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Neuroinflammation, a hallmark of neurodegenerative diseases, is associated with neuronal cell loss and cognitive dysfunction. Monoacylglycerol lipase (MAGL) is involved in neuroinflammation in the brain via the degradation of endocannabinoid 2-arachidonoylglycerol to arachidonic acid, a precursor of some eicosanoids; therefore, MAGL inhibitors are expected to have anti-inflammatory effects. We recently developed a reversible, selective, central nervous system penetrant, and orally available MAGL inhibitor, compound 4f. Compound 4f (1 mg/kg) robustly increased 2-arachidonoylglycerol levels and decreased arachidonic acid levels in the mouse brain. To examine whether compound 4f can suppress neuroinflammation and neuronal cell loss, kainic acid (KA)-injected mice were used as a neuroinflammation model in this study. Compound 4f (1 mg/kg) significantly decreased the cytokine and chemokine expression levels and suppressed neuronal cell loss in the hippocampi of mice. Compound 4f also ameliorated cognitive impairment in KA-injected mice. The cannabinoid receptor 1 antagonist, AM251, and cannabinoid receptor 2 antagonist, AM630, partly blocked the neuroprotective effects of compound 4f in the hippocampi of KA-injected mice. Gene expression profiles and pathway analyses revealed that compound 4f reversed the KA-induced changes in the expression of genes related to inflammation and neurotransmission. These results indicate that the selective and reversible MAGL inhibitor, compound 4f, can be used as a potential therapeutic agent for the treatment of neurodegenerative diseases. [ABSTRACT FROM AUTHOR]

Background: Hypertensive disorders of pregnancy (HDP) significantly increase the risk of developing hypertension and cardiovascular disease (CVD) later in life and are a major cause of maternal mortality. However, little is known about the nationwide, long-term, all-inclusive status of HDP. Objective: To estimate the incidence of HDP from 2011 to 2019 in Hokkaido, Japan, with a focus on age groups. Methods: Using National Database (NDB) insurance medical data, a retrospective analysis was conducted. Due to the absence of direct pregnancy data, birth numbers were used as a surrogate for the number of pregnant women to calculate the incidence of HDP. Results: The average incidence rate of HDP over 9 years was 6.37%. The incidence rate was lowest among women aged 25–29 years, at 5.58% (95% confidence interval [CI]: 5.43–5.73), and increased with age, peaking at 10.58% (95% CI: 10.10–11.09) among women over 40 years. Notably, the incidence rate for women under 20 years of age was 6.70% (95% CI: 5.97–7.51), which was higher than that for women in their 20s. A mean annual increase of 0.25% in age-adjusted incidence was observed during this period, which was statistically significant (R² = 0.87, p < 0.01). Conclusion: This study reveals that the risk of developing HDP is associated with both older childbearing and younger pregnancies and follows a J-curve, suggesting that factors other than maternal aging also contribute to the increased incidence of HDP and that further research on risk factors for HDP, which is on the rise worldwide, is urgently needed. [ABSTRACT FROM AUTHOR]

The evaluation of short answers from numerous students requires a highly reliable and efficient scoring system that incorporates natural language processing. Specifically, for higher reliability, higher indicators such as accuracy are desirable, whereas for higher efficiency, less data are desirable for labelling. Moreover, these desires are more acute with larger data sets. In this study, we proposed a novel workflow using active and deep learning to improve the accuracy of automated scoring while reducing the scoring cost incurred through manual scoring. In a trial common test for university entrance examinations, the proposed workflow automatically scored more than 60,000 short answers per question (in Japanese). Consequently, we obtained high accuracy for all the questions in the test. In particular, the proposed workflow achieved an accuracy as high as 0.999, which is consistent with the existing manual grading approach in terms of accuracy. Furthermore, the cost of human scoring was reduced to less than one-sixth that of the training data on average, which is a significant advantage over other machine learning methods. Thus, the proposed workflow demonstrates the potential for advancing practical applications of automated scoring. [ABSTRACT FROM AUTHOR]

Background: For magnetic resonance imaging (MRI) findings of intracranial silicone oil migration, little has been described about images obtained with motion correction sequences such as MultiVane XD (Philips Healthcare) that provides high resolution diagnostic images even with severe patient motion. We report a case with intracranial silicone oil migration in which MRI was obtained with MultiVane XD and T2*-weighted imaging (T2*WI) was found the most useful in detecting intracranial silicone oil. Case presentation: A 77-year-old female with a history of eye surgery using silicone oil referred to our hospital due to conscious disturbance. Head computed tomography demonstrated multiple intracranial masses whose signal density was similar to that in the operated eyeball and the tentative diagnosis of intracranial silicone oil migration was made. MRI was performed with MultiVane XD due to the significant patient's restlessness, and among all sequences including T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), fluid-attenuated inversion recovery (FLAIR) and T2*WI, only T2*WI detected intracranial silicone oil. In contrast, another MRI obtained previously with conventional turbo spin-echo detected intracranial silicone oil not only in T2*WI but also in T1WI, T2WI and FLAIR. Phantom experiment revealed that chemical shift artifact played an important role in discriminating silicone oil from artificial cerebrospinal fluid, which attenuated in MultiVane XD. However, T2*WI still showed good discrimination of silicone oil even using MultiVane XD because of susceptibility artifacts. Conclusion: T2*WI was the best sequence to detect intracranial silicone oil in MRI obtained with motion correction sequences because of its ability to depict the susceptibility artifacts. [ABSTRACT FROM AUTHOR]

A tripeptide catalyst derived from natural l -amino acids was employed in the reaction of β-nitrostyrenes with cyclohexanone, serving as a model for the asymmetric Michael addition reaction. The reaction was conducted in the presence of H-Pro-Tle-Gly-OH and 2-fluoro-4-chlorobenzoic acid as co-catalysts (each at 20 mol%) in DMF-H 2 O (5:1) at 0 °C for 3 days. This process yielded the desired Michael adducts with excellent efficiency and good stereoselectivity (up to 98% yield, up to 92% ee). [ABSTRACT FROM AUTHOR]

Chemical and bioactive analyses of spice oils have been widely performed. However, spice blends such as curry powder are not prescribed as herbal medicine, so their bioactivities have not been sufficiently explored. Here, cinnamon, fennel, and clove were blended following the CH1 herbal medicine prescription, and, in mice, appetite-enhancing effects were compared between the blended and individual spices. GC and GC/MS analyses revealed the following major components of the CH1 blended spice oil: trans-anethole, trans-cinnamaldehyde, and eugenol. Food intake was observed in 4 h feeding tests after 16 h of fasting. Eugenol and trans-anethole lowered the dose for the appetite-enhancing effects of trans-cinnamaldehyde 10-fold. After 1 week of daily administration, the dose-lowering effect of eugenol disappeared and the appetite-enhancing effects of trans-cinnamaldehyde occurred at a higher dose. Although the dose-lowering effect of trans-anethole decreased, food intake was still increased significantly by daily administration of blended spices at the lower dose. [ABSTRACT FROM AUTHOR]

