Search

INTRODUCTION Reported in up to 70% of all incident reports, falls among hospitalized patients account for the greatest percentage of reported in-hospital incidents. (1) Although the rate of falls varies [...], BACKGROUND/OBJECTIVES: Fall accidents may reduce an individual's quality of life and ability to perform the activities of daily life, and may delay recovery from illness. Consequently, medical institutions need to take measures to prevent falls. There are various risk factors for falls, including advanced age, illness and medication effects. Although hyponatremia and hypokalemia have been reported to increase the rate of falls, how they affect falls is not fully understood. SUBJECTS/METHODS: We retrospectively examined 2948 patients, ≥18 years old who had been hospitalized for [greater than or equal to]3 days at Gifu (Japan) Municipal Hospital between May 2012 and April 2013 to determine the effects of hyponatremia and hypokalemia on the risk of falls. After the patients had been divided into fall and non-fall groups, their data were subjected to univariate and multiple regression analysis to identify significant differences. RESULTS: The univariate analysis results revealed significant differences between the groups in terms of age (≥65 years); the presence of hyponatremia, hypokalemia, central nervous system disease, cardiovascular disease and/or peripheral nerve/muscular disease; intake of medications that increase the risk of falls; and increased sedative dosage. The multivariate analysis results revealed significant differences between the groups in terms of the presence of hyponatremia (odds ratio (OR), 1.751; 95% confidence interval (CI), 1.020-3.005), hypokalemia (OR, 2.209;95% CI, 1.280-3.813), central nervous system disease (OR, 2.492;95% CI, 1.629-3.814) and/or age ≥ 65 years (OR, 2.180;95% CI, 1.242-3.826). CONCLUSIONS: The results indicated that the presence of hyponatremia or hypokalemia increases the risk of falls. European Journal of Clinical Nutrition (2015) 69, 205-210; doi: 10.1038/ejcn.2014.195; published online 17 September 2014

Copyright of SHILAP Revista de Lepidopterologia is the property of Sociedad Hispano-Luso-Americana de Lepidopterologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Spontaneous reporting systems (SRS) provide valuable data for detecting unidentified adverse events not observed in clinical trials and for conducting safety assessments that accurately reflect real-world clinical practice. With the increasing number of publications using the SRS for disproportionality analysis (DA), there is an increasing demand for a comprehensive understanding of the research limitations associated with the SRS. However, there is a lack of understanding of the caveats associated with adjusting covariates in DA of the SRS. Herein, we summarized the use of covariate adjustment and its caveats in DA. The Council for International Organizations of Medical Sciences VIII suggests considering adjustments such as stratification when they can enhance the sensitivity and/or specificity of statistical analysis. However, several database-specific and statistical caveats have been identified when adjusting for covariates derived from the SRS. Disproportionality analysis may be affected not only by reporting bias at the time of enrollment but also by sparse-data bias due to variations in the number of enrollment reports. Statistical evidence is needed to determine in which cases and to what extent sensitivity and/or specificity are affected. Nevertheless, it is important for researchers to acknowledge that certain limitations discussed in this context may be inherent and cannot be rectified. Based on this understanding, they can then make an informed decision on whether to perform a covariate adjustment., Competing Interests: Declarations. Funding: This work was supported by JSPS KAKENHI Grant number 22K12890. Conflict of interest: All authors declare no competing interests. Ethics approval: Not applicable. Consent to participate: Not applicable. Consent for publication: Not applicable. Availability of data and material: Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study. Code availability: Not applicable. Author contributions: Yoshihiro Noguchi: Conceptualization, Writing – original draft, Writing – review & editing. Tomoya Tachi: Writing – review & editing. Tomoaki Yoshimura: Writing – review & editing, Supervision. All authors read and approved the final version. , (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Viral capsid assembly and the design of capsid-based nanocontainers critically depend on understanding the shapes and interfaces of constituent protein subunits. However, a comprehensive framework for characterizing these features is still lacking. Here, we introduce a novel approach based on spherical tiling theory that explicitly describes the 2D shapes and interfaces of subunits in icosahedral capsids. Our method unfolds spherical dihedrons defined by icosahedral symmetry axes, enabling systematic characterization of all possible subunit geometries. Applying this framework to real T = 1 capsid structures reveals distinct interface groups within this single classification, with variations in interaction patterns around 3-fold and 5-fold symmetry axes. We validate our classification through molecular docking simulations, demonstrating its consistency with physical subunit interactions. This analysis suggests different assembly pathways for capsid nucleation. Our general framework is applicable to other triangular numbers, paving the way for broader studies in structural virology and nanomaterial design., Competing Interests: Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Objectives: In recent years, Japan has experienced a series of earthquakes and torrential rain disasters in various regions, and in Gifu City, there is concern about the possibility ofNankai Trough earthquakes in the near future. However, pharmacists' awareness of disaster preparedness and status of drug stockpiles in pharmacies are not clearly outlined., Methods: A survey on disaster prevention and stockpiling was conducted in 286 pharmacies in Gifu City. Data were collected from August to the end of October 2022. A simple aggregate was used in the study., Results: The response rate was 66.8% (191 pharmacies). Among them, 9.9% (19 pharmacies) had stockpiles of medicines for disasters, in which 33.3% of the medicines needed in the early stages of a disaster were above the average overall stockpiling rate. In addition, 2.1% (4 pharmacies) selected medicines according to national or prefectural manuals, and 96.3% (184 pharmacies) preferred to have the "national or local government" bear the cost of stockpiling., Conclusions: This study allowed us to understand the stockpiling situation of pharmacies in Gifu City in event of a disaster such as the Nankai Trough earthquake, which is likely to occur in the future. Based on these results, it is necessary to consider measures for disaster stockpiling.

