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Abstract Background In hepatocellular carcinoma (HCC), postoperative recurrence remains high. This study aimed to evaluate the recurrence patterns and prognosis of HCC after curative hepatectomy. Methods Among 352 patients with primary HCC who underwent initial hepatectomy between January 2002 and December 2022, 151 with recurrence were assessed for the relationship between recurrence pattern and prognosis. Results The early recurrence group (within 6 months postoperatively; n = 38) had significantly higher serum alpha-fetoprotein (p = 0.002), des-γ-carboxyprothrombin (DCP; p = 0.004) levels and Barcelona Clinic Liver Cancer (BCLC) stage (p 6 months postoperatively; n = 113). The tumor size (p = 0.013) and BCLC stage (p = 0.001) were independent risk factors for early recurrence within 6 months in multivariate analysis. The multiple recurrence group (intrahepatic multinodular recurrence or distant metastasis; n = 89) had significantly lower prognostic nutritional index (p = 0.026), larger tumor size (p = 0.017), lower incidence of liver cirrhosis (p = 0.03) than the single recurrence group (single nodule recurrence; n = 62). The multiple recurrence group, especially patients with ≥ three intrahepatic nodules and distant metastases, had lower postoperative OS (p

Abstract The computational balance between the model grid resolution and the complexity of the data assimilation technique is essential for accurate aerosol forecasting and obtaining aerosol reanalysis data sets. This study aimed to develop a high‐resolution aerosol assimilation system. A 2‐dimensional variational method (2DVar) was implemented in a non‐hydrostatic icosahedral atmospheric model (NICAM). This new model (NICAM/2DVar), with a global grid size of 56 km, assimilated the observed aerosol optical depth (AOD) that is estimated by combining multiple products of geostationary and polar‐orbital satellites. The model results were evaluated against ground‐based AOD observations on a global scale. They exhibited higher correlations, lower uncertainties, and lower biases than those obtained without the 2DVar. The model also reproduced the observed surface aerosols (PM2.5) mass concentrations, especially in Kyushu, Japan. This occurred because the satellite‐estimated AODs over ocean close to air pollution sources were obtained for many occasions. The correlation coefficient values against the PM2.5 observations increased from 0.44 to 0.65 compared to the results without the 2DVar. The impact of the 2DVar on the forecast results was investigated, and the forecast values for 2–3 days were improved. Because satellite‐retrieved AODs are often lacking over land owing to retrieval difficulties, the use of ground‐based AODs in assimilations is essential for precise processing the of aerosol reanalysis data sets. The computational cost with the use of the 2DVar was only 0.6% more than that without its use. Thus, aerosol assimilation using the NICAM/2DVar can be realistically extended to finer grid sizes.

Emission of THz radiation from air breakdown at focused ultra-short fs-laser pulses (800 nm/35 fs) was investigated for the 3D spatio-temporal control where two pre-pulses are used before the main-pulse. The laser pulse induced air breakdown forms a ~ 120 μm-long focal volume generate shockwaves which deliver a denser air into the focal region of the main pulse for enhanced generation of THz radiation at 0.1–2.5 THz spectral window. The intensity of pre- and main-pulses was at the tunnelling ionisation intensities (1–3) × 1016 W/cm2 and corresponded to sub-critical (transparent) plasma formation in air. Polarisation analysis of THz radiation revealed that orientation of the air density gradients generated by pre-pulses and their time-position locations defined the ellipticity of the generated THz electrical field. The rotational component of electric current is the origin of THz radiation.

