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Bovine spongiform encephalopathy (BSE) is a prion disease in cattle caused by classical‐type (C‐), L‐type (L‐), or H‐type (H‐) BSE prions. While C‐BSE prions are zoonotic agents responsible for variant Creutzfeldt–Jakob disease, L‐ and H‐BSE prions are believed not to be connected to human prion diseases. However, L‐BSE prions have been shown to transmit to cynomolgus monkeys (Macaca fascicularis), suggesting they may have zoonotic potential. In the present study, we examined whether H‐BSE prions are transmissible to cynomolgus monkeys. The monkeys were injected intracranially (n = 2) or given orally (n = 2) with brain homogenates from a cow infected with H‐BSE prions. After asymptomatic observation periods of 4–6 years, the monkeys were euthanized for autopsy. Histological examination of the brain did not reveal any pathological changes. Immunohistochemical and Western blot analyses did not detect disease‐associated forms of prion protein (PrPSc) in the brain, peripheral neurons, or lymphatic tissues. The unsuccessful transmission indicates an effective barrier against the transmission of cattle H‐BSE prions to cynomolgus monkeys. Based on the results obtained in this nonhuman primate model, we estimated that the potential transmission of H‐BSE prions to humans is substantially lower than C‐ and L‐BSE prions. [ABSTRACT FROM AUTHOR]

Heterotopic ossification is abnormal bone formation in soft tissues that occurs primarily after injury and major surgery. This condition often causes local pain and limits joint motion in the affected limb. Currently, there is no effective treatment or prophylaxis for this condition other than surgical removal of the lesion. Recent studies suggest that retinoic acid receptor (RAR) agonists are effective in suppressing heterotopic ossification in patients with Fibrodysplasia Ossificans Progressiva, a congenital disorder characterized by progressive ossification of soft tissue, by suppressing the aberrant differentiation of mesenchymal stem cells in muscle. In this study, we aimed to elucidate the potential use of RAR agonists in suppressing injury‐induced ectopic tendon ossification using a mouse Achilles tenotomy model. Contrary to our initial hypothesis, administration of RAR agonists throughout the experimental period (5 weeks) accelerated ectopic tendon ossification in our model. Of note, in vitro differentiation experiments using tendon‐derived mesenchymal stem cells revealed that RAR agonists play opposing roles in osteogenic and chondrogenic differentiation, promoting the former and suppressing the latter. Indeed, we found that RAR agonists suppressed tendon ossification when administered before cartilage nodule formation, but promoted it when administered after. These results suggest that RAR agonists have a dual and opposing effect on tendon ectopic ossification, depending on the duration and timing of their administration. Our data may provide a basis for further investigation of the potential use of RAR agonists in the treatment of injury‐induced heterotopic ossification. [ABSTRACT FROM AUTHOR]

Summary The evolution of green plants from aquatic to terrestrial environments is thought to have been facilitated by the acquisition of gametangia, specialized multicellular organs housing gametes. Antheridia and archegonia, responsible for producing and protecting sperm and egg cells, undergo formative cell divisions to produce a cell to differentiate into germ cell lineages and the other cell to give rise to surrounding structures. However, the genes governing this process remain unidentified. We isolated genes expressed during gametangia development from previously established gene‐trap lines of Physcomitrium patens and characterized their function during gametangia formation. We identified P. patens LATERAL SUPPRESSOR 1 (PpLAS1) from the gene‐trap library, encoding a GRAS transcription factor. The double‐deletion mutant with its paralog PpLAS2 failed to form inner cells in both gametangia. PpLASs are expressed in cells undergoing formative cell division, and introducing PpLAS1 into the double‐deletion mutant successfully rescued the phenotype. These findings underscore the pivotal role of PpLASs in regulating formative cell divisions, ensuring the separation of reproductive cell lineages from surrounding cells in antheridia and archegonia. Furthermore, they suggest a link between PpLASs and the evolutionary origin of male and female gametangia in the common ancestor of land plants. [ABSTRACT FROM AUTHOR]

Introduction: Numerous AI‐based systems are being developed to evaluate peripheral blood (PB) smears, but the feasibility of these systems on different smear preparation methods has not been fully understood. In this study, we assessed the impact of different smear preparation methods on the robustness of the deep learning system (DLS). Methods: We collected 193 PB samples from patients, preparing a pair of smears for each sample using two systems: (1) SP50 smears, prepared by the DLS recommended fully automated slide preparation with double fan drying and staining (May–Grunwald Giemsa, M–G) system using SP50 (Sysmex) and (2) SP1000i smears, prepared by automated smear preparation with single fan drying by SP1000i (Sysmex) and manually stained with M–G. Digital images of PB cells were captured using DI‐60 (Sysmex), and the DLS performed cell classification. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were used to evaluate the performance of the DLS. Results: The specificity and NPV for all cell types were 97.4%–100% in both smear sets. The average sensitivity and PPV were 88.9% and 90.1% on SP50 smears, and 87.0% and 83.2% on SP1000i smears, respectively. The lower performance on SP1000i smears was attributed to the intra‐lineage misclassification of neutrophil precursors and inter‐lineage misclassification of lymphocytes. Conclusion: The DLS demonstrated consistent performance in specificity and NPV for smears prepared by a system different from the recommended method. Our results suggest that applying an automated smear preparation system optimized for the DLS system may be important. [ABSTRACT FROM AUTHOR]

Background: We evaluated for predictors of successful cannulation and post‐endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in minor papilla endotherapy (MPE), emphasizing endoscopic minor papilla morphology. Methods: We retrospectively analyzed 232 MPEs in 65 patients, assessing minor papilla morphology based on three features: bulge as "prominent" or "subtle," mucosal appearance as "papilla‐like" resembling the main papilla or "SMT‐like" akin to a gastrointestinal submucosal tumor, and orifice visibility as "clear" or "unclear." Cannulation success was evaluated in 65 enrolled patients, with PEP risk assessed in all 232 MPEs. Results: Minor papilla morphology was categorized as prominent/subtle bulge in 42/23 patients, papilla‐like/SMT‐like mucosal appearance in 42/23, and clear/unclear orifice visibility in 24/41. Cannulation succeeded in 54/65 patients (83%). A papilla‐like appearance and clear orifice visibility was significantly associated with cannulation success. PEP incidence was 5.2% and predominantly mild. A papilla‐like appearance significantly decreased PEP incidence, while precutting technique and orifice dilation significantly increased PEP risk. Conclusion: Evaluating minor papilla morphology may help predict cannulation success and PEP risk in MPE. A papilla‐like mucosal appearance prognosticates cannulation success and reduced PEP risk, with clear orifice visibility serving as a success predictor. These findings provide practical guidance for preprocedural planning by emphasizing the importance of minor papilla morphology evaluation. [ABSTRACT FROM AUTHOR]