ObjectiveMethodsResultsConclusionThis study aimed to investigate the collagen fiber structure of the subcutaneous fascia, a connective tissue layer between the skin and epimysium.Fascia samples with varying extensibility were examined using biochemical and microscopic methodsLoose fascia, the more extensible type, displayed sparsely distributed collagen fibers, while dense fascia showed tightly packed collagen fiber bundles. Elastase treatment, after urea pretreatment, caused the loosening of collagen fiber bundles and increased collagen fiber generation as the treatment time increased. This suggests that elastic fibers contribute to collagen fiber bundle formation. Additionally, elastase treatment stretched the fascia, indicating the presence of twodimensional tensile stress generated by elastic fibers. Either enzymes capable of cleaving elastic fibers may be activated or the stretching of elastic fibers accompanying tissue deformation may increase the enzyme sensitivity to elastic fibers, leading to the formation of localized collagen fibers in vivo. Tissue staining confirmed that loose and dense fascia corresponded to areas with sparse and dense collagen fibers, respectively. Some dense collagen fibers appeared to migrate and disperse into loose areas.These findings provide insights into the structural organization and functional significance of collagen fibers within the subcutaneous fascia. They particularly highlight the role of elastic fibers in maintaining tissue integrity and facilitating dynamic remodeling. [ABSTRACT FROM AUTHOR]

Keratoconus (KC) is a progressive corneal disorder resulting in severe visual impairment. We aimed to determine the prevalence and corneal tomographic characteristics of KC and keratoconus suspect (KCS) in a population-based study, and to construct discrimination models with or without corneal tomography. A total of 1,544 eyes (822 participants aged ≥35 years) were evaluated using data from the Yamagata Study (2015–2017). Systemic and ophthalmological examinations including corneal tomography with swept-source anterior segment optical coherence tomography (AS-OCT) were conducted to determine the prevalence and corneal tomographic characteristics of KC and KCS. In addition, data on 766 eyes were used to construct discrimination models with or without corneal tomography. In results, KC was diagnosed in six (0.85%) participants, and KCS was diagnosed in 27 (1.46%) participants. The values including corneal power, keratometric cylinder, corneal central and thinnest thickness, corneal asymmetry, higher-order irregularity, and their inter-eye differences were associated with KC and KCS. The areas under the receiver operating characteristic curves for the three multivariate discrimination models (without corneal tomography, with corneal tomography, and without corneal tomography + inter-eye difference models) for participants with KC or KCS were 0.848, 1.000, and 0.930, respectively. When corneal tomography is unavailable, inter-eye differences in corneal parameters may be useful screening tools for KC and KCS. [ABSTRACT FROM AUTHOR]

In this review, the epitaxial growth of transition metal nitrides (TMNs) is explored, focusing on sputter epitaxy as a versatile method for developing advanced materials such as NbN superconductors and ScAlN ferroelectrics. In the recent studies, it is shown that, unlike conventional growth techniques, sputter epitaxy enables the deposition of high‐melting‐point transition metals, offering advantages for growing thin films with unique properties. In this review, recent progress in integrating TMNs with nitride semiconductors to fabricate hybrid devices that exhibit both superconducting and ferroelectric characteristics is addressed. These developments underscore the potential of sputter epitaxy as a foundational tool for advancing the next generation of electronic and quantum devices. [ABSTRACT FROM AUTHOR]

We investigated the effect of post-deposition annealing on the electrical characteristics of SiO2/β-Ga2O3(001) MOS structures. While oxygen annealing effectively improves the interface properties, it induces acceptor defects in Ga2O3, leading to a decrease in net donor density. With the combination of oxygen and nitrogen annealing, carrier compensation was suppressed, and a low interface state density of about 1 × 1011 cm−2 eV−1 was obtained near the conduction band edge of Ga2O3. High immunity against positive gate bias stress was also confirmed. [ABSTRACT FROM AUTHOR]

The epiblast is a pluripotent cell population formed in the late blastocyst stage of preimplantation embryos. During the process of epiblast formation from the inner cell mass (ICM) of the early blastocyst, activation of the Hippo pathway transcription factor TEAD by the nuclear translocation of the coactivator protein YAP is required for the robust expression of pluripotency factors. However, the mechanisms that alter YAP localization during epiblast formation remain unknown. Here, we reveal two such mechanisms. Expansion of the blastocoel promotes nuclear YAP localization by increasing cytoplasmic F-actin and reducing YAP phosphorylation. Additionally, cell differentiation regulates YAP. Expression of the junctional Hippo component, AMOT, gradually decreases during epiblast formation through a tankyrase-mediated degradation. SOX2 expression in the ICM is necessary for the reduction of AMOT and YAP phosphorylation. These two mechanisms function in parallel. Thus, the blastocoel–F-actin and SOX2–AMOT axes cooperatively suppress YAP phosphorylation and promote YAP nuclear localization during epiblast formation. The cooperation of these two distinct mechanisms likely contributes to the robustness of epiblast cell differentiation. [Display omitted] • Two mechanisms promote nuclear YAP localization during epiblast formation. • Blastocoel expansion increases cytoplasmic F-actin and reduces YAP phosphorylation. • Cell differentiation by SOX2 promotes tankyrase-mediated degradation of AMOT. • These mechanisms act in parallel and cooperatively promote YAP nuclear localization. [ABSTRACT FROM AUTHOR]

Early diagnosis and preventive measures are necessary to mitigate diseases' impact on the yield of Colocasia esculenta (Taro). This study addresses the challenges of Taro disease identification by employing two key strategies: integrating explainable artificial intelligence techniques to interpret deep learning models and conducting a comparative analysis of advanced architectures Inception V3, ResNet-50, and Vision Transformers for classifying common Taro diseases, including leaf blight and mosaic virus, as well as identifying healthy leaves. The novelty of this work lies in the first-ever integration of SHapley Additive exPlanations (SHAP) with deep learning architectures to enhance model interpretability while providing a comprehensive comparison of state-of-the-art methods for this underexplored crop. The proposed models significantly improve the ability to recognize complex patterns and features, achieving high accuracy and robust performance in disease classification. The model's efficacy was evaluated through multi-class statistical metrics, including accuracy, precision, F1 score, recall, specificity, Chohen's kappa, and area under the curve. Among the architectures, Inception V3 exhibited superior performance in accuracy (0.9985), F1 score (0.9985), recall (0.9985), and specificity (0.9992). The explainability of Inception V3 was further enhanced using SHAP, which provides insights by dissecting the contributions of individual features in Taro leaves to the model's predictions. This approach facilitates a deeper understanding of the disease classification process and supports the development of effective disease management strategies, ultimately contributing to improved Taro cultivation practices. [ABSTRACT FROM AUTHOR]

Retinopathy of prematurity (ROP) is a major cause of preventable blindness in preterm infants. The association between red blood cell (RBC) parameters and the development of ROP remains unclear. The objectives of the present study were to evaluate the association between RBC parameters and ROP treatment. This single-center, retrospective cohort study included preterm infants born at < 30 weeks of gestation. Data pertaining to RBC parameters and ROP treatment were obtained from the medical records. A receiver operating characteristic (ROC) analysis was performed to determine the cut-off values of the RBC parameters according to the need for ROP treatment. Multiple logistic regression analyses assessed the association between ROP treatment and RBC parameters at birth and on day of life (DOL) 28. We included 202 infants, and 44.1% were treated for ROP. After adjusting for confounders, we observed associations between ROP treatment and mean corpuscular volume (MCV) values > 117.3 fL at birth (adjusted odds ratio [aOR]:2.3; 95% confidence intervals CI 1.0–5.3). Additionally, on DOL 28, hemoglobin (Hb) values < 9.9 g/dL (aOR:3.0; 95% CI 1.4–6.7), hematocrit (Hct) values < 31.0% (aOR:2.7; 95% CI 1.3–5.6), and red cell distribution width (RDW) values > 18.5% (aOR:2.6; 95% CI 1.1–6.2) were associated with ROP treatment. In conclusion, our study indicated that infants born at < 30 weeks of gestation with an MCV > 117.3 fL at birth, along with Hb < 9.9 g/dL, Hct < 31.0%, and RDW > 18.5% on DOL 28, had an increased risk of requiring ROP, warranting treatment. [ABSTRACT FROM AUTHOR]

