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The relationship between interstitial lung abnormalities (ILAs) and the outcomes of lung cancer radiotherapy is unclear. This study investigated whether specific ILA subtypes are risk factors for radiation pneumonitis (RP).

We convert the optical potential in the α + 40Ca elastic scattering, which is determined so as to reproduce the differential cross section precisely, into the spreading width. This spreading width represents the decay width of the α + 40Ca resonance into the more complicated states. The conversion of the optical potential into the spreading width is achieved by the method of the absorbing boundary condition, and it is compared with the escape width of the α emission. The dissociation strength of 44Ti into the α + 40Ca continuum states is calculated to see the effect of the spreading width more clearly. We also estimate the upper value of the decay width into the compound nuclear state, which is a part of the spreading width, on the basis of the formula similar to the strength function originally used in the low-energy neutron scattering.

We apply the comprehensive model of the shell model and the cluster model to the α + 16O resonant scattering. In this model, the coupling of the shell model configuration with 16O + four nucleons and the cluster model configuration with 16O + α is explicitly solved. The absorbing boundary condition is imposed on the α + 16O cluster configuration, and the excitation function of the elastic scattering is calculated from the method of the continuum level density. The shell + cluster calculation nicely reproduces the sharp resonant structures with a small energy interval appearing in the excitation function although the α cluster model reproduces only the broad and gross structure in the excitation function. The resonance width generated by the coupling with the shell model configuration is discussed in comparison to the experimental width.

Enhancement of the monopole and dipole transitions in the low-lying state is discussed on the basis of the microscopic and macroscopic α cluster models. Theoretical calculation clearly demonstrates that the strength of the monopole and dipole transitions are strongly enhanced by the excitation in the relative motion of the α cluster and the residual nucleus. The transition strength induced by the α excitation appears as the discrete distribution, and its excitation energy is much lower than the excitation energy of the single nucleon excitation, which is expected from the naive mean field picture.

The microscopic coupled-channels calculations (MCC), which is based on precise internal wave functions and a realistic nucleon-nucleon interaction, is performed for the α + 12C inelastic scattering in the energy range of Eα = 80 to 400 MeV. The MCC calculations nicely reproduce the observed differential cross sections for the elastic and inelastic scattering, which goes to the 21+, 31−, 02+ states. The partial wave analysis for the differential cross sections has also performed. From the partial wave analysis, the nuclear radius of three α rotational state in 12C with a life time of 10-21 second, which has been expected to have much more extended radius than the ground 12C nucleus, is speculated. Present analysis predicts about 1.0 fm enhancement in the matter radius of the three α rotational state in comparison to the normal radius of the ground state, which is known to be proportional to the mass number to the one third. The spatial extension of the three α rotational state is comparable to the extended radius observed in the neutron halo phenomena. Constraint on the recent ab-initio calculation for the 3α states in 12C is also discussed.

Coulomb shift of the 10Be and 10C nuclei, which can be nicely described by the α + α + N + N four-body degrees of freedom, is investigated by the microscopic cluster model. The Coulomb shift is prominent for the non S-wave configurations, while the shift is suppressed for the S-wave dominant configurations, which have the welldeveloped α cluster structure. This result can be interpreted in terms of the so-called Thomas-Ehrman shift, which is originally discussed in the Coulomb shift of the 17O–17F systems.

The microscopic coupled-channel (MCC) calculations for proton + 12C inelastic scattering are performed in the energy range of Ep = 29.95 MeV to 65 MeV. The nuclear interactions for the proton −12C system are constructed from the folding model, which employs the internal wave function of 12C, obtained from the 3α resonating group method (3α RGM), and an effective nucleon-nucleon interaction of the density-dependent Michigan three-range Yukawa (DDM3Y). The MCC calculation with the 3α RGM + DDM3Y nicely reproduces all of the differential cross sections for elastic and inelastic scattering in the angular range of θc.m. = 30° to 120°. We introduce a scattering radius, which characterizes a spatial size of the scattering area, from partial wave decompositions of an angle-integrated cross section. The scattering radii for the elastic scattering and the various inelastic channels, which involve the rotational or vibrational excitations and the 3α excitations in 12C, are derived. We found that the scattering radii for the inelastic channels with a well developed 3α structure are strongly enhanced in comparison to the scattering radii for the elastic and collective channels. This enhancement of the scattering radius for the 3α channel strongly suggests that the scattering radius is sensitive to a size of the intrinsic structure of the finally excited state in the scattering process.

