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Abstract The in situ measurement of charged particles plays a key role in understanding space plasma physics. Velocity distribution functions of ions and electrons have been acquired with electrostatic analyzers onboard spacecraft. Since conventional energy analyzers (e.g., top-hat electrostatic analyzers) have essentially a two-dimensional field of view, the solid angle coverage is achieved with the aid of spacecraft spin motion or with additional entrance deflection systems in front of the electrostatic analyzer. In the latter case, however, the full angular scan is realized only in the lower energy range (typically only up to 5–15 keV/e), due to the limitation of the electric field applied to the deflector. Here we propose a novel deflection system for extending the energy coverage up to tens of keV. This is especially useful for plasma observations in situations where the anisotropy of the energetic part (> 10 keV) of charged particles plays an essential role in plasma dynamics and hence is of significant interest. Graphical Abstract

Abstract Gene expression is controlled at the transcriptional and post-transcriptional levels. The TACC2 gene was known to be associated with tumors but the control of its expression is unclear. We have reported that activity of the intronic promoter p10 of TACC2 in primary lesion of endometrial cancer is indicative of lymph node metastasis among a low-risk patient group. Here, we analyze the intronic promoter derived isoforms in JHUEM-1 endometrial cancer cells, and primary tissues of endometrial cancers and normal endometrium. Full-length cDNA amplicons are produced by long-range PCR and subjected to nanopore sequencing followed by computational error correction. We identify 16 stable, 4 variable, and 9 rare exons including 3 novel exons validated independently. All variable and rare exons reside N-terminally of the TACC domain and contribute to isoform variety. We found 240 isoforms as high-confidence, supported by more than 20 reads. The large number of isoforms produced from one minor promoter indicates the post-transcriptional complexity coupled with transcription at the TACC2 locus in cancer and normal cells.

Uterine adenomyosis often co-occurs with endometriosis or leiomyoma, but little is known about its molecular underpinnings. Here, the authors show that KRAS mutations are frequent in this disease, which might reduce sensitivity to progestin treatment via epigenetic silencing of the progesterone receptor.

A sudden onset of postpartum hemorrhage (PPH) during a cesarean delivery requires urgent hemostasis procedures, such as the B-Lynch, Hayman, or double-vertical compression sutures, when bimanual compression, uterotonic agent administration, and intrauterine balloon tamponade had failed to achieve sufficient hemostasis. However, after invasive hemostatic procedures, postoperative complications, including subsequent synechiae and infection followed by ischemia, have been reported to occur even in successful cases. To avoid these complications, we devised and performed a minimally invasive combined technique based on a “step-by-step” minimally invasive hemostatic protocol for a case of placenta accreta and severe atonic hemorrhage during a cesarean delivery. A nullipara woman with a history of systemic lupus erythematosus and treatment with prednisolone and tacrolimus underwent a cesarean section because of a nonreassuring fetal status. Severe atonic hemorrhage and placenta accreta were observed which did not respond to bimanual compression and uterotonics. Because severe uterine atony and continuous bleeding from the placental attachment area were observed even with intrauterine balloon tamponade, vertical compression sutures were placed in the uterine isthmus. However, severe uterine atony and atonic bleeding from the uterine corpus persisted; thus, a second balloon was inserted into the uterine corpus. Hemostasis was accomplished with a combination of isthmus vertical compression sutures and double balloons which is a less-invasive approach than existing compression techniques. No complications related to these procedures were observed. This step-by-step minimally invasive hemostatic technique has the potential to control PPH with less complications, especially in immunocompromised patients.

BACKGROUND:Needlestick injury (NSI) is one of the most burdensome professional hazards in any medical setting; it can lead to transmission of fatal infectious diseases, such as hepatitis B, hepatitis C and human immunodeficiency virus. In the United States, the annual cost burden was estimated as somewhere between $118 million to $591 million; in the United Kingdom it is approximated to be £500,000 (US$919,117.65) per the National Health Service. METHOD:This is the first published paper on the national cost burden of NSIs in Japan. A systematic literature review was conducted to review previous study design in global studies and to extract parameter values from Japanese studies. We conducted abstract searches through PubMed and the Japan Medical Abstracts Society (Ichushi), together with grey literature and snowball searches. A simple economic model was developed to calculate cost burden of NSIs from a societal perspective over a one-year time horizon. We assumed all NSIs are reported and perfect adherence in post NSI management that presented in the labour compensation scheme. Local guidelines were also referenced to extract resource utilization. Lastly, a deterministic sensitivity analysis was conducted and a scenario analysis which considered a payer perspective was also included. RESULT AND CONCLUSION:The national cost burden of in-hospital NSIs is estimated as ¥33.4 billion (US$302 million) annually, based on an average cost per NSI of ¥63,711 (US$577) and number of NSIs at 525,000/year. 70% of the cost is due to initial laboratory tests, followed by productivity loss, estimated at 20% of the total cost. Cost of contaminated NSIs remains at 5% of the total cost. Change in number of NSIs significantly influences outcomes. Variation in post-exposure management practices suggests a need for NSI specific National guidelines and holistic labour compensation scheme development in Japan.

