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BackgroundEndovascular therapy (EVT) for distal medium vessel occlusions requires prioritizing effectiveness and safety. We developed a technique combining the deployment of only the distal basket segment of the EMBOTRAP III and an aspiration catheter (AC) for M2 occlusions, called the “ONE-SEG technique,” and evaluated its clinical and technical impacts.MethodsThis was a retrospective review of 30 consecutive patients with M2 segment middle cerebral artery occlusion treated using the ONE-SEG technique. This method involves deploying the EMBOTRAP III through a microcatheter in only one segment and guiding the AC to the M2 origin or distal M1. The rates of final-pass expanded thrombolysis in cerebral infarction (eTICI) scores of 2c/3 or 2b/2c/3, safety (symptomatic intracranial hemorrhage [sICH]), and clinical outcomes (modified Rankin Scale [mRS] score 0–2, 0–3 at 90 days, and mortality at 90 days) were evaluated.ResultsOf the 30 cases, 36.7% were female, and the mean age was 75.6 ± 11.0 years. The ONE-SEG technique was used for 17 cases (56.7%, median NIHSS 10 [5–15.5]) with primary M2 occlusion and 13 cases (43.3%, median NIHSS 20 [14–22.5]) with secondary M2 occlusion after proximal thrombus removal. The successful final reperfusion rate (eTICI 2b/2c/3) was 90% overall (27/30 cases). One case (3.3%) developed sICH with secondary M2 occlusion. At 3 months, mRS scores 0–2 were seen in 64.7% of patients with primary M2 occlusion (11/17 cases) and in 23.1% (3/13 cases) with secondary M2 occlusion.ConclusionEVT using the ONE-SEG technique appears to be safe and effective for M2 occlusion.

Abstract Background Necrotising fasciitis (NF) is a life-threatening soft-tissue infection that rapidly destroys the epidermis, subcutaneous tissue, and fascia. Despite their low virulence, Lactobacillus spp. can cause NF, and because of its rare incidence, there is limited information about its molecular and clinicopathological characteristics. We report a rare case of NF in a patient with type 2 diabetes mellitus diagnosed on admission and severe obesity due to infection with two types of Lactobacillus spp. that manifested in extensive necrosis. Case presentation A 48-year-old woman was referred to our hospital with a complaint of difficulty walking due to severe bilateral thigh pain. She presented with mild erythema, swelling, and severe skin pain extending from the pubic region to the groin. The patient was morbidly obese, had renal dysfunction, and had diabetes mellitus diagnosed on admission.; her LRINEC (Laboratory Risk Indicator for Necrotising Fasciitis) score was 9, indicating a high risk of NF. An exploratory surgical incision was made, and NF was diagnosed based on fascial necrosis. Emergent surgical debridement was performed, and cultures of the tissue culture and aspirated fluid/pus revealed two types of Lactobacillus spp.: Lactobacillus salivarius and L. iners. The patient was admitted to the intensive care unit (ICU), where antibiotics were administered and respiratory and circulatory management was performed. Diabetic ketoacidosis was detected, which was treated by controlling the blood glucose level stringently via intravenous insulin infusion. The patient underwent a second debridement on day 11 and a skin suture and skin grafting on day 36. The patient progressed well, was transferred from the ICU to the general ward on day 41, and was discharged unassisted on day 73. Conclusions Lactobacillus spp. are rarely pathogenic to healthy individuals and can scarcely trigger NF. However, these bacteria can cause rare infections such as NF in immunocompromised individuals, such as those with diabetes and obesity, and an early diagnosis of NF is imperative; surgical intervention may be required for the prevention of extensive necrosis. The LRINEC score may be useful for the early diagnosis of NF, even for less pathogenic bacteria such as Lactobacillus.

Abstract A young patient diagnosed with advanced colon cancer and liver metastasis was found to have familial adenomatous polyposis (FAP) through comprehensive genomic analysis. Whole-genome array comparative genomic hybridization (aCGH) revealed germline deletions at chromosome 5q22.1-22.2 encompassing the entire APC gene. The patient and her son exhibited mild intellectual disability without developmental delay. This case highlights the need for further exploration of the characteristics associated with whole APC deletions. aCGH is a valuable tool for studying FAP and provides a detailed analysis of large deletions.

