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Abstract The novel coronavirus 2019 (COVID-19) pandemic required implementation of a variety of measures. In addition to pharmaceutical measures, such as vaccines, changing individuals’ nonpharmaceutical preventive behaviour is essential to prevent the spread of infection. In uncertain situations, such as a pandemic, media sources are important for guiding individuals’ decision-making behaviour. In this study, we examined the effects of media use on preventive behaviour during COVID-19. Earlier studies have shown that social networking service (SNS) browsing promotes preventive behaviour. However, those studies only assessed a single point during the early stages of the pandemic; therefore, the effects on ongoing preventive behaviour are unclear. Thus, a two-wave panel survey was conducted in 2020 and 2021 for an exploratory analysis of changes in the effects of media on individuals’ preventive behaviour over time. The results show that the effect of SNS browsing on preventing going out was confirmed only during the early stage of the pandemic and was not observed 1 year later. It is also shown that those who shifted from self-restraint to going out within 1 year were not affected by the type of media use, but by cognitive factors. As the situation changes during a pandemic, analyses that consider time-series changes are essential for gaining insights about the effects of media on the promotion and maintenance of continuous prevention behaviours.

Background: We developed a machine learning (ML) model to predict the risk of lymph node metastasis (LNM) in patients with early gastric cancer (EGC) who did not meet the existing Japanese endoscopic curability criteria and compared its performance with that of the most common clinical risk scoring system, the eCura system. Methods: We used data from 4,042 consecutive patients with EGC from 21 institutions who underwent endoscopic submucosal dissection (ESD) and/or surgery between 2010 and 2021. All resected EGCs were histologically confirmed not to satisfy the current Japanese endoscopic curability criteria. Of all patients, 3,506 constituted the training cohort to develop the neural network-based ML model, and 536 constituted the validation cohort. The performance of our ML model, as measured by the area under the receiver operating characteristic curve (AUC), was compared with that of the eCura system in the validation cohort. Results: LNM rates were 14% (503/3,506) and 7% (39/536) in the training and validation cohorts, respectively. The ML model identified patients with LNM with an AUC of 0.83 (95% confidence interval, 0.76–0.89) in the validation cohort, while the eCura system identified patients with LNM with an AUC of 0.77 (95% confidence interval, 0.70–0.85) (P = 0.006, DeLong's test). Conclusions: Our ML model performed better than the eCura system for predicting LNM risk in patients with EGC who did not meet the existing Japanese endoscopic curability criteria. We developed a neural network-based machine learning model that predicts the risk of lymph node metastasis in patients with early gastric cancer who did not meet the endoscopic curability criteria. [ABSTRACT FROM AUTHOR]

Purpose: The preoperative assessment of carotid plaques is necessary to render revascularization safe and effective. The aim of this study is to evaluate the usefulness of chemical exchange saturation transfer (CEST)-MRI, particularly amide proton transfer (APT) imaging as a preoperative carotid plaque diagnostic tool. Methods: We recorded the APT signal intensity on concentration maps of 34 patients scheduled for carotid endarterectomy. Plaques were categorized into group A (APT signal intensity ≥ 1.90 E-04; n = 12) and group B (APT signal intensity < 1.90 E-04; n = 22). Excised plaques were subjected to histopathological assessment and, using the classification promulgated by the American Heart Association, they were classified as intraplaque hemorrhage-positive [type VI-positive (tVI+)] and -negative [no intraplaque hemorrhage (tVI−)]. Results: Of the 34 patients, 22 (64.7%) harbored tVI+- and 12 (35.3%) had tVI− plaques. The median APT signals were significantly higher in tVI+- than tIVI− patients (2.43 E-04 (IQR = 0.98–4.00 E-04) vs 0.54 E-04 (IQR = 0.14–1.09 E-04), p <.001). Histopathologically, the number of patients with tVI+ plaques was significantly greater in group A (100%, n = 12) than group B (45%, n = 22) (p <.01). The number of symptomatic patients or asymptomatic patients with worsening stenosis was also significantly greater in group A than group B (75% vs 36%, p <.01). Conclusion: In unstable plaques with intraplaque hemorrhage and in patients with symptoms or progressive stenosis, the ATP signals were significantly elevated. CEST-MRI studies has the potential for the preoperative assessment of the plaques' characteristics. [ABSTRACT FROM AUTHOR]

Acaryochloris species belong to a special category of cyanobacteria possessing chlorophyll (Chl) d. One of the photosynthetic characteristics of Acaryochloris marina MBIC11017 is that the absorption spectra of photosystem I (PSI) showed almost no bands and shoulders of low-energy Chls d over 740 nm. In contrast, the absorption spectra of other Acaryochloris species showed a shoulder around 740 nm, suggesting that low-energy Chls d within PSI are diversified among Acaryochloris species. In this study, we purified PSI trimer and monomer cores from Acaryochloris sp. NBRC 102871 and examined their protein and pigment compositions and spectral properties. The protein bands and pigment compositions of the PSI trimer and monomer of NBRC102871 were virtually identical to those of MBIC11017. The absorption spectra of the NBRC102871 PSIs exhibited a shoulder around 740 nm, whereas the fluorescence spectra of PSI trimer and monomer displayed maximum peaks at 754 and 767 nm, respectively. These spectral properties were different from those of MBIC11017, indicating the presence of low-energy Chls d within the NBRC102871 PSIs. Moreover, we analyzed the NBRC102871 genome to identify amino acid sequences of PSI proteins and compared them with those of the A. marina MBIC11017 and MBIC10699 strains whose genomes are available. The results showed that some of the sequences in NBRC102871 were distinct from those in MBIC11017 and MBIC10699. These findings provide insights into the variety of low-energy Chls d with respect to the protein environments of PSI cores among the three Acaryochloris strains. [ABSTRACT FROM AUTHOR]

Background: Although the association between higher physical activity and preventive effect on breast-cancer-related lymphoedema (BCRL) has been reported, it is unclear what intervention is optimal. We aimed to investigate the effect of exercise and educational programs on BCRL development. Methods: This study was a secondary endpoint analysis from a prospective randomized controlled trial. We enrolled patients with stage 0–III breast cancer from March 2016 to March 2020 and randomly assigned them to the control (n = 111), education (n = 115), or exercise (n = 104) group. As secondary endpoint, we assessed the incidence of and preventive effect on BCRL at 12 months post-intervention. Results: There were no significant differences in the incidence of BCRL at 12 months post-intervention between the exercise and control groups (9.8% and 10.8%, P = 0.83) and the education and control groups (11.6% and 10.8%, P = 1.00). There were no significant differences in time to BCRL onset from the day of surgery between the exercise and control groups (event rate at 12 months: 20.7% and 17.2%, log-rank, P = 0.54) and the education and control groups (18.8% and 17.2%, log-rank, P = 0.57). The multivariable analyses indicated that axillary dissection and obesity significantly increased the risk of BCRL [hazard ratio (HR): 2.36, 95% confidence interval (CI) 1.52–3.67 and HR: 1.68, 95% CI 1.07–2.63, respectively]. Conclusions: The intervention did not decrease the risk of BCRL, and axillary dissection and obesity were the risk factors of BCRL. Trial registration number: UMIN000020595 at UMIN Clinical Trial Registry. [ABSTRACT FROM AUTHOR]

Tetrasomy X or 48,XXXX is a rare sex chromosome aneuploidy. The parental origin of tetrasomy X in a female patient with developmental delay was analyzed; all four X chromosomes were derived from the mother, and there were no paternally derived sex chromosomes. This finding indicates a rare incidental co-occurrence of maternal and paternal nondisjunction or polysomy rescue. The mechanism of 48,XXYY, which is related to developmental delay in males, was analyzed for comparison. [ABSTRACT FROM AUTHOR]

Abstract We propose a new therapeutic strategy for Alzheimer's disease (AD). Brain peptide p3‐Alcβ37 is generated from the neuronal protein alcadein β through cleavage of γ‐secretase, similar to the generation of amyloid β (Aβ) derived from Aβ‐protein precursor/APP. Neurotoxicity by Aβ oligomers (Aβo) is the prime cause prior to the loss of brain function in AD. We found that p3‐Alcβ37 and its shorter peptide p3‐Alcβ9‐19 enhanced the mitochondrial activity of neurons and protected neurons against Aβo‐induced toxicity. This is due to the suppression of the Aβo‐mediated excessive Ca2+ influx into neurons by p3‐Alcβ. Successful transfer of p3‐Alcβ9‐19 into the brain following peripheral administration improved the mitochondrial viability in the brain of AD mice model, in which the mitochondrial activity is attenuated by increasing the neurotoxic human Aβ42 burden, as revealed through brain PET imaging to monitor mitochondrial function. Because mitochondrial dysfunction is common in the brain of AD patients alongside increased Aβ and reduced p3‐Alcβ37 levels, the administration of p3‐Alcβ9‐19 may be a promising treatment for restoring, protecting, and promoting brain functions in patients with AD.

