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Abstract Punishment serves as a balancing force that dissuades people from acting selfishly, which complements cooperation as an essential characteristic for the prosperity of human societies. Past studies using economic games with two options (cooperation and defection) reported that cooperation decisions are generally faster than defection decisions and that time pressure possibly induces human players to be more intuitive and thus cooperative. However, it is unclear where punishment decisions sit on this time spectrum. Therefore, we recruited human players and implemented two series of online network games with cooperation, defection, and punishment options. First, we find that punishment decisions are slower than cooperation or defection decisions across both game series. Second, we find that imposing experimental time pressure on in-game decisions neither reduces nor increases the frequency of punishment decisions, suggesting that time pressure may not directly interact with the mechanisms that drive players to choose to punish.

Abstract Background Malaria is a major cause of mortality and morbidity in Uganda. Despite Uganda’s efforts to distribute bed nets, only half of households have achieved the World Health Organization (WHO) Universal Coverage Criteria (one bed net for every two household members). The role of peer influence on bed net ownership remains underexplored. Data on the complete social network of households were collected in a rural parish in southwestern Uganda to estimate the association between household bed net ownership and peer household bed net ownership. Methods Data on household sociodemographics, bed net ownership, and social networks were collected from all households across one parish in southwestern Uganda. Bed nets were categorized as either purchased or free. Purchased and free bed net ownership ratios were calculated based on the WHO Universal Coverage Criteria. Using network name generators and complete census of parish residents, the complete social network of households in the parish was generated. Linear regression models that account for network autocorrelation were fitted to estimate the association between households’ bed net ownership ratios and bed net ownership ratios of network peer households, adjusting for sociodemographics and network centrality. Results One thousand seven hundred forty-seven respondents were interviewed, accounting for 716 households. The median number of peer households to which a household was directly connected was 7. Eighty-six percent of households owned at least one bed net, and 41% of households met the WHO Universal Coverage Criterion. The median bed net ownership ratios were 0.67 for all bed nets, 0.33 for free bed nets, and 0.20 for purchased bed nets. In adjusted multivariable models, purchased bed net ownership ratio was associated with average household wealth among peer households (b = 0.06, 95% CI 0.03, 0.10), but not associated with average purchased bed net ownership ratio of peer households. Free bed net ownership ratio was associated with the number of children under 5 (b = 0.08, 95% CI 0.05, 0.10) and average free bed net ownership ratios of peer households (b = 0.66, 95% CI 0.46, 0.85). Conclusions Household bed net ownership was associated with bed net ownership of peer households for free bed nets, but not for purchased bed nets. The findings suggest that public health interventions may consider leveraging social networks as tools for dissemination, particularly for bed nets that are provided free of charge.

Retention in healthcare and health behavior remains a critical issue, contributing to inequitable distribution of intervention benefits. In diseases such as HIV, where half of the new infections occur among racial and sexual minorities, it is important that interventions do not enlarge pre-existing health disparities. To effectively combat this public health issue, it is crucial that we quantify the magnitude of racial/ethnic disparity in retention. Further, there is a need to identify mediating factors to this relationship to inform equitable intervention design. In the present study, we assess the racial/ethnic disparity in retention in a peer-led online behavioral intervention to increase HIV self-testing behavior and identify explanatory factors. The research used data collected from the Harnessing Online Peer Education (HOPE) HIV Study that included 899 primarily African American and Latinx men who have sex with men (MSM) in the United States. Results show that African American participants had higher lost-to-follow-up rates at 12-week follow-up compared to Latinx participants (11.1% and 5.8% respectively, Odds Ratio = 2.18, 95% confidence interval: 1.12 – 4.11, p = 0.02), which is substantially mediated by participants’ self-rated health score (14.1% of the variation in the African American v.s. Latinx difference in lost-follow-up, p = 0.006). Thus, how MSM perceive their health may play an important role in their retention in HIV-related behavioral intervention programs and its racial/ethnic disparity.