Difficulties in the accurate evaluation of tibiofibular clear space in plain radiographs are diagnostic problems in the clinical setting of syndesmosis injury. This study aimed to quantify the anterior tibiofibular gap (ATFG) with weight-bearing using ultrasonography. In total, 32 healthy adults (16 men and 16 women) with 64 feet participated in this cross-sectional study. The ATFG was measured along the anterior inferior tibiofibular ligament for a US assessment conducted in both sitting and standing postures. The ankle joint was set on the tilt table at four different angles as follows: plantar flexion, 20° (P20); neutral position (N); dorsiflexion, 20° (D20); and dorsiflexion, 20°+ external rotation, 30° (D20ER30). The ankle joint position, sex, and side-to-side values were compared with and without weight-bearing. Under all ankle angle conditions, the ATFG was wider in the standing posture than in the sitting posture (p < 0.001). In both sitting and standing postures, the ATFG widened with increasing dorsiflexion angle, eventually reaching a maximum at D20ER30. The widening ratio (D20ER30/N) in the standing posture was higher in women than in men (p < 0.05). No statistical differences were identified side-to-side differences in the ATFG. Ultrasound measurements for identifying unphysiological increases in ATFG with weight bearing, especially given the side-to-side differences, may provide a means for quantitatively assessing syndesmosis injury in a clinical setting. Further research is warranted to clarify direct attribution as a clinical diagnostic utility of the ATFG measurements for syndesmosis injuries. [ABSTRACT FROM AUTHOR]

Background: Normothermic machine perfusion (NMP) aims to reduce ischemia–reperfusion injury in donor livers and its clinical manifestation, early allograft dysfunction (EAD) by maintaining perfusion and oxygenation. However, there is limited data on which NMP perfusate biomarkers might be associated with such EAD and the role of perfusate hemoglobin has not been assessed. Methods: We performed a pilot retrospective analysis of adult donor livers undergoing NMP between 2020 and 2022 at our center. NMP was commenced at the recipient hospital after initial static cold storage. All NMP circuits were primed in the same manner according to the manufacturer's instructions. Livers were stratified by initial perfusate hemoglobin below (≤5.2 mmol/L) or above (>5.2 mmol/L) the median. The association between hemoglobin levels and EAD or recipient peak transaminase levels was assessed. Results: Among 23 livers, eight were considered unsuitable for transplantation, leaving 15 livers for assessment. Higher initial hemoglobin was associated with a lower risk of EAD (0% vs. 55.6%, p = 0.04). Perfusate hemoglobin decreased after NMP initiation (p = 0.003) and negatively correlated with recipient peak transaminase levels (ALT: ρ = −0.72, p = 0.002; AST: ρ = −0.79, p < 0.001). Consistently, higher hemoglobin livers also demonstrated lower perfusate liver enzymes. Conclusions: Perfusate hemoglobin levels decreased during NMP, and lower perfusate hemoglobin levels were associated with a higher incidence of EAD and higher levels of liver injury markers. Maintaining higher hemoglobin levels during NMP may help reduce ischemia–reperfusion injury and prevent or attenuate EAD. Larger prospective studies are needed to validate the findings of this pilot study. [ABSTRACT FROM AUTHOR]

Introduction: Thigh pain, aseptic loosening, and failure after total hip arthroplasty has been reported. Therefore, this study examines the impact of femoral stem alignment on periprosthetic bone mineral density (BMD) in THA using the Avenir Complete cementless stem, focusing on the role of precise stem alignment in maintaining proximal femoral BMD. Materials and Methods: Consecutive patients who received the Avenir Complete stem via mini anterolateral approach in the supine position between March 2019 and March 2022 were included. Dual-energy X-ray absorptiometry was used to assess BMD changes, and computed tomography scans were used to evaluate stem alignment. Results: BMD was maintained in the distal femur, but showed a slight decrease in the proximal femur. A negative correlation was observed among varus malalignment, anteversion errors, and changes in BMD in the proximal femur. Conclusions: The findings underscore the importance of accurate stem positioning in THA, particularly in avoiding varus malalignment and anteversion errors, as misalignment can adversely affect proximal femoral BMD and potentially lead to early stem loosening. This study enhances the understanding of the influence of the Avenir Complete stem on postoperative BMD, highlighting the need for precise alignment to optimize outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Hepatocellular carcinoma (HCC) frequently recurs after radical resection, resulting in a poor prognosis. This study assessed the prognostic value of Mac-2 binding protein glycosylation isomer (M2BPGi) for early recurrence (ER) in patients with HCC. Methods: Patients who underwent radical resection for HCC between 2015 and 2021. HCC recurrence within one year after curative resection was defined as ER. Results: The 150 patients were divided into two groups: non-ER (116, 77.3%) and ER (34, 22.7%). The ER group had a lower overall survival rate (p < 0.0001) and significantly higher levels of M2BPGi (1.06 vs. 2.74 COI, p < 0.0001) than the non-ER group. High M2BPGi levels (odds ratio [OR] 1.78, 95% confidence interval [CI] 1.31–2.41, p < 0.0001) and a large tumor size (OR 1.31, 95% CI, 1.05–1.63; p = 0.0184) were identified as independent predictors of ER. M2BPGi was the best predictor of ER according to a receiver operating characteristic (ROC) analysis (area under the ROC curve 0.82, p < 0.0001). Conclusions: M2BPGi can predict ER after surgery and is useful for risk stratification in patients with HCC. [ABSTRACT FROM AUTHOR]

Objective: We aimed to characterize integrative and conjugative elements (ICEs) in antimicrobial resistant Streptococcs uberis isolates from bovine milk in Chiba, Japan, based on whole-genome sequence (WGS) data. Results: Of the 101 isolates, we found the 36 isolates harboring erm(B)–tet(O), showing resistance to macrolides–lincosamides–tetracyclines. The 22 isolates were randomly selected and subject to WGS determination. The genomes measured 1.991–2.517 Mbp, with G + C contents of 35.8–36.9%. We used ResFinder–ICEfinder (web-based applications) to search for the antimicrobial resistant genes and ICEs. ResFinder detected combined erm(B)–tet(O)–ant(6)-Ia at the identical contig in each WGS. ICEfinder detected ICEs belonging to the same contigs, which contained erm(B)–tet(O)–ant(6)-Ia complete or partial sequences. Detection of putative ICEs using comparative genomic analysis was performed with identification of other streptococcal ICE resembling S. uberis ICEs. Using comparative genomic analysis (a reference WGS in NZ01 strain), putative ICE base size in UB37 isolate was 77,386-bp that was identical in other 13 isolates. Another similar streptococcal ICE was S. suis ICEnsui78–tet(O)–erm(B) mobile element. For ICE characterization in S. uberis with WGSs, a comparative genomic analysis is required with use of ICEfinder and other annotation tools. [ABSTRACT FROM AUTHOR]

We prove in dimension d = 1 a result similar to a classical paper by Soffer and Weinstein, Jour. Diff. Eq. 98 (1992), improving it by encompassing for pure power nonlinearities the whole range of exponents p > 1 . The proof is based on the virial inequality of Kowalczyk et al., J. Eur. Math. Soc. (JEMS) 24 (2022), with smoothing estimates as shown in Mizumachi J. Math. Kyoto Univ. 48 (2008). [ABSTRACT FROM AUTHOR]

