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Objectives: To investigate roles of brain carbon monoxide (CO), an endogenous gasotransmitter, in regulation of the rat micturition reflex. Methods: In urethane‐anesthetized (0.8 g/kg, ip) male rats, evaluation of urodynamic parameters was started 1 h before intracerebroventricular administration of CORM‐3 (CO donor) or ZnPP (non‐selective inhibitor of heme oxygenase, a CO producing enzyme) and continued for 2 h after the administration. We also investigated effects of centrally pretreated SR95531 (GABAA receptor antagonist) or SCH50911 (GABAB receptor antagonist) on the CORM‐3‐induced response. Results: CORM‐3 significantly prolonged intercontraction intervals (ICIs) without changing maximal voiding pressure (MVP), while ZnPP significantly shortened ICI and reduced single‐voided volume and bladder capacity without affecting MVP, post‐voided residual volume, or voiding efficiency. The ZnPP‐induced ICI shortening was reversed by CORM‐3. The CORM‐3‐induced ICI prolongation was significantly attenuated by centrally pretreated SR95531 or SCH50911, respectively. Conclusions: Brain CO can suppress the rat micturition reflex through brain γ‐aminobutyric acid (GABA) receptors. [ABSTRACT FROM AUTHOR]

Exploration of expanded porphyrins with unprecedented reactivities has remained important. Here [22]pentaphyrins(2.0.1.1.0) were synthesized as a constitutional isomer of sapphyrin by acid‐catalyzed cyclization of 1,14‐dibromo‐5,10‐diaryltripyrrin with 1,2‐di(pyrro‐2‐ly)ethenes. These pentaphyrins display roughly planar structures and varying aromaticities depending upon the vinylene structures. The 19,20‐ditolyl pentaphyrin gave an N‐fused product and an unprecedented pyrrole‐rearranged product, depending upon the oxidation conditions. Remarkably, upon the metalation with CuCl, the N‐fused product and the pyrrole‐rearranged product afforded an inner β‐β coupled face‐to‐face CuII complex dimer and an outer β‐β coupled lateral CuII complex dimer, respectively, in fairly good yields. Further, [22]pentaphyrin(2.0.1.1.0) fused with a NiII porphyrin was effectively dimerized upon oxidation with MnO2 to give a 16–16' directly linked dl‐dimer. [ABSTRACT FROM AUTHOR]

Multiple system atrophy (MSA) is a rare neurodegenerative disease characterized by an accumulation of phosphorylated α‐synuclein (p‐αsyn) in oligodendrocytes in the form of glial cytoplasmic inclusions (GCIs). In MSA, not only mature oligodendrocytes but also oligodendrocyte precursor cells (OPCs) are affected. The latter play an important role in remyelination by differentiating into mature oligodendrocytes, as well as maintaining the blood–brain barrier (BBB) by promoting the expression of tight junction proteins. We have hypothesized that in MSA, the BBB is impaired as a result of aberrant interactions between affected OPCs and the cerebral vasculature. To verify this hypothesis, we conducted a neuropathological examination of postmortem brains from MSA patients and control subjects, focusing on the primary motor area, one of the main regions affected in MSA. Using double immunofluorescence, we quantified the expression of tight junction protein claudin‐5 in capillary endothelial cells and found that it was significantly lower in MSA than in controls in both the gray matter and white matter. Furthermore, a significantly higher amount of fibrinogen was extravasated into the brain parenchyma in MSA patients than in controls. In addition, leakage of IgG was detected almost specifically in MSA brain parenchyma, as visualized in three dimensions by combining techniques of chemical tissue clearing and light sheet microscopy. Finally, we confirmed accumulation of p‐αsyn‐positive GCIs along the cerebral vasculature within OPCs. These results suggest that BBB dysfunction and associated fibrinogen extravasation are constant findings in MSA, presumably triggered by the deposition of p‐αsyn in perivascular OPCs. [ABSTRACT FROM AUTHOR]

As representative compositions of the mold flux used in the continuous casting of steel, the temperature and composition dependence of the thermal conductivity of alkali silicate glasses and melts was investigated in the range of 300–1700 K using molecular dynamics (MD) simulations. MD simulations can exclude disturbances such as radiation, convection, and impurities, and extract only the effect of phonons on the thermal conduction. Thermal conductivity determined by the laser flash (LF) method was reported to be three times higher than that obtained by the unsteady hot wire (HW) method in the high‐temperature range of 1250–1550 K for 33.3Na2O–66.7SiO2 (mol%). This study shows that (1) the thermal conductivity estimated by MD simulations was closer to the experimental value of the LF method than those of the HW method above 1200 K, which suggests that the LF method is reliable and that the effect of radiation on the thermal conductivity is not significant. (2) The decrease in the thermal conductivity measured by the LF method in the range of 1250–1550 K was attributed to the decrease in the bulk modulus of the 33.3Na2O–66.7SiO2 melt. (3) In a series of Na2O–SiO2 melts, the sound velocity calculated by MD decreased with increasing Na2O content, which is consistent with Shiraishi's ultrasonic wave measurements. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions The Naples prognostic score (NPS) is a remarkable marker of short‐ and long‐term outcomes in various types of cancer. However, its impact on the postoperative outcomes of hepatocellular carcinoma remains controversial. This study aimed to clarify the impact of the NPS on the prognosis and incidence of postoperative complications in hepatocellular carcinoma.Patients with hepatocellular carcinoma (n = 374) were categorized into high‐ and low‐Naples prognostic score groups; their postoperative outcomes were compared. Prognostic and risk factors for severe postoperative complications were identified using multivariate analyses.The low‐Naples prognostic score group had significantly longer overall and recurrence‐free survivals than the high‐Naples prognostic score group (p = 0.03 and 0.04, respectively). Subgroup analysis revealed a superior predictive value of the NPS in the group with a single tumor (p = 0.03), tumor diameter ≤5 cm (p = 0.04), and tumor stage I or II (p = 0.04). A high NPS was an independent prognostic factor for overall survival (hazard ratio, 1.45; 95% confidence interval (CI), 1.01–2.05; and p = 0.04). The NPS 2–4 group had a higher incidence of the Clavien–Dindo grade ≥ IIIa postoperative complications than the 0–1 group (p = 0.03) and a score of 2–4 was identified as an independent risk factor for the Clavien–Dindo grade ≥ IIIa postoperative complications (odds ratio, 2.06; 95% CI, 1.01–4.20; and p = 0.05).The NPS effectively predicts postoperative outcomes in patients with hepatocellular carcinoma. [ABSTRACT FROM AUTHOR]

With an aim of obtaining a fundamental understanding of C−C bond conformation theory, the molecular structure of an ethane with electron‐withdrawing groups, 1,2‐bis(4‐methoxybenzene‐sulfonate)ethane, was elucidated. According to the general conformation rule for alkanes, which states that molecules adopt a stabilized structure to avoid steric repulsion, ethanes typically adopt anti‐conformation. However, the title compound exhibited gauche‐conformation, as revealed by a single crystal diffraction study. Theoretical studies also support this behavior. Natural Bond Orbital (NBO) analysis suggests that the orbital interaction between the σ*CO orbital, attributable to the sulfonate groups, and the adjacent σCH orbital stabilizes the gauche‐conformation. The authors conclude that the sulfonate group acts as a gauche‐effect synthon, which is widely applicable in organic chemistry. [ABSTRACT FROM AUTHOR]