Abstract Background Few studies have examined prognostic outcomes-associated molecular signatures other than overall survival (OS) for gastric cancer (GC). We aimed to identify DNA methylation biomarkers associated with multiple prognostic outcomes of GC in an epigenome-wide association study. Methods Based on the Cancer Genome Atlas (TCGA), DNA methylation loci associated with OS (n = 381), disease-specific survival (DSS, n = 372), and progression-free interval (PFI, n = 383) were discovered in training set subjects (false discovery rates

Thailand has the highest road traffic fatality rate in Southeast Asia, making road safety a critical public health concern. A 2015 World Health Organization (WHO) Report showed that speeding behavior was the most important determinant for road traffic crashes in Thailand. Here, we aimed to examine associations of socio-demographic factors (gender, age, socioeconomic status) with self-reported motorcycle speeding behavior. Additionally, we examined a potential role of time discounting and risk preference as mediators in the association of socio-demographic factors with speeding. We used data obtained from the Mahasarakham University Social Network Survey 2018 (MSUSSS) (N = 150). We ran linear network autocorrelation models (lnam) to account for the data's social network structure. We found that males are more likely than females to engage in speeding behavior (β = 0.140, p = 0.001) and to discount the future (β = 5.175, p = 0.017). However, further causal mediation analysis showed that time discounting does not mediate the gender-speeding association (p for mediation = 0.540). Although socioeconomic status (subjective social class) was not associated with speeding (β = 0.039, p = 0.177), age was marginally associated with speeding (β = 0.005, p = 0.093). Future studies may consider using a larger sample.

Social connections are mutable. Prior experimental work has shown that circumstances fostering an intermediate rate of forming and breaking social ties (“network fluidity”) facilitate the maintenance of optimal levels of cooperation in experimental social networks. Previous observational work has also suggested a relationship between economic outcomes and network structure (measured statically) at a geographic level. However, it is not known how network fluidity might affect economic growth and inequality, particularly in an experimental setting. Using data from a series of online experiments involving a public goods game in 90 independent, dynamic social networks (with N=1,529 subjects), we show that increasing network fluidity simultaneously achieves the highest level of economic growth and the lowest level of economic inequality, up to a point. These effects of network fluidity on economic outcomes are mediated, in these experiments, by the levels of cooperation and tie formation that subjects evince. Finally, we show that wealthier networks are less unequal. Social network fluidity may play an important role in economic outcomes and hence in social welfare.

Two separate bodies of work have examined whether culture affects cooperation in economic games and whether cooperative or non-cooperative decisions occur more quickly. Here, we connect this work by exploring the relationship between decision time and cooperation in American versus Indian subjects. We use a series of dynamic social network experiments in which subjects play a repeated public goods game: 80 sessions for a total of 1,462 subjects (1,059 from the United States, 337 from India, and 66 from other countries) making 13,560 decisions. In the first round, where subjects do not know if connecting neighbors are cooperative, American subjects are highly cooperative and decide faster when cooperating than when defecting, whereas a majority of Indian subjects defect and Indians decide faster when defecting than when cooperating. Almost the same is true in later rounds where neighbors were previously cooperative (a cooperative environment) except decision time among Indian subjects. However, when connecting neighbors were previously not cooperative (a non-cooperative environment), a large majority of both American and Indian subjects defect, and defection is faster than cooperation among both sets of subjects. Our results imply the cultural background of subjects in their real life affects the speed of cooperation decision-making differentially in online social environments.

ObjectiveTo examine the consequences of early-onset hearing loss on several social and health measures and any related gender differences in Japanese populations.MethodsData from a 2007 nationally representative cross-sectional household survey of 136,849 men and women aged 20 to 39 years were obtained (prevalence of self-reported hearing loss: 0.74%). We focused particularly on four social and health measures: employment status (employed/unemployed), marital status (married/unmarried), smoking behavior (yes/no), and psychological distress (K6 instrument: ≥ 5 or not). We examined the association of hearing loss for each measure using generalized estimating equations to account for correlated individuals within households.FindingsThere was no significant association with employment status (p = 0.447). Men with hearing loss were more likely to be married, whereas women with hearing loss were less likely to be married (p < 0.001 for interaction). Although hearing loss was not associated with a current smoking status in men, women with hearing loss were more likely to be current smokers (p < 0.001 for interaction). Moreover, hearing loss was associated with psychological distress in men and women (both p < 0.001).ConclusionThese findings suggest that hearing loss is related to social and health issues in daily life, including a lower likelihood of marriage, more frequent smoking, and poorer mental health, especially in women. These issues may reflect a gap between the actual needs of women with hearing loss and the formal support received as a result of existing public health policies in Japan.

