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Introduction: In recent years, biotherapy in orthopedics has become widespread, and platelet-rich plasma (PRP) has been readily used to treat sports injuries and osteoarthritis. Production of freeze-dried PRP (PRP-FD) results in PRP that is in powder form, allowing it to be stored for long periods at room temperature. Using this technology, we have developed Valuable Platelet-Derived Factor Concentrate Freeze Dry (VFD). However, whether VFD contains sufficient levels of bioactive substances (BS) remains unknown and retains the same levels of BS during long-term storage. In this study, we examined whether VFD contains sufficient amounts of BS and whether they retain these BS levels during long-term storage. Methods: Peripheral blood was collected from 10 healthy men (mean ± SD: 46.5 ± 15 years old) and various BS, including transforming growth factor β (TGF-β), basic fibroblast growth factor (bFGF), epidermal growth factor (EGF), tissue inhibitors of metalloproteinases-1 (TIMP-1), interleukin-1 receptor antagonist (IL-1ra), matrix metallopeptidase-9 (MMP-9), and interleukin-6 (IL-6), were compared between VFD and normal PRP samples, including both leukocyte-rich PRP (LR-PRP) and leukocyte-poor PRP (LP-PRP). VFD was prepared using two rounds of centrifugation. LP-PRP and LR-PRP were activated by freezing and thawing before measurement. To evaluate the effects of long-term storage, the BS of VFD purified from five professional football players was compared between baseline and 1 year after storage. Results: In terms of the growth factors, the TGF-β and EGF levels were higher in LR-PRP than in VFD and LP-PRP (p

Background and objective: High-resolution micro-ultrasound (microUS) is an advanced imaging tool. Our objective was to determine whether systematic microUS use for transrectal biopsy (TRBx) improves the detection rate for clinically significant prostate cancer (csPCa) in comparison to transperineal biopsy (TPBx) performed with magnetic resonance imaging (MRI)/conventional transrectal ultrasound (TRUS) fusion software. Methods: We retrospectively analyzed data for men who underwent prostate biopsies, including those on active surveillance (AS). TRBx was performed under microUS guidance, while MRI/TRUS fusion was consistently used to guide TPBx. Patients were matched according to propensity score matching (PSM). The primary endpoint was comparison of the csPCa detection rate with the two approaches. Secondary endpoints included predictors of csPCa (International Society of Urological Pathology grade group ≥2, assessed via multivariable logistic regression) and complication rates. Key findings and limitations: Overall, 1423 patients were enrolled. After applying PSM we identified an analytical cohort of 1094 men, 582 in the TRBx group and 512 in the TPBx group. There was no significant difference in the csPCa detection rate between the TRBx (45%) and TPBx (51%) groups (p = 0.07). Complications occurred in nine of 1094 patients (1%). On adjusted multivariable analysis, TPBx had a similar csPCa detection rate to TRBx (adjusted odds ratio [aOR] 1.26;p = 0.09). Predictors of csPCa detection were a positive family history (aOR 1.68; 95% confidence interval [CI] 1.20–2.35; p = 0.002); age (aOR 1.04, 95% CI 1.02–1.06; p

Abstract The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on individuals’ mental health and well-being worldwide. This study investigated the prevalences of and association between mental health and quality of life (QOL) in Thailand after the COVID-19 outbreak. A cross-sectional study was conducted among Thai individuals aged ≥ 20 years across all regions. Descriptive statistics, chi-square tests, and multiple logistic regression analyses were performed to examine the association between mental health and QOL. A total of 1,133 participants (mean age: 35.1 ± 17.2 years) completed the survey. The prevalence of depression with PHQ-9 instrument was 19.4%. Depression was significantly associated with those who have had family members die from COVID-19 infection (adjusted odds ratio [AOR] 2.27, 95% confidence interval [CI] [1.13–4.52]). The percentages of depression, anxiety, and stress with DASS-21 instrument were 32.4%, 45.4%, and 24.1%, respectively. Smokers and alcohol consumption had approximately 1.5-time higher risk of stress compared with non-smokers and no alcohol consumption (AOR = 1.50, 95% CI [1.01–2.24], AOR = 1.48, 95% CI [1.09–2.02], respectively). An association was observed between socioeconomic factors such as job and income loss and mental health outcomes. Depression, anxiety, and stress were significantly negatively associated with QOL. This study demonstrates a strong association between mental health and QOL among Thai people after the COVID-19 outbreak. The findings underscore the need for interventions targeting lifestyles, including those addressing alcohol consumption and smoking, especially among those who have had family members die from COVID-19 infection and mental health support services that can address depression, anxiety, and stress to improve the overall well-being of the population.

