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Introduction: The present study aimed to investigate the prescribing patterns of anticholinergics (anti-AChR) or β3-adrenergic agonists (β 3 A) in the pharmacotherapy of overactive bladder (OAB) and to evaluate the differences in the frequency of adverse events (AEs) between the two types of drugs using a large-scale medical claims database., Methods: This cohort study was conducted using the JMDC claims database between May 2015 and April 2023. Patient characteristics, prescription and treatment patterns of anti-AChR and β 3 A, and the incidence of AEs have been described., Results: Overall, 70,936 patients were analyzed [mean age, 53.6 (standard deviation: 12.3) years]. Among women (48.5%; 34,439), 21.4% initially received anti-AChR and 27.2% received β 3 A; among men (51.5%; 36,497), 17.1% initially received anti-AChR and 34.3% received β 3 A. Most patients (79.6%; women, 83.5%; men, 75.8%) visited clinics. About 10% of patients had a treatment change: 5.6% switched the drug type (change from anti-AChR to β 3 A or vice versa), and 4.0% had an add-on of another drug type. The incidence rate of treatment change per 100 patient-years was higher with β 3 A in both women (12.39) and men (13.65). In the multivariable analysis, initial prescription with anti-AChR compared with β 3 A did not show any association with the risk of AEs., Conclusion: This large-scale database study revealed that treatment for OAB is often initiated with β 3 A and prescribed mainly at clinics. Changes or additions to initial prescriptions were as low as about 5%, indicating that raising awareness among physicians treating OAB is particularly important to improve the quality of life of patients with OAB. Our study also showed that the incidence of AEs was not associated with the initially prescribed drug type. Continued exploration is warranted to further clarify the risk of AEs with each prescription., Competing Interests: Declarations. Conflict of Interest: Hiroshi Nakazawa, Takahiro Kitano, and Masashi Mikami were involved in research and preparation of the manuscript as employees of Pfizer Japan Inc. Kazuna Tsubouchi, Hisatomi Arima, Taiki Emoto, Chikao Aoyagi, Hiroshi Matsuzaki, Kosuke Tominaga, Naotaka Gunge, Takeshi Miyazaki, Yu Okabe, Nobuyuki Nakamura, Yuichiro Fukuhara, Masahiro Tachibana, Chizuru Nakagawa, Fumihiro Yamazaki, and Nobuhiro Haga did not receive any compensation related to this study from Pfizer Japan Inc. Ethical Approval: As we used the already anonymized JMDC dataset only, informed consent and ethical review/approval were not required for this study. The permission to access the JMDC database was under the license between Pfizer Japan Inc. and JMDC Inc., (© 2024. The Author(s).)

Atrial fibrillation (AF) is strongly associated with strokes, heart failure, and increased mortality. This study aims to identify the monocyte-macrophage heterogeneity and interactions of these cells with non-immune cells, and to identify functional biomarkers in patients with AF. Therefore, we assess the single cell landscape of left atria (LA), using a combination of single cell and nucleus RNA-seq. Myeloid cells in LA tissue are categorized into five macrophage clusters, three monocyte clusters, and others. Cell-Chat analysis revealed that monocytes and IL1B + macrophages send epidermal growth factor (EGF) signals to fibroblasts. Amphiregulin (AREG) is the most upregulated gene in monocytes and IL1B + macrophages in the AF group, compared with healthy controls from other groups. Serum AREG levels are higher in patients with persistent AF. These data suggested that EGF signaling pathway could be a therapeutic target for AF and serum AREG levels provide an effective biomarker for predicting persistent AF., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Objectives: Desmopressin is widely used for nocturia in patients with nocturnal polyuria. We investigated the continuation rate and adherence for desmopressin in patients with overactive bladder and nocturia using a claims database and evaluated factors that improved adherence., Methods: Patients with nocturia in a Japanese claims database who started desmopressin between September 2019 and July 2021 were evaluated. Drug persistence was assessed using the Kaplan-Meier method for initial prescription of desmopressin. The proportion of days covered (PDC) was also evaluated among patients with prescription persistence. Multivariate analysis was performed using logistic regression analysis to identify factors predicting adherence to desmopressin., Results: The study included 72,888 patients entered into Japan Medical Data Center (JMDC) database between September 2019 and July 2021. For the 236 patients prescribed desmopressin formulations, mean prescription duration was 114 days. Among the total cases, 90 (38.1%) cases were prescribed only once, mean PDC was 0.60, and the number of high-adherence patients (PDC ≥ 0.80) was 108 (45.8%). Desmopressin prescription doses were fixed in 216 patients and adjusted in 20 patients. Multivariate analysis identified prescription dose adjustment for desmopressin as significantly associated with high PDC., Conclusion: Desmopressin showed a 38% dropout rate after the first dose. However, high medication continuation and high medication adherence rates (PDC) could be maintained with prescription adjustments. Careful patient monitoring and appropriate adjustment of the desmopressin dosage appear to be important factors in improving nocturia., (© 2024 Wiley Periodicals LLC.)

Background: Body mass index (BMI) of patients with ischemic stroke (IS) has been associated with prognosis and disability in studies in the United States. Although the Asian population is leaner, the optimal BMI for stroke-related disability remains unknown., Objectives: To clarify the association between BMI and disability in patients with IS from a national database in Japan., Methods: The present study included 522,421 patients with IS identified in the JROAD-DPC database from April 2016 to March 2020. We used the WHO classification of BMI, which divides Asia-Pacific patients into five groups, to categorize BMI and the modified Rankin Scale (mRS) to assess stroke-related disability at admission and discharge. After multiple imputation for missing values, we conducted a multiple mixed-effect logistic regression analysis for poor mRS score (>2) in September 2023. In addition, we created a restricted cubic spline model between the odds ratio (OR) for poor mRS and BMI., Results: The mRS score worsened during hospitalization in 60.1% of the patients with IS, and 45.7% had a poor mRS score at discharge. Overweight patients had the lowest OR of having a poor mRS score (OR: 0.898, 95% confidence interval: 0.895-0.902). The spline curve for the OR for poor mRS score was U-shaped with a BMI of 24.7 kg/m 2 as the apex value., Conclusion: The present study revealed a U-shaped relationship between BMI and stroke-related disability, with overweight patients having the lowest OR for disability at discharge.