Analysis of acetylation and tri-methylation of the same residue of histone molecules might identify a subset of hepatocellular carcinoma (HCC) with aggressive behavior. In the present study, we examined acetylation and tri-methylation of lysine 27 on histone H3 (H3K27ac and H3K27me3, respectively) because these two modifications are known to exhibit opposite effects (enhancing and silencing) on gene expression. Neoplastic and non-neoplastic tissues from 198 HCC cases were immunostained with specific monoclonal antibodies against H3K27ac and H3K27me3. The stained tissues were evaluated by an image analyzing program to generate histological scores (H-scores, range 0-300), which were determined by multiplying the percentage of positive-stained cells with the classified immunohistochemical marker intensity (0-3). HCC tissues showed significantly higher H3K27ac (156.7±86.8) and H3K27me3 H-scores (151.8±78.1) compared with the background liver (40.3±33.0 and 64.7±45.6, respectively) (both P

OBJECTIVE: To assess the effect on out-of-pocket medical spending and physical and mental health of Japan's reduction in health-care cost sharing from 30% to 10% when people turn 70 years of age. METHODS: Study data came from a 2007 nationally-representative cross-sectional survey of 10 293 adults aged 64 to 75 years. Physical health was assessed using a 16-point scale based on self-reported data on general health, mobility, self-care, activities of daily living and pain. Mental health was assessed using a 24-point scale based on the Kessler-6 instrument for nonspecific psychological distress. The effect of reduced cost sharing was estimated using a regression discontinuity design. FINDINGS: For adults aged 70 to 75 years whose income made them ineligible for reduced cost sharing, neither out-of-pocket spending nor health outcomes differed from the values expected on the basis of the trend observed in 64- to 69-year-olds. However, for eligible adults aged 70 to 75 years, out-of-pocket spending was significantly lower (P < 0.001) and mental health was significantly better (P < 0.001) than expected. These differences emerged abruptly at the age of 70 years. Moreover, the mental health benefits were similar in individuals who were and were not using health-care services (P = 0.502 for interaction). The improvement in physical health after the age of 70 years in adults eligible for reduced cost-sharing tended to be greater than in non-eligible adults (P = 0.084). CONCLUSION: Reduced cost sharing was associated with lower out-of-pocket medical spending and improved mental health in older Japanese adults.

BACKGROUND: Studies have reported that the predictive ability of self-rated health (SRH) for mortality varies by sex/gender and socioeconomic group. The purpose of this study is to evaluate this relationship in Japan and explore the potential reasons for differences between the groups. METHODOLOGY/PRINCIPAL FINDINGS: The analyses in the study were based on the Aichi Gerontological Evaluation Study's (AGES) 2003 Cohort Study in Chita Peninsula, Japan, which followed the four-year survival status of 14,668 community-dwelling people who were at least 65 years old at the start of the study. We first examined sex/gender and education-level differences in association with fair/poor SRH. We then estimated the sex/gender- and education-specific hazard ratios (HRs) of mortality associated with lower SRH using Cox models. Control variables, including health behaviors (smoking and drinking), symptoms of depression, and chronic co-morbid conditions, were added to sequential regression models. The results showed men and women reported a similar prevalence of lower SRH. However, lower SRH was a stronger predictor of mortality in men (HR = 2.44 [95% confidence interval (CI): 2.14-2.80]) than in women (HR = 1.88 [95% CI: 1.44-2.47]; p for sex/gender interaction = 0.018). The sex/gender difference in the predictive ability of SRH was progressively attenuated with the additional introduction of other co-morbid conditions. The predictive ability among individuals with high school education (HR = 2.39 [95% CI: 1.74-3.30]) was similar to that among individuals with less than a high school education (HR = 2.14 [95% CI: 1.83-2.50]; p for education interaction = 0.549). CONCLUSIONS: The sex/gender difference in the predictive ability of SRH for mortality among this elderly Japanese population may be explained by male/female differences in what goes into an individual's assessment of their SRH, with males apparently weighting depressive symptoms more than females.

