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Owing to their high selectivity and low toxicity, synthetic cyclic peptides hold promise as bioactive therapeutics. The corresponding impurity analysis typically relies on reversed-phase high-performance liquid chromatography (RP-HPLC), which, however, often provides inaccurate results because of the abundance of chemically similar impurities. To bridge this gap, hydrophilic-interaction liquid chromatography (HILIC), a technique orthogonal to RP-HPLC, was herein used with an ultraviolet detector to analyze the impurities of four cyclic peptides. Each of these peptides comprises nine amino acids (both natural and nonnatural) and features neutral, acidic, basic, or zwitterionic residues incorporated at positions 3 and 6. Three polymer-based HILIC columns (acidic, basic and zwitterionic) were newly employed, and seven mobile phases were used to investigate the effects of additives and pH. Derringer's desirability functions based on five criteria (purity, impurity factor, peak symmetry factor, theoretical plate number, and retention time) were employed to identify optimal screening conditions. Ammonium acetate was identified as an effective additive, and polymeric selectors with vinylpyridine and phosphoryl choline residues were shown to be effective irrespective of the peptide features. Optimized HILIC conditions were established for each peptide, and the corresponding impurity elution profiles were compared with those obtained by RP-HPLC using a column filled with octadecylsilyl-functionalized silica. RP-HPLC and HILIC were revealed to be mutually orthogonal, i.e., most impurities with small RP-HPLC retention times had large HILIC retention times, and vice versa. The results help make the purity evaluation of synthetic peptides more accurate, thus paving the way for their efficient purification., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.)

Study Design: Retrospective multicenter cohort study., Objective: To investigate the incidence and risk factors of postoperative hip displacement following spinal fusion in nonambulant patients with spastic neuromuscular scoliosis., Summary of Background Data: In patients with spastic neuromuscular disorders, spinal deformity, and hip displacement mutually influence each other; however, little is known about the clinical impact of spinal fusion on the incidence of hip displacement., Methods: We retrospectively analyzed nonambulant patients with spastic neuromuscular disorders undergoing primary fusion with a minimum follow-up of 1 year. The primary outcome was new postoperative hip displacement. To identify potential risk factors for postoperative hip displacement, an association analysis was conducted., Results: We identified 67 eligible patients (29 males and 38 females) with a mean age of 14.1 years and a mean follow-up period of 49.4 months. Overall, 11 cases of postoperative hip displacement (10 up hip, and 1 down hip) were identified in 11 patients (16.4%). Patients with hip displacement were significantly more skeletally immature at surgery, had a significantly larger preoperative curve magnitude (115.6 vs. 97.5 degrees), larger correction of the Cobb angle (71.0 vs. 56.8 degrees), larger preoperative pelvic obliquity (36.2 vs. 24.3 degrees), and included a significantly higher proportion of cases with pelvic fixation (P=0.03). Compared with patients with nondislocated stable up hip joints, 10 patients with new up hip displacement had a significantly higher preoperative migration percentage (MP) in the up hip (40.6 vs. 31.4, P=0.047). Receiver operating characteristic curve analysis revealed that the optimal cutoff value of the preoperative MP of the up hip for predicting postoperative displacement was 28.8 (sensitivity, 90.0%; specificity, 47.8%)., Conclusions: When performing spinal fusion in patients with spastic neuromuscular disorders, especially in those with identified potential risk factors, patients and their caregivers should be informed preoperatively about the possibility of subsequent hip displacement., Level of Evidence: Level III., Competing Interests: The authors declare no conflict of interest., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Background/aim: Liver metastases are a major cause of cancer-related mortality and present significant therapeutic challenges. Chemotherapy is preferred for multiple metastases, while surgery or stereotactic body radiotherapy (SBRT) is used for solitary or few metastases, particularly in oligometastatic cases. This study aimed to evaluate the safety and efficacy of CyberKnife SBRT (CK-SBRT) for liver oligometastases., Patients and Methods: This retrospective study analyzed patients with one to three liver metastases treated with CK-SBRT. The prescribed dose was typically 60 Gy in four fractions to 95% of the target volume, with reductions allowed if organ-at-risk (OAR) constraints could not be met. The local control (LC) and overall survival (OS) rates were estimated using the Kaplan-Meier method, and liver dose-volume parameters were assessed., Results: A total of 39 liver lesions in 27 patients were treated. At a median follow-up of 17 months, the 1-year LC and OS rates were 90% and 80%, respectively. In patients receiving 60 Gy in four fractions, these rates were 95% and 86%. No severe liver toxicity or radiation-induced liver disease occurred. Most patients met liver dose constraints, with low liver V15 and mean liver dose values., Conclusion: CK-SBRT provides effective tumor control with minimal toxicity for liver oligometastases. Careful dose planning and adherence to OAR constraints are essential to minimize toxicity risks., (Copyright © 2025 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Introduction: This retrospective claims analysis characterized contemporary ulcerative colitis (UC) treatment patterns and investigated the economic burden of UC in Japan., Methods: This study used anonymized claims data in the Medical Data Vision database. Patients were included if they had a confirmed UC diagnosis and ≥ 1 claim of systemic treatment for UC (index date) between June 2018 and December 2022, in addition to continuous enrollment for ≥ 6 months before and ≥ 12 months after the index date. Patients were excluded if they were aged < 18 years at index or if they had claimed systemic UC treatment during the pre-index period, had a confirmed diagnosis of Crohn's or Behçet's disease, or had a record of colectomy during the pre-index period. Outcomes of interest were treatment patterns, healthcare resource utilization (HCRU), and UC-related costs per person per month (PPPM). Further exploratory analyses were conducted to understand whether real-world treatment patterns with conventional therapy were optimally aligned with guideline recommendations. Two definitions of suboptimal treatment with conventional therapies were identified: prolonged treatment with corticosteroids (i.e., consecutive use for  > 90 days) and corticosteroid cycling (i.e., three or more ≥ 30-day corticosteroid courses over 1 year, with a ≥ 60-day gap between courses)., Results: Overall, 15,429 patients were included. The most frequently observed class of first-line treatment was 5-aminosalicylic acid monotherapy (75.0%); treatment modification was observed in 39.7% of patients. Within 1 year of follow-up, patients had a mean (SD) of 9.8 (6.8) outpatient visits, and a hospital stay was reported in 23.9% of patients. Mean total cost PPPM was ¥76,374. Of patients with ≥ 1 course of corticosteroids, 39.8% received suboptimal treatment with conventional therapies. HCRU and total costs were higher for patients with versus without suboptimal treatment with conventional therapies., Conclusions: Japanese patients with UC would benefit from treatment options that can reduce costs, HCRU, and suboptimal treatment with conventional therapies., Competing Interests: Declarations. Conflict of Interest: Shingo Kato received honoraria from AbbVie, Janssen Pharmaceutical K.K., Kissei, Mitsubishi Tanabe, and Takeda. Bruno Casaes Teixeira, Thomas Laurent, Yoshiyuki Yamada, Kiran Dave, Shweta Shah, and Hyunchung Kim are employees and/or shareholders of Bristol Myers Squibb. Ethical Approval: This real-world, retrospective, observational study used anonymized patient data from June 2018 to December 2022, obtained from Medical Data Vision, a hospital-based claims database (Medical Data Vision, Tokyo, Japan) that covers approximately 42 million patients across 474 acute care hospitals in Japan. As all data were anonymized, requirements for ethics approval and informed consent under the Ethical Guidelines for Epidemiological Research in Japan do not apply to this study. Permission was obtained to access and use data by Medical Data Vision., (© 2025. The Author(s).)

In 2024, the World Health Organization (WHO) launched a new classification of lymphoid neoplasms, a revision of the previously used Revised 4th Edition of their classification (WHO-4R). However, this means that two classifications are now in simultaneous use: the 5th Edition of the WHO classification (WHO-5) and the International Consensus Classification (ICC). Instead of a comprehensive review of each disease entity, as already described elsewhere, this review focuses on revisions made in both the WHO-5 and ICC from WHO-4R and discrepancies between them regarding B-cell neoplasms. Similarities include cutaneous marginal zone lymphoma, cold agglutinin disease, non-primary effusion lymphoma-type effusion-based lymphoma, and gray zone lymphoma. Differences include plasma cell neoplasms, high-grade B-cell lymphoma (double hit lymphoma), follicular lymphoma, LPD with immune deficiency and dysregulation, extranodal large B-cell lymphoma, transformations of indolent B-cell lymphomas, and diffuse large B-cell lymphoma, not otherwise specified. Understanding the similarities and differences between the two latest classifications will aid daily diagnostic practice and future research on lymphoid neoplasms., Competing Interests: Declarations. Conflict of interests: The authors declare that they have no conflict of interest., (© 2024. Japanese Society of Hematology.)