This study aimed to evaluate the impact of radiation dose and focal spot size on the image quality of super-resolution deep-learning reconstruction (SR-DLR) in comparison with iterative reconstruction (IR) and normal-resolution DLR (NR-DLR) algorithms for cardiac CT. Catphan-700 phantom was scanned on a 320-row scanner at six radiation doses (small and large focal spots at 1.4-4.3 and 5.8-8.8 mGy, respectively). Images were reconstructed using hybrid-IR, model-based-IR, NR-DLR, and SR-DLR algorithms. Noise properties were evaluated through plotting noise power spectrum (NPS). Spatial resolution was quantified with task-based transfer function (TTF); Polystyrene, Delrin, and Bone-50% inserts were used for low-, intermediate, and high-contrast spatial resolution. The detectability index (d') was calculated. Image noise, noise texture, edge sharpness of low- and intermediate-contrast objects, delineation of fine high-contrast objects, and overall quality of four reconstructions were visually ranked. Results indicated that among four reconstructions, SR-DLR yielded the lowest noise magnitude and NPS peak, as well as the highest average NPS frequency, TTF 50% , d' values, and visual rank at each radiation dose. For all reconstructions, the intermediate- to high-contrast spatial resolution was maximized at 4.3 mGy, while the lowest noise magnitude and highest d' were attained at 8.8 mGy. SR-DLR at 4.3 mGy exhibited superior noise performance, intermediate- to high-contrast spatial resolution, d' values, and visual rank compared to the other reconstructions at 8.8 mGy. Therefore, SR-DLR may yield superior diagnostic image quality and facilitate radiation dose reduction compared to the other reconstructions, particularly when combined with small focal spot scanning., (© 2024. Australasian College of Physical Scientists and Engineers in Medicine.)

The 88 th Annual Scientific Meeting of the Japanese Circulation Society (JCS2024) was held from Friday, March 8 th to Sunday, March 10 th in Kobe, Japan. The main theme of this 3-day meeting was "The Future of Cardiology: Challenges in Overcoming Cardiovascular Disease". As COVID-19 has been finally conquered, with revision of its categorization under the Infectious Disease Control Law and relaxation of infection prevention measures, it was once again possible to have face-to-face presentations and lively discussion. JCS2024 was a major success, with 19,209 participants and attendees, thanks to the greatly appreciated cooperation and support from all affiliates.

There is no treatment for acute aortic dissection (AAD) targeting inflammatory cells. We aimed to identify the new therapeutic targets associated with inflammatory cells. We characterized the specific distribution of myeloid cells of both human type A AAD samples and a murine AAD model generated using angiotensin II (ANGII) and β-aminopropionitrile (BAPN) by single-cell RNA sequencing (scRNA-seq). We also examined the effect of an anti-interleukin-1β (IL-1β) antibody in the murine AAD model. IL1B + inflammatory macrophages and classical monocytes were increased in human AAD samples. Trajectory analysis demonstrated that IL1B + inflammatory macrophages differentiated from S100A8/9/12 + classical monocytes uniquely observed in the aorta of AAD. We found increased infiltration of neutrophils and monocytes with the expression of inflammatory cytokines in the aorta and accumulation of inflammatory macrophages before the onset of macroscopic AAD in the murine AAD model. In blocking experiments using an anti-IL-1β antibody, it improved survival of murine AAD model by preventing elastin degradation. We observed the accumulation of inflammatory macrophages expressing IL-1β in both human AAD samples and in a murine AAD model. Anti-IL-1β antibody could improve the mortality rate in mice, suggesting that it may be a treatment option for AAD., (© 2024. The Author(s).)

To assess the diagnostic performance of unenhanced electrocardiogram (ECG)-gated cardiac computed tomography (CT) for detecting myocardial edema, using MRI T2 mapping as the reference standard. This retrospective study protocol was approved by our institutional review board, which waived the requirement for written informed consent. Between December 2017 to February 2019, consecutive patients who had undergone T2 mapping for myocardial tissue characterization were identified. We excluded patients who did not undergo unenhanced ECG-gated cardiac CT within 3 months from MRI T2 mapping or who had poor CT image quality. All patients underwent unenhanced ECG-gated cardiac CT with an axial scan using a third-generation, 320 × 0.5 mm detector-row CT unit. Two radiologists together drew regions of interest (ROIs) in the interventricular septum on the unenhanced ECG-gated cardiac CT images. Using T2 mapping as the reference standard, the diagnostic performance of unenhanced cardiac CT for detecting myocardial edema was evaluated by using the area under the receiver operating characteristic curve with sensitivity and specificity. Youden index was used to find an optimal sensitivity-specificity cutoff point. A cardiovascular radiologist independently performed the measurements, and interobserver reliability was assessed using intraclass correlation coefficients for CT value measurements. A P value of <.05 was considered statistically significant. We included 257 patients who had undergone MRI T2 mapping. Of the 257 patients, 35 patients underwent unenhanced ECG-gated cardiac CT. One patient was excluded from the study because of poor CT image quality. Finally, 34 patients (23 men; age 64.7 ± 14.6 years) comprised our study group. Using T2 mapping, we identified myocardial edema in 19 patients. Mean CT and T2 values for 34 patients were 46.3 ± 2.7 Hounsfield unit and 49.0 ± 4.9 ms, respectively. Mean CT values moderately correlated with mean T2 values (Rho = -0.41; P < .05). Mean CT values provided a sensitivity of 63.2% and a specificity of 93.3% for detecting myocardial edema, with a cutoff value of ≤45.0 Hounsfield unit (area under the receiver operating characteristic curve = 0.77; P < .01). Inter-observer reproducibility in measuring mean CT values was excellent (intraclass correlation coefficient = 0.93; [95% confidence interval: 0.86, 0.96]). Myocardial edema could be detected by CT value of myocardium in unenhanced ECG-gated cardiac CT., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Cervical auscultation is a simple, noninvasive method for diagnosing dysphagia, although the reliability of the method largely depends on the subjectivity and experience of the evaluator. Recently developed methods for the automatic detection of swallowing sounds facilitate a rough automatic diagnosis of dysphagia, although a reliable method of detection specialized in the peculiar feature patterns of swallowing sounds in actual clinical conditions has not been established. We investigated a novel approach for automatically detecting swallowing sounds by a method wherein basic statistics and dynamic features were extracted based on acoustic features: Mel Frequency Cepstral Coefficients and Mel Frequency Magnitude Coefficients, and an ensemble learning model combining Support Vector Machine and Multi-Layer Perceptron were applied. The evaluation of the effectiveness of the proposed method, based on a swallowing-sounds database synchronized to a video fluorographic swallowing study compiled from 74 advanced-age patients with dysphagia, demonstrated an outstanding performance. It achieved an F1-micro average of approximately 0.92 and an accuracy of 95.20%. The method, proven effective in the current clinical recording database, suggests a significant advancement in the objectivity of cervical auscultation. However, validating its efficacy in other databases is crucial for confirming its broad applicability and potential impact.

