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Abstract Electrical stimulation (ES) may be effective for intractable retinal or optic nerve diseases. We studied frequent transcutaneous ES in a single-center, single-arm prospective study in patients with Leber hereditary optic neuropathy (LHON) who carry the mitochondrial (mt) 11778 G > A mutation. A 30-min ES was applied to either eye every other day for 12 weeks. The primary outcome was the difference in the logarithm of the minimum angle of resolution (LogMAR) at baseline and 1 week after completion of ES treatment. The secondary outcomes included changes in visual field; LogMAR; critical flicker frequency; and inner retinal thickness. Safety endpoints included the corneal endothelial cell density and complications during ES. Fourteen patients participated in the study; four dropped out. The median (interquartile range) LogMAR values before stimulation and 1, 4, and 8 weeks after ES were 1.60 (1.45–1.80), 1.70 (1.35–1.80), 1.60 (1.43–1.73), and 1.50 (1.43–1.73), respectively, indicating no significant improvement (primary outcome: Wilcoxon’s signed rank test, p = 1.000, secondary outcome: Friedman test, p = 0.229). There were no improvements in any secondary efficacy endpoints and no complications. In conclusion, frequent transcutaneous ES did not improve visual acuity in patients with LHON carrying the mt11778 G > A mutation.

Immunoglobulin G4-related disease (IgG4-RD) is a chronic inflammatory condition of unknown etiology characterized by lymphocytic infiltration, fibrosis, and infiltration of IgG4-positive plasma cells. It affects various organs, including the pancreas and salivary glands. Immunological abnormalities are suspected to play a role in its pathogenesis, and there is an epidemiological link to allergic conditions and type 2 inflammation. This study focused on the expression of thymus and activation-regulated chemokine (TARC)/CCL17, which is involved in the migration of T helper 2 and/or regulatory T cells, in salivary gland tissues of patients with IgG4-RD. We analyzed 60 salivary gland biopsy samples obtained from patients at Sapporo Medical University Hospital between 2015 and 2020. Immunohistochemical analysis revealed TARC/CCL17 positivity in 87.2% of histologically confirmed IgG4-RD cases and negativity in 84.6% of histologically unconfirmed but clinically suspected IgG4-RD cases. There was a significant correlation between histologically confirmed IgG4-RD and TARC/CCL17 expression, suggesting its potential diagnostic utility and possible involvement in the pathogenesis of IgG4-RD.

Social representation theory provides a theoretical framework for comprehending how information about climate change is transformed as it moves from the scientific realm and becomes intertwined with people’s everyday lives. It also explores the relationship between this knowledge and the shared values, beliefs, and ideas within a specific social group. This article critically reviews 67 papers on social representations of climate change, identifying main contributions, methodological approaches, and future research opportunities. This review offers a broad outlook on the knowledge provided by social representation theory to understand climate change from a social-educational perspective.

Fever and diarrhea are the common symptoms of Clostridioides difficile infection (CDI); however, pseudomembranous enteritis, megacolonization, and paralytic ileus have been observed in severe cases. C. difficile spores are resistant to several types of disinfectants. Thus, they are often the causative pathogens of healthcare-associated infections. Rapid diagnostic tests based on glutamate dehydrogenase and toxins are the mainstay of CDI laboratory diagnosis owing to their simplicity. CDI can be diagnosed with high specificity using the nucleic acid amplification test, a genetic test for C. difficile toxins. The risk factors for CDI include age 65 years; history of antimicrobial use; previous hospitalization; history of gastrointestinal surgery, chronic kidney disease, or inflammatory bowel disease; nasal tube feeding; and use of proton pump inhibitors and histamine H2 receptor antagonists. The risk of CDI development persists even 1 year after discontinuation of proton pump inhibitor use. Furthermore, colorectal surgery and radical cystectomy with urinary diversion are associated with high incidences of postoperative CDI. The choice of therapeutic agent depends on the severity of the disease and recurrence. However, a combination of oral or nasogastric vancomycin, intracolonic vancomycin, and intravenous metronidazole can be considered in patients with toxic megacolonization and paralytic ileus. In January 2024, the European Committee on Antimicrobial Susceptibility Testing established a breakpoint for fidaxomicin (minimum inhibitory concentration breakpoint > 2 mg/L) against C. difficile. Rapid progress has been achieved in CDI treatment. Thus, multidisciplinary teams must collaborate to diagnose, treat, and control CDI.