Background Context: Low back pain (LBP) frequently occurs in patients with lumbar disc herniation (LDH), however the extent to which discectomy ameliorates it and how preoperative LBP influences postoperative outcomes remains unclear., Purpose: To evaluate the improvement in LBP and its impact on postoperative patient-reported outcome measures (PROMs)., Study Design/setting: Multicenter retrospective observational study., Patient Sample: Patients undergoing discectomy for LDH at 8 hospitals from April 2017 to March 2021., Outcome Measures: Data were collected on patients' backgrounds, operative factors, and PROMs, including the Numeric Rating Scale (NRS) for pain in the low back, buttock, or leg, EuroQol 5 Dimension (EQ-5D), Oswestry Disability Index (ODI) scores, and postoperative satisfaction., Methods: Patients were categorized into mild (NRS 0-3), moderate (NRS 4-7), or severe (NRS 8-10) LBP groups. Inverse probability weighting with propensity scores was used to adjust for demographic and clinical differences between groups. Chi-square tests and one-way analysis of variance were conducted to compare background data and clinical characteristics. Additionally, multivariate logistic regression was performed to identify risk factors for less than 50% improvement in LBP., Results: This study included 928 patients: 270 mild, 343 moderate, and 315 severe. After adjustment, preoperative NRS scores were significantly different across groups, with scores of 1.6 (SD 1.3), 5.6 (SD 1.0), and 8.8 (SD 0.9), respectively. Postoperative NRS scores also varied significantly, with worse outcomes observed in the severe group compared to the mild group, yet similar to the moderate group. A total of 46.8% of the mild group, 86.6% of the moderate group, and 72.9% of the severe group achieved a 50% decrease in NRS scores of LBP. Preoperative EQ-5D and ODI scores were significantly worse in the severe group compared to the mild or moderate groups, but postoperative scores were not significantly different between the severe and moderate groups. No significant differences in postoperative satisfaction were observed among the groups. Being female was a significant risk factor for less than 50% improvement in LBP (odds ratio = 1.56, p=.022)., Conclusions: Discectomy significantly improved LBP in patients with LDH, including those with moderate or severe LBP. Patients with severe LBP showed similar improvements in PROMs as those with moderate LBP. Female gender emerged as a significant risk factor for less than optimal improvement in LBP., Competing Interests: Declaration of competing interest One or more of the authors declare financial or professional relationships on ICMJE-TSJ disclosure forms., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

In subsurface methanogenic ecosystems, the ubiquity of methylated-compound-using archaea-methylotrophic methanogens 1-4 -implies that methylated compounds have an important role in the ecology and carbon cycling of such habitats. However, the origin of these chemicals remains unclear 5,6 as there are no known energy metabolisms that generate methylated compounds de novo as a major product. Here we identified an energy metabolism in the subsurface-derived thermophilic anaerobe Zhaonella formicivorans 7 that catalyses the conversion of formate to methanol, thereby producing methanol without requiring methylated compounds as an input. Cultivation experiments showed that formate-driven methanologenesis is inhibited by the accumulation of methanol. However, this limitation can be overcome through methanol consumption by a methylotrophic partner methanogen, Methermicoccus shengliensis. This symbiosis represents a fourth mode of mutualistic cross-feeding driven by thermodynamic necessity (syntrophy), previously thought to rely on transfer of hydrogen, formate or electrons 8-10 . The unusual metabolism and syntrophy provide insights into the enigmatic presence of methylated compounds in subsurface methanogenic ecosystems and demonstrate how organisms survive at the thermodynamic limit through metabolic symbiosis., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer Nature Limited.)

Study Design: Retrospective multicenter study., Objective: The purpose of this study was to compare the prognosis of elderly patients with injuries related to cervical diffuse idiopathic skeletal hyperostosis (cDISH) to matched control for each group, with and without fractures., Methods: The current multicenter study was a retrospective analysis of 140 patients aged 65 years or older with cDISH-related cervical spine injuries; 106 fractures and 34 spinal cord injuries without fracture were identified. Propensity score-matched cohorts from 1363 patients without cDISH were generated and compared. Logistic regression analysis was performed to determine the risk of early mortality for patients with cDISH-related injury., Results: Patients with cDISH-related injuries with fracture did not differ significantly in the incidence of each complication and ambulation or severity of paralysis compared to matched controls. In patients with cDISH-related injury without fracture, those who were nonambulatory at discharge comprised 55% vs 34% of controls, indicating significantly poorer ambulation in those with cDISH-related injuries ( P = .023). There was no significant difference in the incidence of complications and ambulation or paralysis severity at 6 months as compared with controls. Fourteen patients died within 3 months. Logistic regression analysis identified complete paralysis (odds ratio [OR] 36.99) and age (OR 1.24) as significant risk factors for mortality., Conclusions: The current study showed no significant differences in the incidence of complications, ambulation outcomes between patients with cDISH-related injury with fracture and matched controls, and that the ambulation at discharge for patients with cDISH-related injury without fractures were significantly inferior to those of matched controls., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Study Design: Cross-sectional international survey with literature review., Objectives: To evaluate the evidence for these strategies and to understand the current trends in prophylactic antibiotic use during ASD surgery through an international survey., Methods: An online survey was conducted among international AO Spine members regarding the peri-operative management of patients with ASD. The details of perioperative systemic and topical antibiotic use were solicited. Descriptive data were summarized for the responding surgeons who perform at least 10 long-segment fusions of >5 levels extending to the pelvis annually., Results: The literature supports the use of prophylactic antibiotic effective against gram positive organisms. The use of topical vancomycin remains debated, and there is limited evidence for topical tobramycin use. A total of 116 responses were received. 74 (64%) surgeons use topical vancomycin, most usually deep to the fascia only 45 (61%). The most usual dose used is 1-2 g. 4 (3%) surgeons use topical tobramycin deep to fascia. Following surgery, 90 (78%) surgeons use prophylactic cephalosporin with 3 (3%) using cloxacillin, 5 (4%) using ciprofloxacin and 9 (8%) using vancomycin and 6 (5%) using clindamycin either in addition or alone., Conclusions: The present survey identifies a trend towards systemic and topical antibiotic prophylaxis primarily targeted at gram positive pathogens. The use of topical tobramycin, proposedly effective against gram negative infections, remains uncommon. There is a lack of consensus in the selection of perioperative antibiotic prophylaxis, thus a prospective study of the rates of infection with each strategy would be useful to inform guidelines., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: BR is a Consultant for Silony Medical GmbH. SK declares no conflict of interest. SJL is a Consultant for Stryker, Medtronic and AOSpine, and receives payment for lectures and travel for meetings from Medtronic, Stryker, AOSpine, and Depuy Synthes.