The generalized two-center cluster model (GTCM), which can treat covalent, ionic and atomic configurations in general systems with two inert cores plus valence nucleons, is formulated in the basis of the microscopic cluster model. In this model, the covalent configurations constructed by the molecular orbital (MO) method and the atomic (or ionic) configuration obtained by the valence bonding (VB) method can be described in a consistent manner. GTCM is applied to the light neutron-rich system, 10,12Be = α + α + XN (X = 2,4), and the unified studies of the structural changes and the reaction problem are performed. In the structure study, the calculated energy levels are characterized in terms of the chemical bonding like structures, such as the covalent MO or ionic VB structures. The chemical bonding structures changes from level to level within a small energy interval. In the unbound region, the structure problem with the total system of α + α + XN and the reaction problem, induced by the collision of an asymptotic VB state of α+6,8He, are combined by GTCM. The properties of unbound resonant states are discussed in a close connection to the reaction mechanism, and some enhancement factors originated from the properties of the intrinsic states are predicted in the reaction observables. The unified calculation of the structures and the reactions is applied to the Coulomb shift problem in the mirror system, such the 10Be and 10C nuclei. The Coulomb displacement energy of the mirror systems are discussed.

Cluster structures in 19Ne are studied by the microscopic and macroscopic cluster models. In the microscopic calculation, the coupled-channels problem of (3He+16O) + (α+15O) is solved, and the adiabatic energy surfaces, which are the series of the energy eigenvalues as a function of the He–O distance, are investigated. In the adiabatic energy curves, the several local minima are generated in the spatial region of the small core distance, where the neutron hole inside of the He or O nucleus is strongly coupled to the residual nuclei. The energy spectra, which are constructed from the strong coupling states, nicely reproduce the the low-lying energy levels in the 19Ne nucleus. In the macroscopic approach, the α + 15O potential is evaluated from the elastic scattering of the α + 15N system, and the resonant levels of the α + 15O system are calculated under the absorbing boundary condition. The potential model predicts the existence of the resonances above the α threshold, which has a weak-coupling scheme of the α particle and one hole inside of the 16O nucleus. The extended microscopic calculations of (3He+16O) + (α+15O) + (5He+14O) are performed in order to see the coupling effect of the 5p-2h configuration, which corresponds to the shell model limit of the 5He + 14O cluster configuration. The extended calculation suggests that the 5He + 14O configuration plays an important role on the formation of the 3/2+ resonance at 0.5 MeV with respect to the α threshold.

The generalized two-center cluster model (GTCM), which can handle various single particle config urations in general two center systems, is applied to the light neutron-rich system, 12Be= α+α+4N. We discuss the change of the neutrons’ configuratio around two α-cores as a variation of an excitation energy. We show that the covalent, ionic and atomic configuration appear in the unbound region above the α+8Heg.s. particledecay threshold. The GTCM calculation is also applied to even Be isotopes, and the systematics on the structural changes from bound region to continuum is discussed.

Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disease with a linear deposit of autoantibodies at the epidermal basement membrane zone. It was reported that diabetes patients who took a dipeptidyl peptidase‐4 inhibitor (DPP4i), an oral antidiabetic drug, had an increased incidence of BP. However, data on DPP4i‐related BP are limited. In our study, we measured serum levels of various cytokines using LEGENDplex and assessed correlations of these serum levels with clinical severity and laboratory data. Serum samples obtained from BP patients who visited our hospital from June 2016 to February 2023 were collected in this study. Patients' background, characteristics, and clinical data were retrospectively collected from their charts. Serum samples from 27 patients with DPP4i‐unrelated BP, 17 patients with DPP4i‐related BP, and 13 healthy controls were analyzed. Patients with DPP4i‐related BP had lower score of Bullous Pemphigoid Disease Area Index (BPDAI)‐erythema/urticaria, lower number of circulating eosinophils, and lower titer of anti‐BP180 antibody than patients with DPP4i‐unrelated BP. The serum interleukin (IL)‐6 level was significantly higher in patients with DPP4i‐related BP than in healthy controls (P = 0.0037). The serum IL‐10 level was significantly higher in patients with DPP4i‐related BP than in patients with DPP4i‐unrelated BP and in healthy controls (P = 0.0006, P = 0.0448), and was positively correlated with the BPDAI‐blister/erosions score (r = 0.757, P = 0.001), BPDAI‐erythema/urticaria score (r = 0.616, P = 0.013), and BPDAI‐total score (r = 0.833, P < 0.001) in patients with DPP4i‐related BP. In conclusion, patients with DPP4i‐related BP had increased serum levels of IL‐6 and IL‐10 compared with healthy controls and positive correlations between the serum IL‐10 level and BPDAI scores reflecting clinical severity, indicating that the serum IL‐10 level is a potential objective biomarker of disease severity in patients with DPP4i‐related BP. [ABSTRACT FROM AUTHOR]

