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Abstract The interactive pathway of the gut-liver axis underscores the significance of microbiome modulation in the pathogenesis and progression of various liver diseases, including hepatocellular carcinoma (HCC). This study aims to investigate the disparities in the composition and functionality of the hepatic microbiota between tumor tissues and adjacent normal liver tissues, and their implications in the etiology of HCC. We conducted a comparative analysis of the hepatic microbiome between adjacent normal liver tissues and tumor tissues from HCC patients. Samples were categorized according to the modified Union for International Cancer Control (mUICC) staging system into Non-tumor, mUICC stage I, mUICC stage II, and mUICC stage III groups. Microbial richness and community composition were analyzed, and phylogenetic profiles were examined to identify significantly altered microbial taxa among the groups. Predicted metabolic pathways were analyzed using PICRUSt2. Our analysis did not reveal significant differences in microbial richness and community composition with the development of HCC. However, phylogenetic profiling identified significantly altered microbial taxa among the groups. Sphingobium, known for degrading polychlorinated biphenyls (PCBs), exhibited a significantly negative correlation with clinical indices in HCC patients. Conversely, Sphingomonas, a gut bacterium associated with various liver diseases, showed a positive correlation. Predicted metabolic pathways suggested a correlation between atrazine degradation and valine, leucine, and isoleucine biosynthesis with mUICC stage and tumor size. Our results underscore the critical link between hepatic microbial composition and function and the HCC tumor stage, suggesting a potentially pivotal role in the development of HCC. These findings highlight the importance of targeting the hepatic microbiome for therapeutic strategies in HCC.

Abstract The prevalence and dynamics of circulating tumor DNA (ctDNA) in patients with breast cancer recurrence or de novo metastatic cancer were examined in a retrospective analysis of a prospective observational cohort. Twenty-three recurrent/metastatic breast cancer cases (8 locoregional, 15 distant metastasis) were enrolled, and sequential plasma samples were obtained. Anchor mutations were selected from the target sequencing of each patient’s primary and/or metastatic tumor. An in-house developed assay (UHS assay) was employed for a tumor-informed ctDNA assay during treatment and follow-up. A median of three (range 1–5) anchor mutations per case were applied for ctDNA detection. ctDNA was detected in 14 (63.6%, 14/22) cases at the time of enrollment and 18 (78.5%, 18/23) cases during follow-up. More anchor mutations and higher tumor burden were significantly related to higher ctDNA positive rates (p-value 0.036, 0.043, respectively). The mean enriched variant allele frequency (eVAF) at each time point was significantly higher for stable or progressive disease responses (ANOVA test p-value

In recent years, next-generation sequencing (NGS)–based genetic testing has become crucial in cancer care. While its primary objective is to identify actionable genetic alterations to guide treatment decisions, its scope has broadened to encompass aiding in pathological diagnosis and exploring resistance mechanisms. With the ongoing expansion in NGS application and reliance, a compelling necessity arises for expert consensus on its application in solid cancers. To address this demand, the forthcoming recommendations not only provide pragmatic guidance for the clinical use of NGS but also systematically classify actionable genes based on specific cancer types. Additionally, these recommendations will incorporate expert perspectives on crucial biomarkers, ensuring informed decisions regarding circulating tumor DNA panel testing.

Abstract Background Patient-derived xenograft (PDX) models serve as a valuable tool for the preclinical evaluation of novel therapies. They closely replicate the genetic, phenotypic, and histopathological characteristics of primary breast tumors. Despite their promise, the rate of successful PDX engraftment is various in the literature. This study aimed to identify the key factors associated with successful PDX engraftment of primary breast cancer. Methods We integrated clinicopathological data with morphological attributes quantified using a trained artificial intelligence (AI) model to identify the principal factors affecting PDX engraftment. Results Multivariate logistic regression analyses demonstrated that several factors, including a high Ki-67 labeling index (Ki-67LI) (p

A high-fidelity numerical analysis methodology was proposed for evaluating the fuel rod cladding integrity of a Prototype Gen IV Sodium Fast Reactor (PGSFR) during normal operation and Design basis events (DBEs). The MARS-LMR code, system transient safety analysis code, was applied to analyze the DBEs. The results of the MARS-LMR code were used as boundary condition for a 3D computational fluid dynamics (CFD) analysis. The peak temperatures considering HCFs satisfied the cladding temperature limit. The temperature and pressure distributions were calculated by ANSYS CFX code, and applied to structural analysis. Structural analysis was performed using ANSYS Mechanical code. The seismic reactivity insertion SSE accident among DBEs had the highest peak cladding temperature and the maximum stress, as the value of 87 MPa. The fuel cladding had over 40 % safety margin, and the strain was below the strain limit. Deformation behavior was elucidated for providing relative coordinate data on each active fuel rod center. Bending deformation resulted in a flower shape, and bowing bundle did not interact with the duct of fuel assemblies. Fuel rod maximum expansion was generated with highest stress. Therefore, it was concluded that the fuel rod cladding of the PGSFR has sufficient structural safety margin during DBEs.

In-vessel retention through external reactor vessel cooling (IVR-ERVC) is a severe accident management (SAM) strategy that has been adopted and used in many nuclear reactors such as AP1000, APR1400, and light water reactor etc. Some reactor accidents have raised concerns about nuclear reactors among residents, leading to a decrease in residents' acceptability and many studies on SAM are being conducted. Experiments on IVR-ERVC are almost impossible due to its specificity, so fluid characteristics are analyzed through BALI experiments with similar condition. In this study, computational fluid dynamics (CFD) via Reynolds-averaged Navier-Stokes (RANS) and large eddy simulation (LES) for BALI experiments were performed. Steady-state CFD analysis was performed on three turbulence models, and SST k-ω model was in good agreement with the experimental measurement temperature within the maximum error range of 1.9%. LES CFD analysis was performed based on the RANS analysis results and it was confirmed that the temperature and wall heat flux for depth was consistent within an error range of 1.0% with BALI experiment. The LES CFD analysis results were compared with those of the Lagrangian-based solver. LES matched the temperature distribution better than SOPHIA, but SOPHIA calculated the position of boundary between stratified layer and convective layer more accurately. On the other hand, Lagrangian-based solver predicted several small eddy behaviors of the convective layer and LES predicted large vortex behavior. The vibration characteristics near the cooling part of the BALI experimental device were confirmed through Fast Fourier Transform (FFT) investigation. It was found that the power spectral density for pressure at least 10 times higher near the side cooling than near the top cooling.