Abstract The appraisal of trustworthiness from facial appearance of a stranger is critical for successful social interaction. Although self-resemblance is considered a significant factor affecting the perception of trustworthiness, research is yet to be conducted on whether this theory is applicable to natural unfamiliar faces in real life. We examined this aspect by using a state-of-the-art deep convolutional neural network for face recognition to measure the facial similarity of a large sample of people with the evaluators. We found that the more they resembled the rater, the more trustworthy they were evaluated if they were of the same sex as the rater. Contrarily, when the stranger was of the opposite sex, self-resemblance did not affect trustworthiness ratings. These results demonstrate that self-resemblance is an important factor affecting our social judgments of especially same-sex people in real life.

Bone-modifying agents (BMA) are extensively used in treating patients with prostate cancer with bone metastases. However, this increases the risk of medication-related osteonecrosis of the jaw (MRONJ). The safety of long-term BMA administration in clinical practice remains unclear. We aimed to determine the cumulative incidence and risk factors of MRONJ. One hundred and seventy-nine patients with prostate cancer with bone metastases treated with BMA at our institution since 2008 were included in this study. Twenty-seven patients (15%) had MRONJ during the follow-up period (median, 19 months; interquartile range, 9–43 months). The 2-year, 5-year, and 10-year cumulative MRONJ incidence rates were 18%, 27%, and 61%, respectively. Multivariate analysis identified denosumab use as a risk factor for MRONJ, compared with zoledronic acid use (HR 4.64, 95% CI 1.93–11.1). Additionally, BMA use at longer than one-month intervals was associated with a lower risk of MRONJ (HR 0.08, 95% CI 0.01–0.64). Furthermore, six or more bone metastases (HR 3.65, 95% CI 1.13–11.7) and diabetes mellitus (HR 5.07, 95% CI 1.68–15.2) were risk factors for stage 2 or more severe MRONJ. MRONJ should be considered during long-term BMA administration in prostate cancer patients with bone metastases. [ABSTRACT FROM AUTHOR]

Unilateral spatial neglect (USN) results from impaired attentional networks and can affect various sensory modalities, such as visual and somatosensory. The rodent medial agranular cortex (AGm), located in the medial part of the forebrain from rostral to caudal direction, is considered a region associated with spatial attention. The AGm selectively receives multisensory input with the rostral AGm receiving somatosensory input and caudal part receiving visual input. Our previous study showed slower recovery from neglect with anterior AGm lesion using the somatosensory neglect assessment. Conversely, the functional differences in spatial attention across the entire AGm locations (anterior, intermediate, and posterior parts) are unknown. Here, we investigated the relationship between the severity of neglect and various locations across the entire AGm in a mouse stroke model using a newly developed program-based analysis method that does not require human intervention. Among various positions of the lesions, the recovery from USN during recovery periods (postoperative day; POD 10–18) tended to be slower in cases with more rostral lesions in the AGm (r = − 0.302; p = 0.028). Moreover, the total number of arm entries and maximum moving speed did not significantly differ between before and after AGm infarction. According to these results, the anterior lesions may slowly recover from USN-like behavior, and there may be a weak association between the AGm infarct site and recovery rate. In addition, all unilateral focal infarctions in the AGm induced USN-like behavior without motor deficits. [ABSTRACT FROM AUTHOR]

Spontaneous intracerebral hemorrhage (SICH) remains a devastating form of stroke. Prior use of antiplatelets or warfarin before SICH is associated with poor outcomes, but the effects of direct oral anticoagulants (DOACs) remain unclear. This study aimed to clarify trends in prior antithrombotic use and to assess the associations between prior use of antithrombotics and in-hospital mortality using a multicenter prospective registry in Japan. In total, 1085 patients were analyzed. Prior antithrombotic medication included antiplatelets in 14.2%, oral anticoagulants in 8.1%, and both in 1.8%. Prior warfarin use was significantly associated with in-hospital mortality (odds ratio [OR] 5.50, 95% confidence interval [CI] 1.30–23.26, P < 0.05) compared to no prior antithrombotic use. No such association was evident between prior DOAC use and no prior antithrombotic use (OR 1.34, 95% CI 0.44–4.05, P = 0.606). Concomitant use of antiplatelets and warfarin further increased the in-hospital mortality rate (37.5%) compared to warfarin alone (17.2%), but no such association was found for antiplatelets plus DOACs (8.3%) compared to DOACs alone (11.9%). Prior use of warfarin remains an independent risk factor for in-hospital mortality after SICH in the era of DOACs. Further strategies are warranted to reduce SICH among patients receiving oral anticoagulants and to prevent serious outcomes. [ABSTRACT FROM AUTHOR]

Antisense oligonucleotides (ASOs) are synthetic single-stranded oligonucleotides that bind to RNAs through Watson–Crick base pairings. They are actively being developed as therapeutics for various human diseases. ASOs containing unmethylated deoxycytidylyl-deoxyguanosine dinucleotide (CpG) motifs are known to trigger innate immune responses via interaction with toll-like receptor 9 (TLR9). However, the TLR9-stimulatory properties of ASOs, specifically those with lengths equal to or less than 20 nucleotides, phosphorothioate linkages, and the presence and arrangement of sugar-modified nucleotides—crucial elements for ASO therapeutics under development—have not been thoroughly investigated. In this study, we first established SY-ODN18, an 18-nucleotide phosphorothioate oligodeoxynucleotide with sufficient TLR9-stimulatory activity. We demonstrated that an unmethylated CpG motif near its 5′-end was indispensable for TLR9 activation. Moreover, by utilizing various sugar-modified nucleotides, we systematically generated model ASOs, including gapmer, mixmer, and fully modified designs, in accordance with the structures of ASO therapeutics. Our results illustrated that introducing sugar-modified nucleotides in such designs significantly reduces TLR9-stimulatory activity, even without methylation of CpG motifs. These findings would be useful for drug designs on several types of ASOs. [ABSTRACT FROM AUTHOR]

A 3.5-Mb microdeletion in Xq22 was identified in a female patient with early-onset neurological disease trait (EONDT). The patient exhibited developmental delay but no hypomyelination despite PLP1 involvement in the deletion. However, the clinical features of the patient were consistent with those of TCEAL1 loss-of-function syndrome. The breakpoint junction was analyzed using long-read sequencing, and blunt-end fusion was confirmed. [ABSTRACT FROM AUTHOR]