Origami folding structures are vital in shaping programmable mechanical material properties. Of particular note, tunable dynamical properties of elastic wave propagation in origami structures have been reported. Despite the promising features of origami metamaterials, the influence of the kinematics of tessellated origami structures on elastic wave propagation remain unexplored. This study proposes elastic metamaterials using connected Miura-ori tubes, the kinematics of which are coupled by folding and unfolding motions in a tubular axis; achieved by periodically connecting non-rotated and rotated Miura-ori tubes. The kinematics generate wave modes with localized deformations within the unit cell of the metamaterials, affecting the global elastic deformation of Miura-ori tubes via the coupling of wave modes. Dispersion analysis, using the generalized Bloch wave framework based on bar-and-hinge models, verifies the influence of kinematics in the connected tubes on elastic wave propagation. Furthermore, folding the connected tubes changes the coupling strength of wave modes between the kinematics and global elastic deformation of the tubes by breaking the ideal kinematics. The coupling of wave modescontributes to the formation of the band gaps and their tunability. These findings enable adaptive and in situ tunability of band structures to prohibit elastic waves in the desired frequency ranges.This article is part of the theme issue 'Origami/Kirigami-inspired structures: from fundamentals to applications'.

Background: Glioblastoma multiforme (GBM) is the most lethal primary brain tumor for which novel therapies are needed. Recently, chimeric antigen receptor (CAR) T cell therapy has been shown to be effective against GBM, but it is a personalized medicine and requires high cost and long time for the cell production. CAR-transduced natural killer (NK) cells can be used for "off-the-shelf" cellular immunotherapy because they do not induce graft-versus-host disease. Therefore, we aimed to analyze the anti-GBM effect of CAR-T or NK cells targeting B7-H3, which is known to be highly expressed in GBM., Methods: CAR-T cells targeting B7-H3 were generated using previously reported anti-B7-H3 scFv sequences. Cord blood (CB)-derived NK cells transduced with the B7-H3 CAR were also generated. Their anti-GBM effect was analyzed in vitro. The antitumor effect of intracranial injection of the B7-H3 CAR-T or NK cells was investigated in an in vivo xenograft model with patient-derived GBM cells., Results: Both B7-H3 CAR-T cells and CAR-NK cells exhibited marked cytotoxicity against patient-derived GBM cells in vitro. Furthermore, intracranial injection of CAR-T cells and CAR-NK cells targeting B7-H3 resulted in a significant antitumor effect against patient-derived GBM xenografts., Conclusion: Not only CAR-T cells but also CB-derived CAR-NK cells targeting B7-H3 may have the potential to eliminate GBM cells., (© 2024. The Author(s).)

