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Background: This study evaluated the accuracy, clinical concordance, and readability of the chatbot interface generative pretrained transformer (ChatGPT) 3.5 as a source of breast cancer information for patients. Methods: Twenty questions that patients are likely to ask ChatGPT were identified by breast cancer advocates. These were posed to ChatGPT 3.5 in July 2023 and were repeated three times. Responses were graded in two domains: accuracy (4‐point Likert scale, 4 = worst) and clinical concordance (information is clinically similar to physician response; 5‐point Likert scale, 5 = not similar at all). The concordance of responses with repetition was estimated using intraclass correlation coefficient (ICC) of word counts. Response readability was calculated using the Flesch Kincaid readability scale. References were requested and verified. Results: The overall average accuracy was 1.88 (range 1.0–3.0; 95% confidence interval [CI], 1.42–1.94), and clinical concordance was 2.79 (range 1.0–5.0; 95% CI, 1.94–3.64). The average word count was 310 words per response (range, 146–441 words per response) with high concordance (ICC, 0.75; 95% CI, 0.59–0.91; p <.001). The average readability was poor at 37.9 (range, 18.0–60.5) with high concordance (ICC, 0.73; 95% CI, 0.57–0.90; p <.001). There was a weak correlation between ease of readability and better clinical concordance (−0.15; p =.025). Accuracy did not correlate with readability (0.05; p =.079). The average number of references was 1.97 (range, 1–4; total, 119). ChatGPT cited peer‐reviewed articles only once and often referenced nonexistent websites (41%). Conclusions: Because ChatGPT 3.5 responses were incorrect 24% of the time and did not provide real references 41% of the time, patients should be cautioned about using ChatGPT for medical information. Generative artificial intelligence large‐language models like the chatbot interface generative pretrained transformer (ChatGPT) have gained rapid popularity. The authors evaluated the accuracy and appropriateness of ChatGPT as a source of breast cancer information for patients. [ABSTRACT FROM AUTHOR]

Purpose: This is the first of two articles that examine the psychometric properties and treatment outcomes associated with measures of the therapeutic alliance collected in naturalistic settings rather than clinical trials. These articles break new ground in understanding the relationship between measures of alliance and treatment outcome by performing detailed item analyses in order to assess the psychometric properties of each individual item, its propensity to change from session to session and its utility in predicting change in the outcome measure. Methods: Data were taken from the ACORN database for adults attending for psychotherapy treatment in naturalistic settings (N = 147,399). The sample, the largest to date, included only those completing both an alliance measure and an outcome measure at every session. Two sets of three different alliance items are used across three different treatment populations: general outpatient, substance use, and severe and persistent mental health difficulties. To investigate this possibility, the psychometric properties of each item were evaluated, including factor analysis, likelihood of change over time in treatment and correlations between changes in alliance and magnitude of client‐reported improvement in therapy. The predictive validity of each individual item is compared with the predictive validity of their respective three‐item measures. The problem of alliance scores being heavily skewed in a positive direction and the resulting lack of variability from session to session is addressed by categorising change in alliance as same, better or worse, regardless of the magnitude of change. Results: Findings tended to differ from those in clinical trials, with the last alliance score being most predictive of outcome. In this data set, the alliance accounted for, at most, 2% of the variance in outcomes. Measures of the therapeutic alliance demonstrate ceiling effects, and the alliance–outcome correlation is far from linear. Change in alliance score, rather than a single assessment, is more predictive of outcome, regardless of the magnitude of change in the alliance measure, with effect sizes of up to 50% more for those who rated the alliance as worse than for those rating it as no change or better. Conclusion: Therapists using therapeutic alliance questionnaires will benefit from being aware of how the psychometric properties of alliance measures impact outcomes. Even the smallest drop in alliance is predictive of significant clinically meaningful differences. Implications for practice, training and research are considered. [ABSTRACT FROM AUTHOR]

Background: A wearable cardioverter defibrillator (WCD) is indicated for a limited period in patients at high risk of sudden cardiac death (SCD). Nonischemic heart failure (HF) is common among Japanese patients with HF. The aim of this study was to evaluate the incidence of fatal arrhythmias during WCD use and the clinical outcomes after WCD withdrawal in Japanese patients with HF. Methods: We retrospectively studied 105 hospitalized HF patients who were discharged with a WCD. The main outcome was SCD/ventricular arrhythmias during WCD use and the other outcomes were implantation of an implantable cardioverter‐defibrillator (ICD), SCD/ventricular arrhythmias after WCD withdrawal, and changes in left ventricular ejection fraction (LVEF). Results: Eighty‐seven (83%) patients received a WCD for primary prevention of SCD, of whom 60 (69%) were new‐onset HF patients with an LVEF ≤35%. The median daily wear time was 22.1 h. Two patients experienced sustained ventricular tachycardia and one patient experienced atrioventricular block with asystole while on WCD. After WCD withdrawal, 81 (77%) patients decided not to receive ICD implantation. The percentage of patients with an LVEF ≥35% increased from 20% at baseline to 70% at 1 year after discharge. During the median follow‐up of 50 months, 78 (96%) of the 81 patients who did not have an ICD were free of SCD/ventricular arrhythmias. Conclusions: The use of a WCD is useful for determining the appropriate indication for ICD implantation in Japanese patients with new‐onset HF, a low LVEF, and a risk of SCD. [ABSTRACT FROM AUTHOR]

Aim: Recently, substantial studies have been accumulated to indicate the important role of gut microbiota in diabetic kidney disease (DKD). The abnormal change of bacterial‐derived products could imply specific injuries or play beneficial or harmful roles in DKD progression. In this study, we examined the presence and contribution of the Klebsiella oxytoca gene in the circulation of patients with DKD. Method: We enrolled a total of 16 healthy participants, 17 patients with DKD, 5 patients with DKD requiring haemodialysis (HD), and 7 patients with CKD without diabetes. Bacterial‐derived DNA (16S rDNA and a specific K. oxytoca gene) in the blood was detected using droplet digital PCR, then investigated the relationship with clinical characteristics. Results: We identified an increase in K. oxytoca genes in the blood of DKD patients. Interestingly, blood K. oxytoca copies and K. oxytoca/ 16S DNA ratio correlated with higher blood creatinine and BUN levels together with lower eGFR in DKD patients. K. oxytoca levels were also associated with higher neutrophil percentage, lower lymphocyte frequency, and increased neutrophil‐to‐lymphocyte ratio. Conclusion: Collectively, the presence of the K. oxytoca gene in the circulation could serve as a biomarker reflecting reduced renal function in DKD patients. [ABSTRACT FROM AUTHOR]