Singly‐linked aromatic [22]smaragdyrin BF2 complex dimer was synthesized by the reductive coupling of 16‐brominated [22]smaragdyrin BF2 complex, which was oxidized to a stable diradical with PbO2. As the first example of fused smaragdyrin dimer, a fused [22]smaragdyrin BF2 complex dimer was synthesized by the oxidation of a CuCl‐BF2 complex dimer with FeCl3 and subsequent reduction with NaBH4. After removal of the BF2 group, the singly‐linked and fused aromatic dimers were oxidized to the corresponding antiaromatic [20]smaragdyrin free base dimers. The first oxidation and reduction potentials of these dimers are split depending upon the intramolecular electronic interactions, which are larger for the fused dimers. Despite the large electronic interactions, the aromatic and antiaromatic characters are well preserved in the fused dimers. [ABSTRACT FROM AUTHOR]

Although gender equality is a global goal, significant disparity remains between men and women. Benevolent sexism (BS) is widespread and contributes to the maintenance of the gender gap. To reduce BS, many previous studies have implemented long‐term intervention programmes. In contrast, we posit that it is necessary to reduce BS efficiently through simpler methods. This study aimed to reduce participants' BS endorsement by presenting experimental vignettes regarding (a) the harm of BS against women and (b) the pervasiveness of BS. An online experiment was conducted with male and female Japanese participants (n = 816). The results showed that the main effect of presenting the harm of BS against women was significant only among female participants. However, neither the main effect of presenting the pervasiveness of BS nor the interaction between presenting harm and pervasiveness were found. We suggested strategies to reduce BS, especially when endorsed by men. Our experimental manipulation can be conducted in a short time and on many participants simultaneously. More empirical studies aimed at reducing BS should be conducted in the future. [ABSTRACT FROM AUTHOR]

Objective: The objective of our study was to assess the efficacy of Rezum, a minimally invasive surgical treatment, for patients with lower urinary tract symptoms related to benign prostatic hyperplasia (BPH) in real‐world clinical practice at a single institution in Japan. Materials and Methods: We conducted a prospective study involving 100 patients who underwent the Rezum procedure between October 2022 and February 2024. We analyzed patient backgrounds that are compliant with Japanese regulations and assessed descriptive outcomes such as symptom scores, peak flow in uroflowmetry, post‐void residual (PVR) volume, and prostate volume (PVol). These data were collected at 1 and/or 3 months postoperatively. Results: On average, 4.7 water vapor injections were administered during the Rezum procedures, with a mean operative time of 6.3 min. Patients experienced significant relief in symptoms, with reductions of 55% in International Prostate Symptom Score, 53% in quality of life score, and 30% in Overactive Bladder Symptom Score. There was also a significant decrease in mean PVR volume (50% reduction) and PVol (27% reduction). Among the subgroup of 23 pre‐interventional catheter‐dependent patients, 91% achieved catheter independence. Conclusion: Our single‐center analysis demonstrates that Rezum is an effective and safe minimally invasive therapeutic option for patients with BPH. This promising novel technique can be particularly beneficial for patients at an augmented risk of bleeding or those considered high risk for anesthesia. [ABSTRACT FROM AUTHOR]

Reverse power flow from a photovoltaic (PV) power generation system to distribution system is limited below a certain limit value. The behavior of a power conditioning system (PCS) for large capacity PV power generation system when the output power approached the output power limit value was experimentally estimated. Under the condition, the PCS became uncontrollable. It was pointed out that this phenomenon was caused by the maximum power point tracking (MPPT) control of the PCS. Furthermore, some methods to avoid the uncontrollable condition of PCS were shown. [ABSTRACT FROM AUTHOR]

Aims: The bicarbonate (HCO3−) buffer system is crucial for maintaining acid–base homeostasis and blood pH. Recent studies showed that elevated serum HCO3− levels serve as an indicator of the beneficial effects of acetazolamide in improving decongestion in acute heart failure. In this study, we sought to clarify the clinical relevance and prognostic impact of HCO3− in chronic heart failure (CHF). Methods: This cohort study enrolled 694 hospitalized patients with CHF (mean age 68.6 ± 14.6, 62% male) who underwent arterial blood sampling and exhibited neutral pH ranging from 7.35 to 7.45. We characterized the patients based on HCO3− levels and followed them to register cardiac events. Results: Among the patients, 17.3% (120 patients) had HCO3− levels exceeding 26 mmol/L. Patients presenting HCO3− > 26 mmol/L were more likely to use loop diuretics and had higher serum sodium and lower potassium levels, but left ventricular ejection fraction did not differ compared with those with HCO3− between 22 and 26 (379 patients) or those with HCO3− < 22 mmol/L (195 patients). During a median follow‐up period of 1950 days, Kaplan–Meier analysis revealed that patients with HCO3− > 26 mmol/L had the lowest event‐free survival rate from either cardiac deaths or heart failure‐related rehospitalization (P < 0.01 and 0.03, respectively). In the multivariable Cox model, the presence of HCO3− > 26 mmol/L independently predicted increased risks of each cardiac event with a hazard ratio of 2.31 and 1.69 (P < 0.01 and 0.02, respectively), while HCO3− < 22 mmol/L was not associated with these events (hazard ratios, 0.99 and 1.19; P = 0.98 and 0.43, respectively). Conclusions: Elevated blood HCO3− levels may signify enhanced proximal nephron activation and loop diuretic resistance, leading to long‐term adverse outcomes in patients with CHF, even within a normal pH range. [ABSTRACT FROM AUTHOR]

Aim: To compare the outcomes of therapy using recombinant human fibroblast growth factor (rhFGF)‐2 combined with autologous bone grafting (ABG) therapy with those of rhFGF‐2 alone and ABG alone in the treatment of periodontal intraosseous defects. Methods: Periodontal intraosseous defects were randomized to receive rhFGF‐2 therapy + ABG, rhFGF‐2 therapy alone, or ABG alone. Periodontal examination and periapical radiography were performed preoperatively and at 3, 6, and 12 months postoperatively. Results: At the 12 months follow‐up, all three groups showed significant improvement in the clinical attachment level (CAL): 5.6 ± 1.6, 5.8 ± 1.7, and 5.2 ± 1.6 mm in the rhFGF‐2 + ABG, rhFGF‐2 alone, and ABG alone groups, respectively, with no significant inter‐group differences (p <.05). rhFGF‐2 therapy (alone or in combination) resulted in greater bone defect filling (BDF) (2.3 ± 1.2 mm and 2.6 ± 1.9 mm, respectively) than ABG therapy alone (1.2 ± 1.2 mm). Gingival recession was lesser in the ABG alone (1.2 ± 1.1 mm) and rhFGF‐2 + ABG groups (1.4 ± 0.8 mm) than in the rhFGF‐2 alone group (2.2 ± 1.2 mm). Conclusion: The results of this study showed that at 12 months postoperatively, all treatments resulted in statistically significant clinical improvements compared to the baseline. From these results, it can be concluded that rhFGF‐2 promotes hard tissue regeneration in intraosseous defects. [ABSTRACT FROM AUTHOR]

