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A new method of environmental control that does not depend on motor functions is eagerly awaited to support independent living for people with severe quadriplegia. In this study, we conducted an exploratory case study of brain state discrimination in a quadriplegic subject to develop a brain-computer interface controlled by a mental task execution. We measured near-infrared spectroscopy (NIRS) signals in a patient with a cervical spinal cord injury while performing mental tasks. A block design with a task and a rest separated by 30 seconds was used to measure brain function. The utilized mental tasks were mental arithmetic and Japanese word chains. Seventeen trials of the NIRS signal were acquired for each task, and 52 samples with 24-dimensional features per trial data were extracted. Random forest was used as the classifier, and the number of correct responses in the binary discrimination of the brain states were calculated by cross-validation. The exact binomial test was used for the statistical analysis, and a two-tailed test with a significance level of 5% was performed. The results showed that the number of correct responses was 15 out of 17 (p = 0.002) for the mental arithmetic task and 14 out of 17 (p = 0.013) for the Japanese word chains task, for an overall accuracy of 85%. These results indicate that this method can discriminate the brain state of a patient with quadriplegia from the NIRS signal. By applying these findings to a brain-computer interface, it will be possible to provide a new means of environmental control for individuals with quadriplegia. [ABSTRACT FROM AUTHOR]

Various studies on autonomous robots that perform physical tasks in living environments are being conducted at present to solve the social problems of an aging society with a low birth rate. However, because it remains difficult for all robots to work autonomously in complicated environments, remote control robots may be useful for practical applications. As the purpose of remote control robots is to make direct connections between the operator and user, they may reduce affinity between the robot and the user. In this study, we define autonomous remote control robots with the aspects of both autonomy and remote operation explicitly. Affinity is compared among autonomous remote control robots, remote control robots, and autonomous robots, through controlled experiments on interactions in fetch-and-carry tasks using a domestic mobile manipulator, Human Support Robot, on a test field that is compliant with the World Robot Summit 2020 Rulebook. The results demonstrate that affinity exhibits the following order: autonomous robots, autonomous remote control robots, and remote control robots. Considering that autonomous robots remain under development, autonomous remote control robots may be beneficial for expanding the abilities of physical tasks and social acceptance. [ABSTRACT FROM AUTHOR]

In this study, we investigated the effect of the dynamic changes in brain activation during neurofeedback training in the classification of the different brain states associated with the target tasks. We hypothesized that ongoing activation patterns could change during neurofeedback session due to learning effects and, in the process, could affect the performance of brain state classifiers trained using data obtained prior to the session. Using a motor imagery paradigm, we then examined the application of an incremental training approach where classifiers were continuously updated in order to account for these activation changes. Our results confirmed our hypothesis that neurofeedback training could be associated with dynamic changes in brain activation characterized by an initially more widespread brain activation followed by a more focused and localized activation pattern. By continuously updating the trained classifiers after each feedback run, significant improvement in accurately classifying the different brain states associated with the target motor imagery tasks was achieved. These findings suggest the importance of taking into account brain activation changes during neurofeedback in order to provide more reliable and accurate feedback information to the participants, which is critical for an effective neurofeedback application. [ABSTRACT FROM AUTHOR]

Motor imagery (MI), a covert cognitive process where an action is mentally simulated but not actually performed, could be used as an effective neurorehabilitation tool for motor function improvement or recovery. Recent approaches employing brain--computer/brain--machine interfaces to provide online feedback of the MI during rehabilitation training have promising rehabilitation outcomes. In this study, we examined whether participants could volitionally recall MI-related brain activation patterns when guided using neurofeedback (NF) during training. The participants' performance was compared to that without NF. We hypothesized that participants would be able to consistently generate the relevant activation pattern associated with the MI task during training with NF compared to that without NF. To assess activation consistency, we used the performance of classifiers trained to discriminate MI-related brain activation patterns. Our results showed significantly higher predictive values of MI-related activation patterns during training with NF. Additionally, this improvement in the classification performance tends to be associated with the activation of middle temporal gyrus/inferior occipital gyrus, a region associated with visual motion processing, suggesting the importance of performance monitoring during MI task training. Taken together, these findings suggest that the efficacy of MI training, in terms of generating consistent brain activation patterns relevant to the task, can be enhanced by using NF as a mechanism to enable participants to volitionally recall task-related brain activation patterns. [ABSTRACT FROM AUTHOR]

