Springer Science and Business Media LLCActa Medica Okayama0916-96364972026Effect of population-approach programs promoting salt reduction and potassium intake in Japan: the Population-based Sodium/Potassium Improvement Program (PoSPIP)19922003ENTakashiHisamatsuDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMinakoKinutaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakayoshiOhkuboDepartment of Hygiene and Public Health, Teikyo University School of MedicineTakuyaTsuchihashiCardiovascular Center, Steel Memorial Yawata HospitalKatsushiYoshitaDepartment of Public Health, Nutrition, School of Human Life and Ecology, Osaka Metropolitan UniversityYukariTakemiFaculty of Nutrition, Kagawa Nutrition UniversityHitomiHayabuchiGraduate School of Health and Environmental Sciences, Fukuoka Women’s UniversityYukikoOkamiGunma University Center for Food Science and WellnessKaoriKitaokaNCD Epidemiology Research Center, Shiga University of Medical ScienceKeikoSakaguchiFaculty of Nursing and Nutrition, Shukutoku UniversityAtsushiHozawaDivision of Epidemiology, School of Public Health, Tohoku University Graduate School of MedicineTomonoriOkamuraDepartment of Preventive Medicine and Public Health, Keio University School of MedicineHiroshiItohJapanese Society of HypertensionHiromiRakugiJapanese Society of HypertensionKoichiNodeJapanese Society of HypertensionKatsuyukiMiuraNCD Epidemiology Research Center, Shiga University of Medical ScienceReducing sodium intake in populations is essential, but insufficient for preventing and managing high blood pressure, while the importance of increasing potassium intake is overlooked. We investigated the effects of 1-year population-approach programs (2021–2022) promoting salt reduction and potassium intake using urinalysis feedback and food environment improvement. This retrospective observational study included 7649 participants (mean age, 54.0 years; 45.3% women) from 11 municipalities and 4 workplaces. Outcomes in intensive support programs―including urinary sodium, potassium, and sodium-to-potassium (Na/K) ratio measurements with feedback, dietary promotion, and food environment improvement―were compared with standard support programs providing usual health guidance. In linear regression adjusted for demographics, lifestyle factors, and medical history, the reduction in urinary Na/K ratio was greater in the intensive support group (n = 4064) than in the standard support group (n = 3585) (mean difference −0.14 [95% confidence interval, −0.27 to −0.01]). Although estimated potassium intake decreased in both groups, the decline was smaller in the intensive support group (mean difference 31 [12 to 51] mg/day). Estimated salt intake did not differ between the groups. The intensive support group showed greater increases in diastolic blood pressure and high-density lipoprotein cholesterol and smaller increases in blood glucose, as well as greater reductions in hemoglobin A1c and Salt Check Sheet scores. Mean differences between the groups for endpoints were not heterogeneous across intensive support program types. Our findings support the development of hypertension prevention and management strategies that promote healthier dietary behaviors and can be implemented in community and workplace settings, with broad public health applicability.No potential conflict of interest relevant to this article was reported.Frontiers Media SAActa Medica Okayama2296-4185142026High horizontal force and lateral force transmission induced by the twist of the Achilles tendon1874501ENShotaEnomotoGraduate School of Education, Okayama UniversityKohtaItoArtificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST)The Achilles tendon―the largest and strongest of the many tendons in the human body―consists of subtendons arising from each head of the triceps surae. These subtendons run helically and intertwine to form a twisted three-dimensional structure. More than a century has passed since the twisted structure of the Achilles tendon was first described, and numerous studies have investigated its functional morphology. However, it remains unclear how the presence or degree of twist affects the mechanical function of the lower limbs. Here, using finite element models of the Achilles tendon with and without twist, we show that the presence and degree of twist can modulate the forces transmitted from muscle to skeleton in a complex manner. In contrast to the model without twist, the twisted models clearly exhibit anterolaterally directed horizontal forces at the distal end under a simple proximal tensile load. The lateral and anterior components reach approximately 101 N and 63 N, respectively. Furthermore, the twisted structure induces inter-subtendon force transmission, and the magnitude of the transmitted force increases with increasing degree of twist. These results indicate that the uniaxial contractile force generated by the triceps surae is transformed into triaxial forces by the twisted Achilles tendon and is redistributed in a complex three-dimensional manner through inter-subtendon interactions.No potential conflict of interest relevant to this article was reported.Royal Society of Chemistry (RSC)Acta Medica Okayama1463-926228292026Terpolymerization of epoxide, oxetane, and CO2 for the synthesis of polycarbonates with high CO2 contents, physical tunability, and enzymatic degradability1221412224ENKaitoNikiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityChihiroMaedaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTadashiEmaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityAlthough poly(cyclohexene carbonate) (PCHC) synthesized by the copolymerization of cyclohexene oxide (CHO) and CO2 is a promising material, the physical properties of this material need to be altered and tuned for its wider applications. To this end, we employed a terpolymerization strategy increasing the CO2 content in the resulting polymers. Terpolymerization of CHO, oxetane, and CO2 using AlIII porphyrin catalysts with quaternary ammonium halides afforded polycarbonates with high CO2 contents, physical tunability, and enzymatic degradability. The counter anions of the catalysts were crucial factors in the formation of the poly(trimethylene carbonate) (PTMC) unit. 1a with bromide ions preferentially produced trimethylene carbonate (TMC) over PTMC, while 1d with chloride ions suppressed the formation of TMC and produced PCHC–PTMC directly. PCHC–PTMC showed glass transition temperatures (Tg) between 69 °C and −9 °C, depending on the PCHC/PTMC ratio. The tensile test revealed that the PTMC unit contributed to the softening of the film materials. For example, a film material with a CO2 content of 38 wt% showed 505% elongation at break with an elastic character, which contrasted starkly with the 1.3% elongation at break of PCHC with a CO2 content of 31 wt%. Moreover, the selective degradation of the PTMC unit in PCHC–PTMC was achieved with lipases, and a gradient character in the sequence structure was suggested. Overall, PCHC–PTMC is an environmentally benign and sustainable CO2-based polycarbonate.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1344-6223842026Factors that delay discovery in cases of death at home in Japan102895ENYukieYamasakiDepartment of Legal Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNanakoTamiyaDepartment of Health Services Research, Faculty of Medicine, University of TsukubaHidekiYamamotoDepartment of Environmental Health, Faculty of Pharma-Science, Teikyo UniversityMasanobuMiuraDepartment of Legal Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKaoriTaniguchiDepartment of Legal Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChieKobayashiDepartment of Legal Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasafumiMotomuraFaculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityAyakoHimemiya-HakuchoDepartment of Legal Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoruMiyaishiDepartment of Legal Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesIn Japan, solitary deaths have become a social issue, with an increasing number of cases in which the body is discovered long after death. This study aimed to clarify the factors underlying such delays. Cases of death at home were extracted from forensic autopsies. In each case, we collected information about the deceased and their living conditions. The postmortem interval until finding (PMI-f) was calculated by measuring the time between death and discovery. We classified the cases into long PMI-f (LPMI-f; having PMI-f of ≥3 days) and short PMI-f (SPMI-f; having PMI-f of <3 days), and examined the factors that lead to LPMI-f. The characteristics of the group living alone with a PMI-f of <24 h and living with family or acquaintances with an LPMI-f were also analyzed. Among the 420 cases included, 244 (58.1%) were in the LPMI-f group. The LPMI-f group had higher number of males; older individuals; those living alone; those found inside their homes; single, retired, or non-employed individuals; those without long-term care certification; and those with drinking habits. Forty-seven individuals lived alone and had PMI-f of <24 h. Regular visits from relatives living separately led to early detection after death. In the LPMI-f group, 56 individuals lived with family or acquaintances. The absence of regular visits can result in delayed discovery after death; however, the time between death and discovery could be shortened by implementing systems such as allowing neighbors to check the person's safety by noticing uncollected mail.No potential conflict of interest relevant to this article was reported.American Geophysical Union (AGU)Acta Medica Okayama0094-827653142026Electrical Conductivity of Hydrous Ultramafic Melts With Implications for Origin of Low Velocity Layer Atop of the 410 km Seismic Discontinuitye2026GL122472ENTakashiYoshinoInstitute for Planetary Materials, Okayama UniversityLongjianXieCenter for High Pressure Science & Technology Advanced ResearchLow-velocity layers (LVLs) above the 410-km discontinuity are commonly attributed to partial melt generated by dehydration melting when hydrous mantle transition-zone material rises into the upper mantle, where water solubility in nominally anhydrous minerals decreases. Interpreting coexisting high-conductivity anomalies requires constraints on the intrinsic conductivity of the melt phase at pressures just above the transition zone. We measured electrical conductivity of hydrous ultramafic melts representative of incipient melts, ranging from 6.3 to 18.6 wt% H2O at 13 GPa using impedance spectroscopy in a Kawai-type multi-anvil apparatus. Hydrous ultramafic melts are extremely conductive, and conductivity increases systematically with H2O content to values comparable to alkali-carbonate melts. The high conductivity implies that even small fractions of interconnected hydrous melt can dominate bulk mantle conductivity. Combining our measurements with geophysical conductance estimates indicates that <1 vol% melt can produce conductive layers thicker than 10 km, consistent with seismological constraints on LVL structure.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2090-6447202612026Carcinoma ex Pleomorphic Adenoma With an Epithelial‐Myoepithelial Carcinoma Component in the Submandibular Gland: A Case ReportENTomohiroYasuharaDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasanoriMasuiDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYukiKunisadaDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiroakiTakakuraDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityEijiIwataDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoichiKadoyaDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKokiUmemoriDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNorieYoshiokaDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeisukeNakanoDepartment of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySoichiroIbaragiDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground: Carcinoma ex pleomorphic adenoma (CXPA) is an uncommon malignant salivary gland tumor arising from pleomorphic adenoma, whereas epithelial-myoepithelial carcinoma (EMC) is a rare low-grade salivary gland malignancy. CXPA with an EMC component in the submandibular gland is uncommon.<br>
Case Report: A 65-year-old man presented with a painless, firm mass in the left submandibular region and weakness of the left lower lip. Computed tomography and magnetic resonance imaging demonstrated an irregular submandibular mass, and FDG-PET/CT showed increased uptake (maximum standardized uptake value, 9.2). Core biopsy suggested pleomorphic adenoma; however, the clinical and radiological findings strongly indicated malignancy. Incisional biopsy was therefore performed under general anesthesia, with a plan to proceed to definitive treatment if malignancy was confirmed. Intraoperative histopathological examination revealed a malignant salivary gland tumor, and tumor resection with neck dissection was completed during the same procedure. Histopathological examination showed invasive CXPA with an EMC component, accompanied by extracapsular invasion exceeding 6 mm, perineural invasion, and extension into adjacent muscle (pT3N0). Although surgical margins were negative, pulmonary metastases developed 12 months after surgery, followed by suspected pleural dissemination and spinal canal extension. The patient declined further aggressive treatment and died of the disease 48 months after surgery.<br>
Conclusion: This case highlights the importance of integrating clinical, radiological, and pathological findings for accurate diagnosis of salivary gland tumors, particularly when biopsy results are inconsistent with clinical suspicion.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1639-44882026Triple Oxygen Isotope Compositions of Isotopic Reference Waters: Implications for VSMOW-Scale and VSMOW–SLAP-Scale Δ′17O CalibrationENRyojiTanakaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityAndreasPackGeorg-August-Universität Göttingen, Geowissenschaftliches ZentrumTyler B.CoplenUS Geological SurveyTriple oxygen isotope ratios of waters are commonly reported on the VSMOW–SLAP scale, whereas comparison with theoretical calculations and assessment of instrumental scale distortion require accurate constraints on the measured isotopic compositions of the primary isotopic reference materials (iRMs) themselves. In particular, the measured δ17OVSMOW and Δ′17OVSMOW values for SLAP and its substitute, SLAP2, remain insufficiently constrained and reported values differ among laboratories. Here, we measured triple oxygen isotope ratios for two primary iRMs (VSMOW and SLAP) and twelve secondary iRMs (VSMOW2, SLAP2, GISP, GRESP, USGS45, USGS46, USGS46a, USGS47, USGS48, USGS49, USGS50 and USGS53) using BrF5 fluorination and dual-inlet isotope-ratio mass spectrometry. For SLAP, we obtained δ18OVSMOW = -55.50 ± 0.15‰ and δ17OVSMOW = -29.66 ± 0.08‰, giving Δ′17OVSMOW = 34 ± 6 per meg (all expanded uncertainties, k = 2). The corresponding values for SLAP2 agree within uncertainty. When expressed on the conventional VSMOW–SLAP scale, our Δ′17OVSMOW–SLAP values for all secondary iRMs with available literature values agree with previously published values within uncertainty, confirming interlaboratory comparability on that scale. In contrast, waters with low δ18O values, Δ′17OVSMOW values are systematically higher than the corresponding Δ′17OVSMOW–SLAP values. These results further suggest that accurate determination of the VSMOW-scale isotopic composition of SLAP and/or SLAP2 across laboratories is essential, particularly for low-δ18O samples, for which the difference between VSMOW-scale and VSMOW–SLAP-scale Δ′17O values becomes large, and for meaningful comparison between measured data and theoretical calculations.No potential conflict of interest relevant to this article was reported.Ceramic Society of JapanActa Medica Okayama1348-653513472026Dielectric response modulation in relaxor (Sr,Ba)Nb2O6 via engineered defect455460ENRyuseiShiotaGraduate School of Natural Science and Technology, Okayama UniversityTakashiTeranishiGraduate School of Natural Science and Technology, Okayama UniversityShinyaKondoDepartment of Energy Engineering, Nagoya UniversityAkiraKishimotoGraduate School of Natural Science and Technology, Okayama UniversityDefect engineering provides an effective pathway to tune the dielectric response of relaxor ferroelectrics, yet the roles of individual defect species in tungsten bronze (TTB) systems remain unclear. Here, we investigated how engineered Ti–VO•• defect dipoles and native oxygen vacancies introduced through reduction annealing modify the dielectric properties of relaxor (Sr0.5,Ba0.5)Nb2O6 (0.5-SBN). Ti loading forms stable defect dipoles that generate smaller polar nanoregions (PNRs), suppress their overgrowth, and increase the number of dynamically active PNRs at room temperature, leading to enhanced permittivity ε′ while preserving DC-bias stability and breakdown strength (EB). Reduction annealing generates Nb4+-related local polarizations aligned with the external electric field, which strengthen dipole fluctuations and slightly increase ε′. Electron localization further relaxes the TTB-A2 site disorder–induced random fields, yielding a sharper dielectric peak and promoting more uniform PNR growth. Microwave dielectric spectroscopy combined with electromagnetic simulations revealed that the increases in ε′ for both Ti-loaded and reduced samples (0.5-SBNT and Reduced 0.5-SBN, respectively) originate predominantly from enhanced dipole polarization. Despite grain coarsening in 0.5-SBNT, the EB remained unchanged, indicating that defect dipoles act as pinning centers that inhibit field-induced PNR aggregation. In reduced 0.5-SBN, EB increased up to pO0 = 4.3 × 10−3 atm owing to relaxed random fields, whereas excessive reduction reduced EB through carrier-driven space-charge effects. These results demonstrate that precise control of defect species enables simultaneous optimization of ε′, DC-bias stability, and EB in TTB-type relaxor ferroelectrics.