Abstract Purpose The purpose of this study is to investigate the impact of Mayo Adhesive Probability (MAP) score and body mass index (BMI) on renal function decline after robotic assisted partial nephrectomy (RAPN). Methods We queried our prospective database for patients who underwent RAPN between January 2018 and December 2023. Outcomes were development of de novo CKD‐S3 (estimated glomerular filtration rate [eGFR]

Early childhood lays the foundation for many outcomes in later life. Recent studies suggest that early childhood development may contribute to lifestyle-related diseases such as obesity, type 2 diabetes, and cardiovascular disease in adulthood; however, there have been few investigations on this association among adults in Japan. Therefore, we examined the relationship between recent physical measurements in adults who underwent health checkups at our university and their physical measurements at birth and during infancy recorded in the Maternal and Child Health Handbook. The median age and body mass index (BMI) of the participants were 36 years and 20.4 kg/m2, respectively. BMI at the time of health checkup in adults did not correlate with physical measurements at birth, but it was found to be associated with BMI at 1.5 (regression coefficient (β) 0.53, p < 0.05) and 3 (β 0.7, p < 0.01) years of age. In addition, the waist-to-height ratio in adulthood was also associated with BMI at 1.5 (β 0.01, p < 0.05) and 3 (β 0.01, p < 0.05) years of age. These findings suggest that it is critical to provide appropriate guidance to children with high BMI and their parents during health checkups to prevent lifestyle-related disorders in adulthood.

BackgroundExercise prescription by physicians is beneficial for initiating or intensifying physical activity. However, providing specific exercise prescriptions is challenging; therefore, few physicians prescribe exercise. ObjectiveThis infodemiological study aimed to understand trends in exercise-related internet search keywords based on sex, age, and environmental factors to help doctors prescribe exercise more easily. MethodsSearch keyword volume was collected from Yahoo! JAPAN for 2022. Ten exercise-related terms were analyzed to assess exercise interest. Total search activities were analyzed by sex and age. Characteristic scores were based on the Japanese prefecture. By performing hierarchical cluster analysis, regional features were examined, and Kruskal-Wallis tests were used to assess relationships with population and industry data. ResultsThe top-searched term was “Pilates” (266,000 queries). Male individuals showed higher interest in activities such as “running” (25,400/40,700, 62.4%), “muscle training” (65,800/111,000, 59.3%), and “hiking” (23,400/40,400, 57.9%) than female individuals. Female individuals exhibited higher interest in “Pilates” (199,000/266,000, 74.8%), “yoga” (86,200/117,000, 73.7%), and “tai chi” (45,300/65,900, 68.7%) than male individuals. Based on age, search activity was highest in the 40-49 years age group for both male and female individuals across most terms. For male individuals, 7 of the 10 searched terms’ volume peaked for those in their 40s; “stretch” was most popular among those in their 50s; and “tai chi” and “radio calisthenics” had the highest search volume for those in their 70s. Female individuals in their 40s led the search volume for 9 of the 10 terms, with the exception of “tai chi,” which peaked for those in their 70s. Hierarchical cluster analysis using a characteristic score as a variable classified prefectures into 4 clusters. The characteristics of these clusters were as follows: cluster 1 had the largest population and a thriving tertiary industry, and individuals tended to search for Pilates and yoga. Following cluster 1, cluster 2, with its substantial population, had a thriving secondary industry, with searches for radio calisthenics and exercise bike. Cluster 4 had a small population, a thriving primary industry, and the lowest search volume for any term. Cluster 3 had a similar population to that of cluster 4 but had a larger secondary industry. ConclusionsMale individuals show more interest in individual activities, such as running, whereas female individuals are interested in group activities, such as Pilates. Despite the high search volume among individuals in their 40s, actual exercise habits are low among those in their 30s to 50s. Search volumes for instructor-led exercises are higher in cluster 1 than in other cluster areas, and the total number of searches decreases as the community size decreases. These results suggest that trends in search behavior depending on sex, age, and environment factors are essential when prescribing exercise for effective behavioral change.