Purpose: Preoperative medical management is critical to prevent intraoperative cardiovascular complications in patients with pheochromocytomas and paragangliomas (PPGLs). Initial treatment involves α-adrenergic receptor blockers. However, while the routine use of metyrosine alongside these blockers is not strongly recommended due to a lack of evidence supporting its efficacy and associated safety concerns, there are previous studies on combination therapy with phenoxybenzamine and metyrosine. There are few reports on combination therapy with the selective α1-adrenergic receptor blocker doxazosin. Therefore, we investigated this combination treatment, which theoretically can affect perioperative outcomes in patients with PPGLs. To our knowledge, this is the first such study. Methods: This retrospective single-center observational study involved 51 patients who underwent surgical resection of PPGLs at Kobe University Hospital between 2014 and 2022. All patients received doxazosin at maximum doses. Fourteen patients received concomitant metyrosine, while 37 received doxazosin alone. Their perioperative outcomes were compared. Results: No severe event, such as acute coronary syndrome, was observed in either group. Intraoperatively, the doxazosin + metyrosine group exhibited a lower median minimum systolic blood pressure (56 [54–60] vs. 68 [59–74] mmHg, P = 0.03) and required lower median remifentanil (P = 0.04) and diltiazem (P = 0.02) doses than the doxazosin-alone group. Conclusion: The combination of metyrosine and doxazosin as a preoperative treatment for PPGLs affects intraoperative circulatory hemodynamics, such as a reduced occurrence of blood pressure elevation during surgery. Further research is necessary to identify patients who will benefit most from this combination treatment. [ABSTRACT FROM AUTHOR]

The number of umbilical cord blood transplantation (U-CBT) procedures has been growing annually, but little research has been done on long-term immune recovery after U-CBT. Infection risk is high in U-CBT recipients, and this can be partially attributed to immature immunocompetent cells in umbilical cord blood. In this study, we analyzed lymphocyte subset (LST) number to determine the long-term recovery timeline. We included 36 U-CBT and 10 unrelated bone marrow transplantation (U-BMT) recipients who survived more than 2 years after transplantation, and followed them for up to 10 years post-transplant. Recovery kinetics in the early phase post-transplant was different for each LST. Recovery of CD19+ B cells was faster after U-CBT than after U-BMT in the first 5 years after transplantation. Although CD4+ T cells increased in the first several months after U-CBT, long-term cell count recovery was impaired in approximately 20% of patients. Thus, although the LST recovery pattern after U-CBT was unique, LST number recovery was statistically comparable between U-CBT and U-BMT past 5 years post-transplantation. [ABSTRACT FROM AUTHOR]

Purpose: Chronic lung allograft dysfunction (CLAD) is a known long-term fatal disorder after lung transplantation. In this study, we evaluated the CLAD classification of the International Society for Heart and Lung Transplantation (ISHLT) for living-donor lobar lung transplantation (LDLLT). Methods: We conducted a single-center retrospective review of data from 73 patients who underwent bilateral LDLLT between 1998 and 2019. Factors related to opacity on computed tomography (CT) and restriction on pulmonary function tests (PFTs) were also analyzed. Results: Overall, 26 (36%) patients were diagnosed with CLAD, including restrictive allograft syndrome (RAS), n = 10 (38.5%); bronchiolitis obliterans syndrome (BOS), n = 8 (30.8%); mixed, n = 1 (3.8%); undefined, n = 2 (7.7%); and unclassified, n = 5 (19.2%). The 5-year survival rate after the CLAD onset was 60.7%. The survival of patients with BOS was significantly better than that of patients with RAS (p = 0.012). In particular, patients with restriction on PFT had a significantly worse survival than those without restriction (p = 0.001). Conclusions: CLAD after bilateral LDLLT does not have a major impact on the recipient survival, especially in patients with BOS. Restriction on PFT may predict a particularly poor prognosis in patients with CLAD after bilateral LDLLT. [ABSTRACT FROM AUTHOR]

Abstract Infection with the intracellular bacterium Coxiella (C.) burnetii can cause chronic Q fever with severe complications and limited treatment options. Here, we identify the enzyme cis‐aconitate decarboxylase 1 (ACOD1 or IRG1) and its product itaconate as protective host immune pathway in Q fever. Infection of mice with C. burnetii induced expression of several anti‐microbial candidate genes, including Acod1. In macrophages, Acod1 was essential for restricting C. burnetii replication, while other antimicrobial pathways were dispensable. Intratracheal or intraperitoneal infection of Acod1−/− mice caused increased C. burnetii burden, weight loss and stronger inflammatory gene expression. Exogenously added itaconate restored pathogen control in Acod1−/− mouse macrophages and blocked replication in human macrophages. In axenic cultures, itaconate directly inhibited growth of C. burnetii. Finally, treatment of infected Acod1−/− mice with itaconate efficiently reduced the tissue pathogen load. Thus, ACOD1‐derived itaconate is a key factor in the macrophage‐mediated defense against C. burnetii and may be exploited for novel therapeutic approaches in chronic Q fever.

Background: We aimed to determine the capabilities of compressed sensing (CS) and deep learning reconstruction (DLR) with those of conventional parallel imaging (PI) for improving image quality while reducing examination time on female pelvic 1.5-T magnetic resonance imaging (MRI). Methods: Fifty-two consecutive female patients with various pelvic diseases underwent MRI with T1- and T2-weighted sequences using CS and PI. All CS data was reconstructed with and without DLR. Signal-to-noise ratio (SNR) of muscle and contrast-to-noise ratio (CNR) between fat tissue and iliac muscle on T1-weighted images (T1WI) and between myometrium and straight muscle on T2-weighted images (T2WI) were determined through region-of-interest measurements. Overall image quality (OIQ) and diagnostic confidence level (DCL) were evaluated on 5-point scales. SNRs and CNRs were compared using Tukey's test, and qualitative indexes using the Wilcoxon signed-rank test. Results: SNRs of T1WI and T2WI obtained using CS with DLR were higher than those using CS without DLR or conventional PI (p < 0.010). CNRs of T1WI and T2WI obtained using CS with DLR were higher than those using CS without DLR or conventional PI (p < 0.003). OIQ of T1WI and T2WI obtained using CS with DLR were higher than that using CS without DLR or conventional PI (p < 0.001). DCL of T2WI obtained using CS with DLR was higher than that using conventional PI or CS without DLR (p < 0.001). Conclusion: CS with DLR provided better image quality and shorter examination time than those obtainable with PI for female pelvic 1.5-T MRI. Relevance statement: CS with DLR can be considered effective for attaining better image quality and shorter examination time for female pelvic MRI at 1.5 T compared with those obtainable with PI. Key Points: Patients underwent MRI with T1- and T2-weighted sequences using CS and PI. All CS data was reconstructed with and without DLR. CS with DLR allowed for examination times significantly shorter than those of PI and provided significantly higher signal- and CNRs, as well as OIQ. [ABSTRACT FROM AUTHOR]

Background: Laugier's hernia is a very rare atypical femoral hernia and is challenging to diagnose preoperatively. Herein, we report a rare case of inguinal and Laugier's hernias treated with laparoscopic transabdominal preperitoneal repair. Case presentation: A 63-year-old man was admitted to our hospital with right groin swelling for 4 years. Computed tomography revealed an indirect inguinal hernia with protrusion of the small intestine. The preoperative diagnosis was right indirect inguinal hernia; Laugier's hernia was unknown. The patient underwent laparoscopic transabdominal preperitoneal repair. During the surgery, part of the perivesical adipose tissue penetrated the lacunar ligament. It was located medial to the typical site of a femoral hernia. Thus, Laugier's hernia was diagnosed. Finally, laparoscopic transabdominal preperitoneal repair was performed for Laugier's hernia and inguinal hernia. The postoperative course was good, without recurrence. Conclusions: To our knowledge, this is the first reported case of inguinal and Laugier's hernia treated with laparoscopic transabdominal preperitoneal repair. Surgeons should be mindful that inguinal hernias can occur concurrently with other types of hernias, such as femoral hernias, including atypical variants like Laugier's hernia. Additionally, they should actively consider laparoscopic approaches such as transabdominal preperitoneal for femoral hernias. These approaches are beneficial for precise diagnosis, confirming the presence of other hernias, and simultaneously treating all coexisting inguinal hernias. [ABSTRACT FROM AUTHOR]

