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The thermal expansion occurring when a laser beam is incident on the surface of a solid can be used to excite ultrasonic waves in the solid medium, without causing damage to the material. The resulting wavefield is characterized by a dominant shear wave and a weak compressional wave. This Letter demonstrates the possibility of generating a dominant compressional wavefield by coating the surface with a layer of clear ice. This is achieved by exploiting a minimum in the attenuation spectrum of light in ice, which occurs at around 500 nm and renders the coating transparent to green laser radiation. Ice coatings could, therefore, provide a path for the development of more sensitive laser-based nondestructive testing methods that have traditionally been affected by the poor excitability of compressional waves, especially along the direction orthogonal to the surface. [ABSTRACT FROM AUTHOR]

We searched for the |$\alpha$| condensed state in |$^{13}$| C by measuring the |$\alpha$| inelastic scattering at |$E_\alpha = 388$| MeV at forward angles including 0 |$^\circ$|⁠. We performed a distorted-wave Born approximation calculation with the single-folding potential and multipole decomposition analysis to determine the isoscalar transition strengths in |$^{13}$| C. We found a bump structure around |$E_x = 12.5$| MeV due to the isoscalar monopole (⁠|$IS0$|⁠) transition. A peak-fit analysis suggested that this bump consisted of several |$1/2^-$| states. We propose that this bump is due to the mirror state of the 13.5 MeV state in |$^{13}$| N, which dominantly decays to the |$\alpha$| condensed state in |$^{12}$| C. It was speculated that the |$1/2^-$| states around |$E_x = 12.5$| MeV were candidates for the |$\alpha$| condensed state, but the |$3\alpha + n$| orthogonality condition model suggests that the |$\alpha$| condensed state is unlikely to emerge as the negative parity states. We also found two |$1/2^+$| or |$3/2^+$| states at |$E_x = 14.5$| and 16.1 MeV excited with the isoscalar dipole (⁠|$IS1$|⁠) strengths. We suggest that the 16.1 MeV state is a possible candidate for the |$\alpha$| condensed state predicted by the cluster model calculations on the basis of the good correspondence between the experimental and calculated level structures. However, the theoretical |$IS1$| transition strength for this state is significantly smaller than the measured value. Further experimental information is strongly desired to establish the |$\alpha$| condensed state in |$^{13}$| C. [ABSTRACT FROM AUTHOR]

Background: A food environment intervention using nudge tactics was implemented at a hospital convenience store (CVS) in Tokyo to improve employees' eating habits. The objective of this study was to evaluate its effects on the urinary sodium-to-potassium ratio (Na/K), food intake, eating attitude, and behavior., Methods: Using a pre-post design; the intervention incorporated nudge tactics, healthier options, easy-to-pick food placement, and eye-catching information. We also used price incentives. The primary outcomes included changes in Na/K and sodium and potassium excretion assessed using spot urine samples at health checkups. Secondary outcomes were changes in staff food intake, eating attitude, and behavior which were assessed using questionnaire surveys. All outcomes were evaluated statistically. Furthermore, we investigated how the intervention led to outcomes using path analysis., Results: A total of 140 participant (52men and 88women) were analyzed. Significant changes were observed in Na/K (3.16 to 2.98 in median, p = 0.02) and potassium excretion (43.4 to 45.2 mmol/day in mean, p = 0.03). However, sodium excretion did not change significantly. The intake of fruits and dairy products increased with improved self-efficacy. The most influential factor for lowering Na/K and increasing potassium excretion was information from the CVS; purchasing "balanced meals" to lower Na/K and salads to increase potassium excretion were second., Conclusions: Food environment intervention using nudge tactics can improve staff's food intake and lower Na/K., Trial Registration: Registration number: UMIN000049444 (UMIN-CTR). Date of registration: November. 7. 2022., (© 2024. The Author(s).)

We report the case of a 38-year-old man with two von Hippel-Lindau disease-associated T1a renal cell carcinomas (RCCs) (<2 cm in diameter) which developed into a 2.5-cm solitary diaphragmatic metastatic tumor. After diagnosis using percutaneous biopsy, the diaphragmatic metastasis and two RCCs were treated by laparoscopic resection and percutaneous cryoablation, respectively. One year after treatment, the patient survived without local recurrence or distant metastasis. This report describes a rare case of RCC metastasis in VHL disease and its treatment., Competing Interests: The authors declare no potential conflicts of interest with respect to research, authorship, and/or publication of this article., (Copyright: Hirai T., et al.)