Introdução: As espécies do Complexo Mycobacterium avium intracellulare (MAC) e o Mycobacterium kansasii (Mk) são patógenos de crescimento lento que causam pneumopatia. Objetivo: Contrastar a apresentação clínica e o desfecho clínico entre pacientes com Complexo Mycobacterium avium intracellulare ou Mycobacterium kansasii. Método: Coorte retrospectiva de pacientes adultos não infectados pelo HIV, com infecção por MAC ou Mk, de acordo com os critérios da ATS/MS, 2021, acompanhados em hospital de referência em Campinas-SP, de janeiro de 2016 a dezembro de 2023. Resultados: Foram incluídos 49 episódios de MAC (22 M. avium, 20 M. intracellulare, 3 M. chimaera, 4 MAC), correspondendo a 46 pacientes; enquanto que com Mk foram 37 episódios, relativos a 37 pacientes. Houve predomínio do sexo feminino entre os casos de MAC (61,2%) e do sexo masculino entre os pacientes com Mk (52%) (p < 0,01). A mediana de idade foi superior nos pacientes com MAC (62,5 anos) em relação aos com Mk (51 anos) (p < 0,01). Dentre os pacientes com MAC, todos apresentaram forma pulmonar, e naqueles com Mk, a forma pulmonar ocorreu em 35(95%) casos, disseminada em um caso e a óssea em outro. Cavitações pulmonares foram mais frequentes entre os pacientes com Mk, 27 (75%) quando comparado aqueles com MAC 22 (45%) (p < 0,01). O esquema terapêutico para MAC utilizado, mais frequentemente, foi claritromicina + rifampicina + etambutol em 29(59,2%), em 10 (20,4%) foi acrescentado um aminoglicosídeo, em cinco (10,2%) foi acrescentado uma quinolona e em cinco (10,2%) foram utilizados outros esquemas. Para Mk, o regime mais frequentemente utilizado consistiu em rifampicina + isoniazida + etambutol, em 18 (48,6%), acrescido de um aminoglicosídeo em 17 (45,9%), acrescido de uma quinolona em três (8,1%) e feito outro esquema em um (2,7%) episódio. Os casos de MAC evoluíram para tratamento completo em 26(53,1%) casos, para óbito em sete (14,3%) (um óbito por MAC e seis por outras causas), perda do seguimento em quatro (8,2%) e 10(20,4%) estão em tratamento. Para Mk, 26 (70,3%) completaram o tratamento, cinco (13,5%) morreram, dois (5,4%) abandonaram e quatro (10,8%) estão em tratamento. O desfecho clínico de MAC e de Mk foi favorável em 53% e 70% (p = 0.056), respectivamente, na coorte avaliada. Conclusão: Os pacientes com Mk foram mais jovens, com predomínio do sexo masculino, com maior frequência de cavitações ao exame de imagem e maior frequência de desfecho favorável, quando comparados aos pacientes com MAC.

Introdução: Mycobacterium szulgai (M. szulgai) é uma micobactéria não tuberculosis (MNT) de crescimento lento, ubíquo, oportunista, sendo pouco frequente. Objetivo: Expandir o acervo sobre o M. szulgai por meio da descrição de dois casos clínicos de infecção pulmonar acompanhados em um Ambulatório de Referência do estado de São Paulo. Método: Revisão de prontuário com ênfase no diagnóstico, manejo terapêutico, e desfechos clínicos, formulando dois relatos de caso. Resultados: Caso 1 - homem, 58 anos, previamente tabagista e pneumopata. Em 02/2007 iniciou febre vespertina, tosse e síndrome consumptiva, a pesquisa de BAAR foi positiva, iniciando tratamento supervisionado com isoniazida, rifampicina e pirazinamida (esquema padrão à época). Devido à hepatite medicamentosa, em maio, foi alterado esquema para estreptomicina e etambutol. Devido à persistência de BAAR positiva, em 06/2007 trocado para isoniazida, ofloxacino e etambutol e realizado tomografia, com evidência de cavitação em lobo superior direito e árvore em brotamento. O resultado da cultura foi obtido em 01/2008, com crescimento de M. szulgai, sendo o esquema alterado para rifampicina, isoniazida e ofloxacino, sendo o último substituído por Levofloxacino em 04/2008. Em abril/2008 houve negativação da pesquisa de BAAR e da cultura do escarro. O tratamento foi suspenso em abril/2009. Caso 2 - homem, 60 anos, hepatopata crônico, em agosto/2023 iniciou quadro de perda ponderal associado à tontura e astenia. Em exame de imagem evidenciou-se cavitações em lobos superiores, linfonodos mediastinais e árvore em brotamento. Coletado escarro com BAAR e TRM-TB negativos, foi então solicitado lavado broncoalveolar em dezembro/23 o qual identificou M. szulgai em cultura. Iniciou o tratamento em março/2024 com rifampicina, etambutol, claritromicina e amicacina, o qual segue em uso até a presente data. Conclusão: Entre as MNT em humanos a prevalência de isolamento de M. szulgai é muito baixa, cerca de 0,2%. Do ponto de vista clínico e radiológico é indistinguível da tuberculose. Os dois casos relatados foram de apresentação pulmonar em pacientes com doenças crônicas, pneumopatia e hepatopatia. Ressalta-se que no primeiro caso houve um retardo no diagnóstico da espécie e no segundo o diagnóstico foi mais célere. Pelo número escasso de casos, não há tratamento padrão preconizado, entretanto assume-se susceptibilidade a maioria dos antimicobacterianos, com uso de, no mínimo, três drogas efetivas e duração de 12 a 18 meses.