Competition in sports, unlike cooperation in everyday life, does not involve a single solution because individuals aim to behave unpredictably, thereby preventing others from predicting their actions. This study determined how individuals in court-based sports attempted to control others' unpredictable behaviors, addressing the gap in previous studies regarding the lack of clarity around strategies employed by individuals in competitive situations. We achieved this by applying a switching hybrid dynamics model, considering external inputs to analyze individual behaviors. Consequently, the study indicates that skilled individuals, in contrast to intermediate players, exhibit greater consistency in their behaviors. These skilled individuals lead others to anticipate their consistency and subsequently employ strategies to disrupt these expectations. This strategy exploits the principles of active human inference, implying that competition involves cooperation. This was revealed by an analysis of both human decision-making and behavior in actual matches as discrete and continuous dynamical systems. This interpersonal strategy could assist policymakers in the field of everyday life to enhance competitiveness. This strategy enables policymakers to adopt new policies that promote cooperation with competitors, ultimately increasing competitiveness in various aspects of our daily lives. [ABSTRACT FROM AUTHOR]

Govetto's staging system (stages 1–4) for epiretinal membrane (ERM) based on optical coherence tomography images is a useful predictor of monocular visual function; however, an association between Govetto's stage and binocular vision has not been reported. This study aimed to investigate the factors associated with Govetto's stage among the monocular and binocular parameters. This retrospective study included consecutive patients with treatment-naïve eyes with unilateral ERM without pseudo-hole. We investigated Govetto's stage, degrees of aniseikonia and metamorphopsia, foveal avascular zone area, central retinal and choroidal thickness, vertical ocular deviation, stereopsis, and binocular single vision (BSV). We compared the parameters between the BSV-present and BSV-absent groups and investigated correlations between Govetto's stage and the monocular and binocular parameters. Twenty-eight eyes of 28 patients were examined (age, 66.6 ± 10.2 years). In multivariate correlation analyses, Govetto's stage correlated with BSV (P = 0.04, β = − 0.36) and central retinal thickness (P < 0.001, β = 0.74). Of the eyes, 18 were assigned to the BSV-present group and 10 to the BSV-absent group. Govetto's stage was significantly more advanced in the BSV-absent group than in the BSV-present group (3.2 ± 0.8 vs 2.5 ± 0.7, P = 0.03). Of the 28 patients, 11 (39%) showed small-angle vertical deviations (1–12Δ). In conclusion, our findings showed that Govetto's stage correlated with binocular vision in patients with monocular ERM. Govetto's staging is a useful parameter for predicting not only monocular but also binocular vision. [ABSTRACT FROM AUTHOR]

The newly developed portable oxygen concentrator with an auto-demand oxygen delivery system (auto-DODS) automatically switches between 3 sensitivities according to the negative pressure gradient of inhalation and supplies oxygen only during inhalation. The aim of this study was to verify the effectiveness and safety of auto-demand devices compared with a continuous flow oxygen concentrator, during sleep, in a randomized crossover noninferiority trial. We alternatively used an auto-DODS or a continuous-flow oxygen concentrator, all night on separate days for HOT (Home Oxygen Therapy) patients with nocturnal hypoxemic symptoms. The primary endpoints were the mean value of oxygen saturation (SpO2) over the total sleep time. The secondary endpoints included the efficacy endpoints and the safety endpoints. Regarding the primary endpoint, the difference in SpO2 between the auto-DODS and continuous flow was 0.835%. Since the upper limit of this difference did not exceed 2.8, which was set as the noninferiority margin, it was shown that the auto-DODS did not reduce SpO2 by at least 2.8% on average compared to continuous flow. No equipment failure or exacerbation of disease was observed, confirming the safety of the auto-DODS during the night. [ABSTRACT FROM AUTHOR]

To assess the clinical significance of repeated head imaging in children with minor blunt force head trauma who underwent computed tomography (CT), limited to those who exclude with very low risk of important traumatic brain injury. We conducted a retrospective cohort study of children aged under 24 months with minor head trauma who underwent repeated head imaging and initial CT scans according to the Pediatric Emergency Care Applied Research Network (PECARN) rules. We enrolled 741 children and 110 with skull fracture (SF). Of the 96 patients with SF on initial CT who received head magnetic resonance imaging (MRI) a few days later, 36 (37.5%) patients' initial CT findings revealed intracranial injury in addition to SF. The number of children who exhibited new intracranial findings on follow-up MRI among those with isolated SF without intracranial damage and those with SF and intracranial injury on initial CT was 25/60 (40.7%) and 14/36 (38.9%), respectively. Subcutaneous hematoma on arrival and intersection with the coronal suture and lines of fracture were significantly associated with new intracranial findings. Four children with SF and intracranial injury on initial CT received neurosurgical intervention. No intervention was needed for those with isolated SF. We demonstrated that a proportion of children with head trauma had new findings on follow-up MRI, particularly in those without very low risk of clinically important traumatic brain injury. Patients who exhibit new intracranial MRI findings that satisfy the PECARN rules may not require neurosurgical intervention if their initial CT finding is isolated SF. [ABSTRACT FROM AUTHOR]

The hypervariable region (HVR) in the control region of the mitochondrial DNA has frequently been used for population genetics and phylogeographic studies because of its highly variable nature. Although the HVR is beneficial for evaluating recent evolutionary history, including population demography, recent studies have implied the incidence of homoplasy in this region. To assess the accuracy of relying solely on the HVR for population genetics studies, molecular evolutionary analysis of the HVR, NADH-dehydrogenase subunit 2 (ND2), and cytochrome b genes were performed using 120 individuals of marbled flounder Pseudopleuronectes yokohamae. The HVR exhibited the highest genetic variability among the three regions, with sites showing high site-specific substitution rates. Considering the reticulate haplotype network structure and evolutionary linkages between regions, homoplastic mutations were indicated in the HVR in addition to ND2, underestimating genetic diversity. We found that homoplasy was less likely to affect coalescent-based demographic inferences in the population; however, there is still a potential risk of misinterpretation of population demography when solely using the HVR owing to its hypervariable nature. Collectively, we suggest analyzing other regions in addition to the HVR in fish population genetic research to improve accuracy and eliminate biases caused by homoplasy. [ABSTRACT FROM AUTHOR]

Purpose: Radiation pneumonitis (RP) is an obstacle for patients after surgery following induction chemoradiotherapy for locally advanced non-small cell lung cancer (LA-NSCLC). We performed a comparative analysis of the association between clinicopathological factors, including the neutrophil-to-lymphocyte ratio (NLR) and prognosis, in LA-NSCLC patients with or without RP during induction chemoradiotherapy followed by surgery. Methods: The subjects of this analysis were 168 patients undergoing trimodality therapy for LA-NSCLC between January, 1999 and May, 2019. Patients were divided into two groups: the RP group (n = 41) and the non-RP group (n = 127). We compared the clinicopathological factors including the NLR between the groups and analyzed the association between the NLR and prognosis. Results: The RP group had more patients with tumors located in the lower lobe, more bilobar resections, shorter operative times, no implementation of postoperative adjuvant chemotherapy, and a higher postoperative NLR than the non-RP group. There were no significant differences in serious postoperative complications and the prognosis. Patients with a low postoperative NLR had a significantly better prognosis in the non-RP group, and a trend toward a better prognosis even in the RP group. Conclusion: Postoperative NLR may be a useful prognostic factor, even for patients who suffer RP after trimodality therapy for LA-NSCLC. [ABSTRACT FROM AUTHOR]