A recent modelling paper on the coronavirus disease 2019 (COVID-19) epidemic in the US (Bartsch et al.) suggested that maintaining face mask use until a high vaccine coverage (70–90%) is achieved is generally cost-effective or even cost-saving in many of the scenarios considered. Their conclusion was based on the assumed effectiveness of continued face mask use, cited from a study that reported an 18% reduction in the effective reproduction number associated with the introduction of state-level mask mandate policies in the US in the summer of 2020. However, using this value implicitly assumes that the effect of face mask use in 2021 through 2022 is the same as that of summer 2020, when stringent nonpharmaceutical interventions were in place. The effectiveness of universal mask wearing in 2021–2022 is probably more uncertain than considered in Bartsch et al. and rigorous sensitivity analysis on this parameter is warranted.

Abstract Introduction Tooth extraction is one of the clinical internship requirements in Japan. Human posture during tooth extraction is important since poor posture can cause failure of the safe operation and musculoskeletal injuries. Only a few studies aimed to evaluate the posture, but most of them used manual or complex measurement methods which can lead to some inconvenient problems such as subjective biases, quantitativeness, and device availability. Thanks to the recent advancement of computer vision and technology, pose estimation has been widely used for kinematic analysis. However, none of the research has been used for posture analysis during tooth extraction. Aim Therefore, this research aims to analyze posture kinematics during tooth extraction using pose estimation and find key kinematic variables for tooth extraction. Method All participants were grouped into three; dental students, young dentists, and experienced dentists. They were asked to perform tooth extraction on a tooth extraction simulator while being video recorded. Pose estimation was used to extract joint locations on recorded videos. Joint angles of interest were calculated based on the extracted joint locations. Results Right shoulder angles were significantly lower in the experienced dentists’ group than in other groups, Discussion Which has been pointed out by other research as a crucial point. Conclusion Although sample size is a main concern in this study, the result shows that pose estimation can be useful in posture analysis during tooth extraction.

Background: Studies have suggested Medicaid expansion enacted in 2014 has resulted in a reduction in overall cardiovascular disease (CVD) mortality in the United States. However, it is unknown whether Medicaid expansion has a similar effect across race-ethnicity and sex. We investigated the effect of Medicaid expansion on CVD mortality across race-ethnicity and sex. Methods: Data come from the behavioral risk factor surveillance system and the US Centers for Disease Control's Wide-ranging Online Data for Epidemiologic Research, spanning the period 2000-2019. We used the generalized synthetic control method, a quasiexperimental approach, to estimate effects. Results: Medicaid expansion was associated with -5.36 (mean difference [MD], 95% confidence interval [CI] = -22.63, 11.91) CVD deaths per 100,000 persons per year among Blacks; -4.28 (MD, 95% CI = -30.08, 21.52) among Hispanics; -3.18 (MD, 95% CI = -8.30, 1.94) among Whites; -5.96 (MD, 95% CI = -15.42, 3.50) among men; and -3.34 (MD, 95% CI = -8.05, 1.37) among women. The difference in mean difference (DMD) between the effect of Medicaid expansion in Blacks compared with Whites was -2.18; (DMD, 95% CI = -20.20, 15.83); between that in Hispanics compared with Whites: -1.10; (DMD, 95% CI = -27.40, 25.20) and between that in women compared with men: 2.62; (DMD, 95% CI = -7.95, 13.19). Conclusions: Medicaid expansion was associated with a reduction in CVD mortality overall and in White, Black, Hispanic, male, and female subpopulations. Also, our study did not find any difference or disparity in the effect of Medicaid on CVD across race-ethnicity and sex-gender subpopulations, likely owing to imprecise estimates. [ABSTRACT FROM AUTHOR]