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1323-89307532026Outcomes following the discontinuation of biologic therapy in patients with severe asthma400408ENTadaoNagasakiDepartment of Respiratory Medicine and Allergology, Kindai University Nara HospitalHisakoMatsumotoDepartment of Respiratory Medicine and Allergology, Kindai University Faculty of MedicineTakashiIwanagaDepartment of Respiratory Medicine and Allergology, Kindai University Faculty of MedicineKazutoMatsunagaDepartment of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi UniversityKiyoshiSekiyaClinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National HospitalTomoyaHaradaDepartment of Multidisciplinary Internal Medicine, Division of Respiratory Medicine and Rheumatology, Faculty of Medicine, Tottori UniversityShogoSakuraiDepartment of Respiratory Medicine, Shizuoka General HospitalNorihiroHaradaDepartment of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of MedicineToshiyukiKoyaDepartment of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental SciencesKoichiFukunagaDivision of Pulmonary Medicine, Department of Medicine, Keio University, School of MedicineTakeshiKanekoDepartment of Pulmonology, Yokohama City University Graduate School of MedicineKazuhisaAsaiDepartment of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan UniversityYukoKomaseDepartment of Respiratory Medicine, St.Marianna University School of Medicine, Yokohama Seibu HospitalYasuhiroGonDivision of Respiratory Medicine, Department of Internal Medicine, Nihon University School of MedicineAkihikoTanakaDepartment of Medicine, Division of Respiratory Medicine and Allergology, Showa Medical University, School of MedicineHironoriSagaraDepartment of Medicine, Division of Respiratory Medicine and Allergology, Showa Medical University, School of MedicineHironobuSunadomeDepartment of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto UniversityTatsuyaNaganoDivision of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of MedicineYoichiNakamuraMedical Center for Allergic and Immune Diseases, Yokohama City Minato Red Cross HospitalAkioNiimiDepartment of Respiratory Medicine, Allergy, and Clinical Immunology, Nagoya City University Graduate School of Medical SciencesNoboruHattoriDepartment of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, Hiroshima UniversityTakashiHajiroDepartment of Respiratory Medicine, Tenri HospitalHajimeFujimotoDepartment of Pulmonary and Critical Care Medicine, Mie University Graduate School of MedicineMasayukiHojoDivision of Respiratory Medicine, National Center for Global Health and MedicineNobuakiMiyaharaDepartment of Medical Technology, Okayama University Graduate School of Health SciencesMasafumiYamaguchiDivision of Respiratory Medicine, Department of Internal Medicine, Shiga University of Medical ScienceKimikoTsujiDepartment of Respiratory Medicine and Allergology, Kochi Medical School, Kochi UniversityAkikoSanoDepartment of Respiratory Medicine and Allergology, Kindai University Faculty of MedicineRyutaHaraguchiDepartment of Respiratory Medicine and Allergology, Kindai University Faculty of MedicineHiroyukiSanoDepartment of Respiratory Medicine and Allergology, Kindai University Faculty of MedicineMasatoMurakiDepartment of Respiratory Medicine and Allergology, Kindai University Nara HospitalYujiTohdaDepartment of Respiratory Medicine and Allergology, Kindai University Faculty of MedicineBackground: Biologic therapies are pivotal in managing severe asthma. Despite their efficacy, some patients discontinue biologics, with varying outcomes. Predictors of successful versus unsuccessful discontinuation remain poorly defined. This study aimed to identify clinical factors associated with post-discontinuation outcomes in a real-world practice.<br>
Methods: This retrospective cohort included adults with severe asthma who had received biologics for at least 12 months and subsequently discontinued therapy for a minimum of three consecutive months. We assessed the effects of baseline blood eosinophilia (≥300 cells/μL), residual sputum symptoms during biologic therapy, treatment responsiveness, biologic class, and discontinuation reasons on post-discontinuation asthma exacerbation rates using multivariable Cox models.<br>
Results: A total of 118 patients were analyzed. The Kaplan–Meier analysis estimated a 65 % exacerbation-free probability at 12 months after discontinuation. Factors associated with successful discontinuation included a robust clinical response and absence of exacerbations before cessation. Conversely, baseline eosinophilia, residual sputum symptoms during biologics, and discontinuation due to inadequate therapeutic response or financial burden were associated with post-discontinuation exacerbations. In class-stratified restricted models, persistent sputum remained significantly associated with post-discontinuation exacerbations after stopping anti-IL-5 therapies, while baseline eosinophilia was associated with post-discontinuation exacerbations after stopping anti-IgE or anti-IL-4Rα. Among patients with sputum symptoms or poor-response discontinuation, the overall frequency of exacerbations declined after discontinuation.<br>
Conclusions: Baseline eosinophilia, persistent sputum during therapy, and discontinuation prompted by poor response or cost may serve as risk factors for post-discontinuation exacerbations; however, risk is phenotype- and class-dependent. Careful patient selection and monitoring are essential when considering the discontinuation of biologic treatment.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0914-50878752026Cardio-ankle vascular index as a screening tool for coronary artery disease in patients with metabolic dysfunction-associated steatotic liver disease429433ENMitsutakaNakashimaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToruMiyoshiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYutaUekiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakahiroNishiharaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiMikiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShoheiHaraDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeishiIchikawaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhiroOsawaDepartment of General Internal Medicine 3, Kawasaki Medical School General Medicine CentreShinsukeYuasaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common hepatic disorder that significantly increases cardiovascular risk. However, no established screening method exists for detecting subclinical coronary artery disease (CAD) in this high-risk population. The cardio-ankle vascular index (CAVI), a blood pressure–independent measure of arterial stiffness, may offer a non-invasive tool for early detection of coronary atherosclerosis.<br>
Methods: We retrospectively analyzed 295 patients with MASLD who underwent both CAVI measurement and coronary computed tomography angiography at a single center. Significant CAD was defined as ≥50 % luminal stenosis. Receiver operating characteristic (ROC) analysis was used to evaluate diagnostic performance. Multivariable logistic regression was performed to identify independent associations between elevated CAVI and CAD. The incremental predictive value of CAVI was assessed using net reclassification improvement (NRI).<br>
Results: Of the 295 patients, 110 (37.3 %) had significant CAD. Patients with CAD had significantly higher CAVI values (9.0 vs. 8.7, p = 0.007). The area under the ROC curve for CAVI predicting CAD was 0.614. A CAVI cut-off of 8.6 provided a sensitivity of 66.4 % and a specificity of 56.8 %. CAVI ≥8.0 was independently associated with CAD (OR 3.44, 95 % CI: 1.06–11.2, p = 0.040). Adding CAVI to a conventional risk model improved risk reclassification (NRI 0.4236, p < 0.001), although the C-statistic change was not significant (from 0.724 to 0.725, p = 0.835).<br>
Conclusions: CAVI is independently associated with significant coronary stenosis in MASLD patients and may serve as a non-invasive screening tool to enhance cardiovascular risk stratification. Its moderate diagnostic accuracy suggests utility as a component of a multifactorial risk assessment strategy.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1756-05001912025Plasma expression levels of microRNA-101 are downregulated in patients with Parkinson’s disease19ENTomohiroOmuraDepartment of Pharmacy, Kobe University HospitalHirokiNishiguchiDepartment of Pharmacy, Kobe University HospitalHarukaKanedaDepartment of Pharmacy, Kobe University HospitalYumiKitahiroDepartment of Pharmacy, Kobe University HospitalKotaroItoharaDepartment of Pharmacy, Kobe University HospitalKazuhiroYamamotoDepartment of Integrated Clinical and Basic Pharmaceutical Sciences, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshiyasuSakaneDepartment of Pharmaceutical Technology, Kobe Pharmaceutical UniversityIkukoYanoDepartment of Pharmacy, Kobe University HospitalObjective Parkinson’s disease (PD) is a neurodegenerative disorder characterized by the loss of dopaminergic neurons. Endoplasmic reticulum (ER) stress contributes to PD pathogenesis, with the ER-associated degradation (ERAD) system playing a protective role. HRD1, an ER-resident ubiquitin ligase, and its stabilizer SEL1L are involved in ERAD and neuronal survival. This study investigated alterations in the plasma levels of microRNA-101 (miR-101), which targets SEL1L, in patients with PD, and its potential role as a biomarker.<br>
Results Plasma miR-101 levels in patients with PD significantly decreased compared with those in healthy controls. Receiver operating characteristic curve analysis demonstrated that miR-101 could moderately discriminate patients with PD from healthy individuals (area under the curve = 0.781, 95% confidence interval = 0.547–1.00). The optimal cutoff, as determined by the Youden index, was 0.737 (expression ratio relative to that in the healthy control group), yielding a sensitivity of 50% and specificity of 100%. These results suggested that reduced plasma miR-101 expression may reflect the pathophysiological state of PD, and miR-101 has potential as minimally invasive biomarker for PD.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465812026ライブラリ・スキーマによる大学図書館構造の可視化と知識創造 ―共有認知の形成に基づく研究枠組みの構築―119ENKensukeKobayashiSatoruMiyazaki10.18926/OER/70973 This study proposes a theoretical framework for understanding the relationship between the structural representation of university libraries and knowledge creation. In recent years, university libraries have experienced significant transformations due to the digitization of scholarly information, the expansion of research data management, and the increasing importance of learning support services. As their functions diversify, it has become increasingly difficult to comprehensively understand the structure and roles of university libraries.<br>
To address this issue, this study focuses on the concept of a library schema, which represents the structural relationships among the elements that constitute a library, including people, resources, services, and activities. While previous research has discussed methods for organizing library components, little attention has been paid to how structural understanding of libraries contributes to knowledge creation and service value.<br>
Drawing on schema theory, shared cognition in organizational studies, and the knowledge creation theory of Nonaka and Takeuchi, this study constructs a conceptual framework linking library schema visualization, shared cognition, interaction, knowledge creation processes, and library service value. The framework proposes that visualization of library structure through a library schema promotes shared cognition among librarians and users, which in turn facilitates interactions that activate knowledge creation processes. These processes ultimately contribute to the creation of library service value that supports learning and research activities.<br>
Furthermore, the framework introduces two moderating factors: schema representation methods and operational constraints of library management. Based on this framework, six research propositions are presented.<br>
By integrating concepts from library and information science with knowledge management theory, this study contributes to the theoretical understanding of university libraries as knowledge infrastructures and provides a foundation for future empirical research on knowledge creation in library environments.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-29186582026Autopsy Case of a Disseminated Cytomegalovirus Infection with a Cutaneous Ulcer Mimicking Rheumatoid Vasculitis11721177ENKoheiOguniDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalYukichikaYamamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoharuIshidaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokaOhkiDepartment of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesA 60-year-old woman with rheumatoid arthritis and an impaired consciousness was referred to our hospital. Prior to transfer, the patient underwent intensified immunosuppressive therapy under a diagnosis of rheumatoid vasculitis that had developed in her buttocks. Upon hospitalization, she developed severe multiorgan failure and hemophagocytic syndrome. Four days after admission, both blood cytomegalovirus (CMV) antigenemia and the DNA load were markedly elevated. Despite intensive care, the patient died. Later, a histopathological examination revealed that the cutaneous manifestation represented CMV disease, not rheumatoid vasculitis, as was initially suspected. Failure to identify CMV as the underlying cause may result in the inappropriate administration of immunosuppressive therapy, potentially worsening the patient's condition.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2666-63673242026Spatial Transcriptomics Analysis of Macrophage-to-Myofibroblast Transition in Bronchiolitis Obliterans Following Hematopoietic Stem Cell Transplantation454465ENAkiraYamamotoDepartment of Hematology and Oncology, Okayama University HospitalNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalKeisukeSeikeDepartment of Hematology and Oncology, Okayama University HospitalSeiichiroSugimotoDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalYusukeNaoiCenter for Comprehensive Genomic Medicine, Okayama University HospitalTomohiroNaganoDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSayaKubotaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuiKambaraDan L Duncan Comprehensive Cancer Center, Baylor College of MedicineKanakoFujiwaraDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshikiTeraoDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTadashiOyamaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMariKunihiroDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirokiKobayashiDepartment of Hematology and Oncology, Okayama University HospitalTakumiKondoDepartment of Hematology and Oncology, Okayama University HospitalHideakiFujiwaraDepartment of Hematology and Oncology, Okayama University HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalDaisukeEnnishiDepartment of Hematology and Oncology, Okayama University HospitalKeikoFujiiDepartment of Hematology and Oncology, Okayama University HospitalShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalBronchiolitis obliterans (BO) is a severe, fibrotic manifestation of chronic graft-versus-host disease (GVHD) after hematopoietic stem cell transplantation (HSCT). Macrophage-derived TGF-β is linked to GVHD-related fibrosis; however, its role in BO remains unclear. Given emerging evidence of macrophage-to-myofibroblast transition (MMT) in fibrosis, this study aimed to investigate whether MMT contributes to BO development. We analyzed lung samples from 3 HSCT recipients with BO who underwent lung transplantation, with tissues from 2 patients with lung cancer as controls. Immunofluorescent staining for CD68, CD206, and α-SMA was used to identify cells undergoing MMT. Spatial transcriptomics was performed to profile gene expression in foamy macrophages across anatomical regions and histological stages, compared to control peribronchiolar regions. Immunostaining showed strong co-expression of CD68, CD206, and α-SMA in foamy macrophages within and surrounding bronchioles in BO samples, with minimal expression in controls, suggesting MMT involvement. In BO, spatial transcriptomics revealed upregulation of macrophage- and TGF-β signaling genes, with distinct stage- and region-specific gene expression patterns. Unsupervised clustering revealed a shift from inflammation to fibrosis. These findings indicate that MMT contributes to fibrosis in BO. Gene expression shifts from inflammation to fibrosis as the disease advances, underscoring the importance of early intervention.No potential conflict of interest relevant to this article was reported.Fuji Technology Press Ltd.Acta Medica Okayama1883-80302112026Developing and Implementing a Disaster Prevention Game to Enhance Local Understanding128135ENMiriShirokaneOkayama UniversityAiriYamadaOkayama UniversityRyoMisawaOkayama UniversityNobuhisaMattaOkayama UniversityThis study developed and implemented a local disaster prevention sugoroku-style