We proposed a method to evaluate the degree of safe driving based on a cognitive test utilizing the Trail Making Test-J Part B (TMT-J) and a minimum TTC using a driving simulator. We also proposed a training program to acquire compensatory behavior through metacognition. The effectiveness of these methods was tested on 30 elderly drivers. It was confirmed that a combination of TMT-J and driving ability was effective in judging safe driving. In addition, the use of charts comparing driving ability with others and a bird's-eye view of driving improved metacognitive abilities and realized compensatory behaviors for safe driving. [ABSTRACT FROM AUTHOR]

A camomila é uma planta herbácea e anual. Suas flores são usadas na medicina popular como droga vegetal e também como aromatizante. Realizaram-se dois experimentos com o objetivo de avaliar o tempo de armazenamento e a temperatura na porcentagem e velocidade de germinação das sementes de camomila. O primeiro experimento utilizou sementes de camomilas produzidas no Horto Medicinal da Universidade Estadual de Londrina, PR. Elas foram beneficiadas, acondicionadas em sacos de papel e armazenadas em câmara fria por um, dois, três e quatro anos. O teste de germinação foi realizado em temperatura alternada 15-25°C e fotoperíodo de 8 horas. Avaliou-se a porcentagem e o índice de velocidade de germinação (IVG), em oito repetições de 100 sementes cada uma. As sementes de camomila utilizadas no segundo experimento foram comerciais. Os tratamentos foram: temperaturas constantes de 10°C e 15°C e temperaturas alternadas de 10-15°C e 10-20°C, com fotoperíodo de 12 horas. As avaliações foram realizadas no sétimo e no décimo quarto dia após a semeadura (DAS). O potencial de germinação e o índice de velocidade de germinação das sementes foram mantidos nos dois primeiros anos de armazenamento. A germinação das sementes foi reduzida para 3,3% com a temperatura de 10oC ao sétimo DAS. As temperaturas constantes de 10oC e 15oC e alternadas de 10-15°C e 10-20°C proporcionaram germinação das sementes superior a 80% ao final do décimo quarto DAS.Chamomile is an annual herbaceous species. Its flowers are used in popular medicine and as a vegetable flavour. It propagates for seeds. The objective of these trials was to evaluate the ideal temperature, packing time on the percentage and germination speed of chamomile. The first trial used seeds from a medicinal vegetable garden from Universidade Estadual de Londrina, Paraná, Brazil. They were treated, packed in paper bags and kept in refrigerate chamber during one, two, three and four years. In germination test it was used 25°C with 10 hours of light and 14 hours of dark. It was evaluated the percentage and germination speed index (GSI) in 8 replicates with 100 seeds each one. The seeds used in the second trial were commercial ones. The tested treatments were: constant temperatures of 10°C and 15°C with 12 hours of photoperiod, and alternated temperatures of 10°C/15°C and 10°C/20°C with 10 hours of photoperiod. The evaluations were made at 7th and 14th days after seeding. The seeds packed until 2 years showed greatest percentage and germination speed index. The temperature of 10°C reduced the germination for 3.3% at 7 DAS. The constant temperature of 10°C and 15°C, and alternated in 10°C/15°C and 10°C/20°C provided germination of the seeds superior to 80% in the end of 14th day.

Objective: The combination of pembrolizumab and lenvatinib (PEMBRO+LEN) has shown promising efficacy in patients with advanced and recurrent endometrial cancer (EC) in Study 309/KEYNOTE-775. On the other hand, there are only a few reports of the result in real-world experience, especially in Japanese people. The objective of this study is to investigate the efficacy and safety of PEMBRO+LEN for recurrent EC in a real-world setting. Methods: This study included patients with recurrent EC who received PEMBRO+LEN between December 2021 and October 2023 at our institution in Japan. We retrospectively reviewed the medical records and evaluated the response rates, survival outcomes, and treatment-related adverse events (AEs). Results: In total, 10 patients were included in the study. The median age of the patients was 60.5 (range, 52-73) years. The most common histologic subtype was serous carcinoma (40%), followed by endometrioid carcinoma G1 (30%) and endometrioid carcinoma G2 (30%). Most patients (90%) had mismatch repairproficient tumors or mismatch repair unknown tumors. Patients received PEMBRO+LEN for a median of 3 cycles. Overall response and disease control rates were 30% and 80%, respectively. Overall, 80% of patients experienced LEN dose reduction once or more. The most common treatment-related AEs were proteinuria (40%), drug eruption (30%), hypertension (30%), and elevated thyroid stimulating hormone and ACTH in the blood test (11%). Conclusion: In our real-world study, Japanese patients with recurrent EC who received PEMBRO+LEN showed a similar treatment response rate and treatment discontinuation rate, compared to the global Study 309/KEYNOTE-775 results. [ABSTRACT FROM AUTHOR]

Objectives: To identify, describe and summarize evidence on residual symptoms and disease burdens in rheumatoid arthritis (RA) patients qualified as being in remission or low disease activity (LDA). Methods: A systematic literature review (SLR) was conducted according to Cochrane collaboration guidelines. The population of interest was adult patients with RA in remission or LDA. The reported outcomes of interest were any symptoms or burdens. Results: Fifty-one publications were identified through an eDatabase search. Together with 17 articles found through other sources, 68 were included for full text review. The most commonly reported residual symptoms were pain (number of studies = 25), fatigue (n = 21) and morning stiffness (n = 5). Reported disease burdens included mental health (n = 15), sleep disturbances (n = 7) and work productivity (n = 5), impairment in quality of life (n = 21), and functional disability (n = 34). Substantial residual symptoms and disease burdens were found to be present in patients in remission or LDA. Conclusion: This is the first SLR to investigate residual symptoms and disease burdens in RA patients in remission or LDA. The results indicate that despite achieving conventional clinical targets, the disease continues to affect patients, suggesting the existence of unmet need under the current treatment paradigm. [ABSTRACT FROM AUTHOR]