SUMMARY The distributions of monolignol glucosides (MLGs) in compression and opposite woods of Pinus thunbergii were assessed using cryo‐time‐of‐flight secondary ion mass spectrometry to investigate their involvement in lignification. p‐Glucocoumaryl alcohol (PG) was identified in the region of the differentiating xylem adjacent to the cambial zone only in compression wood, whereas coniferin (CF) was similarly localized in both compression and opposite woods. Their distribution from the phloem to the xylem was evaluated by high‐performance liquid chromatography (HPLC) using serial tangential sections. Variations in storage amounts of CF and PG in the stem of P. thunbergii agreed with lignification stages of the tracheid, supporting the idea that MLGs act as a storage and transportation form of lignin precursors. The imaging of monolignol (ML)‐dependent active lignification sites using fluorescence‐tagged MLs supported distinct distribution patterns of MLGs for lignification in compression and opposite woods. Methylation–thioacidolysis was applied to compression and opposite wood samples to examine the structural difference between the guaiacyl (G) and p‐hydroxyphenyl (H) units in lignin. Most of the H units in compression wood were detected as lignin end groups via thioacidolysis. PG was detected in opposite wood by HPLC; however, the H unit was not detected by thioacidolysis. The differences in ML and MLG distributions, enzyme activity, and resultant lignin structures between the G and H units suggest the possibility of individual mechanisms regulating the heterogeneous structures of G and H unit in lignin. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion To compare the surgical and oncologic outcomes between patients with locally recurrent cervical cancer undergoing robotic‐assisted salvage radical hysterectomy (RH) and those undergoing conventional open salvage RH, performed by a single surgeon.This retrospective comparative observational study utilized data obtained from consecutive patients with locally recurrent cervical cancer, developed after definitive radiotherapy. These patients either underwent robot‐assisted RH (robotic group) or conventional open RH (open group). Clinicopathological characteristics, surgical outcomes, and oncological outcomes were compared between the two groups.The operative time was slightly longer in the robotic group; however, this difference was not statistically significant. Estimated blood loss was significantly lower in the robotic group (median; 0 mL [robotic group] vs. 700 mL [open group]: p < 0.01). The incidence of intraoperative and early and late complications did not statistically differ between the two groups. The mean follow‐up was 29.0 and 17.1 months in the open and robotic groups, respectively. Disease recurrence rates were similar between the two groups (40% [robotic group] vs. 44.4% [open group]). Kaplan–Meier survival analysis for progression‐free survival and overall survival did not show statistically significant differences between the two groups.Robot‐assisted salvage RH in women with locally recurrent cervical cancer showed perioperative and oncological outcomes comparable to those of the open procedure. Although our results suggest that the robot‐assisted approach is as good as or better than the open approach, further investigation is required to establish a more robust conclusion. [ABSTRACT FROM AUTHOR]

Aims Methods Results Conclusion Paclitaxel and nanoparticle albumin‐bound (nab)‐paclitaxel can cause early, extremely severe neutropenia, occasionally leading to fatal outcomes. As paclitaxel is a substrate of P‐glycoprotein, this study aimed to investigate the impact of ABCB1 single‐nucleotide variants, which encode P‐glycoprotein, on early, extremely severe neutropenia in patients receiving paclitaxel/nab‐paclitaxel plus ramucirumab as second‐line therapy for unresectable advanced/recurrent gastric cancer.We analysed patients treated at Aichi Cancer Center Hospital from January 2018 to August 2023, with DNA samples stored in the Cancer BioBank Aichi. The impact of ABCB1 variants T1236C (rs1128503), G2677T/A (rs2032582) and C3435T (rs1045642) on early, extremely severe neutropenia was examined. Neutropenia was defined as a decline in neutrophil count to <100/μL within 28 days of therapy initiation. Firth's logistic regression evaluated the association between the ABCB1 C3435T (rs1045642) TT genotype and early, extremely severe neutropenia, adjusted for age, sex, baseline neutrophil count, and serum albumin and aspartate aminotransferase levels.Of the 203 eligible patients, 5 (2%) experienced neutropenia with neutrophil counts of <100/μL. The odds ratio for neutrophil counts of <100/μL was 28.1 (95% confidence interval 2.8–283.3) in patients with the ABCB1 C3435T (rs1045642) TT genotype.The ABCB1 C3435T (rs1045642) TT genotype was significantly associated with early, extremely severe neutropenia in patients receiving paclitaxel/nab‐paclitaxel. Evaluating this genotype status may help predict those at increased risk for early, extremely severe neutropenia. [ABSTRACT FROM AUTHOR]

The lack of a widely accessible method for expressing genes of interest in wild-type embryos is a fundamental obstacle to understanding genetic regulation during embryonic development. In particular, only a few methods are available for introducing gene expression vectors into cells prior to neural tube closure, which is a period of drastic development for many tissues. In this study, we present a simple technique for injecting vectors into the amniotic cavity and allowing them to reach the ectodermal cells and the epithelia of endodermal organs of mouse embryos at E8.0 via in utero injection, using only a widely used optical fiber with an illuminator. Using this technique, retroviruses can be introduced to facilitate the labeling of cells in various tissues, including the brain, spinal cord, epidermis, and digestive and respiratory organs. We also demonstrated in utero electroporation of plasmid DNA into E7.0 and E8.0 embryos. Taking advantage of this method, we reveal the association between Ldb1 and the activity of the Neurog2 transcription factor in the mouse neocortex. This technique can aid in analyzing the roles of genes of interest during endo- and ectodermal development prior to neural tube closure. [Display omitted] • New gene transfection method for embryos at E7 and E8 before neural tube closure. • Only optical fiber and injector needed. • Gene transfection into progenitors in ecto- and endodermal tissues. • Useful to analyze the role of lethal genes during embryogenesis, such as Ldb1. [ABSTRACT FROM AUTHOR]

Background: 5-Aminosalicylic acid (5-ASA), the first-line therapy for ulcerative colitis, is a poorly soluble zwitterionic drug. Unformulated 5-ASA is thought to be extensively absorbed in the small intestine. Methods: The pH-dependent solubility of 5-ASA in vitro and the intestinal membrane distribution of 5-ASA and its N-acetyl metabolite (AC-5-ASA) after the oral administration of 5-ASA were examined in fed rats. 5-ASA was administered as a suspension in water, 0.1 M HCl, or 0.1 M NaOH to untreated rats or as a solution in 5% NaHCO3 to lansoprazole-pretreated rats. Results: 5-ASA solubility in vitro was higher at pH < 2 and pH > 7. In rats, the 5-ASA and AC-5-ASA were detected mostly in the small intestine at 3 h and in the colonic region at 8 h after administration. The dosing vehicle (suspension or solution) and lansoprazole pretreatment did not significantly affect the pH of the luminal fluid in rats or the 5-ASA distribution in membranes. Conclusions: The 5-ASA distribution in membranes in the proximal intestine was found to be restricted by the intrinsic regional luminal pH, low solubility, and saturable membrane permeability. Unabsorbed 5-ASA in the proximal intestine was delivered to the distal intestine. The higher the oral dose of 5-ASA, the more 5-ASA may be delivered to the distal intestine due to the restricted absorption in the small intestine. [ABSTRACT FROM AUTHOR]