Aim: Although immune checkpoint inhibitors (ICPi) for salivary gland cancer (SGC) have been investigated in clinical trials, details of the tumor immune microenvironment (TIME) remain unclear. This research aimed to elucidate the TIME of SGC and its relationship with tumor mutation burden (TMB) and to explore the rationale for the applicability of ICPi. Materials and methods: We selected five pathological types, namely adenoid cystic carcinoma (ACC); adenocarcinoma, not otherwise specified (ANOS); salivary duct carcinoma (SDC); and low/high‐grade mucoepidermoid carcinoma (MEClow/high). We investigated the TIME and TMB of each pathological type. TIME was evaluated by multiplexed fluorescent immunohistochemistry. TMB was measured by next‐generation sequencing. Results: ACC and MEChigh showed the lowest and highest infiltration of immune effector and suppressor cells in both tumor and stroma. ANOS, SDC, and MEClow showed modest infiltration of immune effector cells in tumors. Correlation analysis showed a positive correlation between CD3+CD8+ T cells in tumor and TMB (r = 0.647). CD3+CD8+ T cells in tumors showed a positive correlation with programmed cell death‐ligand 1 expression in tumor cells (r = 0.513) and a weak positive correlation with CD3+CD4+Foxp3+ cells in tumors (r = 0.399). However, no correlation was observed between CD3+CD8+ T cells and CD204+ cells in tumors (r = ‐0.049). Conclusion: The TIME of ACC was the so‐called immune desert type, which may explain the mechanisms of the poor response to ICPi in previous clinical trials. On the other hand, MEChigh was the immune‐inflamed type, and this may support the rationale of ICPi for this pathological subtype. [ABSTRACT FROM AUTHOR]

Objectives: This cross‐sectional study aimed to investigate the age‐related development of five major oral functions—tongue pressure, lip pressure, masticatory efficiency, bite force, and occlusal contact area—in subjects aged 5–20 years. Material and Methods: Ninety‐two subjects were divided into four age groups: 5–8, 9–12, 13–16, and 17–20 years. Oral functions were evaluated using standardized methods, including Chew Check Gum for assessing masticatory efficiency, Dental Prescale II for measuring occlusal force and contact area, JMS tongue pressure measuring device for evaluating tongue pressure, and Ripple‐Kun for measuring lip pressure. Results: Occlusal contact area, maximum bite force, tongue pressure, and masticatory efficiency gradually increased with age, whereas lip pressure remained stable. The occlusal contact area temporarily decreased between 5 and 12 years of age, likely due to the replacement of erupting lateral teeth. Some differences were observed between males and females; however, overall trends in oral function parameters were similar. Spearman's rank correlation analyses revealed significant positive correlations between age and occlusal contact area, bite force, tongue pressure, and masticatory efficiency. Conclusions: Oral function parameters exhibited different age‐related development patterns. Occlusal contact area, maximum bite force, tongue pressure, and masticatory efficiency gradually increased with age. Interestingly, the occlusal contact area tended to reduce temporarily between 5 and 12 years of age due to the replacement of erupting lateral teeth. Conversely, lip pressure was almost stable during this period. Our findings provide valuable insights into the developmental patterns of oral functions during the growing years. [ABSTRACT FROM AUTHOR]

Lack of tumor‐reactive cytotoxic T lymphocytes (CTLs) limits the antitumor efficacy of immune checkpoint inhibitors (ICIs). CD40 agonists have been expected to overcome this limitation by generating tumor‐reactive CTLs. However, the clinical efficacy of CD40 agonistic antibodies is not as good as in non‐clinical studies. The novel human CD40 (hCD40) agonist KHK2840 is a fully human anti‐CD40 IgG2 agonistic antibody that is Fc‐engineered to minimize complement‐dependent cytotoxicity and antibody‐dependent cellular cytotoxicity. Compared to other hCD40 agonists, KHK2840 exhibited the most potent hCD40 agonistic signal in tumor‐bearing hCD40 transgenic mice and human peripheral blood B cells. Moreover, KHK2840 enhanced the antitumor efficacy of the antiprogrammed cell death 1 antibody and paclitaxel. Comprehensive immune profiling revealed that the antitumor immune response of the triple combination involved tumor‐draining lymph nodes in addition to tumor microenvironments. This suggests that a coordinated antitumor immune response between tumors and lymph nodes may underlie the synergistic antitumor efficacy of the triple combination therapy. Finally, a toxicology study in cynomolgus monkeys demonstrated that KHK2840 activated the CD40 signal with tolerable toxicological properties. These results indicate that KHK2840 is a novel and potent hCD40 agonistic antibody for cancer immunotherapy, which is expected to augment the antitumor efficacy of ICIs and chemotherapy. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions Prostatic urethral lift (PUL) for benign prostatic hyperplasia has recently been initiated in Asia; therefore, few studies with real‐world data have been reported. This study evaluated the efficacy and safety of PUL using Japanese real‐world multicenter data.Indications for PUL were based on relevant guidelines in Japan. The preoperative patient status, postoperative progress at 1 and 3 months, and perioperative complications were evaluated. Also, we compared preoperative urinary retention and nonurinary retention patients, and prostate volumes <30, 30 to <50, and ≥50 mL.A total of 160 patients were included in the study. The mean age was 75 years and the mean prostate volume was 44 mL. The International Prostate Symptom Score, quality of life score, maximum flow rate, and postvoid residual volume significantly improved 1 and 3 months postoperatively compared to preoperatively. The catheter‐free rates in the preoperative urinary retention group were 58.1%, 72.1%, 83.7%, and 88.4% on postoperative days 1, 7, 30, and 90, respectively. The catheter‐free rates in the nonurinary retention group were 94.9%, 98.3%, and 100% on postoperative days 1, 7, and 14, respectively. The group with a prostate volume ≥50 mL had a longer operation time and used significantly more implants; however, no difference was observed in the postoperative urinary status among the three groups.PUL can be considered a safe and effective procedure for both preoperative urinary retention and nonurinary retention patients with prostate volumes <100 mL in older patients with comorbidities. [ABSTRACT FROM AUTHOR]

We study model theoretic characterizations of various collection schemes over PA−$\mathsf {PA}^-$ from the viewpoint of Gaifman's splitting theorem. Among other things, we prove that for any n≥0$n \ge 0$ and M⊧PA−$M \models \mathsf {PA}^-$, the following are equivalent: 1.M$M$ satisfies the collection scheme for Σn+1$\Sigma _{n+1}$ formulas.2.For any K,N⊧PA−$K, N \models \mathsf {PA}^-$, if M⊆cofK$M \subseteq _{\mathrm{cof}} K$, M≺Δ0K$M \prec _{\Delta _0} K$ and M≺N$M \prec N$, then M≺Σn+2K$M \prec _{\Sigma _{n+2}} K$ and supN(M)≺ΣnN$\sup _N(M) \prec _{\Sigma _n} N$.3.For any N⊧PA−$N \models \mathsf {PA}^-$, if M≺N$M \prec N$, then M≺Σn+2supN(M)≺ΣnN$M \prec _{\Sigma _{n+2}} \sup _N(M) \prec _{\Sigma _{n}} N$. Here, supN(M)$\sup _N(M)$ is the unique K$K$ satisfying M⊆cofK⊆endN$M \subseteq _{\mathrm{cof}} K \subseteq _{\mathrm{end}} N$. We also investigate strong collection schemes and parameter‐free collection schemes from the similar perspective. [ABSTRACT FROM AUTHOR]