Constipation is a common gastrointestinal disorder that impairs quality of life. Evaluating bowel motility via traditional methods, such as MRI and radiography, is expensive and inconvenient. Bowel sound (BS) analysis has been proposed as an alternative, with BS-time-domain acoustic features (BSTDAFs) being effective for evaluating bowel motility via several food and drink consumption tests. However, the effect of BSTDAFs before drink consumption on those after drink consumption is yet to be investigated. This study used BS-based stimulus-response plots (BSSRPs) to investigate this effect on 20 participants who underwent drinking tests. A strong negative correlation was observed between the number of BSs per minute before carbonated water consumption and the ratio of that before and after carbonated water consumption. However, a similar trend was not observed when the participants drank cold water. These findings suggest that when carbonated water is drunk, bowel motility before ingestion affects motor response to ingestion. This study provides a non-invasive BS-based approach for evaluating motor response to food and drink, offering a new research window for investigators in this field.

Background: Acute coronary syndrome (ACS) involves plaque-related thrombosis, causing primary ischemic cardiomyopathy or lethal arrhythmia. We previously demonstrated a unique immune landscape of myeloid cells in the culprit plaques causing ACS by using single-cell RNA sequencing. Here, we aimed to characterize T cells in a single-cell level, assess clonal expansion of T cells, and find a therapeutic target to prevent ACS., Methods: We obtained the culprit lesion plaques from 4 patients with chronic coronary syndrome (chronic coronary syndrome plaques) and the culprit lesion plaques from 3 patients with ACS (ACS plaques) who were candidates for percutaneous coronary intervention with directional coronary atherectomy. Live CD45 + immune cells were sorted from each pooled plaque samples and applied to the 10× platform for single-cell RNA sequencing analysis. We also extracted RNA from other 3 ACS plaque samples and conducted unbiased TCR (T-cell receptor) repertoire analysis., Results: CD4 + T cells were divided into 5 distinct clusters: effector, naive, cytotoxic, CCR7 + (C-C chemokine receptor type 7) central memory, and FOXP3 (forkhead box P3) + regulatory CD4 + T cells. The proportion of central memory CD4 + T cells was higher in the ACS plaques. Correspondingly, dendritic cells also tended to express more HLAs (human leukocyte antigens) and costimulatory molecules in the ACS plaques. The velocity analysis suggested the differentiation flow from central memory CD4 + T cells into effector CD4 + T cells and that from naive CD4 + T cells into central memory CD4 + T cells in the ACS plaques, which were not observed in the chronic coronary syndrome plaques. The bulk repertoire analysis revealed clonal expansion of TCRs in each patient with ACS and suggested that several peptides in the ACS plaques work as antigens and induced clonal expansion of CD4 + T cells., Conclusions: For the first time, we revealed single cell-level characteristics of CD4 + T cells in patients with ACS. CD4 + T cells could be therapeutic targets of ACS., Registration: URL: https://upload.umin.ac.jp/cgi-open-bin/icdr&#95;e/ctr&#95;view.cgi?recptno=R000046521; Unique identifier: UMIN000040747., Competing Interests: Disclosures None.

Objectives: Patients following renal transplantation (RTX) may experience nocturia exacerbation due to polyuria and reduced bladder capacity, thereby impacting the specific quality of life (QOL) associated with nocturia. The present study aims to investigate factors associated with the deterioration of nocturia-specific QOL in RTX patients., Methods: The study cohort comprised 59 consecutive patients who had undergone successful RTX. Nocturia-related QOL questionnaires (N-QOL) were employed to evaluate the specific QOL related to nocturia. The Bother/Concern and Sleep/Energy domains of the N-QOL were also assessed. The primary outcome measure was to explore factors related to the aggravation of nocturia-specific QOL in patients post-RTX., Results: The mean nocturia frequency post-RTX was 1.3 ± 1.0. Univariate and multivariate analyses revealed a significant reduction in the Bother/Concern domain score associated with increased nocturia (p = .042). Aging significantly decreased the total N-QOL score and the Sleep/Energy domain score (p = .001 and .0002, respectively). Prolonged duration after RTX significantly reduced the scores of both the Sleep/Energy domain and the Bother/Concern domain (p = .018 and .037, respectively). However, the duration of dialysis prior to RTX was not significantly associated with the total score or subdomains of N-QOL., Conclusions: Nocturia-specific QOL affected not only the nocturia itself, but also aging and the prolonged duration after RTX. Thus, comprehensive approaches to the RTX patients were needed to improve the Nocturia-specific QOL in RTX patients., (© 2024 John Wiley & Sons Australia, Ltd.)

Alzheimer's disease (AD) is among the most prevalent age-related neurodegenerative diseases. Endothelial cell (EC) senescence was discovered in the AD brain, but its function in AD pathogenesis was unidentified. Here we created an AD mouse model with EC senescence (APP/PS1;TERF2DN mice) by intercrossing APP/PS1 mice with Tie2 promoter-driven dominant negative telomeric repeat-binding factor 2 transgenic mice (TERF2DN-Tg mice). We evaluated cognitive functions and AD brain pathology in APP/PS1;TERF2DN mice. Surprisingly, compared with the control APP/PS1 mice, APP/PS1;TERF2DN mice demonstrated the attenuation of cognitive impairment and amyloid-β (Aβ) pathology, accompanied by the compaction of Aβ plaques with increased microglial coverage and reduced neurite dystrophy. Moreover, we evaluated whether EC senescence could affect microglial morphology and phagocytosis of Aβ. Compared with wild-type mice, microglia in TERF2DN-Tg mice display increased numbers of endpoints (a morphometric parameter to quantify the number of processes) and Aβ phagocytosis and related gene expression. Single-cell RNA-sequencing analysis showed that compared with APP/PS1 mouse microglia, APP/PS1;TERF2DN mouse microglia displayed a modest decline in disease-associated microglia, accompanied by an altered direction of biological process branching from antigen synthesis and arrangement to ribonucleoprotein complex biogenesis. Our outcomes indicate that EC senescence alters microglia toward a protective phenotype with a rise in phagocytic and barrier roles, and may offer a clue to create a novel preventive/therapeutic method to treat AD., (© 2023 Wiley Periodicals LLC.)

