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Abstract Recently, in Hepatocellular carcinoma (HCC) setting, the use of metformin has been associated to a trend toward worse response rate, overall survival and progression free survival in patients who received immunotherapy. The study population included individuals from both Eastern and Western regions with a confirmed diagnosis of HCC and receiving first line treatment with Atezolizumab plus bevacizumab or Lenvatinib. Univariate and multivariate analyses were performed by Cox proportional. For the analysis, patients were stratified based on their use of concomitant medication or not. At the time of database lock, 319 deaths were observed: 209 in the Lenvatinib cohort, 110 in the Atezolizumab plus bevacizumab cohort. In the Atezolizumab plus Bevacizumab arm, 50 (16.5%) patients were on chronic metformin use. At the univariate analysis for OS, patients who used metformin showed significantly shorter OS compared to patients who did not use metformin (HR 1.9, 95% CI 1.1–3.2). Multivariate analysis confirmed that patients in metformin group had significantly shorter OS compared to patients in no-metformin group (HR 1.9; 95% CI 1.1–3.1). At the univariate analysis for PFS, patients in metformin group had significantly shorter PFS compared to patients in no-metformin group (HR 1.6, 95% CI 1.0–2.6). Multivariate analysis confirmed that patients in metformin group had significantly shorter PFS compared to patients in no-metformin group (HR 1.7; 95% CI 1.1–2.7; p = 0.0147). No differences were reported in terms of ORR and DCR between patients in metformin group and those in no-metformin group. In the Lenvatinib cohort, 65 (15%) patients were recorded to chronically use metformin. No statistically significant differences in terms of both OS and PFS were found between patients in metformin group and patients in no-metformin group. This analysis unveils a negative prognostic role associated with metformin use specifically within the Atezolizumab plus Bevacizumab group.

Abstract Background The continuation rates of pharmacotherapy in schizophrenia exhibit variability, a phenomenon influenced by the specific antipsychotic agent prescribed and patient-related factors such as age and duration of illness. In this context, our study aims to elucidate the predictors of medication continuation for asenapine sublingual tablets, characterized by unique formulation properties. Methods Our investigation leveraged real-world data collected through post-marketing surveillance in Japan, comprising 3236 cases. Utilizing multivariate logistic regression analysis, we identified patient-related factors associated with medication continuation as the primary outcome measure, subsequently employing survival analysis for further evaluation. Additionally, adverse event occurrence was assessed as a secondary outcome measure. Results Multivariate logistic regression analysis unveiled significant predictors of asenapine continuation, notably including patient-related factors such as a chlorpromazine equivalent dose exceeding 600 mg/day and an illness duration of 25 years or more. While the overall continuation rate stood at 40.6%, patients exhibiting factors such as a chlorpromazine equivalent dose surpassing 600 mg/day or an illness duration exceeding 25 years demonstrated continuation rates of 46.3% and 47.9%, respectively. Remarkably, patients presenting both factors showcased the highest continuation rate at 52.5%. Conclusions Our findings shed light on distinct patient-related predictors of asenapine continuation, deviating from those observed with other antipsychotic medications. This underscores the necessity of recognizing that predictive factors for antipsychotic medication continuation vary across different agents. Moving forward, elucidating these predictive factors for various antipsychotic medications holds paramount importance in schizophrenia treatment, facilitating the delivery of tailored therapeutic interventions for individual patients.

Background: Continuous local antibiotic perfusion (CLAP) is a method for preserving tissue and function against surgical site infections (SSIs) after shoulder surgery. Methods: To describe the application of the novel CLAP technique to 10 patients with SSIs after shoulder surgery that were not controlled with repeated surgical débridement or elderly patients who are insufficient physical resilience for further surgeries. Results: CLAP, consisting of gentamicin, was performed for 2 weeks, after which the infection was well-controlled. The white blood cell count and C-reactive protein level improved rapidly within 1 week of initiating CLAP, after which the patients were switched to oral antibiotics for 3 months. None of the patients experienced any adverse events. Conclusion: CLAP for SSIs after shoulder surgery was successful in preserving implants and grafts. The SSIs were controlled with no adverse events. CLAP may be an important treatment option for SSIs after shoulder surgery.

