Reported results of coarse-grained molecular dynamics simulations rationalize the effect of water on the phase-segregated morphology of Nafion ionomers. We analyzed density maps and radial distribution functions and correlated them with domain structures, distributions of protogenic side chains, and water transport properties. The mesoscopic structures exhibit spongelike morphologies. Hydrophilic domains of water, protons, and anionic side chains form a random three-dimensional network, which is embedded in a matrix of hydrophobic backbone aggregates. Sizes of hydrophilic domains increase from 1 to 3 nm upon water uptake. At low water content, hydrophilic domains are roughly spherical and poorly connected. At higher water content, they convert into elongated cylindrical shapes with high connectivity. Further structural analysis provides a reasonable estimate of the percolation threshold. Radial distribution functions from coarse-grained and atomistic molecular dynamics models exhibit a good agreement. Water cluster size distributions from coarse-grained molecular dynamics and dissipative particle dynamics are consistent with small angle x-ray scattering data. Moreover, we calculated the water diffusivity by molecular dynamics methods and corroborated the results by comparison with pulsed field gradient NMR.

Delirium is a common and serious acute neuropsychiatric syndrome characterized by inattention and global cognitive dysfunction. Delirium is associated with higher morbidity, higher mortality and longer hospitalization, but its aetiology remains unclear. We successfully treated five cases of delirium within 1 day with ramelteon, a novel selective melatonin receptor agonist. This suggests that correction of the circadian rhythm disturbance, one of the main symptoms of delirium, plays a crucial role in its treatment and sheds new light on a therapeutic strategy for treatment of delirium.

All patients with IATR were treated with irradiation, and no image findings of a partial or total necrosis of the flap recognized 1 year after examination. They produced good cosmetic results; however, they could not elevate the QOL score on the whole.

Background: Retrospective analysis suggests that anthracycline-containing regimens may be superior to non-anthracycline-containing regimens in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. However, both trastuzumab and anthracycline have cardiotoxicity, and it remains unclear how to use trastuzumab in combination with an anthracycline to curtail their cardiotoxicity. Patients and Methods: From 2010 to 2013, we administered weekly (q1w) paclitaxel (wP) followed by 75 mg/m² epirubicin, fluorouracil, and cyclophosphamide (FEC) every third week (q3w) and concurrent q1w trastuzumab (H) to 41 patients with HER2-positive breast cancer (H+ group), and wP followed by FEC100 without trastuzumab to 57 patients who were HER2-negative (H- group). We routinely assessed the left ventricular ejection fraction (LVEF) by echocardiography, at the time of initiation, after wP, and after FEC, and compared them between these 2 groups. Results: LVEF decreased from 63.2 to 60.9% (p = 0.030) in the H+ group and from 63.9 to 61.9% (p = 0.009) in the H- group. These 2 groups showed no significant difference in the reduction rate of LVEF over the period of chemotherapy (0.968 vs. 0.978: NS, p = 0.6457). There was no severe cardiotoxicity or congestive heart failure in either group. Conclusion: Concurrent administration of epirubicin (q3w, 75 mg/m²) and trastuzumab showed no less cardiac tolerability in an adjuvant setting.

In Trastuzumab Group, LVEF was reduced from the initial level (63.1%) to 60.4 at ``After FEC'' (p= 0.007), but had recovered to 60.9% at ``After 1 year''. A two-way repeated-measures ANOVA demonstrated a significant decline in LVEF level along the time course (p< 0.002), but there was no interaction revealed between time course of LVEF and treatment with or without trastuzumab (p= 0.834). In addition, there was no significant difference between groups (p= 0.386)CONCLUSIONS: P followed by FEC75 with concurrent trastuzumab could provide enough evidence of cardiac safety.