Introdução: As Micobactérias de crescimento rápido (MCR) são definidas como aquelas com crescimento em meio sólido em até uma semana. São microrganismos ubíquos, oportunistas podendo causar acometimento pulmonar e extrapulmonar, este relacionado ou não à assistência em saúde (IRAS). Objetivo: Avaliar o manejo terapêutico, eventos adversos e o desfecho clínico de pacientes com MCR acompanhados em ambulatório de referência do Estado de São Paulo. Método: Foi realizado um estudo de coorte retrospectiva, sendo incluídos pacientes com diagnóstico de doença ativa por MCR com comprovação microbiológica segundo os critérios da American Thoracic Society e ANVISA/MS/Brasil no período de 2016 a 2023 atendidos em hospital de referência. Resultados: Dentre os 168 casos de Micobactéria não tuberculosis (MNT), 34 (20,2%) foram de MCR. Foram 32 casos novos e duas recidivas, com identificação do Complexo M abscessus (CMAB) em 20 (58,8%), da espécie M. fortuitum em 12 (35,2%) e de outras espécies em 2 (5,8%). Formas pulmonares ocorreram em 17 (50%) com maior prevalência de M. abscessus (76,4%). Dentre as extrapulmonares, 10 (58,8%) foram relacionadas à assistência à saúde. Quanto ao sítio da infecção, 7 (41,1%) foram de pele e partes moles. Em dois casos de CMAB, detectaram-se resistência ao macrolídeo. Os regimes terapêuticos antes de 2021 foram individualizados por agente; após este período, seguiram-se as diretrizes do MS, 32 (94,1%) utilizaram macrolídeo, 22 (64,7%) fluorquinolonas, 9 (26,4%) carbapenêmico, 5 (14,7%) tigeciclina, 8 (23,5%) clofazimina. Eventos adversos ocorreram em 44,1% dos casos, sendo os mais frequentemente observados intolerância gastrointestinal em 4 (11,7%), ototoxicidade 3 (8,8%), tendinopatia 2 (5,8%), nefrotoxicidade 2 (5,8%), cardiotoxicidade 2 (5,8%), hepatotoxicidade 1 (2,9%) e mielotoxicidade 1 (2,9%). O tempo médio de tratamento na fase intensiva foi 98,6 dias e na de manutenção foi 340 dias. Quanto ao desfecho, evoluíram 21 (61,7%) com cura, 1 (2,9%) com falência de tratamento, 2 (5,8%) para óbito e 9 (26,4%) com mudança de tratamento. Conclusão: Há um número significativo de eventos adversos relacionados ao tratamento de MCR, associados à toxicidade dos esquemas antimicrobianos utilizados por tempo prolongado, com frequente necessidade de mudança. O manejo da infecção por MCR é desafiador, necessitando da participação ativa do paciente no plano terapêutico e de equipe multidisciplinar para a abordagem e seguimento.

IntroductionThe SARS-CoV-2 pandemic has had a widespread and severe impact on society, yet there have also been instances of remarkable recovery, even in critically ill patients.Materials and methodsIn this study, we used single-cell RNA sequencing to analyze the immune responses in recovered and deceased COVID-19 patients during moderate and critical stages.ResultsExpanded T cell receptor (TCR) clones were predominantly SARS-CoV-2-specific, but represented only a small fraction of the total repertoire in all patients. In contrast, while deceased patients exhibited monoclonal B cell receptor (BCR) expansions without COVID-19 specificity, survivors demonstrated diverse and specific BCR clones. These findings suggest that neither TCR diversity nor BCR monoclonal expansions are sufficient for viral clearance and subsequent recovery. Differential gene expression analysis revealed that protein biosynthetic processes were enriched in survivors, but that potentially damaging mitochondrial ATP metabolism was activated in the deceased.ConclusionThis study underscores that BCR repertoire diversity, but not TCR diversity, correlates with favorable outcomes in COVID-19.

Resumo Objetivo Analisar os fatores preditivos à perda de seguimento do tratamento da tuberculose em pessoas privadas de liberdade no estado de São Paulo, Brasil. Métodos Estudo de coorte retrospectivo. Foram coletados dados de fontes secundárias de pessoas privadas de liberdade notificadas com tuberculose no período de 2015 a 2017 no estado. O risco de perda de seguimento segundo as variáveis de exposição (sociodemográficas, de detecção de casos, clínicas e de acompanhamento) foi estabelecido pelas razões de chance Odds Ratio bruto, as quais, quando significativas, foram incluídas no modelo múltiplo com método forward (Likelihood Ratio), determinando seus Odds Ratio ajustado. Resultados Foram incluídos 9.153 casos no estudo, dos quais 6% foram encerrados como perda de seguimento. Na análise múltipla, as variáveis preditoras para a perda de seguimento foram: sexo feminino; notificação por determinadas coordenadorias; retratamento pós-abandono, resistência medicamentosa em andamento sem informação, tipo de tratamento sem informação e necessidade de internação. Conclusão Os achados do estudo destacam a importância de sensibilizar os profissionais de saúde nas unidades prisionais sobre a identificação do perfil de risco para a perda de seguimento no tratamento da tuberculose em pessoas privadas de liberdade. Tal identificação abrange mulheres detidas na região metropolitana, em centros de detenção provisória e de progressão penitenciária. Além disso, devem-se incluir pessoas em retratamento pós-abandono, com necessidade de internação e ausência de informações sobre resistência medicamentosa e tipo de tratamento.

