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Byline: Yosuke. Miki, Hideomi. Yamashita, Jun. Nakajima, Takahiro. Karasaki, Kentaro. Kitano, Atsuto. Katano, Ryousuke. Takenaka, Mami. Ogita, Subaru. Sawayanagi, Masanari. Minamitani, Haruka. Jinnouchi, Tomoyuki. Noyama, Kenta. Takeuchi, Aki. Ishida, Osamu. [...]

Pelvic lymph node dissection (PLND) is important for accurate staging and prognosis of prostate cancer. Several guidelines recommend extended pelvic lymph node dissection (ePLND) for patients with non-low-risk prostate cancer. However, the therapeutic benefits of ePLND are unclear. Therefore, we reviewed the literature regarding the therapeutic value of PLND for prostate cancer. Although some reports showed that ePLND improves postoperative biochemical recurrence and postoperative overall survival compared with limited lymph node dissection, other reports show no benefits. Overall, the current evidence supporting ePLND is poor. The extent of PLND varied among studies concerning the therapeutic value of ePLND, and study design issues such as patient background and length of follow-up period were different. Some reports demonstrated potential therapeutic value for ePLND when adjusting for patient background. Focusing on patients with high-grade prostate cancer may be important in demonstrating the therapeutic benefits of ePLND. Although the incidence of major adverse events related to ePLND was low, the possibility of adverse events such as lymphedema and lymphocele formation should be considered. In the future, we hope that evidence for optimal selection criteria for ePLND and the extent of ePLND will become more definitive and evidence for the therapeutic value of ePLND will be developed.

Graphical Abstract

This study presents the ferroelectric polarization stability characteristics of ultrathin (6 nm) superlattice (SL) ferroelectric layer metal-ferroelectric-metal (MFM) capacitors fabricated with varying ferroelectric layer stacks. Notably, ZrO2-HfO2 SL MFM capacitors with 1 nm ZrO2 as the starting layer exhibited enhanced polarization stability characterized by nearly wake-up free and fatigue-free behavior. The research demonstrates the deposition of ZrO2-HfO2 superlattice by atomic layer deposition (ALD), resulting in highly stable remanent polarization (2Pr @ 3.3 MV/cm) of approximately $30~\mu $ C/cm2. The variation remained small ( $\Delta 2$ P $_{\text {r}} \le 2.5~\mu $ C/cm2; $\Delta 2$ Pr/2P $_{\text {r, {pristine}}} \le 8$ %) over an impressive $10^{{10}}$ cycles of field cycling. This result is a crucial technique to address the polarization instability commonly reported in ultrathin ( $\le 6$ nm) Hf $_{{0}.{5}}$ Zr $_{{0}.{5}}$ O by utilizing the SL structure to achieve nearly wake-up free and fatigue-free polarization performance up to $10^{{10}}$ cycles.

We elucidated the interpenetration of silane coupling agent (SCA) molecules bound to Si substrates and overcoated rubber using spin-contrast-variation (SCV) neutron reflectivity (NR), which determines the nanostructure of multilayer films from polarized NR curves that change with polarization of hydrogen nuclei in the film samples. In an integral blend film of 15 wt % SCA of trimethoxy(octadecyl)silane and deuterated polybutadiene (dPB) annealed at 120 °C, the (1.7 ± 0.2) nm thick SCA layer was generated between the Si substrate and dPB layer. The SCA layer was composed of 70 vol % SCA molecules extended perpendicularly from the silicon substrate and 30 vol % of dPB molecules. The diffuseness of the interface between the SCA and dPB layers of (1.0 ± 0.2) nm was comparable to the thickness of the SCA layer. These results indicate that SCA and dPB molecules interpenetrate into each other. By contrast, in an SCA-precoated polybutadiene film sample, the layer thickness, diffuseness of interface, and composition of the SCA layer strongly suggest that the densely coated SCA molecules formed a crystal-like structure, and thus, the postcoated polybutadiene molecules could not penetrate into the precoated SCA layer. This poor penetration resulted in peeling off of the polybutadiene layer upon cooling to the cryogenic temperature.

We previously reported a novel compound called S-nitroso-N-pivaloyl-d-penicillamine (SNPiP), which was screened from a group of nitric oxide donor compounds with a basic chemical structure of S-nitroso-N-acetylpenicillamine, to activate the nonneuronal acetylcholine system. SNPiP-treated mice exhibited improved cardiac output and enhanced diastolic function, without an increase in heart rate. The nonneuronal acetylcholine–activating effects included increased resilience to ischemia, modulation of energy metabolism preference, and activation of angiogenesis. Here, we performed transcriptome analysis of SNPiP-treated mice ventricles to elucidate how SNPiP exerts beneficial effects on cardiac function. A time–course study (24 and 48 hours after SNPiP administration) revealed that SNPiP initially induced Wnt and cyclic guanosine monophosphate–protein kinase G signaling pathways, along with upregulation of genes involved in cardiac muscle tissue development and oxytocin signaling pathway. We also observed enrichment of glycolysis-related genes in response to SNPiP treatment, resulting in a metabolic shift from oxidative phosphorylation to glycolysis, which was suggested by reduced cardiac glucose contents while maintaining adenosine tri-phosphate levels. In addition, SNPiP significantly upregulated atrial natriuretic peptide and sarcolipin, which play crucial roles in calcium handling and cardiac performance. These findings suggest that SNPiP may have therapeutic potential based on the pleiotropic mechanisms elucidated in this study.

