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Hepatocellular carcinoma frequently recurs after surgery, necessitating personalized clinical approaches based on tumor avatar models. However, location-dependent oxygen concentrations resulting from the dual hepatic vascular supply drive the inherent heterogeneity of the tumor microenvironment, which presents challenges in developing an avatar model. In this study, tissue samples from 12 patients with hepatocellular carcinoma are cultured directly on a chip and separated based on preference of oxygen concentration. Establishing a dual gradient system with drug perfusion perpendicular to the oxygen gradient enables the simultaneous separation of cells and evaluation of drug responsiveness. The results are further cross-validated by implanting the chips into mice at various oxygen levels using a patient-derived xenograft model. Hepatocellular carcinoma cells exposed to hypoxia exhibit invasive and recurrent characteristics that mirror clinical outcomes. This chip provides valuable insights into treatment prognosis by identifying the dominant hepatocellular carcinoma type in each patient, potentially guiding personalized therapeutic interventions. Hepatocellular carcinoma is the most common type of primary liver cancer. Here the authors show an oxygen gradient chip that separates aggressive hepatocellular carcinoma cells from a heterogeneous tumor mass, mirroring the conditions of the portal vein, hepatic artery, and liver. [ABSTRACT FROM AUTHOR]

Background: Previous studies have demonstrated that a shorter hospital stay reduces adverse outcomes in heart failure (HF), primarily in observational study settings. This trend was further emphasized during the COVID-19 pandemic, resulting in case-control study-like results., Methods and Results: A subanalysis was conducted on 239 patients from a Japanese multicenter cohort study (HINODE), encompassing 32 months before and 6 months after pandemic onset. The duration of hospitalization and clinical outcomes were compared between these 2 periods in HF patients who received guideline-directed medical and cardiac implantable electronic device (CIED) therapy. The duration of HF hospitalization was significantly shortened by 41.1% (95% confidence interval [CI] 6.7-62.8%) during the pandemic period (median 13 days; interquartile range [IQR] 6-19 days) compared with the prepandemic period (median 21 days; IQR 12-38 days). Nonetheless, the incidence rate (IR) of outcomes in the pandemic group was similar (ventricular arrhythmia, HF events, HF and cardiac hospitalization) or lower (all-cause hospitalization [IR ratio 0.6; 95% CI 0.4-1.0]) compared with the prepandemic group. The odds ratio of adverse events was also similar between the 2 groups., Conclusions: A significant reduction in hospitalization duration during the COVID-19 pandemic was associated with similar or improved clinical outcomes for guideline-adherent HF patients. Current hospitalization durations for advanced HF patients are likely unnecessarily long, and efforts to reduce them are warranted.

Background: Isolated true aneurysms in the superficial femoral artery (SFA) have rarely been reported. Most cases are undiagnosed until rupture or the occurrence of complications., Case Summary: A 36-year-old woman presented with a palpable, pulsating mass on her right thigh which had increased in size over 2 months. She also had a swollen right leg and mild claudication (Stage II in Rutherford classification). For 2 months, the patient was treated by manual massage, acupuncture, and extracorporeal shock wave therapy in local clinics. Bed-side ultrasonography identified a 3.4-cm sized true aneurysm of the right SFA. There were no other aneurysms in arteries from head to toe. There was no evidence of atherosclerotic risk factors or connective tissue disease. The patient was successfully treated by a covered stent graft implantation without any complications., Discussion: Isolated true aneurysm in the SFA is rare and tends to go undiagnosed especially in young women. Ultrasonography is an easy and useful diagnostic tool for differential diagnosis of thigh mass. In this case, endovascular treatment was safely applied for a true aneurysm without rupture., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.)