Background: Total hip arthroplasty (THA) using minimally invasive anterolateral approach in the supine position (ALS) is reported to achieve good clinical outcomes including lower dislocation rates and early clinical recovery. However, minimally invasive ALS THA is technically challenging, especially among surgeons who are newly introduced to these techniques. This study aimed to evaluate the learning curves associated with minimally invasive ALS THA. Methods: This study divided 720 primary THAs with a minimally invasive ALS approach into three groups based on the number of previous procedures per surgeon (A:1–100, B:101–200, C: >201). Surgical time and perioperative complications were compared among the three groups. Results: Perioperative complications were seen in 8.0% of patients, including periprosthetic fractures (4.2%), surgical site infection (1.3%), stem subsidence (1.0%), nerve palsy (0.6%), dislocation (0.4%), major bleeding (0.4%), and liner malseating (0.1%). The rate of perioperative complications in each group was 8.6% (30 patients), 10.9% (22 patients), and 3.5% (6 patients) in groups A, B, and C, respectively. Group C has a significantly lower rate than other groups. Group B has significantly higher surgical site infection rate than other groups. No statistically significant difference was found in the surgical times among the three groups. Conclusion: The learning curve associated with minimally invasive ALS THA was approximately 200 cases in terms of perioperative complications. Moderately experienced surgeons should always pay careful attention to avoid complications during ALS THA until they perform >200 cases.

Ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum flavum (OLF) are related diseases associated with the ossification of spinal ligaments that can occasionally lead to thoracic myelopathy. We retrospectively analyzed the clinical data of 34 consecutive patients who underwent thoracic spinal surgeries for OPLL and/or OLF at our hospital between July 2010 and June 2022, and statistically compared data between patients with thoracic OPLL (TOPLL; n = 12) and those with thoracic OLF (TOLF; n = 22). The mean age of the TOPLL group was significantly lower than that of the TOLF group (53.7 vs. 68.4 years). The TOPLL group exhibited a greater female predominance than the TOLF group (58.3% vs. 18.2%). The median body mass index of the TOPLL group was significantly higher than that of the TOLF group (33.0 vs. 26.0 kg/m2). Patients with TOPLL significantly required instrumented fusion and repetitive surgical intervention more than those with TOLF (83.3% vs. 9.1%; 50.0% vs. 0.0%). Although neurological deterioration just after the intervention was more common in patients with TOPLL (41.7% vs. 4.6%), no difference was observed in thoracic Japanese Orthopaedic Association score and recovery rate in the chronic phase between TOPLL and TOLF. The TOPLL group had a younger onset, female dominance, and a greater degree of obesity when compared with the TOLF group. The surgery for TOPLL is challenging, considering that it requires long-range decompression and fusion, subsequent operations, careful management, and long-term follow-up, when compared to TOLF, which necessitates only simple decompression.

EISCAT_3D is a project to build a multi-site phased-array incoherent scatter radar system in northern Fenno-Scandinavia. We demonstrate via numerical simulation how useful monochromatic images taken by a multi-point imager network are for auroral research in the EISCAT_3D project. We apply the generalized aurora computed tomography (G-ACT) method to modelled observational data from real instruments, such as the Auroral Large Imaging System (ALIS) and the EISCAT_3D radar. G-ACT is a method for reconstructing the three-dimensional (3D) distribution of auroral emissions and ionospheric electron density (corresponding to the horizontal two-dimensional (2D) distribution of energy spectra of precipitating electrons) from multi-instrument data. It is assumed that the EISCAT_3D radar scans an area of 0.8° in geographic latitude and 3° in longitude at an altitude of 130 km with 10 × 10 beams from the radar core site at Skibotn (69.35° N, 20.37° E). Two neighboring discrete arcs are assumed to appear in the observation region of the EISCAT_3D radar. The reconstruction results from G-ACT are compared with those from the normal ACT as well as the ionospheric electron density from the radar. It is found that G-ACT can interpolate the ionospheric electron density at a much higher spatial resolution than that observed by the EISCAT_3D radar. Furthermore, the multiple arcs reconstructed by G-ACT are more precise than those by ACT. In particular, underestimation of the ionospheric electron density and precipitating electrons' energy fluxes inside the arcs is significantly improved by G-ACT including the EISCAT_3D data. Even when the ACT reconstruction is difficult due to the unsuitable locations of the imager sites relative to the discrete arcs and/or a small number of available images, G-ACT allows us to obtain better reconstruction results.

Abstract The present study examined the effects of transcutaneous auricular vagus nerve stimulation (taVNS) on short-latency afferent inhibition (SAI), as indirect biomarker of cholinergic system activation. 24 healthy adults underwent intermittent taVNS (30 s on/30 s off, 30 min) or continuous taVNS at a frequency of 25 Hz (15 min) along with earlobe temporary stimulation (15 min or 30 min) were performed in random order. The efficiency with which the motor evoked potential from the abductor pollicis brevis muscle by transcranial magnetic stimulation was attenuated by the preceding median nerve conditioning stimulus was compared before taVNS, immediately after taVNS, and 15 min after taVNS. Continuous taVNS significantly increased SAI at 15 min post-stimulation compared to baseline. A positive correlation (Pearson coefficient = 0.563, p = 0.004) was observed between baseline SAI and changes after continuous taVNS. These results suggest that 15 min of continuous taVNS increases the activity of the cholinergic nervous system, as evidenced by the increase in SAI. In particular, the increase after taVNS was more pronounced in those with lower initial SAI. This study provides fundamental insight into the clinical potential of taVNS for cholinergic dysfunction.