Over the past few years, cases of human papillomavirus (HPV) infection in nail Bowen's disease have been reported. This disease presents diagnostic challenges due to its similarity to nail malignant melanoma, particularly with respect to the clinical manifestation of black nail streaks. While skin biopsy is usually employed for diagnosis, it is an invasive procedure. We report the case of a 52‐year‐old healthy Japanese male with a pigmented streak on the nail of the fourth finger of his right hand, which had extended from the central to the lateral nail fold within 4 months. Dermoscopic examination revealed a dark‐brown pigmented band with splinter microhemorrhage. Clinically, nail Bowen's disease was suspected. The lesion was excised in strips under local anesthesia. Histopathological examination revealed hyperkeratosis, parakeratosis, papillomatosis, and dyskeratotic cells with atypical nuclei irregularly arranged. Immunohistochemistry using anti‐HPV L1 antibody detected HPV‐positive cells in the upper epidermis and stratum corneum of the nail matrix. Mucosal high‐risk HPV type 58 DNA was detected from brush cytology of the keratotic surface prior to surgery, which was confirmed in formalin‐fixed, paraffin‐embedded excised samples using polymerase chain reaction (PCR) and subsequent direct DNA sequencing. Our case highlights HPV type 58 as a potential causative agent of nail Bowen's disease and shows that brush cytology of the surface material prior to excision may be a useful and less invasive way for mucosal high‐risk HPV detection. PCR analysis of the nail surface could serve as a supplementary diagnostic tool for nail Bowen's disease. [ABSTRACT FROM AUTHOR]

Pemphigus vegetans is a rare type of pemphigus characterized by vegetative lesions primarily localized to the intertriginous area. Despite its unique clinical presentation, the underlying pathomechanism remains unclear owing to the rarity of the disease. We report a case of pemphigus vegetans with antibodies against desmoglein 1 and desmocollins 1–3. Furthermore, immunohistochemical analyses were performed to address the pathogenesis of this disease. A 73‐year‐old man presented with multiple vegetative plaques with erythema on the trunk, groins, and extremities. Mucosal lesions were not observed. Laboratory examinations revealed mild leukocytosis with eosinophilia. A histopathological examination of the skin lesion showed epidermal hyperplasia and intraepidermal abscesses with marked infiltration of neutrophils and eosinophils, and infiltration of lymphocytes and eosinophils into the upper derms. Bacterial culture of the skin tissue was positive for Staphylococcus aureus. Direct immunofluorescence showed deposits of IgG and C3 on keratinocyte surfaces in the epidermis. Autoantibodies against desmoglein 1 and autoantibodies against desmocollin 1, desmocollin 2, and desmocollin 3 were detected by enzyme‐linked immunosorbent assays. The diagnosis of pemphigus vegetans was made. Initiation of prednisolone (1.0 mg/kg/day) gradually improved his skin symptoms. We performed immunohistochemical analyses of the lesional skin, which revealed infiltration of CD3‐positive, CD4‐positive, and CD68‐positive cells in the upper dermis, but CD20‐ or CD56‐positive cells were negative. In addition, the present case showed more prominent infiltration of IL‐17A‐ and IL‐22‐positive cells in the upper dermis than in pemphigus foliaceus, a type of pemphigus with autoantibodies against desmoglein 1. Furthermore, these cells co‐expressed CD3 and CD68. We hypothesized that IL‐22 and IL‐17A produced by T cells and macrophages and their dysregulation might be involved in the pathogenesis of pemphigus vegetans. Additionally, skin colonization and/or infection with Staphylococcus aureus could potentially contribute to the pathogenesis of the disease. [ABSTRACT FROM AUTHOR]

Aims: This study was conducted to examine disproportionality, times to onset, incidence rates and outcomes of lenvatinib‐associated cardiac adverse events (AEs) using the Japanese Adverse Drug Event Report database. Methods: We analysed data for the period between April 2004 and May 2023. Data on cardiac AEs were extracted and the relative disproportionality of AEs was estimated using reporting odds ratios (RORs). Furthermore, Weibull distribution parameters were calculated. Results: Of the 2 230 863 reports analysed, we identified 7684 reports of AEs associated with lenvatinib, including 317 cardiac AEs. Signals were detected for eight cardiac AEs: hypertension, cardiac failure, myocarditis, myocardial infarction, immune‐mediated myocarditis, cardiomyopathy, angina unstable and cardiotoxicity. Among these, fatal outcomes were observed for cardiac failure, myocarditis and myocardial infarction. Histograms of median times to onset for the eight detected cardiac AE signals showed that AEs occurred at a median of 3.5–134.5 days after lenvatinib administration. The Weibull distributions showed that cardiac failure occurred early after administration (early failure type), myocarditis occurred in a dose‐dependent manner (wearout failure type), and myocardial infarction occurred constantly throughout the exposure period (random failure type). Conclusions: We focused on cardiac AEs associated with lenvatinib as post‐marketing AEs. Serious outcomes can arise after lenvatinib administration. Patients should be monitored for signs of onset of these AEs not only at the start of administration, but also over an extended period. [ABSTRACT FROM AUTHOR]

Consider an n$$ n $$‐vertex graph where each vertex holds one of two distinct opinions. We are interested in the consensus time of synchronous voting processes, where each vertex is allowed to update its opinion according to a predefined commonly local updating rule. This article proposes a general class of voting processes called quasi‐majority functional voting and gives upper and lower bounds of the consensus time. Our results cover many previous results on specific processes, for example, best‐of‐two (a.k.a. 2Choices) and best‐of‐three (a.k.a. 3Majority), as special cases. Our key ingredient is a nonlinear extension of the expander mixing lemma, which enables us to estimate expected and variance changes in opinions of quasi‐majority functional voting on expander graphs. [ABSTRACT FROM AUTHOR]

Aim: Gamma‐glutamyltransferase (GGT) is known as an oxidative stress marker, induced by alcohol consumption and metabolic disorders, and is reported as a predictor of hepatocellular carcinoma (HCC) development after hepatitis C virus (HCV) elimination. However, it is not clear whether GGT serves simply as a surrogate marker for overlapping metabolic diseases or reflects HCV‐specific carcinogenicity. We investigated the association between GGT and hepatocarcinogenesis after achieving a sustained viral response (SVR), accounting for drinking habits or diabetes, and examined predisposing factors associated with GGT levels after SVR. Methods: This is a prospective, multicenter, and observational study using the database of 1001 patients after HCV eradication with direct‐acting antiviral agents. The association of GGT at SVR with cumulative HCC development was examined in a multivariate analysis using Cox proportional hazard models after adjustment for covariates including alcohol and diabetes. The association between oxidative stress markers or genetic factors and GGT levels was analyzed. Results: High GGT levels at SVR were associated with HCC development (HR] 2.38, 95% CI 1.10–5.17). This association was also significant when restricted to patients without alcohol consumption or diabetes (HR 8.38, 95% CI 2.87–24.47). GGT levels were correlated with serum growth differentiation factor 15 levels, a marker of mitochondrial dysfunction. Single‐nucleotide polymorphisms of ZNF827 and GDF15 were associated with high GGT levels. Conclusions: High GGT levels at SVR were associated with HCC development after accounting for alcohol consumption and diabetes. GGT levels are influenced by genetic predisposition and may reflect mitochondrial dysfunction after HCV eradication. [ABSTRACT FROM AUTHOR]

