Search

A recent study showed that generating local crystalline paths within a glassy matrix provides only a moderate increase in thermal conductivity until the path fills most of the total volume. It was indicated that percolation theory governs the thermal conductivity in such crystalline‐implanted glass composites. In this study, we use computer simulations to investigate the effect of partial vitrification by breaking structural order of silica crystals by local vitrification. Such locally vitrified crystal structures are made by the bond‐transposition method, where the extent of vitrification can be tuned. Also, we test melt‐quenching of three SiO2 crystalline structures (α‐quartz, coesite, and stishovite) to make silica glasses with different densities. The cooling rates and pressures were varied during the melting process in order to obtain glass structures with varied degrees of order. Our results show that the thermal conductivity of silica glasses calculated using Green–Kubo relation decreases rapidly as soon as the crystallinity is disturbed by bond transition or generated local glassy phase. This implies the phonon mean free path rapidly shrinks with even a small number of scatterers, regardless of the original polymorph. Through the investigation of the pressure effect, a strong proportional relation between the thermal conductivity and the density is found among all silica samples. Such correlation can be accounted by assuming a constant integral term in the Green–Kubo relation without the volume scaling, which is reasonable based on a weak dependence of κV on the density of silica glass except with a slight increase at low quench pressures. We hypothesize that when the quench pressure increases moderately, an increase of characteristic ring size tends to generate a more flexible SiO2 structure which results more phonon scattering. Green–Kubo modal analysis further shows that the contribution from modes at low frequencies is suppressed when SiO2 is melt‐quenched at higher pressure and vice versa. [ABSTRACT FROM AUTHOR]

The shortage of surgeons in rural hospitals is a serious problem in Japan. In this study, we investigated the potential contribution of surgical telementoring systems to improving surgical skills and resolving the shortage of surgeons in rural hospitals. The conference room at Tokushima University was connected to the operating room at Miyoshi Hospital, a rural hospital approximately 75 km away, via a virtual private network. Telementoring was conducted for surgeries performed at Miyoshi Hospital from Tokushima University using ADMENIC ANNOTATOR (Carina Corporation). A questionnaire using the NASA Task Load Index was completed by two surgeons who received remote instruction. The surgeries when using the surgical telementoring system had significantly better “mental”, “performance”, and “frustration” scores compared with those performed without using the system. In a questionnaire about the surgical telementoring system, both surgeons did not notice a communication delay and indicated that annotation and voice instruction was easier to understand than voice only. In addition, fifty fifth‐year medical students completed a questionnaire. After experiencing the surgical telementoring system, the number of students who responded favorably to working in a rural hospital increased from 22 (44%) to 31 (62%) (p < 0.01). Surprisingly, 10 of the 27 students who were not interested in becoming a surgeon indicated that they were now interested in becoming a surgeon (p < 0.01). This study suggests that the introduction of a surgical telementoring system in rural hospitals may help improve the skills of rural surgeons and contribute to eliminating the maldistribution and shortage of surgeons in the future. [ABSTRACT FROM AUTHOR]

Objective: Despite being reported safety, the advantages of transanal minimally invasive proctocolectomy (TAMIP) are controversial, and comparative studies on postoperative defecation function between ileal pouch‐anal anastomosis (IPAA) using laparoscopic transanal manipulation (TAMIP‐IPAA) and without this technique (traditional IPAA) are lacking. This study analyzed TAMIP's impact on short‐term and postoperative defecation function in patients with ulcerative colitis (UC) to evaluate its safety and feasibility. Methods: Inclusion criteria comprised patients with UC undergoing minimally invasive proctocolectomy at our hospital from May 2014 to May 2023. The TAMIP‐IPAA approach involved precise rectal mucosa removal while preserving the sphincter muscle during laparoscopic transanal manipulation. Results: In the evaluation of short‐term outcomes for 71 patients undergoing proctocolectomy, the TAMIP group (37 patients) outperformed the non‐TAMIP group in operative time (395 vs. 289 min, p < 0.001) and postoperative hospital stay (12 vs. 8 days, p < 0.001). Additionally, TAMIP‐IPAA demonstrated advantages over traditional IPAA (seven patients), in operative time (443 vs. 289 min, p = 0.006), intraoperative blood loss (392 vs. 130 mL, p = 0.001), postoperative hospital stay (18 vs. 8 days, p = 0.003), anastomotic leakage (42.9% vs. 8.1%, p = 0.041), and re‐admission within 30 days (57.1% vs. 8.1%, p = 0.009). Wexner scores were significantly superior in the TAMIP‐IPAA group at 6 months (14.5 vs. 8.0 points, p = 0.029) and 1 year post stoma closure (14.0 vs. 7.0 points, p = 0.020), indicating enhanced short‐term outcomes and defecation function compared to traditional IPAA. Conclusions: TAMIP‐IPAA for UC has the potential to offer promising benefits, including the enhancement of short‐term outcomes and the improvement of defecation function. [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]

Objectives: This study aimed to quantify the submandibular gland in suppurative sialadenitis, primary Sjögren's syndrome (pSS) and radiation‐induced sialadenitis using the apparent diffusion coefficient (ADC) for differential diagnosis. Subjects and Methods: This retrospective study included 16 patients with suppurative sialadenitis (n = 9), pSS (n = 3) and radiation‐induced sialadenitis (n = 4) who underwent magnetic resonance imaging between June 2006 and May 2022. The ADC of the submandibular glands in each state was calculated, and the differences were analysed using a one‐way analysis of variance and Tukey's post hoc test. Receiver operating characteristic curves were used to assess the ability of the ADC to distinguish each condition. Statistical significance was set at p < 0.05. Results: The mean ADC value (×10−3 mm2/s) ± standard deviation in the control (non‐affected side of the suppurative sialadenitis group), suppurative sialadenitis, pSS and radiation‐induced groups were 0.94 ± 0.16, 1.24 ± 0.16, 1.33 ± 0.13 and 1.5 ± 0.12, respectively (p < 0.001). The diagnostic value for distinguishing each group was ≥0.75. Conclusion: ADC values are useful for quantitatively assessing and distinguishing submandibular glands in suppurative sialadenitis, primary Sjögren's syndrome and radiation‐induced sialadenitis. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to apply diffusion‐weighted imaging to the evaluation of cervical lymph nodes affected by medication‐related osteonecrosis of the jaw (MRONJ). Methods: This retrospective study analysed the diffusion‐weighted imaging data of 70 patients with or without MRONJ (Stages 0–3). The mean apparent diffusion coefficient (ADC) values of the submandibular (level IB) and superior internal jugular (level IIA) nodes in the control and MRONJ groups were calculated, and differences were analysed using the Mann–Whitney test. Moreover, receiver operating characteristic (ROC) curve analysis was performed to evaluate the ability of ADC values to predict lymph nodes that were affected by MRONJ. p < 0.05 was considered statistically significant. Results: The median [interquartile range] (×10−3 mm2/s) of level IB was 0.74 [0.7–0.81] and 0.93 [0.84–1.09] and that of level IIA was 0.79 [0.76–0.85] and 0.97 [0.84–1.06] in the control and MRONJ groups respectively. ROC analysis revealed that the ADC value had excellent ability to discriminate between the control and MRONJ groups. Conclusions: The study findings indicate that diffusion‐weighted imaging can contribute to differentiation of MRONJ from other cervical lymph node diseases and facilitate early detection of MRONJ. [ABSTRACT FROM AUTHOR]