Small Modular Reactors (SMRs) offer transformative potential for maritime propulsion by providing significant benefits such as reduced emissions, enhanced fuel efficiency, and greater operational autonomy. However, their integration into the maritime sector presents complex regulatory challenges due to the convergence of nuclear and maritime laws. A unified, harmonized regulatory framework is essential to ensure safety, radioactive waste management, and accident prevention. While initiatives led by the International Atomic Energy Agency (IAEA) and International Maritime Organization (IMO) are progressing, key gaps remain, particularly regarding maritime-specific risk assessments, emergency response protocols, and cross-border regulatory harmonization. Enhanced collaboration between regulatory bodies, pilot projects, and transparent engagement with stakeholders will be critical to refining safety protocols and accelerating regulatory alignment. Public acceptance remains a vital factor, requiring rigorous environmental impact assessments (EIAs) and transparent communication to build trust and align SMR-powered vessels with global sustainability objectives. While challenges persist, they also present opportunities for innovation and international cooperation. By addressing these regulatory and public acceptance challenges through coordinated efforts and policies, SMR propulsion can become a cornerstone of a more sustainable, efficient, and technologically advanced maritime sector. Successful deployment will position SMRs as a key component of the global energy transition, driving progress toward low-carbon shipping and a greener maritime industry.

Marine sources contribute approximately 2% of global energy-related CO₂ emissions, with the shipping industry accounting for 87% of this total, making it the fifth-largest emitter globally. Environmental regulations by the International Maritime Organization (IMO), such as the MARPOL (International Convention for the Prevention of Pollution from Ships) treaty, have driven the exploration of alternative green energy solutions, including nuclear-powered ships. These ships offer advantages like long operational periods without refueling and increased cargo space, with around 200 reactors already in use on naval vessels worldwide. Among advanced reactor concepts, the molten salt reactor (MSR) is particularly suited for marine applications due to its inherent safety features, compact design, high energy density, and potential to mitigate nuclear waste and proliferation concerns. However, MSR systems face significant challenges, including tritium production, corrosion issues, and complex behavior of volatile fission products. Understanding the impact of marine-induced motion on the thermal–hydraulic behavior of MSRs is crucial, as it can lead to transient design basis accident scenarios. Furthermore, the adoption of MSR technology in the shipping industry requires overcoming regulatory hurdles and achieving global consensus on safety and environmental standards. This review assesses the current progress, challenges, and technological readiness of MSRs for marine applications, highlighting future research directions. The overall technology readiness level (TRL) of MSRs is currently at 3. Achieving TRL 6 is essential for progress, with individual components needing TRLs of 4–8 for a demonstration reactor. Community Readiness Levels (CRLs) must also be addressed, focusing on public acceptance, safety, sustainability, and alignment with decarbonization goals.

A novel Gram-negative, obligate anaerobe, non-motile, flagella-lacking, catalase- and oxidase-negative, coccobacilli-shaped bacterial strain designated AGMB02718T was isolated from swine feces. The 16S rRNA gene analysis indicated that strain AGMB02718T belonged to the genus Mesosutterella with the highest similarity to M. multiformis 4NBBH2T (= DSM 106860T) (sequence similarity of 96.2%), forming a distinct phylogenetic lineage. Its growth occurred at 25–45°C (optimal 37°C) and in 0.5–1% NaCl (optimal 0.5%). Strain AGMB02718T was asaccharolytic and contained menaquinone 6 (MK-6) and methylmenaquinone 6 (MMK-6) as the predominant respiratory quinones. The major cellular fatty acids in the isolate were C18:1ω9c and C16:0. Based on the whole-genome sequencing analysis, strain AGMB02718T had a 2,606,253 bp circular chromosome with a G + C content of 62.2%. The average nucleotide identity value between strain AGMB02718T and M. multiformis 4NBBH2T was 72.1%, while the digital DNA–DNA hybridization value was 20.9%. Interestingly, genome analysis suggested that strain AGMB02718T possessed a low-toxicity lipopolysaccharide (LPS) because the genome of the isolate does not include lpxJ and lpxM genes for Kdo2-Lipid A (KLA) assembly, which confers high toxicity to LPS. Moreover, in vitro macrophage stimulation assay confirmed that AGMB02718T produced LPS with low toxicity. Because the low-toxicity LPS produced by the Sutterellaceae family is involved in regulating host immunity and low-toxicity LPS-producing strains can help maintain host immune homeostasis, we evaluated the anti-inflammatory activity of strain AGMB02718T against inflammatory bowel disease (IBD). As a result, strain AGMB02718T was able to prevent the inflammatory response in a dextran sulfate sodium (DSS)-induced colitis model. Therefore, this strain represents a novel species of Mesosutterella that has a protective effect against DSS-induced colitis, and the proposed name is Mesosutterella faecium sp. nov. The type strain is AGMB02718T (=GDMCC 1.2717T = KCTC 25541T).

Owing to their physical and chemical properties and stimuli-responsive nature, gels and hydrogels play vital roles in diverse application fields. The three-dimensional polymeric network structure of hydrogels is considered an alternative to many materials, such as conductors, ordinary films, constituent components of machines and robots, etc. The most recent applications of gels are in different devices like sensors, actuators, flexible screens, touch panels, flexible storage, solar cells, batteries, and electronic skin. This review article addresses the devices where gels are used, the progress of research, the working mechanisms of hydrogels in those devices, and future prospects. Preparation methods are also important for obtaining a suitable hydrogel. This review discusses different methods of hydrogel preparation from the respective raw materials. Moreover, the mechanism by which gels act as a part of electronic devices is described.

Porous carbon is an emerging material for the capture of CO2 from point sources of emissions due to its high structural, mechanical, and chemical stability, along with reusability advantages. Currently, research efforts are mainly focused on high- or medium-pressure adsorption, rather than low-pressure or DAC (direct air capture) conditions. Highly porous and functionalized carbon, containing heteroatoms (N, O, etc.), is synthesized using different activation synthesis routes, such as hard template, soft template, and chemical activation, to achieve high CO2 capture efficiency at various temperatures and pressure ranges. Fundamental pore formation mechanisms with different activation routes have been evaluated and explored. Higher porosity alone can be ineffective without the presence of proper saturated diffusion pathways for CO2 transfer. Therefore, it is imperative to emphasize more rational multi-hierarchical macro-/meso-/micro-/super-/ultra-pore design strategies to achieve a higher utilization efficiency of these pores. Moreover, the present research primarily focuses on powder-based hierarchical porous carbon materials, which may reduce the efficiency of the capture performance when shaping the powder into pellets or fixed-bed shapes for applications considered. Therefore, it is imperative to develop a synthesis strategy for pelletized porous carbon and to explore its mechanistic synthesis route and potential for CO2 capture.

Herein, a lithium modified Zeolitic Imidazolate Framework-90 (ZIF-90-OLi) was used in a slurry with its organic ligand Imidazole Carboxaldehyde (ICA) water, and glycol to improve the process conditions for the capture system and enhance the sorption ability. The performance of this slurry was compared to two other slurries, one based on the parent ZIF-90 nanoporous material with ICA/water/glycol and another based on ZIF-8, its organic ligand Methylimidazole (MIm) and water/glycol. The comparison to ZIF-8 was done because of its use as a ZIF of reference in carbon capture. The maximum sorption capacity for CO2 by the alkali containing slurry was 7.19 mol/L and the maximum CO2/N2 selectivity was 222.93 compared to 2.72 mol/L and 121.63 for the ZIF-8/water/glycol/mlm slurry.