Purpose: Cases of adenocarcinoma of the uterine cervix (AUC) have poorer prognoses than those of squamous cell carcinoma. Carbon-ion radiation therapy (CIRT) outcomes for AUC have been reported in retrospective or single-institutional prospective studies but not prospective multicenter studies. We present the results of CIRT for AUC in a prospective multicenter study using a nationwide hospital-based registry in Japan., Methods and Materials: Patients with locally advanced untreated AUC who received CIRT at 4 Japanese centers between June 2016 and April 2020 were included in this study. In the absence of organ dysfunction, up to 5 weekly 40 mg/m 2 cisplatin courses were administered. The primary endpoints were 2-year overall survival and local control rates. The secondary endpoints were 2-year disease-free survival rate and late adverse events (AEs)., Results: Forty-two patients were enrolled with a median age of 54 years (range, 34-76 years). Patients were diagnosed with stage IIB (n = 26), IIIB (n = 12), or IVA (n = 4) disease. The median follow-up period was 24 months. The 2-year overall survival, local control, and disease-free survival rates were 97.5% (95% CI, 92.7%-100.0%), 80.9% (95% CI, 66.9%-94.8%), and 64.3% (48.1%-80.4%), respectively. Two patients developed grade 3 rectum/sigmoid AE. One patient required urinary diversion surgery during a salvage operation for local tumor recurrence (grade 3 genitourinary AE). No other grade 3 or worse toxicities were reported., Conclusion: CIRT is an effective treatment for locally advanced AUC. Further research is required to validate the safety and efficacy of CIRT for AUC., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Study Design: Retrospective multicenter study., Objectives: The effectiveness of early surgery for cervical spinal injury (CSI) has been demonstrated. However, whether early surgery improves outcomes in the elderly remains unclear. This study investigated whether early surgery for CSI in elderly affects complication rates and neurological outcomes., Methods: This retrospective multicenter study included 462 patients. We included patients with traumatic acute cervical spinal cord injury aged ≥65 years who were treated surgically, whereas patients with American Spinal Injury Association (ASIA) Impairment Scale E, those with unknown operative procedures, and those waiting for surgery for >1 month were excluded. The minimum follow-up period was 6 months. Sixty-five patients (early group, 14.1%) underwent surgical treatment within 24 hours, whereas the remaining 397 patients (85.9%) underwent surgery on a standby basis (delayed group). The propensity score-matched cohorts of 63 cases were compared., Results: Patients in the early group were significantly younger, had significantly more subaxial dislocations (and fractures), tetraplegia, significantly lower ASIA motor scores, and ambulatory abilities 6 months after injury. However, no significant differences in the rate of complications, ambulatory abilities, or ASIA Impairment Scale scores 6 months after injury were observed between the matched cohorts. At 6 months after injury, 61% of the patients in the early group (25% unsupported and 36% supported) and 53% of the patients in the delayed group (34% unsupported and 19% supported) were ambulatory., Conclusions: Early surgery is possible for CSI in elderly patients as the matched cohort reveals no significant difference in complication rates and neurological or ambulatory recovery between the early and delayed surgery groups., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Study Design: Retrospective multicenter study., Objectives: To investigate the treatments of the geriatric population with hangman's fractures using a multicenter database under the Japan Association of Spine Surgeons with Ambition (JASA)., Methods: The multicenter database included data from 1512 patients. We employed the Levine and Edwards classification for categorizing hangman's fractures. The study incorporated epidemiological data, including the prevalence of hangman's fractures, patient age, and follow-up duration. Bony fusion rates and length of hospitalization were recorded for Type I and Type II fractures, and the degree of neurological impairment was assessed., Results: Hangman's fractures represented 62 cases, accounting for 7.4% of all cervical spine injuries. The patients had an average age of 76.6 ± 6.5 years, and the mean duration of follow-up was 21.5 ± 23.6 months. The study found that the bony fusion rate for hangman's fractures in the geriatric population was 88.9%. Surgical treatment was associated with a shorter hospitalization period for Type II fractures compared to conservative treatment. Thirteen cases of hangman's fractures in the geriatric population, accounting for 21%, were complicated by spinal cord injury., Conclusions: This is the largest study to date on hangman's fractures in geriatric population ≥65 years. Type I and Type II fractures, according to the Levine and Edwards classification, had a bony fusion rate of up to 90%. In patients with Type II fractures, surgical treatment led to a shorter initial hospital stay. Geriatric patients are at risk of spinal cord injury due to hangman's fractures., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Study Design: Retrospective cohort study., Objectives: With the aging of the Japanese population, patients with athetoid cerebral palsy (ACP) are getting older, and the rate of surgery for CSM is increasing in ACP patients. However, postoperative complications of such surgery among adult patients with ACP have not been reported yet. We investigated postoperative complications of surgery for CSM with ACP and compared them with those of surgery for CSM without ACP using a national inpatient database of Japan., Methods: Using the Diagnosis Procedure Combination database, we identified 61382 patients who underwent surgery for CSM from July 2010 to March 2018. We examined patient backgrounds, surgical procedures, and type of hospital, and a 4:1 propensity score matching was performed to compare the outcomes between the non-ACP and ACP groups., Results: There were 60 847 patients without ACP and 535 patients with ACP. The mean age was 68.5 years in the non-ACP group and 55 years in the ACP group. The percentages of patients who underwent fusion surgery were 21.6% and 68.8% in the non-ACP and ACP groups, respectively. The 4:1 propensity score matching selected 1858 in the non-ACP group and 465 in the ACP group. The ACP group was more likely to have postoperative urinary tract infection (.4% vs 2.8%, P < .001), postoperative pneumonia (.4% vs 2.4%, P < .001), and 90-day readmission for reoperation (1.9% vs 4.3%, P = .003)., Conclusions: We found that ACP patients were more vulnerable to postoperative complications and reoperation after CSM than non-ACP patients., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Monitoring oxidation causes (i.e. radical and/or photo-oxidation) of vegetable oil gives very important information for its quality control. This study aimed to develop a rapid and simple near infrared (NIR) spectroscopy method to explore the oxidation causes in vegetable oil by quantifying triacylglycerol hydroperoxide (TGOOH) positional isomers proceeded by different oxidation causes. First, the concentrations of TGOOH isomers were determined by liquid chromatography-mass spectrometry. Partial least square regression for concentrations of TGOOH isomers (R 2 : 0.994-0.998) using NIR spectra in the regions of 7500-6000 cm -1 and 5500-4500 cm -1 as explanatory variables. Principal component analysis revealed that those models were created because NIR spectra capture trace changes of the peak around 6980 cm -1 (-CH 2 -) and 5260 cm -1 (H 2 O) derived by different oxidation causes (i.e. radical and/or photo-oxidation). The application of this method to various kinds of vegetable oil is expected to lead to a simple and rapid quality evaluation of vegetable oil., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Study Design: Cross-sectional survey., Objective: Although literature does not recommend routine wound drain utilization, there is a disconnect between the evidence and clinical practice. This study aims to explore into this controversy and analyze the surgeon preferences related to drain utilization, and the factors influencing drain use and criterion for removal., Methods: A survey was distributed to AO Spine members worldwide. Surgeon demographics and factors related to peri-operative drain use in 1 or 2-level open fusion surgery for lumbar degenerative pathologies were collected. Multivariate analyses by drain utilization, and criterion of removal were conducted., Results: 231 surgeons participated, including 220 males (95.2%), orthopedics (178, 77.1%), and academic/university-affiliated (114, 49.4%). Most surgeons preferred drain use (186, 80.5%) and subfascial drains (169, 73.2%). Drains were removed based on duration by 52.87% of the surgeons, but 27.7% removed drains based on outputs. On multivariable analysis, significant predictors of drain use were surgeon's aged 35-44 (OR = 11.9, 95% CI = 1.2-117.2, P = .034), 45-54 (29.1, 3.1-269.6, P = .003), 55-64 (8.9, 1.4-56.5, .019), and wound closure using coaptive films (6.0, 1.2-29.0, P = .025). Additionally, surgeons from Asia Pacific (OR = 5.19, 95% CI = 1.65-16.38, P = .005), Europe (3.55, 1.22-10.31, P = .020), and Latin America (4.40, 1.09-17.83, .038) were more likely to remove drain based on time duration, but surgeons <5 years of experience (10.23, 1.75-59.71, P = .010) were more likely to remove drains based on outputs., Conclusions: Most spine surgeons worldwide prefer to place a subfascial wound drain for degenerative open lumbar surgery. The choice for drain placement is associated with the surgeon's age and use of coaptive films for wound closure, while the criterion for drain removal is associated with the surgeons' region of practice and experience., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The Esophageal Hypervigilance and Anxiety Scale (EHAS) is an English questionnaire created in the USA to assess these factors in all patients with esophageal diseases. The aim of this study was to develop and validate the Japanese version of EHAS and investigate the relationship between EHAS scores and symptoms in untreated disorders of esophagogastric junction (EGJ) outflow., Methods: This prospective study recruited patients who underwent high-resolution manometry (HRM) at six tertiary centers in Japan. The EHAS was translated to Japanese using standard forward and backward translation methods. Patients completed the following questionnaires: the Japanese EHAS, Eckardt score, Gastroesophageal Reflux Disease Questionnaire, and Hospital Anxiety and Depression Scale for assessment of construct validity. Logistic regression analysis identified factors associated with esophageal symptom severity in untreated disorders of EGJ outflow., Results: Overall, we analyzed 432 patients. Their main symptoms were dysphagia and reflux. The most common HRM diagnosis was normal (35.9%), followed by achalasia (29.4%). The Japanese EHAS demonstrated excellent reliability, and construct validity, with two subscales similar to the original EHAS. Total EHAS score moderately correlated to Eckardt score (r = 0.545, p < 0.001). In 113 patients with untreated disorders of EGJ outflow, multivariable analysis demonstrated that younger age, type II achalasia, and higher EHAS score were independently associated with higher Eckardt score., Conclusions: The Japanese EHAS is a reliable and valid questionnaire. Its subscale scores can be used as in the original version with some caution. Future studies are warranted to assess the appropriateness of factor loading., Competing Interests: Declarations. Conflict of interests: Akinari Sawada: Bristol Myers Squibb (grant).,Daniel Sifrim: Jinshan (speaking, grant, trips), Reckitt Benckiser (speaking, grant, trips).,Tiffany H. Taft: Ayble Health (scientific advisory board), Oak Park Behavioral Medicine LLC (ownership).,John Erik Pandolfino: Medtronic (speaking, consulting, patent, license), Sandhill Scientific/Diversatek (grant), Takeda (speaking), Astra Zeneca (speaking), Torax/Ethicon (speaking, consulting), EndoGastric Solutions (advisory board), Phathom (speaking, consulting).,Yasuhiro Fujiwara: Takeda (speaking), Astra Zeneca (speaking), Astellas (speaking), DaiichiSankyo (speaking), Otsuka (speaking), EA Pharma (speaking).The remaining authors declare no conflicts of interest in this study., (© 2024. The Author(s).)

Background: A need exists for effective treatments for prostate cancer (PCA) due its re-emergence following androgen deprivation therapy, a major clinical problem. In a previous study, we presented evidence on the chemopreventive and chemotherapeutic potential of luteolin, a flavonoid, in PCA including castration-resistant PCA. In this single-arm phase I study, we clinically examined the safety of the oral intake of luteolin in patients under active surveillance (AS). Methods: Between March and September in 2022, five patients with low-intermediate risk PCA and under AS were treated daily with 50 mg of oral luteolin for six months. We investigated the efficacy of oral luteolin in oncological outcomes and any adverse events (AEs) and examined prostate and blood specimens. Results: The median age of patients was 68 years (range: 60-78), and the median initial prostate-specific antigen level was 9.5 ng/mL. All patients were under AS without rapid progression. After treatment with luteolin, AEs were not noted in any patients for six months. All patients underwent a protocol biopsy. Of these, two patients showed a favorable response, one patient had stable disease, and two patients showed disease progression; robot-assisted radical surgery was subsequently performed for the latter. Immunohistochemical analysis revealed decreased expression of androgen receptor and NKX3.1 in noncancerous lesions after luteolin treatment. In addition, quantitative reverse transcription-PCR revealed that serum micro(mi)RNA expression in serum and prostate gland, including miR-29 and miR-30, tended to be upregulated after luteolin treatment compared with during the pretreatment phase. Conclusions: Our small phase I study of men with PCA suggests that daily treatment with 50 mg of an oral supplement of luteolin is safe and effective with regard to oncological outcomes, particularly in patients under AS., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2025 Taku Naiki et al. Prostate Cancer published by John Wiley & Sons Ltd.)

