Volume 10 - 2016 | https://doi.org/10.3389/fnhum.2016.00668 Transcranial direct current stimulation (tDCS) is a representative non-invasive brain stimulation method (NIBS) tDCS increases cortical excitability not only in healthy individuals but also in stroke patients where it contributes to motor function improvement two additional types of transcranial electrical stimulation (tES) methods have been introduced that may also prove beneficial for stimulating cortical excitability; these are transcranial random noise stimulation (tRNS) and transcranial alternating current stimulation (tACS) in terms of efficacy in cortical excitability alteration We compared the efficacy of the three different tES methods for increasing cortical excitability using the same subject population and same current intensity Fifteen healthy subjects participated in this study Similar stimulation patterns (1.0 mA and 10 min) were used for the three conditions of stimulation (tDCS Cortical excitability was explored via single-pulse TMS elicited motor evoked potentials (MEPs) significant increases in MEPs were also observed with tRNS and tACS (p < 0.05) a significant correlation of the mean stimulation effect was observed between tRNS and tACS (p = 0.019 tRNS induced a significant increase in MEP compared with the Pre or Sham at all time points tRNS resulted in the largest significant increase in MEPs These findings suggest that tRNS is the most effective tES method and should be considered as part of a treatment plan for improving motor function in stroke patients tRNS or tACS) have been reported to increase or decrease cortical excitability In previous studies, tRNS has resulted in significantly longer motor evoked potential (MEP) increases than tDCS (Moliadze et al., 2014) there is no direct comparison of after-effect of various tES (i.e. tRNS and tACS) that enhance cortical excitability using the same current intensity Finding the most beneficial stimulation method for cortical excitability would be important for determining treatment options for improving the motor function of stroke subjects The aim of the present study was to compare the efficacy of the three different tES methods for increasing cortical excitability in the same subject population using the same current intensity Fifteen healthy subjects (10 males and 5 females; mean age 22.1 ± 3.0 years) participated in this study Twelve subjects were right-handed and three were left-handed The Edinburgh Handedness Inventory was used to determine the dominant hand None of the subjects were taking medications or had a history of physical This study was conducted in accordance with the Declaration of Helsinki and approved by the ethics committee of the Niigata University of Health and Welfare The study was performed at the Institute for Human Movement and Medical Sciences (to which the authors belong) Experiments were canceled immediately if the subject was not in a suitable condition and the maximum and minimum peak-to-peak amplitude values were excluded The intensity of TMS was kept constant for the post-stimulation assessment Electromyographic activity was recorded via Electromyography (EMG) using surface electrodes placed over the FDI muscle of the right hand EMG signals were amplified (×100) using an amplifier (A-DL-720-140 4 kHz) using an A/D converter (Power Lab 8/30 and filtered using a high-pass filter (20 Hz) Data was recorded on a computer and stored for later analysis (LabChart7 tES was delivered using a DC-STIMULATOR PLUS (Eldith Germany) through a pair of saline-soaked surface sponge electrodes (5 cm × 7 cm For the three conditions of stimulation (tDCS we used similar stimulation patterns (1.0 mA and 10 min) location (FDI hot spot and contralateral orbit) The anode electrode (active) is positioned over the left M1 (FDI hotspot) with the cathode electrode (reference) over the contralateral orbit One electrode was fixed above the left M1 (FDI hotspot) and the other electrode was placed over the contralateral orbit. For tRNS, a random level of current was generated for every sample (sampling rate 1280 samples/s). The random numbers were normally distributed and the density function followed a bell-shaped curve. The noise signal contained all frequencies up to half the sampling rate, that is, a maximum of 640 Hz. The signal had no DC offset (Moliadze et al., 2012) One electrode was fixed above the left M1 (FDI hotspot) and the other electrode was placed over the contralateral orbit. The waveform of the 140 Hz stimulation was sinusoidal (Moliadze et al., 2012) The anode electrode (active) is positioned over the left M1 (FDI hotspot) and the cathode electrode (reference) over the contralateral orbit The experimental procedure is shown in Figure 1 Subjects participated in four different experimental studies the order of the stimulation conditions occurred in a counterbalanced fashion with at least 3 days between two measurements Stimulus intensities (as a percentage of maximal stimulator output) of TMS were determined at the beginning of each experiment 12 single test-pulse MEPs were recorded at 0.2 Hz at approximately 0 min (Post 0) The electrode was quickly removed after tES with the maximum and minimum MEP amplitudes excluded were calculated from the peak-to-peak amplitudes of 10 trials for each of the pre and post stimulation conditions Subjects participated in the following four sessions: (1) anodal Transcranial direct current stimulation (tDCS); (2) transcranial random noise stimulation (tRNS); (3) transcranial alternating current stimulation (tACS); (4) Sham the maximum stimulator output (MSO) was set to elicit a pre-motor evoked potential (MEP) that averaged 1.0 mV peak-to-peak amplitude A Pre measure of cortical excitability was obtained prior to the conditioning protocol and then as multiple time-points following conditioning Two-way repeated measures analysis of variance (ANOVA) was used to analyze MEP amplitude The factors for the ANOVA were four interventions (TYPE OF STIMULATION (tDCS tRNS or Sham)) and five time-points (TIME (Pre Bonferroni’s methods were used for post hoc comparisons the average MEP value of Post 0 to Post 20 was calculated as an after-effect on the stimulation of each condition One-way repeated-measures ANOVA was used to analyze after-effects and Bonferroni’s methods were used for post hoc comparisons Pearson’s product-moment correlation coefficients were calculated for after-effects (tDCS Statistical analyses were performed using PASW statistics software version 22 (SPSS; IBM The level of significance was set at p < 0.05 The sample size required for the present study was calculated utilizing G * Power software version 3.1.9.2 (Franz Faul; University of Kiel The results indicated that 15 subjects would provide a statistical power of 0.80 and an effect size of 0.05 for ANOVA The intensity of TMS was not significantly different in tDCS (52.0 ± 1.9%) Two-way repeated-measures ANOVA revealed a significant main effect of TYPE OF STIMULATION (F(1.879,26.310) = 8.075 partial η2 = 0.366) and TIME (F(4,56) = 14.430 The interaction between TYPE OF STIMULATION and TIME was also significant (F(12,168) = 1.888 We compared MEP amplitudes at the single time-points post-stimulation with Pre MEP amplitudes. The changes in MEP for each stimulation condition are shown in Figure 2 tDCS induced a significant increase in MEP compared with the Pre time-point at time-point Post 20 only (p < 0.000) tRNS induced a significant increase in MEP amplitude compared with the Pre time-point at all time-points (Post 0–Post 20) (Post 0 (p = 0.020) tACS induced a significant increase in MEP amplitude compared with the Pre time-point at Post 0 (p = 0.044) no significant changes at any of the time-points were observed Effect of the transcranial electrical stimulation (tES) on the MEP amplitudes compared with the Pre measure (A) Sham stimulations were without any effect (B) tDCS significantly increased MEP at the Post 20 time-point compared with that at the Pre time-point (C) tRNS significantly increased MEP at the Post 0–Post 20 time-points compared with that at the Pre time-point (D) tACS significantly increased MEP at the Post 0 and Post 20 compared with that at the Pre time-point The gray line shows the amplitude of the MEP for each individual The black line shows mean amplitudes of the MEP Open circles indicate significantly increased post-measurements of MEP amplitudes compared with those at the Pre time-point (Bonferroni’s methods A difference in MEP between the stimulation in each time is shown in Figure 3 Comparing all of the stimulation conditions there were no significant differences in the Pre-condition Bonferroni’s methods showed significantly higher MEP amplitude at each time Post 0–Post 20 with tRNS than with sham [Post 0 (p = 0.035) tACS induced a significant increase of MEP compared with Sham at the time-points Post 5 (p = 0.037) and Post-20 (p = 0.028) In contrast to the effect of tRNS and tACS tDCS did not modify the MEP amplitudes significantly compared with sham Effect of the tES method on MEP amplitudes compared with Sham (A) tDCS did not significantly increase MEP compared with the Sham (B) tRNS significantly increased MEP at the Post 0–Post 20 time-points compared with the Sham (C) tACS significantly increased MEP at the Post 5 and Post 20 time-points compared with the Sham Open circles indicate significantly increased post-measurements of MEP amplitudes compared with the Sham (Bonferroni’s methods (D) The bar graphs show the average value of the after-effect of each stimulation condition tRNS and tACS had significantly higher values than sham (*p < 0.01) Regarding the average value of the after-effect, one-way repeated-measures ANOVA was significant [F(1.876,26.268) = 8.035, p = 0.002, partial η2 = 0.365]. According to Bonferroni’s methods, tRNS (p = 0.001) and tACS (p = 0.002) were significantly higher than sham. A scatter diagram of the after-effects of each stimulation condition is shown in Figure 4 There was a significant correlation between tRNS and tACS (p = 0.019 Scatter diagram of the average after-effect of each stimulation condition (A) Scatter diagram of the after-effect of tDCS vs (B) Scatter diagram of the after-effect of tDCS vs (C) Scatter diagram of the after-effect of tACS vs There was a significant correlation between tRNS and tACS It is assumed that correlation was found between tRNS and tACS in terms of the mean stimulation effect tRNS has significantly more power than tACS because of the numerous frequencies used This difference in frequency may be the reason why tRNS increased MEP at more time points than tACS These two mechanisms may be involved in increased MEP after tRNS it is assumed that the stimulation effect was also different these findings and the results of this study indicate that tRNS is the most beneficial stimulation method is used for the purpose of improving motor function of stroke patients tRNS showed significant cortical excitability increase at many time points compared with tDCS tRNS enhances cortical excitability more stably than tDCS; therefore it may improve the motor function of stroke patients more steadily Further study of its use for improving motor function in stroke patients is needed One limitation of this study is that all the subjects were healthy and young; thus it remains unclear if similar results would be obtained with stroke subjects or elderly subjects Further study is needed to determine whether age or disease state would impact these results this study measured only MEP amplitude over a short time (until after 20 min) Further study is required to determine not only the MEP amplitude of a short time but also the long term effects the evaluation of motor function and behavior in response to stimulation effect should be conducted we compared the after-effects of different excitatory transcranial electrical stimulation methods (tDCS tACS and tRNS) in the same healthy subjects Our findings indicate that tRNS is the most beneficial stimulation method for increasing cortical excitability HO conceived the study and designed the experiment RS and ST performed the interpretation of data SM and KS performed the statistical analysis MM and NO helped in writing and revising the manuscript All authors read and approved the final manuscript This work was supported by a Grant-in-Aid for Exploratory Research from the Niigata University of Health and Welfare The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest We thank all the volunteers for their time and patience during testing. In addition, the authors would like to thank Enago Inc. (http://www.enago.jp) for editorial assistance Brain-derived neurotrophic factor (BDNF) gene polymorphisms shape cortical plasticity in humans Transcranial alternating current and random noise stimulation: possible mechanisms PubMed Abstract | Google Scholar Does anodal transcranial direct current stimulation enhance excitability of the motor cortex and motor function in healthy individuals and subjects with stroke: a systematic review and meta-analysis Differential modulation of corticospinal excitability by different current densities of anodal transcranial direct current stimulation Partially non-linear stimulation intensity-dependent effects of direct current stimulation on motor cortex excitability in humans Transcranial random noise stimulation-induced plasticity is NMDA-receptor independent but sodium-channel blocker and benzodiazepines sensitive Transcranial direct current stimulation post-stroke upper extremity motor recovery studies exhibit a dose-response relationship Transcranial direct current stimulation (tDCS) for improving activities of daily living and physical and cognitive functioning Random noise stimulation improves neuroplasticity in perceptual learning tDCS-enhanced motor and cognitive function in neurological diseases PubMed Abstract | Google Scholar Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke PubMed Abstract | Google Scholar Methods of therapeutic cortical stimulation PubMed Abstract | Google Scholar The contribution of interindividual factors to variability of response in transcranial direct current stimulation studies Pharmacological approach to the mechanisms of transcranial DC-stimulation-induced after-effects of human motor cortex excitability Bihemispheric brain stimulation facilitates motor recovery in chronic stroke patients López-Alonso Inter-individual variability in response to non-invasive brain stimulation paradigms Transcranial direct current stimulation (tDCS): does it have merit in stroke rehabilitation Close to threshold transcranial electrical stimulation preferentially activates inhibitory networks before switching to excitation with higher intensities Boosting brain excitability by transcranial high frequency stimulation in the ripple range