Purpose: This study aimed to investigate clinical practices and factors related to the outcomes of T-DM1 use in patients with HER2-positive metastatic breast cancer (mBC). Methods: We included patients with HER2-positive mBC who received T-DM1 as a palliative therapy between August 2017 and December 2018. The safety and outcomes of T-DM1, including overall response rate (ORR), progression-free survival (PFS), and overall survival (OS), were evaluated. A Cox proportional hazards model was used to estimate the hazard ratio and 95% confidence interval (CI) for mortality or progression to HER2-positive mBC. Results: In total, 824 patients were enrolled during the study period. The mean age of patients was 58 years, and 516 (62.6%) patients relapsed after curative treatment. Excluding a history of endocrine therapy, 341 (41.4%) patients previously received none or first-line chemotherapy, 179 (21.7%) received second-line therapy, and 303 (36.9%) received third-or later-line chemotherapy before T-DM1 therapy. During a median follow-up of 16.8 months, the ORR was 35%, the median PFS was 6.6 months, and the median OS was not reached. The clinical factors associated with the hazard of progression were age (

Abstract Antimicrobial resistant pathogens are a global health threat driven by the indiscriminate use of antimicrobials. Antimicrobial resistance can be acquired by resistance genes encoded by mobile genetic elements. In this study, we identified a strain of Salmonella enterica serovar Gallinarum (SG4021) from an infected chicken in Korea and characterized the presence of resistance genes in its plasmid by whole genome sequencing. The sequence was then compared with that of a plasmid (P2) from strain SG_07Q015, the only other strain of S. Gallinarum isolated in Korea for which a genome sequence is available. The results revealed that both strains harbored nearly identical DNA carrying antibiotic resistance gene cassettes inserted into integron In2 of the transposable element Tn21, namely an aadA1 resistance gene conferring resistance to aminoglycosides and a sul1 resistance gene conferring resistance to sulfonamide. Interestingly, despite the presence of sul1 in SG4021, an antibiotic sensitivity test revealed that it was sensitive to sulfonamides. Further analysis revealed that this disparity was due to the insertion of a ~ 5 kb ISCR16 sequence downstream of the promoter driving sul1 expression in SG4021. Using various mutants, we showed that the insertion of ISCR16 blocked the expression of the sul1 gene from the upstream promoter. Therefore, the functionality of antimicrobial resistance genes determines phenotypic antimicrobial resistance.

In energy applications, the use of materials with hierarchical porous structures and large surface areas is essential for efficient charge storage. These structures facilitate rapid electron and ion transport, resulting in high power density and quick charge/discharge capabilities. Carbon-based materials are extensively utilized due to their tunable properties, including pore sizes ranging from ultra- to macropores and surface polarity. Incorporating heteroatoms such as nitrogen, oxygen, sulfur, phosphorus, and boron modifies the carbon structure, enhancing electrocatalytic properties and overall performance. A hierarchical pore structure is necessary for optimal performance, as it ensures efficient access to the material’s core. The microstructure of carbon materials significantly impacts energy storage, with factors like polyaromatic condensation, crystallite structure, and interlayer distance playing crucial roles. Carbon aerogels, derived from the carbonization of organic gels, feature a sponge-like structure with large surface area and high porosity, making them suitable for energy storage. Their open pore structure supports fast ion transfer, leading to high energy and power densities. Challenges include maintaining mechanical or structural integrity, multifunctional features, and scalability. This review provides an overview of the current progress in carbon-based aerogels for energy applications, discussing their properties, development strategies, and limitations, and offering significant guidance for future research requirements.

Along with serving as drug delivery sensors and flexible devices, hydrogels are playing pioneering roles in water purification. Both chemical and radiation methods can produce hydrogels, with the latter method gaining preference for its pure adducts. The water treatment process entails the removal of heavy and toxic metals (above the threshold amount), dyes, and solid wastes from industrial effluents, seawater, and groundwater, as well as sterilization for microorganism destruction. This review analyzed the different types of hydrogels produced by applying various radiations for water treatment. Particularly, we examined the hydrogels created through the application of varying levels of gamma and electron beam radiation from the electron gun and Co-60 sources. Moreover, we discuss the optimized radiation doses, the compositions (monomers and polymers) of raw materials required for hydrogel preparation, and their performance in water purification. We present and predict the current state and future possibilities of radiation-induced hydrogels. We explain and compare the superiority of one radiation method over other radiation methods (UV-visible, X-ray, microwave, etc.) based on water treatment.

Rotavirus is the main causative agent of viral gastroenteritis among young animals worldwide. Currently, no clinically approved or effective antiviral drugs are available to combat rotavirus infections. Herein, we evaluated the anti-rotaviral activities of extracts and bavachin isolated from Psoralea corylifolia L. (Fabaceae) (P. corylifolia) against the bovine rotavirus G8P[7] and porcine rotavirus G5P[7] in vitro. Two assay strategies were performed: (1) a virucidal assay to reduce viral infectivity by virus neutralization and (2) a post-treatment assay to assess viral replication suppression. The results from the virucidal assay showed that the extracts and bavachin did not exert anti-rotaviral activities. In the follow-up analysis after treatment, bavachin exhibited robust antiviral efficacy, with 50% effective concentration (EC50) values of 10.6 μM (selectivity index [SI] = 2.38) against bovine rotavirus G8P[7] and 13.0 μM (SI = 1.94) against porcine rotavirus G5P[7]. Bavachin strongly suppressed viral RNA synthesis in the early (6 h) and late stages (18 h) after rotaviral infection. These findings strongly suggest that bavachin may have hindered the virions by effectively inhibiting the early stages of the virus replication cycle after rotaviral infection. Furthermore, confocal imaging showed that bavachin suppressed viral protein synthesis, notably that of the rotaviral protein (VP6). These results suggest that bavachin has strong antiviral activity against rotaviruses, inhibits viral replication, and is a candidate natural therapeutic drug targeting rotaviral infection. The utilization of bavachin isolated from P. corylifolia may contribute to decreased mortality rates, lower medication expenses, and enhanced economic viability in domestic farms.

Nitrogen oxide (NOx) pollutants have a significant impact on both the environment and human health. Photocatalytic NOx removal offers a sustainable and eco-friendly approach to combatting these pollutants by harnessing renewable solar energy. Photocatalysis demonstrates remarkable efficiency in removing NOx at sub-scale levels of parts per billion (ppb). The effectiveness of these catalysts depends on various factors, including solar light utilization efficiency, charge separation performance, reactive species adsorption, and catalytic reaction pathway selectivity. Moreover, achieving high stability and efficient photocatalytic activity necessitates a multifaceted materials design strategy. This strategy encompasses techniques such as ion doping, defects engineering, morphology control, heterojunction construction, and metal decoration on metal- or metal oxide-based photocatalysts. To optimize photocatalytic processes, adjustments to band structures, optimization of surface physiochemical states, and implementation of built-in electric field approaches are imperative. By addressing these challenges, researchers aim to develop efficient and stable photocatalysts, thus contributing to the advancement of environmentally friendly NOx removal technologies. This review highlights recent advancements in photocatalytic NOx removal, with a focus on materials design strategies, intrinsic properties, fundamental developmental aspects, and performance validation. This review also presents research gaps, emphasizing the need to understand the comprehensive mechanistic photocatalytic process, favored conditions for generating desired reactive species, the role of water concentration, temperature effects, inhibiting strategies for photocatalyst-deactivating species, and the formation of toxic NO2.