Purpose: Radiofrequency (RF) ablation with half-normal saline (HNS) irrigation is reported to potentially enlarge local lesion compared to normal saline (NS) in power-controlled ablation (PC-Abl). However, the effect of HNS-irrigation in temperature-flow-controlled ablation (TFC-Abl) on lesion characteristics is unknown. We compared this between TFC-Abl with QDOT-Micro™ catheter and PC-Abl with Thermocool SmartTouch SF™ catheter (STSF). Methods: RF-application with NS (n = 480) and HNS (n = 480) irrigation were performed on swine myocardium placed in a circulating saline bath. Lesion characteristics without steam-pops under various conditions (target AI, 400/550; ablation power, 30/50 W; contact force, 10/20/30 g; catheter orientation, perpendicular/parallel) were assessed and compared between two irrigants. Results: After matching, 343 lesions without steam-pops in each group were evaluated. In PC-Abl, lesion size did not differ between two groups (NS, 188 ± 97 vs. HNS, 200 ± 95 mm3, p = 0.28 in volume; 33.9 ± 7.3 vs. 34.8 ± 9.5 mm2, p = 0.34 in surface area; and 4.0 ± 1.0 vs. 4.0 ± 1.0 mm, p = 0.81 in depth), but steam-pops were more frequently observed with HNS-irrigation (23.8% vs. 37.9%, p = 0.001). Contrary, in TFC-Abl, HNS-irrigation produced significantly larger (214 ± 106 vs. 243 ± 128 mm3, p = 0.017) and deeper (4.0 ± 1.0 vs. 4.3 ± 1.1 mm, p = 0.002) lesions without increasing the risk of steam-pops (15.0% vs 15.0%, p = 0.99). Automatic temperature-guided titration was more frequently observed in HNS-irrigation (54.8% vs. 78.5%, p < 0.001). Conclusions: TFC-Abl with QDOT-Micro™ catheter utilizing HNS-irrigation might increase volume and depth of local lesion without increasing the risk of stem-pops compared to NS-irrigation. Power-controlled ablation with HNS-irrigation showed similar focal lesion with higher incidence of steam-pops (SPs) compared to normal saline (NS) irrigation. Contrary, temperature-flow-controlled ablation with HNS-irrigation provided larger and deeper lesion than NS-irrigation with similar incidence of SPs. ns, p > 0.05; *, 0.01 < p ≤ 0.05; **, 0.005 < p ≤ 0.01. HNS, half-normal saline; NS, normal saline. [ABSTRACT FROM AUTHOR]

While patients with cancer show a higher prevalence of psychiatric disorders than the general population, the mechanism underlying this interaction remains unclear. The present study examined whether tumor-bearing (TB) mice show psychological changes using the conditioned fear paradigm and the role of cytokines in these changes. TB mice were established by transplantation with mouse osteosarcoma AXT cells. These TB mice were then found to exhibit disruption in extinction of conditioned fear memory. Eighteen cytokines in serum were increased in TB mice, among which i.c.v. injection of interleukin (IL)-1β and IL-6 strengthened fear memory in normal mice. Contents of IL-17 and keratinocyte-derived cytokine (KC) in the amygdala and KC in the hippocampus were increased in TB mice. KC mRNA in both the amygdala and hippocampus was also increased in TB mice, and i.c.v. injection of KC dose-dependently strengthened fear memory in normal mice. In addition, injection of IL-1β, but not IL-6, increased KC mRNA in the amygdala and hippocampus. In TB mice KC mRNA was increased in both astrocytes and microglia of the amygdala and hippocampus. The microglia inhibitor minocycline, but not the astrocyte inhibitor fluorocitrate, alleviated disruption in extinction of conditioned fear memory in TB mice. Microinjection of KC into the hippocampus, but not into the amygdala, increased fear memory in normal mice. These findings indicate that TB mice show an increase in serum cytokines, including IL-1β, that increases KC production in microglia of the hippocampus, which then disrupts extinction of fear memory. [ABSTRACT FROM AUTHOR]

Background: The contribution of the tumor microenvironment and extracellular matrix to the aggressive biology of Gastric Cancer (GC) has been recently characterized; however, the role of EMILIN-1 in this context is unknown. EMILIN-1 is an essential structural element for the maintenance of lymphatic vessel (LV) integrity and displays anti-proliferative properties as demonstrated in skin and colon cancer. Given the key role of LVs in GC progression, the aim of this study was to investigate the role of EMILIN-1 in GC mouse models. Methods: We used the syngeneic YTN16 cells which were injected subcutaneously and intraperitoneally in genetically modified EMILIN-1 mice. In alternative, carcinogenesis was induced using N-Methyl-N-nitrosourea (MNU). Mouse-derived samples and human biopsies were analyzed by IHC and IF to the possible correlation between EMILIN-1 expression and LV pattern. Results: Transgenic mice developed tumors earlier compared to WT animals. 20 days post-injection tumors developed in EMILIN-1 mutant mice were larger and displayed a significant increase of lymphangiogenesis. Treatment of transgenic mice with MNU associated with an increased number of tumors, exacerbated aggressive lesions and higher levels of LV abnormalities. A significant correlation between the levels of EMILIN-1 and podoplanin was detected also in human samples, confirming the results obtained with the pre-clinical models. Conclusions: This study demonstrates for the first time that loss of EMILIN-1 in GC leads to lymphatic dysfunction and proliferative advantages that sustain tumorigenesis, and assess the use of our animal model as a valuable tool to verify the fate of GC upon loss of EMILIN-1. [ABSTRACT FROM AUTHOR]