Comparing the efficacy of excitatory transcranial stimulation methods measuring motor evoked potentials Calcium imaging reveals glial involvement in transcranial direct current stimulation-induced plasticity in mouse brain Transcranial direct current stimulation: state of the art 2008 Pharmacological modulation of cortical excitability shifts induced by transcranial direct current stimulation in humans Modulation of cortical excitability by weak direct current stimulation—technical Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation Sustained excitability elevations induced by transcranial DC motor cortex stimulation in humans PubMed Abstract | Google Scholar Determinants of the electric field during transcranial direct current stimulation Duration-dependent effects of the BDNF Val66Met polymorphism on anodal tDCS induced motor cortex plasticity in older adults: a group and individual perspective Extracellular stimulation of mammalian neurons through repetitive activation of Na+ channels by weak capacitive currents on a silicon chip Stochastic resonance improves signal detection in hippocampal CA1 neurons PubMed Abstract | Google Scholar Noninvasive brain stimulation for motor recovery after stroke: mechanisms and future views PubMed Abstract | Google Scholar Late cortical plasticity in motor and auditory cortex: role of met-allele in BDNF Val66Met polymorphism Increasing human brain excitability by transcranial high-frequency random noise stimulation Head-to-head comparison of transcranial random noise stimulation transcranial AC stimulation and transcranial DC stimulation for tinnitus Dual-hemisphere tDCS facilitates greater improvements for healthy subjects’ non-dominant hand compared to uni-hemisphere stimulation Noninvasive brain stimulation in stroke rehabilitation PubMed Abstract | Google Scholar Variability in response to transcranial direct current stimulation of the motor cortex Keywords: transcranial direct current stimulation transcranial alternating current stimulation Otsuru N and Onishi H (2016) Comparison of Three Non-Invasive Transcranial Electrical Stimulation Methods for Increasing Cortical Excitability Received: 12 September 2016; Accepted: 15 December 2016; Published: 27 December 2016 Copyright © 2016 Inukai, Saito, Sasaki, Tsuiki, Miyaguchi, Kojima, Masaki, Otsuru and Onishi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) distribution and reproduction in other forums is permitted provided the original author(s) or licensor are credited and that the original publication in this journal is cited in accordance with accepted academic practice distribution or reproduction is permitted which does not comply with these terms *Correspondence: Yasuto Inukai, aW51a2FpQG51aHcuYWMuanA= Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher 94% of researchers rate our articles as excellent or goodLearn more about the work of our research integrity team to safeguard the quality of each article we publish This work, 4th Fighter Squadron brings the lightning during ATR, by SrA Luis E. Rios Calderon, identified by DVIDS, must comply with the restrictions shown on https://www.dvidshub.net/about/copyright Please view the main text area of the page by skipping the main menu. The page may not be displayed properly if the JavaScript is deactivated on your browser Japanese version Copyright THE MAINICHI NEWSPAPERS. All rights reserved. Japan-based writer Ally Hongo finds treasured stories and lessons from Japan's craft masters and contemporary makers a group of Japanese craftsmen remind us that true aesthetics can lie in our imperfections and ability to transform struggles into new forms of life In the dimmed atelier of the master’s studio once-shattered tea bowls glint as they catch the light “They’re beautiful because they have a story.” My thoughts are suddenly interrupted by renowned kintsugi master Showzi Tsukamoto Tsukamoto has been restoring Japanese pottery in the authentic manner of kintsugi the art of joining broken pieces with lacquer and adorning them with gold he has also welcomed hundreds of international travellers willing to deepen their understanding of the kintsugi art through his workshops and master classes master of kintsugi who has perfected the approach to maki-e (Japanese lacquer decoration) kintsugi is a life philosophy of appreciation and acceptance that crosses borders “Kintsugi helps us find an indication of our unique history.” Tsukamoto points to a photo of a plate with numerous golden strokes holding it together The disjointed pieces of the plate were brought to him by a survivor of the 2011 earthquake whose house was washed away in the tsunami that followed “Joining the plate together became proof of her life in that house giving her some comfort,” Tsukamoto recalls “Kintsugi allows us to give a new life to sentimental objects and find peace with life.” The art’s philosophy PreviousThe Japanese art of kintsugi embraces imperfections and breathing new life into broken objects.The Japanese art of kintsugi embraces imperfections and breathing new life into broken objects Next12The early foundations of kintsugi are believed to have started in 16th Century Japan at the time of Oda Nobunaga a leading daimyo lord of the Sengoku (warrior) period Nobunaga was a collector of expensive pottery which he would strategically use in political exchanges This became the work of maki-e (“sprinkled pictures”) artisans who began painting the broken parts with lacquer and sprinkling them with gold kintsugi has taken various forms and shapes Tsukamoto is one of the few remaining practitioners of the maki-e approach to kintsugi Inclined to learn directly from the master I join a one-day workshop at Tsukamoto’s atelier to observe the kintsugi process Tsukamoto hands me a cracked soba cup and tools to breathe new life into it The process begins with carefully polishing up the damaged area then filling it with a mix of urushi tree sap (Japanese lacquer) and binding flour The cup is left to dry and harden in a humidified wooden box the broken part is meticulously polished with a filing tool until flattened followed by several layers of lacquer application The final touch is the careful sprinkling of golden powder on the scarred part the first few minutes of Tsukamoto’s workshop are interrupted by thousands of competing thoughts “Slowly and patiently,” he adds urging me to treat each step with extra care the more the process starts to relax my busy mind Tsukamoto serves green tea and takes a moment to reflect on our experience PreviousLearn the luxurious maki-e approach to kintsugi with Tsukamoto himself a professionally-trained maki-e artist.Learn the luxurious maki-e approach to kintsugi with Tsukamoto himself a professionally-trained maki-e artist Next12“We tend to hide our imperfections The kintsugi philosophy of embracing imperfection and scars resonates with many across the globe as Tsukamoto observed throughout his years of working with prominent overseas brands as well as international museums and students “Taking pride in one’s imperfections offers peace of mind The greatest lesson from kintsugi is that we can deal with misfortunes by turning them into something more beautiful” a group of women have adopted the philosophy of kintsugi as a way to revitalise the local communities that were impacted by the devastating 2011 disasters Believing in “beauty in brokenness” was led by American Sue Plumb Takamoto to find a new purpose for the thousands of broken ceramics left behind in the disaster The project crafts beautiful jewellery and other objects from broken pottery and sells them worldwide creating a healing journey for those affected PreviousThe Nozomi Project is a social enterprise that encourages the art of transforming broken pottery into beautiful accessories.The Nozomi Project is a social enterprise that encourages the art of transforming broken pottery into beautiful accessories.The Nozomi Project is a social enterprise that encourages the art of transforming broken pottery into beautiful accessories Next13“We remind ourselves that turning the broken into something beautiful is a way to remember the lost families and give their stories a new life.” the Nozomi Project has employed more than 30 local women most of whom lost their businesses in the tsunami The project has since spread to other areas of Japan — and overseas — with people donating old pottery to be reborn into beautiful jewellery and ornaments Nozomi has supported regions in Japan affected by other natural disasters as well as overseas foundations supporting children and their families understanding its core values and adapting the project into daily life regardless of where one resides Finding a new purpose for old belongings is a way to continue their legacy and share important lessons on life for the generations to follow “every piece has a story waiting to be told.” an artisanal town in northern Japan’s Niigata Prefecture boasts more than 400 years of craftsmanship excellence “The more people visit our workspace the more they would understand why we strive to preserve the craft,” says Motoyuki Tamagawa the seventh-generation owner of Gyokusendo PreviousExperienced masters and young craft makers demonstrate the making of tsuiki copperware.The traditional craft of Gyokusendo has been transformed into fine art over the years.The traditional craft of Gyokusendo has been transformed into fine art over the years Gyokusendo crafts some of Japan’s finest teapots and copper kitchen utensils entirely by hand Derived from the words “hammer” and “raise” the tsuiki crafts are produced from copperware sheets Gyokusendo is one of the few remaining establishments using this technique faced with increasingly popular and cheaper mass production an ageing population and a severe lack of successors the Gyokusendo artisans boldly introduced an “open factory” system as a last resort to save their craft visitors from around the world are welcome inside the masters’ studios to observe their work — a rare privilege in Japan’s relatively veiled traditional crafts industry the Open Factory tours are available for travellers visiting the area and include a first-hand observation of Gyokusendo’s artisans working their copperware visitors are also invited inside the artisans’ rooms where they can further observe the finished artworks Tsubame has been preserving the authentic craft of Gyokusendo The new system has been successful in increasing revenue and the number of international tourists in the area The brand’s respect reached new heights and new artists increasingly began studying the craft. Today Gyokusendo is one of Japan’s most visited traditional craft factories and the company receives dozens of applications from artisans annually In a country where men heavily dominate traditional crafts more young Japanese women (nearly half of Gyokusendo’s artisans) now embrace the traditional art “The Japanese character for ‘life’ is formed by three parts that mean ‘one human It means that we produce a new life through our work and we should value the product deeply” “We avoid using the word ‘perfect’ It’s the aim for betterment that matters.“ are based on three unifying philosophies anchored in lessons about humanity and preservation “The beauty of kintsugi lies in its ability to be adapted to anything in life.” Tsukamoto’s words stay with me long after I have left the artist’s studio and stepped back into the chaos of managing everyday life They come back to remind me that even with struggles Showzi Tsukamoto offers 1-day and 2-day workshops for travelers, as well as more extended master classes. For more information and bookings, visit his official website here Gyokusendo’s Open Factory tours are held daily, typically five times a day. Advanced bookings for groups under 5 people aren’t required but inquiries in advance are recommended. For more information, see Gyokusendo’s official website here For more information on the Nozomi Project, see here it has abundant rainfall and seas that teem with marine life Embrace responsible travel in Japan – bringing you at one with the beauty of mother nature and changing seasons Gain matchless insights into cherished Japanese customs These authentic experiences will inspire a world of new travel ideas An unrivalled choice of transformative travel and warm welcome awaits monthly sit-ins by atomic bomb survivors and others in the Nagasaki Peace Park calling for the abolition of nuclear weapons and a world without war have been held on the ninth day of each month as a rallying cry for peace Although more than 500 sit-ins have been held to date by hibakusha nuclear weapons are not only still in existence but have only grown as a threat to humanity participants in the city in Japan's southwestern prefecture -- the site of the atomic bombing in the final stages of World War II on Aug 1945 -- continue their rallies in front of the Nagasaki Peace Statue in the face of the growing threat nuclear weapons pose to humanity chairman of the Hibakusha Liaison Council of the Nagasaki Prefectural Peace Movement Center describing the devastation wrought by the atomic bomb to about 420 participants -- four times the usual number of hibakusha high school students and others who attend the monthly events The aftermath of the bombing of Nagasaki saw many of the injured survivors wandering the streets "like a parade of ghosts," Kawano told the gathering quoting what his grandmother had witnessed "Humanity will perish unless nuclear weapons are gotten rid of," he told the participants The sit-ins have their origin in an event that took place on March 16 then chairman of the Council of Labor Unions in Nagasaki Prefecture and some 30 others to protest a port call by Japan's first nuclear-powered ship due to an accidental radiation leak caused by the vessel in 1974 After the ship embarked from Sasebo Port in 1982 people began gathering for sit-ins on the ninth of each month to remember the atomic bombing of the city and to call for the abolition of nuclear weapons Sit-ins in front of the park's peace memorial became the norm following a protest against nuclear tests by hibakusha and four other Nagasaki school teachers in 1974 who began to fully join the monthly sit-ins after retirement "We can express our opposition to nuclear weapons even through a sit-in of a few minutes It is a movement that is easy to take part in." the day that marks the atomic bombing of the city when the Peace Memorial Ceremony is held the sit-in rallies have continued without fail on the ninth of each month even on snow days and during the COVID-19 pandemic While skeptics are doubtful that sit-ins can lead to the abolition of nuclear weapons still finds "meaning in expressing opposition to nuclear weapons." Tsuiki had taken part in the monthly sit-ins before becoming physically unable