Abstract Aim This systematic review and frequentist network meta‐analysis used random‐effects models is conducted to determine whether there are differences in the efficacy, acceptability, tolerability, and safety profiles of brexpiprazole (BRE) and aripiprazole (ARI) for Japanese with major depressive disorder (MDD) who were inadequately responsive to antidepressants. Methods Outcome measures were scores on the Montgomery Åsberg Depression Rating Scale (primary), the Clinical Global Impression severity scale, and social functioning scale; the non‐response rate; the non‐remission rate; all‐cause discontinuation; discontinuation due to adverse events (DAE); at least one adverse event (1AE); serious adverse event, akathisia; tremor; weight gain. Results A literature search identified three double‐blind, randomized, placebo‐controlled trials. These comprised one BRE study (with a 1 mg/day [BRE1] and a 2 mg/day [BRE2]) and two ARI studies (with a 3 mg/day arm and a flexible‐dose arm[within the dosage range approved in Japan]) (n = 1736). Both BRE and ARI demonstrated better efficacy than the placebo. BRE but not ARI had a higher DAE than the placebo. ARI but not BRE had a higher 1AE than the placebo. BRE and ARI had a higher risk of akathisia and weight gain than the placebo. There were no significant differences between BRE and ARI for any of the outcomes. Although BRE1 had good efficacy, it carried risk of weight gain. Although BRE2 also had efficacy, it carried risks of DAE, akathisia, and weight gain. However, the risk of akathisia in BRE2 was reduced by an initial dose of 0.5 mg/day rather than 1.0 mg/day. Conclusions Overall BRE showed similar utility to ARI and a good risk–benefit balance.

Atypical lipomatous tumors (ALTs) are locally aggressive adipocytic malignancies that frequently occur in middle-aged adults. We report the rare case of an ALT of the thigh that occurred in a 4-year-old girl. Since the tumor was initially diagnosed as a lipoblastoma by incisional biopsy, marginal resection was performed. Histopathological findings of the surgical specimen revealed the proliferation of mature and variously sized adipocytes, as well as ectopic ossification; these features differ from the typical findings of lipoblastoma. Immunohistochemical findings showed nuclear positivity for a murine double minute 2 (MDM2) and cyclin-dependent kinase 4 (CDK4) and negativity for pleomorphic adenoma gene 1 (PLAG1). Fluorescence in situ hybridization showed abnormal amplification of the MDM2 gene. The patient was thus finally diagnosed as having an ALT. No signs of local recurrence or metastasis were noted 1 year postoperatively. This case is instructive in the differential diagnosis of primary adipocytic tumors. Lipoblastomas are the most common adipocytic tumors in children, but if a tumor is located in the deep tissue or imaging findings are not typical, the possibility of ALT should be considered and immunohistochemistry for MDM2 and CDK4 should be added.

Abstract Pulse oximetry is widely used in medical settings and in everyday life for the estimation of peripheral blood oxygen saturation (SpO2). However, SpO2 response measured on the peripheral parts of the body (such as fingers and wrists) has a time lag compared to measuring on the forehead. In addition, current devices are centimeter‐thick, making seamless integration with the body difficult, and hindering continuous monitoring. Here a design, fabrication, and evaluation of a SpO2 and heart rate sensor based on flexible hybrid electronics (FHE) is presented. The marriage of flexible electronics with high‐performance commercially available integrated circuit (IC) chips makes advanced sensing, data processing, and wireless data transmission functionalities possible on a thin (1.6 mm) and flexible form that can be attached to various parts of the body. Differently from most devices using FHE, here a cost‐efficient and mass‐production compatible multilayer screen‐printing process for making the interconnection circuitry is described in detail, including topographic analysis. By optimizing the printing steps, interconnecting lines vertically traversing up to five printed layers over several tens of micrometers can be fabricated, increasing the spatial density. The device reliably detects hypoxemia, and when applied on the forehead, changes in SpO2 appear >10 s earlier compared to a finger‐based medical‐grade device.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.solener.2004.04.023 Byline: Akira Hoshi (a), David R. Mills (b), Antoine Bittar (b), Takeo S. Saitoh (c) Keywords: Solar thermal electricity; High-melting point; Phase change material; Compact linear Fresnel reflector; Multi tower solar array; Latent heat thermal energy storage Abstract: We have investigated the suitability of high melting point phase change materials for use in new, large scale solar thermal electricity plants. Candidate materials for latent heat thermal energy storage are identified and their operating parameters modeled and analysed. The mathematical characteristics of charging and discharging these storage materials are discussed. Several high melting point, high conductivity materials are shown to be suitable and advantageous for use with solar thermal electricity plants, such as Sydney University's novel, low cost CLFR and MTSA collector systems, as well as existing parabolic trough and tower technologies. Author Affiliation: (a) Department of Mechanical Engineering, Ichinoseki National College of Technology, Takanashi, Hagisho, Ichinoseki 021-8511, Japan (b) School of Physics, University of Sydney, NSW 2006, Australia (c) Graduate School of Environmental Studies, Tohoku University, Sendai 980-8579, Japan Article History: Received 23 February 2004; Accepted 19 April 2004 Article Note: (miscellaneous) Communicated by: Associate Editor Erich Hahne