During the oncological care path, breast cancer patients treated with chemotherapy suffer from a number of psycho-physical changes, and appearance-related side effects are among the primary determinants of psychosocial impairment. Appropriate interventions are needed due to the fact that treatment-induced transformations have been associated with a decline in overall quality of life, interpersonal and sexual difficulties, and adverse effects on therapeutic adherence. In the framework of integrative oncology, beauty therapy is an affordable and straightforward intervention that could be used in the clinical management of breast cancer side effects. This study aims to comprehend the emotional and lived experiences of women undergoing chemotherapy after a brief beauty therapy intervention with licensed beauticians. The Interpretative Phenomenological Analysis was used as a methodological guideline. Sixteen women were purposefully recruited in a day hospital of a cancer unit, where the beauty therapy was implemented. At the end of the intervention, data were gathered using a semi-structured interview with open-ended questions. A thematic analysis was performed on verbatim transcriptions. Findings support the proposal of beauty therapy for patients undergoing chemotherapy. Assuming a relational viewpoint, beauty therapy could improve patients’ feelings about themselves and the way they feel about others, even if they do not declare a specific interest in their outward appearance.

BackgroundMass drug administration (MDA) with primaquine (PQ) is being considered for accelerating Plasmodium vivax elimination in remaining active foci. This study aimed to determine the acceptability of MDA with PQ in malaria endemic villages in a malarious setting in the South of Thailand undergoing MDA with PQ.MethodsA cross-sectional mixed-methods approach was conducted in seven malaria endemic villages where MDA with PQ was implemented. The data were collected from community villagers and health workers using structured questionnaires, in-depth interviews, and focus group discussions. Descriptive statistics and logistic regression models were used for quantitative data analysis. Thematic analysis was applied for qualitative data.ResultsAmong a total of 469 participants from the MDA villages, 293 participants were eligible for MDA with PQ and 79.86% (234) completed 14-days of PQ. The logistic regressions indicated that males (adjusted odds ratio: 2.52 [95% confidence interval: 1.33-4.81]) and those who are farmers (2.57 [1.12-5.90]) were most likely to participate in the MDA. Among 293 participants in the post-MDA study, 74.06% had originally agreed to participate in the MDA with PQ while 25.94% had originally reported not wanting to participate in the MDA. Of those who originally reported being willing to participate in the MDA, 71.23% followed through with participation in the first or second round. Conversely, 93.24% of those who originally reported not being willing to participate in the MDA did in fact participate in the MDA. Factors contributing to higher odds of agreeing to participate and following through with participation included being male (1.98 [1.06-3.69]) and correctly responding that malaria is preventable (2.32 [1.01-5.35]) with some differences by village. Five key themes emerged from the qualitative analyses: concern about side effects from taking PQ; disbelief that malaria could be eliminated in this setting; low overall concern about malaria infections; misunderstandings about malaria; and a general need to tailor public health efforts for this unique context.ConclusionWhile the reported likelihood of participating in MDA was high in this setting, actual follow-through was relatively moderate, partially because of eligibility (roughly 71% of those in the follow-up survey who originally agreed to participate actually followed through with participation). One of the largest concerns among study participants was PQ-related side effects-and these concerns likely heavily influenced participant adherence to the MDA. The results of this study can be used to tailor future MDAs, or other public health interventions, in this and potentially other similar settings.

BackgroundEvaluating the accuracy and educational utility of artificial intelligence–generated medical cases, especially those produced by large language models such as ChatGPT-4 (developed by OpenAI), is crucial yet underexplored. ObjectiveThis study aimed to assess the educational utility of ChatGPT-4–generated clinical vignettes and their applicability in educational settings. MethodsUsing a convergent mixed methods design, a web-based survey was conducted from January 8 to 28, 2024, to evaluate 18 medical cases generated by ChatGPT-4 in Japanese. In the survey, 6 main question items were used to evaluate the quality of the generated clinical vignettes and their educational utility, which are information quality, information accuracy, educational usefulness, clinical match, terminology accuracy (TA), and diagnosis difficulty. Feedback was solicited from physicians specializing in general internal medicine or general medicine and experienced in medical education. Chi-square and Mann-Whitney U tests were performed to identify differences among cases, and linear regression was used to examine trends associated with physicians’ experience. Thematic analysis of qualitative feedback was performed to identify areas for improvement and confirm the educational utility of the cases. ResultsOf the 73 invited participants, 71 (97%) responded. The respondents, primarily male (64/71, 90%), spanned a broad range of practice years (from 1976 to 2017) and represented diverse hospital sizes throughout Japan. The majority deemed the information quality (mean 0.77, 95% CI 0.75-0.79) and information accuracy (mean 0.68, 95% CI 0.65-0.71) to be satisfactory, with these responses being based on binary data. The average scores assigned were 3.55 (95% CI 3.49-3.60) for educational usefulness, 3.70 (95% CI 3.65-3.75) for clinical match, 3.49 (95% CI 3.44-3.55) for TA, and 2.34 (95% CI 2.28-2.40) for diagnosis difficulty, based on a 5-point Likert scale. Statistical analysis showed significant variability in content quality and relevance across the cases (P