This study demonstrates the effect of fermented botanical product (FBP) on Ralstonia pseudosolanacearum-induced bacterial wilt disease and unravels its action mechanism. Soaking with diluted FBP solutions (0.1%-0.5%) significantly suppressed bacterial wilt in tomato plants, and FBP-treated tomato plants grew well against R. pseudosolanacearuminfection. Growth assays showed that FBP had no antibacterial effect but promoted R. pseudosolanacearumgrowth. In contrast, few or no R. pseudosolanacearumcells were detected in aerial parts of tomato plants grown in FBP-soaked soil. Subsequent infection assays using the chemotaxis-deficient mutant (ΔcheA) or the root-dip inoculation method revealed that FBP does not affect pathogen migration to plant roots during infection. Moreover, FBP-pretreated tomato plants exhibited reduced bacterial wilt in the absence of FBP. These findings suggest that the plant, but not the pathogen, could be affected by FBP, resulting in an induced resistance against R. pseudosolanacearum, leading to a suppressive effect on bacterial wilt.Graphical AbstractFermented botanical product (FBP), a fertilizer produced by fermenting 41 kinds of materials, suppresses bacterial wilt of tomatoes caused by Ralstonia pseudosolanacearum.

An 88-year-old woman was admitted to our hospital with the sudden onset of dyspnea after eating. The patient had undergone nephrectomy for a left renal tumor 24 years previously. The patient had been prescribed ferrous citrate for iron-deficiency anemia. She complained of appetite loss a few days before admission but had no abdominal pain. CT scan showed no abnormalities in the lungs but a mass in the liver.

We investigated the previously unexplored domain of water vapor/gas separation using graphene oxide (GO) membranes, expecting future applications, including gas dehumidifiers and superior humidity controllers. While the importance of manipulation of GO nanosheet size and surface chemistry in traditional water purification and gas separation has been acknowledged, their potential impact on water vapor/gas separation remained unexplored until now. We applied sonication and hydrogen peroxide treatments to GO water dispersions and systematically evaluated the size and surface chemistry of each GO nanosheet. Both treatments reduced the GO nanosheet size to shorten the diffusion length, which improved water permeance. In addition, hydrogen peroxide treatment improved the hydrophilicity of the nanosheet. Our novel findings demonstrate that optimization of GO nanosheet size and the increase in their hydrophilicity via hydrogen peroxide treatments for 5 h significantly enhance water permeance, leading to a remarkable water vapor permeance of 4.6 × 10–6mol/(m2s Pa) at 80 °C, a 3.1-fold improvement over original GO membranes, while maintaining a water vapor/nitrogen permeance ratio exceeding 10,000. These results not only provide important insights into the nature of water vapor/gas separation but also suggest innovative methods for optimizing the GO membrane structure.

Background: There is an increasing demand for automated surgical skill assessment to solve issues such as subjectivity and bias that accompany manual assessments. This study aimed to verify the feasibility of assessing surgical skills using a surgical phase recognition model. Methods: A deep learning-based model that recognizes five surgical phases of laparoscopic sigmoidectomy was constructed, and its ability to distinguish between three skill-level groups—the expert group, with a high Endoscopic Surgical Skill Qualification System (ESSQS) score (26 videos); the intermediate group, with a low ESSQS score (32 videos); and the novice group, with an experience of < 5 colorectal surgeries (27 videos)—was assessed. Furthermore, 1 272 videos were divided into three groups according to the ESSQS score: ESSQS-high, ESSQS-middle, and ESSQS-low groups, and whether they could be distinguished by the score calculated by multiple regression analysis of the parameters from the model was also evaluated. Results: The time for mobilization of the colon, time for dissection of the mesorectum plus transection of the rectum plus anastomosis, and phase transition counts were significantly shorter or less in the expert group than in the intermediate (p= 0.0094, 0.0028, and < 0.001, respectively) and novice groups (all p< 0.001). Mesorectal excision time was significantly shorter in the expert group than in the novice group (p= 0.0037). The group with higher ESSQS scores also had higher AI scores. Conclusion: This model has the potential to be applied to automated skill assessments. Graphical abstract:

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Bead-on-plate welding of pure copper with a blue-IR hybrid laser was conducted to achieve a spatter suppression in deep penetration welding of pure copper for the performance improvement of battery and power device of e-mobility. This hybrid laser combines an infrared (IR) laser and a blue diode laser as the welding source and preheating source, respectively. Preheating increases the light absorptivity of pure copper in the IR region. A 1.5-kW blue diode laser was employed to increase the light absorptivity by changing the phase of the preheated area from solid phase to liquid and gas phase. By experimentally investigating the influence of the blue diode laser intensity, the phase effects of the preheated area on pure copper welding with a blue-IR hybrid laser are elucidated. As a result, it was found that a liquid preheated area minimizes spatter during deep penetration welding.