Key Clinical Message Walking ability may be fairly well maintained after sciatic nerve resection combined with wide resection of soft tissue sarcoma, therefore, surgeons should not hesitate to perform sciatic nerve resection to achieve an adequate surgical margin.

Proteome analyses of the postsynaptic density (PSD), a proteinaceous specialization beneath the postsynaptic membrane of excitatory synapses, have identified several thousands of proteins. While proteins with predictable functions have been well studied, functionally uncharacterized proteins are mostly overlooked. In this study, we conducted a comprehensive meta-analysis of 35 PSD proteome datasets, encompassing a total of 5,869 proteins. Employing a ranking methodology, we identified 97 proteins that remain inadequately characterized. From this selection, we focused our detailed analysis on the highest-ranked protein, FAM81A. FAM81A interacts with PSD proteins, including PSD-95, SynGAP, and NMDA receptors, and promotes liquid-liquid phase separation of those proteins in cultured cells or in vitro. Down-regulation of FAM81A in cultured neurons causes a decrease in the size of PSD-95 puncta and the frequency of neuronal firing. Our findings suggest that FAM81A plays a crucial role in facilitating the interaction and assembly of proteins within the PSD, and its presence is important for maintaining normal synaptic function. Additionally, our methodology underscores the necessity for further characterization of numerous synaptic proteins that still lack comprehensive understanding.

In most countries, contaminated water is the major cause of most water-borne diseases. Disinfection of water may be accomplished by a number of different physical-chemical treatments including direct application of thermal energy, chemical and filtration techniques. Solar energy also can be used effectively in this field because inactivation of microorganisms is done either by heating water to a disinfecting temperature or by exposing to ultraviolet solar radiation. A pilot solar system for disinfecting contaminated water is designed, constructed and tested. Investigations are carried out to evaluate the performance of a wooden hot box solar facility as a solar disinfectant. Experimental data show that solar energy is viable for the disinfection process. A solar radiation model is presented and compared with the experimental data. A mathematical model of the solar disinfectant is also presented. The governing equations are solved numerically via the fourth-order Runge-Kutta method. The effects of environmental conditions (ambient temperature, wind speed, solar radiation, etc.) on the performance of the solar disinfectant are examined. Results showed that the system is affected by ambient temperature, wind speed, ultraviolet solar radiation intensity, the turbidity of the water, the quantity of water exposed, the contact area between the transparent water container in the solar disinfectant and the absorber plate as well as the geometrical parameters of the system. It is pointed out that for partially cloudy conditions with a low ambient temperature and high wind speeds, the thermal efficiency of the solar disinfectant is at a minimum. The use of solar energy for the disinfection process will increase the productivity of the system while completely eliminating the coliform group bacteria at the same time.

ABSTRACTDirect planting (i.e. the planting of seed roots) can reduce the labor requirements of sweet potato (Ipomoea batatas (L.) Lam.) cultivation. To broaden the breeding material for high dry matter productivity in direct planting, root dry matter content (DMC) and root dry matter weight per hill (DMW) were compared under both direct planting and conventional transplanting by using 28 sweet potato genotypes cultivated in 2020 and 2021. Unlike in the case of the mother root DMC, a significant positive correlation between the daughter root DMC in direct planting and the root DMC in transplanting was observed over two years (p