Abstract Background This study investigated the correlation between the prevalence of dental caries and the presence and type of abuse. Methods Participants were 534 children admitted for care at two child guidance centers (CGCs) in Niigata, Japan. Data pertaining to abuse, including the reason for temporary protective care and the type of abuse, and the oral examination results of the children, were collected. These results were then compared with those of a national survey and analyzed in relation to the presence and type of abuse. Results The odds ratio for decayed teeth was 4.1, indicating a higher risk in children admitted to the CGCs. However, no significant association was found between the presence of decayed, filled, or caries-experienced teeth and the presence of abuse. A significant positive association was observed between dental caries and one type of abuse, indicating a greater prevalence of dental caries in cases of neglect. The findings of this study suggest that the type of abuse, rather than its presence, is associated with dental caries. Conclusions Our findings suggest that proactive support should be provided to children in problematic nurturing environments, regardless of whether they have been subjected to abuse.

Feline stomatitis or gingivostomatitis is a chronic inflammatory condition affecting approximately 0.7% of patients. The cause is multifactorial, involving infectious agents, genetic factors, and environmental influences. Therapeutic strategies include pharmacological and surgical interventions to controlling inflammation and enhancing patient quality of life. There are discussions in the literature regarding the potential involvement of adverse food reactions as a contributing factor to oral cavity lesions, without clear evidence. This case report describes the control of gingivostomatitis with a hypoallergenic diet in a cat that had oral lesions and who was refractory to conventional treatment with prednisolone and cyclosporine, even after periodontal treatment and partial tooth extraction. After 30 days of dietary change, there was complete remission of the lesions. The animal was then re-exposed to the previous food, with new lesions appearing after 7 days. Upon returning to the hypoallergenic food, there was new remission of the lesions. This report suggests that food sensitivity may play a role in the control of feline gingivostomatitis, as periods of hypoallergenic diet coincided with the remission of the condition, even without changes in medication. It reinforces the importance of investigating adverse food reactions as clinical signs in the oral cavity of cats.

BackgroundPrognostic implications of peritoneal washing cytology (CY) in patients with localized pancreatic ductal adenocarcinoma (PDAC) undergoing surgical resection following preoperative chemoradiotherapy (CRT) remain unclear. This study aimed to elucidate the prognostic significance and predictors of a positive CY status (CY+) after preoperative CRT.MethodsClinical data from 141 patients with localized PDAC who underwent curative-intent resection after preoperative CRT were retrospectively analyzed to examine the association between CY+ and clinicopathological factors and survival.ResultsCY+ was observed in six patients (4.3%). The CY+ group exhibited significantly higher preoperative serum levels of CA19-9 and a substantially greater incidence of tumor location in the pancreatic body or tail, along with pathological invasion to the anterior pancreatic capsule, than the CY- group. The CY+ group had a significantly higher incidence of peritoneal recurrence compared with the CY- group (83.3% vs. 18.5%, p = 0.002). Overall survival (OS) and recurrence-free survival (RFS) after surgery were significantly shorter in the CY+ group than in the CY- group (CY+ vs. CY-: 18.3 vs. 46.2 months, p = 0.001, and 8.9 vs. 17.7 months, p = 0.009, respectively). Multivariate analyses identified CY+ as an independent prognostic factor for worse OS (hazard ratio 5.00, 95% confidence interval 1.03-12.31) and RFS (hazard ratio 2.58, 95% confidence interval 1.04-6.43). Local invasion grade on imaging before CRT, limited histological response to CRT, and absence of adjuvant chemotherapy were independent predictors of worse OS and RFS.ConclusionDespite the relatively low incidence of CY+ after preoperative CRT, it emerged as an independent prognostic factor in patients with localized PDAC undergoing curative-intent resection following preoperative CRT.

PurposeSeveral reports have shown the importance of margins in pancreatoduodenectomy (PD) specimens; however, whether anterior surfaces are included as margins varies among reports. In this study, we aimed to examine the impact of the anterior surface on disease-free survival (DFS) and overall survival (OS).MethodIn total, 98 patients who underwent PD after chemoradiotherapy for pancreatic ductal adenocarcinoma at Mie University Hospital between January 1, 2012, and December 31, 2019, were included. We investigated the prognostic impact of the distance from the anterior surface to tumor cells on DFS and OS using a log-rank test. Multivariate analysis was performed using Cox proportional hazards analysis.ResultsA significant difference in DFS and OS was observed up to a distance of 5 mm from the anterior surface of tumor cells. The multivariate analysis revealed that the distance from the anterior surface to tumor cells (≤5 mm) was an independent poor prognostic factor for DFS and OS.ConclusionIn patients with PD treated with neoadjuvant therapy, the distance from the anterior surface to tumor cells is an important assessment and should be included in the pathology report.