game to address challenges in preserving and transmitting regional knowledge in areas with high population mobility. Many Japanese communities face both natural and social vulnerabilities, and effective disaster education requires linking hazard knowledge with local characteristics. Conducted at Sonan Junior High School in Okayama, the project combined lectures, workshops, and a community engagement event. Students learned about regional topography, land use, and disaster history and used this knowledge to design quizzes, rules, and disaster scenarios for the game. The final sugoroku set included a map-based board, thematic quiz areas, and preparedness item cards, enabling players to predict damage and consider appropriate actions. After creating the game, students shifted from identifying familiar landmarks to describing concrete disaster impacts such as liquefaction or infrastructure collapse. Interaction with local residents further enriched learning through shared experiences. The model proved feasible in terms of time and cost, and its structure is easily adaptable to other regions by incorporating local information. The findings suggest that this participatory, place-based approach enhances imagination, self-efficacy, and intergenerational knowledge transfer, contributing to community-wide disaster preparedness. Future studies will examine long-term educational impacts and broader regional applications.No potential conflict of interest relevant to this article was reported.Japan Neurosurgical SocietyActa Medica Okayama0470-81056632026Full-endoscopic Laminotomy Is Effective for Lumbar Spinal Stenosis with Low-grade Spondylolisthesis: A Comparative Cohort Study107115ENKyoheiKINDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesRyojiTOMINAGADepartment of Orthopaedics, Iwai Orthopaedic Medical HospitalKentoTAKEBAYASHIDepartment of Orthopaedics, Iwai Orthopaedic Medical HospitalHirokiIWAIDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHirohikoINANAMIDepartment of Orthopaedics, Iwai Orthopaedic Medical HospitalHisashiKOGADepartment of Orthopaedics, Iwai Orthopaedic Medical HospitalThe optimal management of lumbar spinal canal stenosis with spondylolisthesremains controversial, particularly when choosing between decompression alone or decompression with fusion. Current evidence is based on conventional open or endoscopy-assisted surgeries, with limited data on full-endoscopic decompression. This study aimed to assess the impact of spondylolisthesis on outcomes after full-endoscopic laminotomy by evaluating back pain-related disability scores in patients with lumbar spinal canal stenosis, with and without spondylolisthesis. A retrospective analysis was conducted at Iwai Orthopaedic Hospital, Japan. Patients with lumbar spinal canal stenosis who underwent full-endoscopic laminotomy between January 2021 and December 2022 were included and categorized into those without spondylolisthesis and those with spondylolisthesis. Postoperative Oswestry Disability Index scores at 2 years were compared in the groups using multivariable linear regression, adjusting for confounding factors. Exploratory analyses were also conducted to identify factors affecting the Oswestry Disability Index in the patients with lumbar spinal canal stenosis with spondylolisthesis group. Statistical significance was set at p < 0.05. The study included 80 patients, with 40 in each group. Both groups showed improved postoperative Oswestry Disability Index. There was no significant association between spondylolisthesis and postoperative Oswestry Disability Index. However, cauda equina redundancy negatively affected postoperative Oswestry Disability Index improvement in the patients with lumbar spinal canal stenosis with spondylolisthesis group. Full-endoscopic laminotomy is an effective surgical option for lumbar spinal canal stenosis, leading to significant alleviation of disability and improvements in quality of life, regardless of spondylolisthesis. Full-endoscopic laminotomy may offer similar functional improvements regardless of the presence of low-grade spondylolisthesis, supporting its role as a less invasive alternative to fusion.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama2329-69332352026Global trends in sarcoidosis-associated mortality, 2001–2023: insights from the World Health Organization mortality database823827ENKoHaradaBrookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount SinaiMarikoFujiiDepartment of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityNanamiSakoDepartment of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityQuynh ThiVuDepartment of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityYoshitoNishimuraDivision of Hematology and Oncology, Mayo ClinicKeith PardilladaBelangoyDepartment of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHananeOuddoudDepartment of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTatsuakiTakedaDepartment of Education and Research Centre for Clinical Pharmacy, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityYoshitoZamamiDepartment of Pharmacy, Okayama University HospitalHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalToshihiroKoyamaDepartment of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291865112026Endotracheal and Endobronchial Metastases in Epidermal Growth Factor Receptor Exon 19 Deletion Lung Adenocarcinoma: A Case Successfully Managed with Bronchoscopic Therapy and Sequential Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors15201523ENMihoFujiwaraDepartment of Respiratory Medicine, Okayama University HospitalTakahiroBabaDepartment of Respiratory Medicine, Okayama University HospitalKotaroYamadaDepartment of Respiratory Medicine, Okayama University HospitalEriNakamuraDepartment of Respiratory Medicine, Okayama University HospitalTetsuyaTakeguchiDepartment of Respiratory Medicine, Okayama University HospitalYukiTakigawaDepartment of Respiratory Medicine, NHO Okayama Medical CenterAyakoMoritaCenter for Clinical Oncology, Okayama University HospitalNaofumiHaraDepartment of Respiratory Medicine, Okayama University HospitalHiromiWatanabeDepartment of Respiratory Medicine, NHO Okayama Medical CenterKiichiroNinomiyaCenter for Comprehensive Genomic Medicine, Okayama University HospitalKammeiRaiCenter for Innovative Clinical Medicine, Okayama University HospitalEikiIchiharaCenter for Clinical Oncology, Okayama University HospitalKadoakiOhashiDepartment of Respiratory Medicine, Okayama University HospitalKatsuyukiHottaCenter for Innovative Clinical Medicine, Okayama University HospitalKenSatoDepartment of Respiratory Medicine, NHO Okayama Medical CenterYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineYosukeTogashiDepartment of Respiratory Medicine, Okayama University HospitalGoMakimotoDepartment of Respiratory Medicine, Okayama University HospitalEndotracheal and endobronchial metastases from peripheral lung adenocarcinoma are rare, and optimal clinical management remains unclear. We herein report a 60-year-old woman with epidermal growth factor receptor (EGFR) exon 19 deletion-positive early-stage lung adenocarcinoma who underwent surgical resection followed by osimertinib treatment for recurrence. She later developed oligoprogressive disease with airway metastases. Bronchoscopic tumor removal was performed, and next-generation sequencing of the resected specimen revealed an acquired EGFR C797S mutation, along with exon 19 deletion. Gefitinib treatment was initiated, which led to a partial response. This case underscores the utility of repeated molecular profiling and local intervention in managing acquired resistance in EGFR-mutant non-small-cell lung cancer.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1572-1000582026Pathological features of residual head and neck cancer after near-infrared photoimmunotherapy: implications of an unfavorable tumor immune microenvironment105422ENTakumaMakinoDepartment of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuharuSatoDepartment of Hematopathology, Okayama University Graduate School of Health SciencesAsamiNishikoriDepartment of Hematopathology, Okayama University Graduate School of Health SciencesYutoNaoiDepartment of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMizuoAndoDepartment of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesPurpose: Near-infrared photoimmunotherapy has been approved in Japan for unresectable locally advanced or recurrent head and neck cancer. While this therapy theoretically induces selective necrosis of epidermal growth factor receptor-expressing tumor cells following administration of cetuximab sarotalocan sodium and irradiation with 690-nm light, residual disease is not uncommon in clinical practice. The mechanisms underlying such persistence remain poorly understood.<br>
Methods: We examined two patients with head and neck squamous cell carcinoma who underwent salvage resection due to residual disease after four cycles of near-infrared photoimmunotherapy. Resected specimens were subjected to histopathological evaluation, including immunohistochemistry for epidermal growth factor receptor, cluster of differentiation 8, programmed cell death protein 1, and forkhead box P3 proteins.<br>
Results: In both cases, residual tumor cells were predominantly localized in the superficial mucosal layers, while deeper layers were replaced by fibrosis. All residual tumors retained expression of epidermal growth factor receptor. Lymphocytic infiltration was sparse, with scattered cluster of differentiation 8-positive cells but few programmed cell death protein 1-positive or forkhead box P3-positive lymphocytes. These findings suggest that the tumor microenvironment surrounding residual tumors may have been unfavorable for the induction of robust antitumor immune responses.<br>
Conclusion: Residual tumors after near-infrared photoimmunotherapy can occur despite adequate laser irradiation and epidermal growth factor receptor expression. Our observations imply that insufficient immune activation within the tumor microenvironment may contribute to treatment resistance. Further characterization of the post-photoimmunotherapy tumor microenvironment will be essential to better understand treatment mechanisms and to optimize therapeutic efficacy.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0168-95254242026Medaka: a novel model for analyzing genome–environment interactions350361ENKiyoshiNaruseLaboratory of Bioresources, National Institute for Basic BiologyFelixLoosliInstitute of Biological and Chemical Systems, Biological Information Processing (IBCS-BIP), Karlsruhe Institute of TechnologySatoshiAnsaiUshimado Marine Institute, Okayama UniversityEwanBirneyEuropean Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI)JoachimWittbrodtCentre for Organismal Studies (COS), Heidelberg UniversityMedaka is an established vertebrate model system for biological and biomedical research. It possesses unique features that make it particularly suitable for studying genome–environment interactions. Endemic to habitats spanning from 4 to 40°C and varying salinities, it combines broad ecological adaptability with experimental tractability. Its exceptional tolerance to inbreeding enabled the creation of the Medaka Inbred Kiyosu-Karlsruhe panel―80 near-isogenic, fully sequenced lines derived from a single wild population. More than 100 wild-derived, fully sequenced strains, collected throughout East Asia for more than 40 years, show relatively low intra-strain variation (inbreeding coefficient of >0.75) but high inter-strain variability (SNP rates >4%). Advanced quantification methods facilitate genome-wide association studies and quantitative trait locus mapping. The system’s amenability to clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 editing and emerging epigenomic profiling enables causal validation and regulatory-mechanism discovery. Collectively, medaka offers an unparalleled vertebrate framework for integrating genetics, environment, and epigenetics―bridging evolutionary, biomedical, and population-level perspectives.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221612026Asthma-like bronchodilator responsiveness in patients with neuronal intranuclear inclusion disease16760ENDaisukeTaharaDepartment of Neuropathology, Institute for Medical Science of Aging, Aichi Medical UniversityNaoTaharaDepartment of Neuropathology, Institute for Medical Science of Aging, Aichi Medical UniversityChisatoTamaiDepartment of Neuropathology, Institute for Medical Science of Aging, Aichi Medical UniversityAkioAkagiDepartment of Neuropathology, Institute for Medical Science of Aging, Aichi Medical UniversityYuichiRikuDepartment of Neuropathology, Institute for Medical Science of Aging, Aichi Medical UniversityHiroakiMiyaharaDepartment of Neuropathology, Institute for Medical Science of Aging, Aichi Medical UniversityReiKobayashiDepartment of Neurology, NHO Nagoya Medical CenterHisashiOkadaDepartment of Neurology, NHO Nagoya Medical CenterMichiKawamotoDepartment of Neurology, Kobe City Medical Center General HospitalJunkoIshiiDepartment of Neurology, Kobe City Medical Center General HospitalHirokiYamazakiDepartment of Neurology, Tokushima University Graduate School of Biomedical ScienceTakashiKurashigeDepartment of Neurology, NHO Kure Medical Center and Chugoku Cancer CenterAtsuhikoSugiyamaDepartment of Neurology, Chiba UniversityAkikoNagaishiDepartment of Neurology, NHO Nagasaki Kawatana Medical CenterKatsuyaNishidaDepartment of Neurology, NHO Hyogo Chuo National HospitalKazumaSugieDepartment of Neurology, Nara Medical University HospitalTakayasuFukudomeDepartment of Neurology, NHO Nagasaki Kawatana Medical CenterKazukoHasegawaDepartment of Neurology, NHO Sagamihara National HospitalHiroyukiIshiuraDepartment of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHarukiKoikeDepartment of Neurology, Saga UniversityTakashiKasaiDepartment of Neurology, Kyoto Prefectural University of MedicineToshikiMizunoDepartment of Neurology, Kyoto Prefectural University of MedicineMasahiroAndoDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesYujiroHiguchiDepartment of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental SciencesFumiakiTanakaDepartment of Neurology and Stroke Medicine, Yokohama City University Graduate School of MedicineYuishinIzumiDepartment of Neurology, Tokushima University Graduate School of Biomedical ScienceGenSobueAichi Medical UniversityYasushiIwasakiDepartment of Neuropathology, Institute for Medical Science of Aging, Aichi Medical UniversitySatoruItoDivision of Respiratory Medicine and Allergology, Department of Internal Medicine, School of Medicine, Aichi Medical UniversityJunSoneDepartment of Neuropathology, Institute for Medical Science of Aging, Aichi Medical UniversityNeuronal intranuclear inclusion disease (NIID) is a neurodegenerative condition characterized by the presence of intranuclear inclusions in neuronal and visceral cells. Patients with NIID can present respiratory symptoms; however, data on pulmonary functions in NIID are lacking. This study investigated the respiratory conditions in NIID patients diagnosed with histopathological and genetic studies. We conducted two spirometries before and after administrating the bronchodilator in NIID patients with asthmatic histories or symptoms. We statistically compared pre- and post-measured values including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and peak expiratory flow (PEF). Before two spirometries, we also measured fractional concentration of exhaled nitric oxide (FeNO), if possible. Of the 51finally enrolled patients, 17 (33.3%, 95% CI 20.8% to 47.9%) patients had asthmatic histories or symptoms, and 14 patients received two spirometries. After administrating the bronchodilator, FEV1 and PEF significantly increased by 150 mL (6.01%, p = 0.002) and 260 mL/s (6.72%, p = 0.017), respectively. The median (interquartile range) of FeNO measured in nine patients was 15 (10–21) ppb. Patients with NIID have airflow reversibility like asthma. This condition appears to be less associated with airway inflammation and may be related to autonomic dysfunction.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1472-68312612026Differences in understanding of explanations and risk perception between dental staff and patients: a questionnaire study at a university hospital1050ENShihoOtomoSchool of Environment and Society, Institute of Science TokyoMaokoFujisakiSchool of Environment and Society, Institute of Science TokyoRisakoYanagaseSchool of Environment and Society, Institute of Science TokyoKanakoNoritakeInstitute of Science Tokyo Hospital, Institute of Science TokyoYoshinobuYanagiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTaroSugiharaSchool of Environment and Society, Institute of Science TokyoBackground and purpose: Proper self-care necessitates behavioral changes, underpinned by correct knowledge. Oral health literacy (OHL) research constitutes a fundamental foundation for fostering effective self-care practices. However, the extent of the awareness gap between patients and dental staff regarding explanations provided during treatment remains unknown. This descriptive study was conducted to serve as an initial step in bridging this gap.<br>
Methods: Questionnaires were distributed to 92 dental staff members and 205 patients at university hospitals, with responses from 72 staff members and 157 patients.<br>