The discovery of Toll-like receptors (TLRs) and their role in dendritic cells earned the Nobel Prize for 2011 because TLRs profoundly enhanced our understanding of the immune system. Specifically, TLR3 is located within the endosomal compartments of dendritic cells and plays a crucial role in the immune response by acting as a pattern recognition receptor that detects both exogenous (viral) and endogenous (mammalian) double-stranded RNA. However, TLR3 activation is a double-edged sword in various immune-mediated diseases. On one hand, it can enhance anti-viral defenses and promote pathogen clearance, contributing to host protection. On the other hand, excessive or dysregulated TLR3 signaling can lead to chronic inflammation and tissue damage, exacerbating conditions such as autoimmune diseases, chronic viral infections, and cancer. In cancer, TLR3 expression has been linked to both favorable and poor prognoses, though the underlying mechanisms remain unclear. Recent clinical and preclinical advances have explored the use of TLR3 agonists in cancer immunotherapy, attempting to capitalize on their potential to enhance anti-tumor responses. The dual role of TLR3 highlights its complexity as a therapeutic target, necessitating careful modulation to maximize its protective effects while minimizing potential pathological consequences. In this review, we explore the intricate roles of TLR3 in immune responses across different disease contexts, including cancer, infections, autoimmune disorders, and allergies, highlighting both its protective and detrimental effects in these disorders, as well as progress in developing TLR3 agonists as part of the immunotherapy landscape., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: JA serves on the advisory board of CureMatch and is a consultant for datma. SK serves as a consultant for Medpace, Foundation Medicine, NeoGenomics, and CureMatch. He receives speaker’s fees from Roche and Bayer, and the advisory board for Pfizer. He has research funding from ACT Genomics, Sysmex, Konica Minolta, OmniSeq, and Personalis. RK has received research funding from Boehringer Ingelheim, Debiopharm, Foundation Medicine, Genentech, Grifols, Guardant, Incyte, Konica Minolta, Medimmune, Merck Serono, Omniseq, Pfizer, Sequenom, Sysmex, Takeda, and TopAlliance and from the NCI; as well as consultant and/or speaker fees and/or advisory board/consultant for Actuate Therapeutics, AstraZeneca, Bicara Therapeutics, Inc., Biological Dynamics, Caris, Datar Cancer Genetics, Daiichi, EISAI, EOM Pharmaceuticals, Iylon, LabCorp, Merck, NeoGenomics, Neomed, Pfizer, Precirix, Prosperdtx, Recordati, Regeneron, Roche, TD2/Volastra, Turning Point Therapeutics, X-Biotech; has an equity interest in CureMatch Inc.; serves on the Board of CureMatch and CureMetrix and XZOM, and is a co-founder of CureMatch., (© 2025. The Author(s).)

Objective: To investigate the impact of body mass index (BMI), body composition (BC), and the expression of genes linked to obesity or lipid metabolism on the prognosis of endometrial cancer., Methods: We conducted a comprehensive review of patients with confirmed endometrial cancer treated at the Pontificia Universidad Católica de Chile (PUC) and analyzed publicly available data from the endometrial cancer TCGA-UCEC cohort. BC was assessed using computed tomography (CT) scans, and gene expression analysis was performed using RNA-seq data. We evaluated the associations between BMI, BC, gene expression, and patient outcomes, including overall survival (OS) and progression-free survival (PFS)., Results: Our study included 127 patients (67 from PUC and 60 from TCGA-UCEC). BMI was not significantly associated with OS or PFS. However, BC metrics such as visceral adiposity and muscle mass were critical determinants of prognosis. We identified a 30-gene risk score significantly associated with poorer PFS and OS, independent of other factors. Analysis of the tumor microenvironment (TME) revealed significant differences in immune cell composition and functional states between high- and low-risk groups., Conclusion: BMI alone is not a significant prognostic factor in endometrial cancer. Comprehensive assessments of BC, gene expression profiles, and the TME provide more accurate prognostic information and highlight potential therapeutic targets. These findings advocate for a shift towards personalized medicine, incorporating detailed phenotyping and molecular profiling to improve patient outcomes., (© 2025 International Federation of Gynecology and Obstetrics.)

LaeA is a putative nuclear methyltransferase protein that epigenetically influences secondary metabolite production in fungi. LaeA has drawn attention as one of the promising approaches to activate fungal chemical production, and the laeA gene has been introduced into some fungal strains with the aim of producing secondary metabolic changes mainly based on the evaluation of mycotoxicity. However, these studies were applied for limited fungal species, and its utility and versatility for broad fungal species remained unclear. In this study, 47 strains were selected composed of three different genera, Pochonia spp., Gamszarea kalimantanensis , and Lecanicillium spp., which have never been modified with the laeA gene. We obtained a total of 125 mutants with laeA genes for our fungal strain library. The chemical productivity and the biological activity of the library were analyzed, and two natural products, radicicol ( 1 ) and sch210972 ( 2 ), were isolated in more than 10-fold the yield of the parent strains.

Molnupiravir is a prodrug of the antiviral ribonucleoside analogue N 4 -hydroxycytidine (NHC), for use in treatment of coronavirus disease 2019 (COVID-19). However, it is generally considered that NHC-triphosphate is incorporated into the host genome to induce mutations. In our previous preliminary report, we proposed oxidative DNA damage by NHC via cytidine deaminase (CDA)-mediated ROS formation. In the present study, we investigated cell viability using the HL-60 human leukemia cell line and its H 2 O 2 -resistant clone, HP100 cells. The survival rate was significantly reduced in HL-60 cells treated with NHC, but not in HP100 cells. LC-MS analysis revealed that uridine formation occurred from CDA-treated NHC, suggesting that CDA metabolizes NHC to uridine and hydroxylamine. We clarified mechanisms of CDA-mediated reactive oxygen species (ROS) generation and DNA damage by NHC using isolated DNA. CDA-treated NHC induced DNA damage in the presence of Cu(II). The DNA damage was enhanced by NADH addition and piperidine treatment. CDA-treated NHC and Cu(II) caused piperidine-labile sites at thymine, cytosine, and guanine, and the DNA cleavage pattern was similar to that of hydroxylamine. Catalase and bathocuproine inhibited the DNA damage, indicating the involvement of H 2 O 2 and Cu(I). An indicator of oxidative DNA damage, 8-oxo-7,8-dihydro-2'-deoxyguanosine formation by CDA-treated NHC, was lower under hypoxic conditions than under normal conditions. Therefore, hydroxylamine, possibly produced from NHC treated with CDA, could induce metal-dependent H 2 O 2 generation during the redox reactions, suggesting that oxidative DNA damage induced by ROS plays an important role in molnupiravir-related cytotoxicity and mutagenicity.

Purpose: Mucinous neoplasms of the gastrointestinal tract are characterized by a propensity for metastasis to the peritoneum, resulting in peritoneal mucinous carcinomatosis (PMC). A subset of these tumors, most often originating in the appendix, harbor mutations in the GNAS oncogene. While the natural history of GNAS -mutant PMC varies, patient outcomes are generally poor, as is response to cytotoxic chemotherapy. The purpose of this study was to evaluate the clinical efficacy of single-agent palbociclib, a cyclin-dependent kinase (CDK)4/6 inhibitor, in patients with GNAS -mutant PMC., Patients and Methods: We enrolled 16 patients with PMC in a single-arm personalized cancer therapy trial. For all patients, tumor tissue and/or circulating tumor DNA genomic profiling using next-generation sequencing and, when possible, PD-L1 expression, tumor mutational burden, and microsatellite instability status was assessed. Twelve of 16 patients had previous disease progression on at least one previous line of chemotherapy. The primary tumor was appendix in 13 patients, unknown in two patients, and pancreas in one patient. Eleven cases were classified as low grade, and five as high grade., Results: In 13 of 16 patients, we observed a decrease in carcinoembryonic antigen (CEA), and in six patients, the CEA declined by >50%. As measured by clinical and modified peritoneal RECIST criteria, 50% of evaluable patients had stable disease after 12 months of palbociclib. At a median follow-up of 17.6 months, median survival has not been reached. Clinical response to CDK4/6 inhibition was mirrored in tumors with GNAS mutation and mucinous histology using an ex vivo preclinical platform., Conclusion: CDK4/6 inhibition with palbociclib had clinical activity in PMC characterized by mutations in GNAS that was superior to that previously reported with cytotoxic chemotherapy. CDK4/6 inhibition is a novel therapeutic strategy worthy of further evaluation in this subgroup of gastrointestinal neoplasms.

Purpose: Ageing, long illness duration, and poor preoperative Japanese Orthopaedic Association (JOA) score were reported to be risk factors for residual pain after cervical ossification of the posterior longitudinal ligament (cOPLL). In this study, we focused on residual neuropathic pain (NeP) and aimed to elucidate risk factors for residual NeP after cOPLL., Methods: Total of 234 patients who underwent cOPLL surgery were included. NeP was evaluated using painDETECT (PDQ) and Spine painDETECT (SPDQ) questionnaires. Score of ≥ 13 / ≥ 0 was defined as NeP for PDQ/SPDQ. Patient backgrounds factors, preoperative radiographic factors and surgical factors were reviewed, and comparisons between the NeP(+) and NeP(-) groups were made. Independent risk factors for residual NeP were evaluated using multiple logistic regression analysis., Results: Prevalence of residual NeP after cOPLL was 22.6% on PDQ and 55.1% on SPDQ. Preoperative JOA score was significantly lower in the NeP(+) group for PDQ compared with that in the NeP(-) group. Additionally, cervical lordosis angle was significantly lower in the NeP(+) group for SPDQ compared with that in the NeP(-) group. Following multiple logistic regression analysis, poor preoperative JOA score was identified as a risk factor for NeP on the PDQ. Poor preoperative JOA score and low cervical lordosis angle were identified as risk factors using the SPDQ., Conclusions: We found high prevalence of residual NeP after cOPLL. Patients with a poor preoperative JOA score and low cervical lordosis angle might be at risk for residual NeP after surgery evaluated by PDQ or SPDQ and should be monitored with greater care after surgery., Competing Interests: Declarations. Conflict of interest: The authors declare that they have no other financial associations that may be relevant or seen as relevant to this work. Ethical approval: Ethical approval from the Institutional Review Board of Kitasato University was obtained for this study, which was conducted in accordance with the ethical principles specified in the 1964 Declaration of Helsinki and its later amendments. The approval code is B20-320. Consent to participate: The requirement for informed consent was waived. Consent for publication: Not applicable., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background & Aims: Low muscle mass is associated with poor immune checkpoint inhibitor (ICI) efficacy in patients with melanoma; however, whether this is true in all populations remains to be explored. The current study aimed to investigate the effect of low muscle mass on overall survival (OS) and progression-free survival (PFS) of patients with advanced melanoma treated with ICI., Methods: muscle index (SMI) at the third lumbar spine was calculated from computed tomography (CT) images, and SMI values < 42 cm2/m2 for men and <38 cm2/m2 for women diagnosed low muscle mass. The association of low muscle mass, OS, and PFS with ICI treatment in patients was investigated., Results: Seventy-six patients with advanced melanoma were assessed retrospectively at our institution; 32 were in the low muscle mass group, while 44 were in the normal muscle mass group. The median OS in patients with and without low muscle mass was 7.1 and 26.6 months (hazard ratio [HR] 3.12, 95 % confidence interval [Cl], 1.65-5.89; p < 0.001) and median PFS was 2.1 and 14.8 months, respectively (HR, 3.10; 95 % Cl 1.74-5.54, p < 0.001). Multivariate analysis showed significantly poor differences in OS (HR, 2.46; 95 % CI, 1.20-5.03; p = 0.01) and significant differences in PFS independently in the low muscle mass group (HR, 3.10; 95 % CI, 1.74-5.54; p < 0.001)., Conclusions: Low muscle mass may be a poor prognostic factor for patients with advanced melanoma treated with ICI., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