We report here a novel anti-cancer therapy based on an avian-host-specific serotype Salmonella enterica serovar Gallinarum (S. Gallinarum) deficient in ppGpp synthesis. To monitor the tumor targeting, a bioluminescent ΔppGpp S. Gallinarum was constructed and injected intravenously into mice bearing syngeneic and human xenograft tumors. Strong bioluminescent signals were detected specifically in all grafted tumors at 2 days post-injection (dpi). The bacterial counts in normal and tumor tissue at 1 dpi revealed that ΔppGpp S. Gallinarum reached >108 CFU/g in tumor tissue and 106–107 CFU/g in endothelial organs; counts were much lower in other organs. At 16 dpi, ΔppGpp S. Gallinarum counts in tumor tissue decreased to ∼106 CFU/g, while those in the other organs became undetectable. A strong anti-cancer effect was observed after the injection of ΔppGpp S. Gallinarum into BALB/c mice grafted with CT26 colon cancer cells. This could be attributed to reduced virulence, which allowed the administration of at least a 10-fold greater dose (108 CFU) of ΔppGpp S. Gallinarum than other attenuated strains of S. enterica serovar Typhimurium (≤107 CFU). An advantage of the avian-specific S. Gallinarum as a cancer therapeutic should be a reduced capacity to cause infections or harm in humans.

Although vaccines and antiviral drugs are available, influenza viruses continue to pose a significant threat to vulnerable populations globally. With the emergence of drug-resistant strains, there is a growing need for novel antiviral therapeutic approaches. We found that 18-hydroxyferruginol (1) and 18-oxoferruginol (2) isolated from Torreya nucifera exhibited strong anti-influenza activity, with 50% inhibitory concentration values of 13.6 and 18.3 μM against H1N1, 12.8 and 10.8 μM against H9N2, and 29.2 μM (only compound 2) against H3N2 in the post-treatment assay, respectively. During the viral replication stages, the two compounds demonstrated stronger inhibition of viral RNA and protein in the late stages (12–18 h) than in the early stages (3–6 h). Moreover, both compounds inhibited PI3K-Akt signaling, which participates in viral replication during the later stages of infection. The ERK signaling pathway is also related to viral replication and was substantially inhibited by the two compounds. In particular, the inhibition of PI3K-Akt signaling by these compounds inhibited viral replication by sabotaging influenza ribonucleoprotein nucleus-to-cytoplasm export. These data indicate that compounds 1 and 2 could potentially reduce viral RNA and viral protein levels by inhibiting the PI3K-Akt signaling pathway. Our results suggest that abietane diterpenoids isolated from T. nucifera may be potent antiviral candidates for new influenza therapies.

Although breast cancer has a good prognosis compared with various cancers, metastatic breast cancer has an aggressive disease course and remains incurable. Therefore, treatment of early breast cancer to prevent recurrence and metastasis is crucial. Recently, the development of anti-cancer drugs, such as targeted agents and immuno-oncology, has been accelerating. Antibody-drug conjugates (ADCs) are also building a new paradigm. Particularly, ADCs targeting Trop-2 were approved for their efficacy in metastatic triple-negative breast cancer patients who received ≥2 prior systemic therapies and showed significant results in heavily pretreated hormone receptor-positive/HER2-negative breast cancer. In this brief review, we provide an overview of ongoing clinical trials of ADCs targeting Trop-2 in early breast cancer, specifically sacituzumab govitecan.

Continuous worldwide demands for more clean energy urge researchers and engineers to seek various energy applications, including electrocatalytic processes. Traditional energy-active materials, when combined with conducting materials and non-active polymeric materials, inadvertently leading to reduced interaction between their active and conducting components. This results in a drop in active catalytic sites, sluggish kinetics, and compromised mass and electronic transport properties. Furthermore, interaction between these materials could increase degradation products, impeding the efficiency of the catalytic process. Gels appears to be promising candidates to solve these challenges due to their larger specific surface area, three-dimensional hierarchical accommodative porous frameworks for active particles, self-catalytic properties, tunable electronic and electrochemical properties, as well as their inherent stability and cost-effectiveness. This review delves into the strategic design of catalytic gel materials, focusing on their potential in advanced energy conversion and storage technologies. Specific attention is given to catalytic gel material design strategies, exploring fundamental catalytic approaches for energy conversion processes such as the CO2 reduction reaction (CO2RR), oxygen reduction reaction (ORR), oxygen evolution reaction (OER), and more. This comprehensive review not only addresses current developments but also outlines future research strategies and challenges in the field. Moreover, it provides guidance on overcoming these challenges, ensuring a holistic understanding of catalytic gel materials and their role in advancing energy conversion and storage technologies.

Abstract Background This study was conducted to compare the reported adverse event (AE) profiles and unexpected use of medical services during chemotherapy between before and after the healthcare reimbursement of AE evaluation in patients with cancer. Patients and Methods Using the electronic medical record database system, extracted patients with breast, lung, gastric, and colorectal cancers receiving neoadjuvant or adjuvant chemotherapy between September 2013 and December 2016 at four centers in Korea were matched using the 1:1 greedy method: pre‐reimbursement group (n = 1084) and post‐reimbursement group (n = 1084). Unexpected outpatient department (OPD), emergency room (ER) visit, hospitalization rates, and chemotherapy completion rates were compared between the groups. Results The baseline characteristics were well‐balanced between the groups. By chemotherapy cycle, hospitalization (1.8% vs. 2.3%; p = 0.039), and ER visit rates (3.3% vs. 3.9%; p = 0.064) were lower in the post‐reimbursement group than that in the pre‐reimbursement group. In particular, since cycle 2, ER visit and hospitalization rates were significantly lower in the post‐reimbursement group than those in the pre‐reimbursement group (2.6% vs. 3.3%; p = 0.020 and 1.4% vs. 2.0%; p = 0.007, respectively), although no significant differences were observed during cycle 1. The OPD visit rates were similar between both groups, regardless of cycles. The post‐reimbursement group had a higher proportion of patients who completed chemotherapy as planned than the pre‐reimbursement group (93.5% vs. 90.1%; p = 0.006). Post‐reimbursement group had more AEs reported, including alopecia, fatigue, diarrhea, anorexia, and peripheral neuropathy, during cycle 1 than the pre‐reimbursement group, which significantly decreased after cycle 2. Conclusion The introduction of healthcare reimbursement for AE evaluation may help physicians capture and appropriately manage AEs, consequently, decreasing hospital utilization and increasing chemotherapy completion rates.

BackgroundFertility is an important issue for young women with breast cancer, but studies about physicians’ knowledge, attitudes, and practices toward fertility preservation (FP) are largely based on Western populations and do not reflect recent international guidelines for FP. In this international study, we aimed to assess the knowledge, attitudes, and practices of physicians from South Korea, other Asian countries, and Latin America toward FP in young women with breast cancer, and identify the related barriers.MethodsThe survey was conducted anonymously among physicians from South Korea, other Asian countries, and Latin America involved in breast cancer care between November 2020 and July 2021. Topics included knowledge, attitudes, and perceptions toward FP; practice behaviors; barriers; and participant demographics. We grouped related questions around two main themes—discussion with patients about FP, and consultation and referral to a reproductive endocrinologist. We analyzed the relationships between main questions and other survey items.ResultsA total of 151 physicians completed the survey. Most participants’ overall knowledge about FP was good. More than half of the participants answered that they discussed FP with their patients in most cases, but that personnel to facilitate discussions about FP and the provision of educational materials were limited. A major barrier was time constraints in the clinic (52.6%). Discussion, consultations, and referrals were more likely to be performed by surgeons who primarily treated patients with operable breast cancer (FP discussion odds ratio [OR]: 2.90; 95% confidence interval [CI]: 1.24–6.79; FP consultation and referral OR: 2.98; 95% CI: 1.14–7.74). Participants’ knowledge and attitudes about FP were significantly associated with discussion, consultations, and referrals.ConclusionPhysicians from South Korea, other Asian countries, and Latin America are knowledgeable about FP and most perform practice behaviors toward FP well. Physicians’ knowledge and favorable attitudes are significantly related to discussion with patients, as well as consultation with and referral to reproductive endocrinologists. However, there are also barriers, such as limitations to human resources and materials, suggesting a need for a systematic approach to improve FP for young women with breast cancer.

Abstract Cancer of unknown primary (CUP) is a heterogeneous malignancy in which the primary site of the tumor cannot be identified through standard work-up. The survival outcome of CUP is generally poor, and there is no consensus for treatment. Here, we comprehensively analyzed the real-world data of 218 patients with CUP (median age, 62 years [range, 19–91]; male, 62.3%). Next-generation sequencing was conducted in 22 (10%) patients, one of whom showed level 1 genetic alteration. Most (60.3%) patients were treated with empirical cytotoxic chemotherapy, and two patients received targeted therapy based on the NGS results. The median OS was 8.3 months (95% confidence interval [CI] 6.2–11.4), and the median progression-free survival of patients treated with chemotherapy was 4.4 months (95% CI 3.4–5.3). In multivariate Cox regression analysis, Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 or 1 and localized disease were significantly associated with favorable survival outcomes. Collectively, we found that CUP patients had a poor prognosis after standard treatment, and those with localized disease who received local treatment and those with better PS treated with multiple lines of chemotherapy had better survival outcomes. Targeted therapies based on NGS results are expected to improve survival outcomes.

Three-dimensional structures of a vortical flow field and heat transfer characteristics in a partially blocked 7-pin fuel assembly mock-up of sodium-cooled fast reactor have been investigated through a numerical analysis using a commercial computational fluid dynamics code, ANSYS CFX. The simulation with the SST turbulence model agrees well with the experimental data of outlet and cladding wall temperatures. From the analysis on the limiting streamline at the wall, multi-scale vortexes developed in axial direction were found around the blockage. The vortex core has a high cladding wall temperature, and the attachment line has a low cladding wall temperature. The small-scale vortex structures significantly enhance the convective heat transfer because it increases the turbulent mixing and the turbulence kinetic energy. The large-scale vortex structures supply thermal energy near the heated cladding wall surface. It is expected that control of the vortex structures in the fuel assembly plays a significant role in the convective heat transfer enhancement. Furthermore, the blockage plate and grid spacer increase the pressure drop to about 36% compared to the bare case.

Background: Electronic medical records (EMRs) have the highest value among real-world data (RWD). The aim of the present study was to propose a data collection framework of EMR-based RWD to evaluate the effectiveness and safety of cancer drugs by conducting a nationwide real-world study based on the Korean Cancer Study Group. Methods: We considered all patients who received ramucirumab plus paclitaxel (RAM/PTX) for gastric cancer and trastuzumab emtansine (T-DM1) for breast cancer at relevant institutions in South Korea. Standard operating procedures for systematic data collection were prospectively developed. Investigator reliability was evaluated using the concordance rate between the recommended input value for representative fictional cases and the input value of each investigator. Reliability of collected data was evaluated twice during the study period at three institutions randomly selected using the concordance rate between the previously collected data and data collected by an independent investigator. The reliability results of the investigators and collected data were used for revision of the electronic data capture system and site training. Results: Between the starting date of medical insurance coverage and December 2018, a total of 1063 patients at 56 institutions in the RAM/PTX cohort and 824 patients at 60 institutions in the T-DM1 cohort were included. Mean investigator reliability in the RAM/PTX and T-DM1 cohorts was 73.5% and 71.9%, respectively. Mean reliability of collected data in the RAM/PTX and T-DM1 cohort was 90.0% for both cohorts in the first analysis and 89.0% and 84.0% in the second analysis, respectively. Mean missing values of the RAM/PTX and T-DM1 cohorts at the time of simulation of fictional cases and final data analysis decreased from 20.7% to 0.46% and from 18.5% to 0.76%, respectively. Conclusion: This real-world study provides a framework that ensures relevance and reliability of EMR-based RWD for evaluating the effectiveness and safety of cancer drugs.

A few drugs need non-aqueous gels for release in the specific region of the intestine. The present work focuses on preparing N,N-Dimethyl acrylamide-Diallyl Maleate (DMAA-DAM) gel in Dimethyl sulfoxide (DMSO) solvent by applying different doses of gamma radiation and then characterization. The blend solution of 10%: 10%—DMAA: DAM was prepared in DMSO and irradiated at 2, 5, 10, 20, and 30 kGy doses from the Co-60 gamma source. After extraction, it was observed that all of the radiation doses yielded more than 95% gel content. The best gel content was found for 10 kGy dose, which was 97%. The equilibrium swelling was optimized 1800% of the dried gel for 5 kGy dose. Gel formation was confirmed by analyzing characteristic functional groups and the environment of protons in the gel structure by using FTIR and NMR spectroscopy. The thermal stability was tested using DSC and TGA which showed the glass transition temperature at 86.55 °C and the degradation started at 320 °C. The XRD pattern analysis revealed the semi-crystalline nature of the gel. Therefore, DMAA-DAM gels can be a good candidate for use in different fields of study, especially in drug delivery.

Gamma radiation technique for the preparation of pure hydrogels is gaining popularity worldwide. Superabsorbent hydrogels play vital roles in different fields of application. The present work mainly focuses on the preparation and characterization of 2,3-Dimethylacrylic acid-(2-Acrylamido-2-methyl-1-propane sulfonic acid) (DMAA–AMPSA) superabsorbent hydrogel by applying gamma radiation and optimization of the proper dose. To prepare DMAA–AMPSA hydrogel, different doses ranging from 2 kGy to 30 kGy were imparted on the blend aqueous solution of the monomers. The equilibrium swelling increases with increasing radiation dose, followed by decreasing after reaching a certain level, and the highest result is found to be 26,324.9% at 10 kGy. Fourier Transform Infrared (FTIR) and Nuclear Magnetic Resonance (NMR) spectroscopy confirmed the formation of co-polymer by showing the characteristic functional groups and proton environment of the gel. X-ray Diffraction (XRD) pattern indicates the crystalline/amorphous nature of the gel. The Differential Scanning Calorimetry (DSC) and Thermogravimetry Analysis (TGA) revealed the thermal stability of the gel. The surface morphology and constitutional elements were analyzed and confirmed by Scanning Electron Microscopy (SEM) equipped with Energy Dispersive Spectroscopy (EDS). Finally, it can be stated that hydrogels can be usable in metal adsorption, drug delivery, and other relevant fields.

Background: There is no standardized assessment for evaluating response although neoadjuvant chemotherapy (NAT) is widely accepted for borderline resectable or locally advanced pancreatic cancer (BRPC or LAPC). This study was aimed to evaluate NAT response using positron emission tomography (PET) with 2-deoxy-2-[fluorine-18]fluoro-D-glucose (18F-FDG-PET/CT) parameters alongside carbohydrate antigen (CA) 19-9 levels. Methods: Patients who underwent surgery after NAT for BRPC and LAPC between 2017 and 2021 were identified. The study assessed the prognostic value of PET-derived parameters after NAT, determining cutoff values using the K-adaptive partitioning method. It created four groups based on the elevation or normalization of PET parameters and CA19-9 levels, comparing survival between these groups. Results: Of 200 eligible patients, FOLFIRINOX and gemcitabine-based NAT was administered in 166 and 34 patients, respectively (mean NAT cycles, 8.3). In a multivariate analysis, metabolic tumor volume (MTV) demonstrated the most robust performance in assessing response [hazard ratio (HR) 3.11, 95% confidence interval (CI) 1.73-5.58, P< 0.001] based on cutoff value of 2.4. Patients with decreased MTV had significantly better survival than those with elevated MTV among individuals with CA19-9 levels less than 37 IU/l (median survival; 35.5 vs. 20.9 months, P< 0.001) and CA19-9 levels at least 37 IU/l (median survival; 34.3 vs. 17.8 months, P=0.03). In patients suspected to be Lewis antigen negative, the predictive performance of MTV was found to be limited (P= 0.84). Conclusion: Elevated MTV is an influential prognostic factor for worse survival, regardless of post-NAT CA19-9 levels. These results could be helpful in identifying patients with a poor prognosis despite normalization of CA19-9 levels after NAT. [ABSTRACT FROM AUTHOR]

Abstract To facilitate precise tumor resection at the time of breast-conserving surgery (BCS), we developed and implemented a magnetic resonance imaging (MRI)-based three-dimensional-printed (3DP) breast surgical guide (BSG). This prospective cohort study was conducted at a single institution from July 2017 to February 2019 on women with breast cancer who underwent partial breast resection using patient-specific 3DP BSGs. Eighty-eight patients with invasive cancer were enrolled, of whom 1 patient had bilateral breast cancer. The mean size of the tumor long-axis on MRI before surgery was 2.8 ± 0.9 cm, and multiple tumors were observed in 34 patients. In 16 cases (18.0%), the resection margin was tumor-positive according to intraoperative frozen biopsy; all of these tumors were ductal carcinoma in situ and were re-excised intraoperatively. In 93.3% of the cases, the resection margin was tumor-free in the permanent pathology. The mean pathological tumor size was 1.7 ± 1.0 cm, and the mean distance from the tumor to the border was 1.5 ± 1.0 cm. This exploratory study showed that the tumor area on the MRI could be directly displayed on the breast when using a 3DP BSG for BCS, thereby allowing precise surgery and safe tumor removal. Trial Registration Clinical Research Information Service (CRIS) Identifier (No. KCT0002375, KCT0003043).

Background: Adjuvant chemotherapy is the standard treatment after curative-intent surgery for pancreatic ductal adenocarcinoma (PDAC). The phase-3 ESPAC-4 trial demonstrated significantly improved overall survival (OS) with Gemcitabine plus capecitabine (GemCap) over Gemcitabine (Gem) in Europe. We conducted a retrospective efficacy and safety evaluation of GemCap versus Gem in an Asian population. Methods: This retrospective analysis included 292 patients with PDAC who received adjuvant Gem or GemCap after curative resection between January 2017 and December 2020 at Asan Medical Center, Seoul, Korea. Results: Adjuvant Gem and GemCap were administered to 161 (55.1%) and 131 (44.8%) patients, respectively. The Gem group had significantly older patients (median 66 versus 63 years, p = 0.001); otherwise, the groups had similar baseline characteristics. With median follow-up durations of 39.4 [95% confidence interval (CI), 36.9–45.0] and 39.4 (95% CI, 34.7–41.6) months in the Gem and GemCap groups, the median OS was 36.8 (95% CI, 29.7–43.5) and 46.1 (95% CI, 31.5–not reached) months in the Gem and GemCap groups, respectively [unadjusted hazard ratio (HR) = 0.7; 95% CI, 0.5–1.0; p = 0.07). The median recurrence-free survival was 14.3 (95% CI, 12.9–17.7) and 17.0 (95% CI, 13.3–28.2) months, respectively ( p = 0.5). Hand-foot skin reactions (any grade, 15.3% versus 0.6%; p median) were significantly associated with worse OS. Conclusions: Adjuvant GemCap showed the consistent clinical outcomes with the ESPAC-4 trial. As mFOLFIRINOX is the new standard treatment for medically fit patients with resected PDAC, further evaluation of optimal adjuvant chemotherapy in daily practice is warranted.

The gamma radiation technique is simple and time-saving for the synthesis of pure hydrogels. The present work focuses on synthesizing and characterizing Diallyldimethylammonium Chloride-Acrylic acid-(3-Acrylamidopropyl) trimethylammonium Chloride (DADMAC-AAc-APTAC) superabsorbent hydrogels. The hydrogels were synthesized by applying gamma radiation of different doses (2 kGy to 30 kGy) to two different compositions of monomers. The equilibrium swelling was found to be 33483.48% of dried gel for a 1:0.5:1 composition ratio of monomers at a 2 kGy radiation dose. Therefore, on the basis of equilibrium swelling, 2 kGy is the optimum radiation dose for synthesizing the hydrogel. Fourier transform infrared (FTIR), nuclear magnetic resonance (NMR) spectroscopy, and X-ray diffraction (XRD) characterization techniques were used to analyze and confirm the structure of the hydrogel. Thermogravimetric analysis (TGA) and Scanning electron microscopy (SEM) equipped with energy dispersive spectroscopy (EDS) clearly showed the thermal stability and surface morphology of the gel. Therefore, it can be concluded that hydrogels can be used in metal adsorption, drug delivery, and other fields of study.

Traditional computational fluid dynamics (CFD) methods are usually used to obtain information about the flow field over an airfoil by solving the Navier–Stokes equations for the mesh with boundary conditions. These methods are usually costly and time-consuming. In this study, the pix2pix method, which utilizes conditional generative adversarial networks (cGANs) for image-to-image translation, and a deep neural network (DNN) method were used to predict the airfoil flow field and aerodynamic performance for a wind turbine blade with various shapes, Reynolds numbers, and angles of attack. Pix2pix is a universal solution to the image-to-image translation problem that utilizes cGANs. It was successfully implemented to predict the airfoil flow field using fully implicit high-resolution scheme-based compressible CFD codes with genetic algorithms. The results showed that the vortical flow fields of the thick airfoils could be predicted well using the pix2pix method as a result of deep learning.

The gut microbiota (GM) has been shown to be closely associated with the development of colorectal cancer (CRC). However, the involvement of GM is CRC has mainly been demonstrated by metagenomic profiling studies showing the compositional difference between the GM of healthy individuals and that of CRC patients and not by directly studying isolated gut microbes. Thus, to discover novel gut microbes involved in CRC, we isolated the GM from the feces of healthy individuals and evaluated its anti-CRC activity in vitro and in vivo. After GM isolation, cell-free supernatants (CFSs) were prepared from the isolated gut microorganisms to efficiently screen a large amount of the GM for anti-proliferative ability in vitro. Our results showed that the CFSs of 21 GM isolates had anti-proliferative activity against human colon cancer HCT 116 cells. Of these 21 GM isolates, GM07 was chosen for additional study because it had the highest anti-cancer activity against mouse colon cancer CT 26 cells in vitro and was further evaluated in a CT 26 allograft mouse model in vivo. GM07 was identified as Odoribacter splanchnicus through phylogenetic analysis based on 16S rRNA gene sequencing. Further investigation determined that the CFS of O. splanchnicus (OsCFS) induced anti-proliferative activity via apoptosis, but not cell cycle arrest. Moreover, GC/MS analysis suggested that the putative active molecule in OsCFS is malic acid. Finally, in the CRC mouse model, peri-tumoral injection of OsCFS significantly decreased CRC formation, compared to the control group. Altogether, these findings will provide valuable information for the discovery of potential probiotic candidates that inhibit CRC.

BackgroundFew data are available on the risk factors of locoregional recurrence (LRR) after neoadjuvant chemotherapy (NACT) and immediate breast reconstruction (IBR) in breast cancer. Herein, we evaluated the factors predicting LRR in a large series of patients who underwent either nipple- (NSM) or skin-sparing mastectomy (SSM) with IBR after NACT.MethodsWe retrospectively analyzed 609 breast cancer patients who underwent NACT and NSM/SSM with IBR between February 2010 and June 2017. Factors associated with an increased risk of LRR were analyzed by univariate (chi-square or Fisher’s exact test) and multivariate (Cox proportional hazard regression model) analyses.ResultsDuring a median follow-up of 63 months, LRR as the first event occurred in 73 patients, and the 5-year cumulative LRR rate was 10.8%. Multivariate analysis revealed post-NACT Ki67 ≥ 10% [hazard ratio (HR), 2.208; 95% confidence interval (CI), 1.295-3.765; P = 0.004], high tumor grade (HR, 1.738; 95% CI, 1.038-2.908; P = 0.035), and presence of lymphovascular invasion (LVI) (HR, 1.725; 95% CI, 1.039-2.864; P = 0.035) as independently associated with increased LRR risk. The 10-year LRR rate was 8.5% for patients with none of the three associated risk factors, 11.6% with one factor, 25.1% with two factors, and 33.7% with all three factors (P < 0.001).ConclusionsPost-NACT Ki67 ≥ 10%, high tumor grade, and presence of LVI are independently associated with an increased risk of developing LRR after NACT and NSM/SSM with IBR. Future prospective trials are warranted to decrease the risk of LRR in patients with associated risk factors.

The wire-wrapped fuel bundle is an assembly design in a sodium-cooled fast reactor. A wire spacer is used to maintain a constant gap between rods and to enhance the mixing of coolants. The wire makes the flow complicated by creating a sweeping flow and vortex flow. The vortex affects the flow field and heat transfer inside the subchannels. However, studies on vortices in this geometry are limited. The purpose of this research is to investigate the vortex flow created in the wire-wrapped fuel bundle. For analysis, a RANS-based numerical analysis was conducted for a 37-pin geometry. The sensitivity study shows that simulation with the shear stress transport model is appropriate. For the case of Re of 37,100, the mechanisms of onset, periodicity, and rotational direction were analyzed. The vortex structures were reconstructed in a three-dimensional space. Vortices were periodically created in the interior subchannel three times for one wire rotation. In the edge subchannel, the largest vortex occurred. This large vortex structure blocked the swirl flow in the peripheral region. The small vortex formed in the corner subchannel was negligible. The results can help in understanding the flow field inside subchannels with sweeping flow and vortex structures. Keywords: Sodium-cooled fast reactor, Wire-wrapped fuel bundle, Computational fluid dynamics, Vortex identification

The performance and efficiency of a centrifugal compressor are usually affected by the highly complex 3-dimensional flow structures which develop in the flow field of the compressor. Several experiments and research using numerical analysis have been reported, however, there are still many unknown physical phenomena that need to be studied, in order to optimize the design and improve the efficiency of turbomachines, especially those installed on hydrogen-powered fuel cell electric vehicles (FCEVs). In this study, the 3-dimensional vortex structures were analyzed using the critical-point theory and the probabilistic definitions, for an air supply device mounted on the commercial hydrogen FCEVs. The behavior of the complex 3-dimensional vortex structures at the design flow rate and low flow rate were elucidated. A tip leakage vortex was observed to develop at the leading edge of the main blade at all flow rates, which caused interference to the splitter blade. At 60% of the design flow rate, a vortex breakdown occurred at the tip leakage vortex near the leading edge of the main blade, and a reverse flow at 50% chord length of the main blade’s suction surface. The boundary layer which developed at the leading edge of the main blade’s suction surface at all flow rates led to the creation of a hub separation vortex by interfering with the boundary layer developed at the hub surface as a result of the centrifugal force. In addition, the boundary layer developed at the hub and shroud surface created a horseshoe vortex as it moved downstream and interfered with the leading edge of the main blade and splitter blade. It was confirmed that the behavior of the tip leakage, hub separation, and horseshoe vortex structures determined the aerodynamic performance of the centrifugal compressor. The average pressure difference improved by 1.47% of the entire flow rate after optimizing the compressor design.

