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# Background After anterior cruciate ligament reconstruction (ACLR), asymmetry is likely to persist in single-leg (SL) vertical jump and drop jump performance than in SL hop distance. However, its relationship with the return to sport (RTS) remains unclear. # Hypothesis/Purpose This study aimed to determine the association between vertical jump performance after primary ACLR using hamstring tendon autograft and RTS at a pre-injury competitive level. # Study design Cross-sectional study # Methods Patients who underwent primary ACLR using hamstring tendon autograft were recruited for this study. Participants who returned to pre-injury competition after ACLR were recruited at least eight months postoperatively. Knee condition was assessed, including joint laxity, range of motion, muscle strength, and knee pain intensity during sports activities. Performance variables were also assessed, including SL hop distance, jump height in SL vertical jump, and reactive strength index (RSI; jump height/contact time) in SL drop jump. Participants were asked to subjectively report whether they had returned to the same level of competition as pre-injury and their perceived sport performance intensity. Those who answered "Yes" to the dichotomous question and had a postoperative subjective athletic performance of \> 80% were categorized into the Yes-RTS group. The primary outcome was the ability to achieve RTS at the preinjury level. # Results Sixty-five patients (female, 35; male, 30) at 13.0 (13.0) \[median (interquartile)\] months after ACLR participated in this study. Thirty-nine (60%) were assigned to the Yes-RTS group. Regarding knee conditions, the No-RTS group had a significantly higher knee pain intensity, as assessed using a numerical rating scale (p\

The adeno-associated virus (AAV) vector is one of the most advanced platforms for gene therapy because of its low immunogenicity and non-pathogenicity. The concentrations of both AAV vector empty particles, which do not contain DNA and do not show any efficacy, and AAV vector full particles (FPs), which contain DNA, are important quality attributes. In this study, a dual fluorescence-linked immunosorbent assay (dFLISA), which uses two fluorescent dyes to quantify capsid and genome titers in a single analysis, was established. In dFLISA, capture of AAV particles, detection of capsid proteins, and release and detection of the viral genome are performed in the same well. We demonstrated that the capsid and genomic titers determined by dFLISA were comparable with those of analytical ultracentrifugation. The FP ratios determined by dFLISA were in good agreement with the expected values. In addition, we showed that dFLISA can quantify the genomic and capsid titers of crude samples. dFLISA can be easily modified for measuring other AAV vector serotypes and AAV vectors with different genome lengths. These features make dFLISA a valuable tool for the future development of AAV-based gene therapies.

Shogo Watanabe^orcid.org/0000-0002-1700-2892 1. Introduction Metabolic syndrome (MS) is an increasing health issue in today's society that causes lifestyle diseases, such as hypertension, diabetes, and dyslipidemia. Nonalcoholic fatty liver disease (NAFLD) [...], The liver X receptor (LXR) can enhance cholesterol transporters, which could remove excess cholesterol from foam cells in atheromas. LXR has two subtypes: LXR[alpha], which aggravates hepatic lipid accumulation, and LXR[beta], which does not. In 2018, ouabagenin (OBG) was reported as a potential LXR[beta]-specific agonist. We aimed to examine whether OBG specifically affects LXR[beta] in nonalcoholic steatohepatitis (NASH); it did not aggravate hepatic steatosis and can suppress the development of atherosclerosis. SHRSP5/Dmcr rats fed a high-fat and high-cholesterol diet were divided into four groups as follows: (I) L-NAME group, (II) L-NAME/OBG group, (III) OBG (-) group, and (IV) OBG (+) group. All groups' rats were intraperitoneally administered L-NAME. The L-NAME/OBG group's rats were intraperitoneally administered OBG and L-NAME simultaneously. After L-NAME administration, the OBG (+) group's rats were administered OBG, while the OBG (- ) group's rats were not. Although all rats developed NASH, OBG did not exacerbate steatosis (L-NAME/OBG and OBG (+) groups). In addition, endothelial cells were protected in the L-NAME/OBG group and foam cells in the atheroma were reduced in the OBG (+) group. OBG is an LXR[beta]-specific agonist and has a potential therapeutic effect on atherosclerosis without developing lipid accumulation in the liver. Key words: nonalcoholic steatohepatitis, atherosclerosis, SHRSP5/Dmcr, ouabagenin, liver X receptor [beta]