Hepatic ischemia-reperfusion injury causes liver damage during surgery. In hepatic ischemia-reperfusion injury, the blood coagulation cascade is activated, causing microcirculatory incompetence and cellular injury. Coagulation factor Xa (FXa)- protease-activated receptor (PAR)-2 signaling activates inflammatory reactions and the cytoprotective effect of FXa inhibitor in several organs. However, no studies have elucidated the significance of FXa inhibition on hepatic ischemia-reperfusion injury. The present study elucidated the treatment effect of an FXa inhibitor, edoxaban, on hepatic ischemia-reperfusion injury, focusing on FXa-PAR-2 signaling. A 60 min hepatic partial-warm ischemia-reperfusion injury mouse model and a hypoxia-reoxygenation model of hepatic sinusoidal endothelial cells were used. Ischemia-reperfusion injury mice and hepatic sinusoidal endothelial cells were treated and pretreated, respectively with or without edoxaban. They were incubated during hypoxia/reoxygenation in vitro. Cell signaling was evaluated using the PAR-2 knockdown model. In ischemia-reperfusion injury mice, edoxaban treatment significantly attenuated fibrin deposition in the sinusoids and liver histological damage and resulted in both anti-inflammatory and antiapoptotic effects. Hepatic ischemia-reperfusion injury upregulated PAR-2 generation and enhanced extracellular signal-regulated kinase 1/2 (ERK 1/2) activation; however, edoxaban treatment reduced PAR-2 generation and suppressed ERK 1/2 activation in vivo. In the hypoxia/reoxygenation model of sinusoidal endothelial cells, hypoxia/reoxygenation stress increased FXa generation and induced cytotoxic effects. Edoxaban protected sinusoidal endothelial cells from hypoxia/reoxygenation stress and reduced ERK 1/2 activation. PAR-2 knockdown in the sinusoidal endothelial cells ameliorated hypoxia/reoxygenation stress-induced cytotoxicity and suppressed ERK 1/2 phosphorylation. Thus, edoxaban ameliorated hepatic ischemia-reperfusion injury in mice by protecting against micro-thrombosis in sinusoids and suppressing FXa-PAR-2-induced inflammation in the sinusoidal endothelial cells.

This study investigated the role of vascular endothelial growth factor (VEGF) in 18 patients with first-episode schizophrenia (FES) and 19 healthy controls and the effect of risperidone monotherapy on plasma VEGF levels. The plasma VEGF levels were measured at baseline and after four weeks of risperidone treatment. We found no difference in baseline VEGF levels between the groups and no change in VEGF levels after risperidone treatment. No correlation was found between VEGF levels and symptom severity. Our findings suggest that VEGF may not serve as a distinguishing biomarker in FES or be directly influenced by risperidone.

We study the effect of irradiation from two accretion disks (minidisks) around respective black holes of stellar-to-intermediate masses in a circular binary on the spectrum of a circumbinary disk (CBD) surrounding them. We assume the CBD to be a standard disk and adopt the orbit-averaged irradiation flux because the viscous timescale is much longer than the orbital period. We then solve the energy equation both analytically and numerically to compute the CBD temperature distribution and the corresponding disk spectrum. We find that the analytically calculated spectra are in good agreement with the numerical ones. The CBD spectrum is almost independent of the binary mass ratio. We also find that the combined spectra of two minidisks and the CBD have double peaks, one peak in the soft X-ray band and the other in the infrared (IR) band. The former peak comes from the two minidisks, while the latter peak from the CBD. The observed flux density increases with frequency as ν ^1/3 toward the soft X-ray peak, while it decreases with frequency away from the IR peak as ν ^−5/3 . The latter feature is testable with near-IR observations with Subaru and JWST.