Objectives: Inguinal hernia (IH) is a common postoperative complication after robot‐assisted radical prostatectomy (RARP). We developed a novel clipping technique for the prevention of IH developing after RARP. Methods: This cohort included 759 consecutive patients who underwent RARP for prostate cancer at the University of Tokyo Hospital between January 2011 and December 2018. We reviewed clinical parameters and identified the risk factors of postoperative IH. The prophylactic preventive procedure of IH development was performed by clipping the peritoneum and underlying tissue around the internal inguinal ring using Hem‐o‐Lok clip to prevent the prolapse of the intestine through the internal inguinal ring. Results: In total, 236 patients received the clipping procedure. The median follow‐up time was 50 months. The incidence rate of IH was 10.8% (78/720). The median time to the diagnosis of IH was 10 months. Univariate analysis revealed that patients with higher age (age ≥ 63), low BMI (BMI < 25 kg/m2), and lower number of surgical experiences (Surgical experience < 40) showed a significantly higher odds ratio of developing IH. Multivariate analysis showed that "BMI < 25 kg/m2" and "Surgical experience < 40" were independent predictive factors of IH. Among the patients with a high risk of IH due to receiving surgery from inexperienced surgeons, there was a statistically significant preventive effect for the patients with "BMI ≥ 25 kg/m2" by the novel clipping procedure. Conclusions: The novel clipping procedure reduced the risk of post‐operative IH in obese patients when the RARP was performed by inexperienced surgeons. [ABSTRACT FROM AUTHOR]

Many of the egg cases of oviparous chondrichthyans remain unknown and undescribed in the literature. Egg cases can be a useful taxonomic character for species distinction and can be a valuable indicator of a species distribution in the field. In this study, the egg cases for 9 of the 10 nominal species of Heterodontus are described and compared, and the terminology and methodology for studying them are standardized. Heterodontus egg cases are distinct and easily identifiable from other oviparous egg cases by having a unique corkscrew shape formed by a pair of lateral keels spiraling along its length. Heterodontus egg cases range between 7.5 and 14.5 cm in egg case length, 3.7 and 5.8 cm in egg case width at midportion, and have 0.75–4 complete rotations. Morphometric measurements of egg cases from the nine species were subjected to multivariate analysis, with unique characters enabling distinction between them. Egg cases can be separated into three morphotypes: the “wide keels lacking tendrils” group, the “narrow keels with tendrils” group, and the “wide keels with tendrils” group. The egg case of Heterodontus ramalheira remains unknown. [ABSTRACT FROM AUTHOR]

Summary: This study aimed to determine whether objective sleep time is associated with the concentrations of various plasma cytokines in older adults with mild cognitive impairment (MCI). In total, 118 adults with MCI (66 women; mean age: 75.7 years) participated in this prospective cohort study. All participants were required to wear a wristband sensor for 7.8 days, on average, every 3 months for 1 year and undergo measurement of 27 plasma cytokines using multiplex immunoassays. After adjusting for potential confounders, the associations of total sleep time with cytokine concentrations were assessed by multiple linear regression analysis. The total sleep time was significantly correlated with plasma interleukin (IL)‐9 and macrophage inflammatory protein (MIP)‐1β levels (r = 0.239, p = 0.009, and r = 0.242, p = 0.008, respectively). Moreover, these associations remained significant after adjusting for covariates, including demographic characteristics, lifestyle‐related diseases, and apolipoprotein E status (β = 0.272, 95% confidence interval: 0.095–0.448, p = 0.003, and β = 0.27, 95% confidence interval: 0.092–0.449, p = 0.003, respectively). Thus, this study is the first to demonstrate the association between objective prolonged sleep and higher plasma IL‐9 and MIP‐1β levels in older adults with MCI. [ABSTRACT FROM AUTHOR]

Introduction: Robotic surgery without contact‐force feedback could be less safe, as forces exerted by the robot system may exceed tissue tolerance. This study aimed to evaluate the benefit of contact‐force feedback. Methods: Nine junior and 11 senior surgeons performed two tasks using Saroa, a robotic surgical system with a force feedback function. In Task A, the participants estimated the order of stiffness of substances when feedback was on and off. In Task B, the effect of feedback on compression with a designated force (3 N) was assessed. Results: In Task A, the proportion of participants who correctly estimated the order of stiffness of the substances was similar when feedback was on and off. However, the median maximum force applied to the substances was significantly smaller when feedback was on than when it was off (5.0 vs. 6.9 N, p =.011), which was more obvious among the junior surgeons (5.0 vs. 7.7 N, p =.015) than among the senior surgeons (4.7 vs. 5.9 N, p =.288). In Task B, deviations from the designated force (3 N) for three substances were smaller when feedback was on (0, −0.1, and 0.7, respectively) than when it was off (−0.3, −0.5, and 1.3, respectively). Regarding the dispersion of the force to the substances, the interquartile range tended to be smaller with feedback; this trend was more obvious in the junior surgeons. Conclusion: With contact‐force feedback, tissue stiffness could be estimated with a small force, particularly by the junior surgeons; specified force could be accurately applied to the tissue. [ABSTRACT FROM AUTHOR]

Vertebrate embryos are protected from bacterial infection by various maternally derived factors, yet little is known about the defence mechanisms in elasmobranchs. This study aimed to characterize the intracapsular environment of freshly laid eggs of the oviparous catshark (Scyliorhinus torazame) by investigating the microbial abundance and microbiota to understand its potential contribution to embryonic defence. The egg capsule of oviparous elasmobranchs is tightly sealed until pre‐hatching, after which seawater flows into the capsule, exposing the embryos to the surrounding seawater. We found that early embryos were highly vulnerable to environmental pathogens, suggesting that the embryos are somehow protected from infection before pre‐hatching. Indeed, the intracapsular environment of freshly laid eggs exhibited significantly low bacterial density, maintained until pre‐hatching. Furthermore, the microbiome inside eggs just after oviposition differed markedly from those of rearing seawater and adult oviducal gland epithelia; these eggs were predominantly populated by an unidentified genus of Sphingomonadaceae. Overall, this study provides compelling evidence that early embryos of oviparous cloudy catshark are incubated in a clean intracapsular environment that potentially plays a significant role in embryonic development in oviparous elasmobranchs. [ABSTRACT FROM AUTHOR]

Background: The use of robotic surgery (RS) for gastric cancer (GC) has been rapidly increasing. However, the utility of RS for advanced GC (AGC), especially T3 or more AGC, is unclear. Methods: Ninety patients who underwent curative upfront minimally invasive surgery (MIS) (D2 lymph node dissection) for fStage II or III GC were enrolled in this study. Among these patients, 68 underwent MIS for T3 or more AGC. Thirty‐six patients underwent RS, and 32 patients underwent laparoscopic surgery (LS). The short‐term and long‐term surgical outcomes were compared between the two groups. Results: In the T3 or more AGC cohort, there were no significant intergroup differences in the operative time or blood loss volume. The number of retrieved lymph nodes tended to be higher in the RS than LS group (38.5 vs. 33.0, p =.11). The drain amylase content on postoperative day 1 was significantly lower in the RS than LS group (243.5 vs. 521.0 IU/L, p <.01). The morbidity rate (Clavien–Dindo grade ≥2) was similar between the groups. There were no significant differences between the LS and RS groups in the 3‐year overall survival rate (80.7% vs. 74.5%, respectively; p =.95) or 3‐year disease‐free survival rate (75.0% vs. 69.7%, respectively; p =.95). Conclusions: RS for primary T3 or more AGC was safe and contributed to similar short‐term and long‐term outcomes compared with LS. [ABSTRACT FROM AUTHOR]