Traumatic intracranial pseudoaneurysm (TIP) after head trauma is rare, but it frequently ruptures in early phase. Although early detection and prompt treatment is important, the details are still unknown. Here, we report a case who was diagnosed with TIP in early phase after trauma and underwent endovascular treatment with parent artery occlusion (PAO), resulted in a good outcome.A 17-year-old boy hospitalized for severe head trauma. Computed tomography (CT) revealed an acute epidural hematoma (AEDH) in the right middle fossa along with the fracture from the right lateral optic canal to the right superior orbital fissure, and CT angiography showed no obvious aneurysm at that time. CT angiography on 5 days showed an irregular shaped aneurysm at a C2-C3 posterior wall in the right internal carotid artery (ICA). As balloon occlusion test revealed complete ischemic tolerance, endovascular PAO was performed without any bypass. Postoperative imaging showed no hypoperfusion area.Prompt diagnosis for TIP is important and the patients with skull fracture around ICA area are considered to provide cerebral angiography in early phase. In addition, TIP in early phase has a risk of rupture, suitable treatment strategy using BOT is important for the favorable outcome in those patients.

The goal of treating patients with suprasellar meningioma is improving or preserving visual function while achieving long-term tumor control. We retrospectively examined patient and tumor characteristics and surgical and visual outcomes in 30 patients with a suprasellar meningioma who underwent resection via an endoscopic endonasal (15 patients), sub-frontal (8 patients), or anterior interhemispheric (7 patients) approach. Approach selection was based on the presence of optic canal invasion, vascular encasement, and tumor extension. Optic canal decompression and exploration were performed as key surgical procedures. Simpson grade 1 to 3 resection was achieved in 80% of cases. Among the 26 patients with pre-existing visual dysfunction, vision at discharge improved in 18 patients (69.2%), remained unchanged in six (23.1%), and deteriorated in two (7.7%). Further gradual visual recovery and/or maintenance of useful vision were also observed during follow-up. We propose an algorithm for selecting the appropriate surgical approach to a suprasellar meningioma based on preoperative radiologic tumor characteristics. The algorithm focuses on effective optic canal decompression and maximum safe resection, possibly contributing to favorable visual outcomes.

Abstract This paper tackles the challenge of accurate depth estimation from monocular laparoscopic images in dynamic surgical environments. The lack of reliable ground truth due to inconsistencies within these images makes this a complex task. Further complicating the learning process is the presence of noise elements like bleeding and smoke. We propose a model learning framework that uses a generic laparoscopic surgery video dataset for training, aimed at achieving precise monocular depth estimation in dynamic surgical settings. The architecture employs binocular disparity confidence information as a self-supervisory signal, along with the disparity information from a stereo laparoscope. Our method ensures robust learning amidst outliers, influenced by tissue deformation, smoke, and surgical instruments, by utilizing a unique loss function. This function adjusts the selection and weighting of depth data for learning based on their given confidence. We trained the model using the Hamlyn Dataset and verified it with Hamlyn Dataset test data and a static dataset. The results show exceptional generalization performance and efficacy for various scene dynamics, laparoscope types, and surgical sites.

Abstract Background and Aim The purpose of this study was to analyze factors associated with the overall survival (OS) of atezolizumab/bevacizumab combination therapy for advanced hepatocellular carcinoma (aHCC). We also assessed the OS of patients with ineffective therapy and those who discontinued treatment owing to adverse events (AEs). Methods This retrospective multicenter study involved 139 patients with aHCC who received atezolizumab/bevacizumab combination therapy between November 2020 and September 2022. Results The median duration of treatment was 136.5 days, and the median observation period was 316 days. The overall response rate was 40%, and the disease control rate was 78% according to mRECIST criteria. Grade ≥2 AEs occurred in 63 patients (43%) and led to treatment discontinuation in 16 patients. Multivariate analysis revealed that treatment response and occurrence of grade ≥2 AEs after therapy, as well as low level of albumin‐bilirubin (ALBI) grade and low level of des‐gamma carboxy prothrombin (DCP) before therapy, were extracted as factors that contributed to OS. Log‐rank tests with the Kaplan–Meier method showed significant differences in OS among these factors. The OS of patients who discontinued owing to AEs was significantly shorter than that of other patients. Conclusion Not only factors before therapy but also treatment response and the appearance of AEs are involved in OS for atezolizumab/bevacizumab combination therapy. Although the development of AEs also contributed to OS, appropriate management of AEs is important to avoid discontinuing treatment with this combination.