Objectives: To evaluate the effect of super-resolution deep-learning-based reconstruction (SR-DLR) on the image quality of coronary CT angiography (CCTA)., Methods: Forty-one patients who underwent CCTA using a 320-row scanner were retrospectively included. Images were reconstructed with hybrid (HIR), model-based iterative reconstruction (MBIR), normal-resolution deep-learning-based reconstruction (NR-DLR), and SR-DLR algorithms. For each image series, image noise, and contrast-to-noise ratio (CNR) at the left main trunk, right coronary artery, left anterior descending artery, and left circumflex artery were quantified. Blooming artifacts from calcified plaques were measured. Image sharpness, noise magnitude, noise texture, edge smoothness, overall quality, and delineation of the coronary wall, calcified and noncalcified plaques, cardiac muscle, and valves were subjectively ranked on a 4-point scale (1, worst; 4, best). The quantitative parameters and subjective scores were compared among the four reconstructions. Task-based image quality was assessed with a physical evaluation phantom. The detectability index for the objects simulating the coronary lumen, calcified plaques, and noncalcified plaques was calculated from the noise power spectrum (NPS) and task-based transfer function (TTF)., Results: SR-DLR yielded significantly lower image noise and blooming artifacts with higher CNR than HIR, MBIR, and NR-DLR (all p < 0.001). The best subjective scores for all the evaluation criteria were attained with SR-DLR, with significant differences from all other reconstructions (p < 0.001). In the phantom study, SR-DLR provided the highest NPS average frequency, TTF 50% , and detectability for all task objects., Conclusion: SR-DLR considerably improved the subjective and objective image qualities and object detectability of CCTA relative to HIR, MBIR, and NR-DLR algorithms., Clinical Relevance Statement: The novel SR-DLR algorithm has the potential to facilitate accurate assessment of coronary artery disease on CCTA by providing excellent image quality in terms of spatial resolution, noise characteristics, and object detectability., Key Points: • SR-DLR designed for CCTA improved image sharpness, noise property, and delineation of cardiac structures with reduced blooming artifacts from calcified plaques relative to HIR, MBIR, and NR-DLR. • In the task-based image-quality assessments, SR-DLR yielded better spatial resolution, noise property, and detectability for objects simulating the coronary lumen, coronary calcifications, and noncalcified plaques than other reconstruction techniques. • The image reconstruction times of SR-DLR were shorter than those of MBIR, potentially serving as a novel standard-of-care reconstruction technique for CCTA performed on a 320-row CT scanner., (© 2023. The Author(s), under exclusive licence to European Society of Radiology.)

BACKGROUND. A super-resolution deep learning reconstruction (SR-DLR) algorithm may provide better image sharpness than earlier reconstruction algorithms and thereby improve coronary stent assessment on coronary CTA. OBJECTIVE. The purpose of our study was to compare SR-DLR and other reconstruction algorithms in terms of image quality measures related to coronary stent evaluation in patients undergoing coronary CTA. METHODS. This retrospective study included patients with at least one coronary artery stent who underwent coronary CTA between January 2020 and December 2020. Examinations were performed using a 320-row normal-resolution scanner and were reconstructed with hybrid iterative reconstruction (HIR), model-based iterative reconstruction (MBIR), normal-resolution deep learning reconstruction (NR-DLR), and SR-DLR algorithms. Quantitative image quality measures were determined. Two radiologists independently reviewed images to rank the four reconstructions (4-point scale: 1 = worst reconstruction, 4 = best reconstruction) for qualitative measures and to score diagnostic confidence (5-point scale: score ≥ 3 indicating an assessable stent). The assessability rate was calculated for stents with a diameter of 3.0 mm or less. RESULTS. The sample included 24 patients (18 men, six women; mean age, 72.5 ± 9.8 [SD] years), with 51 stents. SR-DLR, in comparison with the other reconstructions, yielded lower stent-related blooming artifacts (median, 40.3 vs 53.4-58.2), stent-induced attenuation increase ratio (0.17 vs 0.27-0.31), and quantitative image noise (18.1 vs 20.9-30.4 HU) and higher in-stent lumen diameter (2.4 vs 1.7-1.9 mm), stent strut sharpness (327 vs 147-210 ΔHU/mm), and CNR (30.0 vs 16.0-25.6) (all p < .001). For both observers, all ranked measures (image sharpness; image noise; noise texture; delineation of stent strut, in-stent lumen, coronary artery wall, and calcified plaque surrounding the stent) and diagnostic confidence showed a higher score for SR-DLR (median, 4.0 for all features) than for the other reconstructions (range, 1.0-3.0) (all p < .001). The assessability rate for stents with a diameter of 3.0 mm or less ( n = 37) was higher for SR-DLR (86.5% for observer 1 and 89.2% for observer 2) than for HIR (35.1% and 43.2%), MBIR (59.5% and 62.2%), and NR-DLR (62.2% and 64.9%) (all p < .05). CONCLUSION. SR-DLR yielded improved delineation of the stent strut and in-stent lumen, with better image sharpness and less image noise and blooming artifacts, in comparison with HIR, MBIR, and NR-DLR. CLINICAL IMPACT. SR-DLR may facilitate coronary stent assessment on a 320-row normal-resolution scanner, particularly for small-diameter stents.