The omentum is the primary site of metastasis for ovarian cancer (OC). Interactions between cancer cells and adipocytes drive an invasive and pro-metastatic phenotype. Here we studied cancer cell-adipocyte crosstalk by using a direct co-culture model with immortalized human visceral pre-adipocytes (VNPAD) and OC cells. We demonstrate increased proliferation, invasiveness, and resistance to cisplatin of co-cultured compared to mono-cultured OC cells. RNA-sequencing of OC cells from co-culture vs. mono-culture revealed significant transcriptomic changes, identifying over 200 differentially expressed genes (DEGs) common to OVCAR5 and OVCAR8 cell lines. Enriched pathways included PI3K/AKT and Complement activation. Lipid transfer into OC cells from adipocytes induced upregulation of complement C3 and C5 proteins. Inhibiting C3 or C5 reversed the invasive phenotype and C3 knockdown reduced tumor progression in-vivo. Increased C3 expression was observed in omental implants compared to primary ovarian tumors and C3 secretion was higher in OC ascites from high BMI vs. low BMI patients. C3 upregulation in OC cells involved activation of ATF4-mediated integrated stress response (ISR). Overall, adipocyte-cancer cell interactions promote invasiveness and tumorigenesis via lipid transfer, activating ISR, and upregulating complement proteins C3 and C5.

Background: To evaluate the efficacy of computed tomography (CT) lymphangiography after direct mesenteric lymph node injection for thoracic duct (TD) visualization in mice., Methods: Twelve female BALB/c mice were injected with 35 μL of iodinated contrast medium (iomeprol 350 mgI/mL) into the mesenteric (mesenteric group) or popliteal (popliteal group) lymph nodes. CT images were acquired before injection and 1 min, 3 min, 5 min, 10 min, and 15 min after injection using a micro-CT scanner. Contrast ratios (CRs) were measured at the cisterna chyli and three levels of the TD (diaphragm, carina, and venous angle). Two experienced radiologists qualitatively assessed images as good, fair, or poor., Results: The mesenteric group had significantly higher mean (± standard deviation) CRs than the popliteal group for all examined regions at 1 min after injection: cisterna chyli (14.01 ± 4.77 versus 1.47 ± 1.21, p < 0.001), diaphragm (7.28 ± 2.50 versus 0.85 ± 0.61, p = 0.0011), carina (10.33 ± 3.42 versus 0.44 ± 0.40, p < 0.001), and venous angle (6.26 ± 2.02 versus 0.79 ± 0.75, p < 0.001). For the TD between the cisterna chyli and the diaphragm, 6/6 mice in the mesenteric group showed strong enhancement, whereas 5/6 mice in the popliteal group showed minimal or no enhancement. The visual scores of the mesenteric group were significantly higher than those of the popliteal group for all the evaluated regions (p = 0.002)., Conclusion: CT lymphangiography via mesenteric lymph node injection provides better imaging of the TD in mice than popliteal lymph node injection., Relevance Statement: This study enhances TD visualization in mice, advancing preclinical research on lymphatic disorders and improving translational applications for better clinical diagnostics and treatments., Key Points: Mesenteric lymph node injection improved the efficacy of TD CT lymphangiography in mice. Mesenteric injection provided significantly better TD visualization than popliteal injection. Enhanced TD visualization in mice advances preclinical research on lymphatic diseases., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: All animal experiments were conducted following institutional guidelines and were approved by the institutional animal research committees of the Institute of Medical Science, University of Tokyo (approval code: PA21-18; approval date: June 23, 2021). The study protocol was designed in accordance with the ethical standards outlined by the committee, and all efforts were made to minimize animal suffering. Consent for publication: Not applicable., (© 2025. The Author(s).)

Background: Boron neutron capture therapy (BNCT) was conducted in a hospital using an accelerator-based neutron source. The neutron beam intensity at the patient position was evaluated offline using a gold-based neutron activation method. During BNCT neutron beam irradiation on patients, the neutron intensity was controlled in real time by measuring the proton beam current irradiated on a lithium neutron target. The neutron intensity at NCCH decreased owing to the degradation of the lithium neutron target during neutron irradiation. The reduction in the neutron beam intensity could not be monitored via proton beam measurement due to the dependence of neutron production on the neutron target condition., Purpose: The duration of BNCT neutron irradiation should be controlled by monitoring the neutron beam intensity with a real-time neutron detector for reliable neutron irradiation on patients. The measurement accuracy of the online neutron beam monitor was experimentally obtained by comparing the gold radioactivity measured at the patient position. Radiation-induced damage was observed from the variation in the pulse height distributions of multichannel analyzer during long-term neutron exposure., Methods: Neutron beams were measured during neutron beam irradiation at the BNCT facility of Edogawa hospital in Japan using a neutron beam monitor comprising a 0.07- μ m $\umu{\rm m}$ LiF layer and 40- μ m $\umu{\rm m}$ back-illuminated thin Si pin diode. The proton beam was continuously irradiated until a cumulative total beam charge of approximately 3 kC was achieved. The online neutron beam monitor counting rates on the neutron target unit and gold saturation activities at the patient position were simultaneously measured through the entire duration of proton beam irradiation., Results: The experimental results demonstrated the long-term operation of the online neutron beam monitor positioned on the neutron target unit during the entire duration of the neutron target lifespan without significant performance deterioration. A good synchronization was observed in a correlation distribution measured using the online neutron beam monitor and the gold neutron activation method. A conversion coefficient of 1.199 Bq - 1 ${\rm Bq}^{-1}$ g with a standard deviation of 2.5% was evaluated. The neutron beam intensity irradiating on patients within an acceptable level of ± $\pm$ 5% as per the International Commission on Radiation Units and Measurements was evaluated from the online neutron counting rate at the 95% confidence level. The channel numbers of the triton peak and alpha particle edge decreased linearly owing to displacement damage and total ionizing dose effects induced mainly by thermal neutrons and photons., Conclusions: Neutron doses can be accurately administered by complementing proton beam current measurements with the online neutron beam monitor. The online neutron beam monitoring technique allows monitoring fluctuations in the neutron beam intensity and tracking the degradation of the lithium target through the neutron target lifespan. Using a calibrated online neutron beam monitor, a prescribed dose can be administered in a manner similar to that in x-ray therapy, and the duration of neutron beam irradiation on the patient can be controlled in real time., (© 2025 American Association of Physicists in Medicine.)

Objectives: To evaluate the preoperative risk factors for early intravesical recurrence after radical nephroureterectomy (RNU) in patients with upper urinary tract carcinoma (UTUC) according to the history of non-muscle invasive bladder cancer (NMIBC)., Methods: We retrospectively evaluated patients who underwent RNU for UTUC between 2012 and 2022 at 14 hospitals. Early recurrence was defined as intravesical pathologically confirmed recurrence within 1 year after RNU. Patients who received single-dose immediate intravesical instillation (IVI) as prevention for intravesical recurrence were excluded. Using preoperative factors, we examined the risk factors for early intravesical recurrences in patients with and without a history of NMIBC. Death from any cause within 1 year after RNU was regarded as a competitive risk., Results: We included 504 UTUC patients who were treated with RNU. Among these patients, 126 (25.0%) had a history of NMIBC, whereas 378 (75%) did not. According to multivariate analysis, the presence of macrohematuria, positive cytology in self-voided urine, and performing diagnostic ureteroscopy prior to RNU were risk factors in patients without a history of NMIBC. On the other hand, an NMIBC diagnosis within 1 year prior to RNU and an extravesical approach for bladder cuff management were risk factors in RNU-treated patients with a history of NMIBC., Conclusions: Early intravesical recurrence risk factors differ between UTUC patients with and without a history of NMIBC. Different stratification may be needed to predict intravesical recurrence risk in these two types of UTUC patients., (© 2025 The Japanese Urological Association.)