Aim: Climate change can have a broad range of impacts on the physiology and behaviour of animals. These effects can be mediated by the presence of other species in the community, but current forecasts of species responses to climate change largely ignore biological interactions. This is particularly true for novel interactions between range‐extending and native species, as this is often considered as noise and excluded from predictive models. Here we simulate how a tropical range‐extending and a local temperate fish species respond to the independent and combined effects of future ocean warming (RCPs 4.5 and 8.5) and novel ecological interactions in temperate ecosystems. Location: East coast of Australia, along a ~ 2,000 km latitudinal gradient in a global climate warming hotspot. Taxon: Abudefduf vaigiensis (tropical) and Atypicthys strigatus (temperate) fishes. Methods: We use a dynamic energy budget model to simulate the length growth (i.e., increases in body length of individuals over time) and population persistence of juveniles of a tropical and a temperate fish species that form mixed‐species shoals, under different climate scenarios with and without the effects of novel ecological interactions. Results: Our model forecasts that length growth of the juvenile tropical species will increase under ocean warming across subtropical to temperate regions. This increased length growth will be more drastic in temperate regions than in the subtropics, as winter warming will allow the tropical species to overwinter more frequently and show positive growth throughout the year. In contrast, warmer summer temperatures in the subtropics will likely exceed the optimal temperature of the juvenile temperate species at their trailing edge, resulting in reduced length growth under climate warming. Novel species interactions increased length growth of the juvenile tropical species but did not affect its winter or summer survival. In contrast, novel species interactions with tropical species were forecast to reduce length growth of the juvenile temperate species. Main Conclusions: Our study suggests that for some coastal fish species future warming will likely reverse body size dominance between temperate and tropical fish species, with increased novel interactions in temperate ecosystems (due to range extensions) but decreased novel interactions in the subtropics (due to range contractions). Novel species interactions and warming effects on body size and species survival are likely to reshuffle temperate fish communities and their competitive interactions. [ABSTRACT FROM AUTHOR]

Background: Nurturing environments have a critical influence on children's language development. It is unclear to what extent nurturing environments in institutions influence children's language development. Methods: The present study investigated the early lexical development in Japanese children raised in institutional care (IC) (N = 86; 10–33 months; 37 boys) and compared their lexical skills to a large sample of age peers being raised in biological family care (BFC) (N = 1897; 937 boys) using vocabulary checklists. Results: Our results present three main findings: (1) Japanese IC children did not exhibit a delay in productive vocabulary compared with BFC children, although their comprehensive vocabulary was delayed; (2) IC children who experienced maltreatment showed poorer vocabulary scores than non‐maltreated IC children; (3) both the duration at the institution and the number of books read to them significantly predicted children's vocabulary scores. Conclusion: Our study suggests that the Japanese institutions included in the present study did not show a negative impact, at least on productive vocabulary, and may competently foster children's language development. We discussed the relationship between institutional environments and children's language development. [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]

Nano/microfabrication is of fundamental importance both in scientific and industrial situations. There are, therefore, many attempts at realizing easier, quicker, and more precise fabrication of various structures; however, achieving this aim without a bulky and costly setup is still challenging. Here, we introduce a facile and versatile means of printing an ordered structure consisting of nanoscale stripes and more complicated geometries including pillars and wavy form with a lateral resolution of single micrometers. To this end, we prepare a polydimethylsiloxane (PDMS) slab with an oxygen plasma‐induced wrinkled surface where liquid PDMS exudes by syneresis. Since this liquid PDMS is automatically loaded, the printing is repeatable without inking. A substrate moderately wettable to the liquid PDMS as well as amount/property‐controlled syneresis is primarily important for the creation of well‐defined structures. Precisely controlling these conditions will make this method universally applicable to diverse substrates and liquids including suspensions. [ABSTRACT FROM AUTHOR]

Robotic‐assisted laparoscopic radical prostatectomy and intensity‐modulated radiation therapy are the most common radical treatments for localized prostate cancer, and brachytherapy (BT) also plays a role in this field. Iodine‐125 (I‐125) low–dose rate (LDR) prostate BT is an established treatment. However, it remains controversial. Specifically, there are a variety of issues, such as indications for combined treatment with external beam radiotherapy and androgen deprivation therapy, prostate‐specific antigen follow‐up, the significance of postimplant biopsy, the usefulness of salvage BT and focal therapy, reduction of toxicities, and bladder cancer after BT. In this review, we summarize the recent developments in I‐125 LDR BT. [ABSTRACT FROM AUTHOR]

Odor information is modulated by centrifugal inputs from other brain regions to the olfactory bulb (OB). Neurons containing monoamines, such as serotonin, acetylcholine, and noradrenaline, are well known as centrifugal inputs; however, the role of histamine, which is also present in the OB, is not well understood. In this study, we examined the histaminergic neurons projecting from the hypothalamus to the OB. We used an antibody against histidine decarboxylase (HDC), a synthesizing enzyme of histamine, to identify histaminergic neurons and assess their localization within the OB and the ultrastructure of their fibers and synapses using multiple immunostaining laser microscopy, ultra‐high voltage electron microscopy (EM), and EM to confirm their relationships with other neurons. To further identify the origin nucleus of the histaminergic neurons projecting to the OB, we injected the retrograde tracer FluoroGold and analyzed the pathway to the OB anterogradely. HDC‐immunoreactive (‐ir) fibers were abundant in the olfactory nerve (ON) layer compared to other monoamines. HDC‐ir neurons received asymmetrical synapses from ONs and formed synapses containing pleomorphic vesicles with variable postsynaptic densities to non‐ON elements, thus forming serial synapses. We also confirmed that histaminergic neurons project from the rostral ventral tuberomammillary nucleus to the granule cell layer of the OB and, for the first time, successfully visualized their axons from the hypothalamus to the OB. These findings indicate that histamine may regulate odor discrimination in the OB, suggesting a regulatory relationship between hypothalamic function and olfaction. We thus elucidate morphological mechanisms with tuberomammillary nucleus–derived histaminergic neurons involved in olfactory information. [ABSTRACT FROM AUTHOR]