Background/aim: The aim of the present study was to investigate the factors related to overactive bladder (OAB)-like symptoms in patients with bladder cancer., Patients and Methods: This study included 59 patients who underwent transurethral resection of bladder tumor (TURBT). OAB-like symptoms were identified based on the Overactive Bladder Symptom Score (OABSS) and International Prostate Symptom Score (IPSS) questionnaires. The main outcome measures were elucidation of bladder cancer-related factors that might induce OAB-like symptoms., Results: Non-muscle invasive bladder cancer (NMIBC) was observed in 50 patients, and carcinoma in situ (CIS) was observed in 14 patients. OABSS total score, IPSS total score, and quality of life index were 5±3, 12±7 and 3±1, respectively. The OABSS question 1 score, indicating pollakisuria, was significantly higher in NMIBC patients with CIS than in those without CIS (presence of CIS vs. absence of CIS=1.0±0.6 : 0.5±0.6, p=0.02). IPSS question 4 score, indicating urgency (r=0.31, p=0.01), and OABSS question 4 score, indicating urgency incontinence (r=0.29, p=0.03), correlated significantly with the maximum bladder tumor diameter. Multivariate regression analysis demonstrated that presence of CIS in NMIBC cases correlated significantly with pollakisuria (p=0.02), and that maximum diameter of the bladder tumor correlated significantly with both urgency (p=0.04) and urgency incontinence (p=0.01)., Conclusion: CIS induced pollakisuria in NMIBC. Larger diameter bladder tumors induced both urgency and urgency incontinence. Patients with bladder cancer who present with pollakisuria might have CIS., (Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Objectives: To evaluate the image quality of deep learning-based reconstruction (DLR), model-based (MBIR), and hybrid iterative reconstruction (HIR) algorithms for lower-dose (LD) unenhanced head CT and compare it with those of standard-dose (STD) HIR images., Methods: This retrospective study included 114 patients who underwent unenhanced head CT using the STD (n = 57) or LD (n = 57) protocol on a 320-row CT. STD images were reconstructed with HIR; LD images were reconstructed with HIR (LD-HIR), MBIR (LD-MBIR), and DLR (LD-DLR). The image noise, gray and white matter (GM-WM) contrast, and contrast-to-noise ratio (CNR) at the basal ganglia and posterior fossa levels were quantified. The noise magnitude, noise texture, GM-WM contrast, image sharpness, streak artifact, and subjective acceptability were independently scored by three radiologists (1 = worst, 5 = best). The lesion conspicuity of LD-HIR, LD-MBIR, and LD-DLR was ranked through side-by-side assessments (1 = worst, 3 = best). Reconstruction times of three algorithms were measured., Results: The effective dose of LD was 25% lower than that of STD. Lower image noise, higher GM-WM contrast, and higher CNR were observed in LD-DLR and LD-MBIR than those in STD (all, p ≤ 0.035). Compared with STD, the noise texture, image sharpness, and subjective acceptability were inferior for LD-MBIR and superior for LD-DLR (all, p < 0.001). The lesion conspicuity of LD-DLR (2.9 ± 0.2) was higher than that of HIR (1.2 ± 0.3) and MBIR (1.8 ± 0.4) (all, p < 0.001). Reconstruction times of HIR, MBIR, and DLR were 11 ± 1, 319 ± 17, and 24 ± 1 s, respectively., Conclusion: DLR can enhance the image quality of head CT while preserving low radiation dose level and short reconstruction time., Key Points: • For unenhanced head CT, DLR reduced the image noise and improved the GM-WM contrast and lesion delineation without sacrificing the natural noise texture and image sharpness relative to HIR. • The subjective and objective image quality of DLR was better than that of HIR even at 25% reduced dose without considerably increasing the image reconstruction times (24 s vs. 11 s). • Despite the strong noise reduction and improved GM-WM contrast performance, MBIR degraded the noise texture, sharpness, and subjective acceptance with prolonged reconstruction times relative to HIR, potentially hampering its feasibility., (© 2023. The Author(s), under exclusive licence to European Society of Radiology.)

Purpose: To evaluate the diagnostic performance of myocardium-to-lumen R1 (1/T1) ratio on postcontrast T1 maps for the detection of cardiac amyloidosis in a large patient sample., Materials and Methods: This retrospective study included consecutive patients who underwent MRI-derived extracellular volume fraction (MRI ECV) analysis between March 2017 and July 2021 because of known or suspected heart failure or cardiomyopathy. Pre- and postcontrast T1 maps were generated using the modified Look-Locker inversion recovery sequence. Diagnostic performances of MRI ECV and myocardium-to-lumen R1 ratio on postcontrast T1 maps (a simplified index not requiring a native T1 map and hematocrit level data) for detecting cardiac amyloidosis were evaluated using the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity., Results: Of 352 patients (mean age, 63 years ± 16 [SD]; 235 men), 136 had cardiac amyloidosis. MRI ECV showed 89.0% (121 of 136; 95% CI: 82%, 94%) sensitivity and 98.6% (213 of 216; 95% CI: 96%, 100%) specificity for helping detect cardiac amyloidosis (cutoff value of 40% [AUC, 0.99 {95% CI: 0.97, 1.00}; P < .001]). Postcontrast myocardium-to-lumen R1 ratio showed 92.6% (126 of 136; 95% CI: 89%, 96%) sensitivity and 93.1% (201 of 216; 95% CI: 89%, 96%) specificity (cutoff value of 0.84 [AUC, 0.98 {95% CI: 0.95, 0.99}; P < .001]). There was no evidence of a difference in AUCs for each parameter ( P = .10)., Conclusion: Postcontrast myocardium-to-lumen R1 ratio showed excellent diagnostic performance comparable to that of MRI ECV in the detection of cardiac amyloidosis. Keywords: MR Imaging, Cardiac, Heart, Cardiomyopathies Supplemental material is available for this article. © RSNA, 2023., Competing Interests: Disclosures of conflicts of interest: M.K. Belongs to the endowed department at Kumamoto University funded by donations from Philips Healthcare. S.O. No relevant relationships. S.T. No relevant relationships. Y.K. No relevant relationships. H.H. No relevant relationships. K.M. No relevant relationships. T.E. No relevant relationships. S.S. No relevant relationships. F.Y. No relevant relationships. T.N. No relevant relationships. Y.N. No relevant relationships. M.M. No relevant relationships. M.U. Research grants from Pfizer and Alnylam Pharmaceuticals; honoraria for lectures from Pfizer and Alnylam Pharmaceuticals. K.T. No relevant relationships. T.H. Research support from Philips Healthcare., (© 2023 by the Radiological Society of North America, Inc.)

