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Background/Aims: To evaluate invasive treatment outcomes for hepatocellular carcinoma (HCC) in patients aged over 90 years. Materials and methods: Twenty-six patients were included. Information on backgrounds, course of treatment, outcomes, and changes in Child-Pugh (CP) score and performance status (PS), as well as a comparison of treatment-related complications and 2-year survival after treatment, were retrospectively examined and compared with 311 patients aged under 90 years who were matched under the same conditions. Results: The mean patient age was 91.1 years. Seventeen patients had cirrhosis. The CP score was ≤ 7 across all cases. The Barcelona Clinic Liver Cancer stage was ≤B across all cases. The initial treatments were percutaneous local treatment and transcatheter arte- rial chemoembolization in 14 and 12 cases, respectively. Several patients with postoperative delirium and cognitive impairment were observed. No significant early post-treatment declines were observed in hepatic reserve and PS. The cumulative survival rates after treatment were 77.8% and 61.5% at 12 and 24 months, respectively. The 2-year survival after treatment for patients aged under 90 years was 87.4% and 75.7% at 12 and 24 months, respectively. No significant difference was observed in treatment-related complica- tions or 2-year survival rates between patients aged over and under 90 years. Conclusion: This is the first report to analyze the course of invasive treatment for HCC in patients aged over 90 years. Safety was ensured if hepatic reserve and PS were maintained. The 2-year survival was comparable with that of patients aged under 90 years, sug- gesting benefit from HCC treatment.

Introduction: The diagnostic tools of nucleic acid amplification tests and antigen tests have been extensively employed for the detection of Coronavirus disease 2019 (COVID-19). Although the reverse-transcriptase polymerase chain reaction (RT)-PCR test has high sensitivity and specificity, it is a time-consuming and labor-intensive process. On the other hand, antigen tests are simple and prompt, however, their low sensitivity and potential for false positives have been identified as limitations. In light of these factors, the development of novel tests that combine speed and clinical dependability is a promising prospect., Methods: Surface plasmon field-enhanced fluorescence spectroscopy (SPFS) excites chromophores by means of an enhanced electromagnetic field induced on a gold film surface. It enables the highly sensitive measurement of biomarkers in a short and simple 20-min window. In this study, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) SPFS-based antigen test targeting the SARS-CoV-2 nucleocapsid protein was performed and evaluated in 25 patients with COVID-19 and 10 non-infected controls., Results: A positive correlation was observed between antigen levels determined by SPFS and RNA levels determined via RT-PCR. The sensitivity values were 100 %, 92 %, and 62.5 %; and the specificity values were 100 %, 90 %, and 100 %; for nasopharyngeal swabs, nasal swabs, and saliva specimens when the cutoff values were set to 65.1, 0.2, and 1.5 pg/mL, respectively. No clinically problematic cross-reactivity with analogous coronaviruses was observed., Conclusions: The SARS-CoV-2 SPFS antigen test showed excellent clinical diagnostic accuracy for nasopharyngeal and nasal swabs, with a rapid turnaround., (Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)

Objective: The staircase phenomenon, which refers to the increases in the force of contraction with repetitive stimulation of the muscle, has been studied for many years, but the method is difficult and not widely used. Our objective was to evaluate the staircase phenomenon in skeletal muscle using a piezoelectric sensor., Methods: Thirty-five subjects without neuromuscular diseases (normal controls), 11 patients with Becker muscular dystrophy (BMD), and 19 patients with myotonic dystrophy type 1 (MyD) were studied. Compound muscle action potential (CMAP) and movement-related potential (MRP) waveforms were recorded using piezoelectric sensors during repetitive stimulation of the median nerve, and the amplitudes and durations were measured. Excitation-contraction (E-C) coupling time (ECCT) was calculated from the difference between onset latencies of CMAP and MRP., Results: In normal controls, MRP amplitude ratio (relative to baseline) increased significantly with increase in stimulation duration and with increase in stimulation frequency. In BMD and MyD, however, MRP amplitude ratio did not change significantly with increase in stimulation duration. Especially, in MyD, there was no change in MRP amplitude ratio with increase in frequency., Conclusion: Staircase phenomenon abnormalities can be evaluated easily using piezoelectric sensors, indicating their potential utility for evaluating E-C coupling impairment in myopathies., Significance: Piezoelectric sensors may be a useful tool to evaluate staircase phenomenon in skeletal muscle., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 International Federation of Clinical Neurophysiology. Published by Elsevier B.V.)