Background: Nivolumab monotherapy is the standard second-line treatment for advanced esophageal squamous cell carcinoma (ESCC) after failure of platinum-based chemotherapy without anti-PD-1 antibody. Fixed dosing with 240 mg every 2 weeks was approved initially, followed by fixed dosing with 480 mg every 4 weeks based on pharmacokinetics data. However, information on the comparative efficacy and safety of the two doses remains limited. Methods: We compared progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and the incidence of adverse events (AEs) between the two doses in 117 patients who received second-line (n = 85) or later-line (n = 32) nivolumab monotherapy at our institution between January 2016 and December 2021. Results: In the second-line group, patient characteristics for the 240 mg and 480 mg groups were as follows (240 mg vs. 480 mg): performance status (PS) 0/1/2 was 34/61/5% vs. 54/42/4%, and prior fluoropyrimidine plus platinum therapy (FP) was 81.3% vs. 42.3%. In the later-line group, the characteristics were: PS 0/1/2 was 28/60/12% vs. 14/86/0%, and prior FP was 60.0% vs. 42.8%. ORR was 11.9 vs. 24.0% in the second-line group (p = 0.19) and 0 vs. 14.3% in the later-line group (p = 0.22). Median PFS was 1.7 vs. 4.1 months on second-line (hazard ratio [HR] 0.60, 95% confidence interval [CI] 0.35–1.01, p = 0.056) and 1.4 vs. 1.8 months on later-line (HR 0.58, 95% CI 0.23–1.46, p = 0.25); AEs of any grade were observed in 58.3 vs. 69.7%, respectively. Conclusions: The efficacy and safety of the two doses of nivolumab monotherapy were comparable in patients with advanced ESCC. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate retrospectively the influence of percutaneous cryoablation for small renal tumors on total and affected kidney function and risk factors associated with worsening function of the affected kidney. Materials and methods: Between April 2016 and March 2022, 27 patients who underwent cryoablation for small renal tumors at our institution participated in this study, which investigated time-dependent changes in postoperative renal function. We evaluated estimated glomerular filtration rates (eGFRs) and split renal function revealed by scintigraphy using 99 m technetium-mercaptoacetyltriglycine (99mTc-MAG3) before cryoablation and at 1 week, 1 month, and 6 months after cryoablation. Numerous variables were analyzed to assess risk factors for worsening renal function. Results: Baseline eGFR (mean ± standard deviation) was 56.5 ± 23.7 mL/min/1.73 m2 (mean ± SD; range, 20.5–112.5). Mean eGFRs at 1 week, 1 month, and 6 months after cryoablation were 57.4 ± 24.5 (19.1–114.9), 57.1 ± 25.1 (21.5–114.9), and 53.8 ± 23.9 mL/min/1.73 m2 (20.0–107.5), respectively. Changes were statistically insignificant (p = 1.0000, = 0.6749, and = 0.0761, respectively). Regarding split renal function, mean baseline contribution of the affected kidney determined by 99mTc-MAG3 was 49.7% ± 6.0% (38.8–63.3%); these rates at 1 week, 1 month, and 6 months after cryoablation were 43.7% ± 8.8 (29.1–70.6%), 46.2% ± 7.7% (32.6–70.3%), and 46.0% ± 8.5% (32.5–67.6%), respectively. Differences from baseline were significant for all periods (p < 0001, < 0001, = 0.0001, respectively). Serum C reactive protein and lactate dehydrogenase at 1 day following cryoablation, tumor's nearness to the collecting system or sinus, and volume of ablated normal renal parenchyma were significantly correlated with decreased contributions of the affected kidney by > 10% after cryoablation. Conclusion: Unlike total renal function, affected kidney function could worsen after cryoablation. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the prognostic value of the Gustave Roussy Immune score (GRIm-score) in platinum-refractory metastatic urothelial carcinoma (UC) treated with pembrolizumab. Methods: This multicenter retrospective study (YUSHIMA study) evaluated 331 patients with metastatic UC treated with pembrolizumab after platinum-based chemotherapy between January 2018 and June 2023 at 13 institutions. We collected pretreatment variables, including the GRIm-score based on serum albumin, lactate dehydrogenase, and neutrophil-to-lymphocyte ratio. The patients were divided into low and high GRIm-score groups. Prognostic factors for overall survival (OS) and progression-free survival (PFS) were determined using the multivariate Cox proportional hazard model. Results: During the median follow-up period of 7.3 months, 278 (84%) patients showed disease progression, and 223 (67%) died from any cause. Multivariate analysis revealed that the high GRIm-score group was an independent and significant adverse prognostic factor of both OS and PFS (hazard ratio, 1.65 and 1.82, respectively; both p < 0.001) along with Eastern Cooperative Oncology Group Performance Status of ≥ 2 (both p < 0.001), presence of visceral metastasis (both p < 0.001), and hemoglobin of < 9.2 g/dL (p = 0.030 and p = 0.038). C-reactive protein of > 42 mg/L was a significant prognostic factor for OS (p = 0.001). Conclusion: The GRIm-score is an independent prognostic marker for survival outcomes in patients with platinum-refractory metastatic UC treated with pembrolizumab. [ABSTRACT FROM AUTHOR]

Accurate river streamflow forecasting is pivotal for effective water resource planning, infrastructure design, utilization, optimization, and flood planning and warning. Streamflow prediction remains a difficult task due to several factors such as climate change, topography, and lack of observed data in some cases. This paper investigates and evaluates the individual performances of the seasonal auto-regressive integrated moving average (SARIMA) and Prophet models in forecasting the streamflow of the Sobat River and proposes a hybrid SARIMA-Prophet model to leverage the strengths of both approaches. Using the augmented Dickey-Fuller (ADF) and the Kwiatkowski-Phillips-Schmidt-Shin (KPSS) tests, the flow of the Sobat River was found to be stationary. The performance of the models was then assessed based on their residual errors and predictive accuracy using the mean absolute error (MAE), root mean squared error (RMSE), and coefficient of determination (R2). Residual analysis and prediction capabilities revealed that Prophet slightly edged SARIMA in terms of prediction efficacy; however, both models struggled to effectively capture extreme values, resulting in significant overestimations and slight underestimations. The hybrid SARIMA-Prophet model significantly reduced residual variability, achieving a lower MAE of 4.047 m3/s, RMSE of 6.17 m3/s, and a higher R2 of 0.92 than did the SARIMA (MAE: 5.39 m3/s, RMSE: 8.70 m3/s, R2: 0.85) and Prophet (MAE: 5.35 m3/s, RMSE: 8.32 m3/s, and R2: 0.86) models. This indicates that the hybrid model handles both long-term patterns and short-term fluctuations more effectively than the individual models. The findings of the present study highlight the potential of hybrid SARIMA-Prophet models for streamflow forecasting in terms of accuracy and reliability, thus contributing to more effective water resource management and planning, particularly in the Sobat River.Article Highlights: The Sobat River’s flow patterns remained statistically consistent, affirming stationarity. Both the SARIMA and Prophet models showed good performance but with limitations in handling extreme values The hybrid SARIMA-Prophet model effectively minimized residual variability and extreme prediction errors. [ABSTRACT FROM AUTHOR]

Purpose: As Japanese society ages, the number of surgeries performed in elderly patients with hiatal hernia (HH) is increasing. In this study, we examined the feasibility, safety, and potential effectiveness of the addition of anterior gastropexy to hiatoplasty with or without mesh repair and/or fundoplication in elderly Japanese HH patients. Methods: We retrospectively evaluated 39 patients who underwent laparoscopic HH repair between 2010 and 2021. We divided them into 2 groups according to age: the "younger" group (< 75 years old, n = 21), and the "older" group (≥ 75 years old, n = 18). The patient characteristics, intraoperative data, and postoperative results were collected. Results: The median ages were 68 and 82 years old in the younger and older groups, respectively, and the female ratio was similar between the groups (younger vs. older: 67% vs. 78%, p = 0.44). The older group had more type III/IV HH cases than the younger group (19% vs. 83%, p < 0.001). The operation time was longer in the older group than in the younger group, but there was no significant difference in blood loss, perioperative complications, or postoperative length of stay between the groups. The older group had significantly more cases of anterior gastropexy (0% vs. 78%, p < 0.001) and less fundoplication (100% vs. 67%, p = 0.004) than the younger group. There was no significant difference in HH recurrence between the groups (5% vs. 11%, p = 0.46). Conclusions: The addition of anterior gastropexy to other procedures is feasible, safe, and potentially effective in elderly Japanese patients with HH. [ABSTRACT FROM AUTHOR]

Purposes: The present study evaluated the impact of clinical guidelines for gastric cancer surgery on surgeons' choice of procedure in real-world practice. We focused on the 2014 guideline revision recommending laparoscopic surgery and the evidence concerning splenectomy for prophylactic lymphadenectomy reported in 2015 using the National Clinical Database, which is the most comprehensive database in Japan. Methods: We investigated the monthly percentages of laparoscopic distal gastrectomies performed for stage I gastric cancer (LDG%) and splenectomies performed during total gastrectomy for advanced cancer (TGS%) between 2014 and 2017. We evaluated the descriptive statistics of the time-series changes in the LDG%, TGS%, and annual trends of outcomes. Results: In total, 124,787 patients were enrolled. The mean LDG% and TGS% were 69.8% and 9.2%, respectively. The LDG% and TGS% were 66.4% and 16.7%, respectively, in January 2014 and 73.1% and 5.9%, respectively, in December 2017. LDG% consistently increased, and TGS% showed a consistent downward trend throughout the observation period. There was no significant change in this trend after the publication of the guideline recommendations or clinical trial results. Conclusion: No significant changes in surgical procedures were observed after publication of the guidelines or results of clinical trials. [ABSTRACT FROM AUTHOR]

