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The movement history of boulders is crucial for the reconstruction of paleo‐tsunamis. We report findings from viscous remanent magnetization studies of the boulders on Tongatapu Island, aiming to reconstruct their reworkings. Two boulders exhibited viscous remanence, whereas two larger boulders lacked viscous components but exhibited stable remanence. Both the viscous and stable components deviated from the geomagnetic field direction. These observations indicate that: (a) the boulders with a viscous component were reworked before the latest event, which could have reworked all boulders, and (b) the magnitude of the latest event was larger than that of an earlier event. The reworked timing indicated that the event occurred between 3,000 years ago and the fifteenth century. The difference in the wave height required to move boulders on the eastern and western coasts suggests that the source of the earlier tsunami was likely an eruption due to volcanoes along the Tonga Ridge. Plain Language Summary: This study explores prehistoric tsunamis on Tongatapu Island by examining large rocks transported during the past tsunamis. Upon analyzing the magnetic records of the rocks, we discovered evidence of multiple rock movements, shedding light on the recurrence and magnitude of past events. Magnetic measurements and previously dated latest movement ages revealed that a tsunami occurred between 3,000 years ago and the fifteenth century. Considering the mobility and immobility of the large rocks and their sizes, the data suggest a smaller paleo‐tsunami magnitude than that of the fifteenth‐century event that transported all the rocks; this expands our understanding of natural hazard history and has implications for assessing tsunami risks in the region. The approach adopted here provides a valuable model for investigating historical natural disasters and their impact on coastal areas, offering insights to enhance global tsunami hazard assessment strategies. Key Points: Viscous remanent magnetization of large boulders indicates multiple reworkings, enhancing our understanding of past tsunamis in TongatapuCombined magnetic records and published radiocarbon ages suggest tsunamis occurred between 3,000 years ago and the fifteenth centuryRemanence and wave height estimates show that the older tsunami was smaller than the fifteenth‐century event, with a possible volcanic source [ABSTRACT FROM AUTHOR]

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

Background: Left ventricular stroke work index (LVSWI) and cardiac power index (CPI) account for the haemodynamic load of the left ventricle and are promising prognostic values in cardiogenic shock. However, accurately and non‐invasively measuring these parameters during veno‐arterial extracorporeal membrane oxygenation (V‐A ECMO) is challenging and potentially biased by the extracorporeal circulation. This study aimed to investigate, in an ovine model of cardiogenic shock, whether Pressure‐Strain Product (PSP), a novel speckle‐tracking echocardiography parameter, (1) can correlate with pressure‐volume catheter‐based LVSWI and CPI, and (2) can be load‐independent during the flow modification of V‐A ECMO. Methods: Nine Dorset‐cross ewes (51 ± 4 kg) were included. After cardiogenic shock was induced, full support V‐A ECMO (X L/min based on 60 mL/kg/min) commenced. At seven time points during 24‐h observation, echocardiographic parameters as well as pressure‐volume catheter‐based LVSWI and CPI were simultaneously measured with X and following X‐1 L/min of ECMO flow. PSP was calculated by multiplying global circumferential strain or global radial strain, and mean arterial pressure, for PSPcirc or PSPrad, respectively. Results: PSPcirc showed a stronger correlation with LVSWI (correlation coefficient, CC =.360, p <.001) and CPI (CC =.283, p <.001) than other echocardiographic parameters. The predictability of PSPcirc for pressure‐volume catheter‐based LVSWI (AUC.82) and CPI (AUC.80) was also higher than other echocardiographic parameters. No statistically significant differences were identified between the two ECMO flow variations in PSPcirc (p =.558). Conclusions: A novel echocardiographic parameter, PSP, may non‐invasively predict pressure‐volume catheter‐based LVSWI and CPI in a load‐independent manner in a cardiogenic shock supported by V‐A ECMO. [ABSTRACT FROM AUTHOR]

Background: The commonest echocardiographic measurement, left ventricular ejection fraction, can not necessarily predict mortality of recipients following heart transplantation potentially due to afterload dependency. Afterload‐independent left ventricular stroke work index (LVSWI) is alternatively recommended by the current guideline; however, pulmonary artery catheters are rarely inserted in organ donors in most jurisdictions. We propose a novel non‐invasive echocardiographic parameter, Pressure‐Strain Product (PSP), as a potential surrogate of catheter‐based LVSWI. This study aimed to investigate if PSP could correlate with catheter‐based LVSWI in an ovine model of brain stem death (BSD) donors. The association between PSP and myocardial mitochondrial function in the post‐transplant hearts was also evaluated. Methods: Thirty‐one female sheep (weight 47 ± 5 kg) were divided into two groups; BSD (n = 15), and sham neurologic injury (n = 16). Echocardiographic parameters including global circumferential strain (GCS) and global radial strain (GRS) and pulmonary artery catheter‐based LVSWI were simultaneously measured at 8‐timepoints during 24‐h observation. PSP was calculated as a product of GCS or GRS, and mean arterial pressure for PSPcirc or PSPrad, respectively. Myocardial mitochondrial function was evaluated following 6‐h observation after heart transplantation. Results: In BSD donor hearts, PSPcirc (n = 96, rho =.547, p <.001) showed the best correlation with LVSWI among other echocardiographic parameters. PSPcirc returned AUC of.825 to distinguish higher values of cardiomyocyte mitochondrial function (cut‐off point; mean value of complex 1,2 O2 Flux) in post‐transplant hearts, which was greater than other echocardiographic parameters. Conclusions: PSPcirc could be used as a surrogate of catheter‐based LVSWI reflecting mitochondrial function. [ABSTRACT FROM AUTHOR]

In this study, glucose oxidase (GOx) was immobilized on the electrode surface by layer‐by‐layer and gel membrane technique and characterized the GOx immobilized film morphology, H2O2 permeability, and glucose response. Concanavalin A (Con A)‐GOx multilayer electrodes showed higher glucose‐related current response than GOx‐bovine serum albumin gel membrane‐coated electrode, a common modification method. The thin thickness of the Con A/GOx multilayer film efficiently catalyzed the enzymatic reaction, and H2O2 was produced near the electrode surface, resulting in an immediate electrode response. [ABSTRACT FROM AUTHOR]

Aim: Measurement of O‐glycosylated middle hepatitis B surface antigen (HBsAg glycan isomer, HBsAgGi) has been developed to quantify hepatitis B virus (HBV) infectious virions and distinguish them from subviral particles. This study aimed to evaluate the association between serum HBsAg seroclearance and serum HBV virions measured by HBsAgGi in patients with chronic hepatitis B (CHB). Methods: Serum HBsAgGi levels were quantified in 232 treatment‐naïve patients with CHB genotype C. Cox proportional hazards analysis was used to calculate hazard ratios (HRs) for factors associated with HBsAg seroclearance. Results: Baseline HBsAgGi levels showed significant differences among HBV phenotypes. During a median follow‐up period of 7.4 years, 22 of the 232 patients achieved HBsAg seroclearance. Multivariate analysis demonstrated that quantitative HBsAg, nucleoside/nucleotide analog therapy during the follow‐up period, and HBsAgGi levels were independent predictors of seroclearance. The adjusted HR indicated that the HBsAg seroclearance probability in patients with low HBsAgGi (≤3.5log ng/mL) was over five times higher than that in patients with high HBsAgGi. Kaplan–Meier analysis indicated that the 10‐year probabilities of HBsAg seroclearance were 21.0% and 3.0% in patients with low and high HBsAgGi levels, respectively (p < 0.001), and that patients with high HBsAgGi levels showed low seroclearance probabilities irrespective of the other predictors. Conclusion: Serum HBV infectious virion levels, measured using HBsAgGi, may be a novel predictor of HBsAg seroclearance. [ABSTRACT FROM AUTHOR]