Objective: It is not clear whether self-rated health is associated with internet use among community-dwelling patients living with diabetes. This study investigated what kind and level of use of the internet is desirable for the subjective sense of health among patients living with diabetes in the community., Research Design and Methods: This was a cross-sectional study of patients living with diabetes aged 18 years or older who visited our clinic between April 2022 and June 2022. The final analysis included 654 subjects (mean age: 56-90 years). The objective variable was self-rated health, and the explanatory variable was purpose of internet use. We used logistic regression analysis to identify odds ratios (ORs) and 95% confidence intervals (CIs) for the association between internet use and self-rated health by purpose of internet use., Results: Of the 654 patients living with diabetes using our clinic, 488 (64.7%) were internet users. Communication with friends/family (66.6%) was the most common use of the internet, followed by social media (54.3%) and shopping (36.7%). Logistic regression models showed that social media (OR: 1.81; 95% CI [1.02, 3.21], p  = 0.04), shopping for food and other items (OR: 1.95; 95% CI [1.00, 3.77], p  = 0.04), online securities and banking (OR: 2.75; 95% CI [1.02, 7.39], p  = 0.04) were associated with self-rated health., Conclusions: Using the internet for social media, shopping, and banking were found to be associated with self-rated health. Use for these purposes could help support diabetic care., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

In this study a new genus of the tribe Blondeliini, Shimamyia, is established. In this genus, Shimamyia exigua comb. nov., S. orientalis comb. nov., S. taiwanensis sp. nov., and S. vietnamensis sp. nov. are described and the key to species is provided. Shimamyia exigua and S. orientalis were initially identified as members of Medinodexia Townsend but were thought to belong to an undescribed genus based on external morphology and male and female postabdomens. The present study provides comprehensive descriptions of the four species. The phylogenetic tree reconstructed from 27 blondeliine species (including two from Shimamyia) and 6 outgroup using 16S, 28S, white, and CAD genes is also provided to discuss the placement of Shimamyia. Morphological and molecular evidence support the differentiation of Shimamyia from Medinodexia while confirming its inclusion in Blondeliini. Additionally, the modified female postabdomens of the new genus and other Blondeliini members are briefly discussed.

Chimeric antigen receptor (CAR) T cells are effective against hematological cancers, but are less effective against solid tumors such as non-small cell lung cancer (NSCLC). One of the reasons is that only a few cell surface targets specific for NSCLC cells have been identified. Here, we report that CD98 heavy chain (hc) protein is overexpressed on the surface of NSCLC cells and is a potential target for CAR T cells against NSCLC. Screening of over 10,000 mAb clones raised against NSCLC cell lines showed that mAb H2A011 bound to NSCLC cells but not normal lung epithelial cells. H2A011 recognized CD98hc. Although CAR T cells derived from H2A011 could not be established presumably due to the high level of H2A011 reactivity in activated T cells, those derived from the anti-CD98hc mAb R8H283, which had been shown to lack reactivity with CD98hc glycoforms expressed on normal hematopoietic cells and some normal tissues, were successfully developed. R8H283 specifically reacted with NSCLC cells in six of 15 patients. R8H283-derived CAR T cells exerted significant anti-tumor effects in a xenograft NSCLC model in vivo. These results suggest that R8H283 CAR T cells may become a new therapeutic tool for NSCLC, although careful testing for off-tumor reactivity should be performed in the future., (© 2024. The Author(s).)

Chemotherapy has helped prolong survival in patients with malignant lymphoma, enhancing their quality of life (QOL). Despite the eventual decline in the QOL of patients, the impact of initial chemotherapy remains poorly understood. A prospective patient-reported QOL survey among patients with malignant lymphoma receiving initial chemotherapy was conducted, targeting those treated at Gifu Municipal Hospital (Gifu, Japan) between January 2021 and December 2022. Surveys were conducted pre- and post-chemotherapy based on the EuroQol 5 dimensions. Drug costs were calculated using official prices and analyzed from the cost payer's perspective via cost-utility analysis. Among the 60 patients included in the present study, 28 had diffuse large B-cell lymphoma. Cyclophosphamide, doxorubicin, vincristine, prednisolone ± rituximab therapy was the most common treatment (38 patients) and demonstrated superior cost-effectiveness due to its lowest cost and change in utility value. Initial chemotherapy for patients with malignant lymphoma generally improved the QOL. Clinical trial registration: UMIN000042868 (registered on December 28, 2020)., Competing Interests: The authors declare that they have no competing interests., (Copyright: © 2024 Tanaka et al.)