to do so a decade ago due to his advanced age maintain policies of nuclear deterrence and are not moving toward abolition there are also moves to push states to ratify the Treaty on the Prohibition of Nuclear Weapons But the United States as well as other countries with nuclear arsenals have not signed on since the treaty was adopted by the U.N citing the fact that it is "not likely to produce any results" as the treaty has not been ratified by any of the states in possession of nuclear weapons Though discouraged by nuclear powers and other countries that have so far stuck to a policy based on the promise of retaliation and possibly mutually assured destruction "I feel that anti-nuclear sentiment has spread somewhat compared to when we started our protest movement." only accounting for some 10 percent of participants in recent years But young people have been attending and are ready to pick up the mantle a student at Chinzei Gakuin High School in Nagasaki Prefecture who attended the 500th sit-in "I will pass on what I have learned from hibakusha down to my juniors and strive to keep this movement active among future generations," she said Nagasaki mayor says Israel not invited to A-bomb peace ceremony FEATURE: Nagasaki survivor-doctor works for nuke-free world into his 80s Hiroshima survivor who broke silence at 70 seeks "blue sky" of peace To have the latest news and stories delivered to your inbox Simply enter your email address below and an email will be sent through which to complete your subscription Please check your inbox for a confirmation email Thank you for reaching out to us.We will get back to you as soon as possible Associate Professor Kosuke Tsuiki of the Institute for Research in Humanities has been named Chevalier de l'Ordre des Palmes Académiques (Knight of the Order of Academic Palms) by the French ministry of education receiving the honor at a ceremony held 26 October at the Consulate-General of France in Kyoto located within l'Institut Français du Japon – Kansai The Order of Academic in Palms was originally established in 1808 by Emperor Napoleon Bonaparte to honor distinguished academics and cultural and educational figures including those involved in higher education Previous Japanese honorees were selected for their contributions to French language education the dissemination of French scholarly works in Japan and the promotion of cultural exchange between Japan and France Associate Professor Tsuiki was recognized for his long-lasting contributions in promoting French culture in Japan Associate Professor Tsuiki being decorated with the Chevalier medal This work, Cloudy with a chance of F-35s, by SrA Luis E. Rios Calderon, identified by DVIDS, must comply with the restrictions shown on https://www.dvidshub.net/about/copyright. Volume 13 - 2019 | https://doi.org/10.3389/fnbeh.2019.00038 Repetitive passive movement (PM) affects corticospinal excitability; however it is unknown whether a duty cycle which repeats movement and rest or subjects’ conscious attention to movements We aimed to clarify the effect of the presence or absence of a duty cycle and subjects’ attention on corticospinal excitability PM of the right index finger was performed for 10 min Three conditions were used: (1) continuous PM (cPM) at a rate of 40°/s; (2) intermittent PM (iPM) with a duty cycle at 40°/s; and (3) iPM at 100°/s motor evoked potential (MEP) amplitude was significantly reduced PM was performed for 30 min: condition 1 comprised cPM at a rate of 40°/s and Condition 2 comprised iPM at 40°/s MEP amplitude significantly decreased in both conditions PM was performed for 10 min: condition 1 comprised paying attention to the moving finger during iPM and Condition 2 was similar to Condition 1 but while counting images on a monitor without looking at the movement finger and Condition 3 comprised counting images on a monitor without performing PM MEP amplitude significantly increased only under Condition 1 afferent input from movements above a certain threshold may affect corticospinal excitability reduction corticospinal excitability increases when paying attention to passive finger movement This fluctuation in corticospinal excitability is thought to be influenced by differences in various stimuli such as the duration of movement presence or absence of a duty cycle of repeated movement and rest and presence or absence of a subject’s active attention on the movement it appears that continuous and intermittent intervention with duty cycles of repeated stimulus and rest may have different effects on corticospinal excitability we hypothesized that corticospinal excitability would increase when setting a duty cycle in repetitive PM and the purpose of Experiment 1 was to clarify the effect of the presence or absence of a duty cycle of repetitive PM on corticospinal excitability the influence of number of movements was examined in order to clarify the effects of continuous repetitive PM and intermittent repetitive PM on corticospinal excitability and the number of the movements was increased These previous studies suggested that attention to the stimulated side during an intervention diminishes the activity of suppressive circuits in the cortex and thus increases corticospinal excitability we hypothesized that directing attention to the PM of index fingers would induce an increase in corticospinal excitability and we aimed to clarify the influence of paying attention to repetitive PM on corticospinal excitability A total of 19 healthy adults (16 males; age 24.7 ± 6.0 years [mean ± standard deviation]; 17 right-handed) participated in this study Experiment 1 utilized 15 healthy adults (13 males; age 24.7 ± 6.6 years; 13 right-handed); Experiment 2 utilized 10 healthy adults (eight males; age 24.0 ± 4.8 years; eight right-handed); and Experiment 3 utilized 14 healthy adults (12 males; age 25.4 ± 6.6 years; 12 right-handed) No subjects had any central neurological or psychological disorders This study was approved by the Ethics Committee of Niigata University of Health and Welfare and was conducted in accordance with the Declaration of Helsinki All participants provided written informed consent before participating in this research The target muscle was the right first dorsal interosseous muscle (FDI) which was monitored with disposable Ag/AgCl electrodes in a belly−tendon montage The earth electrode was wrapped around the right forearm Electromyography (EMG) data were recorded using a surface electrode (Blue sensor Metz) connected to an amplifier (×100; A-DL-720-140 The amplified EMG signal was digitized using an A/D converter (Power Lab 8/30 and filtering was also performed using a 20 Hz high-pass filter Data was imported into a personal computer and stored using analysis software (LabChart 7 Motor evoked potential (MEP) was measured by TMS as a means of evaluating corticospinal excitability The coil was placed tangentially to the scalp and the handle part of the coil was placed tangentially at approximately 45° behind the midline The magnetic stimulation site was the finger area on the left M1 and was defined as the site (hot spot) where the MEP was most induced by the right FDI Magnetic resonance imaging and Visor 2 TMS Neuronavigation (eemagine Medical Imaging Solutions GmbH Germany) were also used for identification of the hot spot on the right FDI direction and angle of the coil were made constant before and after the intervention The magnetic stimulation intensity was defined as the intensity at which MEP amplitude was induced to about 1 mV at rest MEP was measured 15 times before intervention (Pre) as well as immediately and 5 and 10 min after intervention (Post-0 The magnetic stimulation interval was set to 5–6 s A custom-made PM control device (Takei Kiki kogyo Japan) that can control motion speed and angle was used in all three experiments Three PM conditions were used (Figure 1) The movements examined were repetitive abduction–adduction movements of the right index finger from 0° to 20° abductions of the metacarpophalangeal (MP) joint for 10 min Zero position was defined as the intermediate position of the MP joint angular velocity was 40°/s and the movement was continuously repeated (continuous PM−600; cPM_600) consisted of PM for 4 s and rest for 6 s with an angular velocity of 40°/s intermittent fast PM−600 (ifPM_600) consisted of 4 s of movement followed by 6 s of rest was to produce the same number of movements as in Condition 1 the angular velocity was set to 100°/s and presence or absence of duty cycle and attention of each experimental condition are indicated The PM condition were used and based on Condition 1 and Condition 2 in Experiment 1; however, both movement times were increased to 30 min (Figure 1) whereas Condition 2 was an iPM with duty cycle of 4 s of movement followed by 6 s of rest (iPM_720) Focusing on the presence or absence of the subject’s attention, three conditions were utilized (Figure 1) Condition 2 of Experiment 1 was slightly modified to produce Condition 1 the subject was asked to observe and count the number of movements of the finger performing PM and each of these cycles was randomly performed in 20 sets during the test Instructions to the subject were as follows: “Please look at your right index finger and count how many times it moves There will be a break of 6 s between each set of movements at which point please tell me how many times your finger moved PM was the same as in Condition 1 but subjects were asked to count the number of circles displayed on a monitor placed directly in front of their faces The image sequence displayed on the monitor is shown in Figure 2 a perfect circle was presented for 0.5 s every 1 s and randomly blinked 3–5 times This was followed by a white screen for 6 s and the process was then repeated The subjects were given the following instructions: “Please count the number of blinking circles presented on the monitor please tell me how many times the circle flashed The circle presentation time was set to 0.5 s whereas the circle presentation interval was set to 1 s Three to five circles were randomly presented 20 times each The break time between groups of circle displays was 6 s the number of circles randomly displayed on the monitor was counted All the experiments were performed in the afternoon and each condition was randomly assigned on a different day the subjects sat in a reclining chair to which a headrest was attached with their right forearms on a table while maintaining a comfortable posture at all times LabChart 7 software (AD Instruments) was used for MEP analysis The maximum and minimum values of the 15 MEP waveforms obtained before and after the intervention for each condition were excluded and the MEP amplitudes of the remaining 13 waveforms were averaged The peak-to-peak value was then calculated as the MEP amplitude value Two-way repeated measure analysis of variance (ANOVA) was used to compare MEPs between INTERVENTION and TIME factors (Pre Mauchly’s test of sphericity was used to analyze the sphericity of the data obtained in each experiment When the Mauchly’s test of sphericity could not be assumed the Greenhouse–Geisser correction statistic was used When a main effect or interaction was observed multiple comparisons were performed using the Bonferroni method Changes in MEP over time are shown in Figure 4 Two-way repeated-measures ANOVA showed a significant main effect of the INTERVENTION factor (F(2,28) = 5.019 of the main effect of the TIME factor (F(2.036,28.500) = 5.443 partial η2 = 0.280) and of their interaction (F(6,84) = 3.277 Results of post hoc test showed that there was significant decrease in MEP in Post-0 and Post-5 compared with Pre in Condition 1 (P < 0.01) and 3 (P < 0.05) whereas there was no significant change in MEP in Condition 2 and all participating subjects performed randomly assigned intervention tasks on different days 15 motor evoked potentials (MEPs) were measured before intervention (Pre) and immediately (Post-0) and 5 (Post-5) and 10 min (Post-10) after the intervention MEP amplitude before and after the intervention at Experiment 1 Mean MEP amplitude (mean ± standard error; SE) Pre MEP amplitude decreased significantly between Post-0 and Post-5 compared with Pre (P < 0.01) MEP amplitude decreased significantly between Post-0 and Post-5 compared with Pre (P < 0.05) the iPM_240 condition did not result in any significant change in MEP amplitude before or after the intervention Changes in MEP over time are shown in Figure 5 Two-way repeated-measures ANOVA revealed a significant difference of the main effect of the TIME factor (F(2.004,18.040) = 23.652 but no of the main effect of the INTERVENTION factor (F(1,9) = 1.729 partial η2 = 0.161) or their interaction (F(3,27) = 0.632 Because the main effect of the TIME factor was significant post hoc test was performed using the average results from the two conditions and found a significant decrease in MEP in Post-0 and Post-10 compared with Pre (P < 0.01) MEP amplitude before and after the intervention at Experiment 2 Mean MEP amplitude (mean ± SE) at Pre Two-way repeated measure analysis of variance (ANOVA) showed that the main effect in the TIME factor was significant and a post hoc test was conducted on the average results for the two conditions (lower panel) MEP amplitude decreased significantly between Post-0 Changes in MEP over time are shown in Figure 6 Two-way repeated-measures ANOVA showed a significant difference in the main effect of the INTERVENTION factor (F(2,26) = 5.079 partial η2 = 0.281) and the interaction between INTERVENTION and TIME (F(6,78) = 2.858 partial η2 = 0.180) but no significant difference in main effect of the TIME factor (F(3,39) = 1.678 Results of post hoc test showed that Condition 1 exhibited a significant increase in MEP amplitude at Post-10 compared with Pre (P < 0.01) but no significant MEP amplitude changes were observed in Conditions 2 and 3 MEP amplitude before and after the intervention at Experiment 3 the MEP amplitude increased significantly at Post-10 compared with Pre (P < 0.01) when not paying attention and in the control condition there was no significant change in MEP amplitude before and after the intervention The number counted in all conditions was 240 only one person made a mistake in the count number once no subject made a mistake in the count number repetitive activity of M1 due to repetitive PM may have changed corticospinal excitability in order to induce corticospinal excitability changes after PM a minimum number of repetitive activities of M1 may be necessary we hypothesized that proprioceptive somatosensory input due to a number of movement cycles above a certain threshold affects corticospinal excitability and Experiment 2 was performed to test this It is suggested that the decline in MEP in Experiments 1 and 2 is due