We report the syntheses of novel marine biodegradable poly(ethylene succinate) (PES)- and poly(butylene succinate) (PBS)-based copolymers containing different dicarboxylic acid (DCA) units with various carbon numbers and different feed ratios. Biochemical oxygen demand tests demonstrated that some of the obtained PES- and PBS-based copolymers were biodegradable in seawater. Specifically, polymers with longer-chain DCA units, even at low contents, exhibited marine biodegradability. The thermomechanical properties of the copolymers, such as their thermal stabilities, melting points, glass transition temperatures, tensile moduli, strains at break, and stresses at break, also varied with the DCA contents. These results indicated that the thermomechanical properties and the marine biodegradabilities of the PES- and PBS-based copolymers were regulated by controlling their structures and DCA contents. The polymers obtained in this study may replace general-purpose polymers. Our approach may also be applicable to other polymeric materials. Furthermore, our findings pave the way for the rational design and preparation of polymeric materials that are biodegradable in environments other than oceans and have good thermomechanical properties.

Since lung magnetic resonance imaging (MRI) became clinically available, limited clinical utility has been suggested for applying MRI to lung diseases. Moreover, clinical applications of MRI for patients with lung diseases or thoracic oncology may vary from country to country due to clinical indications, type of health insurance, or number of MR units available. Because of this situation, members of the Fleischner Society and of the Japanese Society for Magnetic Resonance in Medicine have published new reports to provide appropriate clinical indications for lung MRI. This review article presents a brief history of lung MRI in terms of its technical aspects and major clinical indications, such as (1) what is currently available, (2) what is promising but requires further validation or evaluation, and (3) which developments warrant research-based evaluations in preclinical or patient studies. We hope this article will provide Investigative Radiologyreaders with further knowledge of the current status of lung MRI and will assist them with the application of appropriate protocols in routine clinical practice.

Background: Postoperative pancreatic fluid collections (POPFCs) are common adverse events (AEs) after pancreatic surgery and may need interventions. Endoscopic ultrasound (EUS)-guided drainage for POPFCs is increasingly reported, but its appropriate timing has not been fully elucidated. The aim of this meta-analysis was to evaluate treatment outcomes of POPFCs according to the timing of EUS-guided drainage. Methods: Using PubMed, Embase, Web of Science, and the Cochrane database, we identified clinical studies published until December 2022 with data comparing outcomes of early and delayed EUS-guided drainage for POPFCs. We pooled data on AEs, mortality, and technical and clinical success rates, using the random-effects model. Results: From 1415 papers identified in the initial literature search, we identified 6 retrospective studies, including 128 and 107 patients undergoing early and delayed EUS-guided drainage for POPFCs. The threshold of early and delayed drainage ranged from 14 to 30 days. Distal pancreatectomy was the major cause of POPFCs, ranging from 44 to 100%. The pooled odds ratio (OR) for AEs was 0.81 (95% confidence interval [CI] 0.40–1.64, P= 0.55) comparing early to delayed drainage. There was no procedure-related mortality. Technical success was achieved in all cases and a pooled OR of clinical success was 0.60 (95% CI 0.20–1.83, P= 0.37). Conclusion: POPFCs can be managed by early EUS-guided drainage without an increase in AEs.

Abstract: Objective: Exposure to polychlorinated biphenyls (PCBs) is considered to have culminated between 1950 and 1970 in Japan, and exposure through diet, the major exposure route, has decreased significantly over the last 10 years. The primary goal of the present study was to investigate the long-term trends and congener profiles of serum and dietary levels of PCBs using historical samples. Methods: Using banked samples collected in 1980, 1995, and 2003 surveys, we determined the daily intakes and serum concentrations of 13 PCB congeners (#74, #99, #118, #138, #146, #153, #156, #163, #164, #170, #180, #182, and #187) in women. Results: The total daily PCB intake [ng/day, geometric mean (geometric standard deviation)] decreased significantly from 523 (2.5) in 1980 to 63 (3.2) in 2003. The serum total PCB level (ng/g lipid) in women <40 years of age decreased significantly from 185 (1.8) in 1980 to 68 (1.8) in 2003. In contrast, the level in women >50 years of age increased significantly from 125 (1.7) in 1980 to 242 (1.7) in 2003. Specifically, the serum concentrations of hexa (#138, #146, #153, #156, #163, and #164) and hepta (#170, #180, #182, and #187) congeners increased significantly. A comparison of the serum PCB levels of women born from 1940 to 1953 revealed that their serum total PCB level was significantly higher in the 2003 survey [242 (1.7), n = 9] than in the 1995 [128 (2.0), n = 17] surveys. This increase in the total PCB level was attributable to increases in the hepta congener groups. Conclusion: Present results suggest a decreased rate of elimination of hepta congeners with aging in females, rather than a birth-generation phenomenon.

Abstract: Purpose: Mosapride citrate (mosapride) is a serotonin 5-hydroxytryptamine 4 receptor agonist known to promote gastric emptying and large-intestine motility. We assessed the effect of mosapride on postoperative ileus following colon surgery. Methods: Forty patients with colon cancer undergoing hand-assisted laparoscopic colectomy were randomly assigned to a mosapride group or a control group. The mosapride group received 15 mg of mosapride by mouth with 50 ml of water three times a day, starting on postoperative day 1. The control group received 50 ml of water on the same schedule. Patients were allowed to resume oral feeding on the evening of postoperative day 2. Postoperative time to first bowel movement was evaluated by one investigator blinded to treatment. Postoperative gastric emptying was evaluated with the [13C]-acetate breath test at 24 and 48 hours after the operation. Results: Postoperative time to first bowel movement was significantly shorter in the mosapride group than in the control group (48.5 vs. 69.3 hours, P = 0.0149). The time to maximal gastric emptying rate as determined by the breath test was significantly shorter in the mosapride group than in the control group at the 48-hour time point (27.9 vs. 35.3 minutes, P = 0.0294). Postoperative hospital stay was shorter in patients receiving mosapride than in controls (6.7 vs. 8.4 days, P = 0.0398). No adverse effects were observed with mosapride. Conclusions: Gastric emptying was improved by mosapride. The results suggested that the period of postoperative ileus following hand-assisted laparoscopic colectomy can be shortened by treatment with mosapride.