BackgroundAlthough the guidelines recommend gynecological assessment and close monitoring for symptoms of endometrial cancer in postmenopausal breast cancer survivors taking tamoxifen (TAM), the risk of endometrial cancer in young breast cancer survivors has not yet been fully assessed. This study aimed to investigate the risk of developing endometrial cancer and the frequencies of gynecological examinations in young breast cancer survivors taking TAM in South Korea.MethodsA nationwide retrospective cohort study was conducted using the Health Insurance Review and Assessment Service claims data. Kaplan–Meier analyses and log-rank tests were used to assess the probability of endometrial cancer, benign endometrial conditions, and the probability of invasive endometrial procedure. To analyze the risk of endometrial cancer and benign endometrial conditions, we used a multivariable Cox proportional hazards regression model.ResultsBetween 2010 and 2015, 60,545 newly diagnosed female breast cancer survivors were included. The total person–years were 256,099 and 140 (0.23%) patients developed endometrial cancer during the study period. In breast cancer survivors aged ≥60 years [hazard ratio (HR), 5.037; 95% confidence interval (CI), 2.185–11.613], 50–59 years (HR, 4.343; 95% CI, 2.122–8.891), and 40–49 years (HR, 2.121; 95% CI, 1.068–4.213), TAM was associated with an increased risk of endometrial cancer. In subjects aged below 40 years, TAM did not significantly increase the risk of endometrial cancer. However, among the TAM subgroups, breast cancer survivors aged below 40 years [1.61 per 1,000 person–years (PY); HR, 12.460; 95% CI, 2.698–57.522] and aged 40–49 years (2.22 per 1,000 PY; HR, 9.667; 95% CI, 4.966–18.819) with TAM-related endometrial diseases showed significantly increased risks of endometrial cancer. Among the TAM subgroup with benign endometrial conditions, the ratios of the frequency of invasive diagnostic procedures to the incidence of endometrial cancer were higher in subjects under 40 than subjects aged 60 or more.ConclusionYoung breast cancer survivors with TAM-related benign endometrial diseases are at a higher risk of developing endometrial cancer. Gynecological surveillance should be tailored to the risk of endometrial cancer in young breast cancer survivors to improve the early detection of endometrial cancer and avoid unnecessary invasive procedures.

BackgroundIn patients with hormone receptor-positive (HR+)/premenopausal breast cancer, luteinizing hormone-releasing hormone analogs (LHRHas) are used as standard endocrine treatment. Based on previous clinical studies, 1-month formulations are recommended in most breast cancer treatment guidelines, but long-acting formulations facilitate reductions in side effects and patient discomfort caused by frequent administration. However, few efficacy studies have been conducted on 6-month formulations. Therefore, this study aimed to evaluate the efficacy of 6-month formulations of LHRHas.MethodsThis retrospective study was conducted from January 2018 to December 2019 and involved premenopausal patients with HR+ breast cancer administered 6-month LHRHas as adjuvant treatment after surgery, and those previously administered chemotherapy or other LHRHa types were excluded. Patients’ estradiol (E2) and follicle-stimulating hormone (FSH) levels were measured before surgery, and their E2 levels were also measured at 3, 6, 12, 18, and 24 months at periodic postsurgical examinations.ResultsA total of 228 patients were included, and the median patient age was 44 (range, 25–54) years. The mean serum E2 and FSH levels before surgery were 69.7 (range, 4–683) pg/mL and 7.3 (range, 0.4–88.9) mIU/mL, respectively, whereas the mean serum E2 level monitored at intervals during the 6-month LHRHa administration was 5.5 (range, 4.0–52) pg/mL. No women menstruated during the follow-up period after the LHRHas administration, and the E2 levels were less than 30 pg/mL in all patients except one.ConclusionsThe 6-month LHRHa formulation adequately suppressed ovarian function in premenopausal patients with HR+ breast cancer. This indicates that long-acting LHRHas can be effectively used for patient convenience and that there is high compliance with long-term use.

Introduction: Liposomal irinotecan (nal-IRI) plus fluorouracil/leucovorin (5-FU/LV) has shown clinical benefit in patients with metastatic pancreatic adenocarcinoma (mPAC) who progressed on gemcitabine-based chemotherapy. However, its role in patients with mPAC previously treated with conventional irinotecan-containing chemotherapy has not been appropriately investigated. Methods: In this retrospective analysis, patients with mPAC who received nal-IRI plus 5-FU/LV after conventional irinotecan-containing regimen between January 2017 and March 2020, were identified from two referral cancer centers in South Korea. The ratio of time to progression (TTP) with nal-IRI plus 5-FU/LV to TTP with conventional irinotecan (TTPr) was analyzed with respect to the duration and cumulative dose of conventional irinotecan treatment. Results: In total, 35 patients treated with nal-IRI plus 5-FU/LV after the irinotecan-containing regimen were analyzed. The median age was 58 years and 16 (46%) patients were male. The median duration of conventional irinotecan therapy was 4.6 months at a median cumulative dose of 1230 mg. The objective response rate of nal-IRI plus 5-FU/LV was 2.9%, and stable disease was achieved in 11 (31.4%) patients. During the median follow-up of 9.2 [95% confidence interval (CI): 7.8–10.5] months, the median progression-free survival (PFS) and overall survival (OS) were 2.0 (95% CI: 1.4–2.6) months and 4.4 (95% CI: 3.6–5.7) months, respectively. The 6-month PFS and OS rates were 16.3% and 37.5%, respectively. The median TTPr was 0.41 (range, 0.07–2.07), showing a negative correlation with the cumulative dose of prior irinotecan therapy (R = −0.37, p = 0.041). A tentative negative correlation between TTPr and duration of prior irinotecan therapy was observed ( R = −0.35, p = 0.062). The most common grade 3–4 toxicities were neutropenia (20%) and fatigue (8.6%). Conclusion: Nal-IRI plus 5-FU/LV showed modest effectiveness and manageable toxicities for patients with mPAC previously treated with conventional irinotecan-containing chemotherapy. The cumulative dose of prior conventional irinotecan therapy may be inversely correlated with the effectiveness of nal-IRI plus 5-FU/LV.

PurposeMore than half of patients with bile duct cancer (BDC) develop recurrence even after curative resection. Recurrent BDC has a poor prognosis, and no optimal treatment modality has been established. We therefore analyzed our experience on the survival outcomes of radiation therapy (RT) for recurrent extrahepatic bile duct cancer (EHBDC).Patients and methodsWe retrospectively analyzed the records of patients with recurrent EHBDC who underwent concurrent chemoradiation therapy (CCRT) or RT alone at our institution between January 2001 and June 2015. Freedom from locoregional progression (FFLP), progression-free survival (PFS), and overall survival (OS) were assessed, and univariate and multivariate analyses were performed to identify the prognostic factors.ResultsA total of 76 patients were included in the analysis. The median OS was 16 months and the rates of 2-year FFLP, PFS, and OS were 61%, 25%, and 33%, respectively. Among the evaluable patients, the first site of failure was the locoregional area in 16 patients, distant metastasis in 27, and both sites in 8. On univariate analysis, disease-free interval (p = 0.012) and concurrent chemotherapy (p = 0.040) were found as significant prognostic factors for OS. One patient with CCRT developed a grade 3 hematologic toxicity, and two patients experienced late grade 3 toxicities including duodenal ulcer bleeding and obstruction.ConclusionsRT for recurrent EHBDC showed favorable survival and local control with limited treatment-related toxicities. Considering that the most common pattern of failure was distant metastasis, further studies on the optimal scheme of chemotherapy and RT are warranted.