Dendritic cells (DCs) are known to be major antigen-presenting cells, and lymph nodes (LNs) play an important role in DC-mediated immune response. CD1a is known as a marker of monocyte-derived DCs. The present study focused on the infiltration of CD1a-positive DCs (CD1a-DCs) into regional LNs in 70 cases of gallbladder cancer (GBC). After univariate analyses, the results showed that LN infiltration by CD1a-DCs was associated with unfavorable clinical outcomes in patients with GBC, with all cases categorized in the CD1a-DCs high group had nodal metastasis. LN infiltration by CD1a-DCs was not an independent prognostic factor identified by multivariate analyses. After subgroup analyses of cases with LN metastasis (n = 32), no significant impacts of CD1a-DCs infiltration into metastatic LNs were observed. In contrast, CD1a-DCs infiltration into primary tumors had a significant impact on surgical outcomes. The results of strong confounding between CD1a-DCs and LN metastasis support the theory that CD1a-DCs are developed from monocytes at tumor sites. As the results of previous research focused on CD1a-DCs infiltration into regional LNs of other organs varied, the role and significance of CD1a-DCs infiltration in regional LNs may be different according to the tumor histology or its primary site. Thus, further studies are needed to clarify the role and significance of CD1a-DCs infiltration into regional LNs of solid cancers. [ABSTRACT FROM AUTHOR]

Background and Objectives: Study aim was to determine the levels and barriers of the Nutrition Care Process (NCP), a practical method of individualized nutrition support. Methods and Study Design: Delegate of registered dietitians (RDs) from acute-care hospitals answered our nationwide web-based questionnaire (April-June, 2023) to determine the implementation status of screening, assessment, intervention (including planning), and monitoring (components of the NCP). Results: Of 5,378 institutions contacted, 905 (16.8%) responded. For Screening, 80.0% screened all inpatients: primary personnel in charge were RDs (57.6%); the most used screening tool was Subjective Global Assessment (SGA) (49.2%). For Assessment, 66.1% assessed all inpatients: food intake (93.3%) was most evaluated whereas muscle mass and strength (13.0%, 8.8%) were least evaluated. For Intervention, 43.9% did so within 48h of hospital admission: oral nutritional supplement (92.9%) was the most common RDs intervention and parenteral nutrition (29.9%) was used less. For Monitoring, 18.5% of institutions had monitoring frequency of = 3 times/week whilst 23.0% had monitoring less than once a week for severely malnourished patients. Energy and protein intake (93.7%, 84.3%) were most monitored and lipid intake (30.1%) was less monitored. Conclusions: Barriers of NCP included inefficient staffing systems and unsuitable tools in Screening, inaccurate patient targeting and lack of important evaluation items in Assessment, delayed timing and incomplete contents in Intervention, and inadequate frequency and lack of important evaluation items in Monitoring. An increase in RDs staffing in acute-care general wards, widespread NCP instruction manuals, and education about the tools and evaluation items utilized in nutritional management are possible solutions. [ABSTRACT FROM AUTHOR]

Purpose: Total knee arthroplasty (TKA) has consistently demonstrated lower patient satisfaction compared to total hip arthroplasty (THA). However, prior investigations failed to account for the patients' demographic characteristics. This study aimed to conduct a comparative analysis of patient-reported outcomes between TKA and THA while adjusting for patient background. Methods: A total of 326 primary TKAs and 259 THAs conducted at a single center were assessed using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores preoperatively and at 3 months, 1 year, and 2 years postoperatively. Notably, TKA patients exhibited advanced age and higher body mass index (BMI) than their THA counterparts. To mitigate the impact of these differences, we employed propensity score-matched data, adjusting for background characteristics such as age, gender, BMI, and diagnosis. Results: THA consistently demonstrated significantly superior WOMAC total, pain, and stiffness scores compared to TKA at 3 months, 1 year, and 2 years postoperatively. Nevertheless, no statistically significant disparity in WOMAC physical function scores was observed between the two groups at 3 months and 1 year postoperatively in the matched data (3 months, p = 0.131; 1 year, p = 0.269). Conclusion: In contrast to earlier findings, our analysis of propensity score-matched data revealed no significant differences in WOMAC physical function scores between the TKA and THA groups at 3 months and 1 year postoperatively. The distinctive background factors observed in patients undergoing TKA and THA, notably advanced age and higher BMI, coupled with the delayed improvement timeline in TKA's WOMAC scores compared to that of THA, have the potential to impact patient-reported outcomes. Consequently, clinicians should be mindful of the potential impact of patient background on variations in patient-reported outcome measures following total joint arthroplasty. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between adverse childhood experiences (ACEs) and pregnancy morbidities, including preterm birth (PTB), gestational diabetes (GDM), preeclampsia, and small‐for‐gestational‐age (SGA) among the general population in Japan. Methods: The data were from the JACSIS study, an online‐based nationwide survey conducted from July to August 2021 in Japan (N = 5444). ACEs included physical, sexual, and psychological abuse, neglect, childhood poverty, bully victimization, domestic violence, parental death, and parental divorce. Pregnancy morbidities, including PTB, GDM, preeclampsia, and SGA were identified through questionnaires. A multivariable logistic regression model was applied. Results: Of 5444 women, 2778 (51.0%) had no ACEs, and 374 (6.9%) had four or more ACEs. A dose–response association was found between total ACE score and PTB and preeclampsia (p‐value: 0.016 and 0.001). Women with four or more ACE scores showed higher risks of preeclampsia (adjusted odds ratio [aOR] [95% confidence interval, CI]: 3.06 [1.57–5.94], p‐value: 0.001). Besides, those with two or three ACEs had higher risks of PTB (aOR [95%CI]: 1.42 [1.01–2.02], p‐value: 0.046, and aOR [95%CI]: 1.61 [1.04–2.50], p‐value: 0.041), and women with one ACE showed a higher risk of GDM (aOR [95%CI]: 1.34 [1.02–1.77], p‐value: 0.035). SGA was not associated with ACEs. Conclusion: ACEs were associated with an increased risk of PTB, preeclampsia, and GDM, but not SGA among the general population in Japan. [ABSTRACT FROM AUTHOR]

Hypoxia‐ischaemia (HI) before birth is a key risk factor for stillbirth and severe neurodevelopmental disability in survivors, including cerebral palsy, although there are no reliable biomarkers to detect at risk fetuses that may have suffered a transient period of severe HI. We investigated time and frequency domain measures of fetal heart rate variability (FHRV) for 3 weeks after HI in preterm fetal sheep at 0.7 gestation (equivalent to preterm humans) until 0.8 gestation (equivalent to term humans). We have previously shown that this is associated with delayed development of severe white and grey matter injury, including cystic white matter injury (WMI) resembling that observed in human preterm infants. HI was associated with suppression of time and frequency domain measures of FHRV and reduced their circadian rhythmicity during the first 3 days of recovery. By contrast, circadian rhythms of multiple measures of FHRV were exaggerated over the final 2 weeks of recovery, mediated by a greater reduction in FHRV during the morning nadir, but no change in the evening peak. These data suggest that the time of day at which FHRV measurements are taken affects their diagnostic utility. We further propose that circadian changes in FHRV may be a low‐cost, easily applied biomarker of antenatal HI and evolving brain injury. Key points: Hypoxia‐ischaemia (HI) before birth is a key risk factor for stillbirth and probably for disability in survivors, although there are no reliable biomarkers for antenatal brain injury.In preterm fetal sheep, acute HI that is known to lead to delayed development of severe white and grey matter injury over 3 weeks, was associated with early suppression of multiple time and frequency domain measures of fetal heart rate variability (FHRV) and loss of their circadian rhythms during the first 3 days after HI.Over the final 2 weeks of recovery after HI, exaggerated circadian rhythms of frequency domain FHRV measures were observed. The morning nadirs were lower with no change in the evening peak of FHRV.Circadian changes in FHRV may be a low‐cost, easily applied biomarker of antenatal HI and evolving brain injury. [ABSTRACT FROM AUTHOR]