An 8‐year‐old, female, neutered labrador retriever presented for surgical excision of a subcutaneous mast cell tumour and extirpation of the right inguinal and right medial iliac lymph nodes. Histology confirmed a completely excised, low mitotic count subcutaneous mast cell tumour with lymph node metastasis. Vinblastine and prednisolone were administered as adjunctive chemotherapy. Six weeks post‐operatively, the dog presented dehydrated, tachycardic and pyrexic, with haematochezia, vomiting and abdominal pain. Coeliotomy revealed a communication between the jejunum and the proximal right ureter, with no obvious aetiology identified. Right ureteronephrectomy was performed, with debridement and closure of the affected jejunum. Histopathology reported a subacute to chronic neutrophilic and necrohaemorrhagic pyelonephritis and haemolytic Escherichia coli, resistant to amoxicillin clavulanate, was cultured. The dog recovered and re‐started the chemotherapy protocol following restaging 2 months post‐operatively. Unfortunately, 7 weeks after starting this protocol, the patient developed acute necrotising pancreatitis following dietary indiscretion and was electively euthanased. [ABSTRACT FROM AUTHOR]

The current System of National Accounts (SNA) Gross Domestic Product (GDP) concept does not measure the income generated by the production sector since it includes depreciation and excludes capital gains and losses on assets used in the production sector. The paper suggests an accounting framework that measures the income generated by the production sector of an economy and implements this measure using the Augmented Productivity Database (APDB) developed by Asian Productivity Organization and Keio University for China over the years 1970–2020. Real gross and real net income generated by the Chinese production sector are decomposed into explanatory factors including TFP growth using the framework suggested by Jorgenson and Diewert and Morrison. TFP growth is further decomposed into technical progress and inefficiency components using the nonparametric approach developed by Diewert and Fox. The APDB has estimates for the price and quantity of agricultural, industrial, commercial, and residential land used in China. The paper argues that changes in land use should be treated in the same manner as inventory change and added to the alternative output measures. It turns out that Jorgensonian user costs for land are frequently negative. The problems associated with negative user costs are discussed in the paper. [ABSTRACT FROM AUTHOR]

Defect chemistry that results in the thermal processing of dielectric and piezoelectric films, crystals and ceramics ultimately controls the properties and long‐term performance of materials and devices. This paper reviews several thermochemical defect reactions using important perovskite base composition dielectrics including Pb(Zr,Ti)O3, (Na,K)NbO3, (Bi0.5Na0.5)TiO3‒BaTiO3, and Ca(Hf,Ti,Mn)O3. Within this group of perovskite‐based functional materials, we note ways the point defects can be formed to create non‐stoichiometric compositions changing the overall cation‐to‐anion ratios during the synthesis process. These reactions can be developed with the loss of volatile species such as metal and oxygen ions. The relative concentrations of these can impact the over conductions in terms of the mixed contributions of ionic conductivity from the oxygen vacancies and the electronic conductivity, along with microstructure and properties in some cases. [ABSTRACT FROM AUTHOR]

Background: Neuromuscular scoliosis is associated with cerebral palsy caused by metabolic diseases. Patients with scoliosis require meticulous consideration in abdominal surgery, as scoliosis can reduce the abdominal cavity volume, compress abdominal organs, and cause abdominal complications. Special attention should be paid to the graft position, especially in the setting of liver transplantation (LT). We herein describe a pediatric case of LT for carbamoyl phosphate synthetase I (CPS1) deficiency with severe scoliosis. Case Presentation: A 13‐year‐old girl with CPS1 deficiency was transferred to our department as a candidate for liver transplantation. She underwent living donor liver transplantation with a left lobe from her mother. Following LT, portal vein (PV) complications occurred due to the kinking anastomosis, requiring several rounds of graft repositioning, PV reconstruction, thrombectomy, and finally stent placement due to severe scoliosis. Technical efforts were made to ensure PV blood flow with stent placement via the umbilical vein. Three months after LT, she was discharged from our hospital with sufficient PV flow. Conclusions: This report suggests the need for a careful surgical approach in patients with skeletal abnormalities, such as the management of complications arising from anatomical abnormalities and selection of the appropriate graft size. Preoperative assessment and surgical planning of both donors and recipients according to patient characteristics should be carefully conducted. [ABSTRACT FROM AUTHOR]

Background: Liver transplantation has been indicated for propionic acidemia (PA) patients with frequent metabolic decompensation and performed as an enzyme replacement therapy. We retrospectively evaluated the outcomes of patients with PA and analyze the appropriate timing of living donor liver transplantation (LDLT). Methods: We reviewed 12 children with PA who underwent LDLT, who were divided into early (period from the first episode of metabolic decompensation to LDLT < 1 year; n = 6) and late (> 1 year; n = 6) indication groups depending on the timing of LDLT. Results: The patient and graft survival rates were 100% in 12 children with PA, and the median observation period was 61 months (5–193 months). None of the patients experienced any episodes of metabolic decompensation after LDLT. The timing of LDLT did not influence the incidence of surgical complications. Two patients in the late indication group had episodes of cardiac arrest and long QT syndrome before LDLT, and one patient showed prolongation of QT interval after LDLT. Two of the six patients in the late indication group had findings of metabolic stroke of the brain on MRI before LDLT. Although LDLT improved the findings of metabolic stroke, a decrease in development quotient score was shown in the post‐LDLT course. Conclusions: LDLT may be an effective therapeutic option for improving metabolic control. Early LDLT might be help prevent cardiomyopathy and neurological impairment. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aim Methods Results Conclusions Three Janus kinase (JAK) inhibitors are approved for ulcerative colitis (UC) in Japan.To compare the real‐world efficacy and safety of these three JAK inhibitors in UC.This was a multicentre, retrospective study of patients with UC started on JAK inhibitors. The primary outcome was clinical remission at 10, 26 and 58 weeks, and at the most recent follow‐up. To compare the efficacy and safety among the JAK inhibitors, we created three matched cohorts (upadacitinib vs. filgotinib, tofacitinib vs. filgotinib and upadacitinib vs. tofacitinib) using propensity score matching.We identified 228 upadacitinib‐treated patients (median follow‐up 49 weeks; IQR 25–72), 215 filgotinib‐treated patients (follow‐up 56 weeks; IQR 17–82) and 159 tofacitinib‐treated patients (follow‐up 112 weeks; IQR 10–258). Clinical remission rates for upadacitinib, filgotinib and tofacitinib at the most recent follow‐up were 72.8%, 50.6% and 45.8%, respectively. Over 70% of the patients previously treated with other biologics or JAK inhibitors achieved clinical remission with upadacitinib. On multivariate analysis, the number of previous advanced therapies was inversely associated with the efficacy of filgotinib and tofacitinib. Comparative analysis showed that upadacitinib‐treated patients had higher efficacy and lower risk of discontinuation than patients treated with other JAK inhibitors. However, upadacitinib had a significant risk of acne.Considering the particularly high efficacy of upadacitinib, even in patients with refractory UC, filgotinib or tofacitinib may be considered as an upfront JAK inhibitor before using upadacitinib. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims/Introduction Materials and Methods Results Conclusions To determine the association of irregular dietary habits with HbA1c and body mass index (BMI) in people with diabetes.We included 4,421 people with diabetes aged 20–74 years (type 1 diabetes (T1D), 19.1%) who answered a questionnaire at mealtime. Adjusted least square means in HbA1c and BMI in patients with irregular dietary habits: “irregular mealtimes (irregular),” “skipping breakfast (SB),” and “late dinner (LD)” were compared to those with “regular dietary habits (regular).” Multivariable logistic regression analyses were performed to examine the association of irregular dietary habits with HbA1c ≥ 7% and BMI ≥25 kg/m2.HbA1c was significantly higher for “irregular” in both sexes and for “LD” in women than those of “regular” in people with T1D. HbA1c was significantly higher for “LD,” and BMI was higher for almost all irregular dietary habits than those of “regular” in people with type 2 diabetes (T2D). Odds ratios (ORs) for HbA1c ≥7% were 3.20 (95% confidence interval (CI), 1.30–7.89) for T1D women with “irregular” and 1.73 (1.20–2.49) and 2.20 (1.14–3.65) for T2D men and women with “LD,” respectively. ORs for BMI ≥25 kg/m2 were 1.60 (95% CI, 1.15–2.22) for T2D men with “irregular” and 1.43 (1.02–2.01) and 2.11 (1.21–3.65) for T2D women and men with “LD,” respectively.Irregular mealtimes are associated with poor glycemic control in T1D women and are associated with obesity in T2D men. Furthermore, a late dinner was associated with high HbA1c levels and BMI in people with T2D. [ABSTRACT FROM AUTHOR]