Purpose: Cervical spine injuries in the elderly (defined as individuals aged 65 years and older) are increasing, often resulting from falls and minor trauma. Prognosis varies widely, influenced by multiple factors. This study aimed to develop a deep-learning-based predictive model for post-injury outcomes., Methods: This study analyzed a nationwide dataset from the Japan Association of Spine Surgeons with Ambition, comprising 1512 elderly patients (aged 65 years and older) with cervical spine injuries from 2010 to 2020. Deep learning predictive models were constructed for residence, mobility, and the American Spinal Injury Association Impairment Scale (AIS). The model's performance was compared with that of a traditional statistical analysis., Results: The deep-learning model predicted the residence and AIS outcomes with varying accuracies. The highest accuracy was observed in predicting residence one year post-injury. The model also identified that the AIS score at discharge was significantly predicted by upper extremity trauma, mobility, and elbow extension strength. The deep learning model highlighted factors, such as upper extremity trauma, that were not considered significant in the traditional statistical analysis., Conclusion: Our deep learning-based model offers a novel method for predicting outcomes following cervical spine injuries in the elderly population. The model is highly accurate and provides additional insights into potential prognostic factors. Such models can improve patient care and individualize future interventions., Competing Interests: Declarations. Conflict of interest: The authors declare no conflict of interest., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background and Aims: The intima-media thickness (IMT) of the carotid artery, an indicator of subclinical atherosclerosis, varies in close association with various factors such as diabetes and immune response. The extent of changes in IMT varies among individuals owing to both genetic and epigenetic factors. In this study, we aimed to identify single nucleotide polymorphisms (SNPs) and DNA methylation patterns that affect carotid IMT in monozygotic (MZ) twins., Methods: We measured the maximum IMT (IMT-Cmax) and the mean IMT in the common carotid artery wall using ultrasonography in 107 pairs of MZ twins recruited from the Osaka University Twin Registry. The genotyping of SNPs and the measurement of methylation levels were performed using a beads array, and the expression of each gene was determined by RNA sequencing. Linear regression analysis was performed on each of the two groups: one group consisted of twins randomly selected from each pair, and the other group consisted of co-twins., Results: We identified a CpG site (cg02432467) on HS3ST6 as a significant epigenetic factor in both IMT-Cmax and mean IMT analyses. The methylation level at another site (cg07927379) was negatively correlated with LINC01006 expression and IMT-Cmax. Furthermore, there were significant differences in AP2A2 expression and mean IMT among individuals with each genotype of the rs10902263 polymorphism., Conclusions: We identified genetic and epigenetic factors associated with carotid IMT that may be useful for individualized assessments., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Mikio Watanabe reports financial support was provided by Japan Society for the Promotion of Science. Osaka Twin Research Group reports financial support was provided by Government of Japan Ministry of Education Culture Sports Science and Technology. Osaka Twin Research Group reports equipment, drugs, or supplies was provided by Beckman Coulter Inc. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper]., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Aims: Heart failure with preserved ejection fraction (HFpEF) continues to be an increasingly common health problem associated with a high mortality rate. Elevated levels of Growth differentiation factor-15 (GDF15) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are reportedly associated with poor clinical outcomes in a broad range of cardiovascular diseases. The aim of the present study was to examine the effect of the combined assessment of these markers on clinical outcomes in patients with HFpEF., Methods: This study is the prospective observational study. We measured the serum levels of GDF15 and NT-proBNP in 643 patients (mean age 73 ± 12, 42% females). All patients were prospectively followed up for a median period of 1998 days. Total 132 HF-related events and 88 all-cause deaths occurred during the follow-up period., Results: Multivariate Cox proportional hazards regression analysis demonstrated that both serum GDF15 and NT-proBNP levels were independently associated with HF-related events after adjustment for confounding risk factors (GDF15: hazard ratio, 1.72; 95% confidence interval, 1.35-2.19; P < 0.0001 and NT-proBNP: hazard ratio, 1.63; 95% confidence interval, 1.25-2.13; P = 0.0003). Serum GDF15 levels improved the prediction capacity for HF-related events (0.7405 vs. 0.7190; P = 0.0422), with a significant net reclassification index (0.2724) and integrated discrimination improvement (0.0246). The C indices of GDF15 for HF-related events and all-cause deaths were significantly larger than those of NT-proBNP in men (HF-related events: 0.7389 vs. 0.6721; P = 0.0393, and all-cause deaths: 0.6922 vs.0.6109; P = 0.0262) but not in women. The combination of GDF15 and NT-proBNP levels stratified patients with HFpEF, identifying those at a high risk for HF-related events and all-cause deaths., Conclusions: Serum GDF15 could be an additional prognostic information to NT-proBNP in patients with HFpEF. The prognostic abilities of serum GDF15 and NT-proBNP differed according to sex. These markers were the feasible markers for patients with HFpEF, identifying those at a high risk for HF-related events and all-cause deaths., (© 2024 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)

Liver abscesses can be associated with biliary disease and are occasionally accompanied by portal vein thrombosis. Hepatic artery obstruction has been reported to result from aneurysms, thrombosis, iatrogenic factors, and arterial dissection; however, to the best of our knowledge, no cases of liver abscess with obstruction of the portal vein and hepatic artery have been reported. A 51-year-old man presented with a chief complaint of heartburn. A detailed investigation revealed common bile duct stones and an 8-cm multilocular abscess in the left lobe of the liver. Choledocholithiasis was achieved by endoscopic retrograde cholangiopancreatography. Despite antibiotic treatment with meropenem, his symptoms and inflammatory reaction did not improve, and computed tomography (CT) revealed obstruction of the left branch of the portal vein and left hepatic artery. Because it proved difficult to control his infection, we performed a left hepatic lobectomy. Histopathological examination of the operative specimen revealed a hepatic abscess with portal vein thrombosis and left hepatic artery dissection. The postoperative course was favorable, and the patient was discharged on postoperative day eight. Thirty months later, he continues to do well. We here report a patient with a liver abscess with portal vein thrombus and hepatic artery dissection whose infection was successfully controlled by hepatectomy., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2025, Iseda et al.)

Introduction: There is an unmet need for tools to quantify dementia risk during its multi-decade preclinical/prodromal phase, given that current biomarkers predict risk over shorter follow-up periods and are specific to Alzheimer's disease., Methods: Using high-throughput proteomic assays and machine learning techniques in the Atherosclerosis Risk in Communities study (n = 11,277), we developed the Dementia SomaSignal Test (dSST)., Results: In addition to outperforming existing plasma biomarkers, the dSST predicted mid-life dementia risk over a 20-year follow-up across two independent cohorts with different ethnic backgrounds (areas under the curve [AUCs]: dSST 0.68-0.70, dSST+age 0.75-0.81). In a separate cohort, the dSST was associated with longitudinal declines across multiple cognitive domains, accelerated brain atrophy, and elevated measures of neuropathology (as evidenced by positron emission tomography and plasma biomarkers)., Discussion: The dSST is a cost-effective, scalable, and minimally invasive protein-based prognostic aid that can quantify risk up to two decades before dementia onset., Highlights: The Dementia SomaSignal Test (dSST) predicts 20-year dementia risk across two independent cohorts. dSST outperforms existing plasma biomarkers in predicting multi-decade dementia risk. dSST predicts cognitive decline and accelerated brain atrophy in a third cohort. dSST is a prognostic aid that can predict dementia risk over two decades., (© 2025 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)

Background/aim: Amrubicin is recognized as a second-line treatment for refractory small-cell lung cancer (SCLC) and is administered immediately after chemotherapy; however, it has not been evaluated in patients with recurrent SCLC following chemoradiotherapy (CRT). This study aimed to examine the activity and safety of amrubicin monotherapy in patients with relapsed SCLC previously treated with CRT., Patients and Methods: This retrospective study evaluated patients with relapsed SCLC who had been previously treated with CRT, followed by amrubicin monotherapy between April 2007 and June 2021. The clinical efficacy and toxicity were assessed., Results: Overall, 30 patients (20 men and 10 women) were enrolled. The response rate was 50.0% [95% confidence interval (CI)=33.1-66.8%]. The median progression-free survival and overall survival from the first amrubicin treatment was 4.1 months (95%CI=2.3-6.0 months) and 13.5 months (95%CI=7.5-16.0 months), respectively. Grade ≥3 hematological adverse events occurred as follows: decreased white blood cells in 63.3% of patients, decreased neutrophil count in 70.0%, and febrile neutropenia in 10.0%. Grade 3 pneumonitis was observed in one patient. No treatment-related deaths occurred., Conclusion: Amrubicin is both feasible and effective in patients with relapsed SCLC who were previously treated with CRT. The efficacy and toxicity of amrubicin in this study were consistent with those of previous reports, indicating that amrubicin retained its effectiveness post-CRT. Consequently, amrubicin following CRT may be the optimal chemotherapeutic choice for patients with relapsed limited-disease SCLC., (Copyright © 2025 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Introduction: Recent studies have reported that essential tremor (ET) presents with not only motor symptoms but also cognitive dysfunction. However, detailed pathological mechanisms remain unclear. Here, we evaluate the characteristics of cognitive changes in older patients., Methods: Eighty-five patients aged 65 years or older with ET but without dementia were evaluated for cognitive function using the Addenbrooke Cognitive Examination Revised (ACE-R). The patients were compared with healthy controls (HCs), and the characteristics of cognitive dysfunction were examined. Age at onset and correlations with tremor severity were also investigated. Moreover, we performed resting-state network (RSNs) analysis in a subset of these patients, and the functional connectivity (FC) within the networks was compared with age-matched controls., Results: Compared to HCs, older patients with ET showed a clear reduction in the total (p = 0.001), attention (p = 0.005), verbal fluency (p = 0.001), and memory (p = 0.001) ACE-R scores. Older-onset patients showed significant cognitive dysfunction compared with younger-onset patients. Verbal fluency correlated with tremor severity in the multiple regression analysis (p < 0.001). RSNs showed an increase in FC in the frontal lobes within the language network in patients with ET compared to HCs (p < 0.05, FWE-corrected)., Conclusion: Older patients with ET showed obvious cognitive dysfunction compared to HCs, indicating that cognitive dysfunction varies by age of onset and correlates with tremor severity. The results of the RSNs analysis suggest that the pathological mechanism of cognitive dysfunction in ET patients involves network changes similar to those in the early stages of Alzheimer's disease., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The prognosis of acute myeloid leukemia (AML) with KMT2A::MLLT3 rearrangement and MECOM overexpression and/or KRAS mutation is dismal, and the optimal treatment strategy remains unclear. However, to the best of our knowledge, a suitable model (such as a cell line or its xenograft model) for research on this subtype has not been established. We established a novel AML cell line, YCU-AML2, and its xenograft model harboring KMT2A::MLLT3 rearrangement, MECOM overexpression, and KRAS G12A mutation. YCU-AML2 xenograft mice models developed AML and mimicked the clinical phenotype of the original patient. YCU-AML2 expressed high sensitivity to MEK inhibitors, such as trametinib and selumetinib. Moreover, YCU-AML2 also exhibited high sensitivity to L-asparaginase with glutaminase activity, perhaps because of its reliance on oxidative phosphorylation via glutaminolysis as its main energy source. We believe that the YCU-AML2 cell line and its xenograft model can serve as models to explore the molecular pathogenesis of high-risk AML with KMT2A::MLLT3 rearrangement, MECOM overexpression, and/or KRAS mutation and develop new treatment strategies., Competing Interests: Declarations. Conflict of interest: All authors declare no conflict of interests., (© 2025. The Author(s), under exclusive licence to Japanese Society of Hematology.)