We previously demonstrated that dietary supplementation with Dunaliella tertiolecta(DT) increases uncoupling protein 1 (UCP1) expression in brown adipose tissue (BAT) and improves diet-induced obesity (DIO) in C57BL/6 J mice at thermoneutrality (30 °C). Here, we investigated whether DT improves DIO in a thermoneutral UCP1-deficient (KO) animal. KO mice were fed a high-fat diet supplemented with DT for 12 weeks. Compared to control group without DT, body weight was significantly reduced in DT group with no difference in food intake. Dunaliella tertiolecta-supplemented mice exhibited lower adiposity and well-maintained multilocular morphology in BAT, in which a significant increase in gene expression of PR domain containing 16 was detected in DT group compared to control group. Moreover, increase in UCP2 level and/or decrease in ribosomal protein S6 phosphorylation were detected in adipose tissues of DT group relative to control group. These results suggest that DT supplementation improves DIO by stimulating UCP1-independent energy dissipation at thermoneutrality.Graphical AbstractDunaliella tertiolectasupplementation improves diet-induced obesity by stimulating UCP1-independent energy dissipation at thermoneutrality.

We successfully demonstrated an add-drop Si microring resonator switch using an InGaAsP/Si hybrid metal-oxide-semiconductor (MOS) optical phase shifter. We revealed that a Si shallow rib waveguide is effective to achieve a quasi-single-mode microring resonator, even when employing a 200-nm-thick InGaAsP membrane on the Si ring waveguide. Owing to the careful design in the Si waveguide, we experimentally demonstrated the well-behaved add-drop switching operation using the InGaAs/Si hybrid MOS phase shifter with a modulation efficiency of 0.53 Vcm. The integration of a 200-nm-thick InGaAsP enabled both positive and negative phase tuning through carrier accumulation and depletion at the InGaAsP MOS interface. As a result, the modulation efficiency was improved by a factor of 7.5, compared to the hybrid MOS phase shifter utilizing a 25-nm-thick InP membrane. With an insignificant gate leakage current, we achieved an exceptionally low switching power of 150 fW. Additionally, the measured switching time was less than 6 ns. These characteristics make the demonstrated add-drop microring resonator switch highly promising for wavelength division multiplexed programmable photonic integrated circuits.

In-line optical power monitors are essential building blocks in a Si programmable photonic integrated circuit (PIC) for calibrating optical phase shifters and correcting phase errors inevitably induced in a PIC. Nevertheless, current state-of-the-art in-line optical power monitors struggle to simultaneously achieve low optical loss and high responsivity. Here, we demonstrate an in-line optical power monitor using a waveguide phototransistor with an ultrathin InP membrane. The trap-mediated photodetection with the photogating effect of a phototransistor enables the detection of a weak light down to −44 dBm with an optical insertion loss of &lt; 0.25 dB at a wavelength of 1550 nm. We measured the switching speed to be approximately 100 μs, which is sufficiently fast for optical power monitoring applications. Furthermore, a Mach–Zehnder interferometer (MZI) with an energy-efficient InP/Si hybrid metal-oxide-semiconductor (MOS) optical phase shifter was monolithically integrated with the proposed InP/Si hybrid phototransistor using the same fabrication process. The photocurrent of the phototransistor increased with the input light power modulated by the InP/Si hybrid MOS phase shifter, demonstrating in-line optical power monitoring using an InP/Si hybrid phototransistor. The proposed InP/Si hybrid phototransistor is promising for transparent optical power monitoring in a Si programmable PIC by III–V/Si hybrid integration.

We propose a low-insertion-loss (IL) and non-volatile optical intensity modulator based on Ge2Sb2Te3S2 (GSTS), a recently proposed Se-free wide-gap phase change material. Owing to the negligibly small optical absorption of amorphous GSTS at a wavelength of 1550 nm, a non-volatile intensity modulator with a low IL of less than 0.08 dB and a high extinction ratio (ER) of 19.6 dB is realized using GSTS with a device length of 8 μm, overcoming the trade-off relationship between IL and ER in conventional Ge2Sb2Te5 (GST). Using visible laser light irradiation, we demonstrate multilevel modulation up to 24 levels by taking advantage of the small optical absorption of amorphous GSTS and the moderately large optical absorption of crystalline GSTS compared with GST. With the proposed GSTS intensity modulators, we demonstrate 4×4 matrix-vector multiplication using a recently proposed photonic tensor core, which shows a high tolerance to hardware error accumulation. On the basis of the experimental results, we numerically confirm that a high recognition accuracy of 97.33% can be obtained using a convolutional neural network with emulated optical convolutional operations.