Results: In the category assessing understanding of explanations (patient vs. dental staff), patients’ self-assessed understanding exceeded the dental staff’s estimates in three aspects: disease name (p = 0.03, r = 0.17), treatment period (p = 0.01, r = 0.21), and pain relief (p = 0.01, r = 0.19). Regarding health self-awareness, the high-scoring group significantly outperformed the low-scoring group in explaining treatment risks (p = 0.03, r = 0.21) and understanding (p = 0.01, r = 0.23). Nevertheless, patients’ risk recognition was higher than that of dental staff in three aspects: root canal treatment (p < 0.01, r = 0.23), holes in the teeth (p < 0.01, r = 0.24), and bleeding during toothbrushing (p = 0.02, r = 0.17). Questions on “crack” (p = 0.02, r = 0.21) by sex, holes in one’s own teeth (p = 0.05, r = 0.03), and feeling one’s own teeth wobble (p < 0.01, r = 0.07) in the intergenerational comparison showed significant differences.<br>
Conclusion: Dental staff should not be satisfied merely with having "explained" something to the patient; they must engage in a confirmation process to verify the patient's correct understanding of the information or to identify excessive anxiety.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2090-6447202612026A Rare Case of Hyperplastic Dental Follicle Presenting With an Unusually Large Radiolucent Area2879891ENSatoshiOtsukiDepartment of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYukiKunisadaDepartment of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoichiKadoyaDepartment of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityChizuruKobayashiDepartment of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeisukeNakanoDepartment of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshiyukiKawazuDepartment of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySoichiroIbaragiDepartment of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHyperplastic dental follicle (HDF) is a rare odontogenic hamartomatous lesion typically associated with unerupted teeth in children and adolescents and is often found incidentally on radiographic imaging. HDF usually presents as a pericoronal radiolucency of 2–3 mm in diameter and is commonly difficult to distinguish from dentigerous cysts on radiographs. We report an unusual case of HDF in an 11-year-old male who was referred for evaluation of delayed eruption of the left maxillary canine. Panoramic radiography and cone-beam computed tomography (CBCT) revealed a remarkably large radiolucent area, with a maximum dimension of 25.3 mm. The initial clinical diagnosis was a dentigerous cyst; however, incisional biopsy revealed solid tissue characteristics, and histopathological examination confirmed HDF, with no evidence of cystic lining, neoplastic transformation, or inflammation. Following the patient′s and parents′ preference for complete removal, resection of the lesion together with extraction of the impacted canine was performed under general anesthesia. At the 6-month follow-up, no recurrence was observed and bone regeneration was confirmed on radiographic examination. This case underscores the diagnostic challenge posed by atypical radiographic findings and highlights the necessity of histopathological confirmation. Given the exceptional size and potential for recurrence, long-term follow-up is warranted.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1432-058410572026WT1 mRNA in peripheral blood enables early prognostic stratification in AML patients receiving venetoclax and azacitidine therapy105ENHiroyukiSugiuraDivision of Internal Medicine, Fukuyama City HospitalNoboruAsadaDepartment of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTakeruAsanoDepartment of Hematology and Oncology, Japanese Red Cross Society Himeji HospitalYasushiHiramatsuDepartment of Hematology and Oncology, Japanese Red Cross Society Himeji HospitalTomohiroUrataDepartment of Hematology and Blood Transfusion, Kochi Health Sciences CenterToshiImaiDepartment of Hematology and Blood Transfusion, Kochi Health Sciences CenterMakotoNakamuraDepartment of Hematology, Okayama City HospitalKazuhikoYamamotoDepartment of Hematology, Okayama City HospitalTatsunoriIshikawaDepartment of Hematology, Chugoku Central Hospital of Japan Mutual Aid Association of Public School TeachersMasanoriMakitaDepartment of Hematology, Chugoku Central Hospital of Japan Mutual Aid Association of Public School TeachersTakanoriYoshiokaDepartment of Hematology, NHO Okayama Medical CenterKazutakaSunamiDepartment of Hematology, NHO Okayama Medical CenterKyosukeSaekiDivision of Hematology, Ehime Prefectural Central HospitalYuichiroNawaDivision of Hematology, Ehime Prefectural Central HospitalMaikoKimuraDepartment of Hematology, Japanese Red Cross Okayama HospitalMakotoTakeuchiDepartment of Hematology, Japanese Red Cross Okayama HospitalMasayaAbeDepartment of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineShojiAsakuraDepartment of Internal Medicine, Okayama Rosai HospitalTomofumiYanoDepartment of Internal Medicine, Okayama Rosai HospitalYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineVenetoclax and azacitidine (VEN/AZA), which target BCL-2 and DNA methylation, have demonstrated substantial efficacy, particularly in older or unfit patients with acute myeloid leukemia (AML). Wilms’ Tumor-1 (WT1) mRNA, measurable in peripheral blood (PB), is an established biomarker for monitoring treatment response and predicting AML prognosis. We conducted a retrospective analysis of patients with AML treated with VEN/AZA within the Okayama Hematology Study Group (OHSG). Patients who showed a marked reduction in PB WT1 mRNA levels from baseline after the first or second treatment cycle had significantly improved overall survival (OS) and progression-free survival (PFS). Moreover, achieving PB WT1 mRNA negativity-regardless of whether this occurred early or later in the therapy།was consistently associated with superior OS and PFS. These findings suggest that PB WT1 mRNA is a sensitive and reliable biomarker for predicting treatment response and long-term outcomes in patients with AML receiving VEN/AZA.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0300-95722252026Decline in rescue breathing and its impact on outcomes in pediatric out-of-hospital cardiac arrest due to drowning: a nationwide study, 2012–2023111049ENTakafumiObaraDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTsuyoshiNojimaDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityNaomiMatsumotoDepartment of Epidemiology, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityKoheiTsukaharaDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTakashiHongoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTetsuyaYumotoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTakashiYorifujiDepartment of Epidemiology, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHiromichiNaitoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityBackground: Rescue breathing is considered essential in pediatric out-of-hospital cardiac arrest (OHCA) due to drowning, a type of asphyxial arrest where hypoxia precedes circulatory collapse. However, the increasing promotion of compression-only CPR (CO-CPR) may have contributed to changes in bystander CPR practices, including a decline in rescue-breathing CPR (RB-CPR). Whether such temporal changes have influenced outcomes in pediatric drowning OHCA remains unclear.<br>
Methods: We analyzed nationwide data from the All-Japan Utstein Registry (2012–2023), including pediatric OHCA patients (≤17 years old) whose arrests were caused by drowning and received bystander CPR from laypersons. Patients were categorized into RB-CPR and CO-CPR groups. The primary outcome was 30-day mortality; secondary outcomes included prehospital absence of return of spontaneous circulation (ROSC) and 30-day unfavorable neurological survival, defined as Cerebral Performance Category score 3–5. We used multivariable Poisson regression to estimate adjusted risk ratio (aRR) and conducted analyses by age and witnessed status.<br>
Results: Among 740 eligible patients, 41.6% received RB-CPR and 58.4% received CO-CPR. The proportion of RB-CPR declined over the study period. CO-CPR was associated with higher 30-day mortality (aRR 1.38, 95% CI 1.14–1.67), higher prehospital absence of ROSC, and worse neurological outcomes compared with RB-CPR. The adverse association of CO-CPR was most pronounced in unwitnessed arrests, where ventilation may be particularly important.<br>
Conclusions: In pediatric drowning OHCA, CO-CPR was associated with worse survival and neurological outcomes than RB-CPR. These findings underscore the necessity for rescue breathing and the importance of ventilation-focused bystander CPR training in pediatric and drowning-related scenarios.No potential conflict of interest relevant to this article was reported.Ovid Technologies (Wolters Kluwer Health)Acta Medica Okayama2047-99801592026Insomnia and the Risk of Atrial Fibrillation: A Nationwide, Real‐World Cohort Studye045149ENTakuroMasudaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaroEjiriDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidehiroKanekoDepartment of Cardiovascular Medicine, The University of TokyoYutaSuzukiDepartment of Advanced Cardiology, The University of TokyoToruMiyoshiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiTayaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeiichiroIwasakiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiNakagawaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuhiroNishiiDepartment of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiMoritaDepartment of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkiraOkadaDepartment of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of TokyoKatsuhitoFujiuDepartment of Cardiovascular Medicine, The University of TokyoNorifumiTakedaDepartment of Cardiovascular Medicine, The University of TokyoHiroyukiMoritaDepartment of Cardiovascular Medicine, The University of TokyoHideoYasunagaDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of TokyoNorihikoTakedaDepartment of Cardiovascular Medicine, The University of TokyoShinsukeYuasaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: Insomnia is one of the most prevalent diseases observed in clinical practice, contributing to increased death and a range of chronic diseases. While numerous studies have explored the relationship between insomnia and cardiovascular disease, research on its association with atrial fibrillation (AF) remains limited. This study aimed to investigate the association between insomnia and incident AF in the general population by comprehensive, nationwide, real‐world data in Japan.<br>
Methods: A total of 1 780 764 individuals without prior cardiovascular disease including AF from the DeSC database were included between April 2014 and August 2023. Insomnia was defined by International Classification of Diseases, Tenth Revision (ICD‐10) codes (F510, G470) before the baseline health checkup. The primary outcome was incident AF (I480–I482 and I489). Cox proportional hazards models were used to estimate hazard ratios of AF according to present insomnia (versus absent).<br>
Results: Insomnia was observed in 216 919 individuals (12.2%), showing a significant association with incident AF after adjusting for potential confounding factors (adjusted hazard ratio, 1.14 [95% CI, 1.10–1.18]). Among subgroups, a similar pattern in the association between insomnia and incident AF was seen, while the association was stronger in younger individuals aged <65 years (versus ≥65 years) and women (versus men) (P for interaction=0.01 and 0.03, respectively).<br>
Conclusions: Insomnia was significantly associated with the risk of AF. It highlighted the importance of recognizing insomnia as a risk factor for AF, given its high prevalence in the general population and the substantial impact of AF on quality of life and prognosis.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1471-24312612026Sebastidae-specific food allergy causing anaphylaxis: a pediatric case report and fish allergen analysis628ENMitsuruTsugeDepartment of Pediatric Acute Diseases, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuhiroUdaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasanoriIkedaDepartment of Pediatrics, Okayama University HospitalHirokazuTsukaharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground Fish allergy affects approximately 0–0.3% of the population. Parvalbumin is the major allergen in fish allergy, and patients with fish allergy sensitized to parvalbumin demonstrate allergic reactions to various fish species. However, a subset of patients exhibits allergic responses to only specific fish species. Fish of the Sebastidae family, widely consumed in Asian, North American, and European countries, has rarely been reported as an allergenic trigger.<br>
Case presentation A 14-year-old Japanese boy visited our clinic for evaluation of fish allergy after experiencing allergic reactions to Sebastes alutus (Alaskan rockfish). He developed respiratory symptoms, eyelid edema, and skin erythema after consuming a meal containing Sebastes alutus, suggesting anaphylaxis; however, he was able to consume many other fish species without any issues. Skin prick tests and basophil activation tests using fish species from the Sebastidae family showed positive reactions, whereas other fish species that the patient could tolerate showed negative reactions. Immunoblot analysis performed to identify the causative allergen revealed two IgE-binding bands (17 and 110 kDa) in Sebastidae, distinct from parvalbumin. Mass spectrometry identified these proteins as alpha-actinin-3b, ATPase sarcoplasmic/endoplasmic reticulum Ca2 + transporting 1, and several myosin-related proteins.<br>
Conclusions This case highlights the need for clinicians to recognize fish allergy specific to the Sebastidae family. Identifying the causative non-parvalbumin allergens would improve understanding of fish allergy diversity and individualized dietary management for patients. Additional cases and detailed analyses are necessary to identify the specific allergens involved in Sebastidae allergy.No potential conflict of interest relevant to this article was reported.American Society of HematologyActa Medica Okayama2473-952910132026Drivers of temporal improvement in CAR T-cell therapy for large B-cell lymphoma: a Japanese nationwide registry analysis44274438ENYuYagiDepartment of Medical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalYusukeKanemasaDepartment of Medical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalToshikiTerao2Department of Hematology, Okayama University Hospital, Okayama, JapanMotohiroKatoDepartment of Pediatrics, The University of TokyoTomoyasuJoDepartment of Hematology, Kyoto University HospitalTatsuShimoyamaDepartment of Medical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalToshioKitawakiDepartment of Hematology, Kyoto University HospitalRyoHanajiriDepartment of Hematology and Oncology, Nagoya University Graduate School of MedicineNorikoDokiHematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalSatoshiYoshiharaDepartment of Hematology, Hyogo Medical University HospitalNobuharuFujiiDepartment of Hematology, Okayama University HospitalNorikoIwakiDepartment of Hematology, National Cancer Center HospitalGoYamamotoDepartment of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon HospitalMasatoshiSakuraiDivision of Hematology, Department of Medicine, Keio University School of MedicineToshihiroMatsukawaDepartment of Hematology, Hokkaido University HospitalEmikoSakaidaDepartment of Hematology, Chiba University HospitalYasuhiroNakashimaHematology and Hematopoietic Cell Transplantation, Osaka Metropolitan University HospitalAkiyoYoshidaDivision of Transfusion Medicine, Kanazawa University HospitalYoshihiroUmezawaDepartment of Hematology, Institute of Science Tokyo HospitalHaryoonKimDivision of Hematology, Department of Medicine, Keio University School of MedicineKeisukeKataokaDivision of Hematology, Department of Medicine, Keio University School of MedicineHidekiGoto11Department of Hematology, Hokkaido University Hospital, Sapporo, JapanYoshikoAtsutaJapanese Data Center for Hematopoietic Cell TransplantationKojiKatoDepartment of Hematology, Oncology, and Cardiovascular Medicine, Kyushu University HospitalReal-world CD19 chimeric antigen receptor (CAR) T-cell therapy for large B-cell lymphoma (LBCL) is characterized by expanded eligibility and evolving management practices. However, the prognostic impact of these changes remains inconsistent, and the specific drivers of outcomes remain unclear. This study analyzed 913 patients with relapsed/refractory (R/R) LBCL from a Japanese registry and compared the outcomes between 2 calendar periods (2019-2021 vs 2022-2024). The 2022-2024 cohort was older, had more adverse baseline features, and was less pretreated. Treatment patterns have shifted toward higher utilization of second-line therapy, a growing preference for axicabtagene ciloleucel (axi-cel) and lisocabtagene maraleucel (liso-cel), and improved disease control before infusion. Accordingly, the 2022-2024 cohort achieved a longer progression-free survival (PFS; 6-month PFS, 63.2% vs 55.2%; P = .005), which persisted after adjusting for baseline characteristics using propensity score matching. Multivariable analysis identified second-line therapy, improved preinfusion disease control, and a shift in product selection from tisagenlecleucel to axi-cel or liso-cel as the primary drivers of this improvement. This benefit was pronounced in high-risk populations, including patients with stable or progressive disease at infusion (6-month PFS, 54.6% vs 43.8%; P = .012) and those who were refractory to first-line therapy (6-month PFS, 51.7% vs 40.3%; P = .013). Despite broader use in higher-risk populations and greater axi-cel exposure, 6-month nonrelapse mortality remained low (2.1% vs 1.5%). Real-world outcomes of CD19 CAR T-cell therapy for R/R LBCL have improved, predominantly driven by second-line therapy, enhanced preinfusion disease control, and increased use of more potent CAR T products.