In internal parasitism, the respiration strategy within the host's body is as essential as evading attack from the host's immune system. Tachinid flies are parasitoids of terrestrial arthropods, mostly insects, during their larval stage. To obtain oxygen while living in the host body, they build a cylindrical structure known as the respiratory funnel at the aperture opened by the tachinid larva on the host integument or trachea. These funnels can be divided morphologically into sheath and cone types. Previous research on sheath-type funnels revealed that they are derived from the encapsulating substance produced by the host's immune system. In contrast, the cone-type funnels cover part of the body of the larval tachinid and may be constructed independently from the host immune system. To determine the mechanisms of cone-type funnel formation, histological observations were carried out on Gymnosoma rotundatum (L.) (Diptera: Tachinidae), which possesses this type of funnel. The respiratory funnel of G. rotundatum was found to be derived from the tube-shaped faeces wrapped with the peritrophic membrane and excreted by the fly larva, not from host tissue or haemocytes. Additionally, secretory glands putatively involved in the funnel formation were discovered around the larval anal plate of G. rotundatum . A comparison of funnel types within Tachinidae revealed that Phasiinae and Dexiinae have cone-type funnels, which may be created by the same mechanism as in G. rotundatum . These new findings suggest that funnel formation that does not use the host immune system is relevant to tachinid phylogeny.

Background: Although awake surgery is the gold standard for resecting brain tumors in eloquent regions, patients with hearing impairment require special consideration during intraoperative tasks., Case Description: We present a case of awake surgery using sign language in a 45-year-old right-handed native male patient with hearing impairment and a neoplastic lesion in the left frontal lobe, pars triangularis (suspected to be a low-grade glioma). The patient primarily communicated through sign language and writing but was able to speak at a sufficiently audible level through childhood training. Although the patient remained asymptomatic, the tumors gradually grew in size. Awake surgery was performed for tumors resection. After the craniotomy, the patient was awake, and brain function mapping was performed using tasks such as counting, picture naming, and reading. A sign language-proficient nurse facilitated communication using sign language and the patient vocally responded. Intraoperative tasks proceeded smoothly without speech arrest or verbal comprehension difficulties during electrical stimulation of the tumor-adjacent areas. Gross total tumor resection was achieved, and the patient exhibited no apparent complications. Pathological examination revealed a World Health Organization grade II oligodendroglioma with an isocitrate dehydrogenase one mutant and 1p 19q codeletion., Conclusion: Since the patient in this case had no dysphonia due to training from childhood, the task was presented in sign language, and the patient responded vocally, which enabled a safe operation. Regarding awake surgery in patients with hearing impairment, safe tumor resection can be achieved by performing intraoperative tasks depending on the degree of hearing impairment and dysphonia., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Surgical Neurology International.)

High pathogenicity avian influenza (HPAI) poses a significant threat to both domestic and wild birds globally. The avian influenza virus, known for environmental contamination and subsequent oral infection in birds, necessitates careful consideration of alternative introduction routes during HPAI outbreaks. This study focuses on blowflies (genus Calliphora), in particular Calliphora nigribarbis, attracted to decaying animals and feces, which migrate to lowland areas of Japan from northern or mountainous regions in early winter, coinciding with HPAI season. Our investigation aims to delineate the role of blowflies as HPAI vectors by conducting a virus prevalence survey in a wild bird HPAI-enzootic area. In December 2022, 648 Calliphora nigribarbis were collected. Influenza virus RT-PCR testing identified 14 virus-positive samples (2.2% prevalence), with the highest occurrence observed near the crane colony (14.9%). Subtyping revealed the presence of H5N1 and HxN1 in some samples. Subsequent collections in December 2023 identified one HPAI virus-positive specimen from 608 collected flies in total, underscoring the potential involvement of blowflies in HPAI transmission. Our observations suggest C. nigribarbis may acquire the HPAI virus from deceased wild birds directly or from fecal materials from infected birds, highlighting the need to add blowflies as a target of HPAI vector control., (© 2024. The Author(s).)

We established a transition program from hospital to home administration of blinatumomab using the CADD-Legacy® pump and evaluated its safety and feasibility in 2 pediatric patients. The program recommended that repeated overnight stays with continued hospitalization would help patients safely transition to home administration of blinatumomab. Pediatric patients who do not attend school, such as preschoolers, or who return to their original school, can be transited to an outpatient setting if people caring for pediatric patients, including teachers in the school, are educated.