Background: Pelvic exenteration (PE) is the last resort for achieving a complete cure for pelvic cancer; however, it is burdensome for patients. Minimally invasive surgeries, including robot-assisted surgery, have been widely used to treat malignant tumors and have also recently been used in PE. This study aimed to evaluate the safety and efficacy of robot-assisted PE (RPE) by comparing the outcomes of open PE (OPE) with those of conventional laparoscopic PE (LPE) for treating pelvic tumors. Methods: Following the ethics committee approval, a multicenter retrospective analysis of patients who underwent pelvic exenteration between January 2012 and October 2022 was conducted. Data on patient demographics, tumor characteristics, and perioperative outcomes were collected. A 1:1 propensity score-matched analysis was performed to minimize group selection bias. Results: In total, 261 patients met the study criteria, of whom 61 underwent RPE, 90 underwent OPE, and 110 underwent LPE. After propensity score matching, 50 pairs were created for RPE and OPE and 59 for RPE and LPE. RPE was associated with significantly less blood loss (RPE vs. OPE: 408 mL vs. 2385 ml, p&lt; 0.001), lower transfusion rate (RPE vs. OPE: 32% vs. 82%, p&lt; 0.001), and lower rate of complications over Clavien–Dindo grade II (RPE vs. OPE: 48% vs. 74%, p= 0.013; RPE vs. LPE: 48% vs. 76%, p= 0.002). Conclusion: This multicenter study suggests that RPE reduces blood loss and transfusion compared with OPE and has a lower rate of complications compared with OPE and LPE in patients with locally advanced and recurrent pelvic tumors.

Hf0.5Zr0.5O2 (HZO)-based ferroelectric field effect transistor (FeFET) has been recognized as a promising nonvolatile memory due to its excellent scalability and CMOS process compatibility. To realize memory operation with low operating voltage, it is essential to gain a systematic understanding of HZO scaling effects, especially under the thickness of HZO < 10 nm conditions. In this work, we study n-FeFET with HZO thickness ranging from 4.1 to 11 nm and analyze the HZO scaling effects in FeFET. Differing from metal–ferroelectric–metal (MFM) with thin HZO, FeFET with thin HZO shows no strong wake-up effect. Besides, the low-voltage operation, low subthreshold swing (SS) value, and higher current memory window (MW) (or ${I}_{ \mathrm{\scriptscriptstyle ON}}/{I}_{ \mathrm{\scriptscriptstyle OFF}}$ ratio) brought by HZO scaling are revealed. Moreover, the lower charge trapping density is observed in FeFETs with HZO thinner than 10 nm and improved read-after-write delay is observed in 5.2-nm FeFET. This work sets up a systematical direction for understanding the scaling impacts of HZO on the electrical characteristics of Si FeFET.

A 9-y-old Mangalarga Marchador gelding was referred to a veterinary hospital because of a swelling on the upper right side of the neck. Ultrasound examination revealed a multilocular structure adjacent to the thyroid gland with low echogenic content suggestive of fluid. The mass was removed surgically. Histologically, the cystic cavities in the surgical sample were filled with abundant eosinophilic secreta and lined by cuboidal, segmentally ciliated, columnar epithelium with interspersed goblet cells. Segmental crowding of the multilayered lining of the cyst was noted. Immunohistochemistry suggested the presence of both C cells and follicular cells, given the positivity of the immunomarkers calcitonin and TTF-1, respectively. The histogenesis of ultimobranchial cysts is uncertain. Based on clinical, histopathologic, and immunohistochemical identification, the cystic structure in this case is compatible with an ultimobranchial body cyst.

A mystery shopping company accumulates numerous subjective evaluations of services by mystery shoppers in various industries. Mystery shopping companies can develop more sophisticated sending plans of mystery shoppers if they understand the tendency of subjective evaluation of each mystery shopper. We examined the possibility of using lifestyle factor scores to represent the mystery shoppers' tendency of subjective services evaluations. Using multi-group structural equation modelling on mystery shopping data of Japanese pubs, reported by 4,686 mystery shoppers, we demonstrate that their lifestyle factors influence their service evaluation. Our results suggest that considering the lifestyle of mystery shoppers provide a new avenue in understanding mystery shopping.

Background: Subcutaneous emphysema (SCE) is a common complication in laparoscopic surgery. However, its precise incidence and impact on the clinical course are partially known. In this study, the incidence and risk factors of SCE were retrospectively analyzed. Methods: Patients who underwent laparoscopic/robotic abdominal surgery (e.g., gastrointestinal, hepatobiliary, gynecologic, and urologic surgery) between October 2019 and September 2022 were retrospectively analyzed. The presence of SCE was confirmed by either conclusive findings obtained through chest/abdominal X-ray examination immediately after operation, or intraoperative palpation conducted by nurses. X-ray examination was performed in the operation room before extubation. Results: A total of 2503 patients treated with laparoscopic/robotic abdominal surgery between October 2019 and September 2022 were identified and all of them were included in the analysis. SCE was confirmed in 23.1% of the patients (i.e., 577/2503). SCE was identified by X-ray examination in 97.6% of the patients. Extubation failure was observed in 10 patients; however, pneumothorax was not observed. Female sex (odds ratio [OR]: 2.09; 95% confidence interval [95%CI]: 1.69–2.57), age ≥ 80 years (OR 1.63; 95%CI 1.19–2.22), body mass index &lt; 20 (OR 1.32; 95%CI 1.06–1.65), operation time > 360 min (OR 1.97; 95%CI 1.53–2.54), robotic surgery (OR 2.54; 95%CI 1.91–3.38), maximum intraabdominal pressure with CO2> 15 mmHg (OR 1.79; 95%CI 1.02–3.16), and endo-tidal CO2> 50 mmHg (OR 1.32; 95%CI 1.08–1.62)were identified as independent factors of SCE. Regarding the extubation failure due to SCE, age (OR 5.84; 95%CI 1.27–26.8) and maximum intraabdominal pressure with CO2(OR 21.7; 95%CI 4.76–99.3) were identified as risk factors. Conclusion: Although the presence of SCE is associated with a low risk of severe complications, monitoring of the perioperative intraabdominal pressure is essential for performing safe laparoscopic/robotic surgery, particularly in elderly patients.