The first two examples of a tetrasilatetrathia[8]circulene were synthesized in two steps from a tetraiodotetrathienylene by using a fourfold intramolecular dehydrogenative silylation of C−H bonds as the key step. A single-crystal X-ray diffraction analysis revealed that tetrasilatetrathia[8]circulene contains a perfectly planar [8]radialene skeleton. The excited-state dynamics of tetrasilatetrathia[8]circulene were evaluated by steady-state and time-resolved spectroscopic measurements, revealing an efficient intersystem crossing in the excited state. [ABSTRACT FROM AUTHOR]

SUMMARY When people listen to other's speech for the first time, they always attribute personality traits to the speaker subconsciously. We consider that if robots can predict personality traits of users from their speech, the communication in human-machine interaction will improve significantly. This paper proposes an approach for the automatic estimation of the traits, in which the listeners attribute to unanimous speakers. And the discrimination experiments based on hidden Markov model and canonical discrimination analysis show that, it is possible to predict with high accuracy (more than 75%), whether a speaker is perceived to be in the higher or lower part of the 'Extraversion', 'Openness', and 'conscientiousness' by using nonverbal information. [ABSTRACT FROM AUTHOR]

We have succeeded in the diversity-oriented synthesis of tetrathia[8]circulenes by sequential C–H borylation and annulation from cyclic tetrathiophene, and time-resolved microwave conductivity studies have proved that the intrinsic hole mobilities of tetrathia[8]circulenes are dependent on the chain length of the alkyl substituents at the peripheral positions. [ABSTRACT FROM AUTHOR]

The mechanisms of the [2 + 2 + 2] cycloaddition reaction of three ethyne molecules were studied by ab initio molecular orbital and density functional methods. The transition states range from that of the concerted mechanism with D3h symmetry to that of the stepwise mechanism with C2 symmetry. The transition state structure and the activation energy depend on the basis set and computational method employed in the analysis. The activation energy barrier was determined to be in the range of 36-44 kcal/mol. The activation energy determined by various methods corresponds to the interaction energy, which is related to the electron correlation energy. The best estimation of the activation energy barrier is 41.6 kcal/mol, achieved from the relation between the interaction energy and the activation energy. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

With the development of computer networks, it has become easy to have huge databases. Accordingly, it is becoming difficult for users to extract knowledge from such databases. In this paper we focus on data mining, especially classification. In real-world data mining, the missing value problem occurs in cases such as speech containing noise, facial occlusion, and the like. When a test sample has missing values, a classification system cannot handle them. In previous studies, various imputation methods have been developed, with the objective of solving the missing value problem with numerous explanatory variables, even if some explanatory variables were ineffective for imputation. It has been said that the use of many variables degrades learning efficiency, and thus we believe that imputation methods should be developed considering the relations among explanatory variables. It is also effective to consider the relations between the test sample and each of the training samples. Therefore, we have proposed an imputation method using a Bayesian network with weighted learning. Experiments have confirmed that the proposed method imputes missed values with approximate values, and the classification system successfully classified test samples in which missed values were imputed by the proposed method, with better success than some conventional imputation methods. [ABSTRACT FROM AUTHOR]

An artificial ecosystem model was developed to study complex behavior of real organisms. The subject of the research is multigenerational migration of the Monarch butterfly in North America, and we approached the problem from an evolutionary simulation. The ecosystem consists of artificial agents and five areas. The model is based on real organisms and the areas where they live simulated with a genetic algorithm. We then designed a model of agents that have genetic factors. These genetic factors determine the behavioral strategies, physical features, and transformational strategies of the agent. Each area is modeled on areas where we can see the migration of the Monarch, and the environmental factors of each area change periodically. Because of the genetic factor of the agent and the change of the environmental factors, the agent adapts to the environment and evolves gradually by using a genetic algorithm. Results of the evolutionary simulation show that multigenerational migration behavior of the agent emerges as its genetic factors adapt to periodic changes of the environmental factors in their evolution. The migration process of agents and their genetic factors are discussed, and the migration of the agent and that of the Monarch butterfly are compared. [ABSTRACT FROM AUTHOR]