The aim of this study is to evaluate the dynamic accuracy and latency of the surface-guided radiotherapy (SGRT) system using TrueBeam and AlignRT in compliance with SGRT guidelines. Beam characteristics-flatness, symmetry, beam quality, and output-were compared between gated and nongated beams using a two-dimensional ionization chamber array and a Farmer-type chamber. Dynamic accuracy was assessed using a moving platform and breast phantom, with measurements taken for various shift values (5, 10, 30 mm), region-of-interest (ROI) shapes, reference-surface image types (DICOM and capture), surface resolutions, and room illuminations. Latency due to differences in frame rates was evaluated using radiochromic film, calculated from position displacements of profiles at two speeds. Differences in beam characteristics between gated and nongated beams were within 0.1%. Dynamic accuracy showed minimal dependence on settings, with deviations of < 1 mm for a 10-mm shift. A maximum displacement of 1.9 mm was observed with a 30-mm shift at the body ROI. Beam-on latency at 12, 16, 25, and 35 frames per second was 253.2 ± 21.9, 225.7 ± 33.7, 177.1 ± 43.0, and 112.4 ± 29.2 ms, respectively, with similar trends for beam-off latency. This study is the first to evaluate the dynamic accuracy of the TrueBeam and AlignRT system under SGRT-specific settings. While accuracy was generally maintained (< 1 mm), ROI shape significantly impacted results. Latency results indicate that certain frame rates may not meet guideline limits, underscoring the need for careful SGRT system use in clinical applications., Competing Interests: Declarations. Conflict of interest: This work was supported by Shintaro Akatsu Young Scientist Incentive Program of the St. Luke’s Health Science Research Fund. Ethical approval and informed consent. This study did not involve any experiments using human participants or animals. This study did not involve any human participants; therefore, no informed consent was required., (© 2024. The Author(s), under exclusive licence to Japanese Society of Radiological Technology and Japan Society of Medical Physics.)

The maintenance of germ cells is critical for the prosperity of offspring. The amount of food consumption is known to be closely related to reproduction, i.e. the number of eggs decreases under calorie-restricted conditions in various organisms. Previous studies in Caenorhabditis elegans have reported that calorie restriction reduces the number of eggs and the reduction can be rescued by methionine. However, the effect of methionine on the reproductive process has not been fully understood. In this study, to assess the gonadal function of methionine metabolism, we firstly demonstrated that a depletion in dietary methionine resulted in reduced levels of S-adenosyl-l-methionine (SAM) and S-adenosyl homocysteine in wild-type N2, but not in glp-1 mutants, which possess only a few germ cells. Second, we found no recovery in egg numbers upon methionine administration in SAM synthase (sams)-1 mutants. Furthermore, a reduced number of proliferative zone nuclei exhibited in the sams-1 mutants was not rescued via methionine. Thus, our results have shown that dietary methionine is required for the normal establishment of both the germline progenitor pool and fecundity, mediated by sams-1., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Japanese Biochemical Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Visualizing the specific regions where atrial fibrillation (AF) is maintained is crucial for effective treatment, but it remains challenging in clinical practice. We aimed to address this challenge by developing a mapping approach focused on the cycle length (CL) and its gradient (CL-gradient)., Methods: In 105 patients undergoing initial ablation for persistent AF, pre-ablation CARTOFINDER data were utilized to create maps based on three indicators: (1) CL, the atrial frequency during AF calculated using CARTOFINDER; (2) Short CL, encompassing CLs within 5 ms of the minimum CL; and (3) CL-gradient, the CL range within a 6 mm radius. We evaluated the association between the AF termination through ablation and the measured values and patterns in each map., Results: AF termination occurred in 17 patients. The AF termination group exhibited the significant large maximum CL-gradient (48.8 ms [interquartile range, 38.6-66.3], p  <.001) and the short distance between the minimum CL site and the maximum CL-gradient site (15.8 mm, [interquartile range, 6.0-23.2], p  =.029). Of the 17 AF termination cases, 13 exhibited a CL distribution pattern characterized by a steep CL-gradient near the minimum CL site (SG-MCL), defined as the distance of less than 23.2 mm and the maximum CL-gradient greater than 33.1 ms. In these AF termination cases, SG-MCL was also correlated with the ablation area., Conclusions: The minimum CL area accompanied by significant CL gradients in the immediate vicinity may play a crucial role in sustaining AF., Competing Interests: Drs. Shimojo and Tsuji are affiliated with a department sponsored by Japan Lifeline Co., Ltd, BIOTRONIK Japan, Inc., FUKUDA DENSHI Co., Ltd, and SUZUKEN Co., Ltd. Other authors have no conflict of interest., (© 2024 The Author(s). Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.)