Rationale and Objectives: To evaluate the image properties of lung-specialized deep-learning-based reconstruction (DLR) and its applicability in ultralow-dose CT (ULDCT) relative to hybrid- (HIR) and model-based iterative-reconstructions (MBIR)., Materials and Methods: An anthropomorphic chest phantom was scanned on a 320-row scanner at 50-mA (low-dose-CT 1 [LDCT-1]), 25-mA (LDCT-2), and 10-mA (ULDCT). LDCT were reconstructed with HIR; ULDCT images were reconstructed with HIR (ULDCT-HIR), MBIR (ULDCT-MBIR), and DLR (ULDCT-DLR). Image noise and contrast-to-noise ratio (CNR) were quantified. With the LDCT images as reference standards, ULDCT image qualities were subjectively scored on a 5-point scale (1 = substantially inferior to LDCT-2, 3 = comparable to LDCT-2, 5 = comparable to LDCT-1). For task-based image quality analyses, a physical evaluation phantom was scanned at seven doses to achieve the noise levels equivalent to chest phantom; noise power spectrum (NPS) and task-based transfer function (TTF) were evaluated. Clinical ULDCT (10-mA) images obtained in 14 nonobese patients were reconstructed with HIR, MBIR, and DLR; the subjective acceptability was ranked., Results: Image noise was lower and CNR was higher in ULDCT-DLR and ULDCT-MBIR than in LDCT-1, LDCT-2, and ULDCT-HIR (p < 0.01). The overall quality of ULDCT-DLR was higher than of ULDCT-HIR and ULDCT-MBIR (p < 0.01), and almost comparable with that of LDCT-2 (mean score: 3.4 ± 0.5). DLR yielded the highest NPS peak frequency and TTF 50% for high-contrast object. In clinical ULDCT images, the subjective acceptability of DLR was higher than of HIR and MBIR (p < 0.01)., Conclusion: DLR optimized for lung CT improves image quality and provides possible greater dose optimization opportunity than HIR and MBIR., (Copyright © 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Background/aim: Nocturia is defined as the symptom that an individual has to disrupt their sleep at night, for one or several times, in order to void. Nocturia is a bothersome event that markedly reduces a patient's quality of life. The aim of the study was to elucidate which drugs, prescribed to reduce nocturia, show real-world efficacy in patients with bladder storage symptoms., Patients and Methods: One hundred consecutive patients who visited the Fukuoka University Medical Center were evaluated between May and July 2022. Anticholinergic drugs, β 3 adrenoceptor agonists, α 1 blockers, desmopressin, and other medicines were prescribed for relieving nocturia. Desmopressin was used as second-line treatment of nocturia only in males with nocturnal polyuria. The association between each drug and actual decrease in nocturia was investigated using multivariate analysis., Results: The number of nocturia episodes was reduced in patients using anticholinergic drugs, β 3 adrenoceptor agonists, and desmopressin (-1.4±0.9, -1.3±0.9, -2.0 ±0.8 episodes/night, respectively). Multivariate analysis for the entire cohort showed that anticholinergic drugs and β 3 adrenoceptor agonists were associated with significantly decreased nocturia episodes (p=0.01 and p=0.04, respectively). In males, only desmopressin was associated with a significant decrease in nocturia (p=0.03), and combination therapy significantly decreased the number of nocturia episodes compared to monotherapy (p=0.001)., Conclusion: In a real-world clinical setting, anticholinergic drugs and β 3 adrenoceptor agonists were similarly effective in reducing nocturia. Administration of desmopressin combined with anticholinergic drugs and/or β 3 adrenoceptor agonists is the most effective method for reducing nocturia in male patients with both storage symptoms and nocturnal polyuria., (Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Glycemic disorders involving large glucose fluctuations and recurrent hypoglycemia may lead to adverse cardiovascular events, including acute coronary syndrome (ACS). Flash glucose monitoring (FGM) has reportedly been useful for detecting latent glycemic disorders. However, only a few studies have so far reported latent glycemic disorders in coronary artery disease. Thus, we herein present a unique case of ACS due to intraplaque hemorrhage in a post-gastrectomy patient who had no apparent coronary risk, except for a latent severe glycemic disorder detected via FGM. This masked etiology should be considered in ACS patients who have no apparent cardiovascular risks in order to improve their cardiovascular outcomes.

Background: Abdominal aortic aneurysm (AAA) is a life-threatening cardiovascular disease characterized by dilated abdominal aorta. Immune cells have been shown to contribute to the development of AAA, and that the gut microbiota is associated with numerous diseases, including cardiovascular diseases, by regulating immune systems or metabolic pathways of the host. However, the interaction between the gut microbiota and AAA remains unknown., Methods: Apolipoprotein E-deficient male mice were fed a high-cholesterol diet and divided into three groups: the control group was maintained under normal water (control group), the oral AVNM group was maintained under drinking water supplemented with ampicillin, vancomycin, neomycin, and metronidazole, and the i.p. AVNM group was injected AVNM intraperitoneally. After 1 week of pretreatment with antibiotics, these mice were administrated Ang II via subcutaneous osmotic pumps for 4 weeks and euthanized to evaluate AAA formation., Results: Depletion of gut microbiota by oral AVNM ameliorated the incidence of AAAs (control group: 58.9% versus oral AVNM group: 28.6% versus i.p. AVNM group: 75.0%, P = 0.0005) and prevented death due to ruptured aneurysms (control group: 11% versus oral AVNM group: 0% versus i.p. AVNM group: 15%). Oral AVNM suppressed monocyte storage in the spleen, but not in other organs. Despite possessing a higher level of cholesterol, recruitment of monocytes into the suprarenal aorta was suppressed in the oral AVNM group. In AVNM drinking mice, NOD1 ligand, a kind of PRR ligands, increased the development of AAAs and accumulation of macrophages in the aortae., Conclusions: The gut microbiota plays a critical role in AAA formation. Therefore, regulation of the microbiota or the immune system can be a therapeutic approach for AAA.

Background: The impact of body mass index (BMI) on hospital mortality in patients with acute heart failure has been well documented in Asian populations. However, the relationship between BMI, hospital-associated disability (HAD), and hospitalization costs in patients with heart failure is poorly understood. This study aimed to explore the impact of BMI on HAD and hospitalization costs for acute heart failure in Japan., Methods: From April 2012 to March 2020, the Japanese Registry of All Cardiac and Vascular Disease Diagnosis Procedure Combination (JROAD-DPC) database was used to identify patients with acute heart failure. All patients were categorized into five groups according to the World Health Organization Asian BMI criteria. The hospitalization costs and HAD were evaluated., Results: Among the 238,160 eligible patients, 15.7% were underweight, 42.2% were normal, 16.7% were overweight, 19.3% were obese I, and 6.0% were obese II, according to BMI. The prevalence of HAD was 7.43% in the total cohort, and the risk of HAD increased with a lower BMI. Restricted cubic spline analysis showed a U-shaped relationship between BMI and hospitalization costs for all ages. Furthermore, developing HAD was associated with greater costs compared with non-HAD, regardless of BMI category., Conclusions: We found that the lower the BMI, the higher the incidence of HAD. A U-shaped association was confirmed between BMI and hospitalization costs, indicating that hospitalization costs increased for both lower and higher BMI regardless of age. BMI could be an important and informative risk stratification tool for functional outcomes and economic burdens., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022. Published by Elsevier B.V.)