We present a time-dependent, one-dimensional, magnetically driven disk wind model based on magnetohydrodynamic (MHD) equations, in the context of tidal disruption events (TDEs). We assume that the disk is geometrically thin, is gas pressure dominated, and explicitly accounts for magnetic braking and turbulent viscosity through an extended α -viscosity prescription. We find a particular wind solution for a set of basic equations that satisfies the necessary and sufficient conditions for vertically unbound MHD flows. The solution shows that the disk evolves with mass loss due to wind and accretion from the initial Gaussian density distribution. We confirm that the mass accretion rate follows the power law of time t ^−19/16 at late times in the absence of wind, which matches the classical solution of J. K. Cannizzo et al. We find that the mass accretion rate is steeper than the t ^−19/16 curve when the wind is present. Mass accretion is also induced by magnetic braking, known as the wind-driven accretion mechanism, which results in a faster decay with time of both the mass accretion and mass-loss rates. In the disk emission, the ultraviolet (UV) luminosity is the highest among the optical, UV, and X-ray luminosities. While the optical and X-ray emission is observationally insignificant without magnetic braking, the X-ray emission is brighter at late times, especially in the presence of magnetic braking. This provides a possible explanation for observed delayed X-ray flares. Our model predicts that late-time bolometric light curves steeper than t ^−19/16 in UV-bright TDEs are potentially compelling indicators of magnetically driven winds.

Abstract Background In pancreaticoduodenectomy, the pancreas-visceral fat CT value ratio and serrated pancreatic contour on preoperative CT have been revealed as risk factors for postoperative pancreatic fistulas. We aimed to evaluate whether they could also serve as risk factors for postoperative pancreatic fistulas after distal pancreatectomy. Methods A total of 251 patients that underwent distal pancreatectomy at our department from 2006 to 2020 were enrolled for the study. We retrospectively analyzed risk factors for postoperative pancreatic fistulas after distal pancreatectomy using various pre and intraoperative factors, including preoperative CT findings, such as pancreas-visceral fat CT value ratio and serrated pancreatic contour. Results The study population included 147 male and 104 female participants (median age, 68 years; median body mass index, 21.4 kg/m2), including 64 patients with diabetes mellitus (25.5%). Preoperative CT evaluation showed a serrated pancreatic contour in 80 patients (31.9%), a pancreatic thickness of 9.3 mm (4.0–22.0 mm), pancreatic parenchymal CT value of 41.8 HU (4.3–22.0 HU), and pancreas-visceral fat CT value ratio of − 0.41 (− 4.88 to − 0.04). Postoperative pancreatic fistulas were developed in 34.2% of the patients. Univariate analysis of risk factors for postoperative pancreatic fistulas showed that younger age (P = 0.005), high body mass index (P = 0.001), absence of diabetes mellitus (P = 0.002), high preoperative C-reactive protein level (P = 0.024), pancreatic thickness (P

Abstract Background To evaluate the impact of three risk factors (age [≥75 years], renal impairment [creatinine clearance

Abstract Background Left‐sided portal hypertension (LSPH) caused by splenic vein (SV) division in pancreaticoduodenectomy (PD) with portal vein (PV) resection remains challenging. The current study aimed to investigate the efficacy of splenic artery (SA) ligation in preventing LSPH. Methods One‐hundred thirty patients who underwent PD with PV resection for pancreatic ductal adenocarcinoma were classified into SV and SA preservation (SVP, n = 30), SV resection and SA preservation (SVR, n = 59), and SV resection and SA ligation (SAL, n = 41). The postoperative incidence of LSPH was assessed. Results The incidence of variceal formation in SVP, SVR, and SAL were 4.8%, 53.2%, and 46.4% at 3 mo, 13.0%, 71.2%, and 62.5% at 6 mo, and 25.0%, 87.5%, and 87.1% at 12 mo, respectively. The rate was significantly higher in SVR at 3 and 6 mo (P = .001 and P