Objectives: This study analyzed the long-term survival of dialysis patients undergoing AVR using the Japanese National Clinical Database with additional survival data. Methods: De-novo AVR for dialysis-dependent patients between 2010 and 2012 who were registered in the Japan Cardiovascular Surgery Database were included. Concomitant aortic surgery and transcatheter aortic valve replacement were excluded. An additional questionnaire was sent to each hospital regarding the underlying kidney disease, the duration of dialysis initiation to the surgery, and clinical outcomes. The Kaplan–Meier survival curve was descriptively shown for all cohorts and each renal pathology. Furthermore, we compared the incidence of bioprosthetic valve failure in patients who were < 65 years old (group Y) and ≧65 years old (group O). Results: Of these 1529 patients, diabetic nephropathy was 517, chronic glomerulonephritis was 437, and renal sclerosis was 210, regarding renal pathology. 1, 3, and 5-year survival in each pathology was 78.4%, 58.6%, 45.9% in diabetic nephritis, 78.8%, 68.4%, 58.2% in chronic glomerulonephritis, 79.0%, 67.8%, 52.1% in renal sclerosis, and 74.4%, 62.6%, 49.2% in others. Active infectious endocarditis was more prevalent in group Y (O 2.7% vs. Y 9.6%). The incidence of bioprosthetic valve failure requiring re-hospitalization was too small to analyze. 1, 3, and 5-year survival was 76.0%, 63.4%, 49.2% in group O and 74.3%, 64.2%, and 47.7% in group Y. Conclusions: Long-term survival of AVR for dialysis-dependent was higher in patients with chronic glomerulonephritis and lower in patients with diabetic nephritis than in other pathologies. [ABSTRACT FROM AUTHOR]

It has become increasingly apparent that even mature forests are susceptible to plant invasions. However, invasive plants are often more abundant in younger forest stands. It is difficult to disentangle possible mechanisms that would explain this pattern due to the scarcity of long-term studies in successional forests. Several mechanisms have been proposed to explain patterns of invasions as forests age, including biotic resistance, window of opportunity, historical legacies, and invasion debt. We explored patterns and potential mechanisms of plant invasions over 70 years in a regenerating forest with different land-use histories in the Bolleswood Natural Area, Connecticut, USA. We examined how environmental factors related to colonization patterns of invasive and non-invasive introduced species over time, and whether these patterns were consistent with the proposed mechanisms. Non-invasive introduced species declined rapidly with canopy closure, while many invasive plants persisted or even increased over time as the forest aged. Colonization was focused in younger post-agricultural areas, although this declined with time. Dispersal distance, soil conditions, and land-use history played important roles in patterns of colonization, while the effect of shading was less clear. There was some evidence for each mechanism, but the relative importance of each mechanism was species-dependent, making generalizations about how invasive plants invade forests difficult. We found that land-use history impacted invasion more strongly than forest age, but over time even mature forests were slowly being invaded by some species. Thus, invasive species management may be required even in mature forests. [ABSTRACT FROM AUTHOR]

In recent years, bedside ultrasound examinations have been used in many clinical departments and are called point-of-care ultrasound (POCUS). Regarding POCUS in the cardiac field, a protocol called focus (focused) cardiac ultrasound (FoCUS) has been developed in Europe and the United States, is being used clinically, and an educational syllabus has been created. According to them, FoCUS is defined as a point-of-care cardiac ultrasound examination using standardized limited sections and protocols. FoCUS is primarily intended to be performed by non-cardiologists, and in order to avoid making mistakes in judgment, it is important to be familiar with its limitations and it is necessary to understand pathological conditions that can only be diagnosed using conventional comprehensive echocardiography. The Japanese Society of Echocardiography has edited this clinical guideline because we believe that FoCUS should be used effectively and appropriately in Japan, and that appropriate education is essential to popularize FoCUS in Japan. Furthermore, lung POCUS has recently come into clinical use. Lung POCUS is useful for the diagnosis and follow-up of heart failure when used in conjunction with FoCUS, and is especially useful in primary care where chest X-rays are not available. The working group that created this manual agreed that it is desirable to educate patients about lung POCUS in conjunction with FoCUS, so we decided to include the basic techniques of lung POCUS and how to use them in this manuscript. [ABSTRACT FROM AUTHOR]

Hematopoietic stem cell transplants for inherited metabolic disorders performed at Tokai University Hospital between June 5, 1986, and May 28, 2021, were analyzed and compared between the period before 2007 and the period from 2007 onward based on availability of medical resources. Transplants were performed for 38 patients with mucopolysaccharidosis, 33 with adrenoleukodystrophy, and 16 with another disorder. Before 2007, oral busulfan-based regimens were mainly used. From 2007 onward, intravenous busulfan-based regimens or 4 Gy of thoracoabdominal irradiation (TAI), fludarabine, and melphalan (Mel)/treosulfan were adopted. Between 2002 and 2010, adrenoleukodystrophy was treated with 12 Gy of TAI and Mel. HLA-identical sibling bone marrow was used in 43% of cases before 2007 and 15% from 2007 onward, while alternative donors were selected for other transplants. Overall survival and event-free survival (EFS) before 2007 and from 2007 onward were 76% and 62%, and 97% and 85%, respectively (P = 0.006 and 0.017). Transplant era predicted superior overall survival and EFS, while myeloablative conditioning also predicted EFS. The incidence of primary graft failure decreased from 2007 onward, especially in cord blood transplant when 4 Gy of TAI with 150 mg/m2 fludarabine and 180 mg/m2 Mel or 42 g/m2 treosulfan were used as conditioning. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this randomized controlled trial was to evaluate whether early urinary catheter removal is feasible during epidural anesthesia during gastrointestinal surgery in male patients at high risk for urinary retention. Methods: Male patients who underwent radical surgery for gastric or colon cancer were enrolled in this randomized controlled trial. Patients were randomized 1:1 into 2 groups: the early group, in which the urinary catheter was removed before removal of the epidural catheter on the second or third postoperative day, and the late group, in which the urinary catheter was removed after removal of the epidural catheter. The randomization adjustment factors were age (≥ 65 or < 65 years) and operative site (gastric or colon). The primary endpoint was urinary retention. The secondary endpoints were the incidence of urinary tract infection and length of postoperative hospital stay. Results: Seventy-three patients were enrolled between March 2020 and February 2024 and assigned to the Early (n = 37) and Late (n = 36) groups. Four patients withdrew their consent after randomization. The intention-to-treat analysis showed that urinary retention occurred in 4 patients (11.1%) in the early group and 1 patient (3.0%) in the late group (P = 0.20). Urinary tract infection occurred in 1 patient (3.0%) in the late group. The median postoperative hospital stay was 9 days in both groups. Conclusion: Early urinary catheter removal in male patients undergoing gastrointestinal surgery with epidural anesthesia could increase urinary retention within the expected acceptable range. Trial registration number: UMIN000040468, Date of registration: May 21, 2020. [ABSTRACT FROM AUTHOR]

Electric discharge in deep-sea hydrothermal fields leads us to expect the existence of electroactive microbial ecosystems in the environments. Electrochemical properties such as electric field distribution on the seafloor and electrical conductivity of the rock can be useful indicators of searching electroactive microbial community in natural environments. We performed electric field measurements in deep-sea hydrothermal fields and collected rock samples by a remotely operative vehicle (ROV) operation. Several spots on the seafloor with strong electric fields were detected, which included both active hydrothermal vent areas and inactive sulfide deposits far from the vents. The electrical conductivity of the rock samples was correlated with the copper and iron sulfide content. Microbial community compositions of the rock samples were characterized by small subunit (SSU) rRNA gene amplicon sequencing analysis. The abundance of several microbial components, which are highly related to electroactive microorganisms such as Geobacteraceae and Thiomicrorhabdus, was affected by the electrical properties of rock samples. The results suggested that electrochemical properties on the seafloor would be related to the abundance of possible electroactive microbial populations, and that the electrochemical survey may be a powerful tool for exploring electroactive ecosystems. [ABSTRACT FROM AUTHOR]