A 50-year-old man with von Hippel-Lindau disease underwent cryoablation (CRA) for two adjacent renal cell carcinomas in the upper pole of his right kidney. Although computed tomography (CT) immediately after CRA revealed involvement of part of the liver parenchyma in the ice-ball, the treatment was completed without complications. Contrast-enhanced CT on day 2 post-CRA revealed a thrombus in the portal vein of segment 6 near the ablated liver parenchyma, prompting the initiation of oral anticoagulation. The patient was discharged on day 4 after CRA without any sequelae, and a follow-up contrast-enhanced CT done 6 weeks later demonstrated resolution of the portal vein thrombus., Competing Interests: Takao Hiraki, Yusuke Matsui, and Noriyuki Umakoshi received speaker fees from Boston Scientific. Takao Hiraki received a speaker fee from Guerbet Japan., (Copyright: Kawabata T., et al.)

To search for low-energy resonant structures in isospin T=3/2 three-body systems, we have performed the experiments ^{3}H(t,^{3}He)3n and ^{3}He(^{3}He,t)3p at intermediate energies. For the 3n experiment, we have newly developed a thick Ti-^{3}H target that has the largest tritium thickness among targets of this type ever made. The 3n experiment for the first time covered the momentum-transfer region as low as 15  MeV/c, which provides ideal conditions for producing fragile systems. However, in the excitation-energy spectra we obtained, we did not observe any distinct peak structures. This is in sharp contrast to tetraneutron spectra. The distributions of the 3n and 3p spectra are found to be similar, except for the displacement in energy due to Coulomb repulsion. Comparisons with theoretical calculations suggest that three-body correlations exist in the 3n and 3p systems, although not enough to produce a resonant peak.

Background: Cardiac resynchronization therapy (CRT) with biventricular pacing is a well-established therapy. Left bundle branch area pacing (LBBAP) is a safe technique providing physiological pacing, and LBBAP-optimized CRT (LOT-CRT) has been shown to provide better electrical resynchronization than traditional CRT. However, there are few reports on shock lead placement in the left bundle branch area (LBBA) during CRT-defibrillator (CRT-D) implantation., Case Summary: A 76-year-old woman with heart failure from dilated cardiomyopathy presented with left bundle branch block pattern (QRS duration, 160 ms). Left ventricular ejection fraction was 21%. Cardiac resynchronization therapy-defibrillator implantation was performed due to worsening symptoms. By reshaping the Agilis HisPro catheter and adding a septal curve, the shock lead was placed deep into the ventricular septum, narrowing QRS duration to 114 ms. Left ventricular activation time was 84 ms. A defibrillation threshold test confirmed successful treatment without adverse events. At 6-month follow-up, left ventricular ejection fraction improved from 21 to 63%, with the patient's condition improving from New York Heart Association class III to class I., Discussion: It was reported that QRS narrowing in CRT was related to long-term mortality, and LOT-CRT further decreased QRS duration as compared with LBBP only or biventricular pacing and increased the response rate. Combining LBBAP with coronary sinus pacing can potentially achieve superior electrical resynchronization. Lack of a suitable tool for direct shock lead placement in LBBA necessitated additional LBBAP lead in conventional LOT-CRT. Our successful LOT-CRT-D procedure with minimal number of leads through Agilis HisPro catheter reshaping enabled direct LBBA shock lead placement., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Polyethylene terephthalate (PET) is a major component of plastic waste. Enzymatic PET hydrolysis is the most ecofriendly recycling technology. The biorecycling of PET waste requires the complete depolymerization of PET to terephthalate and ethylene glycol. The history of enzymatic PET depolymerization has revealed two critical issues for the industrial depolymerization of PET: industrially available PET hydrolases and pretreatment of PET waste to make it susceptible to full enzymatic hydrolysis. As none of the wild-type enzymes can satisfy the requirements for industrialization, various mutational improvements have been performed, through classical technology to state-of-the-art computational/machine-learning technology. Recent engineering studies on PET hydrolases have brought a new insight that flexibility of the substrate-binding groove may improve the efficiency of PET hydrolysis while maintaining sufficient thermostability, although the previous studies focused only on enzymatic thermostability above the glass transition temperature of PET. Industrial biorecycling of PET waste is scheduled to be implemented, using micronized amorphous PET. Next stage must be the development of PET hydrolases that can efficiently degrade crystalline parts of PET and expansion of target PET materials, not only bottles but also textiles, packages, and microplastics. This review discusses the current status of PET hydrolases, their potential applications, and their profespectal goals. KEY POINTS: • PET hydrolases must be thermophilic, but their operation must be below 70 °C • Classical and state-of-the-art engineering approaches are useful for PET hydrolases • Enzyme activity on crystalline PET is most expected for future PET biorecycling., (© 2024. The Author(s).)