to PED the influence of movement number of PM engaging in the neurophysiological mechanism remains unknown and this is the limitation of our study it is necessary to clarify detailed evaluation and mechanism in movement number of PM the attention task in this study might also have contributed to the reduction in GABA system and choline system suppression circuit in M1 it is possible that corticospinal excitability increased in this study as well as in the previous study when attention was paid to passive finger movements since detailed mechanism is unknown in this research This study demonstrated that continuous repetitive PMs and intermittent repetitive PMs consisting of a total number of 600 movements reduced corticospinal excitability but a total of 240 intermittent repetitive PMs did not 1,800 continuous repetitive PMs and 720 intermittent repetitive passive exercises decreased corticospinal excitability corticospinal excitability was affected by afferent input based on the number of movements above a certain threshold corticospinal excitability increased when subjects directed their attention to the moving finger during PM Anonymized data for the manuscript are available on request Please contact the corresponding authors for the same HO and ST conceived the study and designed the experiments RS and MP performed the experiments and performed statistical analysis YI and NO helped in writing the manuscript All authors have read and approved the final manuscript This work was supported by a Grant-in-Aid for Scientific Research (B) 16H03207 from the Japan Society for the Promotion of Science and a Grant-in-Aid for Scientific Research of Graduate Students of Niigata University of Health and Welfare (H28F02) We would like to thank Enago (http://www.enago.jp/) for editorial assistance with the manuscript and all subjects for their collaboration Short interval intracortical inhibition; SAI Repetitive transcranial magnetic stimulation; EMG Gaze direction modulates finger movement activation patterns in human cerebral cortex Sustained attention modulates the immediate effect of de-afferentation on the cortical representation of the digits: source localization of somatosensory evoked potentials in humans Corticospinal excitability is dependent on the parameters of peripheral electric stimulation: a preliminary study Effects of attention on inhibitory and facilitatory phenomena elicited by paired-pulse transcranial magnetic stimulation in healthy subjects Attention influences the excitability of cortical motor areas in healthy humans Theta burst stimulation of the human motor cortex Motor learning elicited by voluntary drive Responses of neurones in motor cortex and in area 3A to controlled stretches of forelimb muscles in cebus monkeys Corticospinal facilitation following prolonged proprioceptive stimulation by means of passive wrist movement Attention modulates specific motor cortical circuits recruited by transcranial magnetic stimulation and duration of muscle contraction have an effect on the degree of post-exercise depression Decrease in short-latency afferent inhibition during corticomotor postexercise depression following repetitive finger movement Corticomotor excitability induced by anodal transcranial direct current stimulation with and without non-exhaustive movement Muscle-afferent projection to the sensorimotor cortex after voluntary movement and motor-point stimulation: an MEG study Neuromagnetic activation following active and passive finger movements Post-exercise cortical depression following repetitive passive finger movement Altered cortical activation with finger movement after peripheral denervation: comparison of active and passive tasks The effect of sensory input and attention on the sensorimotor organization of the hand area of the human motor cortex Rapid cortical motor output map changes assessed by the triple stimulation technique Characterization of postexercise facilitation and depression of motor evoked potentials to transcranial magnetic stimulation Regulation of primary motor cortex excitability by repetitive passive finger movement frequency Modulation of associative human motor cortical plasticity by attention Changes in corticomotor excitability and inhibition after exercise are influenced by hand dominance and motor demand Post-exercise depression in corticomotor excitability after dynamic movement: a general property of fatiguing and non-fatiguing exercise Participation of primary motor cortex area 4a in complex sensory processing: 3.0-T fMRI study Attentional influences on short-interval intracortical inhibition Short latency inhibition of human hand motor cortex by somatosensory input from the hand doi: 10.1111/j.1469-7793.2000.t01-1-00503.x Brain representation of active and passive movements Long-lasting depression of motor-evoked potentials to transcranial magnetic stimulation following exercise Projection from area 3a to the motor cortex by neurons activated from group I muscle afferents Effects of antiepileptic drugs on motor cortex excitability in humans: a transcranial magnetic stimulation study The effect of lorazepam on the motor cortical excitability in man Otsuru N and Onishi H (2019) Repetitive Passive Movement Modulates Corticospinal Excitability: Effect of Movement and Rest Cycles and Subject Attention Received: 11 August 2018; Accepted: 14 February 2019; Published: 01 March 2019 Copyright © 2019 Tsuiki, Sasaki, Pham, Miyaguchi, Kojima, Saito, Inukai, Otsuru and Onishi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) distribution or reproduction in other forums is permitted provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited *Correspondence: Shota Tsuiki, aHBtMTYwMDdAbnVody5hYy5qcA== Metrics details This study aimed to develop a machine-learning algorithm to diagnose aldosterone-producing adenoma (APA) for predicting APA probabilities A retrospective cross-sectional analysis of the Japan Rare/Intractable Adrenal Diseases Study dataset was performed using the nationwide PA registry in Japan comprised of 41 centers Patients treated between January 2006 and December 2019 were included Forty-six features at screening and 13 features at confirmatory test were used for model development to calculate APA probability Seven machine-learning programs were combined to develop the ensemble-learning model (ELM) The strongest predictive factors for APA were serum potassium (s-K) at first visit The average performance of the screening model had an AUC of 0.899; the confirmatory test model had an AUC of 0.913 the AUC was 0.964 in the screening model using an APA probability of 0.17 The clinical findings at screening predicted the diagnosis of APA with high accuracy This novel algorithm can support the PA practice in primary care settings and prevent potentially curable APA patients from falling outside the PA diagnostic flowchart A more efficient diagnosis of APA is needed but few have been tested using artificial intelligence many of these models were developed using findings from CT and confirmatory tests instead of focusing on clinical data obtained by general practitioners The ability to predict PA subtypes using primary care data would help ensure that no APA cases are missed that should be diligently examined according to the PA diagnostic flowchart Such a predictive model may also provide economic benefits to patients with BAH by reducing the cost of CT scans and AVS The purpose of this study was to develop and validate an ensemble learning model to predict APA probability based on clinical characteristics of a nationwide cohort database in Japan Figure 1 shows the top 10 feature-importance ranking and scores in the RF model of the screening and confirmatory test datasets. The five most important variables of the screening datasets were s-K at first visit, the potassium supplementation dose, s-K after medication, aldosterone-to-renin ratio (ARR), and plasma aldosterone concentration (PAC). (A) and (B) are rankings in the screening and confirmatory testing models There are three different APA datasets depending on the definition of APA This figure shows 6 of the top-10 importance score rankings The ranking order is reflected in Set B and Set C with priority given to the order of Set A The combination of the three APA patterns and the three datasets resulted in the development of nine ELM prediction algorithms. Figure 2 shows heatmaps of the performance of the APA prediction models using the screening test dataset, the five most important variables of the screening dataset, and the confirmatory test dataset. Heatmap comparing the area under the receiver operating characteristic curve The counts in each box are the average of 50 runs and are shown in units of 10–3 The average AUC of the screening test data set was 0.899 ± 0.043 In the five most important variable data sets the model with the highest AUC was 0.889 ± 0.048 (sensitivity 0.793 ± 0.074 and the AUC for ELM was 0.887 ± 0.046 (sensitivity 0.791 ± 0.071 The models with the highest AUCs w”re d’veloped in the confirmatory test data set: 0.913 ± 0.039 (sensitivity 0.809 ± 0.062 specificity 0.903 ± 0.042) for ELM in Set A specificity 0.909 ± 0.034) for RF in Set B and 0.899 ± 0.038 (sensitivity 0.760 ± 0.096 specificity 0.904 ± 0.039) for ELM in Set C Figure 3 shows the performance of ELMs based on external validation data using the receiver operating characteristic curves (ROC). The AUCs in APA Set A, Set B, and Set C were 0.954, 0.952, and 0.948 for the Top 5 data set; 0.964, 0.960, and 0.959 for the screening data set; and 0.891, 0.897, and 0.899 for the confirmation test data set. Receiver operating characteristic curves for predictive diagnosis of aldosterone-producing adenoma using external validation data There are three different APA datasets depending on the definition of APA (Set A A top 5 model is a model developed using only the top 5 features of the importance score of the screening model and the gray line shows the confirmatory test model Table 2 shows the sensitivity and specificity for a cut-off value of 0.5 for the APA probability and for the APA probability with the highest Youden index the sensitivity was improved by using the APA probability with the highest Youden index as the cutoff The mean predicted rate of APA for Case 1 ranged from 53.0 to 71.7% The mean predicted rate of APA for Case 2 ranged from 1.8 to 6.8% We developed a new prediction algorithm for PA subtype and evaluated its performance This algorithm differs from conventional PA prediction methods in the following points: (1) The model predicts subtype not localization; (2) is based on a national multicenter registry database not a single center; (3) CT findings are not required; (4) provides good predictive performance even with only clinical parameters at screening; and (5) is predictive even in the presence of missing clinical information The algorithm’s prediction of two PA cases may be closer to the endocrinologist’s intuition general clinicians will be able to perform high-quality examinations to avoid missing cases with a high probability of PA The model using the Set B and C data sets predicts not only the type of disease but also the benefits of postoperative treatment for patients with APA; thereby indicating the benefits of both surgery and histopathology which is hidden in many hypertension cases It may be a burdensome task for inexperienced clinicians to make decisions based on guidelines This algorithm may become a reliable partner for non-specialists in PA Appropriate completion methods for missing values can also maximize large registry data with multiple sites participating but these are only available in specialized facilities or research centers or scintigraphy; can be analyzed on a standard computer or smartphone; and can predict PA subtypes in primary care practices the diagnosis may be confirmed by different loading tests such as the saline infusion test PA cases not diagnosed by CCT and FUT cannot be predicted by this algorithm The fact that the type of confirmatory test does not matter is an advantage of the algorithm using the screening dataset External validation showed that screening models tended to be more accurate than confirmatory test models It is standard practice for artificial intelligence to mathematically predict diagnosis based on whether the predicted probability of APA is higher or lower than 0.5 one might want to set the cutoff lower than 0.5 to avoid missing subjects with APA About 0.2 in the screening model and 0.3–0.4 in the confirmatory test model should be the standard to proceed with the test as per the PA diagnostic flowchart PAC in the models has not been measured using a mass spectrometer this algorithm can indicate the presence of APA but it cannot determine whether the disease is localized in the left or right adrenal gland no large-scale prospective study was conducted to evaluate the generalization performance of the EML we have not validated the APA probability when this EML is used in patients with essential hypertension (EHT) the clinical background of patients with EHT has similar characteristics to BAH compared to APA we expect that EML would correctly answer EHT patients as having a low APA probability Further investigation is needed in the future we developed a novel PA-subtype diagnosis prediction system combining physical observations and PA screening data with machine-learning methods The model answers APA probability with a high degree of accuracy ELMs will support the prediction of APA with a high degree of diagnostic accuracy for non-specialists in primary care settings it reduces the diagnostic burden on primary care physicians thereby preventing curable APA patients from falling outside of the PA diagnostic flowchart Our algorithm is an innovative PA-subtype prediction system that may significantly improve the diagnosis and management of this disease thereby positively impacting patients and primary care practice A detailed description of the physical examinations and statistical analysis is available in the Supplementary Appendix This retrospective cross-sectional analysis was part of the JRAS The nationwide PA registry in Japan comprised 41 centers—22 university hospitals and 19 city hospitals The study was performed in accordance with the guidelines for clinical research published by the Japanese Ministry of Health The study protocol was approved by the Ethics Committee of the National Hospital Organization Kyoto Medical Center (Kyoto Japan) (the lead center) and the institutional ethics committees of the participating centers with consent waivers This study was registered with the University Hospital Medical Information Network (UMIN ID: 18756) All procedures were performed in accordance with the 1964 Helsinki Declaration and its later amendments As an external validation of