Aims/Introduction: Chronic kidney disease (CKD) is a very important issue globally because of the risk of its progressing to end‐stage renal disease. We aimed to identify factors contributing to long‐term estimated glomerular filtration rate (eGFR) decline to determine an early diagnosis and prevent CKD progression. Materials and Methods: From January 2003 to December 2006, 5,507 individuals underwent health checkups at our hospital's Preventive Medicine Research Center. We ultimately enrolled 2,175 individuals. The eGFR was ≥60 mL/min/1.73 m2 at the start of observation period, which was 20 years. The event onset time was the day that the eGFR became <30 mL/min during the 20‐year period. Baseline risk factors – in particular, the effect of plasma glucose levels on the eGFR – were extracted and evaluated by using Fine and Gray analysis. Results: During the 20‐year observation, the hazard ratio (HR) of CKD progression was examined. A fasting plasma glucose (FPG) level ≥105 mg/dL was significantly associated with the risk of CKD progressing to an eGFR <30 mL/min. This trend was similar in the slope of eGFR. An FPG ≥105 mg/dL or an glycated hemoglobin level ≥6.5% was useful for intervening in CKD progression. Multivariate analysis showed that independent risk factors were an FPG level ≥105 mg/dL (HR 1.9; P < 0.001), age ≥60 years (HR 3.86; P < 0.001), obesity (HR 1.61; P < 0.01) and urinary protein (HR 1.55; P < 0.01). Conclusions: For early intervention against a reduction in the eGFR, detecting mild increases in FPG ≥105 mg/dL in patients with CKD with or without diabetes is useful. [ABSTRACT FROM AUTHOR]

Sweat glucose serves as a significant biomarker of health, necessitating accurate determination at the micromolar level for noninvasive monitoring. To address this need, we design an organic field‐effect transistor (OFET)‐based enzymatic sensor to quantify glucose levels in human sweat. The extended‐gate structure of the OFET device ensures stable analyte detection in human sweat owing to its isolated configuration. The extended‐gate‐type OFET has been functionalized with glucose oxidase and an N‐ethylphenazonium‐based mediator‐attached monolayer. This configuration facilitates electron relay, enabling accurate and reproducible glucose detection. Leveraging the amplification ability of the OFET, the enzymatic sensor exhibited highly sensitive glucose detection, achieving a low limit of detection (2.9 μM) suitable for sweat analysis requirements. In addition, the sensor exhibited high discriminability in detecting glucose amidst interferents commonly found in sweat, indicating its practical feasibility for sweat analysis. Validation of glucose recovery rates (95–105 %) in human sweat, without pretreatment, was performed using established instrumental analysis methods. [ABSTRACT FROM AUTHOR]

Spermidine is an essential biomarker related to antiaging. Although the detection of spermidine levels is in high demand in life science fields, easy‐to‐use analytical tools without sample purification have not yet been fully established. Herein, we propose an organic field‐effect transistor‐based chemical sensor for quantifying the spermidine concentration in commercial cosmetics. An extended‐gate structure was employed for organic field‐effect transistor (OFET)‐based chemical sensing in aqueous media. A coordination‐bond‐based sensing system was introduced into the OFET device to visualize the spermidine detection information through changes in the transistor characteristics. The extended‐gate‐type OFET has shown quantitative responses to spermidine, which indicates sufficient detectability (i. e. the limit of detection for spermidine: 2.3 μM) considering actual concentrations in cosmetics. The applicability of the OFET‐based chemical sensor for cosmetic analysis was validated by instrumental analysis using high‐performance liquid chromatography. The estimated recovery rates for spermidine in cosmetic ingredient products (108–111 %) suggest the feasibility of cosmetic analysis based on the OFET‐based chemical sensor. [ABSTRACT FROM AUTHOR]

Background Materials & Methods Results Conclusion The goal of this research was to identify how early in psychotherapy a reliable prediction regarding the probability of premature termination, treatment failure or treatment success can be made, and which variables are most predictive. This research breaks new ground by including data on each clinician's historical outcomes (therapist effects) to explore to what degree predictions and decision rules might differ with therapist effectiveness.Data was drawn from a large online database of clients regularly completing self‐report outcome questionnaires. The sample included clinicians (n = 1020) treating clients (n = 68,690) with an intake score in the clinical range during a treatment episode of between 2 and 10 sessions. Variables available at the first session and later sessions were tested for predictive validity for status at subsequent sessions using general linear regression models and logistic regression models.The results suggest that therapy outcomes can be predicted as early as the second session with a good degree of accuracy, 65%. The analyses revealed that predictions made as early as the second session remain valid even for clients taking up to 10 sessions to complete treatment. Adding therapist effects to the predictive model provides a much more nuanced understanding of the results. By session two, therapists in the top quartile demonstrate effect sizes comparable to the effect sizes of bottom quartile therapists at session ten.The probability of client success, failure or early termination varies significantly depending on the clinician. Implications for training and supervision are discussed. [ABSTRACT FROM AUTHOR]

The low‐concentration boron doping is performed from 1016 to 1018 cm−3 by ion implantation into heteroepitaxially synthesized large‐area diamond and electrical properties are investigated. Photoluminescence analysis is first carried out to clarify the optical properties of the heteroepitaxial diamond substrate. As a result, defect complexes of nitrogen‐vacancy and silicon‐vacancy are hardly detected in this substrate, suggesting that optically high‐purity diamond can be accomplished by heteroepitaxial growth. Then, the electrical properties of resistivity, mobility, carrier concentration, and conductive type by Hall effect measurements are investigated. For the samples with doping concentrations higher than 1016 cm−3, the electrical activation of implanted B acting as acceptors is confirmed. The compensation ratio for the sample with 3.5 × 1017 cm−3 concentration reaches 76%, indicating the presence of compensating donor‐like centers. With increasing the doping concentration to 3.5 × 1018 cm−3, the compensation ratio is significantly reduced to 35%. The observed mobility of the higher doped sample takes almost the ideal value observed for the sample doped by chemical vapor deposition process. It is suggested that the heteroepitaxial synthesis of large‐area and high‐purity substrates should contribute to the further development of the application to electronic, optical, and sensing devices in the future. [ABSTRACT FROM AUTHOR]

Background: In a randomized phase II/III trial (JCOG1008), weekly cisplatin (40 mg/m2) was non‐inferior to 3‐weekly cisplatin (100 mg/m2) for postoperative high‐risk head and neck cancer. We investigated how acute kidney injury (AKI), a major dose‐limiting toxicity effect of cisplatin, affects overall survival (OS). Methods: We analyzed 251 patients from JCOG1008 receiving chemoradiotherapy. AKI was defined based on AKI Network criteria (serum creatinine increase of ≥0.3 mg/dL or ≥1.5‐fold [≥ stage I]) within 30 days after completing chemoradiotherapy. OS in the two arms was compared according to AKI development using the log‐rank test. Results: The total incidence of AKI was lower in the weekly arm than in the 3‐weekly arm (38/122 [31.1%] vs. 56/129 [43.4%]). Additionally, stage II/III AKI occurred less frequently in the weekly arm than in the 3‐weekly arm (8/122 [6.6%] vs. 19/129 [14.7%]). Cisplatin doses were similar in the weekly arm for patients with and without AKI (median, 238.6 mg/m2 vs. 239.2 mg/m2; p = 0.94), but lower in the 3‐weekly arm for those who developed AKI (median, 276.3 mg/m2 vs. 297.4 mg/m2; p = 0.007). In the weekly arm, there was no difference in OS between patients with and without AKI (hazard ratio [HR], 1.06; 95% confidence interval [CI], 0.53 to 2.10). However, in the 3‐weekly arm, patients with AKI had poorer OS than those without AKI (HR, 1.83; 95% CI, 1.04 to 3.21). Conclusions: In this supplementary analysis of JCOG1008 data, AKI impacted the OS of patients with head and neck cancer undergoing postoperative chemoradiotherapy in the 3‐weekly arm but not in the weekly arm. Our results further endorse the utilization of weekly cisplatin at 40 mg/m2 in this setting. [ABSTRACT FROM AUTHOR]