Superconducting magnets based on high-temperature superconductors (HTSs) have become critical components in cutting-edge technologies such as advanced medical applications. In HTSs, weak links of superconductivity are inevitable at high-angle grain boundaries (GBs). Thus, two adjacent grains should be crystallographically aligned within the critical angle (θc), for which the intergrain critical current density (Jc) starts to decrease exponentially. The θc of several iron-based superconductors (IBSs) is larger than that of cuprates. However, the decreases in both θc and intergrain Jc under magnetic fields for IBSs are still substantial, hampering their applications in polycrystalline forms. Here, we report that potassium-doped BaFe2As2 (Ba122:K) exhibits superior GB performance to that of previously reported IBSs. A transport Jc of over 0.1 MA/cm2 across [001]-tilt GBs with misorientation angles up to θGB = 24° was recorded even at 28 K, which is a required level for practical applications. Additionally, even in an applied magnetic field, θc was unaltered, and the decay of the intergrain Jc was small. Our results highlight the exceptional potential of Ba122:K for polycrystalline applications and pave the way for next-generation superconducting magnets. We have fabricated artificial grain boundaries in K-doped BaFe2As2 (Ba122:K), one of the Fe-based superconductors. The crystalline orientation map, acquired through the scanning precession electron diffraction measurements, revealed that spontaneous connectivity modification occurred at the grain boundary, which may mitigate weak-link behavior. Specifically, a self-field critical current density Jc of over 0.1 MA/cm2 across the grain boundary with misorientation angles up to 24° was recorded even at 28 K. This performance surpasses the grain boundary properties of hitherto reported Fe-based superconductors. Our results highlight the exceptional potential of Ba122:K for polycrystalline applications and pave the way for next-generation superconducting magnets. [ABSTRACT FROM AUTHOR]

Immunoglobulin E (IgE) plays pivotal roles in allergic diseases through interaction with a high-affinity receptor (FcεRI). We established that Fab fragments of anti-IgE antibodies (HMK-12 Fab) rapidly dissociate preformed IgE-FcεRI complexes in a temperature-dependent manner and inhibit IgE-mediated anaphylactic reactions, even after allergen challenge. X-ray crystallographic studies revealed that HMK-12 Fab interacts with each of two equivalent epitopes on the Cε2 homodimer domain involved in IgE F(ab')2. Consequently, HMK-12 Fab-mediated targeting of Cε2 reduced the binding affinity of Fc domains and resulted in rapid removal of IgE from the receptor complex. This unexpected finding of allosteric inhibition of IgE-FcεRI interactions by simultaneous targeting of two epitope sites on the Cε2 homodimer domain of IgE F(ab')2 may have implications for the development of novel therapies for allergic disease. The authors show that the allosteric inhibition of the interactions between Immunoglobulin E and the high-affinity receptor FcεRI by targeting two epitope sites of IgE may have implications for the development of novel therapies for allergic diseases. [ABSTRACT FROM AUTHOR]

Background: Automatic stapling devices are commonly utilized in pulmonary resections, including sublobar segmentectomy. Large tumors can develop around the staple line, posing challenges in distinguishing them from cancer recurrence or inflammatory changes. In this report, we present two cases of symptomatic staple granulomatous lesion effectively managed with medications. Case presentation: A 74-year-old man presented with a persistent cough and sputum production six years post-segmentectomy for a hamartoma in the left upper lobe. Chest computed tomography (CT) revealed a large tumor around the staple line. Laboratory investigations and bronchoscopic examination revealed no malignancy. The patient received corticosteroids and a cyclooxygenase-2 inhibitor; despite experiencing adverse reactions to steroids, both tumor size and respiratory symptoms were significantly reduced. The second case involved a 78-year-old woman who underwent pulmonary resection for suspected lung cancer. Despite a non-malignant tumor diagnosis, she reported a cough six months post-surgery. Chest CT revealed extensive shadow around the surgical staple, which was diagnosed as mycobacterium granuloma. Low-dose erythromycin induced inflammatory changes but effectively reduced the lesion. Conclusions: Granulomatous lesions around the staple can be effectively managed with medication, and monitoring the treatment response proves valuable in distinguishing them from tumor recurrence post-pulmonary resection. [ABSTRACT FROM AUTHOR]

Generation and accumulation of amyloid-β (Aβ) protein in the brain are the primary causes of Alzheimer's disease (AD). Alcadeins (Alcs composed of Alcα, Alcβ and Alcγ family) are a neuronal membrane protein that is subject to proteolytic processing, as is Aβ protein precursor (APP), by APP secretases. Previous observations suggest that Alcs are involved in the pathophysiology of Alzheimer's disease (AD). Here, we generated new mouse AppNL-F (APP-KI) lines with either Alcα- or Alcβ-deficient background and analyzed APP processing and Aβ accumulation through the aging process. The Alcα-deficient APP-KI (APP-KI/Alcα-KO) mice enhanced brain Aβ accumulation along with increased amyloidogenic β-site cleavage of APP through the aging process whereas Alcβ-deficient APP-KI (APP-KI/Alcβ-KO) mice neither affected APP metabolism nor Aβ accumulation at any age. More colocalization of APP and BACE1 was observed in the endolysosomal pathway in neurons of APP-KI/Alcα-KO mice compared to APP-KI and APP-KI/Alcβ-KO mice. These results indicate that Alcα plays an important role in the neuroprotective function by suppressing the amyloidogenic cleavage of APP by BACE1 in the brain, which is distinct from the neuroprotective function of Alcβ, in which p3-Alcβ peptides derived from Alcβ restores the viability in neurons impaired by toxic Aβ. [ABSTRACT FROM AUTHOR]

As a member of 2D family, amorphous 2D nanosheets have received increasing attention due to their unique properties that are distinct from crystalline 2D nanosheets. However, compared with the vast library of crystalline 2D nanosheets, amorphous 2D nanosheets are still infancy due to the lack of an efficient synthetic approach. Here, we present a strategy that yields a library of 10 distinct amorphous 2D metal oxides/oxyhydroxides using solid-state surfactant crystals. A key feature of this process is a stepwise reaction using solid surfactant; the solid-state surfactant crystals have metal ions arranged in the interlayer space, and hydrolysis of the metal ions leads to the formation of isolated clusters in the surfactant crystals via limited condensation reactions. Immersing the surfactant crystals in formamide promotes nanosheet formation through the self-assembly of clusters by templating the morphologies of the crystals generated from surfactants crystals. Our approach opens a flatland in amorphous 2D world. The authors developed a method for creating amorphous 2D nanosheets using solid-state surfactant crystals. This strategy results in a library of 10 distinct amorphous 2D metal oxides/oxyhydroxides through stepwise hydrolysis and assembly processes. [ABSTRACT FROM AUTHOR]

Poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS) has recently gained interest as a potential candidate for small-scale thermoelectric conversion because of the facile doping, solution processability, and flexibility. However, the practical applications of PEDOT:PSS are limited by its comparatively low figure of merit (ZT) compared with inorganic thermoelectric materials. Herein, to further improve the thermoelectric properties of PEDOT:PSS, we investigated the role of the addition of surfactants, sodium dodecyl sulfate, sodium dodecyl benzenesulfonate (SDBS) or Triton X-100, to the PEDOT:PSS free-standing films on their thermoelectric properties. We showed that the addition of the surfactant improved the film crystallinity, significantly improving the electrical conductivity. The highest conductivity was obtained for anionic surfactant SDBS at a 0.94 wt% concentration. Moreover, the inclusion of the surfactant reduced the thermal conductivity while maintaining a relatively constant Seebeck coefficient, consequently improving the ZT value. Furthermore, a flexible thermoelectric device crafted from the as-fabricated PEDOT:PSS/SDBS sheets was developed to explore the potential applications of wearable electronics using low-grade thermal energy. Overall, we indicate the significance of surfactants in enhancing the thermoelectric properties of free-standing PEDOT:PSS films in this study. [ABSTRACT FROM AUTHOR]