the developed algorithm we used data from 78 PA patients (15 APA and 63 BAH) who were not included in the JRAS dataset This dataset includes 57 and 21 PA patients admitted for AVS at Takaoka City Hospital (Takaoka 2020 or Kanazawa University Hospital (Kanazawa Additional ethical approvals required for external validation were obtained from both the Ethics Committees of Takaoka Municipal Hospital (receipt number 2–29) and Kanazawa University Hospital (trial number 2012-013) The JRAS database contains the following PA diagnostic criteria: physical observations; medical history; electrolyte and lipid metabolism parameters; ARR at screening; and confirmatory tests results Variables obtained at the time of screening tests included 46 items Variables obtained at the time of confirmatory tests A maximum of 46 features were available for the screening model and a maximum of 59 features were available for the confirmatory test model The handling of datasets and features is described in the Supplementary Appendix Machine-learning workflow for data processing and model development MissForest used training data to impute missing values Feature selection determined the best set of features based on importance ranking analyzed using Random Forest Oversampling was performed with Synthetic Minority Oversampling Technique (SMOTE) to resolve class imbalance problems and test datasets were used to train prediction models The performance of each model was evaluated using the 50-replicate average generalization performance was evaluated using an external database JRAS Japan Rare/Intractable Adrenal Diseases Study The data that support the findings of this study are available from the JPAS/JRAS Study Restrictions apply to the availability of these data which were used under license for this study Data are available from Takashi Yoneda with the permission of the JPAS/JRAS Study High incidence of primary aldosteronism in 199 patients referred with hypertension The unrecognized prevalence of primary aldosteronism: A cross-sectional study Hyperaldosteronism among black and white subjects with resistant hypertension The management of primary aldosteronism: Case detection and treatment: An Endocrine Society clinical practice guideline Study heterogeneity and estimation of prevalence of primary aldosteronism: A systematic review and meta-regression analysis Prevalence of primary aldosteronism without hypertension in the general population: Results in Shika study Long-term cardio- and cerebrovascular events in patients with primary aldosteronism Cardiometabolic outcomes and mortality in medically treated primary aldosteronism: A retrospective cohort study Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: A systematic review and meta-analysis complications and outcomes of primary aldosteronism and future direction of research: A position statement and consensus of the Working Group on Endocrine hypertension of the European Society of Hypertension The Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2019) Impact of adrenocorticotropic hormone stimulation during adrenal venous sampling on outcomes of primary aldosteronism Adrenal venous sampling: evaluation of the German Conn’s registry A blood RNA signature for tuberculosis disease risk: A prospective cohort study Automatic classification of MR scans in Alzheimer’s disease Classification and regression by randomForest A multilayer perceptron-based medical decision support system for heart disease diagnosis Sagi, O. & Rokach, L. Ensemble learning: A survey. WIREs Data Min. Knowl. Discov. 8, e1249. https://doi.org/10.1002/widm.1249 (2018) Sidey-Gibbons, J. A. M. & Sidey-Gibbons, C. J. Machine learning in medicine: A practical introduction. BMC Med. Res. Methodol. 19, 64. https://doi.org/10.1186/s12874-019-0681-4 (2019) A clinical prediction score to diagnose unilateral primary aldosteronism A subtype prediction score for primary aldosteronism A clinical prediction score using age at diagnosis and saline infusion test parameters can predict aldosterone-producing adenoma from idiopathic adrenal hyperplasia Burrello, J. et al. Development and validation of prediction models for subtype diagnosis of patients with primary aldosteronism. J. Clin. Endocrinol. Metab. 105, dgaa379. https://doi.org/10.1210/clinem/dgaa379 (2020) Diagnosis and treatment of primary aldosteronism: Practical clinical perspectives Guidelines for primary aldosteronism: Uptake by primary care physicians in Europe Diagnostic rate of primary aldosteronism in Emilia-Romagna Akbar, K. W. et al. Comparison of imputation methods for missing laboratory data in medicine. BMJ Open 3, e002847. https://doi.org/10.1136/bmjopen-2013-002847 (2013) Wei, R. et al. Missing value imputation approach for mass spectrometry-based metabolomics data. Sci. Rep. 8, 663. https://doi.org/10.1038/s41598-017-19120-0 (2018) Kaneko, H. et al. Machine learning based models for prediction of subtype diagnosis of primary aldosteronism using blood test. Sci. Rep. 11, 9140. https://doi.org/10.1038/s41598-021-88712-8 (2021) Eisenhofer, G. et al. Use of steroid profiling combined with machine learning for identification and subtype classification in primary aldosteronism. J. Am. Med. Assoc. Netw. Open. 3, e2016209. https://doi.org/10.1001/jamanetworkopen.2020.16209 (2020) Iodomethylnorcholesterol uptake in an aldosteronoma shown by dexamethasone-suppression scintigraphy: Relationship to adenoma size and functional activity 131I–6beta-iodomethyl-19-norcholesterol SPECT/CT for primary aldosteronism patients with inconclusive adrenal venous sampling and CT results Evaluation of the sensitivity and specificity of (11)C-metomidate positron emission tomography (PET)-CT for lateralizing aldosterone secretion by Conn’s adenomas A novel CYP11B2-specific imaging agent for detection of unilateral subtypes of primary aldosteronism Prevalence of cardiovascular disease and its risk factors in primary aldosteronism: A multicenter study in Japan The Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2014) The Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2009) Role for adrenal venous sampling in primary aldosteronism An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism Primary Aldosteronism Surgery Outcome (PASO) investigators Outcomes after adrenalectomy for unilateral primary aldosteronism: an international consensus on outcome measures and analysis of remission rates in an international cohort The diagnosis of Cushing’s syndrome: An Endocrine Society Clinical Practice Guideline Abraham, A. et al. Machine learning for neuroimaging with scikit-learn. Front. Neuroinform. 8, 14. https://doi.org/10.3389/fninf.2014.00014 (2014) Download references We would like to thank Editage (www.editage.jp) for English language editing We also thank Koichiro Daidai for his assistance with the analysis This study was funded by the National Center for Global Health and Medicine 30-1008) and Japan Agency for Medical Research and Development (Grant no These authors contributed equally: Shigehiro Karashima and Masaki Kawakami A list of authors and their affiliations appears at the end of the paper Shigehiro Karashima & Shigehiro Karashima School of Electrical Information Communication Engineering Department of Endocrinology and Metabolism Kanazawa University Graduate School of Medicine Marianna University Yokohama City Seibu Hospital National Hospital Organization Kyoto Medical Center Department of Molecular and Internal Medicine Graduate School of Biomedical and Health Sciences Department of Medicine and Bioregulatory Science Mie University Graduate School of Medicine Department of Medical Science and Cardiorenal Medicine Yokohama City University Graduate School of Medicine Department of Molecular Endocrinology and Metabolism Takanobu Yoshimoto & Takanobu Yoshimoto Department of Medicine and Molecular Science Gunma University Graduate School of Medicine National Center for Global Health and Medicine Department of Health Promotion and Medicine of the Future Division of Endocrinology and Hypertension Department of Geriatric and General Medicine Osaka University Graduate School of Medicine Department of Endocrinology and Diabetes Mellitus International University of Health and Welfare Kyushu Medical Center Kyushu Medical Center wrote the study protocol and supervised the conduct of the study created the machine learning-based classification algorithm and performed the statistical analyses contributed to data analysis and data interpretation co-wrote and all other authors edited the manuscript contributed equally as co-first authors of this work All authors read and approved the final manuscript version The authors declare no competing interests Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations Download citation DOI: https://doi.org/10.1038/s41598-023-29653-2 Anyone you share the following link with will be able to read this content: a shareable link is not currently available for this article Sign up for the Nature Briefing newsletter — what matters in science Metrics details Determination of plasma aldosterone concentrations (PAC) and plasma active renin concentrations (ARC) is essential for the diagnosis of primary aldosteronism (PA) although PAC and ARC are measured by radioimmunoassay and immunoradiometric assay non-radioisotopic methods with better detection sensitivity We developed two-site sandwich chemiluminescent enzyme immunoassays (CLEIAs) to measure both PAC and ARC using monoclonal antibodies immobilized onto ferrite particles The results of both assays are obtained simultaneously from a single plasma sample within 30 min using a fully automated system The novel CLEIAs were validated using plasma samples from patients with PA (n = 52) and essential hypertension (n = 23) The PAC determined by the CLEIA was significantly correlated with that measured by liquid chromatography/mass spectrometry or conventional radioimmunoassay The ARC determined by the CLEIA was significantly correlated with that measured by immunoradiometric assay The limits of detection of the CLEIAs for PAC and ARC were 0.1 ng/dl and 0.04 pg/ml which were better than those of conventional methods (PAC: 2.5 ng/dl; ARC: 5 pg/ml) The PAC and PAC/ARC ratio (ARR) were significantly higher in patients with PA than in those with essential hypertension An ARR cut-off of 1.31 ng/dl per pg/ml showed a sensitivity of 96.2% and specificity of 78.3% for PA screening The newly developed CLEIAs for measuring PAC and ARC could provide a clinically powerful alternative to conventional methods used for hypertension screening in clinical practice We developed new CLEIAs for detecting PAC and plasma ARC characterized by high sensitivity sufficient traceability back to the certified reference materials and versatile and efficient implementation by an automated system Patients referred to Kyoto Medical Center for further investigation of hypertension were evaluated Diagnostic criteria for diagnosing PA is shown in Supplementary PA was diagnosed if the screening test was positive and at least one confirmatory test showed positive results EH was diagnosed if any secondary cause of hypertension was excluded Other miscellaneous diseases include renovascular hypertension ACTH-independent macronodular adrenal hyperplasia and adrenocortical carcinoma were used for method comparison using peripheral blood we also evaluated the level of PAC and ARC by RIA and CLEIA using 50 samples from 5 patients for adrenal vein blood As part of routine clinical investigations blood samples were collected into EDTA-2Na tubes from the antecubital veins of patients in the sitting position for at least 30 min in the clinic Plasma samples were stored at less than −20 °C and subjected to our CLEIA immediately after thawing to room temperature in a 20 °C water bath plasma samples collected from the adrenal veins of patients with PA (n = 50) and urine samples collected from patients with hypertension (n = 18) were analyzed The study was conducted according to the tenets of the Declaration of Helsinki All patients provided written informed consent The study was approved by the ethical committee of Kyoto Medical Center (#17-105) Our CLEIAs for measuring PAC and ARC were developed using two monoclonal antibodies against different epitopes of aldosterone (Fujirebio and recovery were determined for each CLEIA according to the recommendations of the Clinical and Laboratory Standards Institute (EP17-A2 using the dedicated fully automated systems (LUMIPULSE® Presto II and LUMIPULSE® L2400) with CLEIAs enables simultaneous determination of PAC and ARC Interference with assays measuring ascorbic acid as well as cross-reactivity with corticosterone and 18-hydroxycorticosterone were analyzed we developed two-site sandwich immunoassay using two specific mouse monoclonal antibodies against different epitopes of renin An anti-active renin mouse monoclonal antibody that binds to the active site of active renin specifically was used as the detection antibody An anti-renin monoclonal antibody that recognizes the non-active site of renin was used as the capture antibody The plasma sample (40 µl) was incubated with 250 µl reagent A containing the detection antibody immobilized to ferrite particles and incubated for 10 min at 37 °C the sample was incubated with 250 µl reagent B containing the ALP-conjugated capture antibody and incubated for 10 min at 37 °C the complex consisting of the detection antibody and 200 µl solution containing AMPPD was added to measure chemiluminescence The CLEIA for ARC was calibrated using in-house human recombinant renin (human activated renin [GenBank accession number NM_000537] amino acids 67–406 with C-terminal HIS tag) as the reference material Correlation and linear regression analyses were conducted to compare PAC measurements by our novel CLEIA with those by LC-MS/MS and a conventional RIA (SPAC-S Aldosterone kits and to compare plasma ARC measurements by our novel CLEIA with those by a conventional immunoradiometric assay (IRMA) (Renin IRMA FR Fujirebio Inc.) and PRA by a conventional RIA (Renin activity FR and the PAC/ARC ratio (ARR) determined by the CLEIAs were compared between patients with PA and patients with EH and ARR were compared between the patient groups using the Mann–Whitney U test regression analysis was performed using the Passing–Bablok method and Pearson’s correlation coefficients Bland–Altman analysis was used to evaluate mean differences The statistical significance was set at P ≤ 0.05 Statistical analyses were performed using Analyse-it software (Analyse-it Ltd.) and SAS for Windows (version 9.4; SAS institute Three different concentrations of certified reference materials for ensuring the traceability of aldosterone (NMIJ CRM 6402-a) were assayed in duplicate using our CLEIA for PAC. The certainty of the CLEIA for measuring the certified reference materials ranged from 99 to 104% (Table 1) Correlations between CLEIA and liquid chromatography/ mass spectrometry (LC-MS/MS) (a) Bland–Altman analysis was performed to analyze the correlations of the CLEIA results with those of LC-MS/MS (b) Correlations of the plasma aldosterone concentration (PAC) in peripheral blood measured by chemiluminescent enzyme immunoassay (CLEIA) with that measured by radioimmunoassay (RIA) (c) The PAC in samples A and B showed significant discrepancy between the CLEIA and RIA measurements and was measured by LC-MS/MS as well Bland–Altman analysis was performed to analyze the correlations of the CLEIA results with those of RIA (d) The correlation between the three methods was investigated by Passing–Bablok regression analysis Correlations of the PAC in adrenal vein blood (a) or the urine aldosterone concentration (b) between CLEIA and RIA The correlation between the two methods was investigated by Passing–Bablok regression analysis Correlation of the ARC in the peripheral blood between chemiluminescent enzyme immunoassay (CLEIA) and immunoradiometric assay (IRMA) (a) Bland–Altman analysis was performed to analyze the correlation between the ARC measured by the CLEIA and that measured by IRMA (b) Correlations of the plasma ARC and PRA in the peripheral blood between the CLEIA and radioimmunoassay (RIA) (c) The correlation between the two methods was investigated by Passing–Bablok regression The plasma aldosterone concentration (PAC) (a) plasma active renin concentration (ARC) (b) and PAC/ARC ratio (ARR) (c) in patients with primary aldosteronism (PA) and those with essential hypertension (EH) An ARR cutoff of 1.31 ng/dl per pg/ml had the best sensitivity (96.2%) for diagnosing PA with a specificity of 78.3% (area under the curve [AUC]: 0.967; 95% CI: 0.932–1.000) (a) An ARR cutoff of 1.51 ng/dl per pg/ml had a sensitivity of 94.2% and specificity of 87.0% (b) An ARR cutoff of 1.62 ng/dl per pg/ml had a sensitivity of 92.3% and specificity of 91.3% (c) An ARR cutoff of 1.65 ng/dl per pg/ml had a sensitivity of 90.4% and specificity of 95.7% (d) the conversion formulas between conventional and the new assays were as follows: PAC (CLEIA) = 0.62 × PAC (RIA) − 1.98 and PAC (CLEIA)/PRA (RIA) = − 1.05 + 0.49 × PAC (RIA)/PRA (RIA) the ARR cut-off value of 20 determined by RIA for PAC and PRA can be converted to 8.75 by PAC (CLEIA)/PRA (RIA) The PAC cut-off value of 6 determined by RIA which is used to diagnose PA by the saline infusion test an early and accurate diagnosis of PA is of great importance there are methodological issues with RIAs for measuring PAC which are critical for the screening and diagnosis of PA we developed novel CLEIAs for measuring PAC These CLEIAs demonstrated good traceability to the certified reference material of aldosterone good linearity over a wide range of concentrations and good correlation with the LC-MS/MS results both in plasma and urine samples measurement of relatively low PACs is important in decision making of the confirmatory tests our CLEIA showed a good correlation with LC-MS/MS and good sensitivity and accuracy at concentrations <10 ng/dl it could be a useful tool for the diagnosis of PA Further study is needed to determine the optimal cut-off of ARR for screening PA with consideration of the different PA subtypes The present CLEIA is applicable as a standard assay method for measuring the PAC in daily clinical practice and an automated system with these CLEIAs enables us to obtain PAC and plasma ARC results within 30 min This significant decrease in measurement time will help improve the efficiency of the PA diagnostic process in the clinic and the success rate of adrenal venous sampling The novel CLEIAs for PAC and ARC could affect the clinical practice of hypertension and PA blood sampling in the patients was not optimized in terms of food intake which may affect PAC and/or ARC measurements the major aim of the present study was to validate the new CLEIAs and compare their efficacies with those of conventional assays The sampling conditions likely did not affect the correlations between the assays an ARR cut-off in the current study is calculated by small sample size Further systematic studies using larger numbers of samples obtained under standardized conditions are needed to establish the appropriate cut-offs of PAC and ARR for screening PA Radioimmunoassay (RIA) has been used to determine the PAC such as the usage and disposal of radioisotopic materials poor traceability of certified reference materials and low detection sensitivity at lower concentrations The novel CLEIAs using a fully automated system developed to measure PAC and ARC were characterized by a better detection sensitivity and lower cost compared with the conventional RIA These new methods are expected to facilitate the diagnostic process and improve the quality of hypertension and PA clinical practice Primary aldosteronism: does underlying pathology impact clinical presentation and outcomes following unilateral adrenalectomy Yang Y, Reincke M, Williams TA. Prevalence, Diagnosis and Outcomes of Treatment for Primary Aldosteronism Best Pract Res Clin Endocrinol Metab. 2019:101365. https://doi.org/10.1016/j.beem.2019.101365 The expanding spectrum of primary aldosteronism: implications for diagnosis Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: a systematic review and meta-analysis Prevalence of cardiovascular disease and its risk factors in primary aldosteronism: a multicenter study in Japan Excess arterial damage in hyperaldosteronism Guidelines for the diagnosis and treatment of primary aldosteronism – The Japan Endocrine Society 2009 The management of primary aldosteronism: case detection The latest consensus statement on the clinical practice of primary aldosteronism in Japan Off J Jpn Assoc Endocr Surg Jpn Soc Thyroid Surg Aldosterone LC-MS/MS assay-specific threshold values in screening and confirmatory testing for primary aldosteronism Japan Health Policy Now, http://japanhpn.org/en/home-1/ Calibration and evaluation of routine methods by serum certified reference material for aldosterone measurement in blood Rapid screening of primary aldosteronism by a novel chemiluminescent immunoassay Rapid and sensitive chemiluminescent enzyme immunoassay for measuring reference tumor markers National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan, https://www.nmij.jp/service/C/ Increased diagnosis of primary aldosteronism Prevalence and clinical manifestations of primary aldosteronism encountered in primary care practice Cardiovascular outcomes in patients with primary aldosteronism after treatment Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism Cardiovascular complications associated with primary aldosteronism: a controlled cross-sectional study Rapid screening test for primary hyperaldosteronism: ratio of plasma aldosterone to renin concentration determined by fully automated chemiluminescence immunoassays Diagnostic accuracy of aldosterone and renin measurement by chemiluminescent immunoassay and radioimmunoassay in primary aldosteronism Prospective validation of an automated chemiluminescence-based assay of renin and aldosterone for the work-up of arterial hypertension Clinical validation for the aldosterone-to-renin ratio and aldosterone suppression testing using simultaneous fully automated chemiluminescence immunoassays Download references We thank Maki Kashiwabara and Keiko Umegaki for their technical and secretarial assistance All of the authors have accepted responsibility for the entire content of this submitted paper and approve its submission This study was supported in part by grants-in-aid for the Japan Primary Aldosteronism Study and Japan Rare Adrenal Diseases Study of the Practical Research Project for Rare/Intractable Diseases from the Japan Agency for Medical Research and Development (AMED) (JP17ek0109122 This study was conducted in part by the research expenses provided by the research contract between NHO Kyoto Medical Center and Fujirebio Inc MN received lecture fees from Daiichi Sankyo Co. The authors declare that no conflicts of interest related to employment Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations Download citation DOI: https://doi.org/10.1038/s41371-020-00465-5 “Please don’t describe our work in too much detail,” comes the greeting from Yamada Ritsu as we began our visit to the head office of the long-established copperware firm Clockwise from top: The Gyokusendō head office building is a national registered tangible cultural property; store shelves lined with outstanding examples of the company’s products; Gyokusendō’s general manager “All Gyokusendō’s products are made by hand and with just twenty-one artisans on our staff we cannot produce them on a mass scale,” says Yamada “Thanks to the high reputation we enjoy among our customers we rarely advertise and do not intend to expand our sales channels The reason we allow visits from the media is that we want to encourage many people come to our workshop and see just how much painstaking effort goes into making each of our products.” Gyokusendō’s beautiful and tasteful Tsuiki copperware Gyokusendō allows people to tour its workshop at any time during working hours The aim is to help people appreciate the value of Tsuiki copperware The first stop on the tour is a look at the fabrication process with artisans creating samples for the visitors the edges of a single copper sheet are first raised with a wooden mallet The worker then strikes the piece with a hammer reducing its diameter and forming the final shape This work takes an enormous amount of time and labor to build up a three-dimensional vessel The fabrication process proceeds counterclockwise starting with the copper plate on the left several pieces are put through each labor-intensive process at the same time but if a single piece were done from start to finish it would take more than two weeks to complete “Our tea kettles cost more than 50,000 yen even for the less expensive ones whose pouring spouts are crafted separately and attached after the main vessels are shaped,” says Yamada or ‘pounded-out spouts,’ with every part of the kettle made from a single sheet of copper The difference is clear in the actual products if you see the painstaking tasks we do in the workshop you’ll understand that this price is reasonable “If people who already own Tsuiki copperware sees this they’ll treasure these pieces even more and treat them with great care But if your readers feel like they’ve come to the workshop just by viewing your article they won’t make the trip and get the real experience That’s why I asked you not to write in too much detail!” laughs Yamada “I urge everyone to come visit the actual workshop at least once.” These two kuchi uchidashi teakettles are the same product but the one on the right is new and the one on the left has been used for 50 years “These kettles develop a deeper aesthetic quality with use over many years People often ask us to sell them the one on the left The sharp clanging sound of metal hammers rings throughout the workshop many of the older workers say it has become difficult for them to hear high-pitched sounds The high workshop ceiling weakens the echoes of the hammer noise while large windows help to brighten the space The implements that line the workshop’s walls and pillars are called toriguchi These tools are Gyokusendō originals: artisans hand the copperware on them for working The toriguchi are inserted into one of several holes made in a platform that looks like a tree stump Artisans sit at these agariban to work on the copperware with the toriguchi serving as an anvil for the hammer Different ones are used depending on the process and the shape of the vessel with 20–30 different types of toriguchi used to make a single product The workshop is equipped with about 200 types of hammer and about 300 types of toriguchi Clockwise from upper left: Toriguchi fixed in place in a block; using the block as a platform the worker strikes the copper with metal hammers to form many different curved surfaces; large and small toriguchi of various shapes it maintains its softness even after cooling it rapidly becomes harder as its size is reduced by hammering annealed in a furnace to restore their malleability and hammered again to form beautiful copperware Chief master craftsman Tamagawa Tatsushi anneals a piece Gyokusendō products have abundant variations The copperware has different surface types: Some feature a large hammered pattern called ōtsuchime others have a textured pattern made with fine hammers The beautiful colors range from tones close to the original color of the copper to unique hues created by soaking the pieces in solutions potassium sulfide Clockwise from upper left: An ōtsuchime (large hammered pattern) sake cup; a teapot adorned with a flower pattern; an oxidized silver coffee pot; a teapot engraved with a streamline pattern The techniques for Tsuiki copperware were introduced to what is now Niigata Prefecture by a craftsman traveling from Sendai in the late eighteenth century Located near Tsubame were the Maze copper mine (located in today’s Nishiura in the city of Niigata) and Shitadago (Sanjō) The industry developed with the triad of technique Preserving the tradition is “exceedingly difficult,” says Chief Master Craftsman Tamagawa Tatsushi “When people hear ‘traditional crafts,’ they tend to think that we’re simply continuing to make things as they were made in the past Now we use copper sheets imported from South America Even if we wanted to make things in exactly the same way the materials we used for many years may no longer be available and the tools we are familiar with may no longer be produced We search the world for substitute materials and new tools We’ve got to adjust our production techniques to them if we want to preserve the traditional craft.” Artisans work with a type of string they have used for generations When the specific string preferred by Gyokusendō recently became unavailable the firm was forced to switch to material from a different production area General Manager Yamada says that the image of traditional crafts as a rarified artistic pursuit is also mistaken “Craft products are in the end nothing more than tools They only have significance to people’s lives when they are actually being used at their tables.” He also echoes the words of company president Tamagawa Motoyuki who describes traditional crafts as “a continual process of innovation.’” The firm began exhibiting its wares at World Expositions starting with Vienna in 1873 and the second- and third-generation owners began using engraving and other decoration adding artistic elements to their creations The biggest innovation in recent years was the incorporation of the wood-grained metal technique by Tamagawa Norio More than 20 sheets of metal of different colors The surface is then shaved with a chisel while being hammered Norio was certified as a Living National Treasure in 2010 the first Tsuiki copperware craftsman to be so honored Clockwise from upper left: A wood-grained metal flower vase; a water kettle using the wood-grained technique; the metal layers flow intricately as they are formed by hammering silver and other metals This designation as a Living National Treasure led to a rapid increase in the number of visitors to the workshop When they first began counting five years ago with about 400 of these coming from other countries our Tsubame Sanjō brand become widely known both in Japan and abroad It was a happy turn of events,” says Yamada Seven years ago the company hired the first female artisan to work there in its 200-year history; today that number has increased to six a large upscale shopping complex in Tokyo that has attracted attention for its well-appointed facilities targeting tourists visiting Japan Clockwise from upper left: One of the company’s female artisans crafts a piece; a Gyokusendō vase; some of the vases intended for single flowers designed by female artisans we hope to show Tsuiki copperware and the Tsubame Sanjō brand to the world,” says Yamada is that the Ginza shop is ultimately just a way to increase public awareness of Tsuiki copperware Our main purpose is to attract people who become interested to our main store and workshop in Tsubame We’d like visitors to hear the sound of the hammers We hope they will then understand the feeling we put into these products as they purchase our Tsuiki copperware and use it with loving care.” Gyokusendō Ginza is a gorgeous space decorated with hammered copper plates An Air Self-Defense Force fighter jet lost its cockpit canopy weighing about 90 kilograms while flying over mountainous areas in southwestern Japan on Sunday but there were no reports of any injuries or property damage from the incident The F-2 fighter jet's canopy fell off the aircraft during a scramble mission in response to a possible violation of Japan's airspace by a foreign plane leaving the pilot exposed to the air in mid-flight The Self-Defense Forces have been searching for the canopy which was believed to have fallen in Asakura The fighter made an emergency landing at Tsuiki Air Base in the prefecture after the incident took place at around 12:50 p.m Another plane was deployed to replace the F-2 fighter jet for the scramble mission The fighter also lost a ladder weighing about 480 grams The ASDF decided to conduct inspections of all aircraft and to see if any other parts have fallen from the F-2 fighter "We are sorry for causing concern to local residents and the general public," the ministry said Chief Cabinet Secretary Hirokazu Matsuno said Monday the incident was serious as it could have posed great danger to local people said that such a loss of a canopy is rare but that loosening or defective parts could cause such an incident But the loss of the canopy would not affect an aircraft's flight functions U.S. F-16 drops dummy bomb off firing range in northeastern Japan Japan ASDF concludes F-35A crash caused by human error Japan resumes F-35A flights 4 months after fatal crash Please enable JS and disable any ad blocker the Trump administration’s proposal to sell F-16 fighter jets to Taiwan seems to make sense But a closer look reveals that it will prolong the trade war And that is a deal the United States can do without Let’s start with the trade war. Trump started slapping tariffs on Chinese imports to the United States in March 2018, based on his assumption that trade wars were “easy to win.” Unfortunately to be a much tougher customer than he expected Rather than sitting down at the negotiating table A smarter move would have been to use the arms sales as leverage to broker a deal Both the Bush and Obama administrations denied Taiwan’s request for new F-16’s out of concern for Chinese reactions The Trump administration could have used China’s unhappiness about a potential F-16 deal to encourage Chinese concessions on another issue it lets China know America would intervene on our behalf in a conflict.” The reality is that a few more F-16s won’t change the balance of power between Taiwan and China So instead of providing for Taiwan’s defense from China what the F-16 deal will do is give Taiwan the confidence to act in ways that aggravate China and encourage China to act more aggressively in turn by raising tensions between the two nations the F-16 deal also increases the possibility of a conflict breaking out one that could drag the United States into a costly and dangerous war on the other side of the world with a nuclear-armed superpower Help us tailor content specifically for you: Thank you for subscribing! 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FUKUOKA — Kokura-ori is a cotton fabric that was once used to make samurai hakama pants and other products but fell out of fashion in the early Showa era (1926-1989) Kitakyushu-based fabric-dyeing artist Noriko Tsuiki revived the textile 40 years ago and has been pursuing the beauty of its vertical-striped patterns created using many different colored threads Her designs are well-suited for a wide range of products beyond textiles helping Kokura-ori grow into a material culture that represents Kitakyushu please disable the ad blocking feature and reload the page This website uses cookies to collect information about your visit for purposes such as showing you personalized ads and content By clicking “Accept all,” you will allow the use of these cookies Users accessing this site from EEA countries and UK are unable to view this site without your consent At an atelier in a mountainous part of Yahata-Higashi Ward Kokura-ori textiles are produced by repeatedly weaving warps through wefts the operation of inserting wefts into a weaving machine must be repeated more than 30,000 times inserting the wefts requires some strength,” Tsuiki said The level of concentration required for effectively weaving evenly can last for up to an hour she takes a short break to make mental and physical preparations and then continues to weave The production of Kokura-ori textiles started in the Buzen Kokura domain in the Edo period (1603-1867) The textile was so strong that it was said to be impervious to spears Kokura-ori fabric was widely available and was used for samurai hakama pants and obi sashes is said to have worn a Kokura-ori haori coat when he engaged in falconry the textile was used to make school uniforms fake or low-quality products were produced in many parts of the country and a wave of mechanization hit Japan the production of Kokura-ori stopped in the early Showa era Tsuiki encountered the long-gone and mostly forgotten textile at the age of 30 when she was pursuing a career in dyeing and weaving She found a 10-centimeter strip of fabric at an antique shop she frequented in Kitakyushu with its stylish vertical-striped patterns The unique patterns are created by using more warps than wefts She read the few documents related to the textile she could find at libraries and museums She also analyzed how it was woven and the thickness of threads in cooperation with a research institute she was not able to recreate the right texture she finally recreated Kokura-ori textiles in 1984 by spreading 2,160 warps and established a technique for weaving at a density where the loom barely moved She learned dyeing and weaving techniques in Kume Island in Okinawa Prefecture among other places She supervises the design process of “Kokura Shima Shima,” a shop that produces machine-woven products she was awarded the Cultural Affairs Agency commissioner award at the Japan traditional craftwork dyeing and weaving exhibition “I want many people to use the fabric as a general-purpose product,” she said she has made efforts to develop machine-woven fabrics She has tried to introduce Kokura-ori fabrics in clothing fashion accessories and interior decorations while also producing art pieces “I want to create vertical-striped patterns that no one has never seen before,” she said She has continued her dogged pursuit even after turning 70 Our weekly ePaper presents the most noteworthy recent topics in an exciting © 2025 The Japan News - by The Yomiuri Shimbun Your browser does not support JavaScript, or it is disabled．Please check the site policy for more information OITA--Set against a backdrop of military fighter jets and passenger airliners sharing the runways the Self-Defense Forces used a commercial airport for the first time in a training exercise simulating an attack on Japan Four F-2 fighter jets based at Tsuiki Air Base in Fukuoka Prefecture landed at Oita Airport about 70 kilometers away on Nov 13 under a simulation that the Tsuiki base had come under enemy attack rendering it impossible for them to return there The exercise was a manifestation of the call included in national security documents compiled late in 2022 for greater use of public infrastructure by the SDF SDF members refueled the F-2 jets and inspected the planes before they flew back to the Tsuiki base about two hours later commercial jets landed and took off from the airport that had never been used in the past for such SDF training Civilian airports are considered an important backup base because should fighting break out SDF bases would more than likely be among the first enemy targets along with fighter jet buffs who turned up at Oita Airport to photograph the planes local citizens and prefectural assembly members gathered at a nearby park to protest the use of the commercial airport The massive joint training exercise began on Nov It will involve a total of about 30,000 SDF members from all three branches as well as about 10,000 U.S Three other commercial airports--Amami and Tokunoshima in Kagoshima Prefecture as well as Okayama Momotaro Airport--will be used for similar training exercises The Air Self-Defense Force does not have a facility at any of those three airports as well the training exercise is intended to deal with a potential Chinese attack on Taiwan Both Japan and the United States envisage Okinawa Prefecture playing a key role for rear-line support to respond to an attack on Taiwan military bases in the region are insufficient to receive such a large influx of personnel the more available bases there were the better (This article was written by Takayuki Kozaki Information on the latest cherry blossom conditions Please right click to use your browser’s translation function.) A series based on diplomatic documents declassified by Japan’s Foreign Ministry Here is a collection of first-hand accounts by “hibakusha” atomic bomb survivors chefs and others involved in the field of food introduce their special recipes intertwined with their paths in life A series about Japanese-Americans and their memories of World War II In-house News and Messages No reproduction or republication without written permission Japanese version Japanese version K-pop Mystic Story’s first girl group Billlie debuts with star-studded ‘Ring X Ring’ a subsidiary label of K-pop powerhouse S.M The six-piece act -- comprising four South Korean members Tsuki and Haruna -- have landed in the K-pop scene with their first EP “The Billage of Perception : Chapter One.” the group conducted a debut showcase in Seoul which was live-streamed as a pandemic precaution Their name combines the English name Billie with an extra “l.” They said the regular name Billie reflected their “B-sides” -- the inner-self that everyone has inside them They hope to empathize with people by expressing their “B-sides,” while adding a twist -- like the extra letter -- to create some thing special “We want to make music that could warmly touch people‘s hearts,” Moon Sua said Moon is the younger sister of Astro member Moonbin Leading their EP is “Ring X Ring,” which tells a mysterious story surrounding a fictional village the song marks the start to an upcoming story universe expressing a dilemma on whether to accept the given situation or to take a daring step to make a change The group garnered much attention ahead of their debut as the first girl group assembled at the hands of South Korea’s star singer-songwriter and producer Yoon Jong-shin The members originally belonged to the pre-debut group called Mystic Rookies which consists of versatile artists nurtured through the label’s “Mystic Incubation Camp” training system Yoon had advised them to “never forget the mind and the passion we hold right now as we start and to keep on trying hard and to enjoy every stage.” Billlie’s debut also comes with high anticipations as their title song “Ring X Ring” is backed by some of the biggest names in the entertainment industry composer Lee Min-su and music video director Hwang Su-ah While the three artists all have their own extensive careers they have together created numerous K-pop hits including IU’s “Good Day” and “The Red Shoes” and Brown Eyed Girls’ “Abracadabra” and “Candy Man.” Proudly presenting themselves as a group strong in dance and performance Billlie also caught the public eye with their collaboration with star choreographer Lia Kim who has created dances for some of the most popular K-pop musicians contributed to the choreography of “Ring X Ring.” Their six-track album also includes “Flipp!ng a Coin,” “Flowerld,” “The Eleventh Day,” “Everybody’s Got a $ECRET” and “The Rumor,” which will illustrate the versatile talents of each of the members The girls voiced some daring ambitions they had with their debut Haruna hoped to win the rookie of the year at music awards with their debut EP while Tsuki wanted nicknames such “an all-rounder group” and “chart-topper” to follow their name the K-pop scene is seeing a flush of new girl groups recently Asked how they differentiate themselves from other rookie groups The synergy of six distinctive members will be special.” We’ve released several performance videos ahead of our debut so please look forward to what we have to show with our title song.” The plan to unify the candidacies of conservative People Power Party presidential candidate Kim Moon-soo and former Prime Minister Han Duck-soo faces a rocky road What’s next after deadline: Mass medical student retentions to come Azerbaijan urges Korean firms to invest in Alat FEZ UAE seeks Korean partnerships in water management Koryo saram are 'living bridges' of Kazakh-Korean ties Hybe’s profit-driven push draws backlash from fans HITGS debuts amid scrutiny over members being all under 18 Maroon 5 collaborates with Blackpink’s Lisa for new single ‘Priceless’ Blackpink’s Rose to sing for Brad Pitt movie Respect wanes: Teaching no longer highly coveted job in S Lee Jae-myung leads in hypothetical three-way race with Han Duck-soo Costco’s steep membership hike tests loyalty of Korean shoppers South Koreans get creative with Parents’ Day gifts Japanese version How To Wear It The Cartier Tank Cintrée In-Depth Examining Value And Price Over Time With The ‘No Date’ Rolex Submariner Watches In The Wild The Road Through America, Episode 1: A Model Of Mass Production The G-Shock is a lot of things – the world's toughest watch; arguably its most practical; in some versions "I love Patek Philippe perpetual calendars only marginally more than I dig the Casio Frogman G-Shock – but for different reasons – and if you’re wearing either chances are I’ll sidle over to you and start a conversation about it." The G-Shock is a lot of things – the world's toughest watch; arguably its most practical; in some versions, arguably its ugliest. It is also, however – as John Mayer's remark above, from 2012 so pithily underscores – a watch that has achieved what as far as I can tell is a unique degree of crossover status It's the one quartz multifunction watch likeliest to be appreciated for its qualities by otherwise diehard mechanical watch fans and it's full of technical qualities that you have to admire from an engineering standpoint even if you wouldn't be caught dead with one on your wrist It would be difficult to say for sure without the sort of meticulous statistical analysis that only organizations like the NSA but it's probably the single most-often-chosen watch for people who need a watch and need it to be able to tolerate considerable abuse who understands very well that when it comes to luxury winning a popularity contest often means winning a visibility contest first.) All this led up to the inevitable: the creation and decade-long (or more) success of the G-Shock as a piece of jewelry is the fact remains that the ornamentation was very much in a European or American style but something actually designed and sanctioned by G-Shock creator Kikuo Ibe himself seems very much a product of an Americanized design sensibility Casio decided to make a luxury-leaning version of its most relentlessly practical watch that was as Japanese in its ornamentation as the G-Shock itself is in its origin Before going any further into the decorative aspects of the Hammer Tone – designated MRGG1000HT – let's talk a little more in depth about its technical aspects this is a G-Shock; the original G-Shocks were built to tolerate a 10-meter drop and have a 10-year battery life and this still remains the minimum standard for all watches that call themselves G-Shocks The MRGG1000HT (HT for Hammer Tone) is based on the various MRGG1000 models which are among the most technically advanced (and Typically G-Shocks have used backlit LCD screens Casio's been making them with analog hands as well and the MRGG1000 watches have analog-only displays which if you're a decades-long G-Shock user like me takes a little getting used to Home time is shown on a sub-dial at 8:00; the main hour and minute hands show local time The dial at 3:00 has several functions and depending on the mode you've selected either shows the day of the week; the latitude at which you've taken your most recent time fix from the GPS system; whether or not the watch is in airplane mode; and whether or not you're set to summer or winter time One of the most interesting features of the Hammer Tone and the MRGG1000 watches on which it's based is its use of the GPS satellite network to establish correct location and correct time for that location automatically Of course the Hammer Tone isn't the only watch to use the GPS network for this purpose; the Seiko Astron and Citizen Satellite Wave watches both use the GPS network as well but watches using the GPS system are still somewhat rare and technically very interesting GPS watches work like any other GPS receiver: four satellites have to be in view in order for the time to be set correctly as three position coordinates are required and one additional signal to compute the deviation of the clock on the ground from the atomic clocks on board the GPS satellites (which are themselves corrected by ground based atomic clocks) if the MRGG1000 watches are unable to obtain the time from the GPS system they can use national time-broadcasting radio signals such as those found in Europe and Japan in order to obtain the correct time – and if all else fails they are of course autonomous quartz timekeepers as well (and the Hammer Tone is solar powered as well) What really sets the Hammer Tone apart from any other G-Shock – and for that matter from pretty much any other watch I can think of not of conventional forms of horological ornamentation and especially not of ones based in European cultural norms but rather of decorative methods and materials that are native to Japan We've gone over some of the details in our previous coverage of the Hammer Tone but here's a recap: the watch is made largely of titanium but with considerable additional work given to decorating it above and beyond anything Pharrell or Kanye might ever have imagined and as we mentioned in our introduction to the watch some weeks ago it consists of painstaking striking a metal surface with a hammer in such a way as to leave a pattern of tiny indentations (the technique is often found in traditional Japanese arms and armor) The technique creates a seemingly random pattern yet despite its random nature it takes years of practice to be able to achieve the seemingly natural artless effect – something intrinsic to much of the Japanese decorative arts from painting The tsuiki pattern (applied by tsuiki master Bihou Asano who has created ornaments for the Kyoto State Guest House) is directly applied to the titanium bezel and center links for the bracelet which are then hardened to make them 4-5 times harder than conventional titanium The last step is to apply DLC coating to areas where a darker finish is desired and a decorative metal coating to other areas Despite the rather hefty dimensions of the watch and the impression you get at first that this is going to be a bulky affair in the hand and on the wrist thanks to the considerable use of titanium in its construction (and of course the use of composites for the inner shock and impact shielding for the movement) the dial can be illuminated at night; since there's no LCD display to backlight The Hammer Tone is an immensely confusing watch to encounter because it doesn't really fit in anywhere There is a huge range of conceptual categories into which watches can fit so as a rule we don't very often see a watch that refuses to seem appropriate for any of them which makes life very difficult because the way most of us judge a watch is by how well it fits our preconceived notion of what any given type of watch should be We all have our idea of what the ur-chronograph is or the ur-dress watch (which is part of the problem with watch criticism from both specialist writers and enthusiasts; most of the time we're really judging a watch on the basis of its adherence to our deeply held and typically quite inflexible personal prejudices rather than evaluating it on its own terms) but it's obviously a tremendous departure from any produced to date (or at least any series produced G-Shock to date) and it also resolutely refuses to fit any of the usual stereotypes of a blinged-out such as we've seen both in their more honest form (say what you like about gem-set Technomarines at least they weren't pretending to be anything they're not) and in their more covert (any number of carelessly made and exorbitantly priced so-called ladies' watches It also happens to be very well made; the technology is right now up to the minute for an externally controlled quartz watch and in 50 years given that it's a G-Shock there's an excellent chance it will still be running it'll expire at some point but at least it will have the somewhat mournful appeal of once cutting-edge it's physically made very well; both the tsuiki decoration and the machining of the case and other elements are judged by the designer's apparent intentions or at least famously to Western and American eyes is a place where incredible cultural extremes can coexist and there's a profound commitment to the cultural identity to be found in its adherence to ancient norms and forms on the one hand and an incredible fascination with technology and modernity on the other Based on the reaction to our earlier introduction to the Hammer Tone (and the jolt of reading about a G-Shock that costs $6,200) I wonder if some readers mightn't think I'm pulling their legs a little bit with this review What unifies every part of it is a certain single-mindedness – the pursuit of the most advanced timekeeping technology the most exacting hand decoration techniques the most visually and graphically striking design and nominally a G-Shock – and it'll perform well in both roles – but what it really is is a collision of many different worlds brought together by a single obsessive fascination with what happens when you take seemingly completely divergent and even contradictory worlds to their extremes in one object What you get is something that could have come from nowhere else than Japan a watch that couldn't have come from anyone other than Casio Read more about the MRG G-Shocks from Casio here. For full specs and first impressions, as well as pricing, check out our First Look coverage of the Hammer Tone here Don't have the HODINKEE App yet? Get years of amazing watch content plus new stories, breaking news, and access to great new features like HODINKEE Live, free on iOS. Business News Rolex Will Raise U.S. Prices In Response To Tariffs Six Of The Coolest CPO Rolex Watches I Saw In London's Old Bond Street Rolex Boutique Reference Points The Cartier Tank Louis Introducing The Christopher Ward C12 'Loco' (Live Pics) Hands-On Tudor's Black Bay Pro Gets A Surprisingly Dramatic Facelift With An Opaline Dial A Japan Air Self Defense Force F-2 fighter taxis to join nine other F-2s which arrived on Guam Jan Air Force photo by Airman 1st Class Courtney Witt) Guam Customs Officer Tommie Pablo greets Japan Air Self Defense Force F-2 fighter pilot Capt The F-2 Fighters arrived on Andersen to participate in Exercise Cope North 09-1 a regularly scheduled exercise scheduled for Feb Air Force photo by Senior Airman Nichelle Griffiths) (AAFB) - Ten Japan Air Self Defense Force F-2 attack fighters have arrived on Guam in preparation for Cope North a two-week exercise which begins today The fighters are assigned to the 6th Squadron The exercise is one of the longest-running series of exercises in the Pacific theater This will be the tenth time the United States and Japan will hold a Cope North exercise on Guam and it will be the fourth time that the JASDF will use live ordnance Since the first Cope North exercise in 1978 thousands of American and Japanese personnel have honed skills that are vital to maintaining a high level of readiness The 12-day war game will involve 40 jets and 450 troops from the U.S "This exercise is designed to increase the combat readiness and interoperability of US Air Force and JASDF," he said According to an article posted on the AAFB news website Cope North 09-1 "has been in the planning stages for several months and bears no connection to any real-world events." The bilateral exercise is part of the ongoing series of exercises designed to enhance air operations in defense of Japan Poll results are published every Monday in The Guam Daily Post Your browser is out of date and potentially vulnerable to security risks.We recommend switching to one of the following browsers: USAF-JASDF field training exercise at Andersen AFB in Yigo An F-2 support fighter aircraft from the 6th Squadron WHILE most visitors traveling to Guam have no choice but to arrive on a commercial airplane Sano was able to fly here on his first visit to Guam via an F-2 support fighter aircraft Nearly 200 other JASDAF personnel based out of Tsuiki and Misawa air bases are on island to participate in the Cope North training exercise at Andersen Air Force Base Air Force units out of Alaska and Japan are also participating in the field training exercise alongside Andersen based airmen Cope North kicked off on Sunday and will continue until next Thursday military personnel are participating in the training exercises as well Sano said he is enjoying Guam’s sunny skies and humid climate so far a drastic change from the cloudy and often rainy Japan However he admitted his visit to Guam is not all fun and games Sano said that he will be dropping live bombs tomorrow night at Farallon de Medinila in the CNMI as part of the Cope North’s training exercises has been utilized for many years as a practice bombing site for the military but this will be my first time dropping live bombs,” said Sano noting that training in a plane with live bombs is drastically different than training without them pilots participating in surface attack missions at FDM are going to be expected to carry out the highly stressful mission of dropping of live bombs Bowers said that although the exercise is entering its 10th year this is only the 5th year Japanese forces have trained with live ammunition Bowers explained that the goal of the exercises is to allow both countries’ military forces to familiarize themselves with this region to ensure smoother operations in case an emergency calls for both forces to be deployed together “We need to learn to fly together,” said Bowers adding that both Guam and Japan are becoming increasingly strategic to U.S “We need to make sure we have access to Asia in the event of a contingency.” Bowers added that Cope North is the longest running bilateral training exercise Guam’s location makes it ideal for training exercises like Cope North military forces are not able to fly as feely over the heavily congested Japanese airspace or train over the open ocean He added that since Andersen is located on the Northern end of the island local residents are not disturbed by constant take-offs and landings Bowers also said that Cope North is the only opportunity JASDAF has to drop live munitions pilots will be tested over this coming week on their abilities to not only fly the planes but their abilities to maintain them as well Navy EA-6B Prowlers and E-2C Hawkeyes will be flown alongside the Japanese F-2’s during the training exercises Bowers said that the two countries’ military forces have improved considerably as a result of the exercises “Offensive operations on many tactical levels have greatly improved,” said Bowers adding that the annual training is paying off Bowers added however that he would like to see more training exercises focused on Japan based efforts He said that participants from all over the Pacific region should be able to participate in similar training will take place before the field training exercise is over next week