Background/aim: Nivolumab and ipilimumab combination therapy has been extensively explored for the treatment of advanced non-small-cell lung cancer (NSCLC) through the pivotal phase III trials CheckMate 227 and CheckMate 9LA. However, the relationship between immune-related adverse events (irAEs) and the effectiveness of nivolumab plus ipilimumab-based therapy in a real-world clinical setting remains uncertain., Patients and Methods: We performed a retrospective analysis of 28 patients with advanced or recurrent NSCLC who underwent treatment with nivolumab plus ipilimumab, with or without platinum-doublet chemotherapy, from February 2021 to January 2023. The primary objective was to elucidate the clinical association between irAEs and treatment efficacy associated with nivolumab plus ipilimumab-based therapy., Results: Among the 28 patients, 22 (78.6%) experienced irAEs. The median progression-free survival (PFS) was significantly longer for patients with irAEs than for those without (p=0.0158), as was overall survival (OS) (p=0.000394). The severity of irAEs had no significant influence on PFS or OS. The objective response rate tended to be higher in patients with irAEs than in those without (50.0% versus 0.0%, respectively; p=0.0549). Multivariate analysis indicated that irAE occurrence was an independent factor for improved PFS (hazard ratio=0.2084, p=0.01383) and OS (hazard ratio=0.0857, p=0.001588). Interstitial lung disease was inferior to other irAE profiles for both PFS and OS., Conclusion: Patients with advanced NSCLC experiencing irAEs demonstrated superior clinical outcomes when treated with nivolumab plus ipilimumab-based therapy compared with those without irAEs. However, immune-related interstitial lung disease may be less linked with PFS and OS than other irAE profiles., (Copyright © 2024 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

One-carbon metabolism (OCM) is a complex and interconnected network that undergoes drastic changes during pregnancy. In this study, we investigated the longitudinal distribution of OCM-related metabolites in maternal and cord blood and explored their relationships. Additionally, we conducted cross-sectional analyses to examine the interrelationships among these metabolites. This study included 146 healthy pregnant women who participated in the Chiba Study of Mother and Child Health. Maternal blood samples were collected during early pregnancy, late pregnancy, and delivery, along with cord blood samples. We analyzed 18 OCM-related metabolites in serum using stable isotope dilution liquid chromatography/tandem mass spectrometry. We found that serum S-adenosylmethionine (SAM) concentrations in maternal blood remained stable throughout pregnancy. Conversely, S-adenosylhomocysteine (SAH) concentrations increased, and the total homocysteine/total cysteine ratio significantly increased with advancing gestational age. The betaine/dimethylglycine ratio was negatively correlated with total homocysteine in maternal blood for all sampling periods, and this correlation strengthened with advances in gestational age. Most OCM-related metabolites measured in this study showed significant positive correlations between maternal blood at delivery and cord blood. These findings suggest that maternal OCM status may impact fetal development and indicate the need for comprehensive and longitudinal evaluations of OCM during pregnancy., Competing Interests: The research fund for this research was a donation from Amway Japan G.K. The funding company played no role in the design of the study, in the collection, analysis, or interpretation of data, in the writing of the manuscript, or in the decision to publish the results.

Objectives: For preoperative biliary drainage (PBD) of malignant hilar biliary obstruction (MHBO), current guidelines recommend endoscopic nasobiliary drainage (ENBD) due to the higher risk of cholangitis after endoscopic biliary stenting (EBS) during the waiting period before surgery. However, few studies have supported this finding. Therefore, we aimed to compare the outcomes of preoperative ENBD and EBS in patients with MHBO., Methods: Patients with MHBO who underwent laparotomy for radical surgery after ENBD or EBS were included from retrospectively collected data from 13 centers (January 2014 to December 2018). We performed a 1:1 propensity score matching between the ENBD and EBS groups. These patients were compared for the following: cholangitis and all adverse events (AEs) after endoscopic biliary drainage (EBD) until surgery, time to cholangitis development after EBD, postsurgical AEs, and in-hospital death after surgery., Results: Of the 414 patients identified, 355 were analyzed in this study (226 for ENBD and 129 for EBS). The matched cohort included 63 patients from each group. The proportion of cholangitis after EBD was similar between the two groups (20.6% vs. 25.4%, P = 0.67), and no significant difference was observed in the time to cholangitis development. The proportions of surgical site infections, bile leaks, and in-hospital mortality rates were similar between the groups., Conclusion: For PBD of MHBO, the proportion of AEs, including cholangitis, after EBD until surgery was similar when either ENBD or EBS was used., (© 2023 Japan Gastroenterological Endoscopy Society.)