Background: Antibiotics are inappropriately prescribed for respiratory tract infections for various reasons. The differences of the effects of education based on these reasons has not been fully elucidated. This study assessed the impact of an educational film on antibiotic prescription patterns according to physicians' prescribing justifications. Methods: This was a secondary analysis of a nationwide web-based survey involving 1100 physicians. The physicians were required to view a short educational film and determine the need for prescribing antibiotics in simulated scenarios of different acute respiratory tract infectious diseases. The associations between the reasons for antibiotic prescription to patients not requiring antibiotics before viewing the educational film and the positive effects of the intervention were analyzed. Results: The educational intervention positively affected prescribing trends among physicians who prescribed antibiotics for "fever" in mild acute rhinosinusitis (prescription rates from 100% to 25.9%), "pus in the laryngopharynx" in mild acute pharyngitis (prescription rates from 100% to 29.6%), and "purulent sputum" in acute bronchitis without chronic lung disease (prescription rates from 100% to 29.9%) before viewing the film. In contrast, no benefits were observed when the justification was "patient's desire for antibiotics" in mild acute pharyngitis (prescription rates from 100% to 48.5%) and acute bronchitis without chronic lung disease (prescription rates from 100% to 44.0%) or "parents' desire for antibiotics" in narrowly defined common cold in children (prescription rates from 100% to 45.7%). Conclusions: although educational interventions might reduce inappropriate antibiotic prescription by providing accurate knowledge about respiratory tract infections, they appear ineffective for physicians who prescribe antibiotics based on patients' or parents' desires for antibiotic treatment. [ABSTRACT FROM AUTHOR]

Dupilumab, an anti‐interleukin (IL)‐4 receptor α‐antibody, was approved in 2018 for the treatment of moderate‐to‐severe atopic dermatitis (AD) in Japan. Although real‐world data have accumulated on the effectiveness and safety of dupilumab in patients with AD in the short term, real‐world data on its long‐term use are limited. In this study, we retrospectively investigated its effectiveness, safety and laboratory data in patients with AD who received dupilumab for 3 years. All adult patients with moderate‐to‐severe AD who were administered dupilumab between June 2018 and December 2020 and were treated with dupilumab for more than 3 years were included in this study. Sixty Japanese patients with AD (male, 48; female, 12) were included in this study. Their mean age was 36.6 ± 11.0 (standard deviation) years. The mean Eczema Area and Severity Index (EASI) was 29.9 ± 9.2. The clinical severity scales, including Investigator's Global Assessment (IGA), EASI and affected body surface area (BSA), and patient‐reported outcomes, such as Dermatology Quality Life Index (DLQI), Patient‐Oriented Eczema Measure (POEM) and visual analogue scale (VAS) of pruritus, significantly improved at 3 months, and at 1, 2 and 3 years after initiating dupilumab. The total EASI score significantly decreased by a mean of 66.8% at 3 months, 81.0% at 1 year, 85.3% at 2 years and 90.0% at 3 years after initiating dupilumab. The serum levels of thymus and activation‐regulated chemokine (TARC), immunoglobulin E (IgE) and lactate dehydrogenase (LDH) significantly decreased at 1, 2 and 3 years. A slight decrease in circulating neutrophils was observed in patients with AD treated with dupilumab over periods from 3 months to 3 years. The number of circulating eosinophils significantly decreased at 2 and 3 years after initiating dupilumab. The most common adverse event was ocular disorders observed in 23 patients (38.3%). Our study shows the sustained effectiveness and tolerable safety of 3‐year usage of dupilumab in Japanese patients with atopic dermatitis. Furthermore, dupilumab decreased neutrophil values at 3 months and later, and reduced the number of circulating eosinophils after long‐term use (≧ 2 years). [ABSTRACT FROM AUTHOR]