The understanding of supramolecular chirality in self‐assembled molecular networks (SAMNs) on surfaces generates a lot of interest because of its relation to the production of chiral sensors, reactors, and catalysts. We herein report the adsorption of a prochiral solvent molecule in porous SAMNs formed by a chiral dehydrobenzo[12]annulene (cDBA) derivative. Through the prochirality recognition of a solvent molecule, the supramolecular chirality of the SAMN is switched: the cDBA exclusively forms a counter‐clockwise pore through co‐adsorption of the solvent molecule in prochiral 1,2,4‐trichlorobenzene, while in 1‐phenyloctane it produces the opposite chiral, clockwise pore. The prochirality recognition of the solvent molecule in the chiral SAMN pores is attributed to the adaptable conformational changes of the chiral chains of the cDBA molecule. [ABSTRACT FROM AUTHOR]

A woman in her mid‐60s with recurrent polychondritis was admitted to our hospital due to airway stenosis secondary to an uncovered metallic stent. She underwent a bronchoscopic intervention under general anaesthesia. During the procedure, the stent fracture was cauterized using Argon Plasma Coagulation (APC) cauterisation, performed with argon flow at 1 L/min and power set at 70 W. APC cauterisation caused the stent wire to flex circularly, gradually improving the stenosis. Tracheal dilatation was then performed using an airway balloon. Following the ballooning, a thin bronchoscope was easily passed through the lower trachea, and the left and right main bronchi were observed; therefore, the procedure was completed without any complications. APC coagulation and airway ballooning are viable choices for the temporary treatment of airway stenosis due to broken metallic stents. [ABSTRACT FROM AUTHOR]

We present the case of a 34‐year‐old Japanese man with anaplastic lymphoma kinase (ALK)‐positive non‐small cell lung cancer and brain metastases. After central nervous system (CNS) disease progression with alecintib and brigatinib, treatment with lorlatinib resulted in a good intracranial response. In this case, we investigated brain penetration ratio of brigatinib using cerebrospinal fluid and paired serum samples, and the ratio was 0.012. Further, we investigated resistance mechanisms via next‐generation sequencing (NGS) using lung biopsy at lung cancer diagnosis and brain biopsy sample at progressive disease of brigatinib. No apparent resistance mechanism of known ALK resistance, such as ALK mutations, amplifications, epithelial‐mesenchymal transition (EMT) and bypass pathway activation were detected. Taken together, we speculate that the low CNS penetration rate of brigatinib confers CNS progression. Further studies are warranted to reveal the resistance mechanism and propose a treatment strategy for CNS progression in ALK‐positive patients. [ABSTRACT FROM AUTHOR]

Lenvatinib (LEN), a multitarget tyrosine kinase inhibitor used in various cancer treatments, is mainly metabolized by cytochrome P450 3A (CYP3A) enzymes. The importance of therapeutic drug monitoring (TDM) in patients administered LEN has been proposed. Although some biomarkers of endogenous CYP3A activity have been reported, their utility in dosage adjustments has not been well evaluated. This study investigated the correlation between plasma LEN concentrations and endogenous urinary CYP3A biomarkers in clinical practice. Concentrations of plasma LEN (N = 225) and CYP3A biomarkers (cortisol, 6β‐hydroxycortisol, deoxycholic acid, and 1β‐hydroxydeoxycholic acid) in urine (N = 214) from 20 patients (hepatocellular carcinoma, N = 6; thyroid cancer, N = 3; endometrial cancer, N = 8; and renal cell carcinoma, N = 3) collected for consultation for up to 1 year were evaluated using liquid chromatography–tandem mass spectrometry. Moreover, plasma trough LEN concentrations were predicted using a three‐compartment model with linear elimination for outpatients administered LEN before sample collection. Moderate correlations were observed between the quantified actual concentrations and the predicted trough concentrations of LEN, whereas there was no correlation with endogenous urinary CYP3A biomarkers. The utility of endogenous urinary CYP3A biomarkers could not be determined. However, TDM for outpatients administered orally available medicines may be predicted using a nonlinear mixed effect model (NONMEM). This study investigated the utility of endogenous urinary CYP3A biomarkers for personalized medicine and NONMEM for predicting plasma trough drug concentrations. These findings will provide important information for further clinical investigation and detailed TDM. [ABSTRACT FROM AUTHOR]

Objective: In pharyngeal dysphagia, poor pharyngeal contraction and upper esophageal sphincter (UES) dysfunction result in post‐swallow saliva residue (SR). This study aimed to clarify the relationship between swallowing pressure and SR in the valleculae and piriform sinuses on flexible endoscopic evaluation of swallowing (FEES). Methods: Pharyngeal dysphagia patients with Wallenberg syndrome were included. Amounts of post‐swallow SR in the valleculae and piriform sinuses were classified into four grades using SR scores based on FEES. The Hyodo score was also calculated to evaluate swallowing function. High‐resolution manometric data in the nasopharyngeal, oropharyngeal, hypopharyngeal, oro‐hypopharyngeal, and UES zones on swallowing were obtained for comparison with SR and Hyodo scores. Results: Of the 31 recruited, data from 26 patients who successfully underwent FEES and manometry were analyzed. Vallecular SR scores were strongly negatively correlated with a maximum pressure of the oropharynx (r = −0.52, p = 0.006), distal contractile integrals (DCI) of the oropharynx (r = −0.52, p = 0.007), and DCI of the oro‐hypopharynx (r = −0.55, p = 0.004). Hyodo scores for parameters 1 and 4 (corresponding to salivary pooling and pharyngeal clearance, respectively) were strongly negatively correlated with a maximum hypopharyngeal pressure (r = −0.57, p = 0.002) and strongly positively correlated with peristaltic velocity (r = 0.53, p = 0.007), respectively. SR scores and Hyodo scores related to SR were not correlated with pressure data of the UES. Conclusion: Manometric analysis of our SR scoring method using FEES revealed that a higher amount of SR in the valleculae, but not in the piriform sinuses, is associated with weaker pharyngeal pressure in pharyngeal dysphagia, especially at the oropharyngeal level. Level of Evidence: 4 Laryngoscope, 134:3519–3526, 2024 [ABSTRACT FROM AUTHOR]

An 86‐year‐old woman with leg edema and dyspnea on exertion was admitted to our hospital. Chest computed tomography (CT) revealed a mass in the anterior mediastinum with pericardial invasion. Histological examination with endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) led to the diagnosis of Masaoka stage IVa type B2 thymoma. For palliation, radiotherapy (32 Gy/16 fractions) and prednisolone (30 mg/day) were administered and tapered. After treatment, both the pericardial effusion and tumour size decreased. Combination therapy with steroids and radiotherapy may be effective for treating thymomas. [ABSTRACT FROM AUTHOR]