Background: The fibrosis-5 (FIB-5) index is a noninvasive marker for assessing the progression of liver fibrosis and predictor in patients with heart failure (HF). This study investigated the association between the FIB-5 index and response to cardiac resynchronization therapy (CRT) and evaluated its predictive value for prognosis., Methods: In total, 203 patients who underwent CRT/CRT-defibrillator (CRT-D) implantation were retrospectively included. The FIB-5 index was calculated using blood samples obtained before and after CRT/CRT-D. Response to CRT was defined as a relative reduction in left ventricular end-systolic volume of ≥15% 6 months after CRT/CRT-D. We compared the prognosis after CRT/CRT-D between the groups according to the FIB-5 index., Results: One hundred and twenty-three patients (61%) responded to CRT. The responder group demonstrated a significantly higher FIB-5 index than the nonresponder group (-2.76 ± 3.85 vs. -4.67 ± 3.29, p < 0.001). Receiver-operating characteristic analysis demonstrated that the area under the curve of the FIB-5 index was 0.660 with a cutoff value of -4.00 for responders. In multivariate analysis, FIB-5 index ≥ -4.00 was an independent predictor for CRT response (odds ratio: 3.665, p = 0.003), in addition to QRS duration ≥ 150 ms and echocardiographic dysynchrony. The FIB-5 index increased significantly after 6 months in the responder group but not in the nonresponder group. The FIB-5 index ≥ -4.00 group showed a significantly better prognosis for cardiac death, HF hospitalization, and composite endpoint than the FIB-5 index < -4.00 group., Conclusion: The FIB-5 index in addition to classical predictors may be a useful marker for predicting response to CRT., (© 2024 The Author(s). Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC.)

Manual delineation of organs at risk and clinical target volumes is essential in radiotherapy planning. Atlas-based auto-segmentation (ABAS) algorithms have become available and been shown to provide accurate contouring for various anatomical sites. Recently, deep learning auto-segmentation (DL-AS) algorithms have emerged as the state-of-the-art in medical image segmentation. This study aimed to evaluate the effect of auto-segmentation on the clinical workflow for contouring different anatomical sites of cancer, such as head and neck (H&N), breast, abdominal region, and prostate. Patients with H&N, breast, abdominal, and prostate cancer (n = 30 each) were enrolled in the study. Twenty-seven different organs at four sites were evaluated. RayStation was used to apply the ABAS. Siemens AI-Rad Companion Organs RT was used to apply the DL-AS. Evaluations were performed with similarity indices using geometric methods, time-evaluation, and qualitative scoring visual evaluations by radiation oncologists. The DL-AS algorithm was more accurate than ABAS algorithm on geometric indices for half of the structures. The qualitative scoring results of the two algorithms were significantly different, and DL-AS was more accurate on many contours. DL-AS had 41%, 29%, 86%, and 15% shorter edit times in the HnN, breast, abdomen, and prostate groups, respectively, than ABAS. There were no correlations between the geometric indices and visual assessments. The time required to edit the contours was considerably shorter for DL-AS than for ABAS. Auto-segmentation with deep learning could be the first step for clinical workflow optimization in radiotherapy., Competing Interests: Conflicts of Interest The authors declare no conflicts of interest., (Copyright © 2023 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.)

Life-space mobility (LSM) in older adults is influenced by physical, cognitive, and psychological states. However, the relationship between LSM and personality traits remains unclear. Thus, our cross-sectional study investigated this correlation, which included 144 participants aged ≥60 years. LSM was assessed using the life-space assessment (LSA), and personality traits were evaluated using the Japanese version of the Ten-Item Personality Inventory (TIPI-J). Physical data were also collected. Univariate analyses revealed that among young-older adults, extroversion in the TIPI-J showed a significant association with LSA scores in addition to handgrip strength. Among old-older adults, openness to experience in the TIPI-J demonstrated a significant association with LSA scores in addition to quadriceps strength. This study revealed correlations between personality traits (extroversion and openness to experience) and LSM, in addition to physical function. Considering older adults' personality traits is crucial for designing support and interventions to maintain and expand LSM., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background/aim: This study aimed to investigate the role of transient receptor potential vanilloid 2 (TRPV2) in a mouse model with non-alcoholic steatohepatitis (NASH) and to examine the effects of tranilast on TRPV2 and fibrosis-related cytokines., Materials and Methods: C57BL/6N mice were fed a Gubra-Amylin NASH (GAN) diet for 20 weeks to induce NASH. The tranilast groups received oral administration of tranilast at doses of 300, 400 and 500 mg/kg/day, five days per week for 20 weeks, in addition to the GAN diet. The effects of tranilast were assessed based on the dosage of food intake, changes in body weight, liver weight, blood biochemical parameters, histopathological examination, and expression of TRPV2 and inflammatory cytokines., Results: Hepatic expression of TRPV2 was observed in the GAN-fed NASH mouse model. The tranilast groups showed significantly suppressed increases in body and liver weights. The development of intrahepatic fat deposition and liver fibrosis, assessed histopathologically, was inhibited. Tranilast administration improved the expression of TRPV2 and inflammatory cytokines in the liver. Additionally, blood tests indicated a reduction in elevated liver enzyme levels., Conclusion: In GAN diet NASH models, TRPV2 was up-regulated in the liver and tranilast inhibited TRPV2 and suppressed fibrosis. Therefore, it might prevent the incidence of hepatocellular carcinoma associated with NASH., (Copyright © 2024 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