Body mass index (BMI) distribution and its impact on cardiovascular disease (CVD) vary between Asian and western populations. The study aimed to reveal time-related trends in the prevalence of obesity and underweight and safe ranges of BMI in Japanese patients with CVD. We analyzed 5,020,464 records from the national Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination dataset over time (2012-2019) and evaluated BMI trends and the impact on in-hospital mortality for six acute CVDs: acute heart failure (AHF), acute myocardial infarction (AMI), acute aortic dissection (AAD), ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH). Patients were categorized into five groups using the WHO Asian-BMI criteria: underweight (< 18.5 kg/m 2 ), normal (18.5-22.9 kg/m 2 ), overweight at risk (23.0-24.9 kg/m 2 ), obese I (25.0-29.9 kg/m 2 ), and obese II (≥ 30.0 kg/m 2 ). Age was significantly and inversely related to high BMI for all diseases (P < 0.001). The proportion of BMI categories significantly altered over time; annual BMI trends showed a significant and gradual increase, except AAD. In adjusted mixed models, underweight was significantly associated with a high risk of in-hospital mortality in all CVD patients (AHF, OR 1.41, 95% CI 1.35-1.48, P < 0.001; AMI, OR 1.27, 95% CI 1.20-1.35, P < 0.001; AAD, OR 1.23, 95% CI 1.16-1.32, P < 0.001; IS, OR 1.45, 95% CI 1.41-1.50, P < 0.001; ICH, OR 1.18, 95% CI 1.13-1.22, P < 0.001; SAH, OR 1.17, 95% CI 1.10-1.26, P < 0.001). Moreover, obese I and II groups were significantly associated with a higher incidence of in-hospital mortality, except AHF and IS. Age was associated with in-hospital mortality for all BMI categories in six CVD patients. BMI increased annually in patients with six types of CVDs. Although underweight BMI was associated with high mortality rates, the impact of obesity on in-hospital mortality differs among CVD types., (© 2022. The Author(s).)

Background and Aims: Gut microbial lipopolysaccharide (LPS) induces endotoxemia, an independent risk factor for cardiovascular disease (CVD). However, no studies have demonstrated how structural differences in each bacterial LPS contribute to endotoxemia. Here, we investigated the effects of different acyl chains in the lipid A moiety of LPS on endotoxemia and the subsequent immune response and atherosclerotic plaque formation., Methods: Apoe -/- mice were intraperitoneally administered 2 mg/kg of Escherichia coli-derived LPS (E. LPS, as a representative of hexa-acylated lipid A), Bacteroides-derived LPS (B. LPS, as a representative of penta- or tetra-acylated lipid A), or saline (control) once a week, six times. An immunohistological assessment was performed on plaque sections., Results: E. LPS administration induced endotoxemia, but B. LPS and saline did not. In E. LPS-treated mice, total plaque areas in the aortic root were significantly increased, and neutrophil accumulation and increased formation of neutrophil extracellular traps (NETs) were observed at the plaque lesions, but not in B. LPS-treated mice. A single dose of E. LPS significantly increased the accumulation of neutrophils in plaque lesions on day 3, and NET formation on day 7. E. LPS also increased interleukin-1 beta (IL-1β) production in plaque lesions on day 7. Furthermore, NET formation and IL-1β production were also observed in human coronary plaques., Conclusions: We identified a previously unknown link between structural differences in LPS and atherosclerosis. Lowering microbial LPS activity may reduce NET formation in plaques and prevent CVD progression., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Objectives: The aim of the present study was to clarify the relationships of intraoperative surgical position with the incidence of postoperative rhabdomyolysis and with postoperative renal function to safely perform robot-assisted radical prostatectomy., Methods: The participants in the present study were 276 consecutive patients who underwent robot-assisted radical prostatectomy at our institutions between 2013 and 2020; 130 cases were performed in the opened legs position and 146 cases in the lithotomy position with a steep 23°-25° head-down position. Rhabdomyolysis was defined as creatine kinase values greater than 1000 IU/L. Propensity score matching including age, body mass index, the presence of comorbidities, preoperative creatine kinase, preoperative estimated glomerular filtration rate, and prostate-specific antigen was performed, resulting in a matched cohort of 146 patients (opened legs position group n = 73; lithotomy position group n = 73)., Results: After propensity score matching, creatine kinase values on the first day after surgery were significantly lower in the opened legs position group than in the lithotomy position group (opened legs position group: lithotomy position group = 246.9 ± 114.9 IU/L: 558.2 ± 114.9 IU/L, P = 0.034). There were significantly fewer patients diagnosed with postoperative rhabdomyolysis in the opened legs position group (opened legs position group: lithotomy position group = 0% (0/73): 9.6% (7/73), P < 0.001). In addition, fluid replacement volume was significantly less in the opened legs position group (opened legs position group: lithotomy position group = 5747 ± 180 mL: 6349 ± 0176 mL, P = 0.018)., Conclusions: To prevent rhabdomyolysis after surgery, robot-assisted radical prostatectomy should be performed in the opened legs position., (© 2022 The Japanese Urological Association.)

Purpose: Myocardial extracellular volume (ECV) measured by cardiac magnetic resonance imaging (MRI) has been suggested as a marker of disease severity in pulmonary hypertension (PH). However, consistency between ECVs quantified by computed tomography (CT) and MRI has not been sufficiently investigated in (PH). We investigated the utility of CT-ECV in PH, using MRI-ECV as a reference standard., Method: We evaluated 20 patients with known or suspected PH who underwent dual-energy CT, cardiac MRI, and right heart catheterization. We used Pearson correlation analysis to investigate correlations between CT-ECV and MRI-ECV. We also assessed correlations between ECV and mean pulmonary artery pressure (mPAP)., Results: CT-ECV showed a very strong correlation with MRI-ECV at the anterior (r = 0.83) and posterior right ventricular insertion points (RVIPs) (r = 0.84). CT-ECV and MRI-ECV were strongly correlated in the septum and left ventricular free wall (r = 0.79-0.73) but weakly correlated in the right ventricular free wall (r = 0.26). CT-ECV showed a strong correlation with mPAP in the anterior RVIP (r = 0.64) and a moderate correlation in the posterior RVIP and septum (r = 0.50-0.42). Compared with CT-ECV, MRI-ECV had a higher correlation with mPAP; however, the difference was not significant (anterior RVIP, r = 0.72 [MRI-ECV] vs. 0.64 [CT-ECV], p = 0.663; posterior RVIP, r = 0.67 vs. 0.50, p = 0.446)., Conclusion: Dual-energy CT can quantify myocardial ECV and yield results comparable to those obtained using cardiac MRI. CT-ECV in the anterior RVIP could be a noninvasive surrogate marker of disease severity in PH., (Copyright © 2022 Elsevier B.V. All rights reserved.)