We used the method of moments (MoM), which is a numerical electromagnetic field computation method, to study the surge characteristics of twisted pair single-phase electric power lines. The results show that wires stranded with less than several turns per meter have almost the same surge characteristics as parallel lines, but the surge impedance decreases in tens of % when the number of strands increases. To verify the simulation results, we measured the surge characteristics of a model line of twisted pair experimentally, and there is good accordance between them. It is possible to simulate the surge in twisted pair covered with polymer dielectric insulators by MoM. Moreover, we studied the surge characteristics of twisted pair which is inserted into a metal tube. According to the results, the effect of the strand is smaller than that in free space without the metal pipe. There are two propagation modes in common mode: fast surge and slow surge. Few influences of the number of strands on the surge velocity occur in the fast propagation surge, but the increase of the surge impedance and the slowdown of the propagation speed are caused by twining in the slow propagation mode. © 2009 Wiley Periodicals, Inc. Electr Eng Jpn, 167(3): 1–9, 2009; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/eej.20737 [ABSTRACT FROM AUTHOR]

This paper proposes a method for dynamic load balancing which works efficiently in the workstation cluster environment. A parallel abductive reasoning system based on the proposed method is also proposed. In the workstation cluster environment, parallel processing is performed using workstations with various processing abilities and loads. Thus, dynamic load balancing must consider the performance and loading conditions of the workstations. This paper proposes a method of estimating the processing ability of the workstation during operation, and also a dynamic load balancing algorithm to balance the estimated conditions. Using the proposed method, a parallel abductive reasoning system which can derive the most preferable explanation for a given observation is implemented. The results of experiments on the system are also reported. © 2006 Wiley Periodicals, Inc. Syst Comp Jpn, 37(3): 80–89, 2006; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/scj.10190 [ABSTRACT FROM AUTHOR]

This paper presents the fundamental surge phenomenon when a step voltage is applied to a horizontal line above the ground which has branch feeders. We study line current and voltage at joint with the method of moments that calculates electromagnetic field in frequency domain. It is widely noted that the current reflection factor changes to a third at the junction of the same three lines in conventional transmission line theory based on TEM wave, and the stepwise current reflected appears overlapping to the incident current. On the other hand, the reflected current from the joint shows the inductive characteristic or the capacitive one depending on the angle between lines, which varies gradually and not stepwise in our numerical analysis considering TM wave. The time characteristic of the voltage at joint depends on the angles also, and the peak voltage slightly exceeds the voltage by the transmission line theory. These phenomena are caused by the electromagnetic coupling between the main line and branch lines. In addition to the computer simulations, we measured the currents in the reduced-scale model lines and the results show the validity of our analysis regarding changes of the reflected current depending on the angles. © 2003 Wiley Periodicals, Inc. Electr Eng Jpn, 144(2): 1–8, 2003; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/eej.10176 [ABSTRACT FROM AUTHOR]

AbstractBackground and Objectives: In geriatrics and dementia care, early diagnosis is crucial. We developed a dementia screening model using drawing features from clock drawing tests (CDT) and investigated the features contributing to the discrimination of dementia and its screening performance. Methods: This study included 129 older adults attending a dementia outpatient clinic. We obtained information on the diagnosis of dementia and CDT data from medical records and quantified 12 types of drawing features according to the Freedman scoring system. Based on the dementia diagnosis information, participants were assigned to two groups: 58 in the dementia diagnosis group and 71 in the non-diagnosis group. Using Boruta, an iterative feature selection algorithm, and a support vector machine, a machine learning method, we analyzed the drawing features contributing to dementia discrimination and evaluated discrimination performance. Results: Five types of drawing features were selected as contributors to discrimination, including “numbers in the correct position,” “minute target number indicated,” and “hand in correct proportion.” These features exhibited a discriminating sensitivity of 0.74 ± 0.16 and specificity of 0.74 ± 0.18 for detecting dementia. Conclusion: This study demonstrated a method for identifying individuals likely to be diagnosed with dementia among patients attending a dementia outpatient clinic using drawing features. The knowledge of drawing features contributing to dementia differentiation may assist healthcare practitioners in clinical reasoning and provide novel insights for clinical practice. In the future, we plan to develop a primary screening for dementia based on machine learning using CDT. [ABSTRACT FROM AUTHOR]