This review briefly traces the historical development of antibody research and related technologies. The path from early perceptions of immunity to the emergence of modern immunotherapy has been marked by pivotal discoveries and technological advances. Early insights into immunity led to the development of vaccination and serotherapy. The elucidation of antibody structure and function paved the way for monoclonal antibody technology and its application in diagnosis and therapy. Breakthroughs in genetic engineering have enabled the production of humanized antibodies and the advances in Fc engineering, thereby increasing therapeutic efficacy. The discovery of immune checkpoints and cytokines revolutionized the treatment of cancer and autoimmune diseases. The field continues to evolve rapidly with the advent of antibody–drug conjugates, bispecific antibodies, and CAR T-cell therapies. As we face global health challenges, antibody research remains at the forefront of medical innovation and offers promising solutions for the future. [ABSTRACT FROM AUTHOR]

Background: The effect of sarcopenia on depressive mood during geriatric rehabilitation remains unclear. This study investigated the potential influence of sarcopenia on depressive mood among geriatric patients in a rehabilitation setting. Methods: This observational cohort study enrolled 204 patients aged ≥65 years (mean age, 78.8±7.6 years; women, 45.1%) admitted to a rehabilitation unit between April 2020 and July 2021. Sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment criteria, which include low handgrip strength and muscle mass. Depressive mood was defined as a 15-item Geriatric Depression Scale score of ≥6 points. We applied logistic regression models to examine the influence of sarcopenia on depressive mood at discharge. Results: We observed sarcopenia in 58.3% of patients. The logistic regression model showed that sarcopenia negatively influenced depressive mood at discharge (odds ratio=5.460; 95% confidence interval, 2.344–13.415). Of the 68 patients without depressive mood at admission, those with sarcopenia (n=31) had a significantly higher incidence of depressive mood at discharge compared with patients without sarcopenia (n=37) (41.9% vs. 16.2%, p=0.037). Conclusion: Sarcopenia at admission negatively affected depressive mood at discharge from geriatric rehabilitation. Thus, early and routine assessment of sarcopenia is vital for patients undergoing geriatric rehabilitation. [ABSTRACT FROM AUTHOR]

As talk grows about billions or even trillions of dollars being directed toward potential "Net Zero" activities, it is imperative that the chemistry inherent in or driving those actions make scientific sense. The challenge is to close the mass and energy balances to the carbon and oxygen cycles in the Earth's atmosphere and oceans. Several areas of climate science have been identified that chemists can investigate through methods that do not require a supercomputer or a climate model for investigation, most notably the following: (1) The carbon cycle, which still needs to be balanced, as many known streams, such as carbon to landfills, carbon in human-enhanced sewage and land runoff streams, and carbon stored in homes and other material, do not seem to have been accounted for in carbon balances used by the IPCC. (2) Ocean chemistry and balances are required to explain the causes of regional and local-scale salinity, pH, and anoxic conditions vs. global changes. For example, local anoxic conditions are known to be impacted by changes in nutrient discharges to oceans, while large-scale human diversions of fresh water streams for irrigation, power, and industrial cooling must have regional impacts on oceanic salinity and pH. (3) Carbon Capture and Storage (CCS) schemes, if adopted on the large scales being proposed (100s to 1000s of Gt net injection by 2100), should impact the composition of the atmosphere by reducing free oxygen, adding more water from combustion, and displacing saline water from subsurface aquifers. Data indicate that atmospheric oxygen is currently dropping at about twice the rate of CO2 concentrations increasing, which is consistent with combustion chemistry with 1.5 to 2 molecules of oxygen being converted through combustion to 1 molecule of CO2 and 1 to 2 molecules of H2O, with reverse reactions occurring as a result of oxygenic photosynthesis by increased plant growth. The CCS schemes will sabotage these reverse reactions of oxygenic photosynthesis by permanently sequestering the oxygen atoms in each CO2 molecule. [ABSTRACT FROM AUTHOR]

SUMMARY: Plants direct substantial amounts of carbon toward the biosynthesis of aromatic amino acids (AAAs), particularly phenylalanine to produce lignin and other phenylpropanoids. Yet, we have a limited understanding of how plants regulate AAA metabolism, partially because of a scarcity of robust analytical methods. Here, we established a simplified workflow for simultaneous quantification of AAAs and their pathway intermediates from plant tissues, based on extraction at two alternative pH and analysis by Zwitterionic hydrophilic interaction liquid chromatography coupled to mass spectrometry. This workflow was then used to analyze metabolic responses to elevated or reduced carbon flow through the shikimate pathway in plants. Increased flow upon expression of a feedback‐insensitive isoform of the first shikimate pathway enzyme elevated all AAAs and pathway intermediates, especially arogenate, the last common precursor within the post‐chorismate pathway of tyrosine and phenylalanine biosynthesis. Additional overexpression of an arogenate dehydrogenase enzyme increased tyrosine levels and depleted phenylalanine and arogenate pools; however, the upstream shikimate pathway intermediates remained accumulated at high levels. Glyphosate treatment, which restricts carbon flow through the shikimate pathway by inhibiting its penultimate step, led to a predictable accumulation of shikimate and other precursors upstream of its target enzyme but also caused an unexpected accumulation of downstream metabolites, including arogenate. These findings highlight that the shikimate pathway and the downstream post‐chorismate AAA pathways function as independently regulated modules in plants. The method developed here paves the way for a deeper understanding of the shikimate and AAA biosynthetic pathways in plants. Significance Statement: Aromatic amino acids (AAA) are key precursors to plant phenylpropanoids and other specialized metabolites. However, the regulation of AAA biosynthesis remains obscure partially due to the absence of robust methods for analyzing AAA pathway metabolites. Here, we report an extraction and LC–MS method for the simultaneous quantification of AAAs and their precursors from plant tissues. This methodology identified potentially regulated steps in the AAA pathways and will facilitate a deeper understanding of AAA metabolism. [ABSTRACT FROM AUTHOR]

Development of efficient electrocatalysts for hydrogen evolution reactions (HERs) is necessary to achieve environmentally friendly and sustainable hydrogen production. To reduce cost and to circumvent the scarcity of platinum, the most efficient catalyst for HER, it is essential to develop catalysts using ubiquitous base metals or minimal amounts of precious metals. Bis(diimino)metal (MDI) coordination nanosheets are potential HER catalysts because their electric conductivities, two‐dimensionality, and porous structures provide large surface areas and efficient mass and electron transfer. In addition, with sparse metal arrangements in their chemical structures, nanosheets can reduce the amount of metal needed. We synthesized bis(diimino)palladium coordination nanosheets (PdDI) as a coordination polymer composed of bis(diimino)palladium, with semiconducting characteristics, using gas‐liquid interfacial synthesis and electrochemical oxidation. These electrochemically synthesized PdDIs exhibit remarkable catalytic performance with overpotential reaching 10 mA cm−2 of 34 mV, a Tafel slope of 47 mV dec−1, and an exchange current density of 2.1 mA cm−2 after appropriate activation. This performance is closely comparable to that of metallic platinum. An ex‐situ investigation of the activation process revealed that reduction of the divalent Pd center in bis(diimino)palladium produced a composite of Pd(0) species and PdDI, combining high catalytic activity with smooth electron transfer. [ABSTRACT FROM AUTHOR]