Interest is growing in transition metal‐free compounds for small molecule activation and catalysis. We discuss the opportunities arising from synthesizing sodium‐doped amorphous silicon‐boron‐nitride (Na‐doped a‐SiBN). Na+ cations and 3‐fold coordinated BIII moieties were incorporated into an amorphous silicon nitride network via chemical modification of a polysilazane followed by pyrolysis in ammonia (NH3) at 1000 °C. Emphasis is placed on the mechanisms of hydrogen (H2) activation within Na‐doped a‐SiBN structure. This material design approach allows the homogeneous distribution of Na+ and BIII moieties surrounded by SiN4 units contributing to the transformation of the BIII moieties into 4‐fold coordinated geometry upon encountering H2, potentially serving as frustrated Lewis acid (FLA) sites. Exposure to H2 induced formation of frustrated Lewis base (FLB) N−= sites with Na+ as a charge‐compensating cation, resulting in the in situ formation of a frustrated Lewis pair (FLP) motif (≡BFLA⋅⋅⋅Hδ−⋅⋅⋅Hδ+⋅⋅⋅:N−(Na+)=). Reversible H2 adsorption‐desorption behavior with high activation energy for H2 desorption (124 kJ mol−1) suggested the H2 chemisorption on Na‐doped a‐SiBN. These findings highlight a future landscape full of possibilities within our reach, where we anticipate main‐group‐mediated small molecule activation will have an important impact on the design of more efficient catalytic processes and the discovery of new catalytic transformations. [ABSTRACT FROM AUTHOR]

Metabolic dysfunction-associated steatohepatitis (MASH, previously termed non-alcoholic steatohepatitis (NASH)), is a major complication of obesity that promotes fatty liver disease. MASH is characterized by progressive tissue fibrosis and sterile liver inflammation that can lead to liver cirrhosis, cancer, and death. The molecular mechanisms of fibrosis in MASH and its systemic control remain poorly understood. Here, we identified the secreted-type pro-fibrotic protein, procollagen C-endopeptidase enhancer-1 (PCPE-1), as a brown adipose tissue (BAT)-derived adipokine that promotes liver fibrosis in a murine obesity-induced MASH model. BAT-specific or systemic PCPE-1 depletion in mice ameliorated liver fibrosis, whereas, PCPE-1 gain of function in BAT enhanced hepatic fibrosis. High-calorie diet-induced ER stress increased PCPE-1 production in BAT through the activation of IRE-1/JNK/c-Fos/c-Jun signaling. Circulating PCPE-1 levels are increased in the plasma of MASH patients, suggesting a therapeutic possibility. In sum, our results uncover PCPE-1 as a novel systemic control factor of liver fibrosis. Synopsis: The systemic control of tissue fibrosis by metabolic organs remains poorly understood. This study identifies procollagen C-endopeptidase enhancer-1 (PCPE-1) as an adipokine released from brown adipose tissue (BAT) upon dietary obesity. Secreted PCPE-1 enhances liver fibrosis in a murine metabolic dysfunction-associated steatohepatitis (MASH) model, suggesting new therapeutic avenues. PCPE-1 is a BAT-derived adipokine in mice. Dietary obesity promotes PCPE-1 production in BAT, enhancing liver fibrosis in a murine MASH model. High-calorie diet-induced ER stress increases PCPE-1 production in BAT through the activation of the IRE-1/JNK/c-Fos/c-Jun pathway. PCPE-1 depletion or anti-PCPE-1 vaccine therapy ameliorate non-alcoholic fatty liver disease. Circulating PCPE-1 plasma levels are increased in MASH patients. The BAT-secreted, ER-stress-induced adipokine PCPE-1 systemically enhances liver fibrosis in metabolic dysfunction-associated steatohepatitis. [ABSTRACT FROM AUTHOR]

Aim: The impact of cognitive dysfunction‐associated activities of daily living (ADL) on mortality and rehospitalization for heart failure has not yet been evaluated. Methods: We retrospectively evaluated DASC‐21, the incidence of all‐cause mortality, and rehospitalization for heart failure after discharge in 329 older patients with heart failure. Results: The mean age was 85.1 ± 7.4 years (62.6% women). There were 110 cases of death from any cause (33.4%) during 25.5 ± 16.1 months of follow‐up and 166 cases of rehospitalization from heart failure (50.5%) during 16.1 ± 15.2 months of follow‐up. The DASC‐21 score was not significantly associated with an increased risk of all‐cause mortality or rehospitalization. For each item of the DASC‐21 questionnaire, defective route‐finding (item 6) (HR = 2.631, P = 0.003), common sense and capacity for judgement (item 9) (HR = 1.717, P = 0.040), instrumental ADL (IADL) for shopping (item 10) (HR = 1.771, P = 0.020), and IADL for meal preparation (item 14) (HR = 1.790, P = 0.019) were significantly associated with an increased risk of all‐cause mortality. Disabilities in route finding (HR = 2.257, P = 0.005), IADL for shopping (HR = 1.632, P = 0.016), and IADL for transportation (HR = 1.537, P = 0.033) were significant risk factors for rehospitalization due to heart failure. Even in the multivariate‐adjusted model, disability in defective route‐finding was significantly associated with an increased risk of all‐cause mortality (hazard ratio [HR] = 2.148, 95% confidence interval [CI] 1.090–4.236; P = 0.027) and of rehospitalization for heart failure (HR = 2.138, 95% CI 1.153–3.963, P = 0.016). Conclusions: In older patients hospitalized for heart failure, route disability was associated with all‐cause mortality and rehospitalization for heart failure after discharge. Geriatr Gerontol Int 2024; 24: 1130–1136. [ABSTRACT FROM AUTHOR]

Background and Objective: Mucus plugs and underlying airway tree structure can affect airflow limitation and prognosis in patients with chronic obstructive pulmonary disease (COPD), but their relative roles are unclear. This study used two COPD cohorts to examine whether mucus plugs on computed tomography (CT) were associated with airflow limitation and clinical outcomes independent of other airway structural changes and emphysema. Methods: Based on visual CT assessment, patients with mucus plugs in 0, 1–2 and ≥3 lung segments were assigned to no‐, low‐ and high‐mucus groups. Loss of health‐related independence and mortality were prospectively recorded for 3 and 10 years in the Kyoto–Himeji and Hokkaido cohorts, respectively. The percentages of the wall area of the central airways (WA%), total airway count (TAC) and emphysema were quantified on CT. Results: Of 199 and 96 patients in the Kyoto–Himeji and Hokkaido cohorts, 34% and 30%, respectively, had high mucus scores. In both cohorts, TAC was lower in the high‐mucus group than in the no‐mucus group, whereas their emphysema severity did not differ. High mucus score and low TAC were independently associated with airflow limitation after adjustment for WA% and emphysema. In multivariable models adjusted for WA% and emphysema, TAC, rather than mucus score, was associated with a greater rate of loss of independence, whereas high mucus score, rather than TAC, was associated with increased mortality. Conclusion: Mucus plugs and lower airway branch count on CT had distinct roles in airflow limitation, health‐related independence and mortality in patients with COPD. [ABSTRACT FROM AUTHOR]