Crohn's disease (CD) causes gastrointestinal symptoms (i.e., diarrhea and abdominal pain), systemic symptoms (i.e., fatigue, anemia, weight loss, and fever), and perianal fistulas that produce anal pain. Because of the frequent occurrence of diarrhea and ulcers in the rectum, CD is often exacerbated by perianal abscesses and/or fistulas. Perianal fistulizing CD (PFCD) has an unknown etiology and recurring symptoms such as pain and discharge, which seriously affects the patient's quality of life (QOL). In the past, radical surgery was performed for PFCD, but due to the risk of anal sphincter impairment, conservative therapy using antibiotics and immunosuppressive medications is currently the first treatment option. PFCD management has greatly improved with the use of biologics such as the antitumor necrosis factor alpha (TNF-α) antibodies infliximab and adalimumab. In this review, the results of the administration of anti-TNF-α (certolizumab pegol), anti-interleukin-12/23 (ustekinumab), and anti-α4β7 integrin antibodies (vedolizumab) were evaluated. Our investigation showed that these medications may be effective for maintenance therapy to prevent the recurrence of anal fistulas. In addition to biologics, molecular target drugs and even regenerative medicine using mesenchymal stem cells have been introduced to further expand the treatment options for consideration by medical personnel. We herein discuss the management of PFCD by focusing on studies conducted in the United States and Europe where researchers used recommended guidelines and consensus statements to evaluate the efficacy of each medication and published their findings in peer-reviewed journals.

Abstract Background Resin cements often require substrate-specific pretreatment. Recently, universal adhesive systems have been introduced, simplifying procedures by eliminating the need for multiple adhesives and offering options that do not require light curing. This study investigated the bonding performance of universal adhesive systems combined with dual-polymerising resin cements on enamel, dentin, zirconia, lithium disilicate ceramics (LDS), and resin blocks. Methods Two universal adhesive and dual-polymerising resin cement combinations from the same manufacturer were tested: Bondmer Lightless II (BLII) with Estecem II (ECII), and Scotchbond Universal Plus adhesive (SBU) with RelyX Universal resin cement (RXU). Enamel, dentin, zirconia (Katana Zirconia UTML), LDS (IPS e.max CAD CEREC), and resin blocks (Katana Avencia P Block) were used as substrates. The universal adhesive was applied to all bonding surfaces, followed by resin cement application in micro-bore Tygon tubes and light curing for 40 s. Micro-shear bond strength (μSBS) was measured after 0 thermal cycles (0TC) or 10,000 thermal cycles (10kTC) (n = 20). Statistical analyses were conducted using t-tests and Welch's t-tests with Bonferroni correction (α = 0.05), and failure modes were examined. Results In the BLII/ECII group, the mean μSBS values exceeded 15 MPa for all substrates at 0TC. After thermocycling, μSBS increased significantly for the enamel (p 0.05) and decreased for LDS and resin blocks (p 0.05), but the BLII/ECII group exhibited higher SBS in the other groups (p

Abstract The deuterium isotope effect on the honeycomb iridate H3LiIr2O6, a quantum spin-orbit-entangled liquid, was examined by synthesizing D3LiIr2O6. The structural refinements indicate the different character of the interlayer OH and OD bonds, which results in a giant isotope effect on the magnetic interactions; the antiferromagnetic Curie-Weiss temperature |θ CW| of D3LiIr2O6 increases to ~ 170 K from ~ 100 K of H3LiIr2O6. Nevertheless, the quantum liquid state is robust against the deuterium isotope exchange in contrast to the theoretical prediction that the Kitaev spin liquid is stable only for a limited phase space of magnetic interactions. The bond- and site disorders associated with disordered OD(H) bonds, in combination with Kitaev physics, may play a role in realizing the quantum liquid state.

Abstract Background Endoscopic ultrasound-guided transmural drainage (EUS-TD) is widely performed to treat postoperative peripancreatic fluid collection (POPFC). Recent reports on EUS-TD lack a consensus on stent selection. This study aimed to assess the efficacy of EUS-TD for POPFC using an external drainage-based approach. Methods We retrospectively examined the medical records of patients with POPFC treated with EUS-TD using external drainage from October 2016 to July 2024. Technical success was defined as successful placement of the external drainage. Clinical success was defined as the reduction in fluid collection, as evidenced by follow-up computed tomography 1 week post-procedure. Results This study included 14 patients. The median duration from surgery to endoscopic treatment was 13 (range: 11–26) days. The median procedural time was 26 (range: 13–35) min. The technical success rate was 100%, and 6 Fr endoscopic nasocystic drainage was performed in all patients. The clinical success rate was 100%, and no adverse events were observed. One patient experienced self-removal and required repuncture. Conclusions EUS-TD for POPFC with an external drainage-based approach is safe and effective, with a short procedure time. However, this was a retrospective study with a small sample size, suggesting that future prospective studies are warranted.

Abstract Suspended particulate matter (PM) in subway premises contain high concentrations of metal components and distinctive compounds owing to their unique emission processes. However, little is known regarding the detailed chemical states of airborne PM and their biological effects. Therefore, to demonstrate the unique chemical states of the PM collected from subway premises and outdoors, this study compared the chemical speciation of iron (Fe) and copper (Cu) components using X-ray absorption fine structure analysis. The potential biological effects of these chemical states on humans were also investigated in vitro by assessing cell damage and its pathways in cells after exposure to several compounds. Compared with a reference outdoor PM sample, Fe was enhanced by at least 10 times in subway PM and the concentrations of several metal components, including Cu, contained in railway bodies, rail, overhead wires, and tunnel walls, also increased. In these chemical speciations, the compounds derived from wear processes with relatively high-temperature oxidation (Fe3O4, γ-Fe2O3, and monovalent Cu compounds) were detected among the Fe and Cu components in subway PM. Our cell-based bioassay suggested that the contribution of the Fe component to cell damage can be enhanced by the predominance of Fe3O4 in subway PM. In contrast to typical bivalent Cu compounds in the atmosphere, monovalent Cu compounds, which are characteristically identified in subway PM, exacerbate cell damage via different cell death pathways. Our results indicate that the chemical states of the distinctive compounds in the PM of subway premises differ from those in the typical atmosphere, thus exerting different biological effects. These findings suggest that the detailed chemical speciation is an important factor in accurately understanding their PM toxicities.