This paper proposes a transmission line tower model in frequency domain for back-flashover analysis, which has a uniform characteristics impedance and a uniform propagation constant. Most conventional tower models are constructed as a constant and uniform parameter transmission line that is independent of frequency. However, the author's models have the frequency dependency of the characteristics impedance and the propagation constant to express the frequency characteristics of the transmission line tower. Two models, a cylinder model and a four-frames model, were investigated to stimulate the tower. Their surge response were computed by numerical electromagnetic field analysis based on the moment method. From the results, the two-port circuit constants were calculated in the frequency domain, and the characteristics impedance and the propagation constant are derived from them. The complex artificial oscillations appeared in frequency dependency of the parameters because the parameters were calculated numerically. The equations with analytical form were obtained by approximating with a smooth curve to the oscillations. It is possible for the equations to represent the transmission line constants as a function of geometrical parameters such as the towers height and the radius. Close agreement was found between the surge response computed by the numerical electromagnetic field analysis and the result calculated by inverse Laplace transformation of the analytical equations. To prove the model, the experimental results were compared with the computed ones of the cylinder model that has arms, and it was shown that the new model agrees closer with the experiment than conventional transmission line models. [ABSTRACT FROM AUTHOR]

Discusses the use of the finite element method in analysis of distributed constant circuits. Calculation of the electric field distribution; Importance of taking into account the frequency dependence of ac electrical potential for the calculation; Description of the behavior of electromagnetic field in general.

Background: Pemetrexed (PEM) is the primary chemotherapy for non‐small cell lung cancer (NSCLC), showing potential for long‐term disease stability in certain cases. However, studies examining disease control with PEM therapy are lacking. This study aimed to pinpoint clinical traits in patients with NSCLC responding well to PEM therapy, predict factors influencing disease control, and suggest optimal treatment approaches. Methods: A retrospective analysis of patients with NSCLC treated with PEM was performed to compare patients who achieved disease control after treatment with those who did not. Results: Of 73 patients, 56 (76.7%) achieved disease control with PEM therapy. In the disease control group, a significantly higher proportion of patients exhibited good performance status (PS) and received PEM doses without reduction after the second cycle. Multivariate analysis identified bevacizumab (Bev) noncompliance, PEM dose reduction, and thyroid transcription factor‐1 (TTF‐1) negativity as significant independent risk factors for disease progression during PEM therapy. Additionally, overall survival was significantly longer in the disease control group (p < 0.001). Conclusions: Our findings indicated that maintaining the dose of PEM after the second treatment cycle in patients with NSCLC, along with concurrent use of Bev and the presence of TTF‐1 positivity, could enhance disease control rates and extend survival. [ABSTRACT FROM AUTHOR]

Background: Several options for second-line therapy are available for patients with advanced non-small cell lung cancer (NSCLC); however, the optimal therapy remains unclear. Docetaxel (DTX) monotherapy and DTX plus ramucirumab (RAM) are the recommended second-line treatment options. However, the efficacy of these treatments remains unsatisfactory. The aim of this study was to identify the clinical characteristics of patients with NSCLC who respond to DTX or DTX + RAM and factors that predict response. Methods: Patients with NSCLC treated with DTX or DTX + RAM after second-line therapy were retrospectively analyzed. Patients were compared with those who responded or did not respond to the post-treatment efficacy assessment. Results: Of 53 patients, 12 (22.6%) had lung cancer that responded to DTX or DTX + RAM therapy (response group). Multivariate analysis identified the absence of immune checkpoint inhibitors (ICIs) in the immediate prior therapy and a reduced dose of DTX after the second cycle as significant independent risk factors predicting nonresponse to DTX and DTX + RAM therapy in patients with NSCLC. The overall survival was significantly longer in the response group compared to the nonresponse group (p = 0.016). Conclusions: Our results suggest that DTX and DTX + RAM therapies immediately after treatment with ICI-containing regimens as well as continuation of DTX without dose reduction after the second cycle may increase the response rate and prolong survival in patients with NSCLC. [ABSTRACT FROM AUTHOR]