High‐fidelity segmentation of blood vessels plays a pivotal role in numerous biomedical applications, such as injection assistance, cancer detection, various surgeries, and vein authentication. Near‐infrared (NIR) transillumination imaging is an effective and safe method to visualize the subcutaneous blood vessel network. However, such images are severely blurred because of the light scattering in body tissues. Inspired by the Vision Transformer model, this paper proposes a novel deep learning network known as transformer connection (TRC)‐Unet to capture global blurred and local clear correlations while using multi‐layer attention. Our method mainly consists of two blocks, thereby aiming to remap skip connection information flow and fuse different domain features. Specifically, the TRC extracts global blurred information from multiple layers and suppresses scattering to increase the clarity of vessel features. Transformer feature fusion eliminates the domain gap between the highly semantic feature maps of the convolutional neural network backbone and the adaptive self‐attention maps of TRCs. Benefiting from the long‐range dependencies of transformers, we achieved competitive results in relation to various competing methods on different data sets, including retinal vessel segmentation, simulated blur image segmentation, and real NIR blood vessel image segmentation. Moreover, our method remarkably improved the segmentation results of simulated blur image data sets and a real NIR vessel image data set. The quantitative results of ablation studies and visualizations are also reported to demonstrate the superiority of the TRC‐Unet design. © 2024 The Author(s). IEEJ Transactions on Electrical and Electronic Engineering published by Institute of Electrical Engineers of Japan and Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

INTRODUCTION: We evaluated the efficacy and safety of brexpiprazole for the treatment of agitation in Alzheimer's dementia (AAD) in Japanese patients. METHODS: This was a phase 2/3 multicenter, randomized, double‐blind, placebo‐controlled, parallel‐group study. Patients with AAD were randomized to receive brexpiprazole 1 mg/day or 2 mg/day, or placebo (3:4:4) for 10 weeks. RESULTS: For the primary endpoint (change in Cohen‐Mansfield Agitation Inventory [CMAI] total score from baseline to Week 10), both brexpiprazole 1 mg and 2 mg groups demonstrated statistically significant improvement versus placebo (2 mg: least squares [LS] mean difference –7.2 [95% confidence interval (CI): –10.0 to –4.3], p‐value < 0.0001, 1 mg: LS mean difference –3.7 [95% CI: –6.8 to –0.7], p‐value = 0.0175). The incidences of treatment‐emergent adverse events reported in the brexpiprazole 1 mg, 2 mg, and placebo groups were 76.8%, 84.6%, and 73.8%, respectively. DISCUSSION: Brexpiprazole 1 mg/day and 2 mg/day for 10 weeks was efficacious and well tolerated. Highlights: Brexpiprazole treatment for 10 weeks improved agitation in Alzheimer's dementia.The efficacy of brexpiprazole 1 mg/day has been confirmed for the first time.The incidence of adverse events was higher compared to the previous studies.Both brexpiprazole 1 mg/day and 2 mg/day were generally well tolerated. [ABSTRACT FROM AUTHOR]

Endograft collapse caused by aortic dissection is rare, but it might cause critical complications and sometimes lead to death. We present a case of bilateral lower limb ischemia caused by endograft collapse due to type B acute aortic dissection (TBAD). A 70‐year‐old man with an abdominal aortic aneurysm (AAA) that was treated by endovascular aortic aneurysm repair (EVAR) 17 days prior returned to our hospital due to chest pain and bilateral lower limb paleness. Contrast‐enhanced computed tomography (CT) showed an aortic dissection extending from the origin of the left subclavian artery to the terminal aorta. The main body of the endograft was compressed and the aneurysm was perfused by the false lumen. Additionally, the right leg of the endograft was occluded and the left one was collapsed. The patient was treated with axillo‐bifemoral bypass without any lower limb sequela. However, contrast‐enhanced CT performed at 2 months after the onset of the TBAD showed that the main body of the endograft was still collapsed, and the aneurysm was perfused by the false lumen of the dissection; thus, open AAA repair was performed. The postoperative course was uneventful and the patient was discharged without any complications. We successfully treated the patient with bilateral lower limb ischemia caused by endograft collapse due to TBAD after EVAR. The treatment should be considered on a case‐by‐case basis and an extra‐anatomical revascularization is one of the good treatment options. [ABSTRACT FROM AUTHOR]

Histone modifications are catalyzed and recognized by specific proteins to regulate dynamic DNA metabolism processes. NSD2 is a histone H3 lysine 36 (H3K36)‐specific methyltransferase that is associated with both various transcription regulators and DNA repair factors. Specifically, it has been implicated in the repair of DNA double‐strand breaks (DSBs); however, the role of NSD2 during DSB repair remains enigmatic. Here, we show that NSD2 does not accumulate at DSB sites and that it is not further mobilized by DSB formation. Using three different DSB repair reporter systems, which contained the endonuclease site in the active thymidine kinase gene (TK) locus, we demonstrated separate dose‐dependent effects of NSD2 on homologous recombination (HR), canonical‐non‐homologous end joining (c‐NHEJ), and non‐canonical‐NHEJ (non‐c‐NHEJ). Endogenous NSD2 has a role in repressing non‐c‐NHEJ, without affecting DSB repair efficiency by HR or total NHEJ. Furthermore, overexpression of NSD2 promotes c‐NHEJ repair and suppresses HR repair. Therefore, we propose that NSD2 has functions in chromatin integrity at the active regions during DSB repair. [ABSTRACT FROM AUTHOR]

Background: The efficacy and safety of conversion surgery (CS) after FOLFIRINOX or gemcitabine plus nab‐paclitaxel (GnP) chemotherapy in patients with initially unresectable pancreatic cancer (PC) remains unclear. Methods: This multicenter retrospective cohort study enrolled patients, between 2014 and 2018, with initially locally advanced or metastatic PC who were considered candidates for CS following FOLFIRINOX or GnP chemotherapy. They were classified into surgery (207 patients [194 resection and 13 exploratory laparotomy only]) and continued chemotherapy (10 patients, control) groups. The primary endpoint was overall survival (OS) from the day of diagnosis of potentially curative resection on imaging studies, with an expected hazard ratio (HR) of 0.7. Results: OS in the surgery group was longer than that in the control group (HR, 0.47; 95% confidence interval [CI]: 0.24–0.93). The median OS was 34.4 (95% CI: 27.9–43.4) and 19.8 (95% CI: 14.9–31.1) months in the surgery and control groups, respectively. The Clavien‐Dindo grade ≥ IIIa postoperative complication and in‐hospital mortality rates were 19.6% and 0.5%, respectively. Multivariate analysis revealed that preoperative chemotherapy duration was not associated with OS. Conclusions: CS, following a favorable response to FOLFIRINOX or GnP chemotherapy, improved initially unresectable PC prognosis (specifically, OS), regardless of the chemotherapy duration. [ABSTRACT FROM AUTHOR]