BACKGROUND. Deep learning-based reconstruction (DLR) may facilitate CT radiation dose reduction, but a paucity of literature has compared lower-dose DLR images with standard-dose iterative reconstruction (IR) images or explored application of DLR to low-tube-voltage scanning in children. OBJECTIVE. The purpose of this study was to assess whether DLR can be used to reduce radiation dose while maintaining diagnostic image quality in comparison with hybrid IR (HIR) and model-based IR (MBIR) for low-tube-voltage pediatric CT. METHODS. This retrospective study included children 6 years old or younger who underwent contrast-enhanced 80-kVp CT with a standard-dose or lower-dose protocol. Standard images were reconstructed with HIR, and lower-dose images were reconstructed with HIR, MBIR, and DLR. Size-specific dose estimate (SSDE) was calculated for both protocols. Image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were quantified. Two radiologists independently evaluated noise magnitude, noise texture, streak artifact, edge sharpness, and overall quality. Interreader agreement was assessed, and mean values were calculated. To evaluate task-based object detection performance, a phantom was imaged with 80-kVp CT at six doses (SSDE, 0.6-5.3 mGy). Detectability index ( d ') was calculated from the noise power spectrum and task-based transfer function. Reconstruction methods were compared. RESULTS. Sixty-five children (mean age, 25.0 ± 25.2 months) who underwent CT with standard- ( n = 31) or lower-dose ( n = 34) protocol were included. SSDE was 54% lower for the lower-dose than for the standard-dose group (1.9 ± 0.4 vs 4.1 ± 0.8 mGy). Lower-dose DLR and MBIR yielded lower image noise and higher SNR and CNR than standard-dose HIR ( p < .05). Interobserver agreement on subjective features ranged from a kappa coefficient of 0.68 to 0.78. The readers subjectively scored noise texture, edge sharpness, and overall quality lower for lower-dose MBIR than for standard-dose HIR ( p < .001), though higher for lower-dose DLR than for standard-dose HIR ( p < .001). In the phantom, DLR provided higher d ' than HIR and MBIR at each dose. Object detectability was greater for 2.0-mGy DLR than for 4.0-mGy HIR for low-contrast (3.67 vs 3.57) and high-contrast (1.20 vs 1.04) objects. CONCLUSION. Compared with IR algorithms, DLR results in substantial dose reduction with preserved or even improved image quality for low-tube-voltage pediatric CT. CLINICAL IMPACT. Use of DLR at 80 kVp allows greater dose reduction for pediatric CT than do current IR techniques.

Purpose: This clinical and phantom study aimed to evaluate the impact of deep learning-based reconstruction (DLR) on image quality and its radiation dose optimization capability for multiphase hepatic CT relative to hybrid iterative reconstruction (HIR)., Methods: Task-based image quality was assessed with a physical evaluation phantom; the high- and low-contrast detectability of HIR and DLR images were computed from the noise power spectrum and task-based transfer function at five different size-specific dose estimate (SSDE) values in the range 5.3 to 18.0-mGy. For the clinical study, images of 73 patients who had undergone multiphase hepatic CT under both standard-dose (STD) and lower-dose (LD) examination protocols within a time interval of about four-months on average, were retrospectively examined. STD images were reconstructed with HIR, while LD with HIR (LD-HIR) and DLR (LD-DLR). SSDE, quantitative image noise, and contrast-to-noise ratio (CNR) were compared between protocols. The noise magnitude, noise texture, streak artifact, image sharpness, interface smoothness, and overall image quality were subjectively rated by two independent radiologists., Results: In phantom study, the high- and low-contrast detectability of DLR images obtained at 5.3-mGy and 7.3-mGy, respectively, were slightly higher than those obtained with HIR at the STD protocol dose (18.0-mGy). In clinical study, LD-DLR yielded lower image noise, higher CNR, and higher subjective scores for all evaluation criteria than STD (all, p ≤ 0.05), despite having 52.8% lower SSDE (8.0 ± 2.5 vs. 16.8 ± 3.4-mGy)., Conclusions: DLR improved the subjective and objective image quality of multiphase hepatic CT compared with HIR techniques, even at approximately half the radiation dose., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Macrophage colony stimulating factor-1 (CSF-1) plays a critical role in maintaining myeloid lineage cells. However, congenital global deficiency of CSF-1 (Csf1 op/op ) causes severe musculoskeletal defects that may indirectly affect hematopoiesis. Indeed, we show here that osteolineage-derived Csf1 prevented developmental abnormalities but had no effect on monopoiesis in adulthood. However, ubiquitous deletion of Csf1 conditionally in adulthood decreased monocyte survival, differentiation, and migration, independent of its effects on bone development. Bone histology revealed that monocytes reside near sinusoidal endothelial cells (ECs) and leptin receptor (Lepr)-expressing perivascular mesenchymal stromal cells (MSCs). Targeted deletion of Csf1 from sinusoidal ECs selectively reduced Ly6C - monocytes, whereas combined depletion of Csf1 from ECs and MSCs further decreased Ly6C hi cells. Moreover, EC-derived CSF-1 facilitated recovery of Ly6C - monocytes and protected mice from weight loss following induction of polymicrobial sepsis. Thus, monocytes are supported by distinct cellular sources of CSF-1 within a perivascular BM niche., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Herpes simplex virus type 1 (HSV-1) is an enveloped virus that mainly infects humans. Given its high global prevalence, disinfection is critical for reducing the risk of infection. Ultraviolet-light-emitting diodes (UV-LEDs) are eco-friendly irradiating modules with different peak wavelengths, but the molecules degraded by UV-LED irradiation have not been clarified. To identify the target viral molecules of UV-LEDs, we exposed HSV-1 suspensions to UV-LED irradiation at wavelengths of 260-, 280-, 310-, and 365-nm and measured viral DNA, protein, and lipid damage and infectivity in host cells. All UV-LEDs substantially reduced by inhibiting host cell transcription, but 260- and 280-nm UV-LEDs had significantly stronger virucidal efficiency than 310- and 365-nm UV-LEDs. Meanwhile, 260- and 280-nm UV-LEDs induced the formation of viral DNA photoproducts and the degradation of viral proteins and some phosphoglycerolipid species. Unlike 260- and 280-nm UV-LEDs, 310- and 365-nm UV-LEDs decreased the viral protein levels, but they did not drastically change the levels of viral DNA photoproducts and lipophilic metabolites. These results suggest that UV-LEDs reduce the infectivity of HSV-1 by targeting different viral molecules based on the peak wavelength. These findings could facilitate the optimization of UV-LED irradiation for viral inactivation., (Copyright © 2022 Elsevier B.V. All rights reserved.)