Clinically, the osteolytic phenotype is rare in prostate cancer (PCa), and the prognosis is generally worse than that of the osteoblastic phenotype. Osteoblastic prostate cancer (BPCa) is a major type of bone metastasis. Several factors responsible for osteogenesis have been identified, but the molecular mechanism of osteoblastic bone metastasis in PCa is not fully understood. Here, we show the osteogenic and tumor‐suppressive roles of SERPINA3 and LCN2 in BPCa. In a co‐culture of osteoblasts (OBs) and BPCa cells, SERPINA3 and LCN2 were remarkably upregulated in BPCa via OB‐derived extracellular vesicles, while they were not in the co‐culture of OBs and osteolytic prostate cancer (LPCa) cells. In both the co‐culture system and mouse xenograft experiments with intracaudal injection, enhanced expression of SERPINA3 and LCN2 in PCa led to osteogenesis. Additionally, the addition of SERPINA3 and LCN2 to BPCa cells significantly suppressed the proliferative potential. Retrospective analysis also confirmed that high expression levels of SERPINA3 and LCN2 were significantly correlated with a better prognosis. Our results may partially explain how osteoblastic bone metastasis develops and why the prognosis for BPCa is relatively better than that for LPCa.

Abstract Background This study aimed to assess the relationship between immune response adverse events (irAEs) and treatment efficacy in patients with extensive disease small cell lung cancer (ED‐SCLC). Methods We retrospectively evaluated the clinical effects in 40 ED‐SCLC patients who had received immune‐checkpoint inhibitors (ICIs), platinum agents, and etoposide between September 2019 and September 2021. We identified and compared patients belonging to two groups: irAE and non‐irAE. Results Fifteen patients experienced irAEs, and 25 did not. The median progression‐free survival in patients with irAE was longer than that in patients without irAE (12.6 months [95% CI: 6.3–19.3 months] vs. 7.2 months [95% CI: 5.8–7.9 months], p = 0.0108). However, the median overall survival (OS) was similar between irAE and non‐irAE groups (27.6 months [95% CI: 15.4–NA] vs. 24.9 months [95% CI: 13.7–NA], p = 0.268). Seven (46.7%) in the irAE group and 20 (80%) in the non‐irAE group received sequential therapy. The median OS was prolonged in patients who received first‐ and second‐line therapy than in those who received first‐line therapy alone (27.6 months [95% CI: 19.2–NA] vs. 6.6 months [95% CI: 0.3–NA], p = 0.053). Grade ≧ 3 irAEs occurred in five (12.5%) patients. Among them, grade 5 irAEs were observed in two patients, including exacerbation of polymyositis and pulmonary arterial embolism. Conclusion In this study, the development of irAEs did not affect OS in patients with ED‐SCLC who received platinum‐based agents, etoposide, or ICI therapy. We determined that managing irAEs and administering first‐ and second‐line therapies could contribute to prolonged OS.

Abstract Advances in cryogenic transmission electron microscopy have revolutionised the determination of many macromolecular structures at atomic or near-atomic resolution. This method is based on conventional defocused phase contrast imaging. However, it has limitations of weaker contrast for small biological molecules embedded in vitreous ice, in comparison with cryo-ptychography, which shows increased contrast. Here we report a single-particle analysis based on the use of ptychographic reconstruction data, demonstrating that three dimensional reconstructions with a wide information transfer bandwidth can be recovered by Fourier domain synthesis. Our work suggests future applications in otherwise challenging single particle analyses, including small macromolecules and heterogeneous or flexible particles. In addition structure determination in situ within cells without the requirement for protein purification and expression may be possible.

Background Typically detected at least 14 days after acute ischemic stroke onset, delayed leukoencephalopathy (DL) involves diffuse hyperintensities restricted to white matter on fluid‐attenuated inversion recovery accompanied mostly by partial diffusion‐weighted image hyperintensities. DL cases, which are rarely reported, have occurred after large‐vessel occlusion (LVO). Herein, we aim to elucidate the incidence and factors associated with DL. Methods Our study covers consecutive ischemic strokes involving: (1) onset‐to‐door time within 7 days and (2) available scans from at least a second magnetic resonance imaging procedure at least 14 days after onset. First, we examined the incidence of DL generally and whether LVO could be a risk factor for DL in ischemic strokes generally, and second, we examined the incidence and risk factors associated with DL in patients with LVO. Results We screened 1857 consecutive patients with ischemic stroke and selected 792 general patients—573 (72%) men, median age 67 years—and 183 patients with LVO—128 (70%) men, median age 67 years. DL was detected in 2.3% of the general patients and 9.2% of the patients with LVO ischemic stroke. LVO was strongly associated with DL (odds ratio [OR], 69.1 [95 CI, 9.06–526]; P

Interactions between an enzyme kinase, an ion channel and cytoskeletal proteins maintain the structure of synapses involved in memory formation.