Abstract Background Olanzapine has been reported to be an effective antiemetic in patients receiving carboplatin-based chemotherapy. However, the efficacy of a neurokinin-1 receptor antagonist (NK1RA) added to olanzapine, a 5-hydroxytryptamine-3 receptor antagonist (5-HT3RA), and dexamethasone (DEX) has not been proven. This study aimed to assess the efficacy and safety of NK1RA, in combination with three-drug antiemetic regimens containing olanzapine, in preventing nausea and vomiting induced by carboplatin-based chemotherapy. Methods Data were pooled for 140 patients receiving carboplatin-based chemotherapy from three multicenter, prospective, single-arm, open-label phase II studies that evaluated the efficacy and safety of olanzapine for chemotherapy-induced nausea and vomiting. The propensity score of the co-administration of NK1RA was estimated for each patient using a logistic regression model that included age, sex, and carboplatin dose. We analyzed a total of 62 patients, who were treated without NK1RA (non-NK1RA group: 31 patients) and with NK1RA (NK1RA group: 31 patients). The patients were selected using propensity score matching. Results The complete response rate (without emetic episodes or with no administration of rescue medication) in the overall period (0–120 h post carboplatin administration) was 93.5% in the non-NK1RA group and 96.8% in the NK1RA group, with a difference of -3.2% (95% confidence interval, -18.7% to 10.9%; P = 1.000). In terms of safety, there was no significant difference between the groups in daytime sleepiness and concentration impairment, which are the most worrisome adverse events induced by olanzapine. Conclusions The findings suggest that antiemetic regimens consisting of olanzapine, 5HT3RA, and DEX without NK1RA may be a treatment option for patients receiving carboplatin-based chemotherapy.

Simple Summary: Feline gingivostomatitis is a common condition affecting the oral cavity of cats, characterized by severe mucosal inflammation. The etiopathogenesis remains not fully clear, but it is known to be multifactorial, involving alterations in immune response which may be related to infectious agents. Other potential triggers include food sensitivity and genetic and environmental factors. This study followed a cat refractory to conventional treatment who was placed on an elimination diet. After the implementation of the elimination diet, the cat showed remission of oral lesions. This report aims to highlight the importance of recognizing food sensitivity as a significant factor in maintaining the chronicity of the disease and how dietary management and switching to a hypoallergenic diet can aid in controlling the lesions. To the authors' knowledge, this is the first documented case demonstrating the impact of food sensitivity on the progression of feline gingivostomatitis. The findings emphasize the importance of incorporating nutritional considerations into the comprehensive management of this challenging condition. Feline stomatitis or gingivostomatitis is a chronic inflammatory condition affecting approximately 0.7% of patients. The cause is multifactorial, involving infectious agents, genetic factors, and environmental influences. Therapeutic strategies include pharmacological and surgical interventions to controlling inflammation and enhancing patient quality of life. There are discussions in the literature regarding the potential involvement of adverse food reactions as a contributing factor to oral cavity lesions, without clear evidence. This case report describes the control of gingivostomatitis with a hypoallergenic diet in a cat that had oral lesions and who was refractory to conventional treatment with prednisolone and cyclosporine, even after periodontal treatment and partial tooth extraction. After 30 days of dietary change, there was complete remission of the lesions. The animal was then re-exposed to the previous food, with new lesions appearing after 7 days. Upon returning to the hypoallergenic food, there was new remission of the lesions. This report suggests that food sensitivity may play a role in the control of feline gingivostomatitis, as periods of hypoallergenic diet coincided with the remission of the condition, even without changes in medication. It reinforces the importance of investigating adverse food reactions as clinical signs in the oral cavity of cats. [ABSTRACT FROM AUTHOR]