Purpose: Total body irradiation before bone marrow transplantation for hematological malignancies using Radixact, a high‐precision radiotherapy machine, can potentially reduce side effects and the risk of secondary malignancies. However, stable control of couch speed is critical, and direct assessment methods outlined in quality assurance guidelines are lacking. This study aims to develop a real‐time couch speed verification system for the Radixact. Methods: The developed system used a linear encoder to measure couch speed directly. Accuracy was verified via a linear stage, comparing measurements with a laser distance sensor. After placing a phantom simulating the human body on the Radixact couch, the couch speed was verified using predefined speed plans. Results: Operating the linear stage at 0.1, 0.5, and 1.0 mm/s revealed that the maximum position error of the developed verification system compared to the laser distance sensor was nearly equivalent to the distance resolution of the system (0.05 mm/pulse), with negligible average speed error. When the Radixact couch operated at 0.1, 0.5, and 1.0 mm/s, the values obtained by the verification system agreed with the theoretical values within the sampling period (0.01 s) and distance resolution (0.05 mm). Conclusion: The verification system developed provides real‐time monitoring of the speed of the Radixact table, ensuring treatment effectiveness and patient safety. It would guarantee the couch speed's soundness and contribute to the "visualization" of safety. [ABSTRACT FROM AUTHOR]

Aim: Nutritional counseling improves malnutrition, which determines the prognosis of patients with chronic liver disease. In this study, we investigated the effects of nutritional counseling on mortality and the risk of overt hepatic encephalopathy (HE) in patients with alcohol‐associated liver disease. Methods: In this retrospective cohort study, we included 211 patients with alcohol‐associated liver disease who visited Gifu University Hospital between August 2008 and June 2023. Patients were classified into two groups according to the frequency of nutritional counseling by a registered dietitian. The primary outcomes were all‐cause mortality and overt HE. Propensity score matching analysis was performed to adjust for potential confounders. Results: Among the patients (median age 67 years; 88% men; and median Model for End‐Stage Liver Disease score, 9), 86 (39%) were in the high‐frequency (≥2) nutritional counseling group. The high‐frequency group had a significantly higher survival rate (46% vs. 25%) and a lower incidence of overt HE (16% vs. 27%) at 5 years than the low‐frequency group. Nutritional counseling was associated with a reduced risk of mortality (hazard ratio [HR] 0.48; 95% confidence interval [CI] 0.36–0.63) and overt HE (HR 0.64; 95% CI 0.42–0.99), independent of hepatocellular carcinoma and liver function reserve. After propensity score matching, nutritional counseling was still associated with a reduced risk of mortality (HR 0.34; 95% CI 0.19–0.59) and overt HE (HR 0.31; 95% CI 0.11–0.87). Conclusions: Nutritional counseling effectively improves mortality and prevents overt HE in patients with alcohol‐associated liver disease, thereby proving essential for the management of these patients. [ABSTRACT FROM AUTHOR]

Aim: Geraniol is an acyclic monoterpenoid that is abundant in many plants, including rose, lemongrass, and lavender. As geraniol has various beneficial functions, rose oil rich in geraniol is not only used for aromatherapy but also as a supplement to promote health benefits. However, the beneficial effects of geraniol on age‐related pathologies are unknown. In this study, we aimed to clarify the effects of geraniol intake on age‐related pathologies. Methods: We orally administered geraniol to aged mice (age: 24–29 months) five times a week for 4 weeks and sampled their blood and various organs. We investigated age‐related changes in the blood and organ samples. Furthermore, we treated HepG2 cells with geraniol and examined the expression level of the ALB gene and the amount of secreted albumin in vitro. Results: Geraniol significantly increased blood albumin, total cholesterol, and red blood cell counts, indicating an improvement in nutritional markers in aged mice. Geraniol also transcriptionally increased the Alb gene expression in the liver of aged mice. Furthermore, treatment with geraniol significantly upregulated the ALB gene expression and the secretion of albumin in the conditioned medium of HepG2 cells. Conclusion: Geraniol increases serum albumin levels at the transcriptional level. Geraniol intake can be an effective strategy for age‐related malnutrition. Geriatr Gerontol Int 2024; 24: 1233–1240. [ABSTRACT FROM AUTHOR]

The article discusses a retrospective study on atlantoaxial arthritis (AA) in juvenile idiopathic arthritis (JIA) patients, comparing the prevalence and clinical characteristics between systemic onset JIA (sJIA) and polyarticular JIA (pJIA). The study found that AA was more common in pJIA patients than in sJIA patients, with clinical manifestations including neck pain, torticollis, and limited range of motion. Treatment for AA involves managing underlying diseases and orthopedic interventions, with a combination of biologics and orthopedic procedures showing promise in improving cervical prognosis in JIA patients with AA. The study highlights the importance of considering JIA as a potential cause of AA and the effectiveness of combined therapy for better outcomes. [Extracted from the article]

Telomerase reverse transcriptase (TERT) gene aberration is detectable in >80% of cases with hepatocellular carcinoma (HCC). TERT reactivation is essential for cellular immortalization because it stabilizes telomere length, although the role of TERT in hepatocarcinogenesis remains unelucidated. To elucidate the significance of aberrant TERT expression in hepatocytes in inflammation‐associated hepatocarcinogenesis, we generated Alb‐Cre;TertTg mice, which overexpress TERT in the liver and examined their phenotype during chronic inflammation. Based on transcriptome data from the liver tissue of Alb‐Cre;TertTg mice, we examined the role of TERT in hepatocarcinogenesis in vitro. We also evaluated the relationship between TERT and cell‐cycle‐related molecules, including p21, in HCC samples. The liver tumor development rate was increased by TERT overexpression during chronic inflammation, especially in the absence of p53 function. Gene set enrichment analysis of liver tissues revealed that gene sets related to TNF‐NFκB signaling, cell cycle, and apoptosis were upregulated in Alb‐Cre;TertTg liver. A luciferase reporter assay and immunoprecipitation revealed that TERT interacted with NFκB p65 and enhanced NFκB promoter activity. On the other hand, TERT formed protein complexes with p21, cyclin A2, and cyclin E and promoted ubiquitin‐mediated degradation of p21, specifically in the G1 phase. In the clinical HCC samples, TERT was highly expressed but p21 was conversely downregulated, and TERT expression was associated with the upregulation of molecules related to the cell cycle. Taken together, the aberrant upregulation of TERT increased NFκB promoter activity and promoted cell cycle progression via p21 ubiquitination, leading to hepatocarcinogenesis. © 2024 The Author(s). The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland. [ABSTRACT FROM AUTHOR]

Histiocytic neoplasms (HNs) in adults have been reported to be associated with a high prevalence of coexisting haematological and solid malignancies. While a proportion of coexisting HNs and haematological malignancies share identical genetic alterations, the genetic association between HNs and solid malignancies has scarcely been reported. We report a case of Rosai–Dorfman disease (RDD) complicated by coexisting clear cell sarcoma (CCS). RDD is a rare HN. CCS is an ultrarare soft tissue sarcoma with a poor prognosis. Mutation analysis with whole‐exome sequencing revealed six shared somatic alterations including NRAS p.G12S and TP53 c.559+1G>A in both the RDD and CCS tissue. This is the first evidence of a clonal relationship between RDD and solid malignancies using mutational analysis. We hypothesise that neural crest cells, which originate in CCS, are likely the common cells of origin for RDD and CCS. This case helps to unravel the underlying clinicopathological mechanisms of increased association of solid malignancies in HNs. © 2024 The Author(s). The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland. [ABSTRACT FROM AUTHOR]