Abstract Introduction The COVID-19 pandemic has severely impacted the health and education of learners globally. However, there is a lack of information on enablers and barriers to the implementation of comprehensive school health policies during the pandemic. Methods This study utilized a case study design, and was conducted in the Division of City Schools of Navotas. A desk review of relevant school health policies released at the national level by the Department of Education and Department of Health during the pandemic was performed. The collected policies were classified if they were related to the Preparedness/Prevention Phase, Early Phase Response, and Chronic Phase Response. Focus group discussions and key a informant interview were conducted to determine the enablers and barriers in implementing school health programs during the pandemic. The identified themes were created deductively by using categories from Whitman’s Wheel of Factors influencing Implementation of Policy and Practice. Results Policies under the Preparedness/Prevention Phase focused on providing a comprehensive healthy school environment for learners, including Water, Sanitation, and Hygiene (WASH) in Schools. Early Phase Response policies included school closures and public health guidelines to prevent further spread of disease. The policies under the Chronic Phase/Response notably included guidelines for implementation of vaccination days and reopening of classes. Most of the factors identified were categorized under Whitman’s wheel of factors. Conclusions Despite COVID-19 restrictions, health policy implementation continued because of the collaborations, innovations, and leadership of various stakeholders. The vaccination of the public, including the pediatric population was implemented through the collaboration of various agencies. WASH in Schools was evident in policies regarding the guidelines on prevention of the spread of disease. The data provided in this study will serve as a guide to address the barriers and further strengthen the implementation of these policies.

Abstract Precision medicine has drastically changed cancer treatment strategies including KRAS-mutant cancers which have been undruggable for decades. While intrinsic or acquired treatment resistance remains unresolved in many cases, epigenome-targeted therapy may be an option to overcome. We recently discovered the effectiveness of blocking small ubiquitin-like modifier (SUMO) signaling cascade (SUMOylation) in MYC-expressing KRAS-mutant cancer cells using a SUMO-activating enzyme E inhibitor TAK-981 that results in SUMOylation inhibition. Interestingly, TAK-981 promoted the degradation of MYC via the ubiquitin–proteasome system. Moreover, combination therapy with TAK-981 and MEK inhibitor trametinib remarkably regressed xenografted KRAS-mutant tumors by accumulating DNA damage and inducing apoptosis. Whereas our recent study revealed immune-independent antitumor efficacy, we evaluated the immune responses of cancer cells and immune cells in this study. We found that TAK-981-induced MYC downregulation promoted the activation of STING followed by Stat1 and MHC class I in KRAS-mutant cancer cells. Activation of dendritic cells or T cells treated with TAK-981 was also verified by upregulated activation markers in dendritic cells or skew-toward effector-like phenotypes in T cells. Furthermore, the enhanced immune-dependent antitumor efficacy of the combination therapy with TAK-981 and trametinib was confirmed by infiltration of immune cells into tumor tissues and immunodepleting-test using immunodepleting antibodies in syngeneic immunocompetent mouse models. Together with our recent study and here, the findings support that combination inhibition of SUMOylation and MEK comprehensively conquers MYC-expressing KRAS-mutant cancers by both immune-dependent and immune-independent antitumor responses.

Abstract Aims/Introduction This study aimed to characterize the global cognition and executive functions of older adults with type 1 diabetes mellitus in comparison with type 2 diabetes mellitus. Materials and Methods This study included 37 patients with type 1 diabetes mellitus aged ≥65 years and 37 age‐ and sex‐matched patients with type 2 diabetes mellitus. Patients with dementia scoring

