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Background: Despite the revolutionary impact of immune checkpoint inhibitors (ICIs) on the treatment of metastatic urothelial carcinoma (mUC), the clinical utility of reliable prognostic biomarkers to foresee survival outcomes remains underexplored. Objectives: The purpose of this study was to ascertain the prognostic significance of serum inflammatory markers in mUC patients undergoing ICI therapy. Design: This is a retrospective, multicenter study. Methods: Data were collected from two independent medical centers in Taiwan, encompassing a validation and a training cohort (TC). Patients with histopathologically confirmed urothelial carcinoma who received at least one cycle of ICI monotherapy were included. Serum inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated prior to ICI therapy. Statistical analyses involved the use of receiver operating characteristic (ROC) curves to determine optimal biomarker cutoffs and Cox proportional hazards models to evaluate the independent predictive capability of these markers. Results: A total of 192 patients were enrolled. In the univariate analysis, serum markers such as NLR, PLR, SII, and Hb were significantly associated with overall survival (OS) in both the training and validation cohorts (VC). White blood cells, NLR, and SII demonstrated a robust correlation with progression-free survival across both cohorts. Multivariate analysis revealed that Eastern Cooperative Oncology Group performance status ⩾2 (p < 0.001), visceral metastasis (p < 0.001), leukocytosis (p < 0.001), Hb levels ⩾10 mg/dL (p = 0.008), and NLR ⩾5 (p = 0.032) as independent predictors of OS. A prognostic nomogram integrating these independent factors yielded a C-index for a 3-year OS of 0.769 in the TC and 0.657 in the VC. Conclusion: Serum inflammatory markers, combined with clinicopathologic factors, provide a practical prognostic tool in mUC treatment with ICIs. Plain language summary: Using blood tests and health information to predict survival in bladder cancer patients receiving immune therapy Study overview Despite the success of new immune therapies in treating advanced bladder cancer, we still need better ways to predict how well patients will respond to treatment. Our study looked at certain blood tests that measure inflammation to see if they can help predict patient outcomes. What we did We reviewed the medical records of 192 patients with advanced bladder cancer who were treated at two medical centers in Taiwan. These patients had received immune therapy, and we analyzed their blood for signs of inflammation before they started treatment. We specifically looked at the ratios of different types of blood cells involved in inflammation and immune response. What we found Certain blood markers were linked to how long patients lived after treatment. For example, patients with higher levels of certain inflammatory markers tended to have shorter survival times. We used this information along with other medical data to create a tool that helps predict how patients might do with treatment. What it means Our findings suggest that checking for inflammation in the blood could help doctors better understand who will benefit most from immune therapy for advanced bladder cancer. This could help tailor treatments more effectively for each patient. [ABSTRACT FROM AUTHOR]

CO2 released from subduction zones plays a vital role in the tectonic carbon cycle. However, the contribution of submarine backarc components to carbon emissions remains poorly understood compared to subaerial arc volcanos. This study utilized a combination of geochemical and hydrodynamic approaches to investigate the sources and flux of dissolved inorganic carbon (DIC) in the deep basin of the southwestern Okinawa Trough. Most deep‐water (depth ≥1,000 m) samples, even those retrieved from sites distant from active venting, exhibited mild geochemical anomalies of elevated 3He/4He ratios and higher DIC content than reference sites. Hydrodynamic observations using bottom‐mounted acoustic instruments in the deep basin revealed strong tidal currents and enhanced turbulent mixing. These findings suggest that active solute dispersal and mixing are responsible for the prevalence of mild geochemical anomalies in the basin. Mixing models indicated that hydrothermal vent fluids are the primary source of excess 3He and DIC above background levels in the deep basin, whereas both CO2 and mineral acid in hydrothermal fluids cause excess acidity. Based on hydrodynamic and geochemical data, a box model estimated a hydrothermal DIC flux of 0.62 ± 1.40 × 1010 mol y−1, equivalent to 40% of CO2 emissions from persistently degassing volcanos in the Ryukyu Arc. Our results suggest that submarine carbon emissions are quantitatively important in subduction systems with subaqueous backarc components. Plain Language Summary: The CO2 released from subduction zones, where tectonic plates collide, is important for the Earth's carbon cycle. However, we know little about CO2 released from submarine backarc basins compared to volcanoes on land. This study examined dissolved inorganic carbon (DIC) sources and quantities released into the deep basin of the southwestern Okinawa Trough. Even far from active hydrothermal vents, deep‐water samples had higher DIC levels than expected. Using instruments placed on the seabed, we discovered strong tidal currents and increased water mixing in the basin. These findings suggest that water movement and mixing contribute to the widespread occurrence of elevated DIC levels. Our calculations show that the primary source of the extra DIC in the deep basin is fluids released from hydrothermal vents, and both CO2 and mineral acid cause excess acidity in the water. Based on our data, we estimate that hydrothermal vents release approximately 6 billion moles of DIC per year, equivalent to 40% of the CO2 emissions from continuously active volcanoes in the Ryukyu Arc. These results demonstrate the potential significance of underwater carbon emissions in submerged backarc basins within subduction zones. Key Points: Mild geochemical anomalies in 3He and dissolved inorganic carbon were widespread in the southwestern Okinawa Trough deep waterMixing models confirmed that hot vent fluids are the primary source of excess dissolved inorganic carbon in the deep waterThe carbon outgassing flux of the Ryukyu subduction system increases by at least 27% when the backarc contribution is considered [ABSTRACT FROM AUTHOR]

Background: Studies on the correlation between high body mass index (BMI) and extended survival among patients receiving immune checkpoint inhibitors (ICIs) have been made, although findings have shown variability. Our research explored the phenomenon of the "obesity paradox" in patients with metastatic urothelial carcinoma (mUC) undergoing treatment with ICIs. Materials and Methods: We conducted a retrospective analysis of patients diagnosed with mUC who received a minimum of one cycle of ICI treatment at two medical centers in Taiwan from September 2015 to January 2023. Features of patients' clinicopathologic factors, including age, sex, primary or metastatic location, treatment line, and BMI were examined. The primary outcome were overall survival (OS) and progression‐free survival (PFS), which were assessed utilizing the Kaplan–Meier method. We employed the Cox‐regression model to adjust for multiple covariates. Results: A total of 215 patients were included, with 128 (59.5%) being male, and the median age was 70 years. In the obese group (BMI ≥25 kg/m2), patients demonstrated significantly better median OS compared to the non‐obese group (BMI <25 kg/m2) (21.9 vs. 8.3 months; p = 0.021). However, there was no significant difference in median PFS between the high and low BMI groups (4.7 vs. 2.8 months; p = 0.16). Post‐hoc subgroup revealed a survival benefit from ICI treatment in male patients within the BMI ≥25 kg/m2 group (HR 0.49, 95% CI 0.30–0.81, p = 0.005). Conclusion: Based on real‐world data from the Asia‐Pacific region, there appears to be a correlation between obesity and prolonged OS in patients receiving ICI treatment for mUC. [ABSTRACT FROM AUTHOR]

Herein, we describe an aberrant artery to a normal lung, focusing on its classification, embryological hypotheses, diagnostic methods, and treatment modalities. We present three cases of aberrant arterial supply to a normal lung in various age groups (51 years, 5 months, and 29 years). The cases presented symptoms ranging from hemoptysis to respiratory distress. Successful transarterial embolization was performed in the 5-month-old infant. In addition, we collected case reports published from 1962 to the present from the literature to compare the trends in management and variations in manifestations. [ABSTRACT FROM AUTHOR]