Aim: Internet gaming disorder (IGD) is receiving increasing attention. In particular, violent gameplay or in‐game spending affects the psychiatric conditions and economic difficulties of patients. We conducted regression analysis and path analysis to investigate the associations between a comprehensive list of factors in patients with IGD, including the degree of internet or gaming dependence, developmental problems, family background, severity of depression, sleeping habits, in‐game spending, and first‐person shooter (FPS) and third‐person shooter (TPS) game playing. Methods: The participants were 47 Japanese individuals (39 males and 8 females) aged ≤20 years diagnosed with IGD with complete data from the internet addiction test, autism spectrum quotient, Quick Inventory of Depressive Symptomatology, and Pittsburgh Sleep Quality Index. All participants were asked whether their parents have divorce history, whether they have siblings, whether they play FPS or TPS games, and whether they engage in in‐game spending. Firstly, we compared these factors between males and females; secondly, we conducted regression analysis and path analysis in male patients. Results: As for simple comparison between sex, female patients showed greater severity of IGD and depressive score. In regression analysis of male patients, significant associations were found between FPS or TPS game playing and in‐game spending. We also created path diagrams. Conclusion: The results of the comprehensive analyses suggest the possibility that bidirectional synergistic effects could be achieved by gradually reducing both violent game playing and in‐game spending. The concept of internet dependence has a wide range of meanings, and for each subtype, it is important to consider the background that led to the dependence to make individualized environmental adjustments and provide psychotherapy. [ABSTRACT FROM AUTHOR]

Respiration is an invaluable signal that facilitates the real‐time observation of physiological dynamics. In recent years, the advancement of noncontact measurement technology has gained momentum in capturing physiological activities in natural settings. This technology is anticipated to be found not only in humans but also in nonhuman primates. Currently, the predominant noncontact approach for nonhuman animals involves measuring vital signs through subtle variations in skin color. However, this approach is limited when addressing areas of the body covered with hair or when working in outdoor settings under fluctuating sunlight. To overcome this issue, we focused on noncontact respiratory measurements using millimeter‐wave radar. Millimeter‐wave radar systems, which employ millimeter waves that can penetrate animal fur and estimate respiration‐derived periodic body motion, exhibit minimal susceptibility to sunlight interference. Thus, this method shows potential for conducting noncontact vital measurements in natural and outdoor settings. In this study, we validated a millimeter‐wave radar methodology for capturing respiration in outdoor‐housed rhesus macaques (Macaca mulatta). The radar was positioned beyond the captive enclosure and maintained at a distance >5 m from the target. Millimeter waves were transmitted to the target, and the reflected waves were used to estimate skin surface displacement associated with respiration. The results revealed periodic skin surface displacement, and the estimated respiratory rates weres within the reported range of respiratory rates for rhesus macaques. These results suggest the potential applicability of millimeter‐wave radar for noncontact respiration monitoring in outdoor‐living macaques without anesthesia or immobilization. The continued advancement of noncontact vital measurement technology will contribute to understanding primate mental and physical dynamics during their daily life. Research Highlights: Millimeter‐wave radar systems succeeded in the outdoor noncontact measurement of respiration in unrestricted rhesus macaques from >5 m. Our results demonstrate the feasibility of radar‐based remote monitoring to better understand primate ecology. [ABSTRACT FROM AUTHOR]

Pyrolysis‐based saccharification consisting of fast pyrolysis followed by hydrolysis of the resulting anhydrosugars such as levoglucosan is a promising method for converting cellulosic biomass into glucose that can be used for producing biofuels and biochemicals. In the present study, hydrolysis of levoglucosan was evaluated in water with a polystyrene sulfonic acid resin (a solid acid catalyst) by heating under microwave irradiation or in an oil bath at 95 °C–120 °C. When the equilibrium temperature of the solution was the same, the conversion rate of levoglucosan was greater under microwave irradiation than in an oil bath. Model experiments indicate that the sulfonyl groups of the solid acid catalyst were selectively heated by microwave irradiation. The temperature of the reaction solution in the vicinity of the catalyst was locally higher than the equilibrium temperature of the solution, which enabled hydrolysis to proceed efficiently. [ABSTRACT FROM AUTHOR]

The effectiveness of interdisciplinary home healthcare service consisting of at least two or more healthcare providers, such as a nurse, physician and physiotherapist, for community‐dwelling older adults remains unclear. This systematic review assesses the effects of interdisciplinary home care on quality of life (QOL) and health outcomes in older adults with chronic conditions using validated tools. Databases were searched using CINAHL Plus with Full Text, PubMed, EMBASE, CENTRAL, PsycINFO, and OpenGrey from inception to January 25, 2021. Eligibility criteria included (i) an interdisciplinary home care approach, (ii) participants aged 65 years and older with chronic conditions, (iii) randomized controlled trials (RCTs), and (iv) original literature in English. The study reviewer's dyad independently screened the literature and assessed the study quality using the Cochrane's Risk of Bias 2 tool. The analysis employed qualitative and quantitative integration and Grading of Recommendations Assessment, Development, and Evaluation. This study included 13 RCTs with 4709 participants. Four RCTs indicated that interdisciplinary home healthcare services reduced hospital admissions during the initial 6 months after the start of home care interventions (risk ratio [RR] = 0.73; 95% confidence interval [CI] = 0.61–0.88; p < 0.001; I2 = 0%). However, evidence certainty was moderate; QOL and mortality showed low certainty; and institutionalization and adherence showed moderate certainty of evidence. This study suggests that the interdisciplinary home care approach reduces hospital admissions but lacks effects on other outcomes. More robust studies are required to evaluate this evidence. Geriatr Gerontol Int 2024; 24: 827–840. [ABSTRACT FROM AUTHOR]