The synthesis of tetrasilatetrathia[8]circulenes as a new family of hetro[8]circulenes from tetrathienylene is described. The saddle structure of tetrathienylene was transformed into the planar structure of tetrasilatetrathia[8]circulene by using iridium, palladium, and rhodium catalysis. For more information, see the Communication by Y. Miyake et al. on page 6948 ff. [ABSTRACT FROM AUTHOR]

Synthesis of tetrathia[8]circulenes is achieved by sequential C-H borylation and annulation from cyclic tetrathiophene. [ABSTRACT FROM AUTHOR]

To the best of our knowledge, no previous reports have described the indication criteria and details of uniportal video-assisted thoracoscopic lobectomy in younger children. We report the utility of uniportal video-assisted thoracoscopic right lower lobectomy via a 2-cm incision in a 2-year-old child with a prenatal diagnosis of congenital cystic lung disease. A male infant with a prenatal diagnosis of congenital cystic lung disease was delivered vaginally at 36 weeks of gestation. Computed tomography after birth showed that the disease was limited to the right lower lobe. The patient was asymptomatic and was initially treated conservatively. At the age of 2 years and 10 months, when compensatory lung growth can still be expected, the patient had become large enough to safely undergo one-lung ventilation and thoracoscopic surgery. Therefore, we decided to perform a curative lobectomy. A single 2-cm incision was made at the anterior axillary line on the 6th intercostal space. The vessels and bronchus were approached from the anterior side. We used a 3-mm thoracoscope and instruments with a small diameter. The patient was discharged without any complications or need for analgesic drugs. The crossing technique was utilized to minimize the interference between multiple instruments in a small incision with a narrow intercostal space. [ABSTRACT FROM AUTHOR]

Background: Immune checkpoint inhibitor (ICI) monotherapy is currently approved for the treatment of advanced non‐small cell lung cancer (NSCLC) patients with programmed death ligand‐1 (PD‐L1) expression ≥50%. However, the efficacy of ICI monotherapy in patients with PD‐L1 expression <50% has not yet been fully elucidated. The aim of this study was to identify the clinical characteristics of NSCLC patients with PD‐L1 expression <50% who respond to single‐agent ICIs and factors that predict response. Methods: Patients with advanced or recurrent NSCLC with a PD‐L1 tumor proportion score (TPS) of 50% or less who received new monotherapy with an ICI between July 2012 and December 2022 were retrospectively analyzed. Patients with response were compared with those without response in the post‐treatment response assessment. Results: Among the 37 patients, six (16.2%) NSCLC patients in the response group responded to ICI monotherapy and had a significantly lower body mass index (BMI) (p = 0.003). Significantly more patients in the response group developed immune‐related adverse events (irAEs) than in the nonresponse group (p < 0.001). Multivariate analysis identified high BMI as a significant independent risk factor predicting nonresponse to ICI monotherapy in NSCLC patients with PD‐L1 < 50%. Conclusions: Among NSCLC patients with PD‐L1 < 50%, those with a higher BMI were more likely to be nonresponders to ICI monotherapy. In addition, the group that responded to ICI monotherapy may have been at higher risk of developing irAEs, suggesting that careful follow‐up is warranted. [ABSTRACT FROM AUTHOR]