Objective: The association between dysphagia and activities of daily living in patients with stroke has been reported, but the effect of improved dysphagia on the increase in trunk muscle mass is not clear. The aim of this study was to investigate the relationship between improved dysphagia and increased trunk muscle mass in older patients with stroke., Research Methods & Procedures: This retrospective, case-control study enrolled patients with stroke aged ≥65 years. Dysphagia was evaluated using the Kuchi-Kara Taberu (KT) Index. Patients were classified into two groups according to KT Index at discharge: improved dysphagia group (≥57 scores) and non-improved dysphagia group (<57 scores). The primary outcome of the study was Trunk Muscle Mass Index (TMI) gain from admission to discharge. Multiple regression analysis was performed to investigate the association between trunk muscle mass gain and improved dysphagia., Results: There were 153 participants with a mean age of 79.8 ± 7.7 years, and 89 (58%) were classified in the improved dysphagia group. The TMI gain was greater in the improved dysphagia group compared to that in the nonimproved group. Multiple regression analysis showed that improved dysphagia (β: 0.776, 95% confidence interval: 0.643 to 0.909, P < 0.001) was independently associated with TMI gain., Conclusion: Improved dysphagia was independently associated with trunk muscle mass gain, suggesting that improved dysphagia is important for trunk muscle mass gain in patients with stroke., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The frequency of cardiac amyloidosis potentially present in patients with atrial fibrillation (AF) remains unclear. The purpose of this study is to determine the frequency and clinical characteristics of cardiac amyloidosis latent in AF by performing cardiac magnetic resonance imaging (MRI) in patients scheduled for AF ablation. We retrospectively analyzed 193 consecutive patients who underwent CA and cardiac MRI for atrial fibrillation. The primary endpoint of the study was the frequency of histologically confirmed cardiac amyloidosis or suspected cardiac amyloidosis [positive imaging findings on cardiac MRI strongly suspecting cardiac amyloidosis (diffuse subendocardial late gadolinium enhancement or MRI-derived extracellular volume of > 0.40)]. Among the 193 patients, 8 were confirmed or suspected cases of cardiac amyloidosis, representing a frequency of 4% (8/193 patients). Multivariate analysis identified interventricular septal thickness at end-diastole (LVSd) as an independent and significant predictor of cardiac amyloidosis (OR: 1.72, 95% CI 1.12-2.87, p = 0.020).The optimal cut-off value for IVSd was determined to be > 12.9 mm based on the Youden index. At this cut-off, the sensitivity was 75.0% (95% CI 34.9-96.8%) and the specificity was 92.3% (95% CI 87.4-95.7%), allowing for the identification of patients with definite or suspected cardiac amyloidosis. The frequency of confirmed and suspected cases of cardiac amyloidosis among patients with an IVSd > 12.9 mm was 30% (6/20 patients). In addition, prevalence of biopsy-proven cardiac amyloidosis was 10% (2/20). The prevalence of cardiac amyloidosis in atrial fibrillation patients scheduled for ablation with cardiac hypertrophy is not negligible., Competing Interests: Declarations. Conflict of interest: All authors have no conflict of interest regarding this study., (© 2024. Springer Nature Japan KK, part of Springer Nature.)

Objective: To clarify the association between skin autofluorescence of advanced glycation end products (AGEs) and clinical outcomes and pain in patients with degenerative cervical myelopathy (DCM)., Methods: Consecutive patients with DCM were prospectively enrolled. AGEs assessed by skin autofluorescence (the AGE score) were examined at the middle fingertip in eligible patients. Patients were divided into lower AGE score (AGE-L) and higher AGE score (AGE-H) groups based on a cutoff AGE score of 0.54. Demographic data, laboratory data, maximum spinal cord compression, clinical outcomes, such as European Quality of Life-5 Dimensions, Neck Disability Index, and Japanese Orthopaedic Association score, and Numerical Rating Scale (NRS) score for neck, arm, hand, leg, and foot pain were compared between the two groups. Multiple linear regression analysis was performed to assess the association between the AGE score and the NRS score for pain in the lower limbs., Results: Of the 263 patients, 93 were included in this study (41 with the AGE-L group and 52 with the AGE-H group). Demographic data, laboratory data, maximum spinal cord compression, and clinical outcomes were comparable between the two groups. The AGE-H group had significantly higher NRS scores for leg and foot pain than the AGE-L group. Multiple linear regression analysis revealed that higher AGE scores were significantly associated with more severe pain in the lower limbs in patients with DCM., Conclusions: Noninvasive skin autofluorescence of AGEs may be a useful biomarker for pain symptoms in the lower limbs in patients with DCM., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Sleep disturbances, especially those lasting more than one hour, are under-researched in patients with degenerative cervical myelopathy (DCM). This study aims to investigate the prevalence and risk factors for such disturbances in DCM patients undergoing decompression surgery and to identify factors contributing to poor postoperative improvement., Methods: A multicenter retrospective observational study was conducted on consecutive patients diagnosed with DCM who underwent cervical decompression surgery between April 2018 and August 2022. The Neck Disability Index sleep component was assessed at baseline and 12 months postsurgery. Univariate and multivariable logistic regression analyses were used to identify risk factors for persistent sleep disturbances and poor improvement., Results: Of the 1912 patients included, 54.8% reported sleep disturbances, with 33.0% experiencing disturbances of more than one hour at baseline. Multivariable analysis identified male sex, high body mass index, high Numerical Rating Scale for arm pain, high Neck Disability Index, and high Core Outcome Measures Index Neck as significant risk factors for sleep disturbances. At 12 months, 35.2% of these patients continued to experience significant sleep issues. The presence of ossification of the posterior longitudinal ligament and high baseline Numerical Rating Scale for neck pain were significant predictors of poor improvement., Conclusions: The study highlights that ossification of posterior longitudinal ligament and high baseline neck pain are significant risk factors for persistent sleep disturbances postsurgery in DCM patients. Early identification and targeted interventions may be necessary to improve outcomes., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Study Design: A prospective study., Objective: To measure 3-dimensional cervical range of motion (ROM) by noninvasive optical tracking-based motion-capture technology in patients undergoing laminoplasty, and to elucidate the postoperative effects of laminoplasty on cervical mobility., Summary of Background Data: Cervical laminoplasty is a motion-sparing decompression surgery for degenerative cervical myelopathy. Unlike cervical laminectomy and fusion, the true postoperative impact of laminoplasty on neck motion has not been well studied., Methods: Participants comprised 25 patients undergoing double-door cervical laminoplasty for degenerative cervical myelopathy in a single center. Maximum flexion/extension, left/right rotation, and left/right side bending were recorded using the motion-capture device preoperatively and 3 months postoperatively. ROMs in 3 orthogonal axes were calculated. Preoperative differences in C2-7 Cobb angles on lateral flexion/extension x-rays were also measured as the radiologic ROM to assess reliability. Preoperative and 1-year postoperative Japanese Orthopaedic Association score, Neck Disability Index [NDI], and Euro-QOL were recorded, and correlations with ROMs were assessed., Results: Preoperative mean (±SD) ROMs for flexion/extension, rotation, and side bending were 90±17, 107±16, and 53±17 degrees, respectively. Although radiologic sagittal ROM measurement showed a smaller range than motion capture, averaging 36±13 degrees, a moderate to strong correlation between radiologic and motion capture values was observed (R=0.57, P =0.003). Preoperative NDI showed a negative correlation with coronal ROM (rho=-0.547, P =0.02). Postoperative ROM showed a significant reduction in rotation (95±16 degrees, P =0.002) but not in flexion/extension or side bending., Conclusions: Three-dimensional motion-capture analysis allowed reliable measurement of cervical ROM. Rotational ROM was significantly reduced after laminoplasty, showing that cervical kinematics are still significantly altered., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

We present a case of an angioimmunoblastic T-cell lymphoma (AITL) and tubulointerstitial nephritis with storiform fibrosis in a 76-year-old man. The patient exhibited lymphadenopathy, polyclonal hypergammaglobulinemia, and renal dysfunction and was diagnosed with AITL on the basis of lymph node biopsy findings. The serum IgG4 level was highly elevated. Renal biopsy revealed IgG4-positive plasma cells and storiform fibrosis without infiltration of AITL, and the findings indicated IgG4-related kidney disease (IgG4-RKD). Following THPCOP therapy for AITL, the renal function improved. While diagnosing IgG4-RKD in a patient with AITL poses challenges, follicular helper T cell involvement appeared crucial in AITL and renal tubulointerstitial lesions in this case., Competing Interests: Declarations. Conflict of interest: The authors have declared that no conflict of interest exists. Ethical approval: This article does not contain any studies with human participants or animals performed by any of the authors. Informed consent: Written informed consent was obtained from the patient for the publication of his treatment-related information and images., (© 2024. The Author(s), under exclusive licence to Japanese Society of Nephrology.)