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama0278-03724632026Estimating the distributional expansion of the invasive crayfish Procambarus clarkii (Girard, 1852) (Decapoda: Astacidea: Cambaridae) in South Korea using environmental DNA analysisruag033ENSeong-NamHamGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKaitoMoriuchiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMayukoHamadaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKazuyoshiNakataGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThe red swamp crayfish Procambarus clarkii (Girard, 1852) is a globally invasive species that poses serious threats to native biodiversity and ecosystem functioning. In South Korea, established populations of P. clarkii have been documented from the Jiseokcheon River in the Yeongsangang River basin since 2018; however, information on its current nationwide distribution remains limited. We conducted environmental DNA (eDNA) surveys at 19 sites across 11 river systems in South Korea, including sites with no prior distributional records, to evaluate the current distribution and potential range expansion of P. clarkii. Water samples collected during July-August 2024 were analyzed using quantitative real-time PCR (qPCR) with two species-specific primer-probe sets targeting the mitochondrial COI gene. Procambarus clarkii eDNA was detected at three sites in the Yeongsangang River basin, whereas no eDNA was detected in the other surveyed river systems. Notably, P. clarkii eDNA was not detected at a site in the Mangyeonggang River system despite previous reports of individuals and eDNA data sampled there, indicating a possible local population decline or very low abundance. By contrast, detections within the Yeongsangang River basin, together with elevated eDNA concentrations at some sites, are consistent with localized upstream expansion and increased local abundance. The concordant results from the two primer-probe sets, together with Sterivex-based on-site filtration, support the reliability of the applied eDNA framework. These findings identify the Yeongsangang River basin as the current primary focus of the P. clarkii invasion in South Korea, with evidence consistent with localized upstream expansion and increasing abundance, and provide baseline data for early detection and long-term monitoring, as well as for developing management strategies.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1465-36212026Impact of pre-existing schizophrenia spectrum disorder on the receipt of invasive and systemic therapy for gastric cancer: a multicenter nationwide cohort study in Japanhyag102ENMyo MinKhantDepartment of Psychiatry, Faculty of Medicine, Shimane UniversityMasakiFujiwaraDepartment of Neuropsychiatry, Medical Development Field, Okayama UniversityYutoYamadaDivision of Survivorship Research, National Cancer Center Institute for Cancer Control, National Cancer CenterTaisukeIshiiDivision of Health Services Research, National Cancer Center Institute for Cancer Control, National Cancer CenterTomoneWatanabeDivision of Health Services Research, National Cancer Center Institute for Cancer Control, National Cancer CenterTakashiFukaoDepartment of Neuropsychiatry, Medical Development Field, Okayama UniversityMaikoFujimoriDivision of Survivorship Research, National Cancer Center Institute for Cancer Control, National Cancer CenterNaokiNakayaTohoku Medical Megabank Organization, Tohoku UniversityToshihikoKawamuraDepartment of Medical Informatics, Shimane University HospitalKojiOtsukiDepartment of Psychiatry, Faculty of Medicine, Shimane UniversityYoshihikoKakiuchiDepartment of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTaichiShimazuDivision of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer CenterShiroHinotsuDepartment of Biostatistics and Data Management, Sapporo Medical UniversityYosukeUchitomiDepartment of Cancer Survivorship and Digital Medicine, The Jikei University School of MedicineMasatoshiInagakiDepartment of Psychiatry, Faculty of Medicine, Shimane UniversityBackground: Patients with schizophrenia spectrum disorders (SSD) experience higher cancer mortality, partly because of later-stage diagnosis and lower rates of recommended treatments. While treatment disparities have been reported across several cancer types, no study has specifically examined stage-appropriate treatment for gastric cancer among patients with SSD.<br>
Methods: We conducted a retrospective cohort study using a nationwide Hospital-Based Cancer Registry linked to administrative data in Japan. Patients who received initial treatment for gastric cancer between 2018 and 2021 were included. Multivariable logistic regression models examined the association between SSD and the receipt of stage-appropriate cancer treatments, adjusting for age, sex, clinical stage, Charlson Comorbidity Index, and Barthel Index.<br>
Results: Among 189 447 patients from 709 hospitals, 1312 had SSD. Patients with SSD were more likely to be diagnosed at advanced stages. In crude analysis, SSD was associated with lower rates of surgical or endoscopic treatment; however, this association was not statistically significant after adjustment (adjusted odds ratio [aOR], 0.90; 95% confidence interval [CI], 0.75–1.08). In contrast, SSD was independently associated with lower rates of postoperative adjuvant chemotherapy for pathological stage II/III disease (aOR, 0.64; 95% CI, 0.45–0.91) and systemic therapy for stage IV disease (aOR, 0.36; 95% CI, 0.28–0.47).<br>
Conclusions: Among patients with gastric cancer, SSD was associated with reduced receipt of systemic therapy but not surgical or endoscopic treatment. Efforts to improve early detection among patients with SSD may be important for reducing treatment disparities, alongside strengthened support for systemic therapy to ensure equitable access to guideline-recommended gastric cancer care.No potential conflict of interest relevant to this article was reported.American Geophysical Union (AGU)Acta Medica Okayama2169-909713172026Surface Geology and Evolution of Asteroid Ryugu: Insights From Hayabusa2 Global Mappinge2025JE009578ENLisa M.VincentDepartment of Earth Sciences, Utrecht UniversityTrishitRujInstitute for Planetary Materials, Okayama UniversityGoroKomatsuInternational Research School of Planetary Sciences, Università G. d'AnnunzioAdityaRayDepartment of Geology, Presidency UniversityHiroshiKikuchiGakushuin UniversityRyodoHemmiInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyHideakiMiyamotoDepartment of Systems Innovation School of Engineering, The University of TokyoSeijiSugitaPlanetary Exploration Research Center, Chiba Institute of Technologythe Hayabusa2 ONC science teamRubble-pile asteroids, characterized by loose aggregates of debris held together by gravity, represent both a significant planetary hazard and a key to understanding planetesimal formation. Geologic mapping of these bodies provides essential insights into their origins, evolution, and surface processes. This knowledge is crucial for advancing space mission capabilities, from precise navigation and safe sampling to assessing the feasibility of future asteroid mining. Here, we present the most comprehensive geologic map of Ryugu in comparison to previous early-stage and single-feature maps, integrating Optical Navigation Camera (ONC) mosaics, LIDAR-derived topography, Mobile Asteroid Surface Scout (MASCOT) descent images, and spectral slope data. The analysis includes reclassification of previously identified features and newly identified features from global to local scales. The geologic mapping technique followed United States Geological Survey (USGS) planetary cartography standards using the ArcGIS Pro platform. This global framework provides an essential geologic context for interpreting returned samples and constraining rubble-pile evolution. We identified geomorphological, structural, and surface texture units on Ryugu's unconsolidated rubble-pile surface using 0.2–0.7 m/pixel image mosaics. Elongated troughs at the poles and mirrored, oblique lineaments near the equatorial ridge are consistent with rotational strain. Compared with another rubble-pile asteroid Bennu, Ryugu shows a more uniform boulder distribution, and its immensely prominent equatorial ridge indicates a more intense period of rotational deformation. However, the western bulge deviates from this trend; its fewer boulders, underdeveloped ridges, and older degraded craters suggest selective resurfacing. These features show evidence of catastrophic disruption, rotational reshaping, and ongoing surface movement.No potential conflict of interest relevant to this article was reported.Institute of Electrical and Electronics Engineers (IEEE)Acta Medica Okayama2187-01361412025Study of Signal Separation and Demodulation Techniques Considering IQ Imbalance by Stored Data Batch Signal Processing3033ENYudaiMitaGraduate School of Natural Science and Technology, Okayama UniversityYutaHiraokaGraduate School of Natural Science and Technology, Okayama UniversityTomofumiHikasaGraduate School of Natural Science and Technology, Okayama UniversityShigeruTomisatoGraduate School of Natural Science and Technology, Okayama UniversitySatoshiDennoGraduate School of Natural Science and Technology, Okayama UniversityKazuhiroUeharaGraduate School of Natural Science and Technology, Okayama UniversityWith the arrival of the IoT era, the problem of interference has become even more serious, and the challenge is to establish techniques for separating and demodulating collide signals. To achieve this, we are conducting research on stored data batch signal processing technology using short-time Fourier transform (STFT). In this paper, we used a feature quantity demodulation method proposed as a method for stored data batch signal processing to evaluate the effect of IQ imbalance, which is a factor in signal degradation in the transmitter, on signal separation and demodulation performance. Furthermore, we proposed a receiver configuration that estimates the amount of degradation due to IQ imbalance from the extracted feature quantities and compensates for the signal degradation. Computer simulation results confirmed that the proposed compensation method can improve signal separation and demodulation performance when degraded by IQ imbalance.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1478-63622712025Performance of the modified 2022 ACR/EULAR giant cell arteritis classification criteria without age restriction for discriminating from Takayasu arteritis19ENTakahikoSugiharaDepartment of Rheumatology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoMasayoshiHarigaiDivision of Rheumatology, Department of Internal Medicine, Tokyo Women’s Medical University School of MedicineHaruhito A.UchidaDepartment of Chronic Kidney Disease and Cardiovascular Disease, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of MedicineHajimeYoshifujiDepartment of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto UniversityYasuhiroMaejimaDepartment of Cardiovascular Medicine, Graduate School of Medical and Dental Sciences, Institute of Science TokyoJunIshizakiDepartment of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of MedicineYoshikoWatanabeDepartment of General Medicine, Kawasaki Medical SchoolHiroakiDobashiDivision of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa UniversityYoshinoriKomagataDepartment of Nephrology and Rheumatology, Kyorin University School of MedicineNaotoTamuraDepartment of Internal Medicine and Rheumatology, Juntendo University School of MedicineYoshikazuNakaokaDepartment of Vascular Physiology, National Cerebral and Cardiovascular Center Research InstituteJapan Research Committee of the Ministry of Health, Labour, and Welfare for Intractable Vasculitis (JPVAS)Objective To evaluate the ability to discriminate giant cell arteritis (GCA) from Takayasu arteritis (TAK) according to the modified 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) GCA classification criteria.<br>
Methods Patients enrolled in the Japanese nationwide retrospective registry were evaluated using the criteria with partial modification; wall thickening of descending thoracic-abdominal aorta were mainly diagnosed by contrast-enhanced computed tomography (CT) or magnetic resonance imaging instead of evaluating with positron emission tomography (PET)-CT. The discriminability of the criteria was evaluated using C-statistic (> 0.7: good ability).<br>
Results Newly diagnosed patients with GCA (n = 139) and TAK (n = 129) were assessed, and 23.3% of TAK were aged 50 years or older at onset. The sensitivity of the modified 2022 ACR/EULAR GCA classification criteria with a score ≥ 6 was 82.0%, 68.5%, and 32.1% in all GCA, GCA with large-vessel involvement, and GCA without cranial arteritis, respectively. The specificity of the modified criteria was 96.1% for the 129 TAK as controls. Five patients with late-onset TAK met the modified criteria, and four had cranial signs and symptoms, two had bilateral axillary artery involvement, and four had descending thoracic-abdominal aorta involvement. The discriminability of the criteria was good (C-statistic: 0.986, 95% confidence interval [CI]: 0.976–0.996) and remained good after excluding age (C-statistic: 0.927, 95% CI: 0.894–0.961). The discriminability of a set of large-vessel lesions (bilateral axillary artery and descending thoracic-abdominal aorta) and inflammatory markers was markedly decreased with poor C-statistic value (C-statistic: 0.598, 95% CI: 0.530–0.667). Discriminability was improved after adding polymyalgia rheumatica (PMR) (C-statistic: 0.757, 95% CI: 0.700–0.813) or age (C-statistic: 0.913, 95%CI: 0.874–0.951) to the set of large-vessel lesions. In GCA patients with a score ≤ 5, 52% had bilateral subclavian and/or axillary artery involvement.<br>
Conclusion The modified 2022 ACR/EULAR GCA classification criteria well performed in classifying GCA and TAK without PET-CT in routine clinical practice. A set of items included in the modified GCA classification criteria had good discriminative ability for GCA and TAK, even when age was excluded. However, age restriction or PMR was required to distinguish GCA without cranial lesions from TAK.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2041-17231712026Bacterial collagenase harnesses collagen geometry for processive cleavage5485ENHiroyaOkiDepartment of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases, The University of OsakaKatsukiTakebeDepartment of Dental Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAdjoaBonsuDepartment of Chemistry and Biochemistry, University of ArkansasKazunoriFujiiDepartment of Chemistry and Biochemistry, School of Advanced Science and Engineering, Waseda UniversityRyoMasudaWaseda Research Institute for Science and Engineering, Waseda UniversityNicholasHendersonDepartment of Chemistry and Biochemistry, University of ArkansasTakehikoMimaDepartment of Medical Technology, Faculty of Health Sciences, Ehime Prefectural University of Health SciencesTakakiKoideDepartment of Chemistry and Biochemistry, School of Advanced Science and Engineering, Waseda UniversityMahmoudMoradiDepartment of Chemistry and Biochemistry, University of ArkansasOsamuMatsushitaDepartment of Bacteriology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJoshuaSakonDepartment of Chemistry and Biochemistry, University of ArkansasKazukiKawaharaGraduate School of Pharmaceutical Sciences, The University of OsakaCollagen, the major structural protein in the animal extracellular matrix, forms a triple helix that resists proteolysis and requires specialised enzymes for degradation. Flesh-eating bacteria secrete collagenases that unwind the collagen triple helix and processively trim Gly–X–Y triplet repeats, yet the molecular basis of this process has remained obscure. Here, cryo-electron microscopy reveals how Hathewaya histolytica collagenase ColH engages its substrate and exploits the helix’s architecture for catalysis. ColH encircles a single collagen triple helix in a closed-ring conformation and, through dynamic domain motions, dehydrates and destabilises it. The enzyme undergoes substrate-assisted twisting to adopt a rigid ratcheted conformation, in which one chain is bent into a tripeptide-long ‘bight’ and threaded into the active site for cleavage, while two uncut strands are partitioned to non-catalytic sites. Release of the bight appears to reset the enzyme, with the uncut strands serving as guiding tracks. Repeated cycling between dynamic and rigid states likely enables triplet-by-triplet translocation, allowing ColH to harness collagen’s geometry for processive degradation. These findings reveal a bacterial strategy for collagen unwinding and cleavage distinct from that of mammalian collagenases, highlighting divergent evolutionary solutions for degrading one of nature’s most intractable substrates.