Background: Hypoglycemia after pheochromocytoma resection is one of the most common postoperative complications, with a reported incidence of 12%–43%. In recent years, we have rarely experienced postoperative hypoglycemia after pheochromocytoma surgery at our institution. We reviewed our own experience and examined factors associated with postoperative hypoglycemia in pheochromocytoma patients. Methods: We collected and retrospectively reviewed medical information from 53 patients with pheochromocytoma who underwent initial surgery in our department between 1996 and 2022, who did not receive steroids in the perioperative period and received the same alpha‐blocker preoperatively. Subjects were divided into two groups by the midpoint of the study period: Group 1 (G1), 1996–2009; and Group 2 (G2), 2010–2022. The two groups were compared. Results: Hypoglycemia occurred significantly less often in G2 (0 patients, 0%) than in G1 (7 patients, 28%; p = 0.003). Preoperative diabetes was significantly less frequent in G2 (2 patient, 7.1%) than in G1 (8 patients, 32%; p = 0.03). Preoperative alpha‐blocker dosage was significantly higher in G2 than in G1 (p = 0.04). Multivariate logistic regression analysis showed that only alpha‐blockers dosage was significantly associated with the occurrence of postoperative hypoglycemia (p = 0.004). Conclusion: The current study suggest that the alpha‐blocker dosage might be related to the lower incidence of postoperative hypoglycemia in Pheochromocytoma patients. [ABSTRACT FROM AUTHOR]

Whether or not vascular endothelial growth factor pathway inhibitors (VPIs) increase the risk of artery dissection is still unknown. This study aimed to quantitatively evaluate the possibility of artery dissection as a class effect of VPIs using nationwide real‐world data. This cohort study was conducted based on the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), which spans nearly the entire Japanese population of over 100 million individuals. We included the patients prescribed with 12 types of VPIs between 2012 and 2020. The incidence rate (IR) ratio of artery dissection for each VPI were estimated in comparison with bevacizumab, the only VPI in Japan with artery dissection listed in the package insert. Artery dissection as an outcome was targeted for acute artery dissection requiring hospitalization (including dissecting aneurysm). As a reference, a natural IR standardized by sex and age of bevacizumab‐prescribed patients was also estimated using the direct method for the general population of NDB. Of 503,342 patients, the IR of artery dissection for bevacizumab was 44.4 (/100,000 person‐years), and the adjusted IR ratios for each VPI compared with bevacizumab were consistently similar to or >1.0. The IRs for each VPI were also higher than the crude natural IR (1.66/100,000 person‐years; 95% CI: 1.59–1.73) and the standardized natural IR (2.18/100,000 person‐years; 95% CI: 1.86–2.50). Real‐world evidence suggests the risk of artery dissection as a class effect of VPIs. More attention on this risk will be necessary when using VPIs in clinical practice. [ABSTRACT FROM AUTHOR]

The 15 January 2022, eruption at Hunga Tonga‐Hunga Ha'apai (HTHH) volcano started shortly after 4:00UTC. There had been noted unconfirmed precursory events. We analyzed seismometer data recorded in Fiji and Futuna, the closest stations operated during the eruption and located over 750 km away. We extracted Rayleigh waves and estimated their powers and source directions, assuming retrograde particle motions. We found a Rayleigh wave from the HTHH's direction about 15 min before the eruption onset. The arrival time difference of the Rayleigh wave between the two stations was consistent with that of the M5.8 earthquake during the eruption located beneath the HTHH. Referring to other seismic signals and satellite images, we concluded that the Rayleigh wave was the most significant eruption precursor with no apparent surface activity. Including our findings and results of previous studies, we propose a scenario of the beginning of the caldera‐forming eruption. Plain Language Summary: Hunga Tonga‐Hunga Ha'apai (HTHH) volcano in Tonga had a caldera‐forming eruption on 15 January 2022. Disturbances associated with the eruption were recorded worldwide and by satellites. Many studies analyzed the data and reported that the eruption onset was shortly after 04:00UTC on January 15. However, some articles reported unconfirmed waves about 15 min before the eruption onset. This study is motivated by the following questions: (a) Were the unconfirmed waves actual? (b) Were they related to the eruption? (c) How did the huge eruption start? (d) How can we improve the monitoring of remote‐island and submarine volcanoes? Here, we analyzed data recorded at the closest seismic stations over 750 km away. We confirmed that a precursor event occurred ∼ ${\sim} $15 min before the eruption and generated a significant seismic wave. This event might have been the trigger of the eruption. This study demonstrated that distant seismic stations and appropriate analysis methods will allow us to capture precursors leading to a catastrophic eruption. Key Points: The volcano generated Rayleigh waves about 15 min before the giant eruption with no apparent surface activityThese waves dominated in 0.03–0.1 Hz with amplitudes comparable to the amplitude of M4.9Seismic stations 750 km from the volcano and appropriate data analyses allowed us to capture precursors of the catastrophic eruption [ABSTRACT FROM AUTHOR]

Insulin is secreted by the pancreatic β‐cells and regulates glucose uptake. Endoplasmic reticulum (ER) stress is known to induce insulin resistance. Identifying novel compounds, which can ameliorate ER stress and insulin resistance may be beneficial in the treatment of diabetes. Since treatment with compounds sourced from edible plants is relatively safe, this study aimed to identify a plant‐derived potential compound attenuating insulin resistance. In the present study, we identified apigenin as an effective compound for ameliorating ER stress and insulin resistance. It attenuated ER stress‐induced cell death and hepatic insulin resistance and improved abnormal glucose tolerance in a db/db diabetic model. The molecular mechanism of apigenin involved direct binding to β‐tubulin and improving tubulin stability, thereby recovering insulin resistance and developing diabetes. To our knowledge, no known antidiabetic drugs are yet known to target β‐tubulin. Edible plants containing apigenins, such as onions, oranges, and parsley, have been consumed since a long time. Therefore, the use of natural edible plants as a source may offer a safe strategy for the prevention of diabetes. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to describe the usefulness of our teleconsultation system for managing multiple sclerosis (MS) in regions without specialists. Methods: A cross‐sectional questionnaire survey involving 11 MS patients and their primary neurologists was carried out between May and December 2023. Real‐time video conferences were conducted between an MS specialist at a hub hospital and patients with their primary neurologists at one of the four regional core hospitals in Hokkaido, Japan. Patients and their primary neurologists completed questionnaires to evaluate the usefulness of the teleconsultation system. Results: The patients and their primary neurologists were generally satisfied with the teleconsultations and expressed willingness to continue using the system. In particular, alleviating the burden of visiting distant MS‐specialized clinics was highly appreciated by patients. In addition, patients gave high scores for questions regarding increased satisfaction with the primary neurologists' care and the treatments they offered. The primary neurologists thought the system enhanced their knowledge of MS management. However, they did not think that the system could ease their burden for managing MS patients because of challenges in time allocation and scheduling for teleconsultation sessions. Conclusions: The present study suggested that our expert teleconsultation system for MS reduces the burden on patients of visiting distant MS‐specialized clinics, and enhances knowledge of MS management for the primary neurologists. It also promotes trust between patients and their primary neurologists, and taken together, these aspects could collectively lead to independent and sustainable MS management in regions without MS specialists. [ABSTRACT FROM AUTHOR]