Mg-Li system alloys also has excellent cold-workability compared to commercial hcp-structured Mg alloys. However, Mg-Li alloys have poor corrosion resistance because not only that is Mg-based alloy but Li as a major alloying element is a less noble metal. For example, Mg-Li alloy sheet indicates high corrosion rate and exfoliation corrosion as a result of long-term corrosion test. The authors reported Mg-14 mass%Li-3 mass%Al alloy has the highest corrosion resistance in β-type solid solution alloy. Even though the optimized alloy composition, the alloy does not have enough corrosion resistance for practical use. In this study, anodized coating on Mg-Li alloy using phosphate solution was investigated. Anodizing of Mg-Li alloy facilitates the dissolution of substrate because of high Li concentration in this alloy. Therefore, the anodizing conditions were widely examined. As a result, the coating with approximately 15-20 μm of the surface layer was successfully formed. The surface layer was composed of MgAl2O4 and some phosphorus compounds. The thickness of anodized layer varied with the anodizing conditions. The dense surface layer was formed at a certain anodizing voltage and the corrosion resistance of anodized Mg-Li alloys was improved. However, the surface has some cracks and large flaky compounds. The formation mechanism of dense layer during anodizing were discussed.

The serial changes in intraventricular pressure gradient in the left ventricle and NYHA functional classification in each case. Both the left intraventricular pressure gradient and symptoms improved after right ventricular pacing. In one case, the left intraventricular pressure gradient disappeared immediately after right ventricular pacing, while in the others it disappeared during the chronic phase, more than a year later.

Coordination polymerization of a series of 2-substituted-[3]dendralenes, i.e., phenyl- (P3D), hexyl- (H3D), and trimethylsilyl-substituted [3]dendralenes (TMS3D), was investigated. No polymerization was observed for TMS3D, whereas P3D polymerized by CpTiCl3as a catalyst and modified methylaluminoxane as an auxiliary catalyst to generate polymers that became insoluble in the process of isolation. Additionally, the coordination polymerization of H3D was conducted using a CpTiCl3/modified methylaluminoxane catalyst to produce polyH3D with mainly a trans-4,6 structure, which differs from that of the polymer obtained via anionic polymerization. The copolymerization of isoprene with H3D was also examined, and it was found that the reaction proceeded in a random fashion.

In 2019, N-nitrosodimethylamine (NDMA) exceeding the maximum allowable intake (96 ng/day) was detected in metformin drug products in Singapore, and since then, many of the drug products have been voluntarily recalled globally for the same reason. In our company, the analysis of the metformin drug products showed that small batches (1.9%) of products contained the excessive level of NDMA, so we investigated the root cause of NDMA formation. As a result, we found that dimethylamine (DMA) in the active pharmaceutical ingredient (API) used in the manufacturing process and nitrogen dioxide (NO2) in the atmosphere had considerable influence on the formation of NDMA in metformin drug products. The results of a model experiment simulating a fluidized bed granulator also supported the hypothesis that atmospheric NO2introduced into the granulator N-nitrosated DMA in the API to form NDMA.

Introduction:Whether white blood cell (WBC) counts are predictors for the effectiveness of thiopurine treatment in ulcerative colitis (UC) has been inconclusive in previous studies with small sample sizes. We investigated the association between WBC counts and future relapses in UC patients in a large-scale multi-center study. Methods:This retrospective cohort study enrolled a total of 723 UC patients in remission from 33 hospitals and followed up for 3 years. Relapse was defined as a need for treatment intensification. The risk of relapse was compared among patients with the baseline WBC counts <3,000/µL (N= 31), 3,000–4,000/µL (N= 167), 4,000–5,000/µL (N= 241), and ≥5,000/µL (N= 284) using a Cox regression model analysis. Moreover, exploratory analyses were conducted to identify other factors predicting relapse. Results:During a median follow-up period of 1,095 (interquartile range, 1,032–1,119) days, relapse occurred in 17.2% (125/723). In a crude analysis, WBC counts were not associated with relapse; hazard ratios (HRs) (95% confidence interval [CI]) were 1.50 (0.74–3.06), 1.02 (0.66–1.59), and 0.67 (0.43–1.05) in WBC <3,000/µL, 3,000–4,000/µL, and 4,000–5,000/µL groups, respectively (WBC ≥5,000/µL group, as reference). Multivariable-adjusted analyses showed similar results; HRs (95% CI) were 1.21 (0.59–2.49), 1.08 (0.69–1.69), and 0.69 (0.44–1.07), in <3,000/µL, 3,000–4,000/µL, and 4,000–5,000/µL groups, respectively. In the exploratory analyses, thiopurine use <1 year and a mean corpuscular volume <90 fL were predictors for relapse. Discussion/Conclusion:WBC counts were not predictors for future relapses in patients with UC treated with thiopurine as a maintenance therapy.