Background: In recent years, the use of tapered-wedge short stems has increased due to their ability to preserve bones and tendons. Surgical techniques occasionally result in a varus position of the stem, which is particularly pronounced in short stems. Although the varus position is not clinically problematic, there are reports of an increased incidence of stress shielding and cortical hypertrophy. Thus, we evaluated and examined the acceptable range of varus angles using finite element analysis. Methods: Patients diagnosed with osteoarthritis of the hip joint who had undergone arthroplasty were selected and classified into three types [champagne-flute (type A), intermediate (type B), and stovepipe (type C)]. Finite element analysis was performed using Mechanical Finder. The model was created using a Taperloc microplasty stem with the varus angle increased by 1° from 0° to 5° from the bone axis and classified into seven zones based on Gruen's zone classification under loading conditions in a one-leg standing position. The volume of interest was set, the mean equivalent stress for each zone was calculated. Results: A significant decrease in stress was observed in zone 2, and increased stress was observed in zones 3 and 4, suggesting the emergence of a distal periosteal reaction, similar to the results of previous studies. In zone 2, there was a significant decrease in stress in all groups at a varus angle ≥ 3°. In zone 3, stress increased from ≥ 3° in type B and ≥ 4° in type C. In zone 4, there was a significant increase in stress at varus angles of ≥ 2° in types A and B and at ≥ 3° in type C. Conclusion: In zone 2, the varus angle at which stress shielding above Engh classification grade 3 may appear is expected to be ≥ 3°. Distal cortical hypertrophy may appear in zones 3 and 4; the narrower the medullary cavity shape, the smaller the allowable angle of internal recession, and the wider the medullary cavity shape, the wider the allowable range. Long-term follow-up is required in patients with varus angles > 3°. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Objectives Methods Results Conclusion Intra‐oesophageal acid stimulation increases masseter muscle activity. However, the infusion speeds used in previous studies are significantly slow, with minimal acid volume (30 mL over 30 min). Additionally, it is unclear how masseter muscle activity, symptoms of discomfort, stress levels and saliva quantity change over time.The time course of masseter muscle activity, heartburn and discomfort symptoms, salivary cortisol concentration to assess stress, autonomic nervous system (ANS) activity and saliva quantity under the influence of intra‐oesophageal acid infusion were evaluated at a faster injection rate and larger volume than in previous studies.Ten healthy adults underwent polygraphic monitoring, consisting of electromyography of the masseter muscle and electrocardiography during intra‐oesophageal acid infusion (10 mL/min, 10 min). Symptoms of heartburn and discomfort were assessed using the visual analogue scale (VAS), and saliva quantity was measured. Friedman's test was used for multiple comparisons.Masseter muscle activity, VAS scores for heartburn and discomfort, as well as saliva quantity during the 10‐min acid infusion, increased significantly compared with that before acid infusion (p < 0.001, 0.001, 0.019 and 0.047, respectively) and decreased 10 and 20 min after acid infusion (p = 0.004, 0.004 and 0.007, respectively). No significant changes were observed in the salivary cortisol concentration or ANS activity.Intra‐oesophageal acid infusion stimulated symptoms of heartburn and discomfort and increased masseter muscle activity and saliva production, which may not be related to psychological stress. [ABSTRACT FROM AUTHOR]

The level of dynamic mechanical instability between the bony parts of the ankle joint provides important information on biomechanical function. However, the dynamics of the distance between the talus and lateral malleolus during gait remain unclear. This study aimed to compare the distance between the talus and lateral malleolus and the ankle joint angles during the stance phase of gait between individuals with chronic ankle instability (CAI) and healthy adults. The comparison was conducted using a synchronized ultrasound (US) imaging with a three-dimensional motion analysis (MA) system. This cross-sectional study included 12 participants (5 males, 7 females; age, 20.5 ± 1.8 years; height, 166.6 ± 9.4 cm; body weight, 60.2 ± 5.3 kg; body mass index, 21.7 ± 2.0 kg/m2; 16 feet) with CAI and 10 healthy controls (4 males, 6 females; age, 21.2 ± 1.6 years; height, 164.6 ± 10.5 cm; body weight, 56.8 ± 11.3 kg; body mass index, 20.8 ± 2.6 kg/m2; 20 feet). The distance between the talus and lateral malleolus during gait was significantly increased in the CAI group compared with that in the control group throughout the stance phase. The ankle dorsiflexion angle was smaller in the CAI group during the middle and terminal stance phases. Additionally, the ankle inversion angle was greater in the CAI group than in the control group. Our findings show the application of the synchronized US and MA system in the assessment of mechanical instability in CAI group, which may be used to determine treatment efficacy. [ABSTRACT FROM AUTHOR]

In damage‐level classification, deep learning. models are more likely to focus on regions unrelated to classification targets because of the complexities inherent in real data, such as the diversity of damages (e.g., crack, efflorescence, and corrosion). This causes performance degradation. To solve this problem, it is necessary to handle data complexity and uncertainty. This study proposes a multimodal deep learning model that can focus on damaged regions using text data related to damage in images, such as materials and components. Furthermore, by adjusting the effect of attention maps on damage‐level classification performance based on the confidence calculated when estimating these maps, the proposed method realizes an accurate damage‐level classification. Our contribution is the development of a model with an end‐to‐end multimodal attention mechanism that can simultaneously consider both text and image data and the confidence of the attention map. Finally, experiments using real images validate the effectiveness of the proposed method. [ABSTRACT FROM AUTHOR]

Patients on hemodialysis (HD) are at a very high risk of stroke, especially hemorrhagic stroke, with worse outcomes than the general population. We have determined the indications for urgent neurosurgery for intracerebral hemorrhage (ICH) based on the hematoma volume and neurological severity, regardless of HD status. This study aimed to evaluate the neurosurgical outcomes of ICH in patients undergoing HD. We retrospectively reviewed 38 cases of surgical removal of ICH performed in patients on HD. Patients were categorized into poor or better (0–4) and very poor (5 or 6) groups according to their modified Rankin Scale (mRS) score at discharge. Patient demographics, clinical characteristics, and operative records were retrospectively analyzed. The median Glasgow Coma Scale (GCS) score and hematoma volume were 6 and 99 mL, respectively. A total of 30 patients (78.9%) had very poor outcomes at discharge. Significant differences were observed in GCS score (13 vs. 6) and hematoma volume (53 vs. 114 mL) between the poor or better and very poor groups. The receiver operating characteristic curve analysis showed the cut-off values were 9 for GCS (AUC = 0.821) and 63.3 mL for hematoma volume (AUC = 0.812). The most common complication was rebleeding (10.5%), followed by seizures (7.9%), infection (7.9%), and cerebral edema (7.9%). In conclusion, neurosurgical outcomes of ICH in patients undergoing HD remain poor, but 21.1% of these patients achieved an mRS ≤ 4. ICH patients on HD with a GCS score > 9 or hematoma volume < 63 mL are more likely to demonstrate mRS ≤ 4 after surgical evacuation. The postoperative management of patients on HD should be performed considering specific risks, such as seizures and rebleeding. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the associations of tomographic parameters in anterior segment optical coherence tomography (AS-OCT) with sex and age in a cohort study. Study Design: A cohort design. Materials and methods: AS-OCT data from 391 Japanese participants aged ≥ 35 years were obtained using swept-source OCT. In the cornea, the keratometric power at the flat (Kf) and steep (Ks) meridians, maximum keratometric power (Kmax), keratometric cylinder, spherical power, regular astigmatism, asymmetry, higher-order irregularity (HOI) from the anterior and posterior surfaces, and the central and thinnest corneal thicknesses were evaluated. Also, anterior chamber depth (ACD), lens thickness, crystalline lens rise (CLR), and nasal and temporal angle opening distances at 500 μm from the scleral spur (AOD500) were assessed. Sex differences and age-related changes were analyzed. Results: Women exhibited higher anterior Kf, Ks, and Kmax and lower posterior Kf, Ks, and Kmax than men. The ACD and nasal/temporal AOD500 were shorter in women than in men. The CLR was higher in women, whereas the lens thickness did not differ between the sexes, indicating a more anteriorly positioned lens in women. Age-related changes included increased anterior/posterior HOI, increased lens thickness and CLR resulting in decreased ACD and AOD500. Conclusion: This study reveals sex-related differences in corneal shape, anterior chamber conformation, and lens position, as well as age-related changes in tomographic parameters. ACD, CLR, nasal and temporal AOD500 showed significant sex differences in the 50–70 s, whereas lens thickness showed no difference. [ABSTRACT FROM AUTHOR]