Pharmacotherapy is frequently selected over surgical interventions for late elderly patients with trigeminal neuralgia (TN). However, medication may affect these patients' activities of daily living (ADL). Hence, we investigated the effect of the surgical treatment of TN on ADL in older patients. This study included 11 late elderly patients >75 years old and 26 nonlate elderly patients who underwent microvascular decompression (MVD) for TN at our hospital from June 2017 to August 2021. We evaluated pre- and postsurgical ADL using the Barthel Index (BI) score, side effects of antineuralgic drugs, the BNI pain intensity score, and perioperative medication. The BI score of late elderly patients significantly improved postoperatively, particularly in transfer (pre: 10.5; post: 13.2), mobility (pre: 10; post: 12.7), and feeding (pre: 5.9 points; post: 10 points). Additionally, antineuralgic drugs caused preoperative disturbances of transfer and mobility. Trends of a longer disease duration and frequent occurrence of side effects were observed in all patients in the elderly group, compared to only 9 out of 26 patients in the younger group (100% vs. 35%, p = 0.0002). In addition, drowsiness was observed more frequently in the late elderly group (73% vs. 23%, p = 0.0084). However, the change in scores indicating improvement after surgery was significantly greater in the late elderly group, although both pre- and postoperative scores were higher in the nonlate elderly group (11.4 ± 1.9 vs. 6.9 ± 0.7, p = 0.027). Surgical treatment can improve older patients' ADL because it relieves pain and facilitates discontinuation of antineuralgic drugs. Consequently, MVD can be positively recommended for older patients with TN if general anesthesia is acceptable.

Abstract The morphology engineering of porous materials is advantageous for improving their properties and designing the structure of their nanopores. Among the synthetic methods available, electrochemical deposition is one of the most advantageous for shape engineering, because the reaction conditions can be easily controlled and the deposition only occurs at the electrode surface. Herein, we report the manipulation in size and shape of pillar[6]quinone (P[Q]6) crystal structure by varying the electrolytic conditions during the electrochemical synthesis. Significant morphological change was observed with the use of supporting electrolytes having different alkylammonium cations, presumably due to the host‐guest interaction between the cation and the 1,4‐dihydroxypillar[6]arene (P[HQ]6) precursor. However, when alkali metal cations were used, the morphology slightly changed, depending on the size of the alkali metal cation. Powder X‐ray diffraction analysis revealed that the electrochemical assembly of P[Q]6 gives the same crystal structure, while DFT calculations suggested that the change in the crystal morphology was caused by the incorporation of the cation species, which inhibited the crystal growth of P[Q]6. In addition, it was found that the manipulation in size and shape of the morphologies could also be achieved by changing the composition of the solvent.

Abstract Purpose This study aimed to investigate the intricate relationship between physical function factors and each subcategory score of the Anterior Cruciate Ligament‐Return to Sport after Injury (ACL‐RSI) scale among patients following ACL reconstruction. Methods Participants comprised 59 patients who had undergone primary ACL reconstruction using hamstring tendon. The ACL‐RSI was completed 6 months after reconstruction and five physical functions were measured in patients on the same day. Simple linear regression was performed multiple times to investigate the relationship between ACL‐RSI subcategory scores as a dependent variable and each independent variable (knee strength, leg anterior reach distance, single‐leg hop [SLH] distances, side bridge endurance, and subjective running ability). Multiple regression analysis was performed using a stepwise method, with factors showing a risk rate