Excimer fluorescent ultraviolet (UV) lamps (UV–228) function as mercury–free sources that use excimer emissions as excitation light sources. First, we evaluated the effects of UV–228–based irradiation (λmax = 228 nm) on the viability of fungi, using Penicillium digitatum, and compared these effects with those of other light sources, such as OEL–222 (λmax = 222 nm) and GL–6 (λmax = 254 nm), to evaluate the effectiveness of the excimer fluorescent lamp. Next, we investigated the effects of UV–228–based irradiation on strawberry storage. Although UV–228 affected weight loss, Brix, ascorbic acid, polyphenol, and DPPH, the effects of UV irradiation for 5 min on strawberry fruit quality were minimal; i.e., only weight loss and ascorbic acid content were higher than those in the non–irradiated treatment. We found that 5 min of UV–C irradiation using UV–228 prevented mold emergence for up to 11 days of storage in strawberries These results indicate that UV–228 contributes to long–term strawberry storage.

Abstract Background Primary central nervous system lymphoma (PCNSL) is a rare lymphoid malignancy. Systemic profiling of the PCNSL tumor microenvironment (TME) was previously conducted through gene expression analysis. We investigated the prognostic impact of TME on survival to establish novel prognostic biomarkers in PCNSL patients. Methods We analyzed expression levels of 770 neuroinflammation‐related (NFR) genes via NanoString nCounter technology in tumor samples from 30 PCNSL patients. Genes related to the “recurrence group (RG)” or “non‐recurrence group (NRG)” were identified and validated using whole transcriptomic analysis of an independent PCNSL cohort (n = 30). Results Forty‐five of 770 NFR genes were highly expressed in the RG (3‐year overall survival (OS, 22.2%), compared with the NRG group (3‐year OS 66.7%). Signatures related to glial cells were enriched in the RG‐associated gene set. Multivariate analysis revealed that high expressions of TUBB4A (p = 0.028, HR: 3.88), S100B (p = 0.046, HR: 3.093), and SLC6A1 (p = 0.034, HR: 3.765) were significantly related to death. Expression levels of these three genes were also significantly associated with poor OS in the validation cohort. Immunohistochemical staining against TUBB4A, S100B, and proteins specific to glial cells (GFAP, OLIG2, and CD68) revealed significantly higher positivity in RG glial cells. Conclusion These data suggest that TME‐related genes play a crucial role in the pathogenesis of PCNSL, complementing the well‐known involvement of the NF‐kB signaling pathway. TME targeting, especially glial cell‐specific proteins, may thus open new and complementary avenues of therapy for all stages of PCNSL.

Background Chondrosarcoma of the maxilla is extremely rare, requiring complete surgical resection with clear margins. Various surgical approaches have been used for wide surgical resection of chondrosarcomas in the head and neck region. 3D printed bone models are useful surgical and educational tools.Case A 69-year-old man presented with a grade II chondrosarcoma of the maxilla. This tumor was resected by otolaryngologists and dental surgeons using an anterior segmental maxillary osteotomy and open rhinoplasty approach with the assistance of a 3D-printed bone model.Conclusion Chondrosarcomas can be differentiated from chondromas by their higher mean apparent diffusion coefficient (ADC) on diffusion-weighted magnetic resonance imaging. The anterior segmental maxillary osteotomy and rhinoplasty approach, with ideal osteotomy and a good visual field, resulted in wide surgical safety margins, improving patient prognosis.

Plaque protrusion (PP) has been identified as a perioperative complication of carotid artery stenosis treated with carotid artery stenting (CAS). The CASPER stent (CS), a dual-layer micromesh stent, may be able to prevent PP. Despite using CS, de novo extra-stent ulceration induced by persistent PP is rare.A 75-year-old male patient, whose superficial temporal artery-middle cerebral artery bypass tended to occlude, underwent CAS using a CS for symptomatic pseudo-occlusive internal carotid artery with a large-volume unstable plaque. This led to de novo extra-stent ulceration induced by persistent PP, resulting in ischemic stroke that necessitated the application of the stent-in-stent technique. There was no recurrence of cerebral infarction postoperatively at 12 months.Here, we present, to the best of our knowledge, the first case of a patient with de novo extra-stent ulceration induced by persistent PP after CAS that led to de novo extra-stent ulceration. The inhibition of intimal formation on the stent surface caused by persistent PP was considered to be the underlying mechanism. The stent-in-stent technique is beneficial even in cases of PP accompanied by de novo extra-stent ulceration.