Abstract Background KRAS mutations frequently occur in cancers, particularly pancreatic ductal adenocarcinoma, colorectal cancer, and non-small cell lung cancer. Although KRAS G12C inhibitors have recently been approved, effective precision therapies have not yet been established for all KRAS-mutant cancers. Many treatments for KRAS-mutant cancers, including epigenome-targeted drugs, are currently under investigation. Small ubiquitin-like modifier (SUMO) proteins are a family of small proteins covalently attached to and detached from other proteins in cells via the processes called SUMOylation and de-SUMOylation. We assessed whether SUMOylation inhibition was effective in KRAS-mutant cancer cells. Methods The efficacy of the first-in-class SUMO-activating enzyme E inhibitor TAK-981 (subasumstat) was assessed in multiple human and mouse KRAS-mutated cancer cell lines. A gene expression assay using a TaqMan array was used to identify biomarkers of TAK-981 efficacy. The biological roles of SUMOylation inhibition and subsequent regulatory mechanisms were investigated using immunoblot analysis, immunofluorescence assays, and mouse models. Results We discovered that TAK-981 downregulated the expression of the currently undruggable MYC and effectively suppressed the growth of MYC-expressing KRAS-mutant cancers across different tissue types. Moreover, TAK-981-resistant cells were sensitized to SUMOylation inhibition via MYC-overexpression. TAK-981 induced proteasomal degradation of MYC by altering the balance between SUMOylation and ubiquitination and promoting the binding of MYC and Fbxw7, a key factor in the ubiquitin–proteasome system. The efficacy of TAK-981 monotherapy in immunocompetent and immunodeficient mouse models using a mouse-derived CMT167 cell line was significant but modest. Since MAPK inhibition of the KRAS downstream pathway is crucial in KRAS-mutant cancer, we expected that co-inhibition of SUMOylation and MEK might be a good option. Surprisingly, combination treatment with TAK-981 and trametinib dramatically induced apoptosis in multiple cell lines and gene-engineered mouse-derived organoids. Moreover, combination therapy resulted in long-term tumor regression in mouse models using cell lines of different tissue types. Finally, we revealed that combination therapy complementally inhibited Rad51 and BRCA1 and accumulated DNA damage. Conclusions We found that MYC downregulation occurred via SUMOylation inhibition in KRAS-mutant cancer cells. Our findings indicate that dual inhibition of SUMOylation and MEK may be a promising treatment for MYC-expressing KRAS-mutant cancers by enhancing DNA damage accumulation.

Although prior studies have shown that consumers who perceive brand authenticity are more likely to spread word-of-mouth (WOM) recommendations, the underlying explanatory mechanism in the context of souvenir products in tourism remains unclear. To fill this gap, this study presents a hypothetical framework that elucidates the mechanisms through which brand authenticity influences positive WOM and identifies the boundary condition that enhances its effects, drawing on consumer inference theory. Through a survey conducted on a fictitious food souvenir brand in Uji City, Kyoto Prefecture, a prominent tourist destination in Japan, we confirm that a company’s commitment to the brand’s roots, as inferred from brand authenticity, mediates the relationship between brand authenticity and positive WOM. Additionally, we show that this indirect effect is strengthened by consumers’ perceptions of the craftsman’s passion. These findings offer novel insights into marketing communication strategies aimed at amplifying positive WOM for future food souvenirs in a tourism context.

We aim to derive a super-radiance solution of coherent light and sound waves involving water degrees of freedom in the environment of a microtubule. We introduce a Lagrangian density functional of quantum electrodynamics with non-relativistic charged bosons as a model of quantum brain dynamics (QBD) involving water molecular conformational states and photon fields. We also introduce the model of charged boson fields (water degrees of freedom) coupled with phonons. Both optical and acoustic super-radiance solutions are derived in our approach. An acoustic super-radiance mechanism involving information transfer is proposed as an additional candidate to solve the binding problem and to achieve acoustic holography. Our results can be applied to achieve holographic memory storage and information processing in QBD.

This study investigates the effects of consumers’ psychological ownership (PO) of payment methods on their willingness to pay (WTP) and willingness to accept (WTA). We conducted two experiments that focused on two types of payment methods: cash and mobile payments. In Experiment 1, participants were asked to read a fictitious purchasing scenario. We verified that a payment method with a lower PO tended to be selected at the point of purchase, resulting in a higher WTP. In Experiment 2, participants were assigned to read two of four fictitious buying and selling scenarios. We found that the payment method with a greater PO tended to be selected at the point of receipt, resulting in a lower WTA.