We determined the complete mitochondrial DNA sequence of a Biwa goby, Gymnogobius isaza (Tanaka, 1916) using next-generation sequencing methods. The composition of its mitogenome is the same as that observed in most other vertebrates, comprising of 13 protein-coding genes, 22 tRNA genes, two rRNA genes, and two control regions. Our molecular phylogenetic analysis confirmed the close phylogenetic relationship between G. isaza and G. petschiliensis. This mitogenome information will be useful for distribution surveys using environmental DNA and the development of conservation strategies for this species.

Point clouds acquired by Mobile Mapping System (MMS) are useful for creating 3D maps that can be used for autonomous driving and infrastructure development. However, many applications require semantic labels to each point of the point clouds, and the manual labeling process is very time consuming and expensive. Therefore, there is a strong need to develop a method to automatically assigning semantic labels. For automatic labeling tasks, classification methods using multiscale features are effective because multiscale features include features of various scales of roadside objects. Multiscale features are calculated using points inside spheres of multiscale radii centered at each point in a point cloud. When calculating multiscale features that are useful for classifying MMS point clouds, it is necessary to calculate features using relatively large radii. However, when calculating multiscale features using wide range of neighbor points, existing methods, such as kd-tree, require unacceptably long computation time for neighbor search. In this paper, we propose a method to calculate multiscale features in practical time for semantic labeling of large-scale point clouds. In our method, an MMS point cloud is first divided into small spherical regions. Then, radius search using multiscale radii is performed, and multiscale features are calculated using those neighbor points. Our experimental results showed that our method achieved significantly faster computational performance than conventional methods, and multiscale features could be calculated from large-scale point clouds in practical time.

Interstitial lung disease (ILD) is a serious complication of connective tissue diseases (CTDs). The heterogeneity of ILDs reflects differences in pathogenesis among diseases. This study aimed to clarify the characteristics of CTD-ILDs via a detailed analysis of the bronchoalveolar lavage fluid (BALF) and blood immune cells. BALF and blood samples were collected from 39 Japanese patients with newly diagnosed ILD: five patients with Sjögren’s syndrome (SS), eight patients with dermatomyositis (DM), six patients with rheumatoid arthritis (RA), six patients with systemic sclerosis, four patients with anti-neutrophil cytoplasmic antibody-associated vasculitis, and 10 patients with idiopathic interstitial pneumonia. We performed single-cell RNA sequencing to analyze the gene expression profiles in these patients’ immune cells. In patients with SS, B cells in the BALF were increased and genes associated with the innate and acquired immunity were enriched in both the BALF and blood. In contrast, patients with DM showed an upregulation of genes associated with viral infection in both the BALF and blood. In patients with RA, neutrophils in the BALF tended to increase, and their gene expression patterns changed towards inflammation. These disease-specific characteristics may help us understand the pathogenesis for each disease and discover potential biomarkers.

The comprehensive understanding of the local structural changes surrounding lithium in lithium silicate (LixSiOy) and silicide (LixSi) within Li/SiOx batteries during the reversible structural transformations has been hindered by the limitations of current methodologies. In this work, the evolution of electronic structure at various lithiation stages has been addressed well by examining the Li K-edge spectra through X-ray Raman spectroscopy (XRS). The features observed in the Li K-edge XRS spectra provide insights into the development and alteration of LixSiOy, which emerges in the initial phases and may be accompanied by a reduction in the ionicity of Li–O bonding during lithiation. These features also agree well with the accompanying FDMNES code simulation. The correlation between electrochemical mechanisms and spectral characteristics is further explored by applying pseudo-Voigt peaks and cumulative pseudo-Voigt functions for fitting purposes. The absence of a significant edge shift indicates a similarity in the electronic structure of LixSi throughout lithiation, and no evidence of Li2O formation has also been observed. The Li K-edge XRS spectra exhibit strong agreement with the electrochemical behavior, establishing it as a valuable tool for investigating the evolution of electronic structure in Li/SiOx batteries.