We conducted a cross‐sectional study on the clinical and mycological features of onychomycosis in patients in the dermatology ward of Iwate Medical University Hospital, an acute care hospital. Of the 226 hospitalized patients, 73 (32.3%) had onychomycosis and 61 (26.9%) were diagnosed after admission. The toenail was the most common site of onychomycosis (94.5%), while toenail plus fingernail and fingernail only sites were 4.1% and 1.4%, respectively. The most common clinical form of onychomycosis was distal and lateral subungual onychomycosis (79%) with Trichophyton rubrum (66.7%) and T. interdigitale (27.8%) as the main causative species. Patients who were older, or had neurological diseases, or needed stretcher transfer had onychomycosis significantly more frequently than those who were obese, had diabetes, cancer, needed an escort for moving, or could move independently. Our study suggests that there is likely to be a significant number of untreated and undiagnosed patients with onychomycosis in acute care hospitals. Therefore, it is necessary to increase awareness of onychomycosis in hospitals. [ABSTRACT FROM AUTHOR]

Objectives: High‐resolution manometry (HRM) and esophagography are used for achalasia diagnosis; however, achalasia phenotypes combining esophageal motility and morphology are unknown. Moreover, predicting treatment outcomes of peroral endoscopic myotomy (POEM) in treatment‐naïve patients remains an unmet need. Methods: In this multicenter cohort study, we included 1824 treatment‐naïve patients diagnosed with achalasia. In total, 1778 patients underwent POEM. Clustering by machine learning was conducted to identify achalasia phenotypes using patients' demographic data, including age, sex, disease duration, body mass index, and HRM/esophagography findings. Machine learning models were developed to predict persistent symptoms (Eckardt score ≥3) and reflux esophagitis (RE) (Los Angeles grades A–D) after POEM. Results: Machine learning identified three achalasia phenotypes: phenotype 1, type I achalasia with a dilated esophagus (n = 676; 37.0%); phenotype 2, type II achalasia with a dilated esophagus (n = 203; 11.1%); and phenotype 3, late‐onset type I–III achalasia with a nondilated esophagus (n = 619, 33.9%). Types I and II achalasia in phenotypes 1 and 2 exhibited different clinical characteristics from those in phenotype 3, implying different pathophysiologies within the same HRM diagnosis. A predictive model for persistent symptoms exhibited an area under the curve of 0.70. Pre‐POEM Eckardt score ≥6 was the greatest contributing factor for persistent symptoms. The area under the curve for post‐POEM RE was 0.61. Conclusion: Achalasia phenotypes combining esophageal motility and morphology indicated multiple disease pathophysiologies. Machine learning helped develop an optimal risk stratification model for persistent symptoms with novel insights into treatment resistance factors. [ABSTRACT FROM AUTHOR]

This article discusses the development of a potential immunotherapy treatment for peanut allergy. The researchers conjugated peanut extract with galactomannan, a higher molecular weight saccharide, to reduce the allergenicity of the extract. They found that the conjugated extract, known as PE-GM, showed reduced reactivity with IgE antibodies and basophil activation in patients with peanut allergy. In a mouse model, PE-GM also demonstrated a lower anaphylactic response compared to untreated mice. These findings suggest that PE-GM could be a safer and more effective treatment option for peanut allergy. [Extracted from the article]

Objectives: The growth and development of the epiglottis and preepiglottic space (PES) of the human larynx as it acquires the vocal tract were investigated. Methods: Three newborns, one infant, four children (2, 7, 8, and 12 years old), and two adult normal larynges were investigated and compared using the whole organ serial section technique. Results: The newborn PES occupied a small area just anterior to the epiglottis. It was composed of immature adipose tissue and areolar tissue. The epiglottis lay on a somewhat horizontal axis and is partially obscured behind the hyoid bone. The hyoid bone overlapped the thyroid cartilage, partially obscuring the superior thyroid notch. The newborn epiglottic cartilage was immature elastic cartilage, and the elastic fiber component was sparse. In the first 8 years of life, as the PES grew, the PES was located not only anterior to but also posterolateral and inferolateral to the epiglottic cartilage and thyroepiglottic ligament. Meanwhile, the epiglottic cartilage matured. Conclusions: In order to develop the vocal tract for speech production, it is reported that the human larynx descends as the child grows in the first 9 years of life. This study showed that the PES, occupying a small area just anterior to the epiglottis, grew and existed astride the epiglottis as the larynx descended and the vocal tract developed. Consequently, its distribution allows the epiglottis to more effectively play the role of retroflection during swallowing in order to prevent aspiration. The human speech faculty likely develops in conjunction with swallowing physiology. [ABSTRACT FROM AUTHOR]

This article discusses a rare case of coexisting lichen planus (LP) and bronchiolitis obliterans (BO) without malignant tumors. LP is a chronic inflammatory disease that affects the skin, nails, hair, and mucous membranes, while BO is a progressive airway disorder characterized by narrowing and obliteration of the airway lumen. The patient in this case study experienced symptoms of LP, such as stomatitis and rash, followed by respiratory symptoms and was eventually diagnosed with CB, a subtype of BO. Despite treatment, the patient's respiratory condition worsened, and she died from respiratory failure. The relationship between LP and BO is not well understood, and more research is needed to establish effective therapeutic options for LP patients. [Extracted from the article]

Many slow slip events (SSEs) occur beneath the ocean, and continuous ocean‐bottom pressure gauge (OBP) observations provide useful data. OBPs record both oceanic variations and crustal movements, so we developed a multi‐channel singular spectrum analysis method to remove oceanic variations and applied our method to OBPs and oceanic model data. Then components of the oceanic model with good correlations to the OBP data were subtracted from the observed data. This method compensates for the incompleteness of the oceanic model and removes oceanic variations better than use of the original model. We applied the method to OBP data for the 2018 Boso, Japan, SSE to estimate its slip distribution. Comparing slip distributions obtained with and without the OBP data, we found that the distribution obtained using OBP data extended further offshore, and the offshore estimation error was smaller. Our study shows that offshore observations using OBPs are important for characterizing SSEs. Plain Language Summary: Slow slip events (SSEs) occur when faults slip slowly without generating seismic waves. Because most SSEs occur under the ocean, continuous observations by ocean‐bottom pressure instruments (OBPs) provide useful data. OBPs record both oceanic changes and seafloor movements. To remove the oceanic changes and more clearly observe seafloor movements, we developed a signal processing method to extract similar components from multiple time series. We applied our method to OBP data and oceanic model data, then subtracted the components of the oceanic model that match the OBP data from the observed data. This method removed the oceanic changes from the OBP data better than use of the original oceanic model alone. We applied this method to OBP data for the 2018 Boso, Japan, SSE and used vertical motions in the OBP data to estimate the slip distribution. The distribution obtained with the OBP data extended further offshore and was more accurate than that obtained without the OBP data. This study shows that observations of the ocean bottom obtained with OBPs are important for characterizing SSEs. Key Points: We removed oceanic variations from ocean‐bottom pressure data using a reconstructed oceanic model, achieving ±4 mm observed accuracyThe reconstructed oceanic model includes only components with good correlations between observed data and the oceanic modelUse of the ocean‐bottom pressure data and the proposed method improved the accuracy of the slow slip distribution in offshore areas [ABSTRACT FROM AUTHOR]