Abstract Background This study aimed to investigate the effect of the use of new lithotomy stirrups-2 on the pressure dispersal on lower limbs, which may lead to the prevention of well-leg compartment syndrome (WLCS) and deep venous thrombosis (DVT), which are the most commonly associated adverse events with laparoscopic and robot-assisted rectal surgery. Methods A total of 30 healthy participants were included in this study. The pressure (mmHg) applied on various lower limb muscles when using conventional lithotomy stirrups-1 and new type stirrups-2 was recorded in various lithotomy positions; 1) neutral position, 2) Trendelenburg position (15°) with a 0° right inferior tilt, and 3) Trendelenburg position (15°) with a 10° right inferior tilt. Using a special sensor pad named Palm Q®, and the average values were compared between two types of stirrups. Results The use of new lithotomy stirrups-2 significantly reduced the pressure applied on the lower limb muscles in various lithotomy positions compared with the use of lithotomy stirrups-1. The most pressured lower limb muscle when using both lithotomy stirrups was the central soleus muscle, which is the most common site for the development of WLCS and DVT. In addition, when using the conventional lithotomy stirrups-1, the pressure was predominantly applied to the proximal soleus muscle; however, when using lithotomy stirrups-2, the pressure was shifted to the more distal soleus muscle. Conclusion These results suggest that the new lithotomy stirrups-2 is useful in reducing the pressure load on leg muscles, especially on the proximal to central soleus, and may reduce the incidence of WLCS and DVT after rectal surgery performed in the lithotomy position. Further clinical studies are needed to determine whether the use of lithotomy stirrups-2 prevents these complications in various clinical settings.

We report a case of limited effectiveness of dabrafenib and trametinib in a 59-year-old man with poorly differentiated lung carcinoma and a rare BRAF K601E mutation. The patient, unresponsive to chemotherapy and immunotherapy, received these targeted agents as second-line treatment. Despite a notable initial response, tumor regression lasted only 52 days. A subsequent liquid biopsy revealed additional alterations (BRAF amplification, KIT amplification, TP53 S241F), indicating a complex resistance mechanism. This case underscores the challenges in treating BRAF K601E-mutant lung carcinoma, emphasizing the need for advanced molecular diagnostics, personalized approaches, and further research into more effective therapies for unique genetic profiles.

We analyzed the relationship between the nanometer-scale structure of amylopectin and physicochemical properties such as thermal properties of starch granules and higher-order internal structure of starch granules evaluated by using synchrotron radiation X-ray scattering and scanning electron microscopy. In this study, a line of allelic mutants of rice lacking in starch branching enzyme IIb (BEIIb) activity in their endosperm were used as starch sources. The crystal lattice changed from A-type to C- and B-type. The nanoscale cluster size, and higher-order structures of the starch granules varied among mutant lines. The thermal gelatinization properties of the rice-derived starch samples, as well as the dependence of this process on their crystal structure, were evaluated using differential scanning calorimetry and synchrotron X-ray scattering. After gelatinization, several nm-scaled density fluctuations owing to the formation of gel balls were observed. These fluctuations of all starch samples correlated with the cluster size decreased with the temperature.

Discontinuation of palliative radiotherapy due to a patient’s declining general condition poses a clinical dilemma for palliative care physicians. This study aimed to investigate the survival duration of patients whose performance status (PS) deteriorated during palliative radiotherapy and inform decisions regarding early treatment discontinuation. We retrospectively analyzed data from patients referred from our institute’s palliative care department who underwent ≥10 fractions of palliative radiotherapy between March 2017 and December 2021. PS was assessed using the Eastern Cooperative Oncology Group (ECOG) scale. Survival duration was calculated from the final day of palliative radiotherapy to death using the Kaplan–Meier method. A total of 35 patients underwent palliative radiotherapy. Seven (20%) experienced deterioration in ECOG PS during treatment. Their median survival duration was significantly shorter at 22 days (95% confidence interval: 1–94 days) compared to 125 days (95% confidence interval: 82–150 days) for the 28 patients whose PS remained stable (p = 0.0007). Deterioration in ECOG PS during palliative radiotherapy signifies a markedly shorter survival duration. Careful assessment of a patient’s condition throughout treatment is crucial, and early discontinuation should be considered if their general health worsens rather than strictly adhering to the initial schedule.