Abstract A ternary catalyst comprising Iridium (Ir) single‐atoms (SA)s decorated on the Co‐oxide supported palladium (Pd) nanoparticles (denoted as CPI‐SA) is developed in this work. The CPI‐SA with 1 wt.% of Ir exhibits unprecedented high mass activity (MA) of 7173 and 770 mA mgIr−1, respectively, at 0.85 and 0.90 V versus RHE in alkaline ORR (0.1 m KOH), outperforming the commercial Johnson Matthey Pt catalyst (J.M.‐Pt/C; 20 wt.% Pt) by 107‐folds. More importantly, the high structural reliability of the Ir single‐atoms endows the CPI‐SA with outstanding durability, where it shows progressively increasing MA of 13 342 and 1372 mA mgIr−1, respectively, at 0.85 and 0.90 V versus RHE up to 69 000 cycles (3 months) in the accelerated degradation test (ADT). Evidence from the in situ partial fluorescence yield X‐ray absorption spectroscopy (PFY‐XAS) and the electrochemical analysis indicate that the Ir single‐atoms and adjacent Pd domains synergistically promote the O2 splitting and subsequent desorption of hydroxide ions (OH−), respectively. Whereas the Co‐atoms underneath serve as electron injectors to boost the ORR activity of the Ir single‐atoms. Besides, a progressive and sharp drop in the ORR performance is observed when Ir‐clusters and Ir nanoparticles are decorated on the Co‐oxide‐supported Pd nanoparticles.

Backgrounds Permanent pacemaker implantation (PPMI) is one of the greatest disadvantages of transcatheter aortic valve implantation (TAVI). To seek the predictors and clinical impacts of PPMI and investigate the recovery rate from conduction disorders.Methods We retrospectively analysed data from 745 consecutive patients who underwent TAVI for severe aortic stenosis from November 2013 to July 2022. The ventricular pacing (VP) rate was recorded at 1 and 6 months after PPMI and the recovery from conduction disorders was defined as the VP rate

Background: The clinical impact of signs of life (SOLs) in traumatic cardiac arrest (TCA) remains to be elucidated. The aim of this study was to examine the association between SOLs and survival/neurological outcomes in TCA patients. Methods: Retrospective data from the Japan Trauma Data Bank (2019–2021) was reviewed. TCA patients were assigned to one of two study groups based on the presence or absence of SOLs and compared. SOLs were defined as having at least one of following criteria: pulseless electrical activity >40 beats per minute, gasping, positive light reflex, or extremity/eye movement at hospital arrival. The primary outcome was survival at hospital discharge. The secondary outcome was favorable neurological status (Glasgow Outcome Scale score of 4 or 5) at hospital discharge. Results: A total of 1,981 patients (114 with SOLs and 1,867 without SOLs) were included. Characteristics of patients were as follows: age (median age 60.0 years old [interquartile range: 41–80] years vs. 55.4 [38–75] years), gender (male: 76/114 (66.7%) vs. 1,207/1,867 (65.0%), blunt trauma (90/111 [81.1%] vs. 1,559/1,844 [84.5%]), Injury Severity Score (29.2 [22–41] vs. 27.9 [20–34]). Patients with SOLs showed higher survival (10/114 (8.8%) vs. 25/1,867 (1.3%), OR 1.96 [CI 1.20–2.72]) and higher favorable neurological outcomes (4/110 (3.5%) vs. 6/1,865 (0.3%), OR 2.42 [CI 1.14–3.70]) compared with patients without SOLs. Conclusions: TCA patients with SOLs at hospital arrival showed higher survival and favorable neurological outcomes at hospital discharge compared with TCA patients without SOLs.