Background: Posterior reversible encephalopathy syndrome (PRES) is known as a transfusion‐related complication with typically favorable prognosis and no report fatalities. Pathological evaluation of PRES is also scarce. Case Report: An 88‐year‐old female with myelodysplastic syndromes (MDS) attended our hospital because of a compression fracture and chronic heart failure with chronic anemia. While her hemoglobin levels improved from 4.6 to 8.0 g/dL and the pleural effusions substantially decreased following six units of red blood cell transfusion and diuretic therapy, a gradual decline in cognitive function and speech reduction was noted. PRES was diagnosed by magnetic resonance imaging of the head. Despite treatment of intensive supportive care, the patient fell into a coma by the 20th day and passed away on the 22nd day. Although the pathophysiological link between blood‐transfusion‐related PRES and its impact on survival is not fully understood, autopsy findings confirmed the diagnosis of PRES and revealed multiple cerebral hemorrhages that were not detected in earlier imaging studies. Conclusion: This case highlights the importance of vigilant monitoring and management of PRES, especially in high‐risk populations such as elderly patients with multiple comorbidities or those with thrombocytopenia. Further studies are needed to elucidate the mechanisms of PRES in patients with hematologic diseases. [ABSTRACT FROM AUTHOR]

Despite ensuring the integrity of bogie frames for railway vehicles via nondestructive inspections during periodic maintenance, the possibility of fatigue cracks occurring at locations other than the predetermined inspection points cannot be dismissed. Therefore, fatigue cracks can be prevented more efficiently by assessing the overall degree of fatigue damage to the entire bogie frame and determining the results via nondestructive inspections. In this study, dynamic stresses in the bogie frame during running were estimated via finite element dynamic analysis by using the axle box acceleration as input, and the degree of fatigue damage and life were calculated from the waveform of the estimated stresses. Furthermore, we developed a bogie frame fatigue prediction system based on a high‐speed and high‐precision stress calculation method. The developed system visualized the overall relative life. [ABSTRACT FROM AUTHOR]

Aims: Schizophrenia (SZ) is a brain disorder characterized by psychotic symptoms and cognitive dysfunction. Recently, irregularities in sharp‐wave ripples (SPW‐Rs) have been reported in SZ. As SPW‐Rs play a critical role in memory, their irregularities can cause psychotic symptoms and cognitive dysfunction in patients with SZ. In this study, we investigated the SPW‐Rs in human SZ. Methods: We measured whole‐brain activity using magnetoencephalography (MEG) in patients with SZ (n = 20) and sex‐ and age‐matched healthy participants (n = 20) during open‐eye rest. We identified SPW‐Rs and analyzed their occurrence and time‐frequency traits. Furthermore, we developed a novel multivariate analysis method, termed "ripple‐gedMEG" to extract the global features of SPW‐Rs. We also examined the association between SPW‐Rs and brain state transitions. The outcomes of these analyses were modeled to predict the positive and negative syndrome scale (PANSS) scores of SZ. Results: We found that SPW‐Rs in the SZ (1) occurred more frequently, (2) the delay of the coupling phase (3) appeared in different brain areas, (4) consisted of a less organized spatiotemporal pattern, and (5) were less involved in brain state transitions. Finally, some of the neural features associated with the SPW‐Rs were found to be PANSS‐positive, a pathological indicator of SZ. These results suggest that widespread but disorganized SPW‐Rs underlies the symptoms of SZ. Conclusion: We identified irregularities in SPW‐Rs in SZ and confirmed that their alternations were strongly associated with SZ neuropathology. These results suggest a new direction for human SZ research. [ABSTRACT FROM AUTHOR]

The article focuses on a rare case of near-triploidy with four Philadelphia chromosomes in adult B-lymphoblastic leukemia with BCR::ABL1 fusion. Topics include the cytogenetic mechanisms leading to near-triploidy, the implications of multiple Philadelphia chromosomes on tyrosine kinase activity and treatment response, and the successful yet challenging management of the condition with dasatinib and chemotherapy.

Background: The recent emergence of targeted radionuclide therapy has increased the demand for imagers capable of visualizing pharmacokinetics in developing radiopharmaceuticals in the preclinical phase. Some radionuclides emit hard x‐rays and gamma‐rays below 100 keV, in which energy range the performance of conventional NaI scintillators is poor. Multipinhole collimators are also used for small animal imaging with a good spatial resolution but have a limited field of view (FOV). Purpose: In this study, a new imager with high sensitivity over a wide FOV in the low‐energy band (<$<$100 keV) was developed for the pharmacokinetic study. Methods: We developed an x‐ray and gamma‐ray camera for high‐resolution spectroscopy, named "CdTe XG‐Cam," equipped with a cadmium telluride semiconductor detector and a parallel‐hole collimator using a metal 3D printer. To evaluate the camera‐system performance, phantom measurements with single and dual nuclides (99mTc$^{\rm 99m}{\rm Tc}$, 111In$^{111}{\rm In}$, and 125I)$^{125}{\rm I)}$ were performed. The performance for in vivo imaging was evaluated using tumor‐bearing mice to which a nuclide (99mTc$^{\rm 99m}{\rm Tc}$ or 125I)$^{125}{\rm I)}$ administered. Results: We simultaneously obtained information on 111In$^{111}{\rm In}$ and 125I$^{125}{\rm I}$, which emit emission lines in the low‐energy band with peak energies close to each other (23–26 keV for 111In$^{111}{\rm In}$ and 27–31 keV for 125I)$^{125}{\rm I)}$, and applied an analytical method based on spectral model fitting to determine the individual radioactivities accurately. In the small animal imaging, the distributions of the nuclide in tumors were accurately quantified and time‐activity curves in tumors are obtained. Conclusions: The demonstrated capability of our system to perform in vivo imaging suggests that the camera can be used for applications of pharmacokinetics research. [ABSTRACT FROM AUTHOR]

Samples from asteroid Ryugu, brought back by asteroid explorer Hayabusa2, are important for investigating the origin and evolution of the solar system. Here, we report the elemental compositions of a 123‐mg Ryugu sample determined with a nondestructive muon elemental analysis method. This method is a powerful tool for determining bulk chemical composition, including light elements such as C, N, and O. From the muonic x‐ray spectra with three carbonaceous chondrites, the relationship between the elemental composition and muonic x‐ray intensity was determined for each element. Calibration curves showed linearity, and the elemental composition of Ryugu was quantitatively determined. The results reflect the average bulk elemental composition of asteroid Ryugu owing to the large amount of samples. Ryugu has an elemental composition similar to that of Orgueil (CI1) and should be classified as CI1. However, the O/Si ratio of Ryugu is 25% lower than that of Orgueil, indicating that Orgueil may have been seriously contaminated by terrestrial materials after its fall to Earth. These results indicate that the Ryugu sample is more representative than the CI chondrites as a solid material of the solar system. [ABSTRACT FROM AUTHOR]

The distribution pattern of the connection length in the divertor region of Heliotron J was calculated by the field line tracing method. A multifold layer structure, characterized by the range of connection length, was revealed to interpret the response of the transport of the lower‐charged impurity ions to the divertor structure. Impurity transport simulated by the EMC3‐EIRENE code shows that lower‐charged impurity ions tend to concentrate in the first multifold layer. This result is consistent with the line‐integral extreme ultraviolet spectroscopy measurement, which implies that the impurity's response to the divertor topological structure needs to be considered in interpreting the spectroscopy result. [ABSTRACT FROM AUTHOR]