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama2977-0548232026Truncation by death in the sufficient-cause frameworkuuag021ENBronner PGonçalvesFaculty of Health and Medical Sciences, University of SurreyEijiYamamotoOkayama University of ScienceEtsujiSuzukiDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityThe sufficient-cause framework has been used for decades to improve our understanding of both basic and complex causal concepts in epidemiology, such as mediation and interaction. Here, we make use of this framework to provide a description of truncation by death, in which the outcome of interest is undefined for individuals who die before the assessment time at the end of follow-up. We explain the noncausal nature of the crude estimand that compares outcomes by treatment levels conditional on observed survival by showing that it corresponds to a comparison of distinct risk-status types, which are defined based on their susceptibility to sufficient causes. Further, expressions for the crude estimand and for the survivor average causal effect (SACE)―a causal estimand defined under the principal stratification approach―are provided in terms of population-level joint frequencies of the background factors of sufficient causes. Finally, we also describe conditions, based on background factors of sufficient causes, under which the SACE is null. Our description of this problem, which studies truncation by death from a new perspective, might encourage further analyses of principal stratification-based estimands using sufficient causes.No potential conflict of interest relevant to this article was reported.American Society for MicrobiologyActa Medica Okayama0066-48046912025Genomic epidemiology and genetic characteristics of clinical Campylobacter species cocirculating in West Bengal, India, 2019, using whole genome analysise01108-24ENDaichiMoritaDepartment of Microbiology, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityAsish KumarMukhopadhyayDivision of Bacteriology, ICMR - National Institute of Cholera and Enteric DiseasesGoutamChowdhuryDivision of Bacteriology, ICMR - National Institute of Cholera and Enteric DiseasesFumitoMaruyamaSection of Microbial Genomics and Ecology, The IDEC Institute, Hiroshima UniversityMiyukiKandaDepartment of Cellular and Molecular Biology, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityYukiYamamotoDepartment of Cellular and Molecular Biology, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityHidetoshiTaharaDepartment of Cellular and Molecular Biology, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityPiyaliMukherjeeDivision of Bacteriology, ICMR - National Institute of Cholera and Enteric DiseasesMainakBardhanDivision of Bacteriology, ICMR - National Institute of Cholera and Enteric DiseasesTakanoriKumagaiDepartment of Microbiology, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityKeiKitaharaCollaborative Research Centre of Okayama University for Infectious Diseases at ICMR-NICEDShin-IchiMiyoshiCollaborative Research Centre of Okayama University for Infectious Diseases at ICMR-NICEDShantaDuttaDivision of Bacteriology, ICMR - National Institute of Cholera and Enteric DiseasesTeruoKurodaDepartment of Microbiology, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityCampylobacter species are the most common pathogens responsible for foodborne gastroenteritis worldwide. India is a region with frequent diarrheal infections and a high level of Campylobacter infection incidence, but the detailed genomic information is limited. This study aimed to characterize 112 isolates of Campylobacter from diarrhea patients at two hospitals in Kolkata, West Bengal, by whole genome analysis. The Campylobacter isolates consisted of 90 C. jejuni, 20 C. coli, and 2 C. lari isolates. Multilocus sequence typing analysis revealed that the largest sequence type (ST) populations were ST-2131 in C. jejuni and ST-830 in C. coli and seven novel STs were found in C. jejuni and one in C. coli. Notably, ST-2131, which is rarely seen elsewhere, was positive for a sialylated LOS-related gene (wlaN +neuA + cstIII) associated with Guillain-Barré syndrome. Antibiotic resistance factors predicted from the genome sequence included blaOXA variants (58.9%), tet(O) (54.5%), tet(W) (0.9%), ant(6)-Ia (0.9%), mutation in GyrA (T86I, T86I+D90N, T86I+P104S, T86I+D90N+P104S) (79.5%), and mutation in 23S rRNA (A2075G) (12.5%). In addition to the high drug resistance of Campylobacter in Kolkata, Campylobacter pathogens were circulating that may be associated with Guillain-Barré syndrome. This study indicates the importance of genomic analysis in the surveillance of pathogens, which provides genomic information on genetic diversity, virulence mechanisms, and determinants of antimicrobial resistance.No potential conflict of interest relevant to this article was reported.Pharmaceutical Society of JapanActa Medica Okayama0918-615847122024Staphylococcus aureus δ-Toxin Induces Ca2+ Influx-Independent Degranulation of Murine Cultured Mast Cells20582064ENKangLiuLaboratory of Pharmacology, Division of Pathological Sciences, Kyoto Pharmaceutical UniversityTomoakiKatayamaDivision of Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHitomiSatoDivision of Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYuhoHamaoka-TamuraLaboratory of Pharmacology, Division of Pathological Sciences, Kyoto Pharmaceutical UniversityMichikoSaitoBioscience Research Center, Kyoto Pharmaceutical UniversityKazuyukiFurutaDivision of Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSatoshiTanakaLaboratory of Pharmacology, Division of Pathological Sciences, Kyoto Pharmaceutical UniversityCutaneous colonization with Staphylococcus aureus (SA) is frequently observed in patients with atopic dermatitis. SA produces a wide variety of bacterial toxins, among which δ-toxin was found to induce degranulation of mast cells. Degranulation of mast cells could enhance bacterial clearance and protection from future SA infection but lead to exacerbation of atopic dermatitis. Because it remains to be determined how δ-toxin triggers degranulation, we investigated δ-toxin-induced changes in murine bone marrow-derived cultured mast cells in this study. We found that δ-toxin-induced degranulation could be classified into two phases, an early Ca2+-independent and a late Ca2+-dependent phase. Recent studies suggest that NOD-like receptor family, pyrin domain containing 3 is involved in the degranulation of mast cells, raising a possibility that leakage of K+ induced by δ-toxin is involved in the Ca2+-independent phase. However, Ca2+-independent degranulation remains unchanged although Ca2+-influx and degranulation induced by δ-toxin were significantly suppressed in the presence of high concentrations of K+. Because actin depolymerization was reported to induce degranulation in the absence of Ca2+ in the permeabilized rat peritoneal mast cells, a slow but steady decrease in the amount of filamentous actin observed here may be involved in Ca2+-independent degranulation induced by δ-toxin. Although Mas-related G protein-coupled receptor (MRGPR) X2 in humans and Mrgprb2 in mice are regarded as the receptors responsible for immunoglobulin E-independent degranulation, δ-toxin-induced degranulation remained unchanged in Mrgprb2−/− mast cells. Our findings pave the way for identification of the target receptors of δ-toxin.No potential conflict of interest relevant to this article was reported.American Physical Society (APS)Acta Medica Okayama2470-001011352026Analytical study of birefringent cavities for axionlike dark matter search055009ENTadashiKuramotoResearch Institute for Interdisciplinary Science, Okayama UniversityYasutakaImaiResearch Institute for Interdisciplinary Science, Okayama UniversityTakahikoMasudaResearch Institute for Interdisciplinary Science, Okayama UniversityYutakaShikanoInstitute of Systems and Information Engineering, University of TsukubaSayuriTakatoriResearch Institute for Interdisciplinary Science, Okayama UniversitySatoshiUetakeResearch Institute for Interdisciplinary Science, Okayama UniversityLight polarization plays a crucial role in optical-cavity experiments; however, mirror birefringence presents a significant challenge that must be addressed carefully. In this study, a rigorous, nonperturbative framework is developed to quantify birefringence effects by incorporating variations in reflectance and polarization misalignment. We analyze the impact of this framework on the sensitivity of axionlike particle (ALP) dark matter searches. The results show that both birefringence and misalignment contribute to sensitivity degradation in the low-mass regime; however, the adverse effects of misalignment can be mitigated by selecting a postselection angle greater than the misalignment angle. Furthermore, birefringence produces an additional resonance peak in the high-mass region, which remains largely unaffected by misalignment and postselection variations. This rigorous framework underscores the importance of considering birefringence in high-precision optical-cavity experiments for ALP detection.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0304-860817112025Novel Escherichia coli phages representing a distinct genus within the subfamily Stephanstirmvirinae: genome and host range characteristics18ENTomoyoshiKanekoDepartment of Life Science and Medical Bioscience, Waseda UniversityJumpeiUchiyamaDepartment of Bacteriology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama UniversityToshifumiOsakaDepartment of Microbiology and Immunology, Tokyo Women’s Medical UniversitySatoshiTsunedaDepartment of Life Science and Medical Bioscience, Waseda UniversityBacteriophages play crucial roles in microbial ecosystems and have potential for biotechnological applications. However, our understanding of culturable phages remains limited. In this study, we characterized six novel Escherichia coli phages isolated from pig farm wastewater and urban sewage, using comprehensive genomic, morphological, and host-range analysis. Using multiple comparative approaches, including gene-sharing network analysis, average nucleotide identity (ANI), and nucleotide intergenomic similarity (NIS), we demonstrated that five of these phages form a distinct group within the subfamily Stephanstirmvirinae, potentially representing a novel genus, for which we propose the name "Wecvirus”. We further propose that these phages, each of which exhibits a unique host range pattern, should be classified in two distinct species within the proposed genus. This host specificity is reflected in differences in the amino acid sequences of tail fibers, which are crucial for infection. The remaining phage, which was not classified as a wecvirus, exhibited characteristics that challenged the current classification criteria, highlighting the need for more-flexible taxonomic approaches. These findings expand our understanding of phage diversity within the subfamily Stephanstirmvirinae and contribute to the evolving phage taxonomy framework.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0012-16065202025Tunicate-specific protein Epi-1 is essential for conferring hydrophilicity to the larval tunic in the ascidian Ciona4152ENKazuKuroiwaShimoda Marine Research Center, University of TsukubaKaoruMita-YoshidaShimoda Marine Research Center, University of TsukubaMayukoHamadaUshimado Marine Institute, Okayama UniversityAkikoHozumiShimoda Marine Research Center, University of TsukubaAtsuo S.NishinoDepartment of Biology, Faculty of Agriculture and Life Science, Hirosaki UniversityYasunoriSasakuraShimoda Marine Research Center, University of TsukubaAnimals must avoid adhesion to objects in the environment to maintain their mobility and independence. The marine invertebrate chordate ascidians are characterized by an acellular matrix tunic enveloping their entire body for protection and swimming. The tunic of ascidian larvae consists of a surface cuticle layer and inner matrix layer. Hydrophilic substances coat the cuticle; this modification is thought to be for preventing adhesion. However, the molecule responsible for regulating this modification has not been clarified. We here found that the tunicate-specific protein Epi-1 is responsible for preventing adhesiveness of the tunic in the ascidian Ciona intestinalis Type A. Ciona mutants with homozygous knockouts of Epi-1 exhibited adhesion to plastic plates and to other individuals. The cuticle of the Epi-1 mutants was fragile, and it lost the glycosaminoglycans supplied by test cells, the accessory cells that normally attach to the tunic surface. Although it has an apparent signal peptide for membrane trafficking, we showed that the Epi-1 protein is localized to the cytosol of the epidermal cells. Our study suggests that the emergence of the tunicate-specific protein Epi-1 made the tunic less adhesive, providing a selective advantage for the last common tunicate ancestor.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama0743-746340522024Formation of Nonspherical Cellulose Acetate Microparticles under Microflow2731427322ENKurumiMoriDepartment of Applied Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTakaichiWatanabeDepartment of Applied Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTsutomuOnoDepartment of Applied Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNonspherical particles have gained significant interest owing to their unique shapes and large specific surface areas, making them suitable for a wide range of applications, such as drug delivery, catalysis, and adsorption. However, conventional methods for preparing nonspherical particles face certain limitations. In this study, we propose a simple method for fabricating nonspherical cellulose acetate (CA) microparticles using a microfluidic device in which droplets undergo rapid diffusion in a continuous aqueous phase. The influence of variations in the flow rate ratio and continuous phase composition on the dimensionless Péclet number (Pe) within the droplet and shape of the resultant particles is investigated. Pe is critical, because it indicates the balance between polymer diffusion and droplet shrinkage dynamics. Our findings reveal that increasing the flow rate ratio and reducing the methyl acetate concentration in the continuous phase lead to faster droplet shrinkage and an increased Pe. A high Pe (>100) suggests that the reduction of the droplet interface predominates over polymer diffusion, resulting in the formation of a viscous layer near the droplet surface, which subsequently leads to nonspherical particle shapes (such as bowl-like or biconcave structures). In situ time-lapse observations of droplets from the top and side of a microchannel reveal that the formation of a viscous layer near the droplet surface and the deformation of the droplet, influenced by the z-axis location of the droplets during particle formation, ultimately determine the final particle shape. Based on these observations, a linear correlation between the initial conditions, i.e., the Pe and z-axis location at which the viscous layer formed, is established, enabling the prediction of the particle structure. In summary, the present study enhances the understanding of shape control in microfluidic particle formation and offers a novel guideline for the fabrication of spherical and nonspherical particles.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841872026Reappraisal of the Entity of Pediatric Uveitis: Bilateral Iridocyclitis With Retinal Capillaritis (BIRC) in Juveniles in 18 Additional Casese112232ENToshihikoMatsuoOphthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityObjectives: Bilateral iridocyclitis with retinal capillaritis (BIRC) in juveniles is a newly recognized entity of juvenile chronic uveitis with no systemic involvement. In this study, 18 additional consecutive patients with BIRC were reported to show that the entity would be useful in the differential diagnosis.<br>
Methods: Clinical features were retrospectively reviewed in 18 consecutive patients diagnosed with BIRC in juveniles at Okayama University Hospital, Okayama, Japan, between 1996 and 2025.<br>
Results: The 18 patients comprised 6 males and 12 females, with an age at onset ranging from 9 to 16 years (median, 13 years). All patients presented with aqueous cells and mutton-fat keratic precipitates in both eyes, and fluorescein angiography revealed varying degrees of optic disc leakage and retinal capillary leakage in the midperipheral to peripheral fundus of both eyes. None had systemic symptoms, including skin rashes, joint pain, or fever, and no abnormalities were detected on blood examinations, urinalysis, or plain chest x-rays. Oral prednisolone, tapered from 30 mg daily, together with topical 0.1% betamethasone four times daily, was administered to five patients: two with optic disc edema and three with macular edema in both eyes or the unilateral eye. The remaining 13 patients were treated with topical 0.1% betamethasone eye drops alone. In patients who developed elevated intraocular pressure, often due to a steroid response, the instillation of topical 0.1% betamethasone was reduced to twice daily, or intraocular pressure-lowering eye drops were used in combination. In two patients who showed relapse of unilateral macular edema after oral prednisolone was tapered or discontinued, oral colchicine (1 mg daily) was introduced, resulting in the subsidence of macular edema. Bilateral uveitis in all 18 patients subsided within 6 months to a few years until 19 years of age, and all topical medications were discontinued, with relapse occurring in only one patient.<br>