Colorectal cancer represents one of the most serious complications of inflammatory bowel disease. The NLRP3 inflammasome plays a pivotal role in the onset and progression of inflammatory bowel disease and is also implicated in colorectal cancer. This study aimed to investigate whether NLRP3 deficiency or glyburide, a sulfonylurea used for diabetes management and known as an NLRP3 inhibitor, could suppress colitis and its related colorectal tumorigenesis. Mice were divided into three groups: a control group, a glyburide group, and an NLRP3-deficient group. We investigated acute colitis and inflammation-related tumor models using azoxymethane and dextran sodium sulfate. In the colitis model, the colonic inflammation grade was significantly increased in NLRP3-deficient mice but not in mice administered glyburide. In the colorectal carcinogenesis model, fewer colorectal tumors were observed in both NLRP3-deficient and glyburide-treated groups. Additionally, a reduction in the expression levels of inflammatory cytokine genes was detected in the colonic mucosa of the mice of these groups. These findings suggest that NLRP3 deficiency may exacerbate acute colitis, while pharmacological inhibition, as well as deficiency of NLRP3, suppresses colitis-related tumorigenesis, presumably due to the attenuation of chronic inflammation in the colorectum. Glyburide holds promise as a potential chemopreventive agent for colitis-related colorectal cancer. [ABSTRACT FROM AUTHOR]

Researchers are seeking alternative 225Ac production methods because of the scarcity of 225Ac for targeted alpha therapy. Although 226Ra from waste sources has been considered, obtaining 226Ra is challenging. Therefore, the authors focused on the contamination of minerals with 232Th-derived 228Ra while investigating methods to recover 226Ra from uranium ores. The effect of 228Ra contamination on 225Ac production by 226Ra transmutation using fast reactors was evaluated. Consequently, toxic 228Ac contaminates 225Ac. However, using the different half-lives of 225Ac and 228Ac, pure 225Ac can be obtained from the chemical separation of actinium after cooling for 5–8 days. [ABSTRACT FROM AUTHOR]

Specific data concerning the efficacy of alternative antibiotics for carbapenems against complicated urinary tract infections (cUTIs) attributed to antimicrobial-resistant (AMR) uropathogens are lacking. This study aimed to assess the efficacy of carbapenems and non-carbapenem antibiotics in the clinical outcomes of cUTIs caused by AMR uropathogens. In this systematic review and meta-analysis, databases, including MEDLINE/PubMed, the Cochrane Library, Embase and ClinicalTrials.gov , were searched. The study eligibility criteria were research articles conducted as randomised controlled trials that evaluated the composite outcomes of cUTIs. Participants were adult patients with cUTIs caused by gram-negative uropathogens resistant to third-generation cephalosporins. The intervention involved a non-carbapenem class of antimicrobial agents with in vitro activities against gram-negative uropathogens resistant to third-generation cephalosporins. Two independent researchers assessed the risk-of-bias using the second version of the Cochrane risk-of-bias tool for randomised trials. The treatment effects on each outcome were estimated as a risk ratio (RR) with a 95 % confidence interval (CI) using the random-effects model. Heterogeneity was assessed using the Cochrane Q-test and I2 statistics. Through database searches, 955 articles were retrieved. After screening the titles and abstracts, 52 articles were screened in full text. Finally, 12 studies met the inclusion criteria. No significant differences in efficacy were observed between alternative antibiotics and carbapenems (composite outcome, RR, 0.96; 95 % CI, 0.63–1.49; I2 = 21 %; low certainty of evidence). Alternative antibiotics had clinical efficacy similar to that of carbapenems for treating patients with cUTI caused by gram-negative uropathogens resistant to third-generation cephalosporins. [ABSTRACT FROM AUTHOR]

Purpose: No definitive procedures have been proposed for orbital floor fractures extending to the slope of the posterior end, which is a challenging problem. This study demonstrates the effectiveness of an orbital reconstruction procedure based on anatomical landmarks that we developed, called the three landmarks procedure (TLP). Methods: This study is a single-center retrospective cohort study conducted by the Department of Otorhinolaryngology, Japanese Red Cross Asahikawa Hospital. Data were collected from April 2000 to December 2023. The effect of TLP and the balloon procedure (BP) on ocular movement was compared. The prevalence of postoperative enophthalmos after TLP was examined. Results: The study included 17 patients who underwent TLP and 25 patients who underwent BP. Postoperative mean Hess area ratio (HAR%) was 98.3 (95% confidence interval (CI), 97.0–99.6) in the TLP group and 88.6 (95% CI 83.2–94.0) in the BP group. Among study patients with fractures extending to the posterior slope, 14 underwent TLP and 16 underwent BP. Postoperative mean HAR% was 98.5 (95% CI 97.3–99.7) in the TLP group and 89.2 (95% CI 82.4–95.8) in the BP group. Among all patients who underwent TLP, mean postoperative enophthalmos was 0.06 mm (95% CI − 0.32 to 0.44). It was 0.14 mm (95% CI − 0.31 to 0.59) among patients with fractures extending to the posterior slope. Conclusion: TLP resulted in better postoperative ocular movements than BP. Furthermore, TLP is an effective technique for treating fractures extending to the posterior slope, which are challenging to reconstruct. [ABSTRACT FROM AUTHOR]

Introduction: Hypotension is common during intermittent hemodialysis (IHD) and may be due to a decreased cardiac index (CI). However, no study has simultaneously and continuously measured CI and mean arterial pressure (MAP) to understand the prevalence, severity, and duration of CI decreases or relate them to MAP, blood volume (BV), and net ultrafiltration (NUF) rate. Methods: In a prospective, pilot and feasibility investigation, we studied 10 chronic IHD patients. We used the ClearSight System™ to continuously monitor CI and MAP; the CRIT-LINE®IV monitor to detect BV changes and collected data on NUF rate. Results: Device tolerance and compliance were 100%. All patients experienced at least ≥1 episode of severe CI decrease (>25% from baseline), with a median duration of 24 min (IQR 6–87) and of 68 min [14–106] for moderate decreases (>15% but ≤25% from baseline). Eight patients experienced a low CI state (<2.2 L/min/m2). The lowest CI was 0.9 L/min/m2 with a concomitant MAP of 94 mm Hg. When the fall in CI was severe, MAP increased in 58% of cases and remained stable in 28%. Overall, CI decreased by −0.55 L/min/m2 when BV decrease was moderate versus mild (p < 0.001) and by −0.8 L/min/m2 when NUF rate was high versus low (p < 0.001). Conclusion: Continuous CI monitoring is feasible in IHD and shows frequent moderate-severe CI decreases, sometimes to low CI state levels. Such decreases are typically associated with markers of decreased intravascular volume status but not with a decrease in MAP, implying marked vasoconstriction. [ABSTRACT FROM AUTHOR]