Objectives: Impaired B‐cell reconstitution after allogeneic hematopoietic cell transplantation (allo‐HCT) contributes to the pathogenesis of chronic graft‐versus‐host disease (cGVHD). Therefore, methods to consistently achieve effective B cell lymphogenesis are required. We assessed the long‐term effects of posttransplantation cyclophosphamide (PTCy) use on immune reconstitution in clinical settings, an emerging strategy to suppress allogeneic immunological inflammation early after allo‐HCT and prevent subsequent GVHD. Methods: We comprehensively analyzed peripheral immune cell subsets and measured serum immunoglobulin G (IgG) or cytokine levels in 39 patients who survived for >1 year after allo‐HCT. Results: The absolute counts of B1 and IgM memory B cells were significantly lower in patients with severe cGVHD than in those without. The absolute count and percentage (among total CD19+ B cells) of switched memory B cells and serum IgG levels were significantly higher in patients transplanted with PTCy than in those transplanted with conventional GVHD prophylaxis. Interestingly, increased percentages of switched memory B cells and serum IgG levels were observed only in patients transplanted with PTCy and not in those transplanted with umbilical cord blood. Conclusions: PTCy administration can mediate favorable memory B‐cell reconstitution long after allo‐HCT and may therefore suppress cGVHD. [ABSTRACT FROM AUTHOR]

The article in Brain Pathology discusses spinal intradural pseudocyst formation in patients with superficial siderosis of the central nervous system (SSCNS). The study examines three cases of SSCNS patients with spinal dural defects and intraspinal fluid collections. The findings suggest that the intradural pseudocyst observed in SSCNS patients is formed by the dissection of the spinal dura mater, leading to hemosiderin deposition and neurological symptoms. Surgical repair of the dural defect resulted in the improvement of symptoms and reduction of intraspinal fluid collection. [Extracted from the article]

Traumatic heterotopic ossification is a condition in which extraskeletal bone formation occurs in soft tissues after injury. It most commonly occurs in patients who had major orthopedic surgery and in those with severe extremity injuries. The lesion causes local pain and can impair motor function of the affected limb, but there is currently no established prophylaxis or treatment for this condition. In this study, we show that immobilization at an early stage of the inflammatory response after injury can attenuate ossification formation in a murine Achilles tenotomy model. Gene expression analysis revealed a decrease in the expression of Tnf and an increase in the expression of Mkx, which encodes one of the master regulators of tendon differentiation, Mohawk. Notably, we found that TNF‐α suppressed the expression of Mkx transcripts and accelerated the osteogenic differentiation of tendon‐derived mesenchymal stem cells (MSCs), suggesting that TNF‐α acts as a negative regulator of Mkx transcription. Consistent with these findings, pharmaceutical inhibition of TNF‐α increased the expression of Mkx transcripts and suppressed bone formation in this mouse model. These findings reveal the previously unrecognized involvement of TNF‐α in regulating tendon MSC fate through suppression of Mkx expression and suggest that TNF‐α is a potential target for preventing traumatic heterotopic ossification. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to explore mothers' perceptions for timely introduction of complementary feeding through interviews with 2–12‐month‐old infants' mothers in Ghana. Methods: Qualitative descriptive research with 16 semi‐structured interviews with mothers attending the Child Welfare Clinic at Ejisu Hospital was conducted from June 2022 to May 2023. The study was guided by the Declaration of Helsinki, and all participants were instructed about informed consent for the study. Interviews and analysis were guided by Theory of Planned Behavior. NVivo 1.5 was used throughout the coding procedure. This study was conducted after the approval from St. Luke's International University. Results: Four themes were revealed: (1) attitude toward the behavior based on the mothers' experience raising children, (2) attitude toward the behavior influenced by subjective norm (grandmothers' recommendation), (3) attitude toward the behavior influenced by perceived behavioral control (difficulty in continuing breastfeeding), and (4) mothers who are worried about underweight despite timely introduction of complementary feeding. Attitudes toward the behavior were influenced by mothers' experiences raising children and grandmothers' recommendations. Surroundings disruptive of breastfeeding also influenced attitudes toward intentions and behavior. Moreover, some mothers suffered from underweight even if they introduce complementary feeding at an optimal time. Conclusion: Supporting to continue breastfeeding and conducting re‐education for grandmothers is a key recommendation for midwives and pediatric nurses. Moreover, pediatric nurses are required to further enhance not only health education regarding the timing of initiating complementary feeding but also support after the introduction. [ABSTRACT FROM AUTHOR]

Aim: A summary of studies focusing on the mental health of midwives during the COVID‐19 pandemic has not yet been conducted. This review aims to comprehensively understand the current state of midwives' mental health in the context of the COVID‐19 pandemic and to provide valuable insights to guide future research. Methods: This study was based on a framework for conducting scoping reviews. The protocol was registered before conducting this review and procedures were carried out according to that protocol. Article searches were conducted in four databases from December 2019 to December 2023. From 921 articles selected according to pre‐registered protocol criteria, the analysis finally included 14 studies. Results: A total of 13 studies were cross‐sectional and one was longitudinal, with pre‐pandemic data. More than 80% of the studies began data collection within approximately 1 year after the pandemic was declared by the World Health Organization (by February 2021). Half of the studies were conducted in Asia. Burnout and turnover intentions were investigated in several studies but used different measures. Only two studies were aimed at positive aspects such as job satisfaction and well‐being. Conclusions: Most research on midwives' mental health during the COVID‐19 pandemic has focused on negative aspects such as burnout and turnover intentions. However, most results were cross‐sectional, with studies in the early stages of the pandemic, so continued follow‐up is needed. [ABSTRACT FROM AUTHOR]