Abstract This study aimed to assess the performance of arterial-spin labeling MRA (ASL-MRA) for visualizing the external carotid artery (ECA) branches in comparison with time-of-flight MRA (TOF-MRA) and CT angiography (CTA). We retrospectively selected 31 consecutive patients, who underwent both MRAs and CTA, prior to the intra-arterial chemoradiotherapy (IACRT) for head and neck cancer. Four patients underwent IACRT bilaterally, so we analyzed 35 ECAs. Pseudo-continuous, three-dimensional ASL using a turbo field echo sequence was acquired. For the TOF-MRA and CTA, clinically used parameters were applied. Two observers evaluated each ECA branch with reference to the angiogram at the IACRT, using five-point scale, in consensus. Friedman test for multiple comparisons was applied. ASL-MRA and CTA better visualized the superior thyroid, lingual, facial, submental, transverse facial, and internal maxillary arteries (IMAs) better than TOF-MRA (p

We investigate Quantum Electrodynamics (QED) of water coupled with sound and light, namely Quantum Brain Dynamics (QBD) of water, phonons and photons. We provide phonon degrees of freedom as additional quanta in the framework of QBD in this paper. We begin with the Lagrangian density QED with non-relativistic charged bosons, photons and phonons, and derive time-evolution equations of coherent fields and Kadanoff–Baym (KB) equations for incoherent particles. We next show an acoustic super-radiance solution in our model. We also introduce a kinetic entropy current in KB equations in 1st order approximation in the gradient expansion and show the H-theorem for self-energy in Hartree–Fock approximation. We finally derive conserved number density of charged bosons and conserved energy density in spatially homogeneous system.

PURPOSETo retrospectively determine the diagnostic accuracy of a percutaneous core biopsy performed before cryoablation for small-sized renal cell carcinoma.METHODSIn this study, 216 patients underwent a percutaneous core biopsy for 242 renal lesions suspected to be renal cell carcinoma on image findings before cryoablation at Kyushu University Hospital. We calculated the success rate of the histological diagnosis and investigated factors that may have contributed to the diagnostic success. Complications caused by the biopsy procedure were also evaluated.RESULTSThe histological diagnosis was successful in 203 lesions (82.8%). The success rate of the histological diagnosis was 65.4% (34/52 cases) for tumors with a diameter of ≤15 mm and 88.9% (169/190 cases) for those >15 mm. Therefore, tumor diameter was a factor contributing to the histological diagnosis success rate in both univariate and multivariable analyses (P < 0.001). For lesions with a tumor diameter ≤15 mm, the histological diagnosis success rates increased from 50.0% to 76.2% in the presence of pre-lipiodol marking and to 85.7% when the biopsy procedure was performed separately from cryoablation; the latter was statistically significant (P = 0.039). Major complications that may have been caused by the biopsy procedure were grade 3 bleeding and tract seeding (one case each).CONCLUSIONPercutaneous core biopsy in cryoablation for small-sized renal cell carcinoma had a high diagnostic rate and was safely performed. For lesions with a tumor diameter ≤15 mm, a separate biopsy procedure and pre-lipiodol marking may improve the diagnostic accuracy.

Abstract To investigate the frequency of pneumonia and chest computed tomography (CT) findings in patients with coronavirus disease 2019 (COVID-19) during the fifth Delta variant-predominant and sixth Omicron variant-predominant waves of the COVID-19 pandemic in Okinawa, Japan. A survey on chest CT examinations for patients with COVID-19 was conducted byhospitals with board-certified radiologists who provided treatment for COVID-19 pneumonia in Okinawa Prefecture. Data from 11 facilities were investigated. Indications for chest CT; number of COVID-19 patients undergoing chest CT; number of patients with late-onset pneumonia, tracheal intubation, and number of deaths; and COVID-19 Reporting and Data System classifications of initial chest CT scans were compared by the chi-squared test between the two pandemic waves (Delta vs. Omicron variants). A total of 1944 CT scans were performed during the fifth wave, and 1178 were performed during the sixth wave. CT implementation rates, which were the number of patients with COVID-19 undergoing CT examinations divided by the total number of COVID-19 cases in Okinawa Prefecture during the waves, were 7.1% for the fifth wave and 2.1% for the sixth wave. The rates of tracheal intubation and mortality were higher in the fifth wave. Differences between the distributions of the CO-RADS classifications were statistically significant for the fifth and sixth waves (p