Abstract This paper describes the instrumentation and the first results of an upper atmospheric observing project conducted in New Zealand. We operate an all-sky aurora camera and a 64-Hz sampling induction magnetometer at Middlemarch, as well as 1-Hz sampling fluxgate magnetometers which have been operative at three stations in New Zealand, Middlemarch, Eyrewell and Te Wharau. Green and red auroras corresponding to the 557.7 nm and 630.0 nm emissions, respectively, were observed on the night of 5 August 2019. Pc1 pulsations were observed in the frequency range of ~ 0.2–1 Hz before and after a small (minimum Dst = − 40 nT) geomagnetic storm during 4–6 October 2020. Before the geomagnetic storm, Pc1 pulsations with several center frequencies were observed regardless of local time. During the recovery phase, an IPDP (interval of pulsations of diminishing period) type of Pc1 and four subsequent intervals of Pc1s were detected. The Ionospheric Alfvén Resonator (IAR) was also identified with spectral resonance structures during this magnetic storm. Lower harmonic modes of the IAR were present throughout the local nighttime, but higher harmonic modes with frequency of 5–15 Hz seemed to disappear at the onset time of substorms. This is the first report of the IAR at such a high frequency range and this is the first IAR observation in the southern hemisphere. Examples of applying cross-phase analysis to observation data of fluxgate magnetometers are also given. Graphical Abstract

Introduction: Although numerous studies have reported outcomes with various conservative approaches for the iliopsoas impingement after total hip arthroplasty (THA), reports on the use of locoregional autologous platelet rich plasma (PRP) injections for the iliopsoas impingement after THA are lacking. This phase 1 study therefore aimed to investigate the safety and feasibility of locoregional PRP injection for iliopsoas impingement after THA. Materials and methods: Patients diagnosed with iliopsoas impingement after THA who met the criteria for participation (symptoms persisting for more than 3 months, aged 20 years or older, and unable to receive non-steroidal analgesic or anti-inflammatory drugs) were eligible to participate in this clinical study. The primary endpoint was observed adverse events including procedure-related pain, and the secondary endpoints included pain and functionality of the hip joint, that were assessed using the Western Ontario and McMaster Universities Arthritis Index, Japanese Hip Disease Evaluation Questionnaire, and Forgotten Joint Score-12. Results: Three patients were screened for eligibility, and 3 patients were finally included in this study. Two participants (patients 1 and 2; aged 66 and 65 years, respectively) were female. The third participant (patient 3; age 73 years) was male. All patients experienced adverse events; however, none were found to be serious. None of the patients experienced any infections, or intra- or post-operative symptoms of nerve damage, or subcutaneous haemorrhage owing to the administration of locoregional PRP. Although patient 2 showed almost complete resolution of the symptom, patient 1 and 3 demonstrated persistent groin pain after the injection. Conclusion: We demonstrated the results of preliminary phase 1 prospective observational clinical study that administration of locoregional PRP injections for iliopsoas impingement following THA is both, safe and feasible.

Purpose: Attempts have been made to enhance knee prostheses design to improve clinical outcomes including bi-cruciate stabilized (BCS) TKA design and single-radius (SR) femoral component design. The complication rate of first generation BCS (fBCS) TKA was higher than that of standard TKA. Regarding BCS TKA, modification of the fBCS TKA system to the second-generation BCS (sBCS) TKA system was performed to avoid complications. This study aimed to compare the midterm clinical results of sBCS TKA and SR TKA. Methods: We retrospectively reviewed data from TKA patients. A total of 142 patients who were followed up for at least 5 years were enrolled: 61 TKAs using sBCS and 81 TKAs using the posterior stabilized (PS) single-radius (SR) design. The clinical results at 6 months, 2 years, and 5 years postoperatively were compared between the sBCS and SR PS groups. Results: At 6 months postoperatively, the maximum flexion angle (MFA) of the sBCS group was larger than that of the SR PS group. At 2 years, MFA, KOOS subscales of pain and ADL in the sBCS group were better and at 5 years, the MFA, KOOS subscales of pain and QOL in the sBCS group were better than those in the SR group. There was no significant differences of the ratios of complications and revision surgeries between the two groups. Conclusion: The midterm clinical results of sBCS TKA were better than those of SR PS TKA in terms of the MFA and KOOS subscales of pain and QOL.