Background: Amrubicin (AMR) has become the standard of care for post‐relapse small cell lung cancer (SCLC). It has also been reported to achieve long‐term disease control in patients with good treatment response. However, the optimal patient population for whom AMR is effective and the factors associated with long‐term disease control are yet to be identified. The aim of the study was to identify the clinical characteristics and factors associated with long‐term disease control in patients with recurrent SCLC who would benefit from AMR therapy. Methods: The clinical records of 33 patients diagnosed with recurrent SCLC and treated with AMR were retrospectively reviewed. Clinical information was compared between patients who achieved disease control (effective group) and who developed disease progression (noneffective group) on the first efficacy assessment after AMR and between patients who continued AMR for more than seven cycles (maintenance group) and those who terminated treatment after 1–6 cycles (discontinuation group). Results: The noneffective group included significantly more patients with AMR dose reductions after the second cycle (p = 0.006). AMR dose reduction was an independent risk factor for disease progression. The maintenance group had significantly lower pretreatment lactate dehydrogenase (LDH) levels than the discontinuation group (p = 0.046). A high LDH level was an independent risk factor for short AMR discontinuation. Overall survival was significantly longer in the effective group than in the noneffective group (p < 0.001). Conclusions: In AMR therapy for patients with relapsed SCLC, continuation of AMR without dose reduction after the second cycle may contribute to disease control and prolonged survival. [ABSTRACT FROM AUTHOR]

Koichi Yamamura,&ast; Masafumi Nojiri,&ast; Kazuaki Nishiki, Ryo Kato, Shohei Shinomiya, Yutaka Takahara, Taku Oikawa, Takeshi Ishizaki, Hirohisa Toga, Shiro Mizuno Department of Respiratory Medicine, Kanazawa Medical University, Ishikawa, Japan&ast;These authors contributed equally to this workCorrespondence: Shiro Mizuno, Department of Respiratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa, 920-0293, Japan, Tel +81-76-218-8157, Fax +81-76-286-0980, Email shirotan@kanazawa-med.ac.jpPurpose: Oxidative stress is known to activate tumor suppressor p53, which inhibits cell cycle progression and induces apoptosis. Levels of p53 in lung tissues from patients with chronic obstructive pulmonary disease (COPD) are increased compared with levels in nonsmokers or smokers without emphysema. A polymorphism in p53 codon 72 (rs1042522) is associated with emphysematous changes in patients with COPD. However, whether oxidative stress in the serum is associated with the p53 polymorphism and disease severity in COPD patients is unclear.Patients and Methods: A total of 251 patients with a history of smoking more than 10 pack-years were enrolled in this study, and serum levels of derivatives of reactive oxygen metabolites (d-ROMs), biological antioxidant potential (BAP), and d-ROMs/BAP ratio (oxidative stress index; OSI) were measured. The percent low-attenuation area (LAA%) and cross-sectional area of the erector spinae muscles (ESMCSA) at the Th12 level were calculated from chest high-resolution computed tomography images. p53 codon 72 C/G genotyping was performed using polymerase chain reaction–restriction fragment length polymorphism analysis.Results: In patients carrying the p53 GG genotype, LAA% was significantly higher than in those carrying the CC genotype. d-ROM levels and OSI were associated with COPD severity and correlated with airflow limitation and markers of muscle atrophy (ESMCSA and creatinine/cystatin C ratio). Associations between markers of oxidative stress and COPD severity were observed primarily in patients carrying the p53 codon 72 GG genotype.Conclusion: Susceptibility to pulmonary emphysema and responses to oxidative stress may be affected by the p53 gene polymorphism.Keywords: oxidative stress, low attenuation area, sarcopenia, smoking status