The development of nonfullerene acceptors (NFAs), represented by ITIC, has contributed to improving the power conversion efficiency (PCE) of organic solar cells (OSCs). Although tuning the electronic structures to reduce the exciton binding energy (Eb) is considered to promote photocharge generation, a rational molecular design for NFAs has not been established. In this study, we designed and developed two ITIC‐based NFAs bearing spiro‐substituted bithiophene or biphenyl units (named SpiroT‐DCI and SpiroF‐DCI) to tune the frontier molecular orbital (FMO) distribution of NFAs. While the highest occupied molecular orbitals (HOMOs) of SpiroF‐DCI and ITIC are delocalized in the main π‐conjugated framework, the HOMO of SpiroT‐DCI is distributed on the bithiophene unit. Reflecting this difference, SpiroT‐DCI exhibits a smaller Eb than either SpiroF‐DCI or ITIC, and exhibits greater external quantum efficiency in single‐component OSCs. Furthermore, SpiroT‐DCI shows improved PCEs for bulk‐heterojunction OSCs with a donor of PBDB‐T, compared with that of either SpiroT‐DCI or ITIC. Time‐resolved spectroscopy measurements show that the photo‐induced intermolecular charge separation is effective even in pristine SpiroT‐DCI films. This study highlights the introduction of spiro‐substituted bithiophene units that are effective in tuning the FMOs of ITIC, which is desirable for reducing the Eb and improving the PCE in OSCs. [ABSTRACT FROM AUTHOR]

Derivatization is essential for optimizing organic material properties. However, because functional groups are often introduced at an early stage of the synthesis, similar intermediates have to be repeatedly synthesized to produce derivatives, which amounts to a daunting and time‐consuming task. Using thienobenzobisthiazole (TBTz) as a building unit of donor polymers for organic photovoltaics (OPVs), we demonstrate an efficient derivatization of a TBTz‐based π‐conjugated polymer by late‐stage functionalization. In the developed synthetic route, functional groups are introduced at the last step of monomer synthesis, enabling us to easily synthesize several derivatives from a common intermediate. Ester and acyl groups are introduced into the polymer instead of the alkyl group, giving rise to deep HOMO energy levels and resulting in OPV cells with high open‐circuit voltage even in the absence of halogen substituents that are typically introduced into the donor polymers. Notably, the ester‐functionalized TBTz‐based polymer shows a small nonradiative voltage loss (ΔVnr) of 0.19 V and has one of the highest charge generation efficiencies among the halogen‐free donor polymers with similar ΔVnr, improving the critical trade‐off relationship between voltage loss and charge generation. Our results provide an important guideline for the efficient development of high‐performance polymers for OPVs. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims/Introduction Materials and Methods Results Conclusions We evaluated the effect of the MiniMed™ 770G, an insulin pump using hybrid closed‐loop technology, on blood glucose management and quality of life in Japanese people with type 1 diabetes.This was a 52‐week, prospective, observational study. Fifty Japanese people with type 1 diabetes switched from the MiniMed™ 640G to 770G, and we analyzed the continuous glucose monitoring data of 24 subjects who used auto mode throughout the study. We also analyzed the scores of the Diabetes Therapy‐Related Quality of Life questionnaire completed by 26 auto‐mode users before and after the treatment change.The baseline time in range 70–180 mg/dL was 67.3 (54.8–78.4)%, with a significant improvement beginning 8 weeks after the switch and lasting until 52 weeks. The baseline time below range <70 mg/dL was 1.9 (0.6–3.6)%, with a significant increase at week 8; however, the mean value was less than 4% throughout the study period. On the other hand, the number of blood glucose measurements significantly increased. While there was no significant difference in the overall change in the total Diabetes Therapy‐Related Quality of Life score, there was a significant decrease in the treatment satisfaction score.Use of the MiniMed™ 770G improved continuous glucose monitoring metrics. However, treatment satisfaction decreased, probably due to the increased frequency of blood glucose monitoring necessary to maintain auto mode. [ABSTRACT FROM AUTHOR]

Molecular cages that contain silicon are highly versatile and stable materials with great potential for various scientific and technological applications due to their ability to form stable three‐dimensional frameworks. The synthesis of 2,2,3,3,5,5,6,6,7,7,8,8‐dodecamethyl‐2,3,5,6,7,8‐hexasilabicyclo[2.2.2]octane has already been reported and its modifications at the CH moiety have been demonstrated to afford varied functionality. Here, we present the synthesis and characterization of 2,2,3,3‐tetraphenyl‐5,5,6,6,7,7,8,8‐octamethyl‐2,3,5,6,7,8‐hexasilabicyclo[2.2.2]octane, which is a phenyl‐substituted analogue of such a silicon‐containing cage. The Ph‐substituted Si‐containing cage exhibits a low‐lying LUMO due to the hyper‐conjugation including Si−Si, Si−C σ*‐orbitals, and π(phenyl)‐orbitals, which results in a remarkable bathochromic shift in the UV‐vis absorption spectrum. [ABSTRACT FROM AUTHOR]

Background and Purpose: Elevated intracranial pressure (ICP) resulting from severe head injury or stroke poses a risk of secondary brain injury that requires neurosurgical intervention. However, currently available noninvasive monitoring techniques for predicting ICP are not sufficiently advanced. We aimed to develop a minimally invasive ICP prediction model using simple CT images to prevent secondary brain injury caused by elevated ICP. Methods: We used the following three methods to determine the presence or absence of elevated ICP using midbrain‐level CT images: (1) a deep learning model created using the Python (PY) programming language; (2) a model based on cistern narrowing and scaling of brainstem deformities and presence of hydrocephalus, analyzed using the statistical tool Prediction One (PO); and (3) identification of ICP by senior residents (SRs). We compared the accuracy of the validation and test data using fivefold cross‐validation and visualized or quantified the areas of interest in the models. Results: The accuracy of the validation data for the PY, PO, and SR methods was 83.68% (83.42%‐85.13%), 85.71% (73.81%‐88.10%), and 66.67% (55.96%‐72.62%), respectively. Significant differences in accuracy were observed between the PY and SR methods. Test data accuracy was 77.27% (70.45%‐77.2%), 84.09% (75.00%‐85.23%), and 61.36% (56.82%‐68.18%), respectively. Conclusions: Overall, the outcomes suggest that these newly developed models may be valuable tools for the rapid and accurate detection of elevated ICP in clinical practice. These models can easily be applied to other sites, as a single CT image at the midbrain level can provide a highly accurate diagnosis. [ABSTRACT FROM AUTHOR]