This work demonstrates the direct bonding of stainless steel (SUS304) to poly(ether ether ketone) (PEEK) using non-thermal atmospheric pressure plasma-assisted joining technology in association with thermal press fitting. The tensile shear stress values of specimens bonded after plasma treatment of both the SUS304 and PEEK surfaces were higher than those of untreated samples and samples for which only one of the two surfaces was exposed to the plasma. These results indicate that the surface physical and chemical changes induced by exposure to the radio frequency plasma jet significantly increased the bonding strength.

Sn–45Bi–2.6Zn–0.5In and Sn–45Bi–2.6Zn–1In alloys have previously been shown to be superior to Sn–58Bi under the thermal aging test. In this study, a comparative analysis of the microstructure and impact strength of Sn–58Bi, Sn–45Bi–2.6Zn–0.5In, and Sn–45Bi–2.6Zn–1In alloy bumps was conducted before and after high-humidity and high-temperature tests. Cross-sectional microstructure observations and impact tests were performed on all alloy bumps. The results indicated that the high-humidity and high-temperature conditions had a slight influence on the Sn–58Bi alloy bump, but it reduced the maximum force of Sn–45Bi–2.6Zn–0.5In and Sn–45Bi–2.6Zn–1In to almost zero and generated voids at the interface between the alloy and Cu pad after the test. This deterioration was mainly attributed to the formation of voids on the accumulated Zn at the interface under the effects of both high-humidity and high-temperature conditions. In addition, a possible approach for enhancing the impact strength of Zn-containing alloy bumps by adjusting the heating profile was proposed, and it was verified that the maximum force of the Zn-containing alloy bumps was significantly improved.

We determined the higher-order structures of polymer-brush-modified nanoparticles (PSiPs) in ionic liquids and explained the self-assembled structures as functions of the PSiP concentrations and brush lengths. The two types of brushes applied herein exhibited comparable structure formation patterns, suggesting that self-assembly of the PSiPs was entropy-driven. The crystallization threshold concentration of the PSiPs was understood through the Kirkwood–Alder transition in the assembly by considering the effective particle sizes. The crystal structure of the PSiP was characterized as a random hexagonal close-packed structure in the concentrated-polymer-brush regime, which exhibited the characteristics of hard spheres. In contrast, face-centered cubic (fcc) and body-centered cubic structures were observed in the semidilute-polymer-brush regime, reflecting softening of the interparticle potential. In addition, formation of the fcc structure was possibly due to partial compression and an imbalance in the swollen brush layer caused by the increased brush length and particle concentration.

Marine ecosystem degradation due to microplastic pollution is a significant environmental problem, as acknowledged by Sustainable Development Goal 14. Decomposition of plastics using near critical or supercritical water is a promising method to remove microplastics. To optimize this method for realizing environmental benefits, it is necessary to clarify the structural change of materials during the process. Thus, we investigated the decomposition processes of polystyrene particles dispersed in deuterated water (D2O) during heating under near critical or supercritical conditions by using in situ small-angle neutron scattering. Under subcritical conditions, the PS particles were swollen by D2O due to increased compatibility with temperature. In subcritical conditions near the critical point, cleavage of PS chains in the particles occurred, so that the swollen ratio was enhanced despite the PS particles keeping their shapes. Under supercritical conditions, the PS particles were degraded into oil, including oligomers or monomers and phase-separated structures with styrene-rich and D2O-rich regions.

We study a reservoir computing (RC) system with ferroelectric field-effect transistors (FeFETs) in a parallel configuration and develop various schemes in a speech classification task. Experimental drain-source, and substrate output currents of a FeFET are used for temporal reservoir state vectors in response to a time-series input signal at a corresponding frequency channel and their different characteristics accelerate the information extraction capability to effectively enhance the performance. Adjustable weights in the readout part are trained by Ridge regression. Finally, we achieved the highest classification accuracy of 98.1%. Our systematic approaches find important knowledge toward the system design establishment of FeFET-based RC for versatile application.