Although urine and bladder washing samples are commonly used for the cytological evaluation of the bladder mucosa, it has been unknown whether these samples are likely suitable to investigate human papillomavirus (HPV) prevalence in the urinary bladder. The present study aimed to elucidate the appropriateness of spontaneously voided urine or bladder washing in screening HPV infection in the urinary bladder. Urine and bladder washing samples were obtained from 201 patients who underwent transurethral bladder tumor resection. After extracting DNA from both samples, HPV‐DNA was examined using a nested polymerase chain reaction with GP5+/6+ and MY09/11 primers. HPV genotyping was performed in the HPV‐positive samples. In situ hybridization (ISH) was performed to observe the HPV‐DNA localization in urothelial cells among cytological samples and paraffin‐embedded tumor tissues in HPV‐positive washing samples. HPV prevalence in urine and washing samples were 9.5% and 7.0%, respectively. High‐risk HPV prevalence in urine and washing samples was 7.5% and 4.0%, respectively. The most common HPV type was HPV 16, followed by HPV 52 and HPV 18 in both samples. HPV type distribution in both samples was not in agreement (κ = −0.431). The ISH analysis revealed that HPV‐DNA signal was observed in urothelial cells of five (55.7%) of nine detectable HPV‐positive cytological samples. Six (66.7%) of nine HPV‐positive cases had HPV‐DNA signals in tumor tissue. The use of washing samples was likely applicable for investigating HPV prevalence in the urinary bladder. HPV‐DNA detected in washing samples might be frequently derived from the urinary bladder. [ABSTRACT FROM AUTHOR]

Background: The clinical characteristics and risk factors for cancer recurrence have not been well evaluated regarding early recurrence in patients with unresectable locally advanced non-small cell lung cancer (LA-NSCLC) who receive concurrent chemoradiotherapy (CRT). The aim of this study was to determine the clinical characteristics and risk factors of patients with stage III unresectable LA-NSCLC treated with CRT who developed early recurrence. Methods: We retrospectively reviewed the clinical records of 46 patients diagnosed with stage III unresectable LA-NSCLC treated with CRT at our center between July 2012 and July 2021. A tumor proportion score (TPS) < 50% was defined as "low expression" and a TPS > 50% was defined as "high expression." Results: A total of 17 (37.0%) patients had a confirmed recurrence within 1 year of treatment. More patients had a lower body mass index in the early recurrence group than in the later recurrence group (p = 0.038). A higher number of patients in the late recurrence group underwent surgery after CRT (p = 0.036). Patients with a higher TPS were more likely to experience late recurrence than early recurrence (p = 0.001), whereas more patients with stage N3 disease were in the early recurrence group (p = 0.011). Multivariate analysis identified lower TPS expression as an independent risk factor for early recurrence after CRT. Overall survival was prolonged in the late recurrence group (p < 0.001). Conclusions: A lower TPS may be a predictor of early recurrence after CRT in patients with LA-NSCLC. These patients should be closely monitored for post- treatment recurrence. [ABSTRACT FROM AUTHOR]

Kazuaki Nishiki, Masafumi Nojiri, Ryo Kato, Shohei Shinomiya, Taku Oikawa, Takeshi Ishizaki, Hirohisa Toga, Shiro Mizuno Department of Respiratory Medicine, Kanazawa Medical University, Ishikawa, JapanCorrespondence: Shiro MizunoDepartment of Respiratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa, 920-0293, JapanTel +81-76-218-8157Fax +81-76-286-0980Email shirotan@kanazawa-med.ac.jpPurpose: Muscle atrophy is a major clinical feature of chronic obstructive pulmonary disease (COPD) and is considered a predictor of mortality in COPD patients. Recently, the cross-sectional area (CSA) of the erector spinae muscles measured by chest computed tomography (CT) scans (ESMCSA) has been reported as a clinical parameter reflecting disease severity and future prognosis in patients with COPD. In addition, the serum creatinine (Cr)/cystatin C (CysC) ratio has been considered a quantitative marker of residual muscle mass, because serum Cr levels are affected by muscle mass, and correction by CysC counteracts the effect of renal function on serum Cr levels. The purpose of this study was to assess whether the serum Cr level corrected by serum CysC can be used as a predictive marker of pulmonary function and disease severity in patients with COPD.Patients and Methods: A total of 99 patients without COPD and 201 patients with COPD, with a smoking history of more than 10 pack-years were enrolled in this study, and serum Cr and CysC levels were measured. On chest high-resolution CT images, %low attenuation area (LAA%) (≤ 960 Hounsfield units (HU)) and ESMCSA at the Th12 level were identified.Results: There was a significant correlation between the ESMCSA and the Cr/CysC ratio. The Cr/CysC ratio was significantly associated with forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) values, especially in former smokers.Conclusion: The serum Cr/CysC ratio could be a convenient substitute for the measurement of muscle atrophy and pulmonary function testing in patients with COPD.Keywords: muscle atrophy, low attenuation area, sarcopenia, smoking status

