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Abstract Introduction To diagnose sinusoidal obstruction syndrome/veno‐occlusive disease (SOS/VOD), transabdominal ultrasonography is usually used to detect hemodynamic changes, but we tried to detect the changes using four‐dimensional computed tomography (4D‐CT). A 42‐year‐old Japanese woman was diagnosed with late‐onset SOS/VOD with transabdominal ultrasonography and was also assessed using 4D‐CT. Method We analyzed the portal vein (PV) contrast effect every 1.5 seconds and plotted the values of the contrast effect. With this graph, we analyzed three hemodynamic parameters. Result We found that these parameters correlated with the patient's status and indicated stasis due to sinusoid constriction. Conclusion 4D‐CT may become a helpful tool to diagnose and follow up with SOS/VOD.

Introduction: TP53-induced glycolysis and apoptosis regulator (TIGAR) is a p53 target protein that has critical roles in glycolysis and redox balance. The reports about the effect of TIGAR on prognosis and its biological role in hepatocellular carcinoma (HCC) are limited. Methods: A total of 386 patients with HCC who had undergone hepatic resection were enrolled. Immunohistochemical staining for TIGAR was performed. Additionally, the regulation of malignant activity and ferroptosis by TIGAR was investigated in vitro. Results: Patients were divided into TIGAR-positive (n = 80, 20.7%) and -negative (n = 306, 79.3%) groups. TIGAR positivity was significantly correlated with lower albumin, higher α-fetoprotein/ des-gamma-carboxyprothrombin, larger tumor size/number of tumors, and greater proportions of BCLC staging C/single nodular type/poor differentiation/microscopic vascular invasion/microscopic intrahepatic metastasis. In multivariate analysis, TIGAR positivity was an independent prognostic factor (p < 0.0001). In addition, TIGAR positivity was significantly associated with a smaller number of cluster of differentiation (CD) 8-positive T cells (p = 0.0450), larger number of CD68-positive macrophages (p = 0.0058), larger number of programmed death-ligand 1-positive cases (p = 0.0002), and larger number of vessels that encapsulate tumor cluster-positive cases (p = 0.0004). In vitro, TIGAR knockdown decreased cell motility and induced ferroptosis. TIGAR knockdown inhibited the phosphorylation of adenosine monophosphate-activated protein kinase and acetyl-CoA carboxylase. Ferroptosis induced by TIGAR knockdown was inhibited by liproxstatin and baicalein treatment. The combination of TIGAR knockdown and lenvatinib further induced ferroptosis. Conclusion: High expression of TIGAR impacted the clinical outcome of HCC patients and TIGAR was associated not only with tumor microenvironment but also with resistance to ferroptosis.

Abstract Aim There is limited evidence regarding the feasibility of living‐donor liver transplantation (LDLT) for patients aged over 70. The aims of this study were to assess postoperative outcomes in elderly recipients and to ascertain the potential feasibility and acceptability of LDLT. Methods Data were collected from 762 recipients, including 26 in the elderly group (aged ≥70) and 736 in the younger group (aged

The increase in Earth observations from space in recent years supports improved quantification of carbon storage by terrestrial vegetation and fosters studies that relate satellite measurements to biomass retrieval algorithms. However, satellite observations are only indirectly related to the carbon stored by vegetation. While ground surveys provide biomass stock measurements to act as reference for training the models, they are sparsely distributed. Here, we addressed this problem by designing an algorithm that harnesses the interplay of satellite observations, modeling frameworks and field measurements, and generated global estimates of above-ground biomass (AGB) density that meet the requirements of the scientific community in terms of accuracy, spatial and temporal resolution. The design was adapted to the amount, type and spatial distribution of satellite data available around the year 2020. The retrieval algorithm estimated AGB annually by merging estimates derived from C- and L-band Synthetic Aperture Radar (SAR) backscatter observations with a Water Cloud type of model and does not rely on AGB reference data at the same spatial scale as the SAR data. This model is integrated with functions relating to forest structural variables that were trained on spaceborne LiDAR observations and sub-national AGB statistics. The yearly estimates of AGB were successively harmonized using a cost function that minimizes spurious fluctuations arising from the moderate-to-weak sensitivity of the SAR backscatter to AGB. The spatial distribution of the AGB estimates was correctly reproduced when the retrieval model was correctly set. Over-predictions occasionally occurred in the low AGB range (300 Mg ha−1). These errors were a consequence of sometimes too strong generalizations made within the modeling framework to allow reliable retrieval worldwide at the expense of accuracy. The precision of the estimates was mostly between 30% and 80% relative to the estimated value. While the framework is well founded, it could be improved by incorporating additional satellite observations that capture structural properties of vegetation (e.g., from SAR interferometry, low-frequency SAR, or high-resolution observations), a dense network of regularly monitored high-quality forest biomass reference sites, and spatially more detailed characterization of all model parameters estimates to better reflect regional differences.

Abstract Distal femoral osteotomy (DFO) is performed alone or with high tibial osteotomy (HTO) for patients with osteoarthritis and distal femur deformities. DFO is technically demanding, particularly when creating an anterior flange. Herein, we examined the morphological characteristics of the distal femur based on the cortical shape as a surgical reference for biplanar DFO. Computed tomography images of 50 valgus and 50 varus knees of patients who underwent biplanar DFO or total knee arthroplasty were analyzed. Axial slices at the initial level of the transverse osteotomy in the DFO and slices 10 mm proximal and 10 mm distal to that level were selected. The medial and lateral cortical angles and heights (MCLA, LCLA, MCH, and LCH) were measured on axial slices. Statistical comparisons were performed between the medial and lateral cortices and valgus and varus knees. MCLA and MCH were significantly smaller and lower, respectively, than LCLA and LCH (P

Abstract Whole lung engineering and the transplantation of its products is an ambitious goal and ultimately a viable solution for alleviating the donor-shortage crisis for lung transplants. There are several limitations currently impeding progress in the field with a major obstacle being efficient revascularization of decellularized scaffolds, which requires an extremely large number of cells when using larger pre-clinical animal models. Here, we developed a simple but effective experimental pulmonary bioengineering platform by utilizing the lung as a scaffold. Revascularization of pulmonary vasculature using human umbilical cord vein endothelial cells was feasible using a novel in-house developed perfusion-based bioreactor. The endothelial lumens formed in the peripheral alveolar area were confirmed using a transmission electron microscope. The quality of engineered lung vasculature was evaluated using box-counting analysis of histological images. The engineered mouse lungs were successfully transplanted into the orthotopic thoracic cavity. The engineered vasculature in the lung scaffold showed blood perfusion after transplantation without significant hemorrhage. The mouse-based lung bioengineering system can be utilized as an efficient ex-vivo screening platform for lung tissue engineering.