Background: To evaluate the efficacy of a catheter system using a 3-Fr sheath with a steerable microcatheter through right upper limb artery access for superselective intra-arterial cisplatin infusion and concomitant radiotherapy (RADPLAT) to treat right maxillary sinus squamous cell carcinoma (MS-SCC)., Material and Methods: We retrospectively studied 46 sessions in eight patients treated between November 2020 and February 2023 using the catheter system briefly described below. A 3-Fr sheath was inserted into the distal radial, conventional radial, or brachial arteries. A coaxial catheter system with a 2.9-Fr steerable microcatheter and a 1.9-Fr microcatheter was advanced into the brachiocephalic artery. The right common carotid artery was selected by bending the tip of the steerable microcatheter. Coil embolization and intra-arterial cisplatin infusion after selecting each external carotid artery branch were achieved using this catheter system., Results: Cisplatin infusion and coil embolization were successful in all sessions. Arterial occlusion at the sheath insertion sites was found in 29.4% (5/17) of the distal radial arteries and 33.3% (3/9) of the conventional radial arteries. No other major complications were observed during the procedure., Conclusion: Using a 3-Fr catheter system with a steerable microcatheter through right upper limb artery access is a feasible method for RADPLAT in treating right MS-SCC.

Introduction: The efficacy of postoperative braces for degenerative lumbar disorders has long been debated, with conflicting reports regarding the promotion of bone fusion and pain relief. The current aspects of postoperative brace prescriptions have been previously reported in Western countries but not in Asia. This study aimed to elucidate prescription practices in Japan and identify factors influencing prescription decisions., Materials and Methods: The survey was conducted at a spine group research meeting comprising spine surgeons from multiple institutions. The questionnaire assessed aspects of postoperative brace prescription, including the type, purpose, and duration of usage, categorized by surgical procedures for degenerative lumbar disorders: endoscopic decompression, open surgery decompression, and fusion involving 1 or more than 3 levels. The respondents' backgrounds, scientific knowledge of postoperative braces, nonscientific reasons, and basis for prescription decisions were also investigated., Results: There were 63 valid responses. The overall postoperative brace prescription rate was 83%, with 66% for decompression and 98% for fusion procedures, surpassing the rates reported in Western studies. The primary prescription purpose was to slow down patient activity (83%, double the previously reported rates). Prescription rates for endoscopic and open surgical decompression were significantly correlated with facility attributes and annual number of surgeries. Scientific knowledge of postoperative braces was lacking in 56% of respondents, with scientific evidence being the least frequent decision for brace prescription (14%). Nonscientific reasons influenced the prescription decisions of 84% of participants., Conclusion: The postoperative brace prescription rate among spine surgeons in Japan was significantly higher than that in Western studies, largely due to nonscientific factors such as physician reassurance and the intention to slow down patient activity. Comprehensive, evidence-based guidelines are needed regarding consistent brace usage to optimize patient outcomes., Clinical Relevance: This study highlights the high postoperative brace prescription rates among spine surgeons in Japan, which are significantly influenced by nonscientific factors, such as tradition, physician reassurance, and patient satisfaction, rather than scientific evidence. These findings underscore the need for evidence-based guidelines to improve consistency in postoperative brace usage. The results are particularly relevant in regions with aging populations and a high prevalence of osteoporosis, providing insights for improving postoperative management strategies and patient outcomes in Japan as well as in similar demographic settings globally., Competing Interests: Declaration of Conflicting Interests : The authors report no conflicts of interest in this work., (This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2025 ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.)

Background/Objectives : Late gadolinium enhancement (LGE)-MRI has proven utility in prognosticating outcomes in patients with non-ischemic cardiomyopathy (NICM). However, evidence regarding its ability to predict responsiveness to optimal medical therapy remains insufficient. This study conducted a meta-analysis to evaluate the predictive utility of LGE-MRI for left ventricular reverse remodeling (LVRR) in response to pharmacological therapy. Methods : Data from 1092 NICM patients across 13 studies were included in the analysis. To assess the predictive ability of LGE-MRI for LVRR following optimal medical therapy, a pooled odds ratio was calculated using an inverse variance random-effects meta-analysis. Subgroup analyses were performed by stratifying patients based on the presence or absence of left ventricular dilation and by LVEF (<30% vs. ≥30%). Results : The pooled odds ratio of the absence of LGE for predicting LVRR in NICM was 3.72 (95% CI: 2.83-4.90, I 2 = 0, P for heterogeneity = 0.54). A comparison of pooled odds ratios between dilated cardiomyopathy (DCM) and NICM showed no significant difference ( p = 0.16). A subgroup analysis in NICM based on the left ventricular ejection fraction (LVEF) demonstrated no significant difference in odds ratios between patients with LVEF <30% (OR: 2.96, 95% CI: 1.80-4.87) and those with LVEF ≥30% (OR: 3.97, 95% CI: 2.97-5.31), ( p = 0.13). Conclusions : This meta-analysis suggested that LGE-MRI serves as a reliable predictor of LVRR in patients with NICM, regardless of left ventricular dilation or baseline LVEF classification.

Introduction: A recent scoping review identified histological chorioamnionitis (HCA), small for gestational age (SGA), and bubbly/cystic appearance on chest X-ray (bubbly/cystic CXR) as risk factors for severe bronchopulmonary dysplasia (BPD). To further validate these results, a large-scale database was analyzed., Methods: This retrospective multicenter cohort study included infants born at <28 weeks' gestational age between 2003 and 2016. The validated risk factors identified from the scoping review were analyzed for independent associations with severe BPD using multivariable logistic regression. Additionally, the association of these factors with long-term outcomes at 3 years, including home oxygen therapy (HOT) and neurodevelopmental impairments (NDIs), was analyzed., Results: Among 15,834 extremely preterm infants, HCA, SGA, and bubbly/cystic CXR on postnatal day 28 were significantly and independently associated with severe BPD (adjusted odds ratio, 1.20; 95% confidence interval, 1.06-1.36) (1.73; 1.51-1.98) (1.79; 1.60-2.01), respectively. These three factors were also linked to HOT at 3 years (1.54; 1.14-2.08) (1.70; 1.21-2.39) (2.63; 1.94-3.56), respectively. Their combination significantly increased the prevalence of severe BPD and HOT at 3 years, particularly with bubbly/cystic CXR. Only SGA was independently associated with NDIs in BPD infants (1.55; 1.32-1.83)., Conclusions: HCA, SGA, and bubbly/cystic CXR on postnatal day 28 were identified as important risk factors for severe BPD and long-term respiratory outcomes. While further research is needed to validate their role in endotype-specific classification of BPD, these findings may contribute to early prognostic strategies and targeted interventions before 36 weeks' postmenstrual age., (© 2025 The Author(s). Published by S. Karger AG, Basel.)

We develop a data harmonization approach for C. elegans volumetric microscopy data, consisting of a standardized format, pre-processing techniques, and human-in-the-loop machine-learning-based analysis tools. Using this approach, we unify a diverse collection of 118 whole-brain neural activity imaging datasets from five labs, storing these and accompanying tools in an online repository WormID (wormid.org). With this repository, we train three existing automated cell-identification algorithms, CPD, StatAtlas, and CRF&#95;ID, to enable accuracy that generalizes across labs, recovering all human-labeled neurons in some cases. We mine this repository to identify factors that influence the developmental positioning of neurons. This growing resource of data, code, apps, and tutorials enables users to (1) study neuroanatomical organization and neural activity across diverse experimental paradigms, (2) develop and benchmark algorithms for automated neuron detection, segmentation, cell identification, tracking, and activity extraction, and (3) share data with the community and comply with data-sharing policies., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.)

Calcium-phosphate cement (CPC), commonly used as a bone graft substitute, sets as hydroxyapatite (HAp) and remains in the body for extended periods. To enhance bioresorbabability, we developed a chelate-setting tricalcium β-phosphate (β-TCP) cement using inositol phosphate (IP6) surface modification. By incorporating poly(lactic-co-glycolic acid) (PLGA) particles as a pore-forming agent and calcium sulfate hemihydrate (CSH) to this CPC, we created an organic/inorganic hybrid cement combining bioresorbability with favorable material properties. In this study, varying amounts of PLGA particles were added alongside CSH, and the resulting cement's properties, cytotoxicity, and in vivo response large animals (pigs) were assessed. The cement exhibited a compressive strength of ∼ 30 MPa and set within 15 min, making it suitable for clinical use. Cytotoxicity tests using Transwell® demonstrated cell growth in all cement specimens. In a pig tibia model, the amount of PLGA particle of 5 mass%, 10 mass%, and 20 mass% were tested to optimize material resorption and bone formation, compared with commercial HAp-based CPCs. Histological evaluations showed that higher amount of PLGA particles (10 mass% and 20 mass%) led to increased material resorption but impaired bone formation. The cement containing 5 mass% PLGA particles achieved the best balance, promoting the highest rate of bone formation. Thus, 5 mass% PLGA is the optimal amount for balancing resorption and bone regeneration in β-TCP cement. This formulation is expected to serve as a fully absorbable hybrid paste-type artificial bone supporting bone remodeling cycles., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2025 The Author(s).)