Herein, the wavelength dependence of the efficiency and the lifetime of far UV‐C light‐emitting diodes (LEDs) on a single‐crystal AlN substrate is systematically analyzed from experiments and simulations. A positive relation between efficiency and emission wavelength is observed. The wall‐plug efficiency reaches 0.47, 1.0, 2.1, and 2.4% at 227, 230, 233, and 235 nm wavelengths, respectively. The simulation results show that carrier injection plays a critical role in the efficiency change in the far UV‐C region rather than in the internal quantum or light extraction efficiency. The lifetime test clearly demonstrates a trade‐off between the L70 lifetime and the emission wavelength, although the initial optical power increases with the longer wavelength. The measurement results under various wavelengths and stress currents indicate that the carriers injected in quantum wells motivate power reduction during current stress. Moreover, the internal quantum efficiency affects the degradation rate because the influence of defects becomes stronger during stress. Finally, the reliability of a 231 nm LED is investigated at a reduced current of 35 mA. The projected L70 and L50 lifetimes are 11 000 and 28 000 h, respectively, from the fitting model based on the defect generation during aging. [ABSTRACT FROM AUTHOR]

Allophane and ferrihydrite are the main hosts of phosphate in allophanic Andosols, which are vital soil resources that support high human population densities. However, the sorption mechanism of phosphate on allophane has not been elucidated, unlike that of ferrihydrite. In particular, the effects of residence time on phosphate sorbed on allophane remain unclear. Therefore, the objectives of this study were to (1) understand the effect of residence time on the stability of phosphate sorbed on allophanic Andosol and allophane by desorption experiments using arsenate and (2) elucidate the sorption mechanism of phosphate on allophane using solid‐state 31P nuclear magnetic resonance (NMR). Consequently, the slow sorption of phosphate onto allophanic Andosol, allophane, and ferrihydrite continued for approximately 150 days. The ratio of total desorbable phosphate to phosphate sorbed onto the allophanic Andosol and allophane decreased with increasing residence time. In other words, phosphate sorption on allophanic Andosol and allophane was more irreversible with increasing residence time. The NMR spectra and X‐ray diffraction patterns showed that the molecular environment of phosphate sorbed onto allophane and ferrihydrite did not change at any residence time. Therefore, the slow sorption and irreversibility of phosphate were caused not by surface precipitation but by internal diffusion. In addition, the NMR spectra showed that most of the phosphate sorbed on allophane was present as inner‐sphere complexes. Core Ideas: We explored residence time's effects on phosphate sorbed on allophanic Andosol and allophane.Phosphate sorption on Andosol and allophane continued for approximately 150 days.Nuclear magnetic resonance (NMR) spectra did not notably change during long‐term phosphate sorption to allophane.Irreversibility of sorbed phosphate increased with residence time.Internal diffusion by soil in the phosphate sorption process is very important. [ABSTRACT FROM AUTHOR]

Objective: This study clarified the measures and necessary factors for regularly and effectively conducting case conferences to improve the quality of public health nurses' care for individuals and families. Design: We employed a qualitative descriptive design. Sample: The study fields were three Japanese municipalities that regularly held case conferences for at least a year to improve the quality of public health nurses' care for individuals and families. The first author conducted semi‐structured interviews with three lead public health nurses and two nurses responsible for case conference projects. Measurements: The audio recordings of the interviews were transcribed verbatim and categorized. Interviews were conducted between December 2021 and May 2022. Results: Measures to regularly and effectively conduct case conferences included "creating a system to promote case conferences," "preparations to achieve case conference objectives," and "case conference progress management." Factors included "resources for promoting case conferences in the organization," "public health nurses' attitudes toward care," and "an environment that allows discussions about care." Conclusion: Lead public health nurses can use the results as a reference to implement the identified measures in their organizations. The factors can enable lead public health nurses to evaluate the status of their organization regarding conducting case conferences. [ABSTRACT FROM AUTHOR]

Ectomycorrhizal (ECM) fungi are important tree symbionts within forests. The biogeography of ECM fungi remains to be investigated because it is challenging to observe and identify species. Because most ECM plant taxa have a Holarctic distribution, it is difficult to evaluate the extent to which host preference restricts the global distribution of ECM fungi. To address this issue, we aimed to assess whether host preference enhances the endemism of ECM fungi that inhabit dipterocarp rainforests. Highly similar sequences of 175 operational taxonomic units (OTUs) for ECM fungi that were obtained from Lambir Hill's National Park, Sarawak, Malaysia, were searched for in a nucleotide sequence database. Using a two‐step binomial model, the probability of presence for the query OTUs and the registration rate of barcode sequences in each country were simultaneously estimated. The results revealed that the probability of presence in the respective countries increased with increasing species richness of Dipterocarpaceae and decreasing geographical distance from the study site (i.e. Lambir). Furthermore, most of the ECM fungi were shown to be endemic to Malaysia and neighbouring countries. These findings suggest that not only dispersal limitation but also host preference are responsible for the high endemism of ECM fungi in dipterocarp rainforests. Moreover, host preference likely determines the areas where ECM fungi potentially expand and dispersal limitation creates distance–decay patterns within suitable habitats. Although host preference has received less attention than dispersal limitation, our findings support that host preference has a profound influence on the global distribution of ECM fungi. [ABSTRACT FROM AUTHOR]

Japanese citizens of all socioeconomic statuses have benefited from the national insurance system by receiving high‐quality healthcare. However, the Japanese healthcare service is facing a severe financial crisis because of the increasing aging society and social security expenses. Many consultations raise medical expenditure and doctors' work overload, which is about to be regulated, but is questionable how the goal can be achieved without delegating doctors' working tasks. Sweden has a similar health index to that of Japan, but the system is different and is anchored by general practitioners and specialist nurses assigned to primary health care centers. They collaborate to share the workload, responsibilities, and patients' continuous care needs. As a result, the number of consultations is kept small, the length of stay in hospitals is shortened, and doctors' working hours are protected. A system change inspired by Swedish primary health care can be a potential solution for Japanese society. [ABSTRACT FROM AUTHOR]

The process‐dependent properties of Al2O3/p‐type GaN (p‐GaN) interfaces formed by atomic layer deposition at 300 °C after photoelectrochemical (PEC) etching are reported. For investigating the gap states at the Al2O3/p‐GaN interface, metal‐oxide‐semiconductor (MOS) diodes are fabricated and examined by sub‐bandgap‐light‐assisted and temperature‐dependent capacitance–voltage (C–V) measurements. PEC etching prior to Al2O3/p‐GaN interface formation is conducted with the etching depth varied in the range between 12.5 and 32.1 nm. The C–V characteristics of the MOS diodes without PEC etching indicate Fermi‐level pinning due to the near‐surface defect level in p‐GaN at 0.7 eV above the valence band edge EV and a high density of gap states around the midgap. However, all samples with PEC etching exhibit C–V characteristics, indicating a reduction in the density of the defect states at EV + 0.7 eV and midgap states. Still, PEC etching after capless annealing at 800 °C for the activation of Mg acceptors cannot reduce the density of gap states near the valence band edge. On the other hand, annealing of a sample with a SiO2 cap layer at 800 °C after PEC etching can reduce the gap state density near the valence band edge. [ABSTRACT FROM AUTHOR]

In a previous study, GaN‐based nanopillars are grown vertically on a multicrystalline Si substrate by inserting (In)GaN steering crystals. In addition, blue‐green and white light‐emitting diodes (LEDs) are prepared on this substrate for the first time using a double heterotype p–n junction. Herein, the emission‐color distribution characteristics of this type of LED are analyzed in depth, and a related luminescence principle is proposed. Each nanopillar plus an electrode is considered a nanopillar LED, and the emission color of each nanopillar LED is inferred. The indium distribution in the InGaN active region is predicted based on the luminous color and corresponding spectra. Simultaneously, the morphology of related materials, electrical properties of LEDs, and chromaticity coordinates of luminous colors are analyzed and discussed. [ABSTRACT FROM AUTHOR]