Objective: In psychiatry, polypharmacy or high psychotropic drug doses increase adverse drug event (ADE) prevalence. However, the full relationship between polypharmacy and ADEs is unclear, and few studies have evaluated dose equivalents for psychotropic drugs for ADEs. Thus, we conducted a retrospective analysis to clarify the effects of polypharmacy and chlorpromazine (CP)-, diazepam (DAP)-, and imipramine- equivalent doses on all ADEs in inpatients., Methods: Psychiatric inpatients in a Japanese hospital from April 1, 2016 to March 31, 2018, were enrolled. ADE severity and causality were assessed. Multiple logistic regression analyses were performed to evaluate ADE risk factors., Results: Among 462 patients analyzed, out of 471 patients enrolled, 145 (31.4%) experienced ADEs. The causality assessment determined that "possible" was 96.5%. The most common ADEs were nervous system disorders (35%). Multiple logistic regression analyses indicated an increase in ADE prevalence with the number of drugs used (≥5; p = 0.026); CP-equivalent dose (p = 0.048); and endocrine, nutritional, and metabolic disorders (p = 0.045). DAP-equivalent dose; infectious and parasitic diseases; and injury, poisoning, and consequences of other external causes decreased ADE prevalence (p = 0.047, 0.022, and 0.021, respectively)., Conclusions: Avoiding polypharmacy in psychiatric inpatients and adjusting drug regimens to safe equivalent doses could reduce ADEs during hospitalization., (© 2024 John Wiley & Sons Ltd.)

Objective: This study aimed to explore the effectiveness of distributing pocket cards with summaries of key information on appropriate medication usage after the implementation of a structured school-based medication education program for junior high school students in Japan., Methods: A total of 227 3rd-grade high school students participated in the intervention. Students who received the program without the provision of pocket cards in 2022 were included in the comparison group, and students who took the program with the provision of pocket cards in 2023 were included in the intervention group. After propensity score matching, the final sample of N  = 116 comprised n  = 58 comparison group participants and n  = 58 intervention group participants. Questionnaires were administered at baseline, end-of-class, and 3-month follow-up to assess the changes in behavior, attitude, and knowledge scores., Results: The matched intervention group showed significantly lower scores at the 3-month follow-up than the matched comparison group. The results of the multiple linear regression analysis showed that for both groups, only the attitude scores were significantly correlated with the behavior scores. In addition, regardless of the baseline scores, the matched intervention group demonstrated smaller or negative changes in scores at the 3-month follow-up., Conclusion: Overall, the results of this study did not support the effectiveness of distributing pocket cards after in-class intervention. However, the usefulness of medication education intervention was confirmed. These results emphasize the need to explore other supplemental teaching tools to further enhance the impact of structured medication education programs., Competing Interests: TT is currently an Associate Editor. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Sakai, Iguchi, Tachi, Noguchi, Hisamatsu, Katsuno and Teramachi.)

No progress has been made in using remote communication tools for less urgent but equally important health support services, such as preventive medicine and health education. In this study, we developed a remote health support program by pharmacists for community residents and conducted a randomized controlled study on its effectiveness in proper self-medication through pharmacists. People over the age of 20 years who lived in the vicinity of Gifu City, Japan were eligible to participate in this study. Participants were recruited using posters and brochures. This program comprised a lecture, based on the health belief model and behavioral economics, and access to remote health support. The participants were randomly assigned to two groups: the medicine/health class only (control) and the medicine/health class along with the program (intervention) groups. The participants were administered questionnaire surveys immediately before (the first survey) and 2 months after (the second survey) the medicine/health class, which allowed us to compare the changes in the two groups' behavior regarding performing proper self-medication through pharmacists. The percentage of individuals who started consulting pharmacists about self-medication in the intervention group (63.9%, 23/36) was significantly higher than that in the control group (15.2%, 5/33; p < 0.001). The percentage of individuals who started recording information about their self-medication in their medication notebooks in the intervention group (16.7%, 6/36) was significantly higher than that in the control group (0%, 0/33; p = 0.026). We clarified the effectiveness of this program for behavioral changes toward proper self-medication using support from pharmacists.