Background: To assess the incidence of anterolateral ligament (ALL) and Kaplan fiber of the iliotibial band (KF) injuries in patients with acute anterior cruciate ligament (ACL) injury on magnetic resonance imaging (MRI), and to investigate the association between these injuries and the magnitude of preoperative pivot-shift test. Method: One-hundred and five patients with primary ACL injury were retrospectively reviewed. ALL injury and KF injury were assessed by preoperative MRI, and subjects were allocated into four groups: Group A, neither injury; Group B, only ALL injury; Group C, only KF injury; Group D, simultaneous ALL and KF injuries. Before ACL reconstruction, tibial acceleration during the pivot-shift test was measured by an electromagnetic measurement system, and manual grading was recorded according to the International Knee Documentation Committee (IKDC) guideline. Results: In MRI, the ALL was identified in 104 patients (99.1%) and KF in 99 patients (94.3%). ALL and KF injuries were observed in 43 patients (43.9%) and 23 patients (23.5%), respectively. Patient distribution to each group was as follows; Group A: 43 patients (43.9%), Group B: 32 patients (32.7%), Group C: 12 patients (12.2%), Group D: 11 patients (11.2%). No significant differences were observed in tibial acceleration, and manual grading among the four groups. Conclusion: Simultaneous injury to both ALL and KF was uncommon, and preoperative pivot-shift phenomenon did not increase even in those patients. The finding suggests that the role of ALL and KF in controlling anterolateral rotatory knee laxity may be less evident in the clinical setting compared to a biomechanical test setting.

Abstract Purpose Graft failure following revision anterior cruciate ligament (ACL) reconstruction is higher than after primary ACL reconstruction. However, data regarding revision surgery is scarce. We aimed to evaluate the associated factors for failure after revision ACL reconstruction. Methods Fifty‐four patients (mean age: 24.7 ± 10.0 years) who underwent revision ACL reconstruction at our hospital with ≥1 year follow‐up were retrospectively examined. Patients were divided into Group F (graft failure) and Group N (no graft failure) groups. Univariate analysis was conducted to identify factors associated with graft failure. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal thresholds for differentiating between the two groups. Results Graft failure was observed in 7 of 54 patients (13.0%). In the univariate analysis, significant differences were observed for age at the initial surgery (Group F: 15.6 ± 1.5, Group N: 20.9 ± 8.1), age at the revision surgery (Group F: 18.0 ± 2.8, Group N: 25.7 ± 10.3), presence of hyperextended knee (Group F: 85.7%, Group N: 14.9%), concomitant meniscectomy (Group F: 42.9%, Group N: 14.9%), prerevision space for the ACL (sACL) (Group F: 7.2 ± 3.4 mm, Group N: 13.4 ± 4.7 mm) and preoperative anterior tibial translation (ATT) (Group F: 5.0 ± 1.4 mm, Group N: 2.7 ± 3.1 m). ROC analysis of preoperative sACL and preoperative ATT on one‐leg standing plain radiograph showed that cutoff values of 6.9 and 4.2 mm were the optimal thresholds, respectively. Conclusion Younger patients with a hyperextended knee, concomitant meniscectomy, small sACL and large ATT before revision ACL reconstruction are predisposed to graft failure. Level of Evidence Level IV.

Abstract Land use land cover (LULC) maps are crucial for various applications, such as disaster management, natural resource conservation, biodiversity evaluation, climate modeling, etc. The Japan Aerospace Exploration Agency (JAXA) has released several high-resolution LULC maps for national and regional scales. Vietnam, due to its rich biodiversity and cultural diversity, is a target country for the production of high-resolution LULC maps. This study introduces a high-resolution and high-accuracy LULC map for Vietnam, utilizing a CNN approach that performs convolution over a time-feature domain instead of the typical geospatial domain employed by conventional CNNs. By using multi-temporal data spanning 6 seasons, the produced LULC map achieved a high overall accuracy of 90.5% ± 1.2%, surpassing other 10-meter LULC maps for Vietnam in terms of accuracy and/or the ability to capture detailed features. In addition, a straightforward and practical approach was proposed for generating cloud-free multi-temporal Sentinel-2 images, particularly suitable for cloudy regions. This study marks the first implementation of the time-feature CNN approach for the creation of a high-accuracy LULC map in a tropical cloudy country.

Abstract Background Nodular regenerative hyperplasia (NRH) is a rare disease that presents pathologically as diffuse hepatic nodules without fibrous septa. It is believed to be caused by vasculopathy against a background of various systemic diseases, such as hematologic, autoimmune, and drug-induced diseases, with various symptoms. In spite of the recent imaging advances, various atypical cases of nodular lesions are observed in daily clinical practice. Cases that do not completely meet these criteria are referred to as -like or -similar lesions in clinical situations, making it difficult to understand their pathogenesis. We present a case in which two hepatic nodular lesions were noted and difficult to differentiate from malignancy preoperatively. The lesions were laparoscopically resected and a pathological diagnosis with non-neoplastic liver regenerative nodules resembling NRH was made. Case presentation A 49-year-old man with no alcohol or drug intake and no past medical history was identified as having liver tumors on screening examination without any symptoms. Contrast-enhanced computed tomography (CT) showed two hepatic tumors; approximately 2-cm tumors at S7 and S8. Gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) revealed fat inclusions in their contents. Ethoxybenzyl (EOB) uptake was also observed during the hepatobiliary phase. Based on preoperative examinations, we suspected well-differentiated hepatocellular carcinoma (HCC) and performed laparoscopic S7/8 partial resection for these lesions. Macroscopically, the resected specimens showed a non-cirrhotic yellowish-cut surface containing brownish, ill-defined lesions with irregular borders. Microscopically, these lesions showed zonal necrosis, congestion, and aggregation of hemosiderin-laden macrophages around the central vein. In these areas, the fatty deposition of hepatocytes was lower than that in the surrounding background hepatocytes. Histopathologically, neither neoplastic nor hyperplastic lesions were observed, and he was diagnosed as regenerative hepatic change with centrilobular necrosis. Conclusions Considering the pathological results, these lesions were thought to be a type of NRH-like lesion with possible hepatic vessel disorder. However, the lesion’s cause and classification was difficult to determine. The accumulation of these regenerative changes accompanying fatty liver is needed to clarify the mechanism and its clinical significance.