Closure of mucosal defects following colorectal endoscopic submucosal dissection (C‐ESD) is often performed to prevent post‐C‐ESD adverse events. However, large mucosal defect closure using conventional clips remains technically challenging. Here, we evaluated the feasibility of the novel endoclip with anchor prongs, called the MANTIS Clip (Boston Scientific, Tokyo, Japan), for mucosal defect closure after C‐ESD. This high‐volume retrospective study was conducted at a single center. From March until December 2023, consecutive patients who underwent post‐C‐ESD mucosal defect closure using MANTIS Clip to achieve complete closure were enrolled. Patient clinical characteristics and outcomes were evaluated. Closure of the mucosal defect using the MANTIS Clip was attempted following C‐ESD in 32 lesions. The median sizes of the resection specimens and the tumors were 32 mm (range, 17–100 mm) and 23.5 mm (range, 5–96 mm), respectively. The lesions were distributed between the cecum, ascending, transverse, descending, sigmoid, and rectum. Complete closure was achieved in 96.9% of cases (31/32). All lesions up to 61 mm in defect size were completely closed. The median closure time was 7.9 (range, 3.3–18.0) min. The median numbers of MANTIS Clip and additional conventional clips were 3 (range, 1–4) and 5 (range, 1–11), respectively. No adverse events associated with closure, post‐ESD bleeding, and delayed perforation occurred. MANTIS Clip closure for large post‐C‐ESD mucosal defects was found to be feasible and reliable with a high complete closure rate and a short procedure time. [ABSTRACT FROM AUTHOR]

Objectives: Distinguishing between intramucosal cancer and submucosal invasive cancer is vital for optimal treatment selection for patients with superficial nonampullary duodenal adenocarcinoma (SNADAC); however, standard diagnostic systems for diagnosing invasion depth are as yet undetermined. Methods: Of 205 patients with SNADAC who underwent treatment at our institution between 2006 and 2022, 188 had intramucosal cancer and 17 had submucosal invasive cancer. The clinical, endoscopic, and pathological features used in the preoperative diagnosis of invasion depth and the diagnostic performance of endoscopic ultrasonography (EUS) were retrospectively analyzed in 85 patients. Results: The oral side of the papilla tumor location, protruded or mixed macroscopic type, and moderately‐to‐poorly differentiated adenocarcinoma based on biopsy specimens were significantly more frequent in submucosal invasive cancer than in intramucosal cancer (88% vs. 48%; 94% vs. 42%; 47% vs. 0%, respectively). From the relationship between the endoscopic features and the submucosal invasive cancer incidence, submucosal invasion risk was stratified as: (i) low‐risk (risk, 2%), all lesions located on the anal side of the papilla and superficial macroscopic type on the oral side of the papilla; and (ii) high‐risk (risk, 23%), protruded or mixed macroscopic type on the oral side of the papilla. Based on the biopsy specimens, all eight patients with moderately‐to‐poorly differentiated adenocarcinoma had submucosal invasive cancer. Furthermore, EUS was not associated with invasion depth's diagnostic accuracy improvements. Conclusion: Optimal treatment indications for SNADAC can be selected based on the risk factors of submucosal invasion by tumor location, macroscopic type, and biopsy diagnosis. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the thresholds of milk production for predicting the achievement of exclusive breastfeeding (EBF) at 4 months postpartum. Methods: The inclusion criteria were singleton, low‐risk primiparas, non‐cesarean section, and healthy mothers and infants. Temporary feeding of artificial milk in the past was included. Women who could be judged to have intentionally used artificial milk were excluded from the analysis. Measurements of the 24‐h milk production by test weights were obtained at early postpartum (days 3–4) and at 1 month postpartum. To predict the achievement of EBF at 4 months postpartum, the area under the receiver operating characteristic (ROC) curve was calculated for early postpartum and 1 month milk production. Results: There were 80 eligible participants analyzed. ROC analysis of milk production for achieving EBF at 4 months revealed an area under the curve (AUC) of 0.736 (95% CI: [0.625, 0.848]) for early postpartum and an AUC of 0.854 (95% CI: [0.772, 0.936]) for 1 month postpartum. The proposed thresholds are 102 g/day (higher sensitivity) and 161 g/day (higher specificity) at early postpartum, and 527 g/day (higher sensitivity) at 1 month postpartum. Conclusions: In low‐risk primiparas, the milk production models at early postpartum and 1 month postpartum showed a high accuracy for predicting the achievement of EBF at 4 months postpartum. The present study indicates that even when formula milk is temporarily used, it is still possible to reach the goal of achieving EBF. [ABSTRACT FROM AUTHOR]

Aim: This study aims to implement team‐based learning (TBL) and assess the impact on faculty members and students within midwifery education in Indonesia. Methods: Proctor's Framework for Implementation Research serves as the guiding approach in investigating the role of implementation strategies in implementing TBL within the context of midwifery education. The RE‐AIM (Reach, Efficacy, Adoption, Implementation, and Maintenance) framework was utilized to assess the outcome. Results: In this study, the implementation of TBL has demonstrated significant reach, with broad participation among both faculty and students in two schools. The efficacy of TBL is evident through enhanced student knowledge, engagement and active learning. Adoption of TBL was observed in both schools, with faculty and students expressing interest and active participation. High levels of implementation fidelity were maintained, even though with challenges related to preparation and implementation. These findings suggest that TBL can be successfully integrated into midwifery education, with positive implications. Regarding maintenance, faculty members have expressed their intention to continue using TBL in various topics for future lectures. Conclusions: The implementation of TBL in Indonesian midwifery education has shown substantial reach and efficacy. Faculty and students are highly interested in adopting TBL for future use. Despite some implementation challenges, the study suggests that TBL can be effectively incorporated with minor adjustments, emphasizing its feasibility and potential impact. This research contributes to understanding TBL's applicability in various educational settings, especially in low‐resource institutions. [ABSTRACT FROM AUTHOR]