X‐ray multi‐projection imaging (XMPI) is an emerging experimental technique for the acquisition of rotation‐free, time‐resolved, volumetric information on stochastic processes. The technique is developed for high‐brilliance light‐source facilities, aiming to address known limitations of state‐of‐the‐art imaging methods in the acquisition of 4D sample information, linked to their need for sample rotation. XMPI relies on a beam‐splitting scheme, that illuminates a sample from multiple, angularly spaced viewpoints, and employs fast, indirect, X‐ray imaging detectors for the collection of the data. This approach enables studies of previously inaccessible phenomena of industrial and societal relevance such as fractures in solids, propagation of shock waves, laser‐based 3D printing, or even fast processes in the biological domain. In this work, we discuss in detail the beam‐splitting scheme of XMPI. More specifically, we explore the relevant properties of X‐ray splitter optics for their use in XMPI schemes, both at synchrotron insertion devices and XFEL facilities. Furthermore, we describe two distinct XMPI schemes, designed to faciliate large samples and complex sample environments. Finally, we present experimental proof of the feasibility of MHz‐rate XMPI at the European XFEL. This detailed overview aims to state the challenges and the potential of XMPI and act as a stepping stone for future development of the technique. [ABSTRACT FROM AUTHOR]

Aims: Cerebral palsy (CP) is the term for a set of neurological disorders resulting from brain damage that impairs motor function. The aim of the present study was to perform a systematic review of the literature to determine whether individuals with CP are at a greater risk of negative periodontal health outcomes compared to those without CP. Methods: This study followed the recommendations of the MOOSE guidelines. Electronic searches were conducted in the PubMed, Web of Science, Scopus, Ovid, Embase, and PsycInfo databases. Observational studies assessing periodontal outcomes in individuals with CP were included. Risk of bias was appraised using the Newcastle‐Ottawa scale. Meta‐analyses were conducted and the results were presented using standardized mean differences (SMD), odds ratios (OR), and 95% confidence intervals (CI). The strength of the evidence was also assessed. Results: A total of 316 records were retrieved from the electronic databases, 17 of which were included in the qualitative synthesis. Meta‐analyses revealed significantly higher scores in individuals with CP compared to those without CP for the oral hygiene index (SMD = 0.47 [95% CI: 0.17–0.78, I2 = 80%), gingival index (SMD = 0.75 [95% CI: 0.39–1.11], I2 = 79%), plaque index (SMD = 0.70 [95% CI: 0.07–1.33], I2 = 93%), and calculus index (SMD = 0.98 [95% CI: 0.76–1.20], I2 = 0%). However, no significant difference was found between groups for the prevalence of gingivitis (OR = 1.27 [95% CI: 0.28–5.66], I2 = 93%). The risk of bias for the outcome assessment and statistical tests was low. The strength of the evidence was deemed very low. Conclusion: Individuals with CP may experience more significant negative periodontal health outcomes compared to those without CP. [ABSTRACT FROM AUTHOR]

An 83‐year‐old woman presented with an acute course of dropped head syndrome (DHS) with muscle weakness localized to the neck. Serum calcium and intact parathyroid hormone (iPTH) levels were elevated to 12.2 mg/dL and 173 pg/mL, respectively, and 99mTc‐MIBI scintigraphy showed a hyperfunctioning parathyroid gland. Electromyography revealed myopathic features in the posterior neck extensor muscles. Primary hyperparathyroidism (PHPT)‐associated myopathy was diagnosed as the cause of the DHS. Oral administration of evocalcet ameliorated DHS and normalized the elevated serum calcium levels, whereas iPTH levels remained elevated. Subsequently, parathyroidectomy reduced the iPTH level to normal, and DHS did not flare‐up. Cases of PHPT with DHS as the initial symptom are extremely rare, and to our knowledge, this is the first report of remission of DHS with evocalcet. Therefore, serum iPTH levels may not necessarily correlate with muscle weakness. [ABSTRACT FROM AUTHOR]

Background: Dual antiplatelet therapy (DAPT) with clopidogrel is one of the initial treatment regimens for early neurological deterioration (END) in branch atheromatous disease (BAD). However, its effectiveness is affected by cytochrome P450 2C19 polymorphism. Prasugrel, with reduced cytochrome P450 2C19 interactions, has been approved for cerebrovascular diseases in Japan. Aim: To explore the efficacy of DAPT with prasugrel and with clopidogrel in preventing END. Methods: Patients with BAD, admitted within 48 h of symptom onset between June 2022 and September 2023, were enrolled. The primary endpoint was the proportion of patients with END within 7 days, which was defined as an increase of 1 point or more on the National Institutes of Health Stroke Scale (NIHSS). Patients meeting specific magnetic resonance imaging (MRI) criteria, including lesions of ≥15 mm in the lenticulostriate artery (LSA) region or infarcts extending to the ventral side of the paramedian pontine region, were included. The patients were randomly assigned to the clopidogrel with loading and prasugrel without loading groups and administered common medications. Results: The study included 9 and 10 patients in clopidogrel and prasugrel groups, of whom 56% and 50% had END, respectively. The prasugrel group had earlier exacerbations after admission (days 0–1) than that of the clopidogrel group (days 1–2). The bleeding complications of both groups were not significantly different. Conclusion: The two groups had similar proportions of patients with END, suggesting comparable efficacies of both drugs for patients with BAD. [ABSTRACT FROM AUTHOR]

Aim: Normoglycaemia was achieved in a significant proportion of Japanese participants with type 2 diabetes in two phase 3 studies of tirzepatide. This post hoc exploratory analysis aimed to identify predictive factors associated with normoglycaemia achievement. Materials and Methods: SURPASS J‐mono and SURPASS J‐combo study data were pooled for this analysis. Characteristics of participants in whom normoglycaemia [glycated haemoglobin (HbA1c) <5.7%] was achieved were summarized. Logistic regression analyses were performed with HbA1c <5.7% achievement as the target variable. Results: Of 912 participants, normoglycaemia was achieved in 553 (60.6%) following 52 weeks of tirzepatide treatment. Overall, the mean (SD) age was 56.7 (10.6) years and mean diabetes duration was 7.7 (6.0) years, and 76% of participants were men. Mean (SD) change from baseline in HbA1c and bodyweight was −2.87% (0.95) versus −2.47% (1.1) and −10.30 (5.8) kg versus −3.75 (4.3) kg for participants in whom normoglycaemia was and was not reached, respectively. Multivariate regression analyses showed that lower baseline body mass index, shorter disease duration and lower baseline HbA1c were significantly associated with higher rates of normoglycaemia achievement (p = 0.009, p = 0.008, p < 0.001, respectively) as was a tirzepatide dose of 10 or 15 mg compared with 5 mg (p < 0.001). The highest percentage of participants in whom normoglycaemia (94%) was achieved were those with lower baseline HbA1c (<8%) and the greatest weight reduction (≥15%). Conclusions: Baseline HbA1c and body mass index, disease duration and the tirzepatide treatment group were shown to be predictive factors for achieving normoglycaemia. A lower baseline HbA1c was most strongly associated with normoglycaemia achievement. [ABSTRACT FROM AUTHOR]