Abstract Background There is limited published information regarding the expression of mechanistic target of rapamycin (mTOR) in vessels that encapsulate tumor cluster (VETC)‐positive hepatocellular carcinoma (HCC). The mTOR inhibitor, everolimus, has been approved as an immunosuppressant for use in HCC patients after living donor liver transplantation (LDLT). Methods Using a database of 214 patients who underwent LDLT for HCC, we examined the mTOR protein and angiopoietin‐2 (Ang‐2) in VETC‐positive HCC by immunohistochemical staining. The presence of VETC and mTOR expression were evaluated in both primary and recurrent HCC lesions. Results Forty‐three of the 214 patients (20.1%) were VETC‐positive, and 29 of these 43 patients (67.4%) expressed mTOR. Relative Ang‐2 expression was significantly higher in the mTOR‐positive than in the mTOR‐negative group (p = 0.037). Thirty‐four of the 214 patients experienced HCC recurrence after LDLT; 20 of these were operable. The primary lesions of six of these 20 patients were VETC‐positive; five of these six patients also had VETC‐positive recurrent lesions (p

Abstract Background Liver transplantation is the definitive therapy for patients with decompensated cirrhosis. Marfan syndrome is a systemic inheritable connective tissue disease associated with fibrillin-1 gene mutations, which cause abnormalities in connective tissue. Vascular changes due to Marfan syndrome occur mostly in the main vessels due to the high amount of connective tissue within the vessel wall and the high pressure and blood flow to which they are exposed. The incidence of changes in visceral arteries is about 0.42% and usually presents with cystic medial necrosis. This report is the first deceased-donor liver transplantation with a donor with Marfan syndrome with a history of abdominal surgery. Case presentation A patient in his 50s underwent liver transplantation for decompensated alcoholic cirrhosis. The donor, a 50s male with Marfan syndrome, was diagnosed with brain-death due to a cerebral hemorrhage caused by a cerebral aneurysm. The donor’s clinical presentation as Marfan syndrome was aortic dissection, with multiple surgical procedures performed from the aortic root to the abdominal aorta. An intraoperative biopsy of the hepatic artery showed no abnormality, so this organ was considered appropriate. The surgery was completed without any problems of the arterial anastomosis. The patient’s postoperative course was uneventful, and he was transferred to a hospital for recuperation on the 18th postoperative day. One year after the surgery, the patient is still alive without any complications from the transplantation or arterial problems. Conclusions Even if the patient had a history of surgery for vascular anomalies extending to the abdominal aorta due to Marfan syndrome, the patient can be a donor for liver transplantation under appropriate judgment, including intraoperative biopsy.

Neutrophils are innate immune cells and the first line of defense for the maintenance of homeostasis. However, our knowledge of the metabolic rewiring associated with their differentiation and immune stimulation is limited. Here, quantitative 13C-metabolic flux analysis was performed using HL-60 cells as the neutrophil model. A metabolic model for 13C-metabolic flux analysis of neutrophils was developed based on the accumulation of 13C in intracellular metabolites derived from 13C-labeled extracellular carbon sources and intracellular macromolecules. Aspartate and glutamate in the medium were identified as carbon sources that enter central carbon metabolism. Furthermore, the breakdown of macromolecules, estimated to be fatty acids and nucleic acids, was observed. Based on these results, a modified metabolic model was used for 13C-metabolic flux analysis of undifferentiated, differentiated, and lipopolysaccharide (LPS)-activated HL-60 cells. The glucose uptake rate and glycolytic flux decreased with differentiation, whereas the tricarboxylic acid (TCA) cycle flux remained constant. The addition of LPS to differentiated HL-60 cells activated the glucose uptake rate and pentose phosphate pathway (PPP) flux levels, resulting in an increased rate of total NADPH regeneration, which could be used to generate reactive oxygen species. The flux levels of fatty acid degradation and synthesis were also increased in LPS-activated HL-60 cells. Overall, this study highlights the quantitative metabolic alterations in multiple pathways via the differentiation and activation of HL-60 cells using 13C-metabolic flux analysis.

Purpose: The treatment of cartilage injury is challenging owing to its low self-healing capacity. Here we describe a literature review of the current diagnostic methods, surgical treatment options, and techniques for knee cartilage injuries, including possible future treatments and augmentations. Methods: Studies describing surgical techniques for knee cartilage injuries were searched and arbitrarily selected in PubMed. Possible future treatments and augmentations, growth factors, and cell-based treatments are also discussed. Results: Surgical options for cartilage injury, such as microfracture, osteochondral autografts or allografts, and autologous chondrocyte implantation, are well-established methods with overall satisfactory short- and long-term outcomes. However, the limitations and disadvantages of these treatments, such as repair with fibrous cartilage, donor site morbidity, and two-step surgery, have raised concerns. Various surgical treatments or augmentations have been developed to overcome these limitations, including autologous matrix-induced chondrogenesis, bone marrow aspirate concentrate, particulate chondrocyte implantation, and particulate juvenile allograft chondrocytes, and promising short-to mid-term results have been reported. Additionally, numerous studies are underway on the augmentation of biological healing including growth factor and stem cell therapies. Conclusions: Although treating cartilage injuries remains challenging, advancements have been made. It is advisable for surgeons and clinicians to update their surgical techniques and knowledge of cartilage repair and regeneration to better treat patients with knee cartilage injuries.

Abstract Background and Aim Many recent studies have shown a relationship between various systemic diseases and the gut microbiota (GM), with the gut–liver axis receiving particular attention. In contrast, no report has comprehensively shown the effects of GM on the pathophysiology of patients undergoing living donor liver transplantation (LDLT). Method We enrolled 16 recipients who underwent LDLT for liver cirrhosis, and 17 donors constituted the reference group. We examined the differences in GM between recipients and donors. We also examined the relationships between GM, short‐chain fatty acids, and portal vein pressure (PVP) in recipients. Results There was no significant difference in alpha‐diversity between the recipients and donors, but there was variation in beta‐diversity among the recipients. The abundance of the phylum Bacteroidetes was significantly higher in recipients than in donors (P = 0.016), and it was positively correlated with PVP (r = 0.511, P = 0.043). Propionic acid, which is a component of short‐chain fatty acids, was positively correlated with PVP (r = 0.544, P = 0.0295), the phylum Bacteroidetes (r = 0.677, P = 0.004), and total bilirubin concentration (r = 0.501, P = 0.048). Propionic acid was negatively correlated with serum albumin concentration (r = −0.482, P = 0.043). Conclusion Our findings suggest relationships between fecal Bacteroidetes levels, propionic acid concentrations, and PVP in patients with liver cirrhosis undergoing LDLT.

Estimating landslide dynamics is vital for the prevention of landslide disasters. Differential interferometric synthetic aperture radar (DInSAR) based on L-band SAR satellites is an effective tool for estimating the dynamics of forested landslides that occur in Japan. High-temporal L-band SAR observations have been planned for the future. Thus, it is necessary to further investigate the specific advantages of high-temporal L-band SAR observations for estimating landslide dynamics. In this study, we used DInSAR data with different time windows to identify active landslides in Hokkaido, Japan. This study is the first attempt to demonstrate the advantages of high-temporal L-band SAR observations for estimating active landslide dynamics. We successfully observed the dynamics of two active landslides, Kounai-1 and Kounai-2, using DInSAR over a time window of 14 days. We present the first spatial observation of the dynamics of Kounai-1 and Kounai-2. In addition, we discuss the dynamics of Kounai-1 and Kounai-2 based on interferograms, and our results suggest that both landslides are subunits of the same landslide, called the Kounai landslide. These results indicate that high-temporal L-band SAR observations can mitigate cycle slips and enable the estimation of active landslide dynamics.