Most cervical cancers are caused by human papillomavirus (HPV) infection. In HeLa cells, the HPV18 viral genome is integrated at chromosome 8q24.21 and activates transcription of the proto‐oncogene c‐Myc. However, the mechanism of how the integrated HPV genome and its transcribed RNAs exhibit transcription activation function has not been fully elucidated. In this study, we found that HPV18 transcripts contain an enhancer RNA‐like function to activate proximal genes including CCAT1‐5L and c‐Myc. We showed that the human genome‐integrated HPV18 genes are activated by transcription coregulators including BRD4 and Mediator. The transcribed HPV18 RNAs form a liquid‐like condensate at chromosome 8q24.21 locus, which in turn accumulates RNA polymerase II. Moreover, we focused on a relatively uncharacterized transcript from the upstream region of CCAT1, named URC. The URC RNA is transcribed as a chimera RNA with HPV18 and is composed of the 3′‐untranslated region of the HPV18 transcript. We experimentally showed that the URC contributes to stabilization of HPV18 RNAs by supplying a polyadenylation site for the HPV18 transcript. Our findings suggest that integrated HPV18 at 8q24.21 locus produces HPV18‐URC chimera RNA and promotes tumorigenesis through RNA‐based condensate formation. [ABSTRACT FROM AUTHOR]

Key Clinical Message: In a patient with anti‐aminoacyl tRNA synthetase antibody and anti‐OJ antibody syndrome, interventions likes warming, prostaglandins, and antiplatelets failed. However, prednisolone pulse treatment rapidly halted disease progression. Patients with mild interstitial pneumonia, myositis, and extremity necrosis should be promptly considered for anti‐synthetase syndrome and receive immunosuppression after ruling out other causes. Anti‐aminoacyl tRNA synthetase (ARS) autoantibodies are myositis‐specific, and patients who test positive for ARS and have common clinical features are usually diagnosed with antisynthetase antibody syndrome (antisynthetase syndrome). Anti‐ARS antibodies include histidyl‐tRNA synthetase‐1 (Jo‐1), anti‐threonyl (PL‐7), anti‐alanyl (PL‐12), anti‐glycyl (EJ), anti‐asparaginyl (KS), anti‐tyrosyl (Ha), and anti‐phenylalanyl (Zo) tRNA synthetases. Among these, anti–isoleucyl tRNA synthetase (OJ) autoantibodies are extremely rare, and patients with these are frequently complicated by interstitial pneumonia. We report the case of an older man with ARS antibody syndrome who tested positive for anti‐OJ and anti‐Sjögren's‐syndrome‐related antigen A (Ro‐52) antibodies. He had muscle weakness due to myositis and unparalleled rapid and severe finger necrosis. Pulsed prednisolone effectively treated the myositis symptoms and terminated the progression of finger necrosis. [ABSTRACT FROM AUTHOR]

Background: The outcomes after liver transplantation have greatly improved, which has resulted in greater focus on improving non‐hepatic outcomes of liver transplantation. The present study aimed to evaluate thoracic spine radio density in children and adolescents after liver transplantation. Methods: A total of 116 patients who underwent living donor liver transplantation were retrospectively analyzed. The radio density at the eleventh thoracic vertebra was measured using computed tomography scan performed preoperatively then annually for 5 years postoperatively and subsequently every 2 or 3 years. Results: The mean thoracic radio density of male recipients of male grafts had the lowest values during the study. The radio density of patients receiving a graft from a female donor was higher than in recipients with grafts from males. Total mean radio density decreased for first 5 years postoperatively and then increased. Changes in radio density were equally distributed in both steroid withdrawal and no steroid withdrawal groups for 5 years, after which patients with steroid withdrawal had a greater increase. Changes in radio density were equally distributed in both the steroid withdrawal and no steroid withdrawal groups up to age 20, after which patients in the steroid withdrawal group had a greater increase. Conclusions: Gender differences may affect the outcome of radio density changes after transplantation. Given the moderate association between thoracic radio density and bone mineral density in skeletally mature adults and further studies are needed to validate this relationship between thoracic radio density and bone mineral density changes in pediatric liver transplantation. [ABSTRACT FROM AUTHOR]

Some rodlike organic molecules exhibit exceptionally high layered crystallinity when composed of a link between π‐conjugated backbone (head) and alkyl chain (tail). These molecules are aligned side‐by‐side unidirectionally to form self‐organized polar monomolecular layers, providing promising 2D materials and devices. However, their interlayer stacking arrangements have never been tunable, preventing the unidirectional arrangements of molecules in whole crystals. Here, it is demonstrated that polar/antipolar interlayer stacking can be systematically controlled by the alkyl carbon number n, when the molecules are designed to involve effectively weakened head‐to‐head affinity. They exhibit remarkable odd–even effect in the interlayer stacking: alternating head‐to‐head and tail‐to‐tail (antipolar) arrangement in odd‐n crystals, and uniform head‐to‐tail (polar) arrangement in even‐n crystals. The films show excellent field‐effect transistor characteristics presenting unique polar/antipolar dependence and considerably improved subthreshold swing in the polar films. Additionally, the polar films present enhanced second‐order nonlinear optical response along normal to the film plane. These findings are key for creating polarity‐controlled optoelectronic materials and devices. [ABSTRACT FROM AUTHOR]

Background: Although brain activities in Alzheimer's disease (AD) might be evaluated MRI and PET, the relationships between brain temperature (BT), the index of diffusivity along the perivascular space (ALPS index), and amyloid deposition in the cerebral cortex are still unclear. Purpose: To investigate the relationship between metabolic imaging measurements and clinical information in patients with AD and normal controls (NCs). Study Type: Retrospective analysis of a prospective dataset. Population: 58 participants (78.3 ± 6.8 years; 30 female): 29 AD patients and 29 age‐ and sex‐matched NCs from the Open Access Series of Imaging Studies dataset. Field Strength/Sequence: 3T; T1‐weighted magnetization‐prepared rapid gradient‐echo, diffusion tensor imaging with 64 directions, and dynamic 18F‐florbetapir PET. Assessment: Imaging metrics were compared between AD and NCs. These included BT calculated by the diffusivity of the lateral ventricles, ALPS index that reflects the glymphatic system, the mean standardized uptake value ratio (SUVR) of amyloid PET in the cerebral cortex and clinical information, such as age, sex, and MMSE. Statistical Tests: Pearson's or Spearman's correlation and multiple linear regression analyses. P values <0.05 were defined as statistically significant. Results: Significant positive correlations were found between BT and ALPS index (r = 0.44 for NCs), while significant negative correlations were found between age and ALPS index (rs = −0.43 for AD and − 0.47 for NCs). The SUVR of amyloid PET was not significantly associated with BT (P = 0.81 for AD and 0.21 for NCs) or ALPS index (P = 0.10 for AD and 0.52 for NCs). In the multiple regression analysis, age was significantly associated with BT, while age, sex, and presence of AD were significantly associated with the ALPS index. Data Conclusion: Impairment of the glymphatic system measured using MRI was associated with lower BT and aging. Level of Evidence: 3 Technical Efficacy Stage: 1 [ABSTRACT FROM AUTHOR]