Introduction: Serpiginous choroiditis presents with large yellow‐white exudative lesions that occur near the optic nerve papillae, that progresses slowly with repeated relapses and cures. Although infection and autoimmunity have been implicated, the cause is unknown. Methods: A man was diagnosed with serpiginous choroiditis on clinical and other examinations. He started treatment with oral corticosteroids, cyclophosphamide, adalimumab, azathioprine, rituximab, and mycophenolate mofetil. Only the steroids and cyclophosphamide had a therapeutic effect. Plasma exchange was initiated, and the lesions quickly resolved. Results: Disease control has been maintained by plasma exchange and cyclophosphamide during flare‐ups in the fall and winter, suggesting that plasma exchange is effective in the treatment of serpiginous choroiditis. Conclusion: The reproducible response with each recurrence suggests a strong association between the disease and autoimmunity. Furthermore, that some, as yet unknown, autoantibodies are involved in the pathogenesis of serpiginous choroiditis. [ABSTRACT FROM AUTHOR]

Aim: The significance of lymphadenectomy and its indications in patients with inguinal lymph node metastasis (ILNM) of anorectal adenocarcinoma is unclear. This study aimed to clarify the surgical outcomes and prognostic factors of inguinal lymphadenectomy for ILNM. Method: This study included patients who underwent surgical resection for ILNM of rectal or anal canal adenocarcinoma with pathologically positive metastases between 1997 and 2011 at 20 participating centres in the Study Group for Inguinal Lymph Node Metastasis from Colorectal Cancer organized by the Japanese Society for Cancer of the Colon and Rectum. Clinicopathological characteristics and short‐ and long‐term postoperative outcomes were retrospectively analysed. Results: In total, 107 patients were included. The primary tumour was in the rectum in 57 patients (53.3%) and in the anal canal in 50 (46.7%). The median number of ILNMs was 2.34. Postoperative complications of Clavien–Dindo Grade III or higher were observed in five patients. The 5‐year overall survival rate was 38.8%. Multivariate analysis identified undifferentiated histological type (P < 0.001), pathological venous invasion (P = 0.01) and pathological primary tumour depth T0–2 (P = 0.01) as independent prognostic factors for poor overall survival. Conclusion: The 5‐year overall survival after inguinal lymph node dissection was acceptable, and it warrants consideration in more patients. Further larger‐scale studies are needed in order to clarify the surgical indications. [ABSTRACT FROM AUTHOR]

Objectives: The prostatic urethral lift (PUL) has been used as a minimally invasive surgery for benign prostatic hyperplasia (BPH) since April 2022 in Japan. This study evaluated the initial outcomes and surgical techniques of PUL for BPH. Methods: In this prospective, single‐center study, indications were based on the proper use guidelines for PUL in Japan. Preoperative patient status, postoperative progress at 1 and 3 months, and perioperative complications were evaluated. The surgical technique was changed twice, and the subgroup analysis and technique were evaluated. Results: Of the 50 patients who underwent surgeries performed by a single surgeon, the median age and prostate volume were 71 years and 42.0 mL, respectively. Furthermore, the median operative time and number of implants used were 20 min and 5, respectively. No postoperative fever or severe hematuria requiring reoperation occurred. All patients were discharged from the hospital the day following the PUL, as scheduled. Postoperative International Prostate Symptom Score, quality of life score, maximum flow rate, and postvoid residual volume at 1 and 3 months were significantly improved compared with the preoperative values. A significant improvement in maximum flow rate was observed in the subgroup analysis from 1 month postoperatively in the group with an anterior channel creation focus. Conclusions: PUL is effective and safe in cases with prostate volumes of <100 mL. Lifting the bladder neck is important for opening an anterior prostatic urethral channel and improving urinary function during the early postoperative period. [ABSTRACT FROM AUTHOR]

Here, we report the reactivity of copper(I) clusters toward sulfide ions; these sulfide copper(I) clusters have attracted much attention due to their relevance to biologically active centers and their fascinating structural and photophysical properties. Treatment of the CuI3RhIII2 pentanuclear complex, [Cu3{Rh(aet)3}2]3+ (aet=2‐aminoethanethiolate), in which a {CuI3}3+ cluster moiety is bound by two fac‐[Rh(aet)3] metalloligands, with NaSH in water produced the CuI6RhIII4 decanuclear complex, [Cu6S{Rh(aet)3}4]4+, accompanied by the dimerization of [Cu3{Rh(aet)3}2]3+ and the incorporation of a sulfide ion at the center. While similar treatment using the analogous CuI3IrIII2 complex with fac‐[Ir(aet)3] metalloligands, [Cu3{Ir(aet)3}2]3+, produced the isostructural CuI6IrIII4 decanuclear complex, [Cu6S{Ir(aet)3}4]4+, the use of the CuI3RhIII2 complex with fac‐[Rh(apt)3] metalloligands, [Cu3{Rh(apt)3}2]3+ (apt=3‐aminopropanethiolate), resulted in the removal of one of the three CuI atoms from {CuI3}3+ to afford the CuI2RhIII2 tetranuclear complex, [Cu2{Rh(apt)3}2]2+. [ABSTRACT FROM AUTHOR]

Circular dichroism (CD) studies on poly(1,4‐phenylene)s bearing a chiral side chain in the aggregated conditions were carried out. Little CD was observed in a solution form, while addition of a poor solvent into the polyphenylene solution induced aggregation and a strong CD was observed, accordingly. Applying the controlled degree of polymerization (DP) of poly(1,4‐phenylene) in the use of bidentate diphosphine Chiraphos as a ligand for the nickel catalyst, the relationship of DP with CD strength was studied to reveal to show the highest CD at the DP=84 (gabs=ca. 2×10−2). It was also found that the related aggregation was observed in good solvent 1,2‐dichloroethane upon standing the solution at 4 °C for 3–23 days to observe gabs=ca. 10−1. Studies on the substituent effect of poly(1,4‐phenylene) suggested that CD behaviors were dependent on the type of non‐chiral substituent on the aromatic ring as well as the side‐chain chirality. [ABSTRACT FROM AUTHOR]

Purpose: This is the second of two articles that examine the psychometric properties and treatment outcomes associated with two measures of the therapeutic alliance in naturalistic routine settings. Methods: Data were taken from the ACORN database for youth, and, where available, parent/carer, attending for psychotherapy treatment in naturalistic settings (N = 12,573). The sample, the largest to date, included only those completing both an alliance measure and an outcome measure at every session. Two sets of three different alliance items are used across the two populations in routine practice. Results: Analyses revealed that the alliance explained no more than 3% of the variance in outcomes. Alliance measures exhibit ceiling effects, and as such, drawing conclusions about correlations with outcomes can be difficult. Any drop in alliance score as rated by both youth and parent/carer is predictive of outcomes, with parent/carer ratings being marginally more predictive. Where the alliance is rated as better by youth or parent/carer in comparison with ratings as worse, effect sizes are up to 50% better for the youth. Conclusion: The therapeutic alliance remains an important non‐specific treatment component; however, measures of the alliance have ceiling effects. Both youth and their parent/carer can provide important feedback to the therapist, and any drop in alliance is predictive of clinically meaningful change. As such, therapists should monitor the alliance with both youth and parent/carer. Implications for practice, training and research are considered. [ABSTRACT FROM AUTHOR]