Polypharmacy exacerbates lower urinary tract symptoms (LUTS). Japan exhibits a higher prevalence of concomitant medication use in drug therapy than other countries. Previous age- and sex-specific reports exist; however, none include patients of all ages. Therefore, this retrospective study determined the impact of polypharmacy and its associated risk factors on LUTS exacerbation in outpatients with urological conditions. We included patients receiving medication who visited the Department of Urology at the Gifu Municipal Hospital (Gifu, Japan) between January, 2018 and December, 2018. The association between LUTS and polypharmacy and the risk factors for LUTS exacerbation were investigated. Patients were categorized into two groups according to their polypharmacy status. We performed propensity score matching and compared the International Prostate Symptom Score (IPSS) between the groups using the unpaired t-test. Multiple logistic regression analysis was performed to examine the risk factors, including "polypharmacy" and "taking multiple anticholinergic medications" for LUTS exacerbation. When comparing the IPSS between the groups, the polypharmacy group was found to have significantly higher scores than the non-polypharmacy group in six items, including "total score" and "storage score." Multiple logistic regression analysis results showed high significance in three items, including "polypharmacy" (odds ratio (OR) = 1.67, 95% confidence interval (CI): 1.03-2.71) and "taking multiple anticholinergic medications" (OR = 8.68, 95% CI: 1.05-71.7). In conclusion, this study revealed that "polypharmacy" and "taking multiple anticholinergic medications" were risk factors for LUTS. Particularly, "polypharmacy" is associated with storage symptom exacerbation. Therefore, eliminating "polypharmacy" and "taking multiple anticholinergic medications" is expected to improve LUTS.

Cerebral organoids (COs) are derived from human-induced pluripotent stem cells in vitro and mimic the features of the human fetal brain. The development of COs is largely dependent on "self-organization" mechanisms, in which differentiating cells committed to cortical cells autonomously organize into the cerebral cortex-like tissue. However, extrinsic manipulation of their morphology, including size and thickness, remains challenging. In this study, we discovered that silicate microfiber scaffolds could support the formation of cortical neuronal layers and successfully generated cortical neuronal layers, which are 9 times thicker than conventional COs, in 70 days. These cortical neurons in the silicate microfiber layer were differentiated in a fetal brain-like lamination pattern. While these cellular characteristics such as cortical neurons and neural stem/progenitor cells were like those of conventional COs, the cortical neuronal layers were greatly thickened in sheet-like configuration. Moreover, the cortical neurons in the scaffolds showed spontaneous electrical activity. We concluded that silicate microfiber scaffolds support the formation of the cortical neuronal layers of COs without disturbing self-organization-driven corticogenesis. The extrinsic manipulation of the formation of the cortical neuronal layers of COs may be useful for the research of developmental mechanisms or pathogenesis of the human cerebral cortex, particularly for the development of regenerative therapy and bioengineering., (© The Author(s) 2023. Published by Oxford University Press.)

5-aminolevulinic acid hydrochloride is a highly effective drug in reducing tumor residuals in transurethral resection of the bladder tumors; however, hypotension is a serious side effect that causes clinical problems. To avoid serious side effects, a pharmacist, in consultation with a physician, decided to discontinue the antihypertensive medication, and the effect of this pharmaceutical intervention was examined retrospectively. This study included patients who received 5-aminolevulinic acid hydrochloride at Gifu Municipal Hospital and were instructed to continue receiving their usual antihypertensive medication on the day of surgery. The control group comprised 17 patients before the pharmaceutical intervention, and the intervention group comprised 18 patients after the pharmaceutical intervention. The difference in systolic blood pressure before and after 5-aminolevulinic acid hydrochloride administration was -19.4±22.5 mmHg in the control group and -2.8±16.0 mmHg in the intervention group. The intervention group showed a significantly lower decrease in blood pressure(p=0.019). Intervention to avoid hypotension through the collaboration between physicians and pharmacists may be effective in improving the safety of 5-aminolevulinic acid hydrochloride.

Origami tessellations, whose crease pattern has translational symmetries, have attracted significant attention in designing the mechanical properties of objects. Previous origami-based engineering applications have been designed based on the "uniform-folding" of origami tessellations, where the folding of each unit cell is identical. Although "nonuniform-folding" allows for nonlinear phenomena that are impossible through uniform-folding, there is no universal model for nonuniform-folding, and the underlying mathematics for some observed phenomena remains unclear. Wavy folded states that can be achieved through nonuniform-folding of the tubular origami tessellation called a waterbomb tube are an example. Recently, the authors formulated the kinematic coupled motion of unit cells within a waterbomb tube as the discrete dynamical system and identified a correspondence between its quasiperiodic solutions and wavy folded states. Here, we show that the wavy folded state is a universal phenomenon that can occur in the family of rotationally symmetric tubular origami tessellations. We represent their dynamical system as the composition of the two 2D mappings: taking the intersection of three spheres and crease pattern transformation. We show the universality of the wavy folded state through numerical calculations of phase diagrams and a geometric proof of the system's conservativeness. Additionally, we present a non-conservative tubular origami tessellation, whose crease pattern includes scaling. The result demonstrates the potential of the dynamical system model as a universal model for nonuniform-folding or a tool for designing metamaterials., (© 2023 Author(s). All article content, except where otherwise noted, is licensed under a Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).)