Purpose: To retrospectively evaluate the depiction rate of feeding arteries in biopsy-proven clear cell renal cell carcinoma (CCRCC) on four-dimensional computed tomography angiography (4D-CTA) images., Materials and Methods: This study included 22 patients with 22 CCRCC and 30 feeding arteries treated with transcatheter renal artery embolization. The depiction rate of the feeding arteries on preprocedural 4D-CTA was evaluated. Images were acquired by 320-row multi-detector computed tomography (CT) 15‒36 s after starting to inject a contrast agent (600 mg/kg iodine) intravenously into patients at 2.1 s intervals (11 phases). Two board-certified radiologists retrospectively assessed the feeder depiction rate in all 11 phases with reference to the procedural images as the gold standard. Discrepancies were resolved by consultation with a third radiologist., Results: Among the feeders, 11 (36.7%) were segmental or lobar, and 19 (63.3%) were interlobar or arcuate arteries. The feeder depiction rate was the highest (25 [83.3%] of 30) in the 5th phase (delay, 23.4 s) where the gap in contrast enhancement between the renal artery and cortex was the largest. This was followed by the 6th (23 [76.7%] of 30), 4th (22 [73.3%] of 30]), and 7th (21 [70.0%] of 30) phases. The overall rate of depicting feeding arteries in the 11 phases of 4D-CTA was 28 (93.3%) of 30., Conclusions: The depiction rate of CCRCC feeding arteries including lobar or smaller artery branches by 4D-CTA was favorable. The feeding arteries were optimally visualized during the phase with the largest contrast gap between the renal artery and cortex., (© 2024. The Author(s).)

We report a case of postoperative pseudoaneurysm, successfully treated with selective arterial embolization, using a steerable microcatheter and triaxial system via retrograde approach. A pseudoaneurysm was detected in the dorsal pancreatic artery, a severely narrow and steeply inverted branch of the superior mesenteric artery, making microcatheter insertion via the antegrade approach challenging. However, a steerable microcatheter was advanced beyond the orifice and the tip was reversed, changing the route to retrograde allowing for easy insertion of the microguidewire. Subsequently, a small microcatheter was advanced beyond the pseudoaneurysm into the dorsal pancreatic artery, and arterial embolization was successfully completed without complications.

Purpose: This study aimed to assess the outcomes of percutaneous cryoablation (PCA) for renal cell carcinomas (RCCs) contacting critical organs without intervening fat tissue., Material and Methods: Twenty-three patients with 24 RCCs (mean size, 28.8 mm) contacting critical organs on preprocedural images were included. The organ displacement techniques, technical success, efficacy, and adverse events per Clavien-Dindo classification were retrospectively reviewed., Results: The organs contacting the RCCs included the colon ( n  = 16), pancreas ( n  = 3), duodenum ( n  = 3), small intestine ( n  = 1), and stomach ( n  = 1). In all procedures, hydrodissection was conducted, and probe traction was additionally utilized in one to displace organs. Two procedures were terminated with an insufficient ice-ball margin (<6 mm) due to recurring proximity of the colon or thermal sink effect by renal hilar vessels, yielding a technical success rate of 91.6% (22/24). No severe adverse events were noted. All patients were alive without any metastases during a median follow-up of 34.4 months. The primary and secondary technical efficacy rates were 91.6% (22/24) and 95.8% (23/24) of tumors, respectively., Conclusion: PCA can be a valid option for RCCs contacting critical organs with a good safety profile and sufficient technical efficacy.