Ecological similarity plays an important role in biotic interactions. Increased body size similarity of competing species, for example, increases the strength of their biotic interactions. Body sizes of many exothermic species are forecast to be altered under global warming, mediating shifts in existing trophic interactions among species, in particular for species with different thermal niches.Temperate rocky reefs along the southeast coast of Australia are located in a climate warming hotspot and now house a mixture of temperate native fish species and poleward range‐extending tropical fishes (vagrants), creating novel species assemblages. Here, we studied the relationship between body size similarity and trophic overlap between individual temperate native and tropical vagrant fishes.Dietary niche overlap between vagrant and native fish species increased as their body sizes converged, based on both stomach content composition (short‐term diet), stable isotope analyses (integrated long‐term diet) and similarity in consumed prey sizes.We conclude that the warming‐induced faster growth rates of tropical range‐extending fish species at their cool water ranges will continue to converge their body size towards and strengthen their degree of trophic interactions and dietary overlap with co‐occurring native temperate species under increasing ocean warming. The strengthening of these novel competitive interactions is likely to drive changes to temperate food web structures and reshuffle existing species community structures. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the effects of diabetes care on periodontal inflammation. Materials and Methods: This prospective cohort study included 51 Japanese patients with type 2 diabetes who underwent intensive diabetes care including educational hospitalization and regular outpatient treatment for 6 months. Dental prophylaxis without subgingival scaling was provided three times during the observational period. Associations between changes in periodontal parameters and glycaemic control levels were evaluated using multiple regression analysis. Results: Overall, 33 participants (mean age: 58.7 ± 12.9) were followed up for 6 months. At baseline examination, 82% were diagnosed with Stage III or IV periodontitis. Haemoglobin A1c (HbA1c) level changed from 9.6 ± 1.8% at baseline to 7.4 ± 1.3% at 6 months. The ratio of probing pocket depth (PPD) ≥4 mm, bleeding on probing (BOP), full‐mouth plaque control record (PCR), periodontal epithelial surface area (PESA) and periodontal inflamed surface area (PISA) also significantly improved. The reduction in PPD and PESA was significantly associated with changes in both HbA1c and fasting plasma glucose (FPG) levels, and the reduction in PISA was significantly associated with an improvement in FPG after adjusting for smoking, change in body mass index and full‐mouth PCR. Conclusions: This is the first study to report a significant improvement in PPD and BOP after intensive diabetes care and dental prophylaxis without subgingival scaling. Clinical trial registration number: UMIN000040218. [ABSTRACT FROM AUTHOR]

Aim: The incidence of Helicobacter pylori‐negative gastric cancer (HPNGC) is increasing worldwide. Recently, metabolic dysfunction‐associated fatty liver disease (MAFLD) has been reported to be associated with various cancers, but its association with HPNGC has not been reported. We aimed to identify important independent factors associated with HPNGC, including MAFLD. Methods: This multicenter observational cohort study enrolled patients with gastric cancer (n = 1078) and health checkup examinees (n = 17 408). We analyzed patients with HPNGC (n = 26) and healthy participants with no H. pylori infection or any abnormal findings on upper gastrointestinal endoscopy (n = 1130). A logistic regression model was used to identify independent factors associated with HPNGC. The priority of the factors associated with HPNGC was evaluated using a decision‐tree algorithm and random forest analysis. Results: Among all patients with gastric cancer, 2.4% (26/1078) were diagnosed with HPNGC (mean age, 64 years; male/female, 13/13). In the logistic regression analysis, age, smoking, and MAFLD (odds ratio, 6.5359; 95% confidence interval, 2.5451–16.7841; p < 0.0001) were identified as independent factors associated with HPNGC. Metabolic dysfunction‐associated fatty liver disease was also identified as the most important classifier for the presence of HPNGC in decision‐tree analyses. Helicobacter pylori‐negative gastric cancer was observed in 5.2% of patients with MAFLD and 0.8% of patients without MAFLD. In the random forest analysis of the HPNGC, MAFLD was identified as the distinguishing factor with the highest variable importance (0.32). Conclusions: Metabolic dysfunction‐associated fatty liver disease was the most influential independent factor associated with HPNGC. These findings suggest that fatty liver and metabolic dysfunction could be involved in the pathogenesis of HPNGC. [ABSTRACT FROM AUTHOR]

Introduction: Catheter ablation of ectopy originating from the vicinity of the His bundle can be challenging. Methods and Results: We report a case of a 33‐year‐old man with narrow QRS ectopy with preferential conduction from a para‐Hisian origin to the proximal left fascicles, which was successfully eliminated by radiofrequency ablation in the right coronary cusp, guided by ultrahigh‐resolution mapping of the His bundle, bundle branch, and fascicular electrograms. Conclusion: Some narrow QRS ectopy may originate from the vicinity of the conduction system, instead of the "true" conduction system, and have concealed connections from its origin to the conduction system. [ABSTRACT FROM AUTHOR]

Objective: In this study, we examine how advancements in novel antirheumatic drugs affect the clinicopathologic features of lymphoproliferative disorder (LPD) in patients with rheumatoid arthritis (RA). Methods: In this multicenter study across 53 hospitals in Japan, we characterized patients with RA who developed LPDs and visited the hospitals between January 1999 and March 2021. The statistical tools used included Fisher's exact test, the Mann‐Whitney U‐test, the log‐rank test, logistic regression analysis, and Cox proportional hazards models. Results: Overall, 752 patients with RA‐associated LPD (RA‐LPD) and 770 with sporadic LPD were included in the study. We observed significant differences in the clinicopathologic features between patients with RA‐LPD and those with sporadic LPD. Histopathological analysis revealed a high frequency of LPD‐associated immunosuppressive conditions. Furthermore, patients with RA‐LPD were evaluated based on the antirheumatic drugs administered. The methotrexate (MTX) plus tacrolimus and MTX plus tumor necrosis factor inhibitor (TNFi) groups had different affected site frequencies and histologic subtypes than the MTX‐only group. Moreover, MTX and TNFi may synergistically affect susceptibility to Epstein‐Barr virus infection. In case of antirheumatic drugs administered after LPD onset, tocilizumab (TCZ)–only therapy was associated with lower frequency of regrowth after spontaneous regression than other regimens. Conclusion: Antirheumatic drugs administered before LPD onset may influence the clinicopathologic features of RA‐LPD, with patterns changing over time. Furthermore, TCZ‐only regimens are recommended after LPD onset. [ABSTRACT FROM AUTHOR]