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

Objectives: To examine the prognosis of lower urinary tract symptoms and function after robot‐assisted radical prostatectomy (RARP) in patients with low preoperative bladder contractility. Methods: A total of 115 patients who underwent RARP were enrolled and divided into two groups by preoperative urodynamic findings: normal (patients with bladder contractility index [BCI] ≥ 100; n = 70) and low contractility (patients with BCI < 100; n = 45) groups. Lower urinary tract symptoms and function parameters were prospectively evaluated at 1, 3, 6, 9, and 12 months after RARP in both groups. Results: International Prostatic Symptom Score voiding scores 1, 3, 6, 9, and 12 months after RARP were significantly higher (p < 0.05), and the maximum flow rate (Qmax) values before and 1, 3, 9, and 12 months after RARP were significantly lower in the low contractility group (p < 0.05). Comparing preoperative and postoperative parameters, IPSS voiding scores in the normal contractility group were significantly improved from 6 months after RARP, whereas those in the low contractility group were almost unchanged. Qmax and the 1‐h pad test in both groups temporarily deteriorated 1 month after RARP, whereas voided volume and postvoiding residual volume significantly decreased from 1 to 12 months after RARP. Conclusions: This observational study showed that patients with low preoperative bladder contractility might have a weak improvement in voiding symptoms and function after RARP. [ABSTRACT FROM AUTHOR]

Aims/Introduction: Sodium–glucose cotransporter 2 (SGLT2) inhibitors effectively and safely reduce fasting and postprandial hyperglycemia while promoting weight loss. However, their unique mechanism of action contributes to concerns regarding their safety. We therefore carried out a large‐scale, non‐commercial, investigator‐initiated study on the safety and effectiveness of the SGLT2 inhibitor tofogliflozin. Materials and Methods: This multicenter, open‐label, uncontrolled, prospective observational study was carried out at hospitals and clinics across Japan in participants aged ≥20 years who were SGLT2 inhibitor‐naïve and had an established diagnosis of type 2 diabetes. The primary endpoint was adverse drug reactions (ADRs) of special interest. Secondary endpoints included all other ADRs and adverse events, glycated hemoglobin (HbA1c), and weight loss. Results: The study, carried out from June 2014 through February 2020, enrolled 11,480 participants from 1,103 medical institutions; 6,967 participants completed the 104‐week follow up. The most common ADRs of special interest were urinary and genital tract infections (1.53%), followed by volume depletion (1.25%). Hypoglycemia occurred in 27 participants (0.24%), adverse events in 1,054 (9.18%) and ADRs in 645 (5.62%). HbA1c decreased by 0.85% (95% confidence interval 0.82%–0.88%) and bodyweight decreased by 3.05 kg (95% confidence interval 2.94–3.17 kg). The HbA1c target was achieved by 51.70% of participants for target HbA1c <7.0%, 85.3% for <8.0% and 5.4% for <6.0% at week 104. Conclusions: Tofogliflozin was associated with only mild or moderate ADRs characteristic of SGLT2 inhibitors, with no unpredictable, new, serious, or high‐incidence adverse events or ADRs. This independent study confirmed the safety and effectiveness of tofogliflozin in adult type 2 diabetes patients. [ABSTRACT FROM AUTHOR]

Introduction/Aims: Multifocal motor neuropathy (MMN) is a rare disease for which epidemiological and clinical data are limited. We conducted a nationwide survey to determine disease prevalence, incidence, clinical profile, and current treatment status in Japan. Methods: A nationwide survey was conducted in 2021 using an established epidemiological method. Questionnaires were sent to all neurology and pediatric neurology departments in Japan. An initial questionnaire was administered to determine the number of patients with and incidence of MMN. A second questionnaire was administered to collect detailed clinical information. The European Federation of Neurological Societies/Peripheral Nerve Society 2010 guidelines were used as diagnostic criteria. Results: The estimated number of patients with MMN was 507. The estimated prevalence was 0.40 per 100,000 individuals. Detailed clinical profiles were available for 120 patients. The male‐to‐female ratio was 2.3:1 and the median onset age was 42 years. The median disease duration at diagnosis was 25 months. Most patients presented with upper limb‐dominant muscle weakness. Motor nerve conduction blocks were found in 62% of patients and positive anti‐GM1 IgM antibody results in 54%. A total of 117 (98%) patients received immunoglobulin therapy, and 91% of them showed improvement. At the time of the last visit (median, 82 months from treatment initiation), 89 (74%) patients were receiving maintenance immunoglobulin therapy. A slight progression of neurological deficits was observed during follow‐up. Discussion: Most patients with MMN in Japan received induction and maintenance immunoglobulin therapies, which appear to suppress long‐term disease progression. [ABSTRACT FROM AUTHOR]

Aim: To evaluate whether the use of a laxative with reduced patient burden in oral antibiotics and mechanical bowel preparation (OAMBP) could prevent surgical site infection (SSI) in left‐sided colon and rectal cancers. Methods: This multicenter, non‐blinded, randomized, non‐inferiority trial included patients who underwent elective colorectal surgery for colorectal cancer in a university and community hospital in Japan from April 1, 2021 to March 31, 2023. We compared conventional OAMBP (polyethylene glycol, metronidazole, and kanamycin) (cOAMBP group) with modified OAMBP (sodium picosulfate hydrate, metronidazole, and kanamycin) (mOAMBP group). The primary outcome was overall incidence of SSI. Secondary outcomes were postoperative complications, degree of patient burden, and intraoperative bowel dilatation. Results: Among 119 patients, 112 were randomly assigned to the two groups, with 56 patients in each group. SSI occurred in three (5.4%) and five patients (8.3%) in the mOAMBP and cOAMBP groups, respectively (90% confidence interval [CI]: −12.8–5.3), with a 15% margin of non‐inferiority. Anastomotic leakage occurred in no patient in the mOAMBP group and three patients (5.4%) in the cOAMBP group (p = 0.24). The cOAMBP group reported significantly more pain than the mOAMBP group (50 [90.9%] vs. 7 [12.5%] participants). The mOAMBP group showed significantly lesser bowel dilatation than the cOAMBP group (1 [1.8%] vs. 21 [37.5%] participants). Conclusion: mOAMBP is safe and less burdensome, can reduce intraoperative bowel dilatation, and is non‐inferior compared with cOAMBP in preventing SSI. Therefore, mOAMBP may be more suitable for sigmoid colon and rectal cancer. Trial Registration: UMIN000043162 (http://www.umin.ac.jp/ctr/). Registered on January 28, 2021. [ABSTRACT FROM AUTHOR]