Previous studies have reported swimming, atopic dermatitis, and filaggrin (FLG) gene mutations as risk factors for molluscum contagiosum (MC) infection. FLG gene mutations impair skin barrier function. The aim of this study was to determine the impact of FLG mutations on the incidence and clinical features of MC. We used data from 2036 children who participated in the Yamanashi Adjunct Study of the Japan Environment and Children's Study, a prospective, birth cohort study. A questionnaire for caregivers (when children were 4 and 8 years of age) asked about clinical features including previous MC incidence and treatment, number of MC lesions at first visit, and time to resolution. Participants underwent genotyping to detect six FLG mutations that are common in the Japanese population. A logistic regression model was used to analyze the association between MC incidence and FLG mutations, adjusted for potential confounders. The cumulative incidence of MC at age 8 years was 47.1%. Among participants with a history of MC, 67.6% had undergone curettage. FLG mutation was a significant risk factor for MC incidence (adjusted odds ratio [aOR] 1.69, 95% confidence interval [CI] 1.18–2.42). Swimming and atopic dermatitis were also significant risk factors for MC. There was no significant association between FLG mutation and the number of MC lesions at the first visit or the time to resolution of lesions. FLG mutation is a risk factor for MC incidence; however, FLG mutations do not affect the number of MC lesions at presentation or the time to resolution. [ABSTRACT FROM AUTHOR]

Watch a video of this article. [ABSTRACT FROM AUTHOR]

The 10Be record in laminated travertines is a potential proxy for reconstructing past solar activity down to the annual scale; however, correcting for the potential influence of climatic or environmental variations remains challenging. Here, we present an annually resolved 10Be record using travertines from Baishuitai, China, covering the period from 1510 to 1701 CE, along with environmental proxies, to evaluate climatic influences and implement corrections to accurately reconstruct solar activity. We demonstrate that the 10Be deposition in travertines exhibits two environmental impacts: the transport efficiency of atmospheric 10Be into travertine and the additional 10Be inflow from overland flow associated with rainfall. We show that these impacts can be corrected based on iron and potassium contents. The resulting corrected record agrees with ice‐core and tree‐ring records, demonstrating the feasibility of using such carbonate sediment 10Be records to reconstruct past solar activity. Plain Language Summary: The travertine 10Be record has great potential as a proxy for high‐resolution reconstruction of past solar activity; however, the methodology for correcting the potential influence of climatic or environmental variations has not been fully established. This study presents a new high‐precision annual 10Be record using travertines from Baishuitai, China, covering the period 1510–1701 CE, together with records of environmental proxies, allowing us to evaluate the climatic influences and establish a methodology for correcting them to facilitate accurate solar activity reconstruction. We find that there are two environmental impacts on the deposition of 10Be in travertine: one is the transport efficiency of atmospheric 10Be into travertine, and the other is the additional 10Be inflow from the runoff following rainfall events, and we use iron (Fe) and potassium (K) contents to correct these impacts. The corrected travertine 10Be record exhibits good agreement with ice‐core 10Be and tree‐ring 14C records, supporting that the 10Be record in Baishuitai travertine reliably reflects the atmospheric radionuclide production rate as regulated by solar activity. This result demonstrates the feasibility of using such carbonate sediment 10Be records to reconstruct annual solar activity and suggests the possibility of extending the annual records further back in time than previously obtained. Key Points: A high‐precision annual record of travertine 10Be from 1510 to 1701 CE was obtained to assess its potential as a proxy for solar activityClimatological and environmental impacts on 10Be deposition were found to be correctable based on the content of trace elementsThe travertine 10Be record corrected for climatological impacts reasonably preserves the decadal and centennial‐scale solar cycles [ABSTRACT FROM AUTHOR]

Attention‐deficit hyperactivity disorder (ADHD) is characterized by persistent symptoms of inattention, hyperactivity, and impulsivity. Both, stimulant and nonstimulant medications have been approved for the treatment of this disorder. Several Western guidelines recommend the use of prescribed Food and Drug Administration (FDA)‐approved medications for ADHD along with parental training in behavior management and behavioral classroom intervention. In 2022, new Japanese guidelines for ADHD were issued, which recommended school environment management and psychosocial treatment as the first‐line treatment, with pharmacological treatment added as the second‐line treatment. Although Japanese guidelines, including pharmacological treatments, have been established, the guidelines and utilization of ADHD medications across Asian regions are unclear. Therefore, to appropriately evaluate the strategy of pharmacological treatments for ADHD, we investigated Asian regional guidelines for ADHD medication in children. We also reviewed the guidelines in Malaysia, Singapore, India, and the Republic of Korea and found that these guidelines differ from Western guidelines. [ABSTRACT FROM AUTHOR]

We investigated the acute effects of caffeine supplementation (6 mg･kg−1) on 60‐m sprint performance and underlying components with a step‐to‐step ground reaction force measurement in 13 male sprinters. After the first round sprint as a control, caffeine supplementation‐induced improvement in 60‐m sprint times (7.811 s at the first versus 7.648 s at the second round, 2.05%) were greater compared with the placebo condition (7.769 s at the first versus 7.768 s at the second round, 0.02%). Using average values for every four steps, in the caffeine condition, higher running speed (all six step groups), higher step frequency (5th–16th and 21st–24th step groups), shorter support time (all the step groups except for 13th–16th step) and shorter braking time (9th–24th step groups) were found. Regarding ground reaction forces variables, greater braking mean force (13th–19th step group), propulsive mean force (1st–12th and 17th–20th step groups), and effective vertical mean force (9th–12th step group) were found in the caffeine condition. For the block clearance phase at the sprint start, push‐off and reaction times did not change, while higher total anteroposterior mean force, average horizontal external power, and ratio of force were found in the caffeine condition. These results indicate that, compared with placebo, acute caffeine supplementation improved sprint performance regardless of sprint sections during the entire acceleration phase from the start through increases in step frequency with decreases in support time. Moreover, acute caffeine supplementation promoted increases in the propulsive mean force, resulting in the improvement of sprint performance. [ABSTRACT FROM AUTHOR]