Conclusions: BIRC in juveniles should be included in the differential diagnosis for school-age children and young adolescents. BIRC follows a chronic course of a few years and subsides completely with a good prognosis. In cases of macular edema or optic disc edema that affects vision, oral corticosteroid treatment is recommended, whereas patients with no sight-threatening signs can be treated with topical corticosteroid eye drops alone. The entity of BIRC may be distinct from juvenile chronic iridocyclitis in young girls with onset at preschool age, which shares common features with juvenile idiopathic arthritis-associated uveitis.No potential conflict of interest relevant to this article was reported.Georg Thieme Verlag KGActa Medica Okayama0013-726X57042024Efficacy and safety of endoscopic ultrasonography-guided ethanol injections of small pancreatic neuroendocrine neoplasms: a prospective multicenter study321329ENKazuyukiMatsumotoGastroenterology and Hepatology, Okayama University HospitalHironariKatoGastroenterology and Hepatology, Okayama University HospitalTakaoItoiGastroenterology and Hepatology, Tokyo Medical UniversityMasayukiKitanoSecond Department of Internal Medicine, Wakayama Medical UniversityKazuoHaraGastroenterology, Aichi Cancer Center HospitalMasakiKuwataniGastroenterology and Hepatology, Hokkaido University HospitalMamoruTakenakaGastroenterology and Hepatology, Kindai University Faculty of Medicine Graduate School of Medical SciencesReikoAshidaSecond Department of Internal Medicine, Wakayama Medical UniversityShuntaroMukaiGastroenterology and Hepatology, Tokyo Medical UniversityNozomiOkunoGastroenterology, Aichi Cancer Center HospitalKazumichiKawakuboGastroenterology and Hepatology, Hokkaido University HospitalTatsuhiroYamazakiGastroenterology and Hepatology, Okayama University HospitalJunSakuraiCenter for Innovative Clinical Medicine, Okayama University HospitalYukiNakatsukaCenter for Innovative Clinical Medicine, Okayama University HospitalMichihiroYoshidaCenter for Innovative Clinical Medicine, Okayama University HospitalMotoyukiOtsukaGastroenterology and Hepatology, Okayama University HospitalBackground Endoscopic ultrasonography (EUS)-guided ethanol injection (EI) has recently been introduced as one of the management strategies for pancreatic neuroendocrine neoplasms (PNENs); however, its role as a surgical alternative is unclear. We evaluated the efficacy and safety of EUS-EI in treating small PNENs through a prospective multicenter study.<bR>
Methods Patients with grade 1 tumors of ≤15 mm confirmed by pathology were included. The primary end point assessed efficacy and safety, measuring complete ablation using computed tomography at 1 and 6 months, prevention of adverse events (AEs) within 1 month, severe pancreatic fistula at 1 month, and incidence/worsening of diabetes mellitus (DM) at 6 months. The composite end point of EUS-EI was compared with that of historical results of a study based on surgical treatment.<br>
Results 25 patients with PNENs, with a median tumor size of 10.1 mm, were treated using EUS-EI. The composite primary end point was achieved by 76.0% of patients (19/25; 95%CI 54.9%–90.6%), a proportion significantly higher than that of surgical treatment (P = 0.008). Regarding efficacy, 88.0% (22/25) of patients achieved complete ablation at 1 and 6 months (95%CI 68.8%–97.5%). Regarding safety, 96.0% (24/25) of patients had no severe AEs within 1 month (95%CI 79.7%–99.9%). No patients had severe pancreatic fistulas at 1 month, and 84.0% (21/25) had no incidence or exacerbation, or both, of DM at 6 months (95%CI 63.9%–95.5%).<br>
Conclusion EUS-EI is safe and could be a potent treatment option for patients with small PNENs.No potential conflict of interest relevant to this article was reported.American Society of Clinical Oncology (ASCO)Acta Medica Okayama0732-183X43162025Methotrexate, Doxorubicin, and Cisplatin Versus Methotrexate, Doxorubicin, and Cisplatin + Ifosfamide in Poor Responders to Preoperative Chemotherapy for Newly Diagnosed High-Grade Osteosarcoma (JCOG0905): A Multicenter, Open-Label, Randomized Trial18861897ENHiroakiHiragaMusculoskeletal Oncology, NHO Hokkaido Cancer CenterRyunosukeMachidaJapan Clinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalAkiraKawaiMusculoskeletal Oncology, National Cancer Center HospitalToshiyukiKunisadaOrthopaedic Surgery, Faculty of Medicine, Okayama UniversityTsukasaYonemotoOrthopaedic Surgery, Chiba Cancer CenterMakotoEndoOrthopaedic Surgery, Graduate School of Medical Sciences, Kyushu UniversityYoshihiroNishidaDepartment of Rehabilitation Medicine, Nagoya University HospitalAkihitoNaganoOrthopaedic Surgery, Gifu University School of MedicineKeisukeAeOrthopaedic Surgery, Cancer Institute HospitalShinichirouYoshidaOrthopaedic Surgery, Tohoku University Graduate School of MedicineKunihiroAsanumaOrthopaedic Surgery, Mie UniversityJunyaToguchidaDepartment of Tissue Regeneration, Center for Induced Pluripotent Stem Cell Research and Application, Institute for Frontier Medical Sciences, Kyoto UniversityTaisukeFurutaOrthopaedic Surgery, Hiroshima UniversityRobertNakayamaDepartment of Orthopaedic Surgery, Keio University School of MedicineToshihiroAkisueOrthopaedic Surgery, Kobe UniversityToruHirumaBone and Soft Tissue Tumour Surgery, Kanagawa Cancer CenterTakeshiMoriiOrthopaedic Surgery, Kyorin UniversityHidekiNishimuraOrthopaedic Surgery, Kagawa University HospitalKojiHiraokaOrthopaedic Surgery, Kurume University HospitalMasanobuTakeyamaOrthopaedic Surgery, Yokohama City University HospitalMakotoEmoriOrthopaedic Surgery, Sapporo Medical University HospitalSatoshiTsukushiOrthopaedic Surgery, Aichi Cancer CenterHiroshiHatanoMusculoskeletal Oncology, Niigata Cancer Center HospitalHiroyukiKawashimaOrthopaedic Surgery, Niigata University Medical & Dental HospitalKazuoIsuOrthopaedic Surgery, Higashi Sapporo HospitalKazuhiroTanakaAdvanced Medical Sciences, Oita University Faculty of MedicineTomokoKataokaJapan Clinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalHaruhikoFukudaJapan Clinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalYukihideIwamotoOrthopaedic Surgery, Kyushu Rosai HospitalToshifumiOzakiOrthopaedic Surgery, Faculty of Medicine, Okayama UniversityPurpose Our previous NECO phase II studies on high-grade osteosarcoma suggested that administering ifosfamide (IF; 16 g/m2 [4g/m2 once on day 1, then 2g/m2 once on days 2-7] × six) to patients showing a poor response (PrRsp) to preoperative chemotherapy with methotrexate, doxorubicin, and cisplatin (MAP) improves their prognoses. In this Japan Clinical Oncology Group (JCOG) study, JCOG0905, we aimed to investigate the efficacy and safety of IF in patients with PrRsp.<br>
Methods JCOG0905 is a multicenter, open-label, multi-institutional, randomized trial. Eligible patients (50 years and younger) had resectable, high-grade osteosarcoma (stage II or III, Union for International Cancer Control TNM) of the extremities, limb girdles, and thoracic wall. After two MAP cycles and tumor resection, patients with PrRsp were randomly assigned to either the MAP or MAP plus 15 g/m2 (3g/m2 once daily on days 1-5) × six IF (MAP + IF [MAPIF]) group. The primary end point was disease-free survival (DFS); secondary end points were overall survival (OS) and safety. The planned sample size was 100 patients with a one-sided α of .1 and a power of 0.7, assuming a 3-year DFS of 50% and 65% for MAP and MAPIF, respectively. This trial is registered with the Japan Registry of Clinical Trials (jRCT; jRCTs031180126).<br>
Results Of the 287 patients registered between February 2010 and August 2020, 51 and 52 patients with PrRsp were assigned to the MAP and MAPIF groups, respectively. As of March 2022, DFS did not differ between groups (hazard ratio [HR], 1.05 [95% CI, 0.55 to 1.98]) and OS was numerically inferior in the MAPIF group (HR, 1.48 [95% CI, 0.68 to 3.22]). Nine and zero patients in the MAPIF and MAP groups discontinued treatment because of adverse events, respectively.<br>
Conclusion Evidence from JCOG0905 does not support the addition of IF for patients with PrRsp.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0911-60284042024Central dentinogenic ghost cell tumor of the maxilla: a case report with new imaging findings and review of the literature561568ENSuzukaYoshidaDepartment of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoheiTakeshitaDepartment of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshiyukiKawazuDepartment of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMikiHisatomiDepartment of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShunsukeOkadaDepartment of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMamikoFujikuraDepartment of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKyoichiObataDepartment of Oral and Maxillofacial Surgery, Okayama University HospitalKiyofumiTakabatakeDepartment of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySaoriYoshidaPreliminary Examination Room, Okayama University HospitalJunichiAsaumiDepartment of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesA dentinogenic ghost cell tumor (DGCT) is a rare benign odontogenic tumor that commonly shows characteristics of solid proliferation and has a relatively high risk of recurrence after surgical treatment. We herein report a case of a central DGCT that occurred in the maxilla and resulted in bone expansion. This study highlights new imaging findings (particularly magnetic resonance imaging) along with histopathological observations. In addition, we conducted a review of the existing literature on this rare tumor. A 37-year-old man developed swelling around the right cheek. A benign odontogenic tumor such as ameloblastoma was suspected based on the imaging examination findings (including bone expansion and the internal characteristics of the tumor) on panoramic imaging, computed tomography, and magnetic resonance imaging. The lesion was surgically excised from the right maxilla. Postoperative histopathological examination led to a definitive diagnosis of central DGCT. The tumor comprised epithelial neoplastic islands, resembling ameloblastoma, inside tight fibroconnective tissue; masses of ghost cells and formation of dentin were also observed. We had suspected that the minute high-density region around the molars on the imaging examinations represented alveolar bone change; however, it represented dentin formation. This led to difficulty diagnosing the lesion. Although DGCT may present characteristic findings on imaging examinations, its occurrence is infrequent, and in some cases, the findings may include the presence or absence of an impacted tooth without obvious calcification. The present case suggests that we should consider the possibility of an odontogenic tumor with calcification when high-density structures are observed inside the lesion.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0031-92013612025Effect of chemistry on the compressibility and high-pressure structural evolution of the CaFe2O4-type aluminous silicate phase107331ENGiacomoCrinitiBayerisches Geoinstitut, University of BayreuthTizianaBoffa BallaranBayerisches Geoinstitut, University of BayreuthAlexanderKurnosovBayerisches Geoinstitut, University of BayreuthTakayukiIshiiInstitute for Planetary Materials, Okayama UniversityElena-MarieRogmannBayerisches Geoinstitut, University of BayreuthKonstantinGlazyrinDeutsches Elektronen-Synchrotron DESYTimofeyFedotenkoDeutsches Elektronen-Synchrotron DESYDaniel J.FrostBayerisches Geoinstitut, University of BayreuthApproximately 22–26 vol% of a basaltic phase assemblage at lower mantle conditions is comprised of a (Na,Mg,Fe2+)(Al,Si,Fe3+)2O4 phase with CaFe2O4-type (CF-type) structure. Previous experimental studies attempted to determine the equation of state of the CF-type phase but reported contrasting compressibility values, even for samples with the same composition. Therefore, the elastic properties of the CF-type phase remain, to date, largely unconstrained. Here, we conducted single-crystal X-ray diffraction (SCXRD) measurements in the diamond anvil cell (DAC) at high pressure and room temperature on three samples of CF-type phase with compositions Na0.90(1)Al1.03(2)Si1.00(2)O4 (NaCF), Na0.66(4)Mg0.28(4)Al1.22(3)Si0.78(3)O4 (MgCF) and Na0.62(2)Mg0.19(1)Fe2+0.17(1)Fe3+0.080(4)Al1.20(3)Si0.70(1)O4 (FeCF). A multi-sample loading approach was employed for most DAC runs, where two samples were loaded in the same sample chamber to reduce possible systematic deviations between datasets, thus enhancing internal consistency and corroborating data reproducibility. Experiments on the NaCF and MgCF samples were conducted up to ∼50 GPa, while the FeCF sample was compressed to ∼72 GPa to better characterize the effect of the spin crossover of octahedrally coordinated Fe3+. We found the isothermal bulk modulus (KT0) to increase with decreasing NaAlSiO4 content, accompanied by only a slight decrease in its pressure derivative (K'T0). Analysis of the crystal structures of the three samples at high pressure allowed compositional trends to be determined also for the interatomic bonds and polyhedral compressibility, as well as the distortion indices. These suggest an overall stiffening of the A site with increasing Mg2+ and Fe2+ content, as well of the two B sites with increasing Al3+ and Fe3+ content. Enhanced compressibility of the unit cell and octahedral B sites was observed between ∼26–42 GPa in the FeCF sample, suggesting a pressure-induced spin crossover of Fe3+, in agreement with some previous observations. Finally, trends in the elastic properties from experimental studies conducted along the NaAlSiO4-MgAl2O4 join are discussed and used as a proxy to evaluate the reliability of end-member properties for the CF-type phase employed in most recent mineral physical and thermodynamic databases. Our analysis suggests current mineral physical models might underestimate densities and overestimate bulk sound velocities of NaAlSiO4-rich CF-type phases with basaltic composition.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1086-937959122024Radial transport and nebular thermal processing of millimeter‐sized solids in the Solar protoplanetary disk inferred from Cr‐Ti‐O isotope systematics of chondrules32823304ENKoheiFukudaWiscSIMS, Department of Geoscience, University of Wisconsin-MadisonYukiHibiyaResearch Center for Advanced Science and Technology, Graduate School of Science, The University of TokyoCraig R.KastelleNational Oceanic and Atmospheric AdministrationKatsuhikoSuzukiSubmarine Resources Research Center, Japan Agency for Marine-Earth Science TechnologyTsuyoshiIizukaDepartment of Earth and Planetary Science, Graduate School of Science, The University of TokyoKatsuyukiYamashitaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThomas E.HelserNational Oceanic and Atmospheric AdministrationNoriko T.KitaWiscSIMS, Department of Geoscience, University of Wisconsin-MadisonUnderstanding the material transport and mixing processes in the Solar protoplanetary disk provides important constraints on the origin of chemical and isotopic diversities of our planets. The limited extent of radial transport and mixing between the inner and outer Solar System has been suggested based on a fundamental isotopic dichotomy between non-carbonaceous (NC) and carbonaceous (CC) meteorite groups. The limited transport and mixing could be further tested by tracing the formation regions of individual meteoritic components, such as Ca-Al-rich inclusions (CAIs) and chondrules. Here, we show further evidence for the outward transport of CAIs and chondrules from the inner and subsequent thermal processing in the outer region of the protoplanetary disk based on the petrography and combined Cr-Ti-O isotope systematics of chondrules from the Vigarano-like (CV) carbonaceous chondrite Allende. One chondrule studied consists of an olivine core that exhibits NC-like Ti and O, but CC-like Cr isotopic signatures, which is enclosed by a pyroxene igneous rim with CC-like O isotope ratios. These observations indicate that the olivine core formed in the inner Solar System. The olivine core then migrated into the outer Solar System and experienced nebular thermal processing that generated the pyroxene igneous rim. The nebular thermal processing would result in Cr isotope exchange between the olivine core and CC-like materials, but secondary alteration effects on the parent body are also responsible for the CC-like Cr isotope signature. By combining previously reported Cr-Ti-O isotope systematics of CV chondrules, we show that some CV chondrules larger than ~1 mm would have formed in the inner Solar System. The accretion of the millimeter-sized, inner Solar System solids onto the CV carbonaceous chondrite parent body would require their very early migration into the outer Solar System within the first 1 million years after the Solar System formation.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1341-96253032025Five-year outcomes with gefitinib induction and chemoradiotherapy in EGFR-mutant stage III non-small-cell lung cancer: LOGIK0902/OLCSG0905 phase II study497503ENKatsuyukiHottaCenter for Innovative Clinical Medicine, Okayama University HospitalShoSaekiDepartment of Respiratory Medicine, Kumamoto University HospitalShinyaSakataDepartment of Respiratory Medicine, Kumamoto University HospitalMasafumiYamaguchiDepartment of Thoracic Oncology, NHO Kyushu Cancer CenterDaijiroHaradaDepartment of Thoracic Oncology, National Hospital Organization Shikoku Cancer CenterAkihiroBesshoDepartment of Respiratory Medicine, Japanese Red Cross Okayama HospitalKentaroTanakaDepartment of Respiratory Medicine, Kyushu University HospitalKojiInoueDepartment of Respiratory Medicine, Kitakyushu Municipal Medical CenterKojiInoueDepartment of Respiratory Medicine, Ehime Prefectural Central HospitalKenichiGembaDepartment of Respiratory Medicine, Chugoku Central HospitalToshioKuboDepartment of Respiratory Medicine, Okayama University HospitalAkikoSatoDepartment of Respiratory Medicine, Okayama University HospitalEikiIchiharaCenter for Clinical Oncology, Okayama University HospitalHiromiWatanabeDepartment of Respiratory Medicine, Okayama University HospitalJunjiKishimotoDepartment of Research and Development of Next Generation Medicine, Faculty of Medical Sciences, Kyushu UniversityYoshiyukiShioyamaRadiation Oncology, Ion Beam Therapy Center, SAGA HIMAT FoundationKuniakiKatsuiDepartment of Radiology, Kawasaki Medical SchoolKenjiSugioDivision of Radiation Oncology, Department of Thoracic and Breast Surgery, Oita UniversityKatsuyukiKiuraDepartment of Respiratory Medicine, Okayama University HospitalBackground We previously showed the 2-year OS rate, the primary endpoint, of 90% in a phase II trial of gefitinib induction followed by chemoradiotherapy (CRT) in unresectable, stage III, EGFR-mutant, non-small-cell lung cancer (NSCLC). However, neither long-term survival data nor late-phase adverse event profiles have been presented.<br>