Abstract Background Bicruciate-retaining (BCR) prosthesis has been introduced to recreate normal knee movement by preserving both the anterior and posterior cruciate ligaments. However, the use of BCR total knee arthroplasty (TKA) is still debatable because of several disappointing reports. We have been performing BCR TKAs with personalized alignment (PA). This study aimed to reveal the limb alignment and soft tissue balance of FA-BCR TKAs and compare the clinical outcomes of FA-BCR TKAs with those of unicompartmental knee arthroplasty (UKA). Methods Fifty BCR TKAs and 58 UKAs were included in this study. The joint component gaps of BCR TKA were evaluated intraoperatively and the postoperative hip–knee–ankle (HKA) angle, medial proximal tibial angle (MPTA), and lateral distal femoral angle (LDFA) were measured using full-length standing radiography. The short-term clinical outcomes of BCR TKAs were compared with those of UKA using the scoring system of 2011 Knee Society Scoring (KSS) and the knee injury and osteoarthritis outcome score (KOOS) at an average of 2 years postoperatively (1-4yeras). Results The coronal alignment values of PA-BCR TKA were as follows: HKA angle, 177.9° ± 2.3°; MPTA, 85.4° ± 1.9°; and LDFA, 87.5° ± 1.9°. The joint component gaps at flexion angles of 10°, 30°, 60°, and 90° were 11.1 ± 1.2, 10.9 ± 1.4, 10.7 ± 1.3, and 11.2 ± 1.4 mm for the medial compartment and 12.9 ± 1.5, 12.6 ± 1.8, 12.5 ± 1.8 and 12.5 ± 1.7 mm for the lateral compartment, respectively. The patient expectation score and maximum extension angle of PA-BCR TKA were significantly better than those of UKAs. Conclusions The short-term clinical outcomes of PA-BCR TKA were comparable or a slightly superior to those of UKAs.

Abstract Pulmonary fibrosis (PF), a condition characterized by inflammation and collagen deposition in the alveolar interstitium, causes dyspnea and fatal outcomes. Although the bleomycin-induced PF mouse model has improved our understanding of exogenous factor-induced fibrosis, the mechanism governing endogenous factor-induced fibrosis remains unknown. Here, we find that Ifngr1 -/- Rag2 -/- mice, which lack the critical suppression factor for group 2 innate lymphoid cells (ILC2), develop PF spontaneously. The onset phase of fibrosis includes ILC2 subpopulations with a high Il1rl1 (IL-33 receptor) expression, and fibrosis does not develop in ILC-deficient or IL-33-deficient mice. Although ILC2s are normally localized near bronchioles and blood vessels, ILC2s are increased in fibrotic areas along with IL-33 positive fibroblasts during fibrosis. Co-culture analysis shows that activated-ILC2s directly induce collagen production from fibroblasts. Furthermore, increased IL1RL1 and decreased IFNGR1 expressions are confirmed in ILC2s from individuals with idiopathic PF, highlighting the applicability of Ifngr1 -/- Rag2 -/- mice as a mouse model for fibrosis research.

Abstract Abstract Objective The aim of this study is to evaluate male awareness of developing prostate cancer (PCa) in families with germline DNA‐repair genes (DRG) variants. Materials and methods Data were collected from a prospective, monocentric cohort study. The study was conducted in a university hospital with a multidisciplinary approach to the patient (collaboration of the Departments of Oncology, Urology, Pathology, Radiology, and Medical Genetics Laboratory). We recruited healthy males, relatives of families of women with breast or ovarian cancer who tested positive for pathogenic variants (PVs) or likely pathogenic variants (LPVs) in DRGs. A dedicated PCa screening was designed and offered to men aged 35 to 69 years, based on early visits with digital rectal examination (DRE), prostate health index (PHI) measurement, multiparametric magnetic resonance imaging (mpMRI) and, if necessary, targeted/systematic prostate biopsies. The primary endpoint was to evaluate the willingness of healthy men from families with a DRG variants detected in female relatives affected with breast and/or ovarian cancer to be tested for the presence of familial PVs. The secondary endpoints were the acceptance to participate if resulted positive and compliance with the screening programme. Results Over 1256 families, of which 139 resulted positive for PVs in DRGs, we identified 378 ‘healthy’ men aged between 35 and 69 years old. Two hundred sixty‐one (69.0%) refused to be tested for DRG variants, 66 (17.5%) declared to have been previously tested, and 51 (13.5%) males were interested to be tested. Between those previously tested and those who accepted to be tested, 62 (53.0%) were positive for a DRG variant, and all of them accepted to participate in the subsequent surveillance steps. The main limitation is that is a single‐centre study and a short follow‐up. Conclusions All men tested positive for a DRG variants agreed to go under the surveillance scheme. However, only 31% of ‘men at risk’ (i.e., relative of a DRG variant carrier) expressed their willingness to be tested for the familial DRG variant. This observation strongly supports the urgent need to implement awareness of genetic risk for PCa within the male population.