Background: Previous research found that self‐concealment was associated with rumination in younger adults. However, no study had investigated the relationship between self‐concealment and rumination in older adults. Hence, this study aimed to investigate the relationship between self‐concealment and the two subfactors of rumination: brooding and reflection, in older adults. Methods: In this study, we investigated the relationship between self‐concealment and rumination in older adults. Considering that rumination has two subfactors: brooding, which reflects the more maladaptive aspects of rumination; and reflection, which reflects the more adaptive aspects of rumination, we separately investigated the relationship between self‐concealment and the two subfactors of rumination. Results: We found that after controlling for other potentially relevant variables and the interrelationship between these two subfactors, self‐concealment was associated with brooding, but not with reflection. Conclusions: Self‐concealment was only associated with the maladaptive aspect of rumination (i.e. brooding), and not with the adaptive aspects of rumination (i.e. reflection). These findings have important implications for enhancing the understanding of older adults' mental health, and imply that improving self‐concealment could potentially mitigate the maladaptive aspects of rumination, which may offer valuable insights for guiding future psychogeriatrics interventions. [ABSTRACT FROM AUTHOR]

Aim: Methods of predicting severe postoperative complications after anatomical resection for hepatocellular carcinoma are yet to be established. We aimed to clarify the relationship between inflammation‐based prognostic scores and liver fibrosis markers and the incidence of postoperative complications after anatomical resection for hepatocellular carcinoma as well as the usefulness of these markers in surgical procedure selection. Methods: We included 374 patients with hepatocellular carcinoma who had undergone initial hepatectomy between January 2007 and December 2021. The association between inflammation‐based prognostic scores or liver fibrosis markers and postoperative complications was evaluated, and severe postoperative complication rates in the high‐risk group defined by these markers were compared in terms of surgical procedure. Results: The advanced lung cancer inflammation index and nonalcoholic fatty liver disease fibrosis score correlated significantly with severe postoperative complications after anatomical resection, with areas under the curve of 0.67 and 0.61, respectively. The combined advanced lung cancer inflammation index and nonalcoholic fatty liver disease fibrosis score resulted in a larger area under the curve (0.69). Furthermore, in the high‐risk group determined by the combined score, the anatomical resection group had a significantly higher incidence of severe complications than the partial resection group (P < 0.01). There were no significant differences in prognosis among the surgical procedures in the high‐risk group. Conclusion: The combined advanced lung cancer inflammation index and nonalcoholic fatty liver disease fibrosis score serves as a predictive marker for severe postoperative complications after anatomical resection. This combined marker may contribute to appropriate surgical procedure selection. [ABSTRACT FROM AUTHOR]

Median arcuate ligament syndrome (MALS) is a rare condition characterized by nonspecific symptoms, such as abdominal pain, nausea, and vomiting. Furthermore, the development and rupture of pancreaticoduodenal artery aneurysms pose a potentially fatal risk. Median arcuate ligament release (MALR) is useful in the treatment of MALS, with most procedures performed laparoscopically. However, detailed descriptions of laparoscopic MALR (lap‐MALR) procedures are rare. In this study, we performed lap‐MALR via an anterior approach with dissection of the right lateral wall of the celiac artery (CA). For optimal visualization of the right side of the CA, the right branch of the inferior phrenic artery was divided. We believe that this procedure allows the MAL to be released within a sufficient surgical field and without excess or deficiency. Here, we present the details of six patients who underwent lap‐MALR for varying indications; three for pancreaticoduodenal artery aneurysms due to CA obstruction (unruptured, n = 1; ruptured, n = 2), two cases prior to hepato‐biliary‐pancreatic surgery, and one symptomatic case. In all cases, lap‐MALR was performed as described above, and the CA stenosis was successfully released. Our case series demonstrates the safety and reliability of our lap‐MALR procedure in the treatment of MALS‐related disorders, including pancreaticoduodenal artery aneurysms associated with CA compression. [ABSTRACT FROM AUTHOR]

Aim: Central liver resections are considered to be high‐risk procedures due to postoperative biliary complications. However, anatomical aspect‐related causes are underreported. Focusing upon right anterior sectionectomy (H58) and central bisectionectomy (H458), we assessed risk factors for postoperative biliary complications. Methods: We retrospectively reviewed patients who underwent H58 or H458 in our hospital between April 2008 and June 2023 (n = 58). We conducted univariate and multivariate analysis of risk factors of postoperative biliary complications among perioperative factors and anatomical factors including the branching type of the right posterior hepatic duct (RPHD) and the length of the right hepatic duct (RHD). Results: Twenty‐six patients (44.8%) had postoperative biliary complications. Potent risk factors in univariate analysis were the tumor proximity to the right anterior Glissonean branch and longer RHD (both P < 0.01). In multivariate analysis, longer RHD was the only independent risk factor and its hazard (95% confidence interval [CI] was 1.19 (1.05–1.35). Receiver operating characteristics curve (ROC) analysis and the area under the ROC showed that 10 mm was the optimal cutoff value with high discriminatory power (0.72). Considering intraoperative procedures of the right anterior segment Glissonean branch dissection, mass ligation at the second‐order branch had marginal risk, especially in patients with RHD >10 mm; its hazard (95% CI) was 5.83 (0.95–35.7). Conclusion: Anatomical factors of RPHD and RHD influenced postoperative biliary complications in this cohort. The supraportal with RHD type was most common anatomy but considered to be hazardous if the RHD was >10 mm. [ABSTRACT FROM AUTHOR]

Human astroviruses (HAstVs) were examined in 1625 stool samples collected from outpatient children with diarrhea who visited clinics in 4–6 prefectures in Japan. The study was conducted over a period of 4 years from July 2018 to June 2022, spanning the period before and after the emergence of COVID‐19. The HAstV and other diarrheal viruses including group A rotavirus, norovirus and sapovirus were screened by RT‐PCR. Of these, HAstV was detected in 140 out of 1625 (8.6%). When the stool samples were categorized by the year of collection, HAstV was detected in 2018–2019, 2019–2020, 2020–2021, and 2021–2022 with the prevalences of 3.1%, 6.6%, 3.0%, and 20.1%, respectively. Among 140 HAstV positive cases, HAstV1, MLB1, MLB2, HAstV3, MLB3, and VA2 were detected in 77, 46, 10, 3, 2, and 2 samples, respectively. High infection rate was found in children 1–3 years of age (95/140; 67.9%). Severity of the disease increased with the co‐infection with norovirus. During the surveillance of 2021–2022, two outbreaks of HAstV were detected, one was an outbreak of HAstV1 and MLB2 in September, 2021 in Kyoto, the second was an outbreak of HAstV1 and MLB1 in December, 2021 in Kyoto and Shizuoka. It was interesting to observe that mixed‐infection of astroviruses between HAstV1 and MLB1 was reported for the first time in this study. Characterization of the subgenotypes in HAstV1 and HAstV3 indicated that most HAstV1 circulating in Japan belonged to HAstV1a and only a single strain was HAstV1b, whereas all HAstV3 was identified as the HAstV3c subgenotype. In conclusion, several HAstV genotypes, including classic HAstV, novel MLB, and VA genotypes, were detected in this study. The incidence of astrovirus outbreaks was also reported after the pandemic of COVID‐19 in 2021–2022. [ABSTRACT FROM AUTHOR]