Background: Prognostic implications of peritoneal washing cytology (CY) in patients with localized pancreatic ductal adenocarcinoma (PDAC) undergoing surgical resection following preoperative chemoradiotherapy (CRT) remain unclear. This study aimed to elucidate the prognostic significance and predictors of a positive CY status (CY+) after preoperative CRT. Methods: Clinical data from 141 patients with localized PDAC who underwent curative-intent resection after preoperative CRT were retrospectively analyzed to examine the association between CY+ and clinicopathological factors and survival. Results: CY+ was observed in six patients (4.3%). The CY+ group exhibited significantly higher preoperative serum levels of CA19-9 and a substantially greater incidence of tumor location in the pancreatic body or tail, along with pathological invasion to the anterior pancreatic capsule, than the CY− group. The CY+ group had a significantly higher incidence of peritoneal recurrence compared with the CY− group (83.3% vs. 18.5%, p = 0.002). Overall survival (OS) and recurrence-free survival (RFS) after surgery were significantly shorter in the CY+ group than in the CY− group (CY+ vs. CY−: 18.3 vs. 46.2 months, p = 0.001, and 8.9 vs. 17.7 months, p = 0.009, respectively). Multivariate analyses identified CY+ as an independent prognostic factor for worse OS (hazard ratio 5.00, 95% confidence interval 1.03–12.31) and RFS (hazard ratio 2.58, 95% confidence interval 1.04–6.43). Local invasion grade on imaging before CRT, limited histological response to CRT, and absence of adjuvant chemotherapy were independent predictors of worse OS and RFS. Conclusion: Despite the relatively low incidence of CY+ after preoperative CRT, it emerged as an independent prognostic factor in patients with localized PDAC undergoing curative-intent resection following preoperative CRT. [ABSTRACT FROM AUTHOR]

The computational balance between the model grid resolution and the complexity of the data assimilation technique is essential for accurate aerosol forecasting and obtaining aerosol reanalysis data sets. This study aimed to develop a high‐resolution aerosol assimilation system. A 2‐dimensional variational method (2DVar) was implemented in a non‐hydrostatic icosahedral atmospheric model (NICAM). This new model (NICAM/2DVar), with a global grid size of 56 km, assimilated the observed aerosol optical depth (AOD) that is estimated by combining multiple products of geostationary and polar‐orbital satellites. The model results were evaluated against ground‐based AOD observations on a global scale. They exhibited higher correlations, lower uncertainties, and lower biases than those obtained without the 2DVar. The model also reproduced the observed surface aerosols (PM2.5) mass concentrations, especially in Kyushu, Japan. This occurred because the satellite‐estimated AODs over ocean close to air pollution sources were obtained for many occasions. The correlation coefficient values against the PM2.5 observations increased from 0.44 to 0.65 compared to the results without the 2DVar. The impact of the 2DVar on the forecast results was investigated, and the forecast values for 2–3 days were improved. Because satellite‐retrieved AODs are often lacking over land owing to retrieval difficulties, the use of ground‐based AODs in assimilations is essential for precise processing the of aerosol reanalysis data sets. The computational cost with the use of the 2DVar was only 0.6% more than that without its use. Thus, aerosol assimilation using the NICAM/2DVar can be realistically extended to finer grid sizes. Plain Language Summary: High‐resolution models and data assimilation techniques should be used to obtain more accurate aerosol distributions. We combined a high‐resolution model and an assimilation method at a low computational cost. We also integrated multiple aerosol satellite products. The new procedure successfully reproduced the aerosol observations. The results were significantly better when observations for multiple grids and times were available. Surface measurements on land, for which satellites often lack aerosol signals, are helpful. Key Points: Combined geostationary and polar orbital satellite aerosol products were assimilatedThe aerosol assimilation results improved with increasing spatiotemporal coverage of the observationsEven though the column‐integrated aerosol optical depth was assimilated, surface aerosol (PM2.5) concentration improved [ABSTRACT FROM AUTHOR]