This study aimed to identify the risk factors of febrile neutropenia(FN)onset associated with melphalan(L-PAM)therapy. Thirty-nine patients(21 men, 18 women)were administered L-PAM intravenously for multiple myeloma(MM)from April 2011 to February 2022 at the Department of Hematology of Gifu Municipal Hospital. Patients were classified into those with and without FN(Grade 3 or higher), complete blood count and liver function tests were performed immediately before starting therapy. Univariate analysis with Fisher's exact probability test was performed. Factors with p<0.2 were considered as independent variables for multivariate analysis in the multiple logistic regression analysis. A multivariate analysis with 2 independent variables, lactate dehydrogenase(LD)level>222 U/L(upper limit of the facility reference value)and white <3.3×103/μL(lower limit of the facility reference value)from the univariate analysis, and FN onset(Grade 3 or higher)as the dependent variable showed that LD level>222 U/L(odds ratio: 6.33, 95% confidence interval: 1.12-35.8, p=0.037)was a significant factor. In conclusion, patients with LD levels >222 U/L immediately before starting therapy require adequate monitoring for FN onset following L-PAM administration.

Purpose: Although the bio-impedance phase angle is a relevant factor in nutritional assessment, studies with community-dwelling patients with type 2 diabetes mellitus have not been identified. The purpose of this study was to determine the association between phase angle and nutritional status in community-dwelling patients with type 2 diabetes mellitus according to gender and accounting for related factors other than nutritional status., Methods: This study included 122 patients (mean age 52.1 ± 13.5 years, 63 males and 59 females) with type 2 diabetes mellitus living in the community who used our Endocrinology and Metabolism medical clinic. The phase angle was measured using bioelectrical impedance analysis. Albumin was an independent variable and the covariates were age, hemoglobin A1c, skeletal muscle index (SMI), and body mass index. Statistical analysis was performed using linear regression with a significance level of 5%., Results: The linear regression model results showed a significant association between phase angle and albumin in both males and females (males: β = 0.26, females: β = 0.16). Age was also a relevant factor (male: β = -0.25, female: β = -0.51), and a significant association was found between phase angle and SMI in males (β = 0.54)., Conclusion: Phase angle was positively associated with albumin, a nutritional assessment index. These results suggest that phase angle can be a simple and noninvasive measure of nutritional status., Competing Interests: Conflict of interestAll authors reported no conflicts of interest., (© The Author(s), under exclusive licence to Tehran University of Medical Sciences 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: New therapies for glioblastoma (GBM) are urgently needed because the disease prognosis is poor. Chimeric antigen receptor (CAR)-T cell therapy that targets GBM-specific cell surface antigens is a promising therapeutic strategy. However, extensive transcriptome analyses have uncovered few GBM-specific target antigens., Methods: We established a library of monoclonal antibodies (mAbs) against a tumor cell line derived from a patient with GBM. We identified mAbs that reacted with tumor cell lines from patients with GBM but not with nonmalignant human brain cells. We then detected the antigens they recognized using expression cloning. CAR-T cells derived from a candidate mAb were generated and tested in vitro and in vivo ., Results: We detected 507 mAbs that bound to tumor cell lines from patients with GBM. Among them, E61 and A13 reacted with tumor cell lines from most patients with GBM, but not with nonmalignant human brain cells. We found that B7-H3 was the antigen recognized but E61. CAR-T cells were established using the antigen-recognition domain of E61-secreted cytokines and exerted cytotoxicity in co-culture with tumor cells from patients with GBM., Conclusions: Cancer-specific targets for CAR-T cells were identified using a mAb library raised against primary GBM tumor cells from a patient. We identified a GBM-specific mAb and its antigen. More mAbs against various GBM samples and novel target antigens are expected to be identified using this strategy., (© The Author(s) 2022. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.)