We previously reported that α-glycosylated naringin (naringin-G), synthesized by enzyme-catalyzed transglycosylation, can enhance the solubility of poorly water-soluble compounds without surface-active property. However, the solubilization mechanism has not been fully elucidated. In this study, the solubilization mechanism of naringin-G was investigated using nuclear magnetic resonance (NMR) spectroscopy, and its application in skin formulations was further investigated. 1 H NMR and dynamic light scattering measurements at various concentrations confirmed the self-assembled nanostructures of naringin-G above a critical aggregation concentration of approximately 2.2 mg/mL. Two-dimensional 1 H- 1 H nuclear Overhauser effect spectroscopy and solubility tests revealed that flavone with poor water solubility, could be solubilized in its self-assembled structure with a stoichiometric relationship with naringin-G. When naringin-G was included in the skin formulation, the permeated amount and permeability coefficient (P app ) of flavones improved up to four times with increasing amounts of naringin-G. However, flavone solubilization by adding an excessive amount of naringin-G resulted in a decreased permeated amount and P app of flavones, indicating the interplay between the apparent solubility and skin permeability of flavones. Naringin-G, which forms a nanoaggregate structure without exhibiting surface-active properties, has the potential to enhance the solubility and skin permeation of poorly water-soluble compounds., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Evidence regarding the association between hyperuricemia and arrhythmia recurrence after catheter ablation for paroxysmal atrial fibrillation (AF) is scarce. We investigated whether hyperuricemia predicts arrhythmia recurrence after catheter ablation for paroxysmal AF and the relationship between hyperuricemia and alcohol consumption in AF recurrence., Methods: Patients who underwent catheter ablation for paroxysmal AF were divided into the hyperuricemia (index serum uric acid [UA] >7.0 mg/dL; n  = 114) and control (UA ≤7.0 mg/dL; n  = 609) groups and were followed for a median of 24 (12-48) months after ablation., Results: The hyperuricemia group had more patients with an alcohol intake of ≥20 g/day (33.3% vs. 22.7%, p  = .017) and a lower incidence of AF-free survival ( p  = .019). Similarly, those with an alcohol intake of ≥20 g/day had a lower incidence of AF-free survival than other patients. Multivariate Cox regression analysis revealed the following independent predictors of AF recurrence (adjusted hazard ratio, 95% confidence interval): hyperuricemia (1.64, 1.12-2.40), female gender (1.91, 1.36-2.67), brain natriuretic peptide level >100 pg/mL (1.59, 1.14-2.22), and alcohol consumption ≥20 g/day (1.49, 1.03-2.15) (all p  < .05). In addition, causal mediation analysis revealed that alcohol consumption of ≥20 g/day directly affected AF recurrence, independent of hyperuricemia., Conclusions: Patients with hyperuricemia may be at a high risk of arrhythmia recurrence after catheter ablation for paroxysmal AF. Although high alcohol consumption may contribute to increased UA levels, the presence of hyperuricemia may independently predict AF recurrence., Competing Interests: The authors declare that there are no conflicts of interest., (© 2024 The Author(s). Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.)

Introduction: This study aimed to further understand the psychological distress associated with skin marking during radiotherapy among patients with breast cancer. The potential benefits of skin mark-free radiotherapy were also explored., Materials and Methods: The study population included female breast cancer patients scheduled for radiation therapy and skin marking. A 12-item survey was administered, encompassing demographics (age, treatment site and mode, and duration of hospital visits), awareness of skin marking, stress induced by skin marking in various life contexts, and perceived advantages of a skin mark-free alternative. Responses were recorded on a 5-point Likert scale., Results: The survey was completed by 107 patients, of whom 90 (84%) underwent whole breast irradiation, 15 (14%) received breast/chest wall and supraclavicular lymph node irradiation, and 2 (2%) were unspecified. The common sources of stress were from the presence of skin markings (33%), bathing (41%), clothing selection (25%), and skincare (30%), whereas 17 patients (16%) were not stressed by any of those factors. Meanwhile, 73% of patients reported taking precautions to prevent the skin marks from fading. Most patients (63%, n = 76) expressed preference for a skin mark-free radiotherapy option, with many willing to spend extra finances and time for this., Conclusions: A significant proportion of female breast cancer patients experience stress from skin markings in various aspects of their daily lives. A preference for skin mark-free radiotherapy was noted among many patients, that next-generation technologies, such as surface-guided radiotherapy, could alleviate patient stress., Implications for Practice: The need for permanent or temporary skin markings in the era of state-of-the-art imaging technology should be reconsidered., (Copyright © 2024. Published by Elsevier Inc.)