Uterine sarcomas have very poor prognoses and are sometimes difficult to distinguish from uterine leiomyomas on preoperative examinations. Herein, we investigated whether deep neural network (DNN) models can improve the accuracy of preoperative MRI-based diagnosis in patients with uterine sarcomas. Fifteen sequences of MRI for patients (uterine sarcoma group: n = 63; uterine leiomyoma: n = 200) were used to train the models. Six radiologists (three specialists, three practitioners) interpreted the same images for validation. The most important individual sequences for diagnosis were axial T2-weighted imaging (T2WI), sagittal T2WI, and diffusion-weighted imaging. These sequences also represented the most accurate combination (accuracy: 91.3%), achieving diagnostic ability comparable to that of specialists (accuracy: 88.3%) and superior to that of practitioners (accuracy: 80.1%). Moreover, radiologists' diagnostic accuracy improved when provided with DNN results (specialists: 89.6%; practitioners: 92.3%). Our DNN models are valuable to improve diagnostic accuracy, especially in filling the gap of clinical skills between interpreters. This method can be a universal model for the use of deep learning in the diagnostic imaging of rare tumors. [ABSTRACT FROM AUTHOR]

Aims: Data regarding prognostic events following catheter ablation (CA) for atrial fibrillation (AF) in patients with heart failure with preserved ejection fraction (HFpEF) are scarce. We conducted this study to compare the incidence of major adverse clinical events (MACE) following CA for AF between patients with HFpEF and those with systolic heart failure (HF). Methods and results: This single‐centre observational study included 142 patients with HF who underwent CA for AF (median follow‐up: 4.0 [2.6, 6.3] years). The patients were grouped based on the presence of HFpEF (n = 84) and systolic HF (left ventricular ejection fraction <50%, n = 58). We compared the cumulative incidence and incidence rate of MACE, comprising all‐cause death, unplanned cardiovascular hospitalization (CVH), and HF hospitalization (HFH) between both groups and the number of HFH before and after CA in each group. Multivariate analysis was performed to identify the predictors of MACE in patients with HFpEF. The incidence of MACE was comparable between the groups (following the first procedure: HFpEF: 23%, 4.7/100 person‐years, vs. systolic HF: 28%, 6.6/100 person‐years, P = 0.18; last procedure: 20%, 4.8/100 person‐years, vs. 24%, 6.9/100 person‐years, P = 0.21). Although the incidence of HFH was lower in patients with HFpEF than in those with systolic HF (first procedure: 14%, 2.9/100 person‐years, vs. 24%, 5.7/100 person‐years, P = 0.07; last procedure: 11%, 2.5/100 person‐years, vs. 24%, 6.9/100 person‐years, P = 0.01), the incidence of CVH was higher (first procedure: 8%, 1.7/100 person‐years, vs. 5%, 1.2/100 person‐years, P = 0.74; last procedure: 6%, 1.4/100 person‐years, vs. 2%, 0.5/100 person‐years, P = 0.4). The number of HFH significantly decreased in both groups after CA (HFpEF: 1 hospitalization [the first and third quartiles: 0, 1] in pre‐CA, vs. 0 hospitalizations [0, 0] in post‐CA, P < 0.0001; systolic HF: 1 hospitalization [0, 1], vs. 0 hospitalizations [0, 0], P < 0.005). The proportion of HFH among total clinical events was significantly smaller in patients with HFpEF than in those with systolic HF (following the first procedure: 56% vs. 88%, P < 0.005; last procedure: 52% vs. 92%, P < 0.005). Conclusions: CA for AF could be beneficial for patients with HFpEF, similar to those with systolic HF. However, clinical events other than HFH should be considered cautiously in such patients. [ABSTRACT FROM AUTHOR]