Patients and methods Patients with unresectable, EGFR-mutant, stage III NSCLC were administered gefitinib monotherapy for 8 weeks. After confirming no disease progression during induction therapy, cisplatin and docetaxel on days 1, 8, 29, and 36 with concurrent radiotherapy at a total dose of 60 Gy were subsequently administered.<br>
Results In the enrolled twenty patients, the 5-year OS rate and median survival time were 70.0% [95% confidence interval: 45.1–85.3] and 5.5 years [4.91-NE], respectively, whereas 5-year PFS rate and median PFS time were 15.0% (3.7–33.5) and 1.4 years [0.69–2.29], respectively. Efficacy did not seem influenced even if radiation field was re-planed in response to the effect of gefitinib induction. As for late adverse events, pulmonary fibrosis occurred in 7 patients (35%). The median time from completion of CRT to the occurrence of the event was 245 days. All were grade 1, and there was no evidence of cavitation of the lesions or chronic infections such as Aspergillus infection during the course of the disease. One case of small cell lung cancer occurred during the period.<br>
Conclusions With longer follow-up time, we demonstrated favorable efficacy with tolerable toxicity profiles in the EGFR-TKI induction followed by standard CRT in EGFR-mutant, stage III, NSCLC.<br>
Trial registration numbers UMIN00005086. https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000006047&type=summary&language=EjRCTs071180036. https://jrct.niph.go.jp/latest-detail/jRCTs071180036No potential conflict of interest relevant to this article was reported.American Physical Society (APS)Acta Medica Okayama0031-9007134242025Acceleration of Positive Muons by a Radio-Frequency Cavity245001ENS.AritomeGraduate School of Science, University of TokyoK.FutatsukawaHigh Energy Accelerator Research OrganizationH.HaraResearch Institute for Interdisciplinary Science, Okayama UniversityK.HayasakaInstitute of Science and Technology, Niigata UniversityY.IbarakiGraduate School of Science, Nagoya UniversityT.IchikawaGraduate School of Science, Nagoya UniversityT.IijimaGraduate School of Science, Nagoya UniversityH.IinumaGraduate School of Science and Engineering, Ibaraki UniversityY.IkedoHigh Energy Accelerator Research OrganizationY.ImaiResearch Institute for Interdisciplinary Science, Okayama UniversityK.InamiGraduate School of Science, Nagoya UniversityK.IshidaHigh Energy Accelerator Research OrganizationS.KamalDepartment of Chemistry, Laboratory for Advanced Spectroscopy and Imaging Research (LASIR), University of British ColumbiaS.KamiokaHigh Energy Accelerator Research OrganizationN.KawamuraHigh Energy Accelerator Research OrganizationM.KimuraHigh Energy Accelerator Research OrganizationA.KodaHigh Energy Accelerator Research OrganizationS.KojiGraduate School of Science, Nagoya UniversityK.KojimaKobayashi-Maskawa Institute for the Origin of Particles and the Universe, Nagoya UniversityA.KondoGraduate School of Science, Nagoya UniversityY.KondoJapan Atomic Energy Agency (JAEA)M.KuzubaGraduate School of Science and Engineering, Ibaraki UniversityR.MatsushitaGraduate School of Science, University of TokyoT.MibeHigh Energy Accelerator Research OrganizationY.MiyamotoResearch Institute for Interdisciplinary Science, Okayama UniversityJ. G.NakamuraHigh Energy Accelerator Research OrganizationY.NakazawaGraduate School of Science and Engineering, Ibaraki UniversityS.OgawaResearch Center of Advanced Particle Physics, Kyushu UniversityY.OkazakiHigh Energy Accelerator Research OrganizationA.OlinDepartment of Physics and Astronomy, University of VictoriaM.OtaniHigh Energy Accelerator Research OrganizationS.OyamaGraduate School of Science, University of TokyoN.SaitoHigh Energy Accelerator Research OrganizationH.SatoGraduate School of Science and Engineering, Ibaraki UniversityT.SatoGraduate School of Science, University of TokyoY.SatoInstitute of Science and Technology, Niigata UniversityK.ShimomuraHigh Energy Accelerator Research OrganizationZ.ShioyaFaculty of Science, Kyushu UniversityP.StrasserHigh Energy Accelerator Research OrganizationS.SugiyamaGraduate School of Science, Nagoya UniversityK.SumiGraduate School of Science, Nagoya UniversityK.SuzukiKobayashi-Maskawa Institute for the Origin of Particles and the Universe, Nagoya UniversityY.TakeuchiFaculty of Science, Kyushu UniversityM.TanidaFaculty of Science, Kyushu UniversityJ.TojoFaculty of Science, Kyushu UniversityK.UedaGraduate School of Science, Nagoya University, NagoyaS.UetakeResearch Institute for Interdisciplinary Science, Okayama UniversityX. H.XieSchool of Physics, Peking UniversityM.YamadaFaculty of Science, Kyushu UniversityS.YamamotoResearch Institute for Interdisciplinary Science, Okayama UniversityT.YamazakiHigh Energy Accelerator Research OrganizationK.YamuraInstitute of Science and Technology, Niigata UniversityM.YoshidaHigh Energy Accelerator Research OrganizationT.YoshiokaResearch Center of Advanced Particle Physics, Kyushu UniversityM.YotsuzukaGraduate School of Science, Nagoya UniversityAcceleration of positive muons from thermal energy to 100 keV has been demonstrated. Thermal muons were generated by resonant multiphoton ionization of muonium atoms emitted from a sheet of laser-ablated aerogel. The thermal muons were first electrostatically accelerated to 5.7 keV, followed by further acceleration to 100 keV using a radio-frequency quadrupole with an intensity of 2×10−3 𝜇+/pulse. The transverse normalized rms emittance of the accelerated muons in the horizontal and vertical planes were 0.85±0.25(stat)+0.22−0.13(syst) 𝜋 mm mrad and 0.32±0.03(stat)+0.05−0.02(syst) 𝜋 mm mrad, respectively. The measured emittance values demonstrated phase-space reduction by a factor of 2.0 ×102 (horizontal) and 4.1 ×102 (vertical) allowing good acceleration efficiency. These results pave the way to realize the first-ever muon accelerator for a variety of applications in particle physics, material science, and other fields.No potential conflict of interest relevant to this article was reported.Department of Mathematics, Faculty of Science, Okayama UniversityActa Medica Okayama0030-15666812026Wronskian theory revisited from a linear algebraic and null space viewpoint147174ENTomomichiHagiwaraDepartment of Electrical Engineering Graduate School of Engineering Kyoto UniversityThis paper aims at providing a new fundamental framework for the Wronskian theory by paying attention to the null space of the Wronski matrix. It is first shown that identical vanishing of the Wronskian leads to two different representations of vector-valued functions that lie in the null space of the Wronski matrix. It is further shown that they are algebraically linearly dependent, by which we are immediately led to a key identity in the Wronskian theory, derived only through very simple linear algebraic arguments. Most fundamental results on the Wronskian theory available in the literature can thus be obtained in a quite straightforward fashion with a very clear perspective, and hence the relevant arguments are believed to be of pedagogical value, too. Some further issues relevant to the null space viewpoint are also discussed, where some other results available in the literature are derived through the null space viewpoint in a somewhat strengthened form.No potential conflict of interest relevant to this article was reported.Department of Mathematics, Faculty of Science, Okayama UniversityActa Medica Okayama0030-15666812026The Dijkgraaf-Witten invariants from second Chern classes6375ENTakefumiNosakaDepartment of Mathematics, Tokyo Institute of TechnologyGiven a 3-cocycle ψ in the cohomology of a finite group G, we can define the Dijkgraaf-Witten invariant of closed 3-manifolds. In this paper, we focus on the case where ψ is a 3-cocycle systematically transferred from the second Chern class of a complex representation of G, and show some procedures for computing the invariant, and clarify its topological interpretation under some conditions.No potential conflict of interest relevant to this article was reported.Department of Mathematics, Faculty of Science, Okayama UniversityActa Medica Okayama0030-15666812026Natural homotopy of multipointed d-spaces1362ENPhilippeGaucherUniversité Paris Cité, CNRS, IRIFWe identify Grandis’ directed spaces as a full reflective subcategory of the category of multipointed d-spaces. When the multipointed d-space realizes a precubical set, its reflection coincides with the standard realization of the precubical set as a directed space. The reflection enables us to extend the construction of the natural system of topological spaces in Baues-Wirsching’s sense from directed spaces to multipointed d-spaces. In the case of a cellular multipointed d-space, there is a discrete version of this natural system which is proved to be bisimilar up to homotopy. We also prove that these constructions are invariant up to homotopy under globular subdivision. These results are the globular analogue of Dubut’s results. Finally, we point the apparent incompatibility between the notion of bisimilar natural systems and the q-model structure of multipointed d-spaces and we give some suggestions for future works.No potential conflict of interest relevant to this article was reported.John Wiley & Sons LtdActa Medica Okayama0364-23132026Indicators for Monitoring Recovery From Surgery to Discharge Using Accelerometer in Patients With Esophageal Cancer14ENTakahiroYamaneDepartment of Biomedical Informatics, Okayama University Graduate School of Interdisciplinary Science and Engineering in Health SystemsYoshikazuKimuraDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesManamiTetsutaniFaculty of Health Sciences, Okayama University Medical SchoolShotaYamamuraFaculty of Health Sciences, Okayama University Medical SchoolAiruItoFaculty of Health Sciences, Okayama University Medical SchoolMoeTanumaFaculty of Health Sciences, Okayama University Medical SchoolMinaHonjohFaculty of Health Sciences, Okayama University Medical SchoolYoshikoMoriwakiDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuhiroNomaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunsukeTanabeDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaoakiMaedaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshikazuMatsuokaDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMizukiMoritaDepartment of Biomedical Informatics, Okayama University Graduate School of Interdisciplinary Science and Engineering in Health SystemsHiroshiMorimatsuDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesEsophageal cancer is a highly invasive malignancy necessitating esophagectomy, which is associated with considerable postoperative morbidity and prolonged hospitalization. Enhanced Recovery After Surgery (ERAS) protocols recommend early mobilization to facilitate recovery; however, objectively assessing physical activity during hospitalization remains challenging. Traditional methods, such as the 6-min walk test or patient-reported questionnaires can be burdensome, or may not accurately reflect recovery. Accelerometer-based measurement provides a low-burden, objective approach, but previous studies focused on the immediate postoperative period or long after discharge, leaving the recovery trajectory from surgery to discharge underexplored.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-291865102026Mycobacterium intracellulare Infection in a Japanese Patient with Signal Transducer and Activator of Transcription-3 Gain-of-function Syndrome14211430ENHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalYoshiakiSoejimaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazukiTokumasuDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYojiHiraiDepartment of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMarinaKawaguchiDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinnosukeFukushimaDepartment of Infectious Diseases, Okayama University HospitalKentaNakamotoDepartment of Infectious Diseases, Okayama University HospitalKoheiOguniDepartment of Infectious Diseases, Okayama University HospitalYusukeShiodeDepartment of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhiroUdaDepartment of Pediatrics, Okayama University HospitalMasatoYashiroDepartment of Pediatrics, Okayama University HospitalKouseiHasegawaDepartment of Pediatrics, Okayama University HospitalKojiIioMicrobiology Division, Clinical Laboratory, Okayama University HospitalFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSignal transducer and activator of transcription-3 (STAT3) gain-of-function (GOF) syndrome predisposes patients to autoimmunity diseases. Yet, nontuberculous mycobacterial (NTM) infections have rarely been described. We herein report a teenage Japanese patient with genetically confirmed STAT3-GOF syndrome who developed Mycobacterium intracellulare disease. Combination antimycobacterial chemotherapy reduced the bacterial burden; however, the refractory NTM infection relapsed after initiation of adjunctive tofacitinib therapy. The present case demonstrates that host-directed therapy must be combined with prolonged antimycobacterial regimens to control drug-resistant NTM in patients with inborn errors of immunity.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0960-98223652026Compound starch granule formation in grass seeds is associated with distinct temporal patterns of gene expression11421155.e6ENAlexanderWatson-LazowskiJohn Innes Centre, Norwich Research ParkDoreenFeikeJohn Innes Centre, Norwich Research ParkQi YangNgaiJohn Innes Centre, Norwich Research ParkLaraEschJohn Innes Centre, Norwich Research ParkNaokoFujitaDepartment of Biological Production, Akita Prefectural UniversityRyoMatsushimaInstitute of Plant Science and Resources, Okayama UniversityAlison M.SmithJohn Innes Centre, Norwich Research ParkDavidSeungJohn Innes Centre, Norwich Research ParkThere is extensive interspecies variation in starch granule morphology in the endosperm of grass species, but the factors underpinning this variation are poorly understood. The two major granule morphology types among species are simple and compound granules, where simple granules arise from a single initiation per amyloplast, and compound granules form from multiple granule initiations. Here, we carried out an extensive survey of seed starch morphology, examining specimens from 105 species within the Pooideae using electron microscopy. This not only expanded our current knowledge of the diversity of starch granule types but also confirmed the homoplasy of simple and compound starch granules. We then selected species representing independent origins of simple (Brachyelytrum japonicum, Phaenosperma globosa, and Brachypodium distachyon) and compound granules (Nardus stricta, Melica altissima, and Calamagrostis brachytricha) for analysis of starch structure and gene expression. There were no clear patterns in starch content, amylopectin structure, or amylose content that could distinguish the two granule types. However, comparative transcriptomics over seed development revealed gene expression patterns associated with granule type, most notably increasing expression of STARCH SYNTHASE 3a (SS3a), STARCH BRANCHING ENZYME 1 (SBE1), and limit dextrinases (LDAs) between 3 and 9 days post anthesis in species with compound granules. Mutation of these genes in rice, which natively produces compound granules, resulted in altered granule shape and/or size. Our work highlights differences in gene expression that could contribute to natural variation in granule morphology within the Pooideae while providing important new starch phenotype and gene expression datasets that can be widely used to study endosperm development.No potential conflict of interest relevant to this article was reported.American Society for MicrobiologyActa Medica Okayama0021-919320852026Knockout of tusA confers cationic antimicrobial resistance via fur and omp genes in Escherichia colie00103-26ENKazuyaIshikawaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKihoNakataGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoichiroYamadaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMioUnemeGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazuyukiFurutaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityChikaraKaitoGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitytRNA 2-thiouridine synthesizing protein A (TusA), a sulfur-carrier protein, plays a crucial role in tRNA sulfur modification. Several studies have reported that tusA deficiency affects iron–sulfur (Fe–S) homeostasis in addition to tRNA sulfur modification, resulting in pleiotropic phenotypes. In this study, we analyzed the phenotype of tusA-deficient Escherichia coli and its underlying mechanisms. Although the Keio tusA knockout strain showed increased swimming motility and flagellar biosynthesis, these phenotypes were not restored by tusA complementation. Genