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Introduction: The systemic immune-inflammation index (SII) has emerged as a promising prognostic marker in various malignancies. However, its prognostic significance in patients with small-cell lung cancer (SCLC) treated with immune checkpoint inhibitors (ICIs) remains unclear. In this study, we evaluated the prognostic impact of the SII in patients with SCLC after ICI use., Methods: Of 62 patients with SCLC who received chemoimmunotherapy at our institution between September 2019 and July 2024, we retrospectively analyzed 36 patients who subsequently received ICI maintenance therapy following the initial chemoimmunotherapy treatment. The SII was calculated at the start of the second cycle of the ICI maintenance therapy. Patients were stratified into high (≥ 570) and low (< 570) SII groups. Overall survival (OS) and progression-free survival (PFS) were compared between the groups using the Kaplan-Meier method and log-rank test. Multivariate analysis using the Cox proportional hazards model was performed to identify independent prognostic factors., Results: The high SII group exhibited a significantly shorter OS (median 12.1 vs. 24.1 months, P = 0.010) and PFS (median 5.2 vs. 8.1 months, P = 0.026) than those in the low SII group. A multivariate analysis identified SII ≥ 570 as an independent negative prognostic factor for OS (hazard ratio 3.83, 95% confidence interval 1.38-10.6, P = 0.010)., Conclusions: Elevated SII in the initial phase of ICI maintenance therapy was associated a with poor prognosis in patients with SCLC, supporting its utility as a prognostic biomarker in this setting. Therefore, prospective validation is required to confirm these findings., Competing Interests: Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki and was approved by the Institutional Review Board of Yokohama Municipal Citizen’s Hospital. The requirement for individual informed consent was waived by the ethics committee due to the retrospective nature of the study and the use of anonymized data from existing medical records. This waiver was granted based on the following considerations: the noninvasive nature of the study, the use of only anonymized data with adequate measures to protect personal information, the impracticality of contacting the study subjects, and the minimal risk of infringing upon the rights or interests of the patients involved. All data were handled confidentially and in compliance with relevant privacy laws and regulations. The study protocol ensured that the research objectives could be achieved without compromising patient privacy or the ethical standards of medical research. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Prognosis of chronic thromboembolic pulmonary hypertension (CTEPH) has improved after the availability of balloon pulmonary angioplasty (BPA) and approved drugs. However, the clinical effects of cancer, which is one of the associated medical conditions of CTEPH, remain unclear. We aimed to investigate prognosis in patients with CTEPH and comorbid cancer., Methods: Between January 2011 and December 2022, data of 264 consecutive patients with CTEPH who were treated with pulmonary endarterectomy, BPA, or medical therapy were retrospectively analyzed. The patients were allocated, based on the comorbidity of cancer as of December 2022, into the cancer (n = 47) and non-cancer (n = 217) groups. In the cancer group, active and non-active cancers were identified in 30 (64%) and 17 (36%) patients, respectively., Results: The baseline characteristics, hemodynamics, and treatments were similar between the groups. More than half of the cancer were diagnosed within two years before or after CTEPH diagnosis. Twenty-seven patients died during the study period. Among them, 13 (48%) and 7 (26%) died of cancer and right heart failure, respectively. The 5-year survival rate was lower in the cancer group than in the non-cancer group (67.8% vs. 94.5%, p < 0.001). In the active cancer group, the 5-year survival rate was also lower than that in the non-active cancer and non-cancer groups (52.0% vs. 99.5%, p < 0.001 and 52.0% vs. 92.3%, p < 0.001, respectively). Multivariate Cox hazard analysis revealed that hemodialysis (p < 0.001) and cancer (p < 0.001) were independently associated with poor survival., Conclusion: Patients with CTEPH rarely die of right heart failure, even if hemodynamically severe at diagnosis in the modern management era. However, patients with CTEPH frequently have comorbid cancer, which may be a strong prognostic factor., Competing Interests: Declarations. Ethics approval and consent to participate: The study protocol was approved by the Ethics Committee of Kobe University Hospital (approval number: B230114). All enrolled patients were provided with the option to opt out if they did not wish to participate. The requirement for written informed consent was waived because the data were retrospectively collected. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Competing Interests: The authors declare no conflict of interest.

Background: Hepatoid adenocarcinoma of the stomach (HAS), a subtype of gastric cancer (GC), includes multiple tumor components, such as enteroblastic and tubular adenocarcinoma components. However, which component mostly contributes to the aggressive behavior of HAS remains unclear. Moreover, the role of tumor-associated macrophages (TAMs) has not been explored in HAS. This study evaluated the clinical significance of the proportion of the hepatoid component within the tumor, CD163 + macrophages, and macrophage colony-stimulating factor-1 (CSF-1) in HAS., Methods: In total, 56 cases of primary HAS were analyzed. In each case, hepatoid (HC), enteroblastic (EC), and tubular (TC) components were identified, and the ratio of HC to the entire tumor (hepatoid component ratio, HCR) was assessed to examine the correlation between HCR and clinicopathological features. Immunohistochemical staining for CD163 and CSF-1 was performed, and differences in immunohistochemical results among the three tumor components were analyzed. In each tumor component, the prognostic impact of CD163 and CSF-1 was examined., Results: A high HCR was associated with worse overall survival (OS). CD163 + TAMs and CSF-1 immunoreactivity score in HC were significantly higher than those in the other components. High infiltration of CD163 + TAMs and a high CSF-1 immunoreactivity score in HC were associated with an aggressive course and worse OS. Multivariate analysis revealed the proportion of HC in HAS as an independent prognostic factor (HR = 3.176, p = 0.006)., Conclusions: The HCR and CD163 + TAMs may be useful prognostic predictors, and TAMs may be novel therapeutic targets of HAS., Competing Interests: Declarations. Conflict of interest: The authors declare that they have no conflicts of interest. Ethical approval: This study was conducted in accordance with the principles of the Declaration of Helsinki. It was approved by the Medical Human Investigation Committee of Kyushu University (institutional Review Board no. 20476). Informed consent was obtained from all patients., (© 2024. The Author(s).)

Objectives: To examine the associations of smoking cessation with the subsequent frailty status trajectory using data from a nationally representative sample of community-dwelling older adults living in England., Design: A prospective panel study., Setting and Participants: A total of 2600 community-dwelling older adults aged 60 or older in England who used to smoke., Methods: The past smokers were divided into 5 groups based on years since smoking cessation: 0-10, 11-20, 21-30, 31-40, and 41+ years. The Frailty Index (FI) was constructed using 60 deficits and repeatedly calculated every 2 years over 16 years. Trajectories of FI according to years since smoking cessation were estimated by a mixed-effects model., Results: A mixed-effects model adjusted for age, sex, education, wealth, and alcohol use showed that FI increased over time in all groups and that longer duration since smoking cessation was significantly associated with lower FI (more fit). Those who quit 41 years earlier or more had the lowest frailty trajectory, however, there was still a gap between them and never smokers., Conclusions and Implications: The current study showed that past smokers with a longer duration of quitting smoking had a significantly lower degree of frailty at baseline and over time. These findings highlight beneficial effects of smoking cessation on frailty even in middle or old age and could be used in public health education to promote the importance of quitting smoking., Competing Interests: Disclosure The authors declare no conflicts of interest., (Copyright © 2024 Post-Acute and Long-Term Care Medical Association. Published by Elsevier Inc. All rights reserved.)

Objective: To clarify the association between skin autofluorescence of advanced glycation end products (AGEs) and clinical outcomes and pain in patients with degenerative cervical myelopathy (DCM)., Methods: Consecutive patients with DCM were prospectively enrolled. AGEs assessed by skin autofluorescence (the AGE score) were examined at the middle fingertip in eligible patients. Patients were divided into lower AGE score (AGE-L) and higher AGE score (AGE-H) groups based on a cutoff AGE score of 0.54. Demographic data, laboratory data, maximum spinal cord compression, clinical outcomes, such as European Quality of Life-5 Dimensions, Neck Disability Index, and Japanese Orthopaedic Association score, and Numerical Rating Scale (NRS) score for neck, arm, hand, leg, and foot pain were compared between the two groups. Multiple linear regression analysis was performed to assess the association between the AGE score and the NRS score for pain in the lower limbs., Results: Of the 263 patients, 93 were included in this study (41 with the AGE-L group and 52 with the AGE-H group). Demographic data, laboratory data, maximum spinal cord compression, and clinical outcomes were comparable between the two groups. The AGE-H group had significantly higher NRS scores for leg and foot pain than the AGE-L group. Multiple linear regression analysis revealed that higher AGE scores were significantly associated with more severe pain in the lower limbs in patients with DCM., Conclusions: Noninvasive skin autofluorescence of AGEs may be a useful biomarker for pain symptoms in the lower limbs in patients with DCM., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Multiple etiologies of West syndrome have been reported; however, there are cases of unknown etiologies. Exposure to volatile organic compounds (VOCs) increases the risk of epilepsy; however, their effects on children remain unknown. This study aimed to investigate the association between maternal occupational usage of VOCs and West syndrome development in children. Using data from a cohort of 88,280 children, we extracted children born to mothers who had used VOCs during pregnancy. Based on an epilepsy diagnosis by the age of 2 years, the frequency of usage of VOCs was comparatively analyzed among the following groups: never diagnosed with epilepsy, West syndrome, and other epileptic syndromes. A total of 15, 154, and 88,111 children were categorized into the West syndrome, other epileptic syndrome, and never diagnosed with epilepsy groups, respectively. The odds ratio (OR) for West syndrome development increased with the frequency of permanent marker usage (one to three times a month: OR = 2.58, 95% confidence interval [CI] 0.75-8.90; one or more times a week: OR = 4.34, 95% CI 1.23-15.26). These results suggested an association between maternal occupational frequent usage of permanent marker and West syndrome development in children., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Dynamic WaveArc (DWA) is a technique used for continuous, non-coplanar volumetric-modulated arc therapy on the Vero4DRT platform. This study aimed to evaluate the application of single-isocenter DWA (SI-DWA) for treating multiple brain metastases by comparing dose distribution and irradiation time with multi-isocenter DWA (MI-DWA) through retrospective treatment planning. Treatment plans were developed for SI-DWA and MI-DWA in 14 cases with 3-5 brain metastases. Parameters assessed included target dose indices, such as conformity index (CI) of the planning target volume (PTV), volumes of normal brain excluding gross tumor volumes (GTVs) receiving a single dose equivalent of 14 Gy (V14), V30%, V20%, V10%, volumes of normal brain, including GTVs receiving a single dose equivalent of 12 Gy (V12), D2% for other organs at risk, and beam-on time. SI-DWA showed inferior CI, V14, and V12 values for lesions with PTV volumes <1 cc, whereas it performed equivalently to MI-DWA for lesions with PTV volumes ≥1 cc. SI-DWA resulted in higher volumes of normal brain receiving low doses compared to MI-DWA. SI-DWA exhibited significantly shorter beam-on times than MI-DWA. In conclusion, SI-DWA is an effective method for treating multiple brain metastases with PTV volumes ≥1 cc, offering an index of radiation-induced brain necrosis comparable with MI-DWA while allowing for shorter irradiation times., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Japanese Radiation Research Society and Japanese Society for Radiation Oncology.)

Objectives: We investigated the long-term effectiveness, safety, and factors affecting Japanese Health Assessment Questionnaire (J-HAQ) improvement during abatacept treatment in Japanese rheumatoid arthritis (RA) patients., Methods: The Orencia® Registry in Geographically Assembled Multicenter Investigation (ORIGAMI) study is an ongoing observational study of biologic-naïve RA patients with moderate disease activity treated with subcutaneous abatacept (125 mg, once weekly). Patients treated with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) were extracted from the Institute of Rheumatology, Rheumatoid Arthritis (IORRA) registry as a historical, weighted control group. The primary end point for this interim analysis was the proportion of patients with J-HAQ remission (score ≤0.5) at 3 years., Results: Among 279 abatacept-treated and 220 csDMARD-treated patients, J-HAQ remission was achieved at 3 years in 40.5% [95% confidence interval (CI) 34.7-46.2%] and 28.9% (95% CI 9.9-47.8%), respectively. Age, RA duration <1 year, baseline J-HAQ score, and Simplified Disease Activity Index remission at 6 months were associated with 3-year J-HAQ remission in the abatacept group. Overall, 24/298 patients (8.1%; safety analysis set) experienced serious adverse drug reactions with an incidence of 5.3 per 100 person-years., Conclusions: This study confirmed the 3-year effectiveness and safety and revealed potential factors associated with J-HAQ remission in biologic-naïve RA patients treated with abatacept in real-world clinical practice., (© Japan College of Rheumatology 2024. Published by Oxford University Press.)

Background: Sleep disturbances, especially those lasting more than one hour, are under-researched in patients with degenerative cervical myelopathy (DCM). This study aims to investigate the prevalence and risk factors for such disturbances in DCM patients undergoing decompression surgery and to identify factors contributing to poor postoperative improvement., Methods: A multicenter retrospective observational study was conducted on consecutive patients diagnosed with DCM who underwent cervical decompression surgery between April 2018 and August 2022. The neck disability index (NDI) sleep component was assessed at baseline and 12 months post-surgery. Univariate and multivariable logistic regression analyses were used to identify risk factors for persistent sleep disturbances and poor improvement., Results: Of the 1912 patients included, 54.8% reported sleep disturbances, with 33.0% experiencing disturbances of more than one hour at baseline. Multivariable analysis identified male sex, high BMI, high numerical rating scale (NRS) for arm pain, high NDI, and high Core Outcome Measures Index (COMI) Neck as significant risk factors for sleep disturbances. At 12 months, 35.2% of these patients continued to experience significant sleep issues. The presence of ossification of the posterior longitudinal ligament (OPLL) and high baseline NRS for neck pain were significant predictors of poor improvement., Conclusion: The study highlights that OPLL and high baseline neck pain are significant risk factors for persistent sleep disturbances post-surgery in DCM patients. Early identification and targeted interventions may be necessary to improve outcomes., (Copyright © 2024. Published by Elsevier Inc.)

Aim: Alpha-actinin 3 (ACTN3) is associated with diminished physical function and muscle mass in older individuals. However, the effects of lifestyle on this relationship remain unclear. This study explored whether the association between ACTN3 polymorphisms and physical function and body composition varied based on exercise and dietary habits., Methods: A longitudinal analysis of 197 community-dwelling individuals aged 60 years and older (mean age 72.5 ± 5.9 years, 60.9% women) in the Tarumizu study provided data on ACTN3 gene polymorphisms, with surveys completed in 2019 and 2022 (mean follow-up 1156 ± 80.0 days). Physical performance (grip strength, walking speed) and body composition (body weight, appendicular skeletal muscle mass [ASMM], and fat mass) were assessed. Genetic polymorphisms were analyzed in oral mucosa samples and categorized into type R allele carriers and type XX alleles (homozygous for minor alleles). Median values determined exercise habits (≤4 days/week or ≥5 days/week) and dietary habits based on high-protein-food frequency scores., Results: The proportion of type XX genetic polymorphism was 26.4%. Two-way repeated-measures analysis of covariance showed a significant interaction between genetic polymorphism and time for ASMM (F = 10.552, P = 0.002) in the ≤4 days/week exercise habits group. Significant interactions were observed in grip strength (F = 7.013, P = 0.009) and ASMM (F = 5.347, P = 0.023) for the ≤11 score high-protein-intake group., Conclusions: This association may contribute to accelerated age-related changes in physical performance and body composition, particularly among individuals with type XX genetic polymorphism who have low exercise habits and a limited intake of high-protein foods. Geriatr Gerontol Int 2024; ••: ••-••., (© 2024 The Author(s). Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.)

Bivalves survive exposure to hypoxic water through anaerobic metabolism. However, the characteristics of anaerobic metabolism that determine the differences in hypoxic tolerance observed between and within species remain unclear. In this study, we examined three species belonging to the superfamily Arcoidea (Anadara kagoshimensis, Tegillarca granosa, and Estellacar olivacea) with differences in hypoxia tolerance as well as one species (A. kagoshimensis) with differences in hypoxia tolerance between the locations. The species were exposed to hypoxic water in a laboratory manipulation experiment to compare temporal changes in metabolites involved in anaerobic metabolism. Comparison of anaerobic metabolic processes showed that the rate of decrease in aspartic acid was strongly correlated with the hypoxia tolerance (LT 50 ) of the target species. Aspartic acid appears to be the main source of energy production during anaerobic metabolism, and the slow rate of its consumption is an indicator of the strength of hypoxia tolerance in Arcoidea bivalves., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Bioresorbable scaffolds (BRS) were developed as an innovative solution to overcome the limitations of metallic stents. While polymeric BRS initially demonstrated comparable clinical outcomes to drug-eluting stent (DES) in clinical trials, subsequent large-scale studies revealed that patients implanted with polymeric BRS experienced higher rates of scaffold thrombosis (ScT) and target lesion failure compared to those with metallic stents. Resorbable magnesium scaffolds (RMS) have emerged as a promising alternative owing to magnesium's natural degradability and favorable mechanical properties. Learning from the mechanism of polymeric BRS failure and through continuous improvements, recent clinical trials have shown promising clinical performance for RMS technology. However, comparative studies between RMS and DES have continued to highlight the remaining challenges with RMS, particularly in regard to late lumen loss. Recent advancements in third-generation RMS show improvements in strut thickness and homogeneous degradation, which enhances sustained structural integrity throughout the degradation process. Based on encouraging results from a first-in-human trial of the latest version of RMS, a randomized controlled trial has been initiated to compare the outcomes between metallic stents and the latest RMS, with patient enrollment already underway. This review aims to explore the limitations of polymeric BRS and provide an overview of the current developments and future potential of magnesium-based BRS., (© 2024. The Author(s) under exclusive licence to Japanese Association of Cardiovascular Intervention and Therapeutics.)

Primary percutaneous coronary intervention (PCI) is the cornerstone of treatment for ST-segment elevation myocardial infarction (STEMI). Previous studies suggest that direct transport by ambulance to a primary PCI facility is associated with better clinical outcomes in patients with STEMI. However, those studies included seriously ill patients for whom direct transport is the only option. We included 462 patients with STEMI who were supposed to select either direct transport by ambulance or indirect transport via primary care doctor, and compared the clinical outcomes between the direct transfer group (n = 172) and the indirect transfer group (n = 290). The primary endpoint was major adverse cardiovascular events (MACE), which was defined as the composite of all-cause death, non-fatal myocardial infarction, re-admission for heart failure, and target vessel revascularization. The median follow-up duration was 540 days (86-1266 days). Age was significantly higher in the indirect transfer group [72.0 (64-80) years] than in the direct transfer group [69.5 (58.3-77) years] (p = 0.013). Onset to balloon time was significantly shorter in the direct transport group (p < 0.001). The Kaplan-Meier curves revealed that MACE were similarly observed between the two groups (31.4% vs. 27.2%; p = 0.330). After adjusting for potential confounders, indirect transfer was not associated with MACE (adjusted hazard ratio: 0.740, 95% confidence interval: 0.485-1.128, p = 0.161). In conclusion, indirect transfer was not associated with poor clinical outcomes in patients with STEMI who were supposed to select either direct transport or indirect transport., Competing Interests: Declarations. Conflict of interest: None., (© 2024. The Author(s) under exclusive licence to Japanese Association of Cardiovascular Intervention and Therapeutics.)

Background: Chemoimmunotherapy is the standard first-line treatment for extensive-stage small-cell lung cancer (ES-SCLC); however, its real-world long-term outcomes associated with patient backgrounds are still unclear. We explored this association using an updated large real-world prospective cohort with a minimum follow-up of 3 years., Methods: This prospective cohort study, conducted across 32 hospitals, enrolled patients with ES-SCLC receiving carboplatin, etoposide, and atezolizumab between September 1, 2019 and September 30, 2020. Updated data with a minimum 3-year follow-up period were analyzed. Patients who met eligibility criteria for pivotal phase 3 clinical trials were considered "trial-eligible.", Results: The median (range) time from the treatment initiation to data cutoff (September 30, 2023) was 42.2 (35.8-48.2) months for the enrolled 207 patients. Most patients (89 %) had an Eastern Cooperative Oncology Group performance status of 0 or 1. Patients fulfilling the inclusion criteria (132 [64 %]) were categorized as trial-eligible. The 3-year progression-free survival (PFS) probability and overall survival (OS) were 6.1 % and 20.9 %, respectively. The 3-year OS probabilities for trial-eligible and trial-ineligible patients were 26.7 and 9.5 %, respectively. The trial-eligible cohort had a larger percentage of patients achieving a 3-year OS (30/132, 22.7 %) than the trial-ineligible cohort (5/75, 6.7 %) (P = 0.003) CONCLUSIONS: Our study provides the first documentation of the long-term outcomes following chemoimmunotherapy in a large prospective real-world cohort of patients with ES-SCLC. Key eligibility criteria significantly influenced the long-term effectiveness. These findings provide valuable insights into the practical effectiveness of chemoimmunotherapy and clinical decision-making for patients with ES-SCLC., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Nobuyuki Yamamoto reports financial support was provided by Chugai Pharmaceutical Co Ltd. Daichi Fujimoto reports a relationship with Chugai Pharmaceutical Co Ltd that includes: consulting or advisory and speaking and lecture fees. Motohiro Tamiya reports a relationship with Chugai Pharmaceutical Co Ltd that includes: speaking and lecture fees. Akito Hata reports a relationship with Chugai Pharmaceutical Co Ltd that includes: funding grants and speaking and lecture fees. Hirotaka Matsumoto reports a relationship with Chugai Pharmaceutical Co Ltd that includes: speaking and lecture fees. Toshihide Yokoyama reports a relationship with Chugai Pharmaceutical Co Ltd that includes: funding grants and speaking and lecture fees. Yoshihiko Taniguchi reports a relationship with Chugai Pharmaceutical Co Ltd that includes: speaking and lecture fees. Yuki Sato reports a relationship with Chugai Pharmaceutical Co Ltd that includes: speaking and lecture fees. Takashi Kijima reports a relationship with Chugai Pharmaceutical Co Ltd that includes: funding grants and speaking and lecture fees. Hisashi Tanaka reports a relationship with Chugai Pharmaceutical Co Ltd that includes: speaking and lecture fees. Naoki Furuya reports a relationship with Chugai Pharmaceutical Co Ltd that includes: speaking and lecture fees. Takeshi Masuda reports a relationship with Chugai Pharmaceutical Co Ltd that includes: speaking and lecture fees. Yoshihiko Sakata reports a relationship with Chugai Pharmaceutical Co Ltd that includes: speaking and lecture fees. Eisaku Miyauchi reports a relationship with Chugai Pharmaceutical Co Ltd that includes: consulting or advisory, funding grants, and speaking and lecture fees. Go Saito reports a relationship with Chugai Pharmaceutical Co Ltd that includes: speaking and lecture fees. Satoru Miura reports a relationship with Chugai Pharmaceutical Co Ltd that includes: speaking and lecture fees. Teppei Yamaguchi reports a relationship with Chugai Pharmaceutical Co Ltd that includes: speaking and lecture fees. Haruko Daga reports a relationship with Chugai Pharmaceutical Co Ltd that includes: speaking and lecture fees. Shinya Sakata reports a relationship with Chugai Pharmaceutical Co Ltd that includes: speaking and lecture fees. Nobuyuki Yamamoto reports a relationship with Chugai Pharmaceutical Co Ltd that includes: consulting or advisory, funding grants, and speaking and lecture fees. Hiroaki Akamatsu reports a relationship with Chugai Pharmaceutical Co Ltd that includes: funding grants and speaking and lecture fees. Hirotaka Matsumoto reports a relationship with Nippon Kayaku Co Ltd that includes: speaking and lecture fees. Toshihide Yokoyama reports a relationship with Nippon Kayaku Co Ltd that includes: speaking and lecture fees. Yuki Sato reports a relationship with Nippon Kayaku Co Ltd that includes: speaking and lecture fees. Eisaku Miyauchi reports a relationship with Nippon Kayaku Co Ltd that includes: speaking and lecture fees. Satoru Miura reports a relationship with Nippon Kayaku Co Ltd that includes: speaking and lecture fees. Hiroaki Akamatsu reports a relationship with Nippon Kayaku Co Ltd that includes: speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: The association between heatwave and heat-related outcomes in people with mental health conditions with and without psychotropics was unclear., Methods: We identified people with severe mental illness (SMI) and depression, respectively, using Japanese claim data of Ibaraki prefecture during 1/1/2014-31/12/2021. We conducted self-controlled case series to estimate the incidence rate ratio (IRR) of heat-related illness, myocardial infarction and delirium, respectively, during 5-day pre-heatwave, heatwave, and 5-day post-heatwave periods v. all other periods (baseline) within an individual, stratified by periods prescribed psychotropics and periods not prescribed psychotropics, respectively., Results: Among people with SMI, heatwave was associated with an increased rate of heat-related illness v. baseline, with no evidence of a difference in the IRRs between those prescribed v. not prescribed antipsychotics (IRR: 1.48 [95% CI 1.40-1.56]; 1.45 [95% CI 1.35-1.56] respectively, p interaction: 0.53). Among people with depression, heatwave was similarly associated with heat-related illness, with no evidence of a difference in the IRRs between those prescribed v. not prescribed antidepressants (IRR: 1.54 [95% CI 1.46-1.64]; 1.64 [95% CI 1.57-1.71] respectively, p interaction: 0.33). Smaller increased rates of heat-related illness were also observed in pre- and post-heatwave periods, v. baseline in both cohorts. There was weak evidence of an increased risk of MI and delirium associated with heatwave v. baseline., Conclusions: We showed an increased risk of heat-related illness, myocardial infarction and delirium associated with heatwave in people with mental health conditions regardless of whether being prescribed psychotropics. Risks of heat-related illness, myocardial infarction and delirium associated with heatwave might not be factors to influence decisions about the routine use of psychotropics.

We aimed to evaluate the accuracy and repeatability of the T1, T2*, and proton density (PD) values obtained by quantitative parameter mapping (QPM) using the ISMRM/NIST MRI system phantom and compared them with computer simulations. We compared the relaxation times and PD obtained through QPM with the reference values of the ISMRM/NIST MRI system phantom and conventional methods. Furthermore, we evaluated the presence or absence of influences other than noise in T1 and T2* values obtained by QPM by comparing the obtained coefficient of variation (CV) with simulation results. The T1, T2*, and PD values by QPM showed a strong correlation with the measured values and the referenced values. The simulated CVs of QPM calculated for each sphere showed similar trends to those of the actual scans., Competing Interests: Declarations. Conflict of interest: Dr. Kudo has research funding from FUJIFILM Healthcare Corporation. Yo Taniguchi, Tomoki Amemiya, and Yoshitaka Bito are currently employed by FUJIFILM Healthcare Corporation. Ethical approval: This study did not involve any experiments using human participants or animals. Informed consent: This study did not involve any human participants; therefore, no informed consent was required., (© 2024. The Author(s).)

Lasers have numerous advantageous tissue interactions such as ablation or vaporization, hemostasis, bacterial killing, as well as biological effects, which induce various beneficial therapeutic effects and biological responses in the tissues. Thus, lasers are considered an effective and suitable device for treating a variety of inflammatory and infectious conditions of periodontal disease. Among various laser systems, the Er:YAG laser, which can be effectively and safely used in both soft and hard tissues with minimal thermal side effects, has been attracting much attention in periodontal therapy. This laser can effectively and precisely debride the diseased root surface including calculus removal, ablate diseased connective tissues within the bone defects, and stimulate the irradiated surrounding periodontal tissues during surgery, resulting in favorable wound healing as well as regeneration of periodontal tissues. The safe and effective performance of Er:YAG laser-assisted periodontal surgery has been reported with comparable and occasionally superior clinical outcomes compared to conventional surgery. This article explains the characteristics of the Er:YAG laser and introduces its applications in periodontal surgery including conventional flap surgery, regenerative surgery, and flapless surgery, based on scientific evidence from currently available basic and clinical studies as well as cases reports., Competing Interests: none., (© 2023 The Authors.)

Background/aim: Survival outcomes in patients with successfully resected non-small-cell lung cancer (NSCLC) are not well understood. Furthermore, the best treatment strategy for postoperative locoregional recurrence has not been established., Patients and Methods: Patients who underwent R0 resection of NSCLC between 2013 and 2022 were retrospectively reviewed. The survival after recurrence was analyzed by categorizing patients into locoregional and distant recurrence groups. Moreover, the efficacy of salvage local therapy including radiotherapy (RT) and concurrent chemoradiotherapy (cCRT) was evaluated in terms of progression-free-survival (PFS), overall survival (OS), and safety., Results: Of the 694 patients who underwent R0 surgery, 150 were diagnosed with post-operative recurrence consisting of 54 cases of locoregional and 96 of distant recurrence. The median OS was 55.9 and 22.3 months in the locoregional and distant recurrence groups, respectively [hazard ratio (HR)=0.52; 95% confidence interval (CI)=0.32-0.84; p<0.001]. In the multivariate analysis, distant recurrence, negative oncogenic driver-mutation, and male sex were identified as independent predictors of a poor prognosis. Of the 54 patients with locoregional recurrence, local therapy was administered to 48 comprising 30 cases of cCRT and 18 of RT alone. The median PFS and OS were 13.3 and 60.4 months, respectively. Regarding adverse events, two cases (4.2%) of grade ≥3 radiation pneumonitis occurred., Conclusion: The OS of patients with locoregional recurrence of NSCLC was significantly better than that of patients with distant recurrence. Salvage local therapy, including cCRT and RT, may be an effective option for the treatment of locoregional recurrence due to its superior PFS, OS, and tolerability., (Copyright © 2024 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background: This study aimed to investigate the potential association between the combination of low physical activity and low dietary diversity with mild cognitive impairment (MCI) in older Japanese adults., Methods: Data from 600 older adults (mean age, 74.1±6.4 years; women, 62.0%) were analyzed. We evaluated dietary variety based on the Food Frequency Score (FFS; maximum 30 points) by assessing the 1-week consumption frequencies of ten foods. An FFS of ≤16 indicated low dietary diversity. We assessed MCI using the National Center for Geriatrics and Gerontology Functional Assessment Tool. Physical activity levels was determined based on participant responses to two questions: "Do you engage in moderate levels of physical exercise or sports aimed at health?" and "Do you engage in low levels of physical exercise aimed at health?" Participants who responded "No" to both questions were classified as having low physical activity levels. We classified the participants into robust, low-dietary diversity, low-physical activity, and coexistence groups., Results: The overall prevalence of MCI was 20.7%, with rates in the robust, low dietary diversity, low physical activity, and coexistence groups of 17.7%, 24.7%, 25.0%, and 41.9%, respectively. Multiple logistic regression analysis revealed that low dietary diversity and physical activity were associated with MCI in older adults (odds ratio=2.80, 95% confidence interval 1.22-6.28)., Conclusion: The results of the present study demonstrated the association of the co-occurrence of low dietary diversity and low physical activity with MCI. Older adults with both risk factors may require early detection, as well as physical activity and dietary interventions.

Background: The use of transport other than cars is a modifiable factor in the association between driving cessation and social frailty. Clarifying this relationship may serve as a new preventive measure against social frailty among current non-drivers. This study examined the potential association of driving status and transport use with social frailty, as well as between the frequency of transport use and social frailty, among current non-drivers., Methods: This study included 977 middle-aged and older adults (average age, 65.3±4.8 years). The participants were classified as transport users (more than a few times a week) and transport non-users (less than a few times a month). Based on driving status and transport use, the groups were further classified into current driver, current non-driver/transport user, and current non-driver/transport non-user groups. The relationships between driving status, transport use, and social frailty were examined using multiple logistic regression., Results: The current non-driver group and the transport non-user group were significant association with a higher social frailty. The current non-driver/transport user group showed no association with social frailty compared with the current driver group. The odds ratio for the social frailty rate for The current non-driver/transport non-user group was 2.14 (95% confidence interval, 1.25-3.73)., Conclusions: Participants who neither drive nor take transport showed significant associations with increased social frailty. Compared with current driver/transport use, current non-driver/transport non-use was associated with social frailty.

This cross-sectional study examined the association of attachment with the frequency of dog walking and physical activity level among dog owners. We analyzed data collected in an internet survey conducted by the Japan Pet Food Association in 2023. Valid data were obtained from 1041 dog owners. The mean (SD) age of participants was 52.5 (14.9) years, with 57.5% being women. Ordinal logistic regression models showed that a higher attachment score was associated with a higher frequency of dog walking after controlling for important confounders (B = 0.04, SE = 0.02, p<0.01, Adjusted R2 = 0.03). Linear regression models showed that a higher attachment score was associated with a higher moderate-vigorous physical activity level (B = 1.43, SE = 0.44, p<0.01, Adjusted R2 = 0.01). These results suggest that dog owners with strong attachment maintain physical activity levels through caring for their dogs. Higher levels of physical activity might have protective effects against adverse health outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Taniguchi, Ikeuchi. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Excellent surgical outcomes of microendoscopic laminectomy (MEL) have been reported for patients with lumbar spinal canal stenosis (LSCS). However, few reports have directly compared MEL with open laminectomy for multi-level LSCS. This study conducted a comparative analysis of patient-reported outcomes (PROs) and perioperative complications in patients undergoing two-level posterior decompression for LSCS by MEL versus open laminectomy., Methods: This multicenter retrospective cohort study involved prospectively registered patients who underwent two-level posterior lumbar decompression surgery for LSCS at one of eight high-volume spine centers between April 2017 and February 2020. Chart sheets were used to prospectively evaluate demographic data, including diagnosis, operative procedure, operation time, estimated blood loss, and perioperative complications. The PROs evaluated were the numerical rating scale (NRS) score for lower back pain and leg pain, 12-item Short Form Health Survey (SF-12) score, EuroQol 5-Dimension (EQ-5D) score, Oswestry Disability Index (ODI) score, and patient satisfaction with the treatment., Results: Of the 882 patients enrolled, 410 underwent MEL (MEL group) and 472 underwent open decompression (open group). A total of 667 (75.6%) patients completed the 1-year follow-up. Intraoperative blood loss was significantly lower in the MEL group than in the open group. The complication rate was comparable (12.4% in MEL group, 12.5% in open group). Although the revision rate did not differ significantly, the incidence of surgical site infection (SSI) was markedly lower in the MEL group (0.0% in MEL group, 1.3% in open group). Propensity score matching was employed to compare 333 patients who underwent MEL with 333 patients who underwent open laminectomy. Intraoperative blood loss was significantly lower in the matched MEL group than in the matched open group. The incidence of SSI was markedly lower in the matched MEL group (0.0% in matched MEL group, 1.2% in matched open group). No significant differences in the preoperative and postoperative values of the PROs or patient satisfaction were observed between the two groups., Conclusions: MEL required an equivalent operating time and resulted in less intraoperative blood loss compared with laminectomy in two-level procedures. The incidence of SSI was significantly lower in the MEL group., Competing Interests: Declarations. Ethics approval and consent to participate: This study was approved by the Institutional Review Board of the Clinical Research Support Center of the the University of Tokyo Hospital hospital (approval no. 10335) and the institutional review boards of all participating hospitals. All procedures adhered to the relevant guidelines and principles of the Declaration of Helsinki. All participants provided written informed consent for participation and were free to withdraw from the study at any time. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background : It is essential to identify the risk factors for poor clinical outcomes in patients with acute myocardial infarction (AMI). The coronary artery calcium score (CACS) is gathering attention as a predictor for future cardiovascular events. This study aimed to (1) measure CACSs in patients with AMI by non-ECG-gated computed tomography (CT), (2) compare clinical outcomes between patients with a high CACS and a low-intermediate CACS and (3) to elucidate the association between high CACS and clinical outcomes. Methods : We defined the high CACS group as the highest quantile of CACS (Q4) and defined the low-intermediate CACS group as the other quantiles of CACS (Q1-Q3). The primary endpoint was major adverse cardiovascular events (MACE), which were defined as the composite of all-cause death, re-admission for heart failure, non-fatal MI and target vessel revascularization. We included 548 patients with AMI who underwent non-ECG-gated CT and divided them into the high CACS group (CACS ≥ 5346.5, n = 137) and the low-intermediate CACS group (CACS ≤ 5329.3, n = 411). Results : During the median follow-up duration of 535 days, 150 MACE were observed. The Kaplan-Meier curves showed that MACE occurred more frequently in the high CACS group than in the low-intermediate CACS group ( p < 0.001). Multivariable Cox hazard analysis revealed that a high CACS was significantly associated with MACE (hazard ratio 1.597, 95% confidence interval 1.081-2.358, p = 0.019) after controlling for multiple confounding factors. Conclusions : Clinical outcomes were worse in AMI patients with a high CACS than in those with a low-intermediate CACS. A high CACS was significantly associated with MACE in multivariate analysis.

Background: The objectives of this phase two study are to investigate the efficacy of two starting doses of 8.4 g and 16.8 g and evaluate the long-term safety of patiromer in Japanese patients with hyperkalemia., Methods: This study comprised three cohorts; non-dialysis patients with baseline serum potassium (sK) level of 5.1 to < 6.0 mmol/L (NDC1); 6.0 to < 6.5 mmol/L (NDC2); dialysis patients with baseline sK level of 5.5 to < 6.5 mmol/L (DC). The study design was one-week, randomized, double-blind, placebo-controlled, and open label extension for one year in NDC1, open label during the study in NDC2 and DC. Patients were randomly assigned to patiromer 8.4 g, 16.8 g or placebo in NDC1, 8.4 g or 16.8 g in NDC2 and DC. Dose was adjusted up to 25.2 g according to the titration algorism in open label period., Results: A total of 185 patients were randomized (NDC1:153, NDC2:10, and DC:22). The primary endpoint of the change in least squares mean sK levels at Week 1 in NDC1 was  - 0.55,  - 0.77 and  - 0.10 mmol/L for the 8.4 g, 16.8 g and placebo group (P < 0.001 for the patiromer group vs the placebo group). In all cohorts for each patiromer group, more than 80% of patients achieved normal sK at Week 5. There was no severe treatment-related adverse event., Conclusion: Treatment with patiromer was effective in lowering and maintaining target sK levels, also well tolerated for one year in Japanese patients with hyperkalemia., Competing Interests: Declarations. Conflict of interest: N Kashihara has received consulting fees from AstraZeneca, Gilead Sciences, Kyowa Kirin, and GlaxoSmithKline, and has received honoraria for lectures from Daiichi Sankyo, Takeda Pharmaceutical, Astellas Pharma, Otsuka Pharmaceutical, and Kyowa Kirin, and has received research grants from Mitsubishi Tanabe Pharma, Toray Industries, Baxter, Chugai Pharmaceutical, Kyowa Kirin, Bayer Yakuhin, Ono Pharmaceutical, Daiichi Sankyo, Nippon Boehringer Ingelheim, Astellas Pharma, and Takeda Pharmaceutical. Y Kumeda, Y Higashino, Y Maeda, Y Kaneko and H Kanai have no conflicts of interest to declare. Y Taniguchi, T Ishii and Y Tomioka are employees of Zeria Pharmaceuticals., (© 2024. The Author(s).)

Objective: This study aimed to improve the health of peri-implant tissues through continuous intake of Lactobacillus salivarius WB21 (LSWB21) tablets., Methods: A double-blind, randomized controlled trial was conducted with 23 maintenance patients who had generally healthy oral peri-implant tissues. Participants were divided into a test group ( n = 12) receiving LSWB21 tablets and a control group ( n = 11) receiving placebos. All patients took one tablet three times daily for 2 months. Evaluation measures included modified Gingival Index (mGI), modified Plaque Index (mPI), modified Bleeding Index (mBI), salivary secretory IgA, and oral symptoms assessed at baseline, 1 month, and 2 months., Results: After 2 months, significant improvements in the mGI, mPI, and mBI were observed in the test group; significant improvement in the mPI was observed in the control group. Changes in the mGI over 2 months significantly differed between the groups ( p = 0.038), and multiple regression analysis confirmed the effectiveness of LSWB21 in reducing the mGI ( p = 0.034). Subjective symptoms such as bad breath in the test group and tongue symptoms in the control group also significantly improved., Conclusion: Continuous intake of LSWB21 may be beneficial for stabilizing peri-implant tissue., Trial Registration: UMIN000039392 (UMIN-CTR).

Background: Coronary artery angiography (CAG) and percutaneous coronary intervention (PCI) are superior to non-invasive approaches in reducing mortality in patients with ST-segment elevation myocardial infarction (STEMI). However, their efficacy remains uncertain in non-ST-elevation acute coronary syndromes (NSTE-ACS) and limited in low-resource settings. This study aimed to compare in-hospital and 5-year mortality rates between patients with a first event of STEMI and NSTE-ACS who underwent CAG and PCI and those with similar severity who did not undergo CAG and PCI., Methods: A propensity-matched retrospective cohort study was conducted using population-based claims data of national universal coverage of Thailand for identification of patients with acute coronary syndromes. The mortality of recruited patients was additionally linked to the national database of vital registration. Patients aged ≥ 40 years who were hospitalized for STEMI and NSTE-ACS in 2017, with a focus on access to CAG and PCI were included. For each condition either STEMI or NSTE-ACS, patients who underwent CAG and PCI were matched to those who did not undergo using propensity score matching (PSM) to balance measured confounders, such as age, sex, and underlying conditions. In-hospital mortality rate ratio and 5-year mortality were analyzed as measures., Results: Through PSM, 2,702 non-intervention STEMI patients were paired with an equal number of intervention patients, and similarly, 5,072 non-intervention NSTE-ACS patients were matched with an equivalent group who received interventions. For patients with STEMI, the in-hospital mortality rate ratio (95% confidence interval (CI)) for those who underwent CAG and PCI compared to those who did not was 30.1% (30.0%, 30.2%). Similar trends were observed in patients with NSTE-ACS with a mortality rate of 34.7% (34.6%, 34.8%). For the five-year mortality comparison, the hazard ratios (95% CI) of mortality after discharge were 0.55 (0.50, 0.62) for STEMI and 0.57 (0.54, 0.61) for NSTE-ACS cases., Conclusions: Access to CAG and PCI was significantly associated with lower in-hospital and 5-year mortality rates in patients who experienced their first event of ACS, despite the limited availability of some unmeasured or residual confounders. Healthcare systems should expand their resources for CAG and PCI in Thailand and other countries to equitably enhance longevity., Competing Interests: Declarations Ethics approval and consent to participate Patient data were encrypted and deidentified for personalized anonymization, according to the Thai Personal Data Protection Act 2019, Thailand. Data were obtained from the NHSO with project approval granted by the Human Research Ethics Committee of the Faculty of Medicine, Prince of Songkla University (REC No. 64-584-18-1). Informed consent was not required as the data obtained did not identify any individuals. Competing interests We have no conflicts of interest to declare., (© 2024. The Author(s).)

The method for a site-specific RNA acetylation using a novel oligonucleotide acetylating probe (Ac-probe) has been developed. It was confirmed that the acetyl group was site-specifically introduced to a 2'-OH of the sugar part of the target RNA via the formation of the RNA-probe duplex.

Competing Interests: The authors declare no conflict of interest.

Background Context: Low back pain (LBP) frequently occurs in patients with lumbar disc herniation (LDH), however the extent to which discectomy ameliorates it and how preoperative LBP influences postoperative outcomes remains unclear., Purpose: To evaluate the improvement in LBP and its impact on postoperative patient-reported outcome measures (PROMs)., Study Design/setting: Multicenter retrospective observational study., Patient Sample: Patients undergoing discectomy for LDH at 8 hospitals from April 2017 to March 2021., Outcome Measures: Data were collected on patients' backgrounds, operative factors, and PROMs, including the Numeric Rating Scale (NRS) for pain in the low back, buttock, or leg, EuroQol 5 Dimension (EQ-5D), Oswestry Disability Index (ODI) scores, and postoperative satisfaction., Methods: Patients were categorized into mild (NRS 0-3), moderate (NRS 4-7), or severe (NRS 8-10) LBP groups. Inverse probability weighting with propensity scores was used to adjust for demographic and clinical differences between groups. Chi-square tests and one-way analysis of variance were conducted to compare background data and clinical characteristics. Additionally, multivariate logistic regression was performed to identify risk factors for less than 50% improvement in LBP., Results: This study included 928 patients: 270 mild, 343 moderate, and 315 severe. After adjustment, preoperative NRS scores were significantly different across groups, with scores of 1.6 (SD 1.3), 5.6 (SD 1.0), and 8.8 (SD 0.9), respectively. Postoperative NRS scores also varied significantly, with worse outcomes observed in the severe group compared to the mild group, yet similar to the moderate group. A total of 46.8% of the mild group, 86.6% of the moderate group, and 72.9% of the severe group achieved a 50% decrease in NRS scores of LBP. Preoperative EQ-5D and ODI scores were significantly worse in the severe group compared to the mild or moderate groups, but postoperative scores were not significantly different between the severe and moderate groups. No significant differences in postoperative satisfaction were observed among the groups. Being female was a significant risk factor for less than 50% improvement in LBP (odds ratio = 1.56, p=.022)., Conclusions: Discectomy significantly improved LBP in patients with LDH, including those with moderate or severe LBP. Patients with severe LBP showed similar improvements in PROMs as those with moderate LBP. Female gender emerged as a significant risk factor for less than optimal improvement in LBP., Competing Interests: Declaration of competing interest During the preparation of this work, the authors used ChatGPT4 in order to assist with the English language editing. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication. One or more of the authors declare financial or professional relationships on ICMJE-TSJ disclosure forms., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Surgical site infections are common in spinal surgeries. It is uncertain whether outcomes in spine surgery patients with vs. without surgical site infection are equivalent. Therefore, we assessed the effects of surgical site infection on postoperative patient-reported outcomes., Methods: We enrolled patients who underwent elective spine surgery at 12 hospitals between April 2017 and February 2020. We collected data regarding the patients' backgrounds, operative factors, and incidence of surgical site infection. Data for patient-reported outcomes, namely numerical rating scale, Neck Disability Index/Oswestry Disability Index, EuroQol Five-Dimensional questionnaire, and 12-Item Short-Form Health Survey scores, were obtained preoperatively and 1 year postoperatively. We divided the patients into with and without surgical site infection groups. Multivariate logistic regression analyses were performed to identify the risk factors for surgical site infection. Using propensity score matching, we obtained matched surgical site infection-negative and -positive groups. Student's t-test was used for comparisons of continuous variables, and Pearson's chi-square test was used to compare categorical variables between the two matched groups and two unmatched groups., Results: We enrolled 8861 patients in this study; 74 (0.8 %) developed surgical site infections. Cervical spine surgery and American Society of Anesthesiologists physical status classification ≥3 were identified as risk factors; microendoscopy was identified as a protective factor. Using propensity score matching, we compared surgical site infection-positive and -negative groups (74 in each group). No significant difference was found in postoperative pain or dysesthesia of the lower back, buttock, leg, and plantar area between the groups. When comparing preoperative with postoperative pain and dysesthesia, statistically significant improvement was observed for both variables in both groups (p < 0.01 for all variables). No significant differences were observed in postoperative outcomes between the matched surgical site infection-positive and -negative groups., Conclusions: Patients with surgical site infections had comparable postoperative outcomes to those without surgical site infections., Competing Interests: Declaration of competing interest None., (Copyright © 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.)

Background: The INCREASE trial, conducted in the United States, showed that inhaled treprostinil improved exercise capacity in pulmonary hypertension associated with interstitial lung disease (PH-ILD). However, hemodynamic and pharmacokinetic measurements were not performed in the trial. The objective of this trial was to evaluate the efficacy on hemodynamics and exercise capacity, safety, and pharmacokinetics (PK) of inhaled treprostinil in Japanese patients with PH-ILD., Methods: This trial was a multicenter, non-randomized, open-label, single-arm trial of patients with PH-ILD. Inhaled treprostinil was administered at 3 breaths (18 μg)/session four times daily, and the dose was gradually increased to a maximum of 12 breaths (72 μg)/session. The primary endpoints were the change of pulmonary vascular resistance index (PVRI) and peak 6-min walking distance (6MWD) from baseline to week 16. Endpoints also included other efficacy parameters, safety, and PK., Results: Twenty patients received inhaled treprostinil. At week 16, PVRI decreased from baseline by -40.1% (95% CI, -53.1 to -27.2) and peak 6MWD increased by 13.0 m (95% CI, -15.0 to 49.0). The most frequently reported adverse events related with treprostinil were cough, malaise and blood pressure decreased. PK was similar to those in pulmonary arterial hypertension (PAH) patients., Conclusions: Treatment with inhaled treprostinil using the same dosing regimen as in the INCREASE trial resulted in improvements in hemodynamics and exercise capacity with a favorable tolerability and safety profile in Japanese patients with PH-ILD., Competing Interests: Declaration of competing interest Seiichiro Sakao received honoraria from Nippon Shinyaku. Co., Ltd.; Yasuhiro Kondoh received honoraria from Nippon Boehringer Ingelheim.; Hideyuki Kinoshita received honoraria from Nippon Shinyaku Co., Ltd.; Osamu; Nishiyama received honoraria from Janssen Pharmaceutical K.K, Nippon Boehringer Ingelheim, and Nippon Shinyaku Co., Ltd.; Takeshi Ogo received honoraria from Bayer Pharma Japan, Janssen Pharmaceutical K.K, and Nippon Shinyaku Co., Ltd.; Nobuhiro Tanabe received honoraria from Bayer Pharma Japan, Janssen Pharmaceutical K.K, and Nippon Shinyaku Co., Ltd.; Shun Minatsuki received research funding from Fukuda Denshi Co. Ltd. and Sumitomo Mitsui Trust Bank.; Kazuhiko Nakayama has no conflict of interest.; Yu Taniguchi received research grant from Janssen Pharmaceutical K.K.; Kenta Takahashi and Masahiro Takatsu are employees of Mochida Pharmaceutical. They have received remuneration and travel fees within the framework of their employment.; Takashi Ogura received honoraria from Nippon Boehringer Ingelheim., (Copyright © 2024 [The Author]. Published by Elsevier B.V. All rights reserved.)

Objective: To investigate the production of leucine-rich α-2-glycoprotein-1 (LRG1) in periodontitis patients and its effectiveness as a new diagnostic marker for periodontitis., Subjects and Methods: In vitro experiments were conducted to analyze LRG1 mRNA expression in human gingival epithelial cells and fibroblasts via quantitative real-time PCR. In vivo experiments were conducted to analyze LRG1 localization in periodontitis patients. The correlation between the serum LRG1 levels and alveolar bone resorption in the mouse periodontitis model was also investigated., Results: A positive correlation existed between the periodontal inflamed surface area and serum LRG1 levels (Spearman's rank correlation coefficient: 0.60). LRG1 mRNA expression in human gingival epithelial cells and fibroblasts was upregulated by Porphyromonas gingivalis stimulation or tumor necrosis factor-α stimulation. Interleukin-6 in human gingival epithelial cells and fibroblasts induced the production of LRG1 and transforming growth factor-β. LRG1 levels in the periodontal tissue and serum in the periodontitis model were higher than those in control mice. LRG1 local administration resulted in alveolar bone resorption, whereas the administration of interleukin-6R antibody inhibited bone resorption., Conclusions: LRG1 levels in serum and periodontal tissue are upregulated in periodontitis and are implicated in periodontal tissue destruction through interleukin-6 production., (© 2024 The Authors. Oral Diseases published by Wiley Periodicals LLC.)

Background: The optimal subsequent treatment strategy for locally advanced non-small cell lung cancer (LA-NSCLC) after chemoradiotherapy (CRT) and consolidative durvalumab therapy remains unknown. We aimed to determine the optimal subsequent treatment strategy for this clinical population., Materials and Methods: We retrospectively enrolled 523 consecutive patients with LA-NSCLC treated with CRT and analyzed the treatment outcomes of subsequent therapy after progression following CRT and consolidative durvalumab therapy. Patients who received tyrosine kinase inhibitors as subsequent therapy were excluded., Results: Out of 122 patients who received subsequent chemotherapy, 55% underwent platinum-based, 25% non-platinum-based, and 20% immune checkpoint inhibitor (ICI)-containing therapies. In the platinum-based group, patients with a durvalumab-progression-free survival (Dur-PFS) ≥ 1 year had a significantly longer median subsequent therapy-PFS (SubTx-PFS) than those with Dur-PFS < 1 year (13.2 months vs. 4.7 months; hazard ratio, 0.45; 95% confidence interval, 0.21-0.97; P = .04). Furthermore, among patients receiving non-platinum-based chemotherapy, the median SubTx-PFS was longer in the combined with angiogenesis inhibitor group than in the without group, although the difference was not statistically significant. No significant difference of SubTx-PFS was observed between the reason for durvalumab discontinuation and the outcomes of ICI-containing therapy., Conclusion: In clinical practice, platinum-based chemotherapy rechallenge is frequently employed following progression subsequent to CRT and consolidative durvalumab therapy for LA-NSCLC. Optimal treatment strategies may consider Dur-PFS and angiogenesis inhibitor feasibility. Further research is warranted to identify clinical biomarkers that can help identify patients who would benefit from ICI rechallenge., Competing Interests: Disclosure Hayato Kawachi reported receiving personal fees from AstraZeneca, Bristol-Myers Squibb, Chugai Pharmaceutical, Eli Lilly, MSD, Ono Pharmaceutical, and Taiho Pharmaceutical outside the submitted work. Motohiro Tamiya reported receiving personal fees from Amgen, Asahi Kasei Pharmaceutical, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Chugai Pharmaceutical, Eli Lilly, MSD, Ono Pharmaceutical, Pfizer, and Taiho Pharmaceutical outside the submitted work. Yuko Oya reported receiving personal fees from Amgen, AstraZeneca, Bristol Myers Squibb, Chugai Pharmaceutical, Eli Lilly, MSD, Novartis Pharma KK, Pfizer, Taiho Pharmaceutical, Daiichi Sankyo, and Takeda Pharmaceutical Company Limited outside the submitted work. Go Saito reported receiving personal fees from AstraZeneca, Chugai Pharmaceutical, Daiichi Sankyo Company, MSD, Novartis Pharma KK, Ono Pharmaceutical, Pfizer, and Taiho Pharmaceutical outside the submitted work. Yoshihiko Taniguchi reports receiving personal fees from AstraZeneca, Bristol Myers Squibb, Chugai Pharmaceutical, MSD, and Ono Pharmaceutical outside the submitted work. Hirotaka Matsumoto reported receiving personal fees from AstraZeneca, Boehringer Ingelheim, Chugai Pharmaceutical, Kyowa Kirin, MSD, Nippon Kayaku Co. Ltd., Ono Pharmaceutical, Taiho Pharmaceutical, and Takeda Pharmaceutical Company Limited outside the submitted work. Yuki Sato reported receiving personal fees from AstraZeneca, Bristol Myers Squibb, Chugai Pharmaceutical, Eli Lilly, MSD, Novartis Pharma KK, Ono Pharmaceutical, Pfizer, Taiho Pharmaceutical, Nippon Kayaku, Kyowa Kirin, and Takeda Pharmaceutical Company Limited outside the submitted work. Taiichiro Otsuki reported receiving personal fees from AstraZeneca, Bristol Myers Squibb, Chugai Pharmaceutical, Eisai Co. Ltd., MSD, Nippon Kayaku Co. Ltd., Ono Pharmaceutical, Takeda Pharmaceutical Company Limited, and Tsumura & Co. outside the submitted work. Hidekazu Suzuki reported receiving personal fees from AstraZeneca, Chugai Pharmaceutical, MSD, and Takeda Pharmaceutical Company Limited outside the submitted work. Yasushi Fukuda reported receiving personal fees from AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Chugai Pharmaceutical, Daiichi Sankyo, Merck Biopharma, MSD, Novartis, Ono Pharmaceutical, and Taiho Pharmaceutical outside the submitted work. Satoshi Tanaka declares that he has no competing financial interests or personal relationships that would affect the research reported in this paper. Yoko Tsukita reported receiving personal fees from AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Chugai Pharmaceutical, Daiichi Sankyo, Eisai, Eli Lilly, MSD, and Taiho Pharmaceutical outside the submitted work. Junji Uchida declares that he has no competing financial interests or personal relationships that would affect the research reported in this paper. Yoshihiko Sakata reported receiving personal fees from AstraZeneca, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Chugai Pharmaceutical Co Ltd, Eli Lilly, Kyowa KIRIN, MSD, Novartis Pharma KK, Taiho Pharmaceutical, Takeda Pharmaceutical Company Limited outside the submitted work. Yuki Nakatani declares that he has no competing financial interests or personal relationships that would affect the research reported in this paper. Ryota Shibaki reported receiving personal fees from AstraZeneca, Chugai Pharmaceutical, MSD, and Taiho Pharmaceutical outside of the submitted work. Daisuke Arai reported receiving personal fees from AstraZeneca, Chugai Pharmaceutical, Merck Biopharma Co. Ltd., MSD, Nippon Kayaku Co. Ltd., Ono Pharmaceutical, Taiho Pharmaceutical, and Takeda Pharmaceutical Company Limited outside the submitted work. Asuka Okada reported receiving personal fees from AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Chugai Pharmaceutical, Eli Lilly, Kyowa KIRIN, MSD, and Nippon Kayaku Co. Ltd. outside the submitted work. Satoshi Hara declares that he has no competing financial interests or personal relationships that would affect the research reported in this paper. Koichi Takayama reported receiving research grants from Chugai Pharmaceutical and Ono Pharmaceutical and personal fees from AstraZeneca, Boehringer Ingelheim, Chugai Pharmaceutical, Daiichi-Sankyo, Eli Lilly, MSD, and Merck outside the purview of the submitted work. Kazumi Nishino reported receiving grants from Ono, TAIHO, MSD, AbbVie, DAIICHI SANKYO, Amgen, Eisai, Sanofi, Janssen, Novartis, Pfizer, Eli Lilly, Merck, Takeda, Chugai, and Merus; and personal fees from AstraZeneca, Bristol Myers Squibb, Chugai, Eli Lilly, Janssen, Nippon Boehringer Ingerheim, Nippon Kayaku, Merck, Novartis, Pfizer, and Roche outside the submitted work., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background/aim: Catheter-related bloodstream infections (CRBSI) are frequently life-threatening. Several factors have been reported to be related to CRBSI development; however, the factors associated with CRBSI mortality are unclear as they have rarely been studied. This study investigated the factors associated with mortality in patients with CRBSI, specifically focusing on nutritional factors., Patients and Methods: This retrospective, multicenter study included in-patients with acute conditions and convalescent patients diagnosed with a CRBSI between January 2019 and December 2021 at 33 hospitals (23 general hospitals, two mixed-care hospitals, and eight convalescent hospitals). The primary outcome was death. Unadjusted and multivariable logistic regression analysis was performed to identify factors associated with mortality., Results: A total of 453 patients with CRBSI were enrolled. The causes of death were analyzed for 382 (84.3%) who survived CRBSI and 71 (15.7%) who died. Multivariable analysis revealed that Candida detected in blood culture [adjusted odds ratio (aOR)=2.72, 95% confidence interval (CI)=1.15-6.41; p=0.025)], CRBSI onset within 30 days of catheter insertion (aOR=2.28, 95% CI=1.27-4.09; p=0.005), concurrent infection (aOR=2.07, 95% CI=1.19-3.60; p=0.009), low serum albumin level (aOR=1.64, 95% CI=1.02-2.63; p=0.044), and elevated C-reactive protein level (aOR=1.05, 95% CI=1.01-1.10; p=0.028) were risk factors for mortality, whereas the use of a peripherally inserted central catheter was associated with a reduced risk of CRBSI mortality (aOR=0.30, 95% CI=0.13-0.69; p=0.004)., Conclusion: Enhanced monitoring of factors, such as candida detected in blood culture, CRBSI onset within 30 days of catheter insertion, concurrent infection, low serum albumin level, elevated C-reactive protein (CRP) level and the use of a peripherally inserted central catheter (PICC), is crucial for mitigating CRBSI severity and risk of death., (Copyright © 2024, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Although serum troponin level is the gold standard under the universal definition of acute myocardial infarction (AMI), serum creatinine kinase (CK) and creatine kinase-myocardial band (CK-MB) is still measured in clinical practice as the compliment of troponin level. The purpose of this retrospective study is to illustrate the dramatic change of CK-MB/CK ratio by comparing CK-MB/CK ratio in patients with ST-segment elevation myocardial infarction (STEMI) among ≤ 24 h before reaching peak CK, peak CK, ≤ 24 h after reaching peak CK, and 24-48 h after reaching peak CK. We included 502 patients with STEMI. We calculated each average CK-MB/CK ratio at ≤ 24 h before reaching peak CK, peak CK, ≤ 24 h after reaching peak CK, and 24-48 h after reaching peak CK. The average values were compared using Friedman test. The average CK-MB/CK ratio at ≤ 24 h before reaching peak CK, peak CK, ≤ 24 h after reaching peak CK, and 24-48 h after reaching peak CK was 0.096 (9.6% of CK), 0.098 (9.8% of peak CK), 0.076 (7.6% of CK), and 0.028 (2.8% of CK), respectively. The Friedman test suggested that the CK-MB/CK ratio significantly declined after reaching peak CK (p < 0.001). In conclusion, the CK-MB/CK ratio was around 0.1 (10% of CK) until CK-MB and CK reached the peak, but dropped sharply after reaching peak CK. The CK-MB/CK ratio less than 0.1 (10% of CK) cannot be used to rule out the possibility of AMI, when the onset of symptom is unclear or late presentation., (© 2024. Springer Nature Japan KK, part of Springer Nature.)

Purpose: The crankshaft phenomenon (CSP) is a corrective loss after posterior surgery for early onset scoliosis (EOS). However, an accurate method for CSP evaluation has yet to be developed. In this study, we evaluated pedicle screw (PS) length and rotation angle using an inverse trigonometric function and investigated the prevalence of the CSP., Methods: Fifty patients from nine institutions (mean age 10.6 years, male/female ratio 4:46) who underwent early definitive fusion surgery at ≤ 11 years of age were included. The rotation angle was calculated as arctan (lateral/frontal PS length) using radiography. Measurements were taken at the apex and lower instrumented vertebra (LIV) immediate, 2-, and 5-year postoperatively. CSP was defined as a rotation angle progression ≥ 5°. We divided patients into CSP and non-CSP groups and measured the demographic parameters, Risser grade, state of the triradiate cartilage, major coronal Cobb angle, T1-T12 length, T1-S1 length, and presence of distal adding-on (DAO). We compared these variables between groups and investigated the correlation between the measured variables and vertebral rotation. Logistic regression analysis investigated factors associated with CSP., Results: The rotation angle progressed by 2.4 and 1.3° over 5 years for the apex and LIV, respectively. CSP occurred in 15 cases (30%), DAO in 11 cases (22%), and CSP and DAO overlapped in 4 cases (8%). In the CSP group, the T1-T12 length was low immediate postoperatively. The rotation angle was negatively correlated with preoperative height (r = - 0.33), T1-T12 length (r = - 0.35), and T1-S1 length (r = - 0.30). A lower preoperative T1-T12 length was associated with CSP (odds ratio: 0.996, p = 0.048)., Conclusions: CSP occurred in 30% of patients with EOS who underwent definitive fusion. The presence of CSP was associated with a lower preoperative T1-T12 length., Level of Evidence: Diagnosis, level IV., (© 2024. The Author(s), under exclusive licence to Scoliosis Research Society.)

Background: This study aimed to clarify the effectiveness of nutrition support team (NST) facilities for preventing central line-associated bloodstream infection (CLABSI)., Methods: We retrospectively analyzed the incidence of CLABSI as well as the presence or absence of additional medical fees for NST activity between 2019 and 2021, including the period before and after the COVID-19 pandemic. Subsequently, we performed between-group comparisons of the CLABSI incidence. CLABSI rates were compared based on cumulative per 1000 catheter uses during the relevant period., Results: Among 47 facilities that were registered for participation, there were 34 and 13 facilities with and without additional medical fees for NST activity (NST and non-NST groups, respectively). The CLABSI incidence rate was significantly lower in the NST group 0.96 [0.28-1.73] than in the non-NST group 1.25 [075-6.10] (p < 0.05). Before the pandemic, the NST group had a lower CLABSI rate per 1000 catheter uses than the non-NST group 2019: 0.70 [0.12-1.26] vs 2.10 [0.62-5.97]. During the pandemic, the CLABSI incidence showed no significant between-group difference 2020: 0.99 [0.51-1.61] vs 1.01 [0.80-4.16]; 2021: 1.24 [0.44-2.35] vs 1.96 [1.23-5.31]; however, the CLABSI rates in the NST group remained low., Conclusion: During the COVID-19 pandemic, the incidence of CLABSI was lower in the NST group than in the non-NST group, indicating the effectiveness of NST in preventing the occurrence of CLABSI., (© 2024. The Author(s).)

Background: The management of chronic thromboembolic pulmonary hypertension (CTEPH) has advanced significantly in recent years, thereby improving patient prognosis. However, the impact of cancer on the outcomes of patients with CTEPH under current treatment remains unclear. This study aimed to investigate the prevalence of cancer in patients with CTEPH and determine how comorbid cancer affects their prognosis and clinical course., Methods: Data from an ongoing Japanese prospective cohort study were analyzed. Prevalence and primary cancer sites were evaluated. The association of a history of cancer with a composite endpoint, including all-cause death, lung transplantation, and worsening of CTEPH, as well as venous thromboembolism and bleeding events, was assessed., Results: Of the 1,270 patients in the cohort, 134 (10.6%) had a history of cancer, with the most common primary sites being the breast in women and the prostate in men. The incidence of composite outcome and all-cause death was higher in those with a history of cancer (p < 0.001, log-rank test). In the Cox proportional hazard model, age- and sex-adjusted hazard ratios for the composite outcome and all-cause death were 2.69 (95% confidence interval, 1.48-4.89, p = 0.001) and 4.25 (95% confidence interval, 1.98-9.10, p < 0.001), respectively, for patients with a history of cancer. No significant differences in venous thromboembolism and bleeding events were observed between patients with and those without a history of cancer., Conclusions: A history of cancer, with a prevalence of 10.6%, is an independent risk factor for mortality in patients with CTEPH undergoing the currently recommended treatment., Competing Interests: Disclosure statement Tsujino I. reports personal fees from Janssen Pharmaceutical and Nippon Shinyaku and affiliation with the division supported by endowments from Nippon Shinyaku, Nippon Boehringer Ingelheim, Mochida Pharmaceutical, Kaneka, Takeyama, and the Medical System Network outside the submitted work. Hosokawa K. reports personal fees from Janssen Pharmaceutical, Bayer Yakuhin, Nippon Shinyaku, and Pfizer outside the submitted work. Taniguchi Y. reported grants from Janssen Pharmaceutical and Nippon Shinyaku and personal fees from Janssen Pharmaceutical and Nippon Shinyaku outside the submitted work. Inami T. reports personal fees from Janssen Pharmaceutical and Bayer Yakuhin outside the submitted work. Yamashita J. reports a grant from Abbott Vascular Japan and personal fees from Kaneka Medix, Boston Scientific Japan, Nihon Kohden, Philips Japan, Janssen Pharmaceutical, and Bayer Yakuhin outside the submitted work. Ogino H. reports consulting fees from Terumo, Japan Lifeline, and Century Medical, outside the submitted work. Ikeda N. reports personal fees from Janssen Pharmaceutical, Bayer Yakuhin, Nippon Shinyaku, Daiichi Sankyo, and Bristol-Myers Squibb outside the submitted work. Yaoita N. reports personal fees from Bayer Yakuhin and Konica Minolta outside the submitted work. Shimokawahara H. reports a grant from Bayer Yakuhin and personal fees from Actelion Pharmaceuticals Japan, Bayer Yakuhin, and Nippon Shinyaku, outside the submitted work. Tanabe N. reports personal fees from Janssen Pharmaceutical, Bayer Yakuhin, and Nippon Shinyaku outside the submitted work. Kubota K. reports personal fees from Janssen Pharmaceutical and Nippon Shinyaku outside the submitted work. Ogihara Y. reports personal fees from Janssen Pharmaceutical, Bayer Yakuhin, Nippon Shinyaku, and Daiichi Sankyo and grants from Bayer Yakuhin and Daiichi Sankyo outside the submitted work. Kawakami T. reports personal fees from Kaneka Medix, Abbott Medical Japan., and ACIST Japan outside the submitted work. Tamura Y. reports grants from Bayer Yakuhin, Nippon Shinyaku, and Mochida Pharmaceutical and personal fees from Bayer Yakuhin, Nippon Shinyaku, Daiichi Sankyo, and Janssen Pharmaceutical outside the submitted work. Abe K. reports a grant from Konica Minolta and Daiichi Sankyo outside the submitted work. Nakamura J., Masaki K., Funakoshi K., Adachi S., Hatano M, Shigeta A., Horimoto K., Dohi Y., and Tatsumi K. report no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: Evidence on prophylactic drugs for pediatric migraine is limited, especially when comorbid conditions contribute to treatment resistance. This study evaluated the efficacy of cyproheptadine in children with migraine and explored the impact of comorbid neurodevelopmental disorders and orthostatic intolerance (OI)., Methods: We retrospectively analyzed pediatric migraine patients treated with cyproheptadine. Efficacy was assessed based on the reduction in headache frequency, with responders defined as patients experiencing at least a 50% reduction in headache episodes. Fisher's exact test analyzed the relationship between efficacy and comorbid conditions or treatment sequence. Multiple logistic regression was performed to identify factors associated with adverse events., Results: In total, 155 children (71 males, 84 females) aged 3-15 years were included. Comorbid neurodevelopmental disorders and OI were present in 27 (17.4%) and 22 (14.2%) patients, respectively. Efficacy was evaluated in 148 patients, with 68.9% classified as responders. Patients with comorbid conditions showed lower efficacy. Responders required a lower dose of cyproheptadine ( p = 0.039). Multiple logistic regression identified headache frequency, cyproheptadine dose, and comorbid OI and neurodevelopmental disorders as factors influencing treatment efficacy., Conclusions: Cyproheptadine is effective in treating pediatric migraine, though patients with neurodevelopmental disorders and OI demonstrated reduced efficacy.

Background and Aims: Data from randomized trials investigating different access closure strategies after transfemoral transcatheter aortic valve implantation (TF-TAVI) remain scarce. In this study, two vascular closure device (VCD) strategies to achieve hemostasis after TF-TAVI were compared., Methods: The ACCESS-TAVI (Comparison of Strategies for Vascular ACCESS Closure after Transcatheter Aortic Valve Implantation) is a prospective, multicenter trial in which patients undergoing TF-TAVI were randomly assigned to a strategy with a combined suture-/plug-based VCD strategy (suture/plug group) using one ProGlideTM/ProStyleTM (Abbott Vascular) and one Angio-Seal® (Terumo) versus a suture-based VCD strategy (suture-only group) using two ProGlidesTM/ProStylesTM. The primary endpoint was a composite of major or minor access site-related vascular complications during index hospitalization according to Valve Academic Research Consortium (VARC)-3 criteria. Key secondary endpoints included time to hemostasis, VARC-3 bleeding type ≥2 and all-cause mortality over 30 days., Results: Between September 2022 and April 2024, 454 patients were randomized. The primary endpoint occurred in 27% (62/230) in the suture/plug group and 54% (121/224) in the suture-only group (relative risk [RR] 0.55 [95% confidence interval: 0.44;0.68]; p<0.001). Time to hemostasis was significantly shorter in the suture/plug group compared to the suture-only group (108±208 s vs. 206±171 s; p <0.001). At 30 days, bleeding type ≥2 occurred less often in the suture/plug group compared to the sutureonly group (6.2% vs. 12.1%, RR 0.66 [0.43;1.02]; p=0.032), with no significant difference in mortality., Conclusions: With regard to the composite of major or minor access-related vascular complications, a combined suture-/plug-based VCD strategy was superior to a suturebased VCD strategy for vascular access closure in patients undergoing TF-TAVI., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

This study examines the association between dog ownership over a period of 5 years (always, sometimes and no ownership) with physical activity on weekdays and weekends over a period of 6 years using the nationally representative German Socio-Economic Panel. Participants were asked if they had any pets and how many hours they spend on sports, fitness, and exercise. We hypothesized that the length of dog ownership may have different effects on the physical activity of the owner. Overall, 15,240 participants completed the questionnaire on dog ownership in both 2011 and 2016, and reported their physical activity levels at least once between 2013 and 2018. Generalized estimating equation models showed that, compared to no ownership, always dog ownership was associated with higher physical activity on weekdays (Coefficient = 0.106, Standard Error: SE = 0.027, P < 0.001) and weekends (Coefficient = 0.121, SE = 0.033, P < 0.001) respectively, after controlling for related socio-demographic, physical, and psychological factors during the 6-year follow-up period. During the same follow-up period, sometimes dog ownership had no clear association with physical activity on both weekdays (Coefficient=-0.012, SE = 0.033, P = 0.706) and weekends (Coefficient = 0.049, SE = 0.039, P = 0.209) compared to no ownership. This study showed for the first time that longer dog ownership is associated with higher physical activity on both weekdays and weekends. Future research will be needed to investigate whether any causal relationships underlie the association., (© 2024. The Author(s).)

This study examines the kinetic origins of the temperature dependence of photoelectrochemical water oxidation on nanostructured titania photoanodes. We observe that the photocurrent is enhanced at 50 °C relative to 20 °C, with this enhancement being most pronounced (by up to 70%) at low anodic potentials (<+0.6 V vs RHE). Over this low potential range, the photocurrent magnitude is largely determined by kinetic competition between water oxidation catalysis (WOC) and recombination between surface holes and bulk electrons (back electron-hole recombination, BER). We quantify the BER process by transient photocurrent analyses under pulsed irradiation. Remarkably, we find that the kinetics of BER (∼90 ms half-time) are independent of temperature. In contrast, the kinetics of WOC, determined from the analysis of the photoinduced absorption of accumulated surface holes, are found to accelerate up to 2-fold at 50 °C relative to 20 °C. We conclude that the enhanced photocurrent densities observed in the low-applied potential region result primarily from the accelerated WOC, reducing losses due to the competing BER pathway. At higher applied potentials (>+0.6 V vs RHE), a smaller (∼10%) enhancement in photocurrent density is observed at 50 °C relative to 20 °C. Photoinduced absorption studies, correlated with studies using triethanolamine as a hole scavenger, indicate that this more modest enhancement at anodic potentials primarily results from an enhanced charge separation efficiency. We conclude by discussing the implications of these results for the practical application of photoanodic WOC under solar irradiation, influenced by these temperature-independent and -dependent underlying kinetic processes., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Context: Causative factors for ectopic ossifications in X-linked hypophosphatemia (XLH) remain to be elucidated., Objective: This work aimed to investigate the genotype-phenotype correlations between the phosphate-regulating endopeptidase homologue, X-linked gene ( PHEX ) and ectopic ossifications in XLH., Methods: Biochemical data, spinal computed tomography scans, and x-rays of hip/knee joints were retrospectively reviewed. Genetic analysis and the measurement of plasma inorganic pyrophosphate (PP i )-a potent inhibitor of tissue calcification-were performed. The effect of PHEX mutations on protein function was predicted using nonsense-mediated decay (NMD) and 3-dimensional structure modeling. The index of ossification of the anterior/posterior longitudinal ligament and yellow ligament (OA/OP/OY index) and the sum of the OA/OP/OY index (OS index) were used to quantify the severity of spinal ligament ossification. The severity of the hip/knee osteoarthritis was evaluated by the Kellgren-Lawrence classification., Results: We examined 24 distinct pathogenic PHEX variants in 28 patients from a study population of 33 individuals in 27 unrelated, nonconsanguineous families. Among the 31 patients whose plasma samples were analyzed for PP i , 14 patients (45%) showed decreased plasma PP i concentrations; however, PP i concentrations did not correlate with mutation type or ectopic ossification. Fibroblast growth factor 23 levels in women with NMD-insensitive mutations trended lower than in men with NMD-sensitive mutations but failed to reach statistical significance. Both models revealed no correlations between PHEX pathogenic variant and ectopic ossification., Conclusion: Neither modeling found correlates between PHEX pathogenic variants and ectopic ossification. The effects of PP i on ectopic ossifications in adults with XLH revealed trends that should be investigated with a large sample size., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)

Purpose: Polymorphisms (rs1815739; R577X) in the gene encoding alpha-actinin-3 (ACTN3) are thought to be associated with body composition and physical function in older people and athletes. RR homozygotes are associated with greater expression of ACTN3 protein in muscle than the X-allele carriers. We aimed to investigate the association between ACTN3 R577X polymorphism and appendicular skeletal muscle mass, walking speed, and muscle strength in older adults., Methods: A cross-sectional analysis was performed on 265 community-dwelling older adults (mean age 74.0 ± 5.8 years, 63.4% female) who provided data on ACTN3 gene polymorphisms and completed surveys in the Tarumizu study conducted between 2018 and 2019. Genetic polymorphisms were categorized as RR homozygous and X allele. Muscle mass was assessed using the appendicular skeletal muscle mass index (ASMI), and physical function was assessed based on walking speed and relative muscle strength. Those in the bottom 25% for each sex were considered "low" and the association with ACTN3 genotype was examined., Results: Considering ACTN3 polymorphism, 72 participants were RR homozygotes (27.2%) and 193 were X-allele carriers (72.8%). After adjusting for potential confounders, RR homozygosity was associated with not having low muscle mass (odds ratio 0.39, 95% confidence interval 0.19-0.82, p = 0.013) but not with low walking speed and muscle strength., Conclusion: The association between ACTN3 genotype and physical function in community-dwelling older adults is not clear; however, it is considered to be associated with muscle mass., (© 2024. The Author(s).)

Competing Interests: The authors declare no conflict of interest.

Depression is a serious public health problem that often emerges during adolescence. Many adolescents do not respond to standard treatments, necessitating the development of novel interventions. We conducted a preliminary study to assess the impact of a novel creative arts intervention on depression and well-being in adolescents. In this quasi-experimental study, 69 adolescents 12-17 years completed an 8-day "Creativity Camp" intervention encompassing multiple creative activities. Self-report questionnaires to measure depression, anxiety, and well-being were administered at five time points to allow examination of change across multiple temporal segments: the 2 weeks before the intervention, the 2 weeks during the intervention, the 2 weeks after the intervention, and the 6 months after the intervention. Adolescents were assigned to one of two groups to compare changes observed during the 2 week before-intervention period (Group A) to the changes observed during the intervention period (pre-post intervention) (Group B). According to both parent and child reports, pre-to-post-intervention, mean adolescent depressive symptoms significantly decreased, and these changes were sustained 2 weeks after the intervention and (according to parents) at the 6-month follow-up. There was preliminary evidence for improved well-being at post-intervention. Comparison of Group A's changes during the before-intervention period to Group B's changes pre-post intervention was significant for parent-reported depression. Preliminary evidence suggests that the Creativity Camp intervention may positively impact adolescent depression and well-being. This evidence highlights the importance of investigating and implementing treatment approaches focusing on creative arts for adolescents with depression., (© 2024. The Author(s).)