Psossibility and appropriate timing of discontinuation of dupilumab for atopic dermatitis (AD) remain unclear. We explored the possibility of patients, who could maintain remission with topical therapy alone after withdrawing dupilumab in the real world. Furthermore, we identified their characteristics. All adult AD patients who initiated dupilumab from June 2018 to July 2022 and were treated with dupilumab for more than 3 months at our hospital were included in this study. The observation period was from June 2018 to July 2023. In 138 patients, 58 (42.0%) discontinued dupilumab at least once. Among them, 18 (13.0%) discontinued dupilumab but reinitiated dupilumab later due to exacerbation. Only seven patients (5.1%) could maintain remission with topical therapy alone after discontinuation of dupilumab, with characteristics of lower POEM, VAS of pruritus, serum levels of TARC and LDH, and neutrophil counts at baseline, and those of longer duration of dupilumab until its discontinuation (24.0 ± 13.3 vs. 12.8 ± 7.3 months) and lower EASI and affected BSA at the discontinuation of dupilumab. In 118 patients treated with dupilumab for at least 1 year, 38 patients (32.2%) discontinued at least once. Only four patients (3.4%) could maintain remission with topical therapy alone after discontinuation of dupilumab, with characteristics of lower POEM at baseline and lower EASI at the discontinuation of dupilumab. In conclusion, maintaining remission after withdrawing dupilumab is challenging. Discontinuation of dupilumab may be considered in patients with low baseline POEM, after more than 2 years of dupilumab treatment, with a substantial decrease in EASI. [ABSTRACT FROM AUTHOR]

Recent studies indicate that hepatic diseases are associated with psoriasis. Non‐invasive tests, including the Fibrosis‐4 (FIB‐4) index, which can confidently rule out the presence of advanced fibrosis, are currently receiving attention. However, data on the FIB‐4 index in psoriasis patients and the effects of biologics on the FIB‐4 index are limited. We investigated the relationships between the FIB‐4 index and demographic or clinical characteristics as well as the effects of biologics on the FIB‐4 index in psoriasis patients. Psoriasis patients aged 36–64 years, whose treatment was initiated with interleukin (IL)‐17 inhibitors or IL‐23 inhibitors for psoriasis from May 2015 to December 2022, were consecutively included. Data were collected retrospectively from the patients' charts. A total of 171 psoriasis patients were included in this study. Thirty‐four, 43, 21, 32, and 41 psoriasis patients were treated with secukinumab, ixekizumab, brodalumab, guselkumab, or risankizumab, respectively. In biologics‐naïve patients, a significant but weak positive correlation was observed between the FIB‐4 index and age (r = 0.3246, p = 0.0018). There was no significant correlation between the FIB‐4 index and other demographic or clinical characteristics. Regarding the effects of biologics on the FIB‐4 index, no significant change was observed in psoriasis patients treated with any biologics. However, in psoriasis patients with a baseline FIB‐4 index of >1.3, patients treated with guselkumab and those treated with either IL‐23 inhibitor showed significantly decreased FIB‐4 index scores 6 months after initiating the biologics (p = 0.0323, p = 0.0212). In contrast, no change was observed in FIB‐4 index scores in patients treated with IL‐17 inhibitors. In conclusion, our study revealed that the FIB‐4 index was correlated with age in psoriasis patients. Furthermore, IL‐23 inhibitors (but not IL‐17 inhibitors) decreased the FIB‐4 index score at 6 months in psoriasis patients with elevated FIB‐4 index scores at baseline. Further studies are needed to clarify whether IL‐23 inhibitors improve liver fibrosis physiologically and functionally. [ABSTRACT FROM AUTHOR]