Background: Non‐Helicobacter pylori Helicobacter (NHPH) is rarely detected in duodenal mucosa due to its preference for slightly acidic environments. Here, we report four cases of NHPH‐infected gastritis with duodenal spiral bacilli, potentially NHPH, indicating the possibility of duodenal mucosal infection. Case Presentation: In every case, gastric mucosa showed endoscopic findings characteristic of NHPH‐infected gastritis, and a mucosal biopsy was taken from the duodenal bulb; spiral bacilli were identified under microscopy using Giemsa staining. Case 1, a 46‐year‐old man, had diffuse spotty redness, mucosal edema, and multiple tiny erosions in the duodenal bulb, along with larger erosions in the second portion of the duodenum upon endoscopic examination. Histopathologically, moderate infiltration of mononuclear cells and neutrophils in the lamina propria and gastric epithelial metaplasia were observed. Case 2, a 54‐year‐old man, showed an elevated lesion, 1 cm in diameter, with multiple red spots and a few tiny erosions in the duodenal bulb. Histopathologically, mild inflammatory cell infiltration and gastric epithelial metaplasia were observed. In Case 3, a 52‐year‐old man, endoscopy revealed a flat elevated lesion, 7 mm in diameter, with multiple red spots and a few tiny erosions in the anterior wall of the duodenal bulb. Histopathologically, we observed moderate inflammatory cell infiltration in the gastric antrum and gastric epithelial metaplasia in the duodenal bulb. Case 4, a 40‐year‐old man, showed mild spotty redness in the duodenal bulb. Histopathologically, mild mononucleocyte infiltration and gastric epithelial metaplasia were observed. A single spiral bacillus was observed in Case 4 by microscopy. In all but Case 2, Helicobacter suis was identified in the gastric juice by polymerase chain reaction analysis. Conclusions: Spiral bacilli resembling NHPH may infect the duodenal mucosa, particularly the bulb, causing inflammation. Gastric contents entering the duodenum may reduce the intraduodenal pH, promoting NHPH survival and proliferation. [ABSTRACT FROM AUTHOR]

Background: The characteristic endoscopic findings of non‐Helicobacter pylori Helicobacter (NHPH) gastritis, including white marbled appearance and crack‐like mucosa, have been reported. However, these findings can also manifest in H. pylori (HP)‐infected gastritis. This study compared NHPH gastritis and mild atrophic HP gastritis to identify features that may enhance NHPH diagnosis. Materials and Methods: A total of 2087 patients underwent upper gastrointestinal endoscopy and were histologically evaluated by multiple gastric mucosal biopsies according to the updated Sydney System (USS) at Shinshu University Hospital between 2005 and 2023. Among them, nine patients were classified into the NHPH group and 134 patients with HP infection and mild atrophy were classified into the HP group for retrospective comparisons of endoscopic findings and clinicopathological characteristics. Results: All nine patients in the NHPH group (eight males [89%], median ± standard deviation [SD] age: 49 ± 13.0 years) were infected with H. suis. The 134 patients in the HP group contained 70 men (52%) and had a median ± SD age of 35 ± 19.9 years. Endoscopic findings were statistically comparable for white marbled appearance (three patients [33%] in the NHPH group and 37 patients [31%] in the HP group) and crack‐like mucosa (three patients [33%] and 27 patients [20%], respectively). Diffuse redness was significantly less frequent in the NHPH group (one patient [14%] vs. 97 patients [72%], p < 0.001). White marbled appearance or crack‐like mucosa without diffuse redness was significantly more common in the NHPH group (56% vs. 13%, p = 0.004), with a sensitivity and specificity of 56% and 87%, respectively. Mean USS neutrophil infiltration and Helicobacter density scores were significantly higher in the HP group (both p < 0.01), which might have influenced the endoscopic findings of diffuse redness. Conclusions: When endoscopic findings of white marbled appearance or cracked‐like mucosa are present, evaluation for diffuse redness may contribute to a more accurate diagnosis of NHPH gastritis. [ABSTRACT FROM AUTHOR]

High photon energy vacuum ultraviolet radiation (VUV, 100−200 nm wavelength) is challenging to detect. It easily degrades conventional silicon and semiconductor photodetectors. Fluoride photodetectors can be the answer, but the correlation between fabrication parameters and photodetector performance is not known. Here, the effect of annealing is investigated on the characteristics of neodymium trifluoride thin film/quartz substrate interface and NdF3 photoconductivity within the VUV. Thin films are deposited on unheated and heated (600 °C) substrates with post‐deposition annealing. Dark current of films on unheated substrates decreases by as much as 1/10 as resistance increases from 1 −12 TΩ after annealing. Dark current of films on heated substrates increases even after annealing, resulting in similar photo and dark currents of ≈303.7 nA and poor detectors. Fluorine diffuses from the film to the substrate during deposition, exacerbated by substrate heating but not by annealing. Fluorine diffusion degrades crystallinity near the interface, increasing the dark current. Fluorine diffusion is absent when MgF2 is used as the heated substrate. Unannealed NdF3/MgF2 detector on 600 °C‐heated substrate and 600 °C‐annealed NdF3/SiO2 detector on unheated substrate exhibit similar resistances of ≈14 TΩ. Considering the film/substrate interface and annealing is crucial when developing VUV photodetectors. [ABSTRACT FROM AUTHOR]

Objective: To evaluate trends in results of care and management for antineutrophil cytoplasmic antibodies (ANCA)‐associated vasculitis (AAV). Methods: We employed multicenter cohort data collected during 2011–2021, recruiting 43 patients with granulomatosis with polyangiitis (GPA) and 91 with microscopic polyangiitis (MPA). According to the median registration date of September 2015, patients have split into two groups: an early group and a late group (both of them, n = 67). To prevent bias, a propensity score according to numerous baseline characteristics variables was calculated; 50 matching members of each group were statistically extracted. Their treatments and clinical outcomes were examined at 6, 12, and 24 months after initial remission therapy. Results: Statistics demonstrated that the baseline characteristics were similar. The late group used rituximab (RTX) more often for both remission induction and maintenance therapy, compared with the early group. The mean daily PSL doses of the late group were significantly lower than those of early group at each time point. The late group discontinued PSL 14.0% at 12 months and 23.3% at 24 months. Despite their intensive glucocorticoids (GC) tapering, the remission rates and the relapse rates were significantly fairer in the late group. The Vasculitis Damage Index (VDI) and VDI due to GC at each time point were lower in the late group, and those differences had become wider over time. Conclusion: Recent developments in AAV treatment have allowed efficient remission and prevention of relapses, which in turn enabled extensive GC tapering causing fewer sequelae. [ABSTRACT FROM AUTHOR]