Geometrical-frustration-induced anisotropy and inhomogeneity are explored to achieve unique properties of metamaterials that set them apart from conventional materials. According to Neumann's principle, to achieve anisotropic responses, the material unit cell should possess less symmetry. Based on such guidelines, a triclinic metamaterial system of minimal symmetry is presented, which originates from a Trimorph origami pattern with a simple and insightful geometry: a basic unit cell with four tilted panels and four corresponding creases. The intrinsic geometry of the Trimorph origami, with its changing tilting angles, dictates a folding motion that varies the primitive vectors of the unit cell, couples the shear and normal strains of its extrinsic bulk, and leads to an unusual Poisson effect. Such an effect, associated with reversible auxeticity in the changing triclinic frame, is observed experimentally, and predicted theoretically by elegant mathematical formulae. The nonlinearities of the folding motions allow the unit cell to display three robust stable states, connected through snapping instabilities. When the tristable unit cells are tessellated, phenomena that resemble linear and point defects emerge as a result of geometric frustration. The frustration is reprogrammable into distinct stable and inhomogeneous states by arbitrarily selecting the location of a single or multiple point defects. The Trimorph origami demonstrates the possibility of creating origami metamaterials with symmetries that are hitherto nonexistent, leading to triclinic metamaterials with tunable anisotropy for potential applications such as wave propagation control and compliant microrobots., (© 2022 Wiley-VCH GmbH.)

A new species of Austrophasiopsis Townsend from Nepal, Austrophasiopsis caliginosa sp. nov., is described and illustrated. Two known species, A. formosensis Townsend and A. luteipennis Mesnil, are redescribed and illustrated and a key to the three species is provided. Based on a morphological study, Austrophasiopsis is moved from its current position in the tribe Minthoini to the Leskiini (Tachininae) where it is considered close to Solieria Robineau-Desvoidy.

Background: Metformin had been recommended as the first-line treatment for type 2 diabetes since 2006 because of its low cost, high efficacy, and potential to reduce cardiovascular events, and thus death. However, dipeptidyl peptidase-4 (DPP-4) inhibitors are the most commonly prescribed first-line agents for patients with type 2 diabetes in Japan. Therefore, it is necessary to clarify the effect of DPP-4 inhibitors on preventing cardiovascular events, taking into consideration the actual prescription of antidiabetic drugs in Japan., Methods: This study examined the effect of DPP-4 inhibitors on preventing cardiovascular events. The Japanese Adverse Drug Event Report (JADER) database, a spontaneous reporting system in Japan, and the Japanese Medical Data Center (JMDC) Claims Database, a Japanese health insurance claims and medical checkup database, were used for the analysis. Metformin was used as the DPP-4 inhibitor comparator. Major cardiovascular events were set as the primary endpoint., Results: In the analysis using the JADER database, a signal of major cardiovascular events was detected with DPP-4 inhibitors (IC: 0.22, 95% confidence interval: 0.03-0.40) but not with metformin. In the analysis using the JMDC Claims Database, the hazard ratio of major cardiovascular events for DPP-4 inhibitors versus metformin was 1.01 (95% CI: 0.84-1.20)., Conclusions: A comprehensive analysis using two different databases in Japan, the JADER and the JMDC Claims Database, showed that DPP-4 inhibitors, which are widely used in Japan, have a non-inferior risk of cardiovascular events compared to metformin, which is used as the first-line drug in the United States and Europe.

Purpose: The dose-limiting factor of ramucirumab plus docetaxel (RAM + DTX) in patients with non-small cell lung cancer (NSCLC) is febrile neutropenia (FN), which has a high incidence in Asians. This study aimed to evaluate the cost-effectiveness of pegfilgrastim (Peg-G) in patients with NSCLC receiving RAM + DTX in Japan., Methods: We simulated model patients treated with RAM + DTX in Japan and developed a decision-analytical model for patients receiving Peg-G prophylaxis or no primary prophylaxis. The expected cost, quality-adjusted life-year (QALY), and incremental cost-effectiveness ratio (ICER) of each treatment were calculated from the perspective of a Japanese healthcare payer. The willingness-to-pay (WTP) threshold was set at 45,867 United States dollars (USD) (5 million Japanese yen) per QALY gained. The probabilities, utility values, and other costs were obtained from published sources. Deterministic sensitivity analysis (DSA) and probabilistic analysis were conducted to evaluate the effect of each parameter and robustness of the base-case results., Results: The expected cost and QALYs were 20,275 USD and 0.701 for Peg-G prophylaxis and 17,493 USD and 0.672 for no primary prophylaxis, respectively. The ICER was calculated to be 97,519 USD per QALY gained. The results were most sensitive to FN risk with Peg-G. When FN risk with no primary prophylaxis exceeded 51% or the cost of Peg-G was less than 649 USD per injection, the ICER was below the WTP threshold. The probabilistic analysis revealed a 9.1% probability that the ICER was below the WTP threshold., Conclusion: Peg-G is not cost-effective in patients with NSCLC receiving RAM + DTX in Japan., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)