Introduction:Ustekinumab is an IgG1 kappa monoclonal antibody directed against the common p40 subunit of interleukin-12 and interleukin-23, which activate Th1- and Th17-mediated immune responses, respectively. It has proven efficacy for the treatment of moderate to severe ulcerative colitis (UC) in the UNIFI phase III clinical trial; however, data on its efficacy in the real world are limited. In this study, we aimed to assess the real-world efficacy of ustekinumab. Methods:This observational study included 30 patients with UC who received ustekinumab from April 2020 to April 2022. We examined demographic information, disease type and activity (Mayo score, partial Mayo score [PMS]), use of biologics, concomitant use of predonisolone (PSL), 8-week ustekinumab clinical response rate, remission induction rate, 44- and 152-week remission maintenance rate, continuation rate, and 44-week steroid-free remission rate. The primary outcomes were the short- and long-term efficacy of ustekinumab. Results:Included patients (53% women; mean age: 41.2 years [16–80 years]) had an average disease duration of 86 weeks. The Mayo score (median) was 7.4 and the PMS was 5.4. Two (7%), 24 (80%), and four (13%) patients had a Mayo endoscopic subscore (MES) of MES1, MES2, and MES3, respectively. The median serum CRP was 1.0 mg/dL. Five patients had no history of biotherapy (naive), while eight and 17 had a history of one and two or more biologic agents, respectively. Eight patients were PSL-resistant and 22 were PSL-dependent. The 8-week clinical response rate was 73% and the clinical remission induction rate was 70%. The remission maintenance rates at 44 and 152 weeks were 67% and 63%, respectively. The ustekinumab retention rate was 67% (86-week mean follow-up period). Regarding biologic failure cases, the clinical response rate in the failure group with up to one biologic agent (including naive cases) was 84.6%, which was higher than the 58.0% rate in the failure group with two or more biologic agents (p= 0.06). Steroid-free remission rates at 44 and 152 weeks were 63% each. In the logistic regression analysis parameters for discontinuation of ustekinumab, only PMS remained significant after multivariate analysis (p= 0.018). Conclusion:Our study showed short-term and long-term ustekinumab effectiveness, especially with comparative low disease activity.

Futibatinib, a selective, irreversible fibroblast growth factor receptor 1–4 inhibitor, is being investigated for tumors harboring FGFRaberrations and was recently approved for the treatment of FGFR2fusion/rearrangement‐positive intrahepatic cholangiocarcinoma. In vitro studies identified cytochrome P450 (CYP) 3A as the major CYP isoform in futibatinib metabolism and indicated that futibatinib is likely a P‐glycoprotein (P‐gp) substrate and inhibitor. Futibatinib also showed time‐dependent inhibition of CYP3A in vitro. Phase I studies investigated the drug‐drug interactions of futibatinib with itraconazole (a dual P‐gp and strong CYP3A inhibitor), rifampin (a dual P‐gp and strong CYP3A inducer), or midazolam (a sensitive CYP3A substrate) in healthy adult participants. Compared with futibatinib alone, coadministration of futibatinib with itraconazole increased futibatinib mean peak plasma concentration and area under the plasma concentration–time curve by 51% and 41%, respectively, and coadministration of futibatinib with rifampin lowered futibatinib mean peak plasma concentration and area under the plasma concentration–time curve by 53% and 64%, respectively. Coadministration of midazolam with futibatinib had no effect on midazolam pharmacokinetics compared with midazolam administered alone. These findings suggest that concomitant use of dual P‐gp and strong CYP3A inhibitors/inducers with futibatinib should be avoided, but futibatinib can be concomitantly administered with other drugs metabolized by CYP3A. Drug‐drug interaction studies with P‐gp–specific substrates and inhibitors are planned.

Study Design Retrospective studyObjective The primary aim of this study was to investigate the predictors of severe complications in patients following surgery for pyogenic spondylodiscitis (PS) using a surgeon-maintained database. The secondary aim was to investigate the predictors of early recovery.Methods We introduced a surgeon-maintained database of prospectively collected multicenter data that mainly focused on perioperative complications in 2012. Our surgeon-maintained database allows the retrospective collection of detailed data. We analyzed 143 patients who underwent surgery for PS from the 19,056 patients in the prospective surgeon-maintained database at 27 affiliated institutions between 2013 and 2017. Data relating to preoperative patient factors, infection factors, surgical factors, and pre- and postoperative blood tests was retrospectively collected. We performed multivariate regression analysis to evaluate the predictors of postoperative severe complications and early recovery in patients with PS.Results High updated Charlson comorbidity index (uCCI), chronic pulmonary disease, diabetes, Gram-negative bacteria, pyogenic osteoarthritis, high preoperative white blood cell count, and low preoperative platelet count were significantly associated with severe complications in patients undergoing surgery for PS. A high uCCI was the sole independent negative predictor on early recovery.Conclusion Careful perioperative management is necessary if surgery is performed on patients who are at a high risk of life-threatening events.

Currently, risk management based on a scientific approach is becoming required in the establishment of cleaning validation limits for pharmaceutical manufacturing equipment, as the acceptable daily exposure (ADE), which is set based on pharmacological and toxicological evaluation, is increasingly applied. At the early stage of development, ADE values may be set using the threshold of toxicological concern (TTC) approach due to lack of human data on toxicity. However, TTC values are estimates, so their application requires careful consideration. Especially in biopharmaceuticals (mainly proteins), whether or not the target product item is inactivated and degraded after cleaning is an important issue in evaluating the cleaning process. Therefore, a study was conducted by carrying out 'CIP (clean in place) + SIP (steam in place)' and 'CI (caustic immersion: alkaline treatment over a certain period of time)', which are usually processes used in the cleaning of antibody drug manufacturing equipment. The inactivation and degradation of antibody drug was evaluated from the molecular structure and physiological activity point of view, using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and surface plasmon resonance. This study was successful in establishing a reliable and effective method for evaluating cleaning processes based on risk., A risk-based approach based on a pharmacological and toxicological evaluation is becoming perceived in the industy as a science-based approach that ensures safety of pharmaceuticals. Since the publication of International [...]