This article, published in Experimental Dermatology, explores the molecular pathogenesis of lentigos, which are hyperpigmented skin lesions that commonly appear on sun-exposed areas of the body. The researchers performed transcriptomic microarray analysis on lentigo samples to identify potential biomarkers. They found that miR-4521, a microRNA, was highly expressed in lentigos compared to control skin samples. Further analysis suggested that miR-4521 may regulate proteosomal degradation and autophagy. This study provides valuable insights into the molecular mechanisms underlying lentigo formation. [Extracted from the article]

Background: In Japan there are limited opportunities for pediatricians to learn gastrointestinal (GI) endoscopy. This study investigated whether a short‐term intensive training for 2 weeks in an adult GI setting enabled pediatricians to acquire basic technical competence for pediatric GI endoscopic procedures. Methods: This was a retrospective case series of pediatricians who underwent 2 weeks of intensive endoscopy training at an adult endoscopy unit in a community hospital. The numbers of esophagogastroduodenoscopy (EGD) and ileocolonoscopy procedures each pediatrician performed were evaluated. All enrolled pediatricians were asked to answer questionnaires regarding the 2 week intensive GI endoscopy training program. Results: There were 17 enrolled pediatricians, of whom 13 were men; average age 32 years (range 27–54). The median (range) numbers of EGDs and ileocolonoscopies performed by each pediatrician during the 2‐week training period were 102 (66–144) and 14 (1–48), respectively. Fifteen out of 17 pediatricians experienced more than 100 GI endoscopies during the 2 weeks. All pediatricians performed biopsies as part of some EGD procedures. All 17 pediatricians found this program satisfactory. All pediatricians became cable of performing pediatric EGD (i.e., for children ≤15 years) after this training program. Sixteen pediatricians have continued to perform pediatric GI endoscopy since this training program. Conclusions: A short‐term intensive training program for 2 weeks in an adult GI setting enabled pediatricians to acquire basic technical competence for pediatric endoscopic procedures. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to examine 1) the degree and frequency of laterality in posterior tibial slope (PTS) with control and anterior cruciate ligament (ACL) injury groups and 2) the laterality of PTS between sides of injury and dominant legs in patients with primary ACL injuries. Methods: A total of 187 consecutive patients with clinically diagnosed noncontact ACL injuries and an age- and sex-matched 1:1 control group were identified. PTS was measured using three different methods (aPTS = anterior PTS, mPTS = middle PTS, pPTS = posterior PTS) on a lateral knee radiograph. PTS of the left and right sides were compared between the patients in the control and ACL-injured groups, and between the injured and non-injured and dominant and non-dominant legs among the patients in the ACL-injured group. The patients with a difference in PTS of ≥ 3° in mPTS were selected. The percentages were compared between left and right between and among both groups, and between the injured and non-injured, and non-dominant and dominant leg, for the ACL group. Multiple regression analysis was performed to analyze the factors influencing the degree of mPTS. Results: Both control (Right vs Left: aPTS; 9.0 ± 2.5 vs 10.5 ± 3.0, mPTS; 6.6 ± 2.3 vs 8.1 ± 2.7, pPTS; 4.0 ± 2.4 vs 5.6 ± 2.8, respectively, p < 0.01) and ACL injury groups (Right vs Left: aPTS; 10.6 ± 3.0 vs 12.6 ± 2.9, mPTS; 7.6 ± 2.6 vs 9.5 ± 2.6, pPTS; 5.9 ± 3.0 vs 8.0 ± 3.0, respectively, p < 0.01) had a significantly greater PTS on the left than on the right side, and the ACL group had a significantly greater PTS than the control group on both the left and right sides. In the ACL group, PTS was greater on the injured and the non-dominant leg than on the non-injured and the dominant leg. The percentage of patients with a PTS difference of ≥ 3° was significantly greater on the left, injured, and non-dominant leg (95.3% vs 4.7%, 73.8% vs 26.2%, 86.1% vs 13.9%, respectively, p < 0.01). Only the left leg had a significant influence on PTS in the multivariate analysis. Conclusion: There was laterality in PTS within control and ACL injury groups, and this information is of benefit for effective treatment of ACL injuries. Level of evidence: Level III. [ABSTRACT FROM AUTHOR]

The energy consumption of a battery‐powered train in an interstation depends on the running time and state of energy (SOE) at departure. In this paper, we develop an optimization method of train timetables to minimize energy consumption in line with several stations. The variables in this proposed optimization model are running, dwell, and charging times as real numbers and places of charging facilities as binaries. Additionally, we conducted a case study using the real‐world light rail transit (LRT) route, vehicle, and onboard battery model to confirm the effectiveness. In the case study, the proposed method can optimize the timetable and placement of charging facilities by considering the track gradient and battery SOE. [ABSTRACT FROM AUTHOR]

Introduction: During ventricular pacing, a fusion of atrial activation may occur owing to the simultaneous retrograde conduction of the atrioventricular (AV) node and accessory pathway (AP), potentially leading to an inaccurate mapping of the atrial AP insertion site. Objective: We tested the hypothesis that landiolol, an ultra‐short‐acting intravenous β1‐blocker, could dissociate a fusion of atrial activation. Methods: We conducted a prospective before‐and‐after study to investigate the effect of landiolol on retrograde conduction via the AV node and AP. We enrolled 21 consecutive patients with orthodromic AV reciprocating tachycardia who underwent electrophysiological studies at our hospital between January 1, 2018, and August 31, 2020. Results: Six patients exhibited a fusion of atrial activation. After landiolol administration (10 μg/kg/min), the effective refractory period was unchanged in AP (280 [240–290] ms vs. 280 [245–295] ms, p =.91), whereas that of the AV node was prolonged (275 [215–380] ms vs. 332 [278–445] ms, p =.03). The Wenckebach pacing rate via retrograde AV node decreased after landiolol administration (180 [140–200] beats per minute [bpm] vs. 140 [120–180] bpm, p =.02). Thus, landiolol decreased the minimum ventricular pacing rate required to dissociate a fusion of atrial activation (180 [160–200] bpm vs. 140 [128–155] bpm, p =.007). Radiofrequency catheter ablation under landiolol administration successfully eliminated AP in all patients during ventricular pacing without complications or recurrence. Conclusion: Landiolol inhibited the AV node without affecting the AP and helped dissociate a fusion of atrial activation at a lower ventricular pacing rate. [ABSTRACT FROM AUTHOR]