Purpose The swelling characteristics and cracking of expansive clayey soils usually lead to their low yield, and as a result, large areas of expansive soils remain uncultivated and unproductive. There is a need for the development of simple, low-cost technologies which will bring these soils into production. The amendment of expansive clayey soils with agricultural waste products is a key goal for enhancing their production potential. Therefore, a study was conducted to evaluate the ameliorative effects of crop residues on the physiochemical and mechanical properties of expansive clayey soils. Method In this study, the potential soil amendments used include uncharred rice husk, rice husk biochar, uncharred sugarcane bagasse, and sugarcane bagasse biochar. The biochar was pyrolyzed at 450 °C. The amendments were applied into the soil at four applications rates: 0, 2, 5, and 10% by weight of soil (w/w), respectively. The mixture was then incubated in a glasshouse for 280 days. Results Charred and uncharred rice husk and sugarcane bagasse improved the physico-mechanical properties related to soil expansion. The liquid limit (LL), plastic limit (PL), plasticity (PI), coefficient of linier extensibility (COLEcore), volumetric shrinkage (VS), fissuresâ dimensions, and crack area density (CAD) of the soil decreased with an increase in treatment application rate. On the contrary, saturated water content increased with an increase in dosage. Conclusion 10% level of amendment application resulted in significantly improved soil properties than either 2% or 5% doses. Moreover, 2% level of amendment application is more preferable than 5% according to feasibility and economic point of view.

Abstract Aims/Introduction Selenoprotein P (SeP; encoded by SEPP1 in humans) is a hepatokine that causes impaired insulin secretion and insulin resistance. Metformin downregulates SELENOP promoter activity through an adenosine monophosphate‐activated kinase–forkhead box protein O3a pathway in hepatocytes. This study aimed to test our hypothesis that circulating SeP levels are associated with the glucose‐lowering effect of metformin in humans. Materials and Methods A total of 84 participants with poorly controlled type 2 diabetes were randomly assigned to receive metformin (1,000 mg, twice daily) or a dipeptidyl peptidase‐4 inhibitor, alogliptin (25 mg, once daily) for 12 weeks. We tested metformin and alogliptin on SeP levels and factors associated therewith as a post‐hoc analysis. Results Both metformin and aloglipitin did not change the SeP levels. Although metformin significantly increased the insulin secretory index secretory units of islets in transplantation only in participants with higher baseline SeP (>3.87), both agents similarly reduced fasting plasma glucose and glycated hemoglobin. SeP levels at baseline were correlated negatively with changes in SeP (r = −0.484, P = 0.004) and fasting plasma glucose (r = −0.433, P = 0.011), and positively with changes in C‐peptide immunoreactivity (r = 0.420, P = 0.017) and secretory units of islets in transplantation (r = 0.388, P = 0.028) in the metformin, but not alogliptin, group. Conclusions Higher baseline levels of SeP significantly predicted metformin‐mediated, but not alogliptin‐mediated, glucose‐lowering and insulinotropic effects. Serum SeP levels might be a novel biomarker for predicting the outcomes of metformin therapy, which might be helpful in tailoring diabetes medication.

Abstract Aim Gastric mucosal changes associated with chronic gastritis are known to be precancerous lesions of gastric cancer. We aimed to identify individuals with a high risk of gastric cancer by detection of microRNAs (miRNA) in the blood as biomarkers. Methods Of 1206 individuals screened, 144 who were positive for Helicobacter pylori (H. pylori) by the serum antibody test and who underwent endoscopy were the subjects of this study. For the gross assessment of mucosal inflammation, we applied the Kimura–Takemoto classification, in which normal mucosa was defined as grade 0, and atrophy was categorized as grade 1 (C‐1 and C‐2), grade 2 (C‐3 and O‐1), and grade 3 (O‐2 and O‐3). Serum samples were divided into two phases and used for miRNA microarray profiling. We compared the expression of miRNAs in grade 3 mucosa and other grades. Expression in gastric cancer was confirmed with TCGA data. Results miR‐196b‐3p was significantly upregulated, and miR‐92a‐2‐5p was downregulated (P

Abstract Background Congenital portosystemic shunt is an infrequent abnormal connection between the portal vascular system and the systemic circulation. Portosystemic shunts are common findings in patients with cirrhosis, causing gastroesophageal varices, hepatic encephalopathy, and others. However, there is no consensus or literature describing how to manage asymptomatic patients with portosystemic shunts and normal liver. Case presentation The patient was a 39-year-old female who underwent donor right hepatectomy for living donor liver transplantation. The patient was healthy by nature, however, developed hepatic encephalopathy after the surgery due to a development of portosystemic shunt. Portosystemic shunt stole portal blood flow, and imaging modalities revealed narrowing of the portal trunk, representing prolonged depletion of portal blood flow. Balloon-occluded retrograde transvenous obliteration (B-RTO) was performed for occlusion of the portosystemic shunt. B-RTO increased portal blood flow, and hepatic encephalopathy with hyperammonemia was successfully resolved without the outbreak of any other symptom of portal hypertension. Conclusions A congenital portosystemic shunt itself is not a contraindication for donor hepatectomy, but perioperative endovascular shunts occlusion or intraoperative ligature of these shunts should be considered.

Abstract The quality and size of liver grafts are critical factors that influence living‐donor liver transplantation (LDLT) function and safety. However, the biomarkers used for predicting graft quality are lacking. In this study, we sought to identify unique graft quality markers, aside from donor age, by using the livers of non‐human primates. Hepatic gene microarray expression data from young and elderly cynomolgus macaques revealed a total of 271 genes with significantly increased expression in the elderly. These candidate genes were then narrowed down to six through bioinformatics analyses. The expression patterns of these candidate genes in human donor liver tissues were subsequently examined. Importantly, we found that grafts exhibiting up‐regulated expression of these six candidate genes were associated with an increased incidence of liver graft failure. Multivariable analysis further revealed that up‐regulated expression of LRRN2 (encoding leucine‐rich repeat protein, neuronal 2) in donor liver tissue served as an independent risk factor for graft failure (odds ratio 4.50, confidence interval 2.08–9.72). Stratification based on graft expression of LRRN2 and donor age was also significantly associated with 6‐month graft survival rates. Conclusion: Up‐regulated LRRN2 expression of liver graft is significantly correlated with graft failure in LDLT. In addition, combination of graft LRRN2 expression and donor age may represent a promising marker for predicting LDLT graft quality.

Purpose: Although the Palliative Prognostic Index (PPI) has been used to predict survival in various cancers, to our knowledge, no study has examined its applicability in gastric cancer. This study aimed to determine the baseline PPI cutoff value for recommending single-fraction radiotherapy in patients with bleeding gastric cancer. Materials and methods: This was a secondary analysis of the Japanese Radiation Oncology Study Group (JROSG) 17–3, a multicenter prospective study of palliative radiotherapy for bleeding gastric cancer. Discrimination was evaluated using a time-dependent receiver operating characteristic curve, and the optimal cutoff value was determined using the Youden index. A calibration plot was used to assess the agreement between predicted and observed survival. Results: We enrolled 55 patients in JROSG 17–3. The respective median survival times were 6.7, 2.8, and 1.0 months (p = 0.021) for patients with baseline PPI scores of ≤ 2, 2 4. The areas under the curve for predicting death within 2, 3, 4, and 5 months were 0.813, 0.787, 0.775, and 0.721, respectively. The negative predictive value was highest when survival

National monitoring of forests is essential for tracking progress towards various global environmental goals, including those of the Kunming-Montreal Global Biodiversity Framework and the Paris Agreement. Inconsistent national definitions of “forest”, however, can complicate the tracking of global progress towards achieving these goals. The FAO’s (Food and Agricultural Organization of the UN) definition of “Forest” is well-known and broad enough to be applicable globally, but it is difficult for countries to produce national forest maps according to this definition using only a single source of remote sensing data. Here, we developed an approach to integrate multiple existing land use/land cover (LULC) maps and generate an integrated map of forests and “Other land with tree cover” that is more consistent with FAO definitions. The proposed approach is based on merging thematic information from the global “PALSAR-2 Forest/Non-forest map”, a global forest/non-forest map, with that of a national map containing more detailed LULC classes. By applying the map integration approach at the national level in the Philippines as a case study, we identified 5.937 ± 0.217 Mha of “Missing forest” that were not included in the country’s national LULC map, mainly forest patches in areas that were predominantly “Brush/shrub”, “Grassland”, or “Marshland/swamp” lands. We also identified 4.294 ± 0.258 Mha of land corresponding to FAO’s definition of “Other land with tree cover” that were previously unmapped; specifically, patches of tree cover on predominantly agricultural and urban lands. Based on these additional areas of “Forest” and “Other land with tree cover” identified, we further estimated an additional 145,480 GgCO2/year of carbon sinks. Our approach is generalizable enough to potentially be applied in other countries for more standardized forest and ecosystem services monitoring.

Purpose: The aim of this study was to understand the income and employment status of patients at the start of and during follow-up after palliative radiation therapy for bone metastasis. Methods and Materials: From December 2020 to March 2021, a prospective multi-institutional observational study was conducted to investigate income and employment of patients at the start of administration of radiation therapy for bone metastasis and at 2 and 6 months after treatment. Of 333 patients referred to radiation therapy for bone metastasis, 101 were not registered, mainly because of their poor general condition, and another 8 were excluded from the follow-up analysis owing to ineligibility. Results: In 224 patients analyzed, 108 had retired for reasons unrelated to cancer, 43 had retired for reasons related to cancer, 31 were taking leave, and 2 had lost their jobs at the time of registration. The number of patients who were in the working group was 40 (30 with no change in income and 10 with decreased income) at registration, 35 at 2 months, and 24 at 6 months. Younger patients (P = 0), patients with better performance status (P = 0), patients who were ambulatory (P = .008), and patients with lower scores on a numerical rating scale of pain (P = 0) were significantly more likely to be in the working group at registration. There were 9 patients who experienced improvements in their working status or income at least once in the follow-up after radiation therapy. Conclusions: The majority of patients with bone metastasis were not working at the start of or after radiation therapy, but the number of patients who were working was not negligible. Radiation oncologists should be aware of the working status of patients and provide appropriate support for each patient. The benefit of radiation therapy to support patients continuing their work and returning to work should be investigated further in prospective studies.

In recent decades, an important number of regional and global digital elevation models (DEMs) have been released publicly. As a consequence, researchers need to choose between several of these models to perform their studies and to use these DEMs as third-party data to compute derived products (e.g., for orthorectification). However, the comparison of DEMs is not trivial. For most quantitative comparisons, DEMs need to be expressed in the same coordinate reference system (CRS) and sampled over the same grid (i.e., be at the same ground sampling distance with the same pixel-is-area or pixel-is-point convention) with heights relative to the same vertical reference system (VRS). Thankfully, many open tools allow us to perform these transformations precisely and easily. Despite these rigorous transformations, local or global planimetric displacements may still be observed from one DEM to another. These displacements or disparities may lead to significant biases in comparisons of DEM elevations or derived products such as slope, aspect, or curvature. Therefore, before any comparison, the control of DEM planimetric accuracy is certainly a very important task to perform. This paper presents the disparity analysis method enhanced to achieve a sub-pixel accuracy by interpolating the linear regression coefficients computed within an exploration window. This new method is significantly faster than oversampling the input data because it uses the correlation coefficients that have already been computed in the disparity analysis. To demonstrate the robustness of this algorithm, artificial displacements have been introduced through bicubic interpolation in an 11 × 11 grid with a 0.1-pixel step in both directionsThis validation method has been applied in four approximately 10 km × 10 km DEMIX tiles showing different roughness (height distribution). Globally, this new sub-pixel accuracy method is robust. Artificial displacements have been retrieved with typical errors (eb) ranging from 12 to 20% of the pixel size (with the worst case in Croatia). These errors in displacement retrievals are not equally distributed in the 11 × 11 grid, and the overall error Eb depends on the roughness encountered in the different tiles. The second aim of this paper is to assess the impact of the bicubic parameter (slope of the weight function at a distance d = 1 of the interpolated point) on the accuracy of the displacement retrieval. By considering Eb as a quality indicator, tests have been performed in the four DEMIX tiles, making the bicubic parameter vary between −1.5 and 0.0 by a step of 0.1. For each DEMIX tile, the best bicubic (BBC) parameter b* is interpolated from the four Eb minimal values. This BBC parameter b* is low for flat areas (around −0.95) and higher in mountainous areas (around −0.75). The roughness indicator is the standard deviation of the slope norms computed from all the pixels of a tile. A logarithmic regression analysis performed between the roughness indicator and the BBC parameter b* computed in 67 DEMIX tiles shows a high correlation (r = 0.717). The logarithmic regression formula b~σslope estimating the BBC parameter from the roughness indicator is generic and may be applied to estimate the displacements between two different DEMs. This formula may also be used to set up a future Adaptative Best BiCubic (ABBC) that will estimate the local roughness in a sliding window to compute a local BBC b~.

Bladder cancer is the 10th most commonly diagnosed cancer worldwide. The current standard treatment for advanced bladder cancer is neoadjuvant cisplatin (NAC)-based chemotherapy followed by cystectomy. However, the response rate to chemotherapy is only 50%, owing to cisplatin resistance, and there is a need for novel therapies. Because the invasiveness of bladder cancer greatly influences patient prognosis, a mechanistic analysis of the invasive function can lead to therapeutic targets. Sialidases, which remove sialic acid residues from the nonreducing ends of sugar chains and catalyze the initial reaction in the degradation of sugar chains, are predicted to be involved in cell invasion and motility. However, the involvement of sialidases in bladder cancer, especially their relationship with the invasive ability, remains unclear. Here, using patient tissues and multiple bladder cancer cell lines, we show that the sialidase NEU3 is highly expressed in bladder cancer. Analysis of NEU3’s function using its siRNA-mediated knockdown revealed that NEU3 contributes to bladder cancer invasiveness. Mechanistic analysis showed that NEU3 activates ERK and PI3K signaling. Our results show that NEU3 is involved in the malignancy of bladder cancer, and its suppression may lead to novel treatments for bladder cancer.

Abstract Aim This study aimed to clarify the clinical effects of the indocyanine green (ICG)‐fluorescence imaging (FI) technique for determination of liver transection lines during laparoscopic partial liver resection for liver tumors. Methods This was a retrospective study including 112 patients who underwent laparoscopic partial liver resection for liver tumors. These enrolled patients were divided into an ICG‐FI group (n = 55) and a non‐ICG‐FI group (n = 57) according to the availability of the ICG‐FI. The clinicopathological characteristics of patients between two groups were compared before and after propensity score matching. Results The ICG‐FI and non‐ICG‐FI groups differed at baseline in terms of ICG retention rate at 15 min. After propensity score matching, two comparable groups of 32 patients each were obtained. The negativity rated of the pathological surgical margins were comparable between the two groups before and after propensity score matching. However, the surgical margins were significantly wider in the ICG‐FI group before and after propensity score matching (P = .039 and P = .047, respectively). Conclusion The ICG‐fluorescence imaging technique may offer clinical benefits in terms of a secure surgical margin in laparoscopic partial liver resection.

Summary: Space-based remote sensing can make an important contribution toward monitoring greenhouse gas emissions and removals from the agriculture, forestry, and other land use (AFOLU) sector, and to understanding and addressing human-caused climate change through the UNFCCC Paris Agreement. Space agencies have begun to coordinate their efforts to identify needs, collect and harmonize available data and efforts, and plan and maintain a long-term roadmap for observations. International cooperation is crucial in developing and realizing the roadmap, and the Committee on Earth Observation Satellites (CEOS) is a key coordinating driver of this effort. Here, we first identify the data and information that will be useful to support the global stocktake (GST) of the Paris Agreement. Then, the paper explains how existing and planned space-based capabilities and products can be used and combined, particularly in the land use sector, and provides a workflow for their harmonization and contribution to greenhouse gas inventories and assessments at the national and global level.

Abstract Aims/Introduction Glucagon‐like peptide‐1 receptor agonists (GLP‐1 RA) might be less effective in patients with severe hyperglycemia, because hyperglycemia downregulated the GLP‐1 receptor in an animal study. To examine this hypothesis clinically, we compared the glucose‐lowering effects of GLP‐1 receptor agonist liraglutide with and without prior glycemic control. Materials and Methods In an open‐label, parallel trial, participants with poorly controlled type 2 diabetes were recruited and randomized to receive once‐daily insulin therapy, degludec (Insulin–GLP‐1 RA relay group, mean 16.8 ± 11.4 IU/day), for 12 weeks and then liraglutide for 12 weeks or subcutaneous injections of GLP‐1 RA, liraglutide (GLP‐1 RA first group, 0.9 mg), for 24 weeks. The primary efficacy end‐points consisted of changes in the levels of fasting plasma glucose and glycated hemoglobin (HbA1c). Results The median fasting plasma glucose and HbA1c before the study were 210.0 mg/dL and 9.8%, respectively. The levels of fasting plasma glucose and HbA1c significantly decreased in the Insulin–GLP‐1 RA relay group (P

We examined phosphorylated nuclear factor erythroid 2–related factor 2 (P‐NRF2) expression in surgically resected primary hepatocellular carcinoma (HCC) and investigated the association of P‐NRF2 expression with clinicopathological features and patient outcome. We also evaluated the relationship among NRF2, cancer metabolism, and programmed death ligand 1 (PD‐L1) expression. In this retrospective study, immunohistochemical staining of P‐NRF2 was performed on the samples of 335 patients who underwent hepatic resection for HCC. Tomography/computed tomography using fluorine‐18 fluorodeoxyglucose was performed, and HCC cell lines after NRF2 knockdown were analyzed by array. We also analyzed the expression of PD‐L1 after hypoxia inducible factor 1α (HIF1A) knockdown in NRF2‐overexpressing HCC cell lines. Samples from 121 patients (36.1%) were positive for P‐NRF2. Positive P‐NRF2 expression was significantly associated with high alpha‐fetoprotein (AFP) expression, a high rate of poor differentiation, and microscopic intrahepatic metastasis. In addition, positive P‐NRF2 expression was an independent predictor for recurrence‐free survival and overall survival. NRF2 regulated glucose transporter 1, hexokinase 2, pyruvate kinase isoenzymes L/R, and phosphoglycerate kinase 1 expression and was related to the maximum standardized uptake value. PD‐L1 protein expression levels were increased through hypoxia‐inducible factor 1α after NRF2 overexpression in HCC cells. Conclusions: Our large cohort study revealed that P‐NRF2 expression in cancer cells was associated with clinical outcome in HCC. Additionally, we found that NRF2 was located upstream of cancer metabolism and tumor immunity.

ABSTRACT Aim Selenoprotein P (SeP, encoded by SELENOP in humans) is a hepatokine that causes insulin resistance in the liver and skeletal muscle. It was found that polyunsaturated fatty acid eicosapentaenoic acid (EPA) downregulates Selenop expression by inactivating SREBP‐1c. The present study aimed to examine the effect of EPA for 12 weeks on circulating SeP levels and insulin sensitivity in humans with type 2 diabetes. Methods A total of 20 participants with dyslipidemia and type 2 diabetes were randomly assigned to an EPA (900 mg, twice daily) group and a control group. The primary endpoint was a change in serum SeP levels. Organ‐specific insulin sensitivity in the liver (HGP and %HGP), skeletal muscle (Rd), and adipose tissue (FFA and %FFA) were assessed using a hyperinsulinemic‐euglycemic clamp study with stable isotope‐labeled glucose infusion. Results Serum SeP levels were not changed in either group at the end of the study. In the EPA group, the changes in SeP levels were positively correlated with the change in serum EPA levels (r = 0.709, P = 0.022). Treatment with EPA significantly enhanced %FFA but not %HGP and Rd. The change in serum EPA levels was significantly positively correlated with the change in %HGP, and negatively correlated with changes in Rd. Conclusions The change in serum EPA levels was positively correlated with serum SeP levels, hepatic insulin sensitivity, and negatively with skeletal muscle insulin sensitivity in humans with type 2 diabetes. The EPA‐induced enhancement of hepatic insulin sensitivity might be associated with a mechanism independent of serum SeP levels.

Abstract Background Sarcopenia is an important factor in the postoperative outcome of gastrointestinal cancer patients. However, little research has been carried out on potential biomarkers of sarcopenia. Carnitine is an amino acid derivative that is stored in skeletal muscle and is essential for muscle energy metabolism. The primary purpose of this study was to investigate whether serum carnitine level is a biomarker of sarcopenia in preoperative patients with gastrointestinal cancer. The secondary purposes were (i) to examine the associations between carnitine, nutritional status, and albumin level, and (ii) to determine whether carnitine is a prognostic factor for postoperative complications. Methods One hundred fourteen patients scheduled to undergo gastroenterological surgery between August 2016 and January 2017 were enrolled. Their mean age was 68.4 ± 10.5, and 64.9% were male. Serum carnitine fractions [total carnitine (TC), free l‐carnitine (FC), and acylcarnitine (AC)] were measured prior to surgery. The correlation between carnitine level and a variety of clinical features was analysed, including skeletal muscle index (SMI), sarcopenia, prognostic nutritional index (PNI), and postoperative complications. Results Tumour locations included the oesophagus (n = 17), stomach (n = 16), pancreas (n = 20), bile duct (n = 9), liver [n = 33; primary liver cancer (n = 18), liver metastasis (n = 15)], and colorectal region (n = 19). TC and FC levels varied significantly by tumour location. TC and FC showed significant positive correlations with SMI [TC (r = 0.295, P = 0.0014), FC (r = 0.286, P = 0.0020)] and PNI [TC (P = 0.0178, r = 0.222), FC (P = 0.0067, r = 0.2526)]. These levels were significantly lower in the sarcopenia group (TC, P = 0.0124; FC, P = 0.0243). In addition, TC and FC showed significant positive correlations with ALB level [TC (P = 0.038 r = 0.19), FC (P = 0.016 r = 0.23)]. When patients were divided into high ALB (≥3.5 g/dL, 96 patients) and low ALB (

Abstract This study aimed to evaluate the robustness against geometric uncertainties in the hybrid intensity-modulated radiation therapy (IMRT) plans generated by commercially available software for automated breast planning (ABP). The ABP plans were compared with commonly used forward-planned field-in-field (FIF) technique plans. The planning computed tomography datasets of 20 patients who received left-sided breast-conserving surgery were used for both the ABP and FIF plans. Geometric uncertainties were simulated by shifting beam isocenters by 2, 3, 5, and 10 mm in the six directions: anterior/posterior, left/right, and superior/inferior. A total of 500 plans (20 patients and 25 scenarios, including the original plan) were created for each of the ABP and FIF plans. The homogeneity index of the target volume in the ABP plans was significantly better (p

Summary: The cellular interactions in the tumor microenvironment of colorectal cancer (CRC) are poorly understood, hindering patient treatment. In the current study, we investigate whether events occurring at the invasion front are of particular importance for CRC treatment strategies. To this end, we analyze CRC tissues by combining spatial transcriptomics from patients with a public single-cell transcriptomic atlas to determine cell-cell interactions at the invasion front. We show that CRC cells are localized specifically at the invasion front. These cells induce human leukocyte antigen G (HLA-G) to produce secreted phosphoprotein 1 (SPP1)+ macrophages while conferring CRC cells with anti-tumor immunity, as well as proliferative and invasive properties. Taken together, these findings highlight the signaling between CRC cell populations and stromal cell populations at the cellular level.

Abstract Forest fires significantly impact permafrost degradation in the subarctic regions. However, interannual and seasonal variations in surface deformation due to permafrost thawing in burned areas were poorly understood. Measuring the ground surface displacement in fire scars helps us understand the freeze‐thaw dynamics of near‐surface ground and predict the future state, particularly in ice‐rich permafrost regions. This study used the L‐ and C‐band interferometric synthetic aperture radar technique to reveal interannual subsidence and seasonal thaw settlement/frost heave in a fire scar near Mayya, Sakha Republic in Eastern Siberia burned in 2013. We found that the cumulative subsidence was up to 7 cm between 2014 and 2020, most of which had occurred by 2016. The magnitude of seasonal thaw settlement and frost heave varied each year from 2017 to 2020 after the fire, but the interannual change in frost heave corresponded to the temporal variation in precipitation during the thawing season from 2017 to 2020. This suggests that the precipitation amount during the thawing season is related to the magnitude of segregation‐ice formation in the sediments, which determines the frost heave amount. The observed seasonal displacements could not be quantitatively explained by models inferred from the Stefan's equation and volume changes associated with ice‐water phase change. This implies that other models associated with segregated ice (ice lens) formation/thaw are required to explain the observed seasonal displacement.

Metastatic renal cell carcinoma (RCC) is not sufficiently responsive to anticancer drugs, and thus, developing new drugs for advanced RCC remains vital. We previously reported that the treatment of globotriaosylceramide (Gb3)-expressing cells with catfish (Silurus asotus) egg lectin (SAL) increased the intracellular uptake of propidium iodide (PI) and sunitinib (SU). Herein, we investigated whether SAL pretreatment affects the intracellular uptake and cytotoxic effects of molecular-targeted drugs in RCC cells. We analyzed Gb3 expression in TOS1, TOS3, TOS3LN, and ACHN human RCC cells. Surface Gb3 expression was higher in TOS1 and TOS3 cells than in TOS3LN and ACHN cells. In the PI uptake assay, 41.5% of TOS1 cells and 21.1% of TOS3 cells treated with SAL were positive for PI. TOS1 cell viability decreased to 70% after treatment with 25 µM SU alone and to 48% after pretreatment with SAL (50 µg/mL). Time-series measurements of the intracellular fluorescence of SU revealed significantly enhanced SU uptake in SAL-treated TOS1 cells compared to control cells. SAL treatment did not increase PI uptake in normal renal cells. Our findings suggest that adequate cytotoxic activity may be achieved even when SU is administered at a sufficiently low dose not to cause side effects in combination with SAL.

Abstract Background and Aim The aims of this study were to determine whether a postoperative decrease in skeletal muscle mass (SMM) after hepatic resection can predict long‐term outcomes in patients with hepatocellular carcinoma (HCC) and identify risk factors for SMM loss in patients who undergo hepatic resection. Methods This was a large retrospective study of 400 patients who underwent hepatic resection for HCC and pre‐ and postoperative computed tomography (CT) scans. SMM was measured at the third lumbar vertebrae, and the postoperative change in SMM compared with preoperative values was calculated as Δ SMM. The cutoff value for the post‐/preoperative ratio was set at 0.9. Results Sixty patients (15.0%) developed SMM loss. These patients had a significantly prolonged prothrombin time (P = 0.0092), longer duration of surgery (P = 0.0021), more blood loss (P = 0.0040), and higher rate of postoperative complications (P = 0.0037) than those without SMM loss. Multivariate analysis revealed that prolonged prothrombin time and postoperative complications were independent risk factors for SMM loss after hepatic resection. Patients with SMM loss had significantly shorter overall survival (P = 0.0018) than the other patients had. SMM loss was an independent prognostic factor for overall survival (hazard ratio 1.551, 95% confidential interval 1.028–2.340, P = 0.0363). Conclusions We demonstrated an association of SMM loss with postoperative complications and long‐term prognosis in patients with HCC. Patients with prolonged prothrombin time, or postoperative complications, may need to maintain their SMM. Further prospective studies are needed to investigate whether nutritional support can improve SMM loss.

Abstract Aims/Introduction This study compares the effects of two different insulin regimens – basal versus bolus insulin – on metabolic and cardiovascular autonomic function in Japanese participants with type 2 diabetes. Materials and Methods Participants were randomly assigned to groups for therapy with insulin glulisine (IGlu) or insulin glargine (IGla). The primary efficacy end‐point was glycemic variability, including M‐values, mean of glucose levels, and a blood glucose profile of seven time points before and after the intervention. The secondary end‐points included pleiotropic effects, including endothelial and cardiac autonomic nerve functions. Results Blood glucose levels at all time points significantly decreased in both groups. Post‐lunch, post‐dinner, and bedtime blood glucose levels were significantly lower in the IGlu group than in the IGla group. Nadir fasting blood glucose levels at the end‐point were significantly lower in the IGla group than in the IGlu group. The M‐value and mean blood glucose levels were significantly decreased from baseline in both groups, although the former was significantly lower in the IGlu group than in the IGla group. IGla, but not IGlu, was found to elevate 24‐h parasympathetic tone, especially during night‐time, and it decreased 24‐h sympathetic nerve activity, especially at dawn. Conclusions Both IGlu and IGla regimens reduced glucose variability, with IGlu bringing a greater reduction in M‐value. IGla, but not IGlu, increased parasympathetic tone during night‐time and decreased sympathetic nerve activity at dawn. These findings shed light on the previously unrecognized role of night‐time basal insulin supplementation on sympathovagal activity in type 2 diabetes patients.

We evaluated the prognostic value of fluorine‐18 fluorodeoxyglucose (18F‐FDG) positron emission tomography/computed tomography (PET/CT) in hepatocellular carcinoma (HCC). Their association with programmed death ligand 1 (PD‐L1) expression and vascular formation was further investigated. In this retrospective study, using a database of 418 patients who had undergone 18F‐FDG PET/CT before hepatic resection for HCC, immunohistochemical staining of PD‐L1, clusters of differentiation (CD) 8, CD68, and CD34 was performed. Patients with a high maximum standardized uptake value (SUVmax) on 18F‐FDG PET/CT showed a significantly worse recurrence‐free survival (RFS) (hazard ratio [HR]: 1.500; 95% confidence interval [CI]: 1.088‐2.069; P = 0.0133) and overall survival (OS) (HR: 2.259; 95% CI: 1.276‐4.000; P = 0.0052) than patients with a low SUVmax. Logistic regression analysis showed that a high SUVmax in HCC was significantly associated with PD‐L1‐positive expression (odds ratio: 4.407; 95% CI: 2.265‐8.575; P

Abstract Background Invasive aspergillosis (IA) is one of the most serious causes of death after liver transplantation (LT). IA is the second most common fungal infection, and its mortality rate exceeds 80%. Case presentation A 67-year-old man presented to our hospital because of fulminant hepatitis caused by hepatitis B virus. Candidiasis was detected in his sputum, and micafungin had already been administered. Living-donor LT was performed using a right lobe graft donated from his daughter with no intraoperative complications. Although he appeared to have good graft function, his oxygenation was inadequate, and a chest radiograph showed many invasive shadows on postoperative day 1. A computed tomography scan also showed many invasive shadows with the halo sign. A blood examination revealed positivity for Aspergillus antigen, and Aspergillus species were detected in his sputum. IA was diagnosed. The antifungal therapy was soon modified to amphotericin B combined with caspofungin. Despite good graft blood flow through the portal vein and hepatic artery and good graft function, the patient died of IA on postoperative day 3. The median time from LT to IA among reports published to date ranges from 18 to 25 days. Conclusions The present report describes the first case of very early onset of IA after LT.

Abstract Aim Little evidence about whether to apply graft‐to‐recipient body weight ratio (GRWR) or graft weight to standard liver weight (GW/SLW) for graft selection has been published. The aim of the present study was to clarify the importance of the correct use of GRWR and GW/SLW for selecting graft according to the recipients’ physique in living donor liver transplantation (LDLT). Methods Data were collected for 694 recipients who underwent LDLT between 1997 and 2020. Results One of the marginal grafts meeting GW/SLW ≥ 35% but GRWR 30 kg/m2, the recipients with GRWR

Abstract Extensive studies have highlighted a need for frequently consistent land cover information for interdisciplinary studies. This paper proposes a comprehensive framework for the automatic production of the first Vietnam-wide annual land use/land cover (LULC) data sets (VLUCDs) from 1990 to 2020, using available remotely sensed and inventory data. Classification accuracies ranged from 85.7 ± 1.3 to 92.0 ± 1.2% with the primary dominant LULC and 77.6 ± 1.2% to 84.7 ± 1.1% with the secondary dominant LULC. This confirmed the potential of the proposed framework for systematically long-term monitoring LULC in Vietnam. Results reveal that despite slight recoveries in 2000 and 2010, the net loss of forests (19,940 km2) mainly transformed to croplands over 30 years. Meanwhile, productive croplands were converted to urban areas, which increased approximately ten times. A threefold increase in aquaculture was a major driver of the wetland loss (1914 km2). The spatial–temporal changes varied, but the most dynamic regions were the western north, the southern centre, and the south. These findings can provide evidence-based information on formulating and implementing coherent land management policies. The explicitly spatio-temporal VLUCDs can be benchmarks for global LULC validation, and utilized for a variety of applications in the research of environmental changes towards the Sustainable Development Goals.

The clinicopathological features of carcinomas expressing AT‐rich interaction domain 1a (ARID1A) and programmed death ligand 1 (PD‐L1) in HCC are poorly understood. Here, we examined ARID1A and PD‐L1 expression in surgically resected primary hepatocellular carcinoma (HCC) and the association of ARID1A and PD‐L1 expression with clinicopathological features and patient outcomes. Their association with ARID1A expression and tumor‐associated CD68‐positive macrophage was further explored. Using a database of 255 patients who underwent hepatic resection for HCC, immunohistochemical staining of ARID1A, PD‐L1, and CD68 was performed. We also analyzed the expression PD‐L1 after ARID1A knockdown in HCC cell lines. Samples from 81 patients (31.7%) were negative for ARID1A. Negative ARID1A expression was significantly associated with male sex, high alpha‐fetoprotein, high des‐gamma‐carboxyprothrombin, large tumor size, high rate of poor differentiation, microscopic intrahepatic metastasis, and PD‐L1 expression. In addition, negative ARID1A expression was an independent predictor for recurrence‐free survival, overall survival, and positive PD‐L1 expression. Stratification based on ARID1A and PD‐L1 expression in cancer cells was also significantly associated with unfavorable outcomes. PD‐L1 protein expression levels were increased through phosphoinositide 3‐kinase/AKT signaling after ARID1A knockdown in HCC cells. HCC with ARID1A‐low expression was significantly correlated with high levels of tumor‐associated CD68‐positive macrophage. Conclusion: Our large cohort study showed that ARID1A expression in cancer cells was associated with a poor clinical outcome in patients with HCC, PD‐L1 expression in cancer cells, and tumor microenvironment. Therefore, ARID1A may be a potential molecular biomarker for the selection of patients with HCC for anti‐programmed death 1/PD‐L1 antibody therapy.