR group, all patients received chemoradiation, all oligometastases were controlled by radiation, and none had brain metastases. Compared with non-CR patients, the stage IV CR patients had smaller primary tumors and fewer metastases, which were independent prognostic factors for OS among long-term survivors. The 80% stage IV CR patients received radiation or surgery for controlling primary tumors, and the surgery rate for oligometastases was high. Pathological findings in the stage IV CR patients revealed that numerous inflammatory cells existed around and inside resected lung and brain tumors, indicating strong immune response. Conclusions Multiple line chemotherapies with primary and oligometastatic controls by surgery and/or radiation might achieve cure in certain advanced NSCLC. Cure strategies must be changed according to stage III or IV. This study was retrospectively registered on 16 th Jun 2019 in UMIN Clinical Trials Registry (number UMIN000037078).

Introduction Hypoxic pulmonary vasoconstriction optimises oxygenation in the lung by matching the local‐blood perfusion to local‐ventilation ratio upon exposure to alveolar hypoxia. It plays an important role in various pulmonary diseases, but few imaging evaluations of this phenomenon in humans. This study aimed to determine whether chest digital dynamic radiography could detect hypoxic pulmonary vasoconstriction as changes in pulmonary blood flow in healthy individuals. Methods Five Asian men underwent chest digital dynamic radiography before and after 60 sec breath‐holding at the maximal inspiratory level in upright and supine positions. Alveolar partial pressure of oxygen and atmospheric pressure were calculated using the blood gas test and digital dynamic radiography imaging, respectively. To evaluate the blood flow, the correlation rate of temporal change in each pixel value between the lung fields and left cardiac ventricles was analysed. Results Sixty seconds of breath‐holding caused a mean reduction of 26.7 ± 6.4 mmHg in alveolar partial pressure of oxygen. The mean correlation rate of blood flow in the whole lung was significantly lower after than before breath‐holding (before, upright 51.5%, supine 52.2%; after, upright 45.5%, supine 46.1%; both P < 0.05). The correlation rate significantly differed before and after breath‐holding in the lower lung fields (upright, 11.8% difference; supine, 10.7% difference; both P < 0.05). The mean radiation exposure of each scan was 0.98 ± 0.09 mGy. No complications occurred. Conclusions Chest digital dynamic radiography could detect the rapid decrease in pulmonary perfusion in response to alveolar hypoxia. It may suggest hypoxic pulmonary vasoconstriction in healthy individuals. Hypoxic pulmonary vasoconstriction optimises oxygenation in the lung by matching the local‐blood‐perfusion‐to‐local‐ventilation ratio upon exposure to alveolar hypoxia. It plays an important role in various pulmonary diseases, but few imaging evaluations of this phenomenon in humans exist. Chest digital dynamic radiography could detect the rapid decrease in pulmonary perfusion in response to alveolar hypoxia, which may suggest hypoxic pulmonary vasoconstriction in healthy individuals.

Key message Chest digital dynamic radiography (DDR) is a novel method for evaluating pulmonary perfusion and ventilation. It could depict ventilation–perfusion mismatch in a pulmonary artery sarcoma with severe stenosis in the right pulmonary artery. This report is the first demonstration of ventilation–perfusion mismatch in a malignant neoplasm using DDR. Chest digital dynamic radiography (DDR) is a novel method for evaluating pulmonary perfusion and ventilation. It could depict ventilation–perfusion mismatch in a pulmonary artery sarcoma with severe stenosis in the right pulmonary artery. This report is the first demonstration of ventilation–perfusion mismatch in a malignant neoplasm using DDR.

Point clouds acquired by Mobile Mapping System (MMS) are useful for creating 3D maps that can be used for autonomous driving and infrastructure development. However, many applications require semantic labels to each point of the point clouds, and the manual labeling process is very time consuming and expensive. Therefore, there is a strong need to develop a method to automatically assigning semantic labels. For automatic labeling tasks, classification methods using multiscale features are effective because multiscale features include features of various scales of roadside objects. Multiscale features are calculated using points inside spheres of multiscale radii centered at each point in a point cloud. When calculating multiscale features that are useful for classifying MMS point clouds, it is necessary to calculate features using relatively large radii. However, when calculating multiscale features using wide range of neighbor points, existing methods, such as kd-tree, require unacceptably long computation time for neighbor search. In this paper, we propose a method to calculate multiscale features in practical time for semantic labeling of large-scale point clouds. In our method, an MMS point cloud is first divided into small spherical regions. Then, radius search using multiscale radii is performed, and multiscale features are calculated using those neighbor points. Our experimental results showed that our method achieved significantly faster computational performance than conventional methods, and multiscale features could be calculated from large-scale point clouds in practical time.

Photovoltaic (PV) power generation is one of most promising means to prevent global warming in the present Japan. Since solar panels mounted on building façades are expected to come into wide use in urban areas, accurate estimation of PV potential of building façades is necessary for urban energy management planning. Accordingly, we have developed a system to estimate PV potential of urban buildings using a 3D city model. The system has two significant features: rapid estimation of hourly solar irradiance of points densely distributed on a building surface, and more flexible estimation of PV potential considering an arrangement of solar panels on a building surface. The paper reports our newly developed method to estimate PV potential of urban buildings considering an arrangement of solar panels using dense solar irradiance distribution on a building surface. The rapid estimation of dense solar irradiance distribution on a building surface enables the system to handle more flexible arrangement of solar panels with providing width and height of a solar panel, and clearance around solar panels. Considering some restrictions such as minimum solar irradiance of a solar panel makes PV potential estimated by the system become more realistic. The paper reports experiments conducted in seven urban districts in Japan to investigate the flexibility of the method by using various settings of panel installing conditions. Experiment results indicate that our developed method can estimate PV potential flexibly considering an arrangement of solar panels corresponding to various settings of panel installing conditions such as size of a solar panel.

Photovoltaic (PV) power generation is one of most promising means to prevent global warming in the present Japan. Since solar panels mounted on building façades are expected to come into wide use in urban areas, accurate estimation of PV potential of building façades is necessary for urban energy management planning. Accordingly, we decided to develop a system to estimate PV potential of urban buildings using a 3D city model. The system has two significant features: rapid estimation of hourly solar irradiance of points densely distributed on a building surface, and more flexible estimation of PV potential considering an arrangement of solar panels on a building surface. The paper reports our newly developed algorithm to estimate solar irradiance of urban buildings. The algorithm adopts the idea that “whether the sun can see us or not” indicates “whether we have sunshine or not” for calculation of hourly solar irradiance of a point on a building surface. In estimation of solar irradiance distributions on roofs and façades, utilization of projection images viewed from the sun created by using computer graphics (CG) techniques such as the depth buffer (Z-buffer) algorithm makes our system have much less computation time than most of existing systems using a hemispherical viewsheds or ray tracing. Results of an experiment conducted in Yokohama of Japan demonstrate that the algorithm would be able to estimate solar irradiance on not only roofs but also façades of urban buildings using a 3D city model accurately enough.

Old maps, such as Inoh Maps and other historical ones, are prospective which might be used for determining the changes of coastal geographical features in the past. It is expected that long-term geographical changes can be known provided that the accuracy of an old map is satisfactorily high. In the present study, the changes of geographical features in the Nobiru Coast, Miyagi Prefecture and the Matsukawaura Lagoon, Fukushima Prefecture are examined by comparing historical and latest maps. Furthermore, long-term sediment deposition rate is analyzed for the Nobiru Coast using old maps.