This article provides guidelines for qualified surgeons on endoscopic surgery procedures related to the stomach. It focuses on laparoscopic surgery for conditions such as gastroduodenal ulcer perforation, gastric gastrointestinal stromal tumor (GIST), gastric cancer, and gastric/esophagogastric junction cancer. The guidelines discuss the outcomes, benefits, and risks of these procedures, emphasizing the need for further research and skilled supervision. The article also mentions the use of laparoscopic gastric restrictive surgery for improving quality of life in Stage I gastric cancer patients and recommends laparoscopic gastric restrictive surgery and robotic gastrectomy for severe obesity and gastric cancer, respectively. It emphasizes the importance of adhering to specific criteria and requirements when performing these procedures. [Extracted from the article]

Background and Aim: Serum interleukin‐6 (IL‐6) before the administration of atezolizumab plus bevacizumab (Atez + Bev) is a prognostic biomarker in patients with hepatocellular carcinoma (HCC) treated with Atez + Bev. We previously revealed that the neutrophil‐to‐lymphocyte ratio and serum chemokine levels during treatment with Atez + Bev were more useful as prognostic biomarkers. Therefore, we examined the predictive ability of serum IL‐6 for the efficacy of Atez + Bev in patients with HCC. Methods: We enrolled 94 patients with HCC who received treatment with Atez + Bev. Initial responses were assessed through dynamic computed tomography or magnetic resonance imaging. The levels of IL‐6 in serum were measured before and at the initiation of the second course of Atez + Bev. Subsequently, the relationship of IL‐6 levels with treatment efficacy was evaluated. Results: IL‐6 levels at the initiation of the second course tended to be higher in patients with progressive disease versus those with non‐progressive disease in the initial evaluation (P = 0.054). Moreover, the cutoff value (7.4 pg/mL) was useful in stratifying patients by overall survival (i.e. low vs high: not reached vs 21.4 months, respectively, P = 0.001) and progression‐free survival (low vs high: 11.9 vs 5.2 months, respectively, P = 0.004). This result was reproduced in patients with HCC who received Atez + Bev as first‐line therapy. In the multivariate analyses, IL‐6 levels at the initiation of the second course were independent predictive factors for progression‐free and overall survival. Conclusions: Serum levels of IL‐6 at the initiation of the second course of treatment may predict Atez + Bev efficacy and prognosis in HCC. [ABSTRACT FROM AUTHOR]

We present a unique case of metastatic metaplastic breast carcinoma responding dramatically to immunochemotherapy. A 46‐year‐old Japanese woman with primary metaplastic carcinoma of the breast, which was immunohistochemically confirmed to be triple‐negative breast cancer, underwent radical surgery, followed by adjuvant chemotherapy with an anthracycline and a taxane. Since multiple lung metastases were detected two months post‐chemotherapy and the primary site was shown to be PD‐L1‐positive, the immune checkpoint inhibitor (ICI) pembrolizumab plus gemcitabine/carboplatin was initiated. While the treatment was discontinued after 15 days due to suspected drug‐induced pneumonitis, the lung metastases significantly shrank with no development of new lesions for three months. The patient remained alive as of approximately 15 months after the recurrence date. This case highlights the potential of immunochemotherapy in treating metaplastic breast carcinomas. [ABSTRACT FROM AUTHOR]

As the clinical course of systemic sclerosis (SSc) varies widely, prognostic indicators have been sought to predict the outcomes of individual patients. Racial differences in SSc render it necessary to validate prognostic indicators in different patient cohorts. In this study, we aimed to assess clinical and laboratory parameters in Japanese patients with early‐stage SSc with diffuse cutaneous involvement and/or interstitial lung disease, and identify predictive factors for disease progression. We performed multivariate analyses of baseline clinical information to estimate symptoms 4 years later in Japanese patients with diffuse cutaneous SSc and/or SSc with interstitial lung disease. Patients were enrolled in the study within 5 years of disease onset at 10 Japanese SSc centers. Over 12 years, 115 patients followed up for 4 years were included in this study. The modified Rodnan skin score (mRSS) at 4 years correlated with the baseline mRSS and finger‐to‐palm distance, defined as the average length from the distal tip of the fourth finger to the distal palmar crease. The percentage predicted vital capacity (%VC) in year 4 positively and negatively correlated with initial %VC and the presence of anti‐topoisomerase I antibodies, respectively. The Health Assessment Questionnaire Disability Index (HAQ‐DI) at 4 years was positively and negatively associated with baseline HAQ‐DI and %VC, respectively. The occurrence of digital ulcers within 4 years was associated with the initial presence of digital ulcers, finger‐to‐palm distance, and the presence of digital pitting scars and anti‐topoisomerase I antibodies. This study identified several factors that may predict the progression of early‐stage SSc in Japanese patients. Finger‐to‐palm distance may be a useful tool for predicting the progression of skin thickening and the development of digital ulcers in the early stages of severe SSc, but larger, long‐term prospective studies are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the apparent diffusion coefficient (ADC) values of normal salivary glands and acute submandibular sialadenitis (SS). Methods: This retrospective study included 22 patients who underwent magnetic resonance imaging (MRI) at the Nihon University School of Dentistry between February 2018 and May 2022. ADC values were compared between the acute SS and control group. Data with non‐normality confirmed by Shapiro–Wilk test was analyzed using the Mann–Whitney U test, Spearman's correlation coefficient, and a receiver operating characteristic (ROC) curve. Statistical significance was set at p < 0.05. Results: The mean ADC values were 1.03 ± 0. 09 × 10−3 and 1.22 ± 0.17 × 10−3 mm2/s in the normal and acute SS groups, respectively (p < 0.001). ROC analysis revealed a cutoff ADC value of 1.1 for distinguishing acute SS from the normal. Conclusion: These findings suggest that ADC values are useful for the quantitative assessment of acute SS. [ABSTRACT FROM AUTHOR]

Objective: It has recently been suggested that the formation of pulmonary vein stump thrombus (PVST) after anatomical lung resection is an underlying cause of arterial thromboembolism including cerebrovascular infarction. This study aimed to investigate the incidence and risk factors of PVST and to evaluate the efficacy and safety of anticoagulant therapy for PVST. Methods: Patients who underwent anatomical lung resection for malignant lung tumors were eligible for inclusion in this study. Chest contrast‐enhanced (CE) computed tomography (CT) was performed after surgery to detect PVST. If PVST was observed, patients received anticoagulant therapy. The size of the PVST was followed‐up by repeated chest CE‐CT. Results: In total, 176 patients were enrolled in this study. Chest CE‐CT was performed on postoperative day 1–13 (median, postoperative day 6). PVST was detected in 22 (12.5%) patients. The median size of PVST was 9.5 (4.1–33.4) mm. Thrombus was most commonly observed in patients who underwent left upper lobectomy (9/36, 25.0%). Hypertension, dyslipidemia, arteriosclerosis, and arrhythmia were not associated with PVST formation. Anticoagulant therapy was administered to all 22 patients with PVST until the PVST disappeared. The median duration between the detection and disappearance of PVST was 77 days (range: 6–146 days). During the period between the detection and disappearance of PVST, cerebrovascular infarction or arterial thromboembolic events were not observed. Conclusions: Postoperative PVST is commonly observed, especially in patients who undergo left upper lobectomy. Anticoagulant therapy for PVST was safely introduced and was efficient to improve PVST without subsequent arterial thromboembolic events. [ABSTRACT FROM AUTHOR]

The topological and morphological changes of the (001) surface of single‐crystal (La0.3Sr0.7)(Al0.65Ta0.35)O3 during treatment with high‐purity deionized water (DI) have been investigated by atomic force microscopy and scanning transmission electron microscopy (STEM). Etching by DI treatment at room temperature proceeded mainly in anisotropic etching mode, resulting in rectangular etch pits with {001} inner surfaces forming in the surface. The dominant etching mode changed from anisotropic to isotropic with increasing DI‐treatment temperature, and the lowest surface roughness occurred for DI treatment at 50°C for 60 min. Direct observation of the atomic structure of the surface by STEM showed that the etched surface was the B‐site‐terminated (001) surface after anisotropic etching at 50°C for 60 min, in which the B‐site‐terminated atomic layer was found to maintain the B‐site ordered structure existing in the crystal. This is because DI treatment, which does not require high‐temperature heat treatment of the substrate, suppresses element diffusion, sublimation, and formation of point defects on and in the vicinity of the surface. [ABSTRACT FROM AUTHOR]

In a fusion DEMOnstration reactor (DEMO)‐relevant scrape‐off layer plasma (SOL), whose collisionality is lower than in the SOLs of present‐day tokamaks, kinetic effects are predicted to reduce the plasma heat conductivity along the magnetic field below the value obtained with the classical Spitzer–Harm model. As a part of ongoing efforts to improve the predictive capability of SOL heat transport calculations, we have implemented the non‐local heat flux model proposed by [Luciani, Mora and Virmont, Phys. Rev. Lett. 51 (1983) 1664–1667] (here referred to as the LMV model) in the integrated SOL–divertor simulation code SONIC in order to account for the kinetic effect on the heat conduction due to the parallel streaming of rapidly moving particles. Our transport simulations for the Japanese demonstration tokamak reactor concept, JA DEMO, show that the LMV model yields a significantly reduced ion parallel conductive heat flux density both on the low‐ and high‐field side of the upstream SOL. The heat flux obtained with the LMV model seems to be consistent with earlier kinetic simulations of tokamak ion transport. As a consequence of the reduced heat flux, a significant increase in the ion temperature and a decrease in the density have also been found over a broad area of the upstream SOL. [ABSTRACT FROM AUTHOR]

By taking advantage of forward genetic analysis in mice, we have demonstrated that Pak1 plays a crucial role during DMBA/TPA skin carcinogenesis. Although Pak1 has been considered to promote cancer development, its overall function remains poorly understood. To clarify the functional significance of Pak1 in detail, we sought to evaluate the possible effect of an allosteric inhibitor against PAK1 (NVS‐PAK1‐1) on a syngeneic mouse model. To this end, we established two cell lines, 9AS1 and 19AS1, derived from DMBA/TPA‐induced squamous cell carcinoma (SCC) that engrafted in FVB mice. Based on our present results, NVS‐PAK1‐1 treatment significantly inhibited the growth of tumors derived from 9AS1 and 19AS1 cells in vitro and in vivo. RNA‐sequencing analysis on the engrafted tumors indicates that NVS‐PAK1‐1 markedly potentiates the epidermal cell differentiation and enhances the immune response in the engrafted tumors. Consistent with these observations, we found an expansion of Pan‐keratin‐positive regions and potentially elevated infiltration of CD8‐positive immune cells in NVS‐PAK1‐1‐treated tumors as examined by immunohistochemical analyses. Together, our present findings strongly suggest that PAK1 is tightly linked to the development of SCC, and that its inhibition is a promising therapeutic strategy against SCC. [ABSTRACT FROM AUTHOR]

Background and Purpose: Bardoxolone methyl (2‐cyano‐3,12‐dioxooleana‐1,9(11)‐dien‐28‐oic acid methyl ester, CDDO‐Me) is a potent activator of nuclear factor erythroid 2‐related factor 2 (Nrf2), which induces the expression of antioxidative‐associated genes. CDDO‐Me exerts protective effects against chronic inflammatory diseases in the kidneys and lungs. However, its pharmacological effects on metabolic dysfunction‐associated steatohepatitis (MASH) caused by fat accumulation remain unknown. In this study, we examined the hepatoprotective effects of CDDO‐Me in a diet‐induced MASH mouse model and elucidated its pharmacological mechanisms using RNA‐seq analysis. Experimental Approach: CDDO‐Me was orally administered to mice fed a choline‐deficient, L‐amino acid‐defined, high‐fat diet (CDAHFD), and histological, biochemical, and transcriptomic analyses were performed on livers of mice that developed MASH. Key results: CDDO‐Me administration induced the expression of antioxidant genes and cholesterol transporters downstream of Nrf2 and significantly prevented the symptoms of MASH. Whole‐transcriptome analysis revealed that CDDO‐Me inhibited the inflammatory pathway that led to phagocyte recruitment, in addition to activating the Nrf2‐dependent pathway. Among inflammatory pathways, CC chemokine ligands (CCL)3 and CCL4, which are downstream of NF‐κB and are associated with the recruitment of macrophages expressing CC chemokine receptors (CCR)1 and CCR5, were released into the blood in MASH mice. However, CDDO‐Me directly inhibited the expression of CCL3‐CCR1 and CCL4‐CCR5 in macrophages. Conclusions and Implications: Overall, we revealed the potent hepatoprotective effect of CDDO‐Me in a MASH mouse model and demonstrated that its pharmacological effects were closely associated with a reduction of macrophage infiltration, through CCL3‐CCR1 and CCL4‐CCR5 inhibition, in addition to Nrf2‐mediated hepatoprotective effects. [ABSTRACT FROM AUTHOR]

Lots of process systems such as chemical plants contain time‐delay and nonlinearity. In particular, there are some cases that such a time‐delay cannot be known in advance. Then, it is not easy to obtain good control performance under such situations. The database‐driven PID control method has been proposed as an effective control method for nonlinear systems, but this method also cannot achieve good control performance for time‐delay systems. In this paper, a design of database‐driven controllers for a nonlinear system with unknown time‐delay is newly proposed. Moreover, the effectiveness of the proposed scheme is verified by a simulation example. © 2024 The Author(s). IEEJ Transactions on Electrical and Electronic Engineering published by Institute of Electrical Engineers of Japan and Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

Research on predator–prey interactions between sharks and cetaceans remain limited. Here, we report on a video of a shortfin mako shark circling a finless porpoise with a damaged caudal fin in the Seto Inland Sea, Japan. The finless porpoise was neither emaciated nor inactive, but unable to swim effectively due to the complete lack of a caudal fin. Some circumstantial evidence, including a bite mark on the porpoise's head, strongly suggests that the mako shark attacked it. Furthermore, the possible time difference between the two injuries the porpoise sustained may reflect the shark's hunting tactics. While mako sharks primarily feed on small fish and cephalopods, this observation suggests they also may prey on live cetaceans more often than previously thought. [ABSTRACT FROM AUTHOR]

This article discusses a study that aimed to develop a liquid biopsy assay using exosomal microRNAs (exo-miRNAs) to predict the response to first-line systemic chemotherapy in patients with metastatic gastric cancer (mGC). The study involved a biomarker discovery phase, biomarker training, and biomarker validation. The exo-miRNA panel demonstrated a robust ability to predict non-responders to chemotherapy, and it was found to be an independent predictor for lack of response in patients with mGC. The study also confirmed the functional relevance of the miRNA biomarkers and highlighted their potential in precision medicine for mGC. However, the study had limitations in terms of sample size and patient population, and further validation is needed. [Extracted from the article]

There is no optimal reconstruction after radical distal esophagectomy for cancers of the esophagogastric junction. We designed a novel reconstruction technique using pedicled ileocolic interposition with intrathoracic anastomosis between the esophagus and the elevated ileum. Two patients underwent the surgery. Case 1 was a 70‐year‐old man with esophagogastric junction adenocarcinoma with 3 cm of esophageal invasion. Case 2 was a 70‐year‐old man with squamous cell carcinoma of the esophagogastric junction; the epicenter of which was located just at the junction. These two patients underwent radical distal esophagectomy and pedicled ileocolic interposition with intrathoracic anastomosis. They were discharged on postoperative days 17 and 14, respectively, with no major complication. Pedicled ileocolic interposition is characterized by sufficient elevation and perfusion of the ileum, which is fed by the ileocolic artery and vein. As a result, we can generally adapt this reconstruction method to most curable esophagogastric junction cancers. [ABSTRACT FROM AUTHOR]

Aim: Quality of care is important to reduce disease progression, and improve both survival and quality of life. The Japan Society of Gynecologic Oncology has published treatment guidelines to promote standardized high‐quality care for ovarian cancer in Japan. We developed quality indicators based on the guideline recommendations and used them on large datasets of health service use to examine the quality of ovarian cancer care. Methods: A panel of experts developed the indicators using a modified Delphi method. Adherence to each indicator was evaluated using data from a hospital‐based cancer registry of patients diagnosed in 2018. All patients receiving first‐line treatment at participating facilities were included. The adherence rates were returned to participating hospitals, and reasons for nonadherence were collected. A total of 580 hospitals participated, and the study examined the care received by 6611 patients with ovarian cancer and 1879 with borderline tumors using 11 measurable quality indicators. Results: The adherence rate ranged from 22.6% for "Estrogen replacement within 6 months of operation" to 93.5% for "Bleomycin, etoposide, and cisplatin for germ cell tumor more than Stage II." Of 580 hospitals, 184 submitted the reasons for nonadherence. Conclusions: The quality of ovarian cancer care should be continuously assessed to encourage the use of best practices. These indicators may be a useful tool for this purpose. [ABSTRACT FROM AUTHOR]

Coastal aquifers with high hydraulic conductivities on the order of 10−2 m s−1 have unconventional salinity distributions with the presence of non‐fresh groundwater at the water table over a wide swath near the coast. This study aims to unravel the mechanisms underlying the phenomenon via numerical simulations for variably saturated, density‐driven flow and solute transport in porous media. The simulation results indicate that the existence of non‐fresh groundwater at the water table is attributed to the upward mass flux in the saturated zone near the coast, which transports solute from deeper groundwater toward the water table. With high hydraulic conductivity, the upward mass flux becomes prominent at shallower elevations because of the high Darcy flux and the shallow saline groundwater. The upward mass flux has two main drivers, upward advection by the upward flow component and transverse dispersion by the seaward flow component. The advective mass flux dominates over the transverse dispersion in the deep part of the saturated zone where only groundwater with sea water salinity exists. In contrast, the transverse dispersion becomes more pronounced than the upward advection in the shallow saturated zone just beneath the water table and in the unsaturated zone immediately above the water table. Our findings help interpret the unconventional salinity distributions observed and elucidate the unique dynamics of groundwater flow and solute transport in highly permeable coastal aquifers. Article impact statement: Upward mass flux controls the presence of non‐fresh groundwater at water tables in highly permeable coastal aquifers. [ABSTRACT FROM AUTHOR]

Background: The situation of Helicobacter pylori eradication therapy has been changing over time, owing to increases in antimicrobial‐resistant strains, lifestyle improvements, and changes in indications for eradication. In Japan, eradication therapy is now available to all H. pylori‐positive patients under the medical insurance system, and the potassium‐competitive acid blocker vonoprazan has been used for eradication from 2015. Recently, with the aging of society, opportunities to provide eradication to elderly patients are increasing, but the current status and effectiveness of eradication in elderly patients remains unclear. Therefore, we aimed to investigate the trends of H. pylori eradication in a metropolitan area to determine the factors associated with successful H. pylori eradication in elderly patients older than 80 years. Methods: Trends in the eradication rates of patients who received first‐ or second‐line eradication at 20 hospitals in the Tokyo metropolitan area from 2013 to 2023 were investigated. Results: The eradication rates in the per‐protocol analysis were 82.3% (95% confidence interval [CI]: 81.2%–83.2%) for the first‐line treatment (n = 6481), and 87.9% (86.9%–88.9%) for the second‐line treatment (n = 4899). Multivariate analysis showed that independent factors for successful eradication in the first‐line treatment were an age of older than 80 years (OR: 0.606; 95% CI: 0.448–0.822), peptic ulcers (vs. atrophic gastritis: 3.817; 3.286–4.433), and vonoprazan (vs. proton pump inhibiters (PPIs), 3.817; 3.286–4.433), and an age of older than 80 years (0.503; 0.362–0.699) and vonoprazan (1.386; 1.153–1.667) in the second‐line treatment. Conclusion: After 2015, the eradication rate of both first‐ and second‐line therapies were maintained at a higher level than before 2015, owing to the use of vonoprazan. As the H. pylori eradication rate in patients older than 80 years was low, an effective strategy for these patients needs to be developed in the future. [ABSTRACT FROM AUTHOR]

The Ras homology (Rho) family of GTPases serves various functions, including promotion of cell migration, adhesion, and transcription, through activation of effector molecule targets. One such pair of effectors, the Rho‐associated coiled‐coil kinases (ROCK1 and ROCK2), induce reorganization of actin cytoskeleton and focal adhesion through substrate phosphorylation. Studies on ROCK knockout mice have confirmed that ROCK proteins are essential for embryonic development, but their physiological functions in adult mice remain unknown. In this study, we aimed to examine the roles of ROCK1 and ROCK2 proteins in normal adult mice. Tamoxifen (TAM)‐inducible ROCK1 and ROCK2 single and double knockout mice (ROCK1flox/flox and/or ROCK2flox/flox;Ubc‐CreERT2) were generated and administered a 5‐day course of TAM. No deaths occurred in either of the single knockout strains, whereas all of the ROCK1/ROCK2 double conditional knockout mice (DcKO) had died by Day 11 following the TAM course. DcKO mice exhibited increased lung tissue vascular permeability, thickening of alveolar walls, and a decrease in percutaneous oxygen saturation compared with noninducible ROCK1/ROCK2 double‐floxed control mice. On Day 3 post‐TAM, there was a decrease in phalloidin staining in the lungs in DcKO mice. On Day 5 post‐TAM, immunohistochemical analysis also revealed reduced staining for vascular endothelial (VE)‐cadherin, β‐catenin, and p120‐catenin at cell–cell contact sites in vascular endothelial cells in DcKO mice. Additionally, VE‐cadherin/β‐catenin complexes were decreased in DcKO mice, indicating that ROCK proteins play a crucial role in maintaining lung function by regulating cell–cell adhesion. [ABSTRACT FROM AUTHOR]

This document provides an overview of a project aimed at creating a database of Major Histocompatibility Complex (MHC) reference sequences to enhance research on immune response genetics. The current human genome reference is limited in diversity as it only includes alleles of European origin. To address this, the International Histocompatibility Working Group (IHWG) is collecting and sequencing samples representing HLA haplotypes from non-European populations. The project involves high-throughput targeted sequencing and bioinformatics pipelines to analyze DNA samples from various countries, with a focus on increasing representation from populations outside of Europe. Efforts are ongoing to collect more samples from underrepresented regions such as Africa, South Asia, and Oceania. [Extracted from the article]

This document summarizes a study on the presence of food allergens in blood and its potential impact on adverse transfusion reactions (ATRs). The study found that the reactivity of basophil activation test (BAT) varied depending on the time between ingestion and blood collection, as well as the type of donor and food ingested. Patients with high levels of food-specific IgE were more likely to have a higher BAT response. However, the study did not verify the identification and concentration of allergens in donor blood, and future studies should further investigate the relationship between allergen content in blood products and the risk of developing ATRs. [Extracted from the article]

Annotating genomic sequence alterations is sometimes a difficult decision, particularly in missense variants with uncertain pathogenic significance and also in those presumed as germline pathogenic variants. We here suggest that mutation spectrum may also be useful for judging them. From the public databases, 982 BRCA1/1861 BRCA2 germline missense variants and 294 BRCA1/420 BRCA2 somatic missense variants were obtained. We then compared their mutation spectra, i.e., the frequencies of two transition‐ and four transversion‐type mutations, in each category. Intriguingly, in BRCA1 variants, A:T to C:G transversion, which was relatively frequent in the germline, was extremely rare in somatic, particularly breast cancer, cells (p =.03). Conversely, A:T to T:A transversion was most infrequent in the germline, but not rare in somatic cells. Thus, BRCA1 variants with A:T to T:A transversion may be suspected as somatic, and those with A:T to C:G as being in the germline. These tendencies of mutation spectrum may also suggest the biological and chemical origins of the base alterations. On the other hand, unfortunately, variants of uncertain significance (VUS) were not distinguishable by mutation spectrum. Our findings warrant further and more detailed studies. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to compare the apparent diffusion coefficient (ADC) values of the masticatory muscles between patients with and without temporomandibular joint osteoarthritis (TMJ‐OA) on diffusion‐weighted magnetic resonance imaging. Methods: This prospective study included 120 patients with temporomandibular disorders (TMD), including 60 patients with TMJ‐OA and 60 without TMJ‐OA, and 60 without TMD patients. All patients underwent magnetic resonance imaging of the TMJs at our hospital between November 2011 and January 2017. The regions of interest included the right and left lateral pterygoid muscles, medial pterygoid muscles, and masseter muscles on axial slices. Magnetic resonance images from the TMJ‐OA and control groups were independently evaluated by two oral and maxillofacial radiologists. ADC values were compared between the two groups using Mann–Whitney U tests. Results: The respective mean ADC values of the lateral pterygoid muscles in patients with TMJ‐OA and controls were 1.18 × 10−3 and 1.33 × 10−3 mm2/s, respectively. Those for the medial pterygoid muscles were 1.14 × 10−3 and 1.25 × 10−3 mm2/s, while those for the masseter muscles were 1.20 × 10−3 and 1.28 × 10−3 mm2/s, respectively. The mean ADC values of the normal lateral pterygoid, normal medial pterygoid, and normal masseter muscles were 1.29 × 10−3, 1.09 × 10−3, and 1.08 × 10−3 mm2/s, respectively. Conclusion: Among patients with TMDs, the ADC values of the masticatory muscles were significantly higher in patients without TMJ‐OA than in those with TMJ‐OA. [ABSTRACT FROM AUTHOR]

Aim: We evaluated the safety and efficacy of vascular endothelial growth factor receptor (VEGFR)‐targeted peptide vaccines for the immunization of patients with unresectable hepatocellular carcinoma (HCC) who had responded to transarterial chemoembolization. Methods: Twenty‐two patients were randomized 1:1 to receive VEGFR‐targeted peptides or placebo. The primary end‐point was the safety assessment of the immunization. The secondary end‐points were evaluation of immunological responses and clinical outcomes. Results: No severe adverse events were induced by the study agents. Among the 12 patients in the vaccine group, a VEGFR1‐specific cytotoxic T lymphocyte (CTL) response was induced in eight (66.7%) patients and a VEGFR2‐specific CTL response was induced in 10 (83.3%). The median progression‐free survival (PFS) and overall survival (OS) rates were 4.8 and 52.0 months, respectively, in the vaccine group, and 2.7 and 21.8 months, respectively, in the placebo group. No statistically significant differences were found between the two groups (PFS p = 0.925, OS p = 0.190). When divided into two groups according to immunoreactivity, the median PFS of patients with and without a strong immune response to VEGFR1 were 7.4 and 2.7 months, and that to VEGFR2 were 10.6 and 2.7 months, respectively; there were significant differences according to the immune response. Conclusions: Immunotherapy with peptide vaccines targeting VEGFR1 and VEGFR2 was well tolerated with no serious adverse events. It also effectively induced peptide‐specific CTLs in patients with unresectable HCC. [ABSTRACT FROM AUTHOR]

Hydroquinones bearing an electron‐withdrawing group at the C2‐position can effectively underwent oxidative coupling with (hetero)arenes (e. g. indoles, electron‐rich benzene derivatives) in the presence of 2,3‐dichloro‐5,6‐dicyano‐p‐benzoquinone (DDQ) and FeCl3 to produce the corresponding biaryl products. In the present reactions, the DDQ‐mediated oxidation of hydroquinone derivatives produce benzoquinone intermediate, which subsequently underwent FeCl3‐catalyzed nucleophilic addition of (hetero)arenes to the α,β‐unsaturated carbonyl moiety to give the biaryl product in a one‐pot manner. Especially, the indole‐based biaryl products were further converted into tetracyclic aromatics through DDQ‐mediated oxidation followed by FeCl3‐catalyzed intramolecular cyclization. Thiophene derivatives were also applicable to give the tetracyclic aromatics. Moreover, the photophysical properties of the indole‐ and thiophene‐based tetracyclic aromatics in the solution and the solid states were investigated. [ABSTRACT FROM AUTHOR]

Background: Long‐term anti‐EGFR antibody treatment increases the risk of severe dermatologic toxicities. This single‐arm, phase II trial aimed to investigate the strategy of switching from cetuximab to bevacizumab in combination with FOLFIRI based on early tumor shrinkage (ETS) in patients with RAS wild‐type metastatic colorectal cancer (mCRC). Methods: Radiologic assessment was performed to evaluate ETS, defined as ≥20% reduction in the sum of the largest diameters of target lesions 8 weeks after the introduction of FOLFIRI plus cetuximab. ETS‐negative patients switched to FOLFIRI plus bevacizumab, whereas ETS‐positive patients continued FOLFIRI plus cetuximab for eight more weeks, with a switch to FOLFIRI plus bevacizumab thereafter. The primary endpoint was progression‐free survival. Results: This trial was prematurely terminated due to poor accrual after a total enrollment of 30 patients. In 29 eligible patients, 7 were ETS‐negative and 22 were ETS‐positive. Two ETS‐negative patients and 17 ETS‐positive patients switched to FOLFIRI plus bevacizumab 8 weeks and 16 weeks after initial FOLFIRI plus cetuximab, respectively. Median progression‐free and overall survival durations were 13.4 and 34.7 months, respectively. Six (20%) patients experienced grade ≥3 paronychia, which improved to grade ≤2 by 18 weeks. Grade ≥3 acneiform rash, dry skin, and pruritus were not observed in any patients. Conclusions: Our novel treatment strategy delivered acceptable survival outcomes and reduced severe dermatologic toxicities. [ABSTRACT FROM AUTHOR]

Mountainous watersheds are characterized by variability in functional traits, including vegetation, topography, geology, and geomorphology, which determine nitrogen (N) retention, and release. Coal Creek and East River are two contrasting catchments within the Upper Colorado River Basin that differ markedly in total nitrate (NO3−) export. The East River has a diverse vegetation cover, and sinuous floodplains, and is underlain by N‐rich marine shale. At 0.21 ± 0.14 kg ha−1 yr−1, the East River exports ∼3.5 times more NO3− relative to the conifer‐dominated Coal Creek (0.06 ± 0.02 kg ha−1 yr−1). While this can partly be explained by the larger size of the East River, the distinct watershed traits of these two catchments imply different mechanisms controlling the aggregate N‐export signal. A causality analysis shows physical and biogenic processes were critical in determining NO3− export from the East River catchment. Stable isotope ratios of NO3− (δ15NNO3 and δ18ONO3) show the East River catchment is a strong hotspot for biogeochemical processing of NO3− at the hillslope soil‐saprolite. By contrast, the conifer‐dominated Coal Creek retained nearly all atmospherically deposited NO3−, and its export was controlled by catchment hydrological traits (i.e., snowmelt periods and water table depth). The conservative N‐cycle within Coal Creek is likely due to the abundance of conifer trees, and smaller riparian regions, retaining more NO3− overall and reduced processing prior to export. This study highlights the value of integrating isotope systematics to link watershed functional traits to mechanisms of watershed element retention and release. Plain Language Summary: The role different functional traits play in the retention and release of nitrogen remains uncertain. Here we describe how two neighboring catchments in the Upper Colorado River Basin, characterized by contrasting vegetation, geology, and geomorphology, cycle and export nitrogen. The East River catchment, which is underlain by nitrogen‐rich shale, and has a diverse vegetation cover, releases over three times as much nitrate (NO3−) than the conifer‐dominated Coal Creek, which is underlain by granitic rock. However, a suite of analyses show that the distinct watershed traits of these two catchments lead to diverse pathways of nitrogen cycling. Biogenic processes, critical to determining NO3− export in East River, impart strong biogeochemical processing prior to export. By contrast, Coal Creek retains almost all of the atmospherically deposited NO3−, likely due to uptake by conifers, and a small riparian region. This study highlights the use of nitrate isotope systematics to parse different mechanisms leading to NO3− export. Key Points: Comparing and contrasting neighboring catchments identifies watershed traits regulating the cycling, retention and release of nitrogenConifer forest‐dominated catchments show a conservative nitrogen cycling, retaining ∼97% of atmospherically dominated nitrateBy contrast, meadow‐dominated catchments underlain Mancos shale are biogeochemical hotspots for N‐cycling, and export higher nitrate loads [ABSTRACT FROM AUTHOR]

Introduction: Hypersensitivity reactions (HSRs) to chemotherapy are serious adverse events associated with cancer drug therapy and can occur with any antitumor drug. This study investigated the safety and efficacy of carboplatin desensitization therapy in Japan and established a method for treating carboplatin HSRs. Methods: Patients diagnosed with gynecological (ovarian, endometrial, or cervical) cancers who underwent carboplatin desensitization therapy between 2016 and 2020 at the Gynecologic Cancer Study Group of Japan Clinical Oncology Group were included. The carboplatin desensitization therapy at each institution and the implementation cases were registered in an online case report form. Results: This retrospective study enrolled 136 patients (ovarian, 108; endometrial, 17; and cervical cancer, 11). Pre‐existing allergies were present in 37 (27.2%) patients, and 32 (23.5%) patients exhibited prodromal symptoms during treatment before HSR onset. Erythema was the most common symptom at HSR onset, affecting 93 (68.4%) patients, followed by itching in 72 (52.9%) patients and decreased oxygen saturation in 43 (31.6%) patients. Loss of consciousness occurred in three (2.2%) patients. The most common timing of HSR onset was during the first recurrence treatment (47%). The mean total carboplatin dose until HSR onset was 7331 (2620–18,282) mg, and the mean number of doses was 14 (4–63). Desensitization treatment was completed in 75% of cases, and breakthrough HSRs occurred in 25% (34/136). No deaths occurred in the study cohort. The risk factors for HSRs were not identified. Conclusion: Although carboplatin desensitization therapy has high success rates in Japan, erythema and pruritus are important HSRs to consider. [ABSTRACT FROM AUTHOR]

Purpose. Mitral valve replacement (MVR) is necessary in cases of severe infective endocarditis (IE). Because the On-X valve is expected to be effective in reducing prosthesis-associated turbulent blood flow, we investigated the hemodynamic efficacy of the On-X valve when used for MVR in cases of mitral valve IE. Methods. We compared postoperative outcomes between two groups of patients who underwent MVR for IE: 13 given an On-X valve and 27 given an SJM valve. Results. There were no in-hospital deaths. Late death occurred in 6 cases, all in the SJM group (P = 0.1520). The incidence of late postoperative atrial fibrillation was relatively low in the On-X group (1 case vs. 10 cases, P = 0.068). Univariate analysis showed an association between the effective orifice area and postoperative atrial fibrillation. The effective orifice area and indexed effective orifice area were significantly larger in the On-X group at 2.8 ± 0.7 cm2 vs. 2.2 ± 0.5 cm2 (P = 0.007) and 1.8 ± 0.5 cm2/m2 vs. 1.4 ± 0.4 cm2 (P = 0.003), respectively. Conclusions. The suggested reduction in left atrial load attributed to the use of the On-X valve in MVR for IE may reduce the incidence of postoperative atrial fibrillation. [ABSTRACT FROM AUTHOR]

Objective: Atrial fibrillation (AF) detected after insular stroke might arise from autonomic and inflammatory mechanisms triggered by insular damage, and be associated with a low embolic risk. We assessed the association of the timing of AF detection and insular involvement with the risk of embolic events after acute ischemic stroke. Methods: Acute ischemic stroke patients with AF who underwent brain magnetic resonance imaging at baseline were enrolled. Patients were classified according to the timing of AF detection (AF detected after stroke [AFDAS] or known AF [KAF]) and insular involvement. The primary outcome was embolic events defined as recurrent ischemic stroke, transient ischemic attack, and systemic embolism within 90 days. Results: Of 1,548 patients, 360 had AFDAS with insular cortex lesions (+I), 409 had AFDAS without insular cortex lesions (−I), 349 had KAF+I, and 430 had KAF−I. Cumulative incidence rates of embolic events at 90 days in patients with AFDAS+I, AFDAS−I, KAF+I, and KAF−I were 0.8%, 3.5%, 4.9%, and 3.3%, respectively. Patients with AFDAS−I (adjusted hazard ratio 5.04, 95% confidence interval 1.43–17.75), KAF+I (6.18, 1.78–21.46), and KAF−I (5.26, 1.48–18.69) had a significantly higher risk of embolic events than those with AFDAS+I. Interpretation: Acute ischemic stroke patients with AFDAS and insular cortex lesions had a lower risk of embolic events than those who had AFDAS without insular cortex lesions or those with KAF, regardless of insular involvement. ANN NEUROL 2024;95:338–346 [ABSTRACT FROM AUTHOR]

Background: Recent studies have revealed that sarcopenia is associated with postoperative complications and poor prognosis. Although neoadjuvant chemotherapy is a promising treatment for gastric cancer, its toxicity may lead to the loss of skeletal muscle mass. This study investigates the changes in skeletal muscle mass during neoadjuvant chemotherapy and its clinical impact on patients with locally advanced gastric cancer. Methods: Fifty patients who completed two courses of neoadjuvant chemotherapy followed by surgery were included. Skeletal muscle mass was measured using computed tomography images before and after chemotherapy. The proportion of skeletal muscle mass change (%SMC) during neoadjuvant chemotherapy and its cutoff value was explored using the receiver operating characteristic for the overall survival of patients undergoing R0 resection. Risk factors of skeletal muscle mass loss were also evaluated. Results: Overall, 64% of patients had skeletal muscle mass loss during neoadjuvant chemotherapy (median %SMC −3.4%; range: −18.9% to 10.3%). Multivariable analysis identified older age (≥70 years) as an independent predictor of skeletal muscle mass loss (mean [95% confidence interval]: −4.70% [−8.83 to −0.58], p = 0.026). Among 43 patients undergoing R0 resection, %SMC <−6.9% was an independent poor prognostic factor for overall survival (hazard ratio, 11.53; 95% confidence interval, 2.78–47.80) and relapse‐free survival (hazard ratio 4.54, 95% confidence interval 1.50–13.81). Conclusions: Skeletal muscle mass loss occurs frequently during neoadjuvant chemotherapy for locally advanced gastric cancer and could adversely affect survival outcomes. [ABSTRACT FROM AUTHOR]

Objective: This retrospective study aimed to assess the parotid glands in diabetes mellitus (DM) using diffusion‐weighted magnetic resonance imaging (DW‐MRI). Methods: We investigated 54 patients aged between 38 and 83 years, with DM (DM group) and without DM (control group), who underwent magnetic resonance imaging (MRI) in the facility between November 2006 and January 2021. We calculated the median apparent diffusion coefficients (ADCs) of the parotid glands in the control group and DM group. These groups were compared using the Mann–Whitney U tests. A receiver operating characteristic (ROC) curve analysis was performed to assess the ability of the ADC to predict DM. Statistical significance was set at p < 0.05. Results: The median ADCs of parotid grands in the control group and DM group were 0.83 × 10−3 mm2/s and 0.74 × 10−3 mm2/s, respectively (p < 0.01). ROC analysis revealed a cut‐off ADC value of 0.81 to distinguish between the control and DM group. Sensitivity, specificity, accuracy, and area under the ROC curve were 0.7, 0.67, 0.69, and 0.71, respectively. Conclusion: The ADC was significantly higher in DM groups than in the control group. This suggests that DW‐MRI may be able to quantitatively distinguish parotid glands between normal and DM patients. [ABSTRACT FROM AUTHOR]

Both the ecological and social dimensions of fisheries are being affected by climate change. As a result, policymakers, managers, scientists and fishing communities are seeking guidance on how to holistically build resilience to climate change. Numerous studies have highlighted key attributes of resilience in fisheries, yet concrete examples that explicitly link these attributes to social‐ecological outcomes are lacking. To better understand climate resilience, we assembled 18 case studies spanning ecological, socio‐economic, governance and geographic contexts. Using a novel framework for evaluating 38 resilience attributes, the case studies were systematically assessed to understand how attributes enable or inhibit resilience to a given climate stressor. We found population abundance, learning capacity, and responsive governance were the most important attributes for conferring resilience, with ecosystem connectivity, place attachment, and accountable governance scoring the strongest across the climate‐resilient fisheries. We used these responses to develop an attribute typology that describes robust sources of resilience, actionable priority attributes and attributes that are case specific or require research. We identified five fishery archetypes to guide stakeholders as they set long‐term goals and prioritize actions to improve resilience. Lastly, we found evidence for two pathways to resilience: (1) building ecological assets and strengthening communities, which we observed in rural and small‐scale fisheries, and (2) building economic assets and improving effective governance, which was demonstrated in urban and wealthy fisheries. Our synthesis presents a novel framework that can be directly applied to identify approaches, pathways and actionable levers for improving climate resilience in fishery systems. [ABSTRACT FROM AUTHOR]

Background: Total body water (TBW) fraction, which accounts for 60% of body weight, is an important indicator of body composition, and the extracellular water to TBW ratio (ECW/TBW) is reportedly useful in predicting clinical outcomes of patients with organ disorders. We aimed to clarify the clinical impact of preoperative ECW/TBW status on survival outcomes in cancer patients. Methods: We used a database of 320 colorectal cancer (CRC) patients who underwent potentially curative resections. Preoperative ECW/TBW was measured using a bioelectrical impedance analysis (BIA), and its correlation with patient survival outcomes, clinicopathological factors, laboratory data, and comorbidities were analyzed. Results: A high preoperative ECW/TBW was significantly associated with poorer relapse‐free survival (RFS; p = 0.001) and overall survival (OS; p = 0.003). A high ECW/TBW ratio was significantly associated with older age (p < 0.001), low BMI (p = 0.009), and right‐sided tumors (p = 0.03). In a multivariate analysis, a high ECW/TBW significantly predicted a higher RFS mortality (HR: 2.07, 95% CI: 1.10–3.88, p = 0.024) and OS mortality (HR: 3.23, 95% CI: 1.25–8.36, p = 0.016). Furthermore, a high ECW/TBW was significantly associated with lower hemoglobin (p < 0.001) and albumin levels (p < 0.001), but not comorbidities. Conclusions: A high preoperative ECW/TBW was a predictive factor for recurrence and poorer overall survival independent of the tumor, node, and metastasis (TNM) stage. Our data suggest that preoperative evaluation of ECW/TBW using BIA might serve as a novel tool for developing CRC treatment strategies. [ABSTRACT FROM AUTHOR]