Aim: Lynch syndrome (LS) is a dominantly inherited syndrome characterized by an increased risk for LS associated tumors such as colorectal cancer (CRC) and gastric cancer (GC). However, the clinical benefit of surveillance for GC remains unclear while it has already been recommended for CRC. This study aimed to elucidate the clinical features of GC in Japanese individuals with LS, and the risk of developing multiple GCs to build regional‐tailored surveillance programs in LS patients with GC. Methods: Data on Japanese individuals with LS were retrospectively collected from a single institution. The clinical features of GC, including the cumulative risk of multiple GCs, were analyzed. Results: Among 96 individuals with LS (MLH1/MSH2/MSH6, 75:20:1), 32 GC lesions were detected in 15 individuals with LS (male/female, 11:4). The median age at initial GC diagnosis was 52.7 y (range: 28–71). Histological examination revealed a predominance of intestinal type (19/24: 87.5%). Moreover, the majority of the GC lesions (82%) were determined to have high‐frequency of microsatellite instability. The cumulative risk of individuals with LS developing GC at 70 y was 31.3% (MLH1 36.1%, MSH2 18.0%). Notably, the cumulative risk of individuals with LS developing metachronous and/or synchronous GCs at 0, 10 and 20 y after initial diagnosis of GC was 26.7%, 40.7%, and 59.4%, respectively. Conclusion: Due to a higher risk of developing multiple GCs, intensive surveillance might be especially recommended for Japanese individuals with LS associated initial GC. [ABSTRACT FROM AUTHOR]

Introduction: Fluorine 18‐fluoro‐glucose positron emission tomography/computed tomography (18F‐FDG PET/CT) is commonly used for the staging of head and neck cancer. This study aimed to evaluate the correlation between 18F‐FDG PET/CT, haematological parameters and prognosis in patients with advanced head and neck cancer. Methods: This was a single‐institutional retrospective study of 83 patients with advanced head and neck squamous cell carcinoma (HNSCC) who underwent 18F‐FDG PET/CT imaging before initial treatment between 2014 and 2018. 18F‐FDG PET/CT after treatment was performed in 57 patients. The prognostic parameters of the pre‐ and post‐treatment maximum standardised uptake value (SUVmax), metabolic tumour volume (MTV), total lesion glycolysis (TLG) of primary tumours and haematological parameters were analysed to evaluate the association between overall survival (OS) and progression‐free survival (PFS). Results: Pre‐MTV, pre‐TLG and post‐SUVmax were significantly associated with poor OS and PFS (p < 0.05). Haematological parameters, including pretreatment neutrophil/lymphocyte ratio and C‐reactive protein/albumin ratio, were associated with 18F‐FDG PET/CT parameters. In multivariate analysis, post‐SUVmax was an independent prognostic factor for OS and PFS. Conclusion: A correlation between PET/CT metabolic and haematological parameters was observed. The volume and intensity of 18F‐FDG uptake region, in addition to haematological parameters, are feasible markers for predicting the progression of HNSCC in daily practice. Further, post‐SUVmax could be an independent parameter for predicting poor survival. [ABSTRACT FROM AUTHOR]

Pancreatic ductal adenocarcinoma (PDAC) is a fatal malignancy due to the difficulty in diagnosis and poor prognosis because of the high recurrence rate, necessitating reliable biomarkers to improve the diagnosis and prognosis. However, the existing markers have limitations. We previously identified extracellular vesicles (EVs) recognized by O‐glycan‐binding lectins (Amaranthus caudatus agglutinin [ACA]) as a novel diagnostic biomarker for PDAC using an EV‐counting system (ExoCounter). This retrospective study analyzed changes in ACA‐positive EVs in perioperative PDAC serum and its association with prognosis using ExoCounter. Absolute EV levels in the pre‐ and postoperative sera of 44 patients who underwent curative pancreatectomy for PDAC were quantified using ExoCounter. The carbohydrate antigen 19‐9 levels declined in most samples postoperatively, and presented no correlation with poor prognosis. In contrast, ACA‐positive EVs increased in serum at 7 days postoperatively in 27 of 44 patients (61.4%). We therefore divided participants with ACA‐positive EVs before and after surgery into elevation and decline groups. The overall survival (OS) and recurrence‐free survival (RFS) of patients with higher ACA‐positive EVs were significantly shorter than those with lower ACA‐positive EVs (26.1 months vs. not reached, P = 0.018; 11.9 vs. 38.6 months, P = 0.013). Multivariable analysis revealed that ACA‐positive EV elevation in postoperative serum was an independent prognostic factor for poor OS (hazard ratio [HR] = 3.891, P = 0.023) and RFS (HR = 2.650, P = 0.024). The detection of ACA‐positive EVs in perioperative serum may be used to predict the prognosis of PDAC in the early postoperative period. [ABSTRACT FROM AUTHOR]

We investigated the detailed characteristics and proportions of typical and atypical rashes in 28 patients with adult‐onset Still's disease (AOSD) by retrospectively examining the clinical symptoms and pathological features. The patients consisted of six males and 22 females aged between 23 and 85 years. The skin rashes observed in the study population were as follows: (i) typical rash in six cases, (ii) atypical rash in 19, and (iii) both typical and atypical rash in three cases (in all three cases, typical rash preceded atypical rash). Furthermore, we classified atypical rashes into persistent pruritic papules and plaques (PPPP) and others. In 22 cases of atypical rashes, 10 cases had PPPP. In a comparison between young‐onset (<65 years) (n = 16) and elderly‐onset (≥65 years) (n = 12) AOSD cases, typical rashes were observed more frequently in the young‐onset cases. Regarding atypical rashes, PPPP was significantly more common in the elderly‐onset cases. [ABSTRACT FROM AUTHOR]

Tasikmadu is a newly discovered porphyry Cu–Au prospect in the eastern Sunda arc, Indonesia. This study aimed to elucidate salient diagnostic characteristics and ore‐forming conditions of the prospect. Fieldwork and various laboratory analyses for a suite of representative samples were performed for mineralogy, bulk‐geochemistry, mineral chemistry and ore fluid characterization. The study area is composed of three diorite porphyries, that is, fine‐grained, medium‐grained and coarse‐grained diorite porphyry, respectively. The intrusions are calc‐alkaline with a high Sr/Y value, which is similar to many ore‐bearing intrusions in the eastern Sunda arc. Ore mineralization occurs in quartz veins and veinlet stockwork, centred in the potassic zone, and dominated by chalcopyrite and bornite occurring in A and B veins, which cut earlier barren (EB) and M veins. The mineralization core has an average grade of 0.63 wt% Cu and 0.25 ppm Au, respectively. Outwardly, the potassic zone changes to the propylitic zone, which still bears copper in the quartz and pyrite veinlets, although the grade is low. Fluid inclusion microthermometry revealed that the A and B veins in the potassic zone formed at 464 and 390°C by hypersaline boiling fluids, respectively. The temperature temporally and spatially decreased, that is, in the propylitic zone, the quartz veinlets formed at 260–400°C. Hypogene mineralization that formed the A veins occurred at 1.5 km below the palaeosurface, indicating a relatively shallow depth as a porphyry deposit. Nevertheless, the δ34SCDT values of sulphides range from −2.0 to −0.1‰, inferring a magmatic origin. The Tasikmadu prospect shares some similarities compared with other porphyry deposits worldwide, but it also reveals unique characteristics that differ from others, for example, potassic‐altered rocks are only typified by secondary biotite without/rare secondary K‐feldspar reflecting the lack of magma contamination by continental crustal components. In addition, current surface geological features and shallow depth erosion level of the prospect may imply that the potential of Cu–Au mineralization underneath is still open to depth. [ABSTRACT FROM AUTHOR]