The association between uric acid (UA) and hyperuricemia with 5-year hypertension incidence using different blood pressure (BP) diagnostic references in men and women without cardiometabolic diseases is unknown. We used the checkup data from Kagoshima Kouseiren Hospital. All participants with hypertension or on BP medication, diabetes, dyslipidemia, obesity, estimated glomerular filtration rate<60 ml/min/1.73m 2 , metabolic syndrome, history of gout, and UA-lowering medication were excluded. UA was categorized into sex-specific quartiles and hyperuricemia was defined as UA > 7 mg/dl in men and UA > 6 mg/dl in women. We performed multivariate logistic regression to assess the effects of UA on hypertension development. The 5-year hypertension incidence was defined as subsets of BP ≥ 140/90 mmHg in cohort 1 and BP ≥ 130/80 mmHg in cohort 2. The study enrolled 21,443 participants (39.8%, men) in cohort 1 and 15,245 participants (36.5%, men) in cohort 2. The incidence of hypertension in cohorts 1 and 2 over 5 years was 16.3% and 29.7% in men and 10.9% and 21.4% in women, respectively. When comparing the fourth to the first UA quartile, there was an association with hypertension in men in cohort 1, with odds ratio (OR): 1.36 (95% confidence interval [CI], 1.13-1.63, p < 0.01) and cohort 2, OR: 1.31 (95%CI, 1.09-1.57, p < 0.01), respectively, but not in women. Additionally, an association between hyperuricemia and hypertension was observed in men only in cohort 1, with OR: 1.23 (95%CI, 1.07-1.42, p = 0.02), and in women in cohort 2, OR: 1.57 (95%CI, 1.14-2.16, p < 0.01). The effect of UA on the development of hypertension is influenced by sex and incidence differs with the BP reference used. Uric acid effect on the development of hypertension is affected by sex and incidence differs with the BP reference used., (© 2023. The Author(s), under exclusive licence to The Japanese Society of Hypertension.)

Purpose of Review: To review the current status of kidney tumor ablation in patients with substantial kidney impairment., Recent Findings: Few reports of kidney tumor ablation in such patients have recently been published. The reported prevalence of patients with stage 4 or 5 chronic kidney disease (CKD) among patients undergoing ablation is 2.0%-10%. In patients with stage 4 or 5 CKD, local tumor control rates were 88%-100%. The effect of ablation on CKD stage is unclear, and the observed deteriorations in kidney function are consistent with both the effect of cryoablation and the natural course of advanced CKD. According to guidelines, active surveillance may be selected. The goals of treatment are complete tumor removal and maintenance of kidney function, both of which can be met by ablation. Given the limited treatment options, ablation may play a pivotal role in the management of patients with advanced CKD., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Replication stress is a major contributor to tumorigenesis because it provides a source of chromosomal rearrangements via recombination events. PARK2, which encodes parkin, a regulator of mitochondrial homeostasis, is located on one of the common fragile sites that are prone to rearrangement by replication stress, indicating that replication stress may potentially impact mitochondrial homeostasis. Here, we show that chronic low-dose replication stress causes a fixed reduction in parkin expression, which is associated with mitochondrial dysfunction, indicated by an increase in mtROS. Consistent with the major role of parkin in mitophagy, reduction in parkin protein expression was associated with a slight decrease in mitophagy and changes in mitochondrial morphology. In contrast, cells expressing ectopic PARK2 gene does not show mtROS increases and changes in mitochondrial morphology even after exposure to chronic replication stress, suggesting that intrinsic fragility at PARK2 loci associated with parkin reduction is responsible for mitochondrial dysfunction caused by chronic replication stress. As endogenous replication stress and mitochondrial dysfunction are both involved in multiple pathophysiology, our data support the therapeutic development of recovery of parkin expression in human healthcare., (© 2024. The Author(s).)

Purpose: To retrospectively assess the time course of complications after image-guided small renal mass biopsy using initial follow-up imaging., Materials and Methods: A total of 190 masses (mean, 2.1 ± 0.70 cm; range, 0.6-3.8 cm) were assessed using initial computed tomography (43 non-enhanced and 141 enhanced) or magnetic resonance imaging (five non-enhanced and one enhanced) after biopsy. Initial follow-up imaging was classified into two groups (i.e., with or without hematoma) and various factors were compared., Results: The masses were histologically diagnosed in all patients except one. Post-procedural complications included 129 Grade I hematomas, 1 Grade I hemothorax, 9 Grade II hematomas, and 1 Grade IIIa pneumothorax. Residual 28 Grade I and 6 Grade II hematomas and 8 new complications (6 small hematomas, 1 pseudoaneurysm, and 1 arteriovenous fistula) were observed on the initial follow-up imaging obtained at a median of 21 days (3-90 days) after the biopsy. On the initial follow-up imaging, the groups with and without hematoma differed significantly in the following factors: age (P = 0.04), size (P = 0.02), guided images (P < 0.01), hematoma at the end of the procedure (P < 0.01), and days after biopsy (P < 0.01). Although three masses exhibited > 25% shrinkage, no significant change was observed in mass diameter on initial follow-up imaging (mean, 2.1 ± 0.71 cm; P = 0.90)., Conclusion: Initial follow-up imaging after a biopsy revealed improvements in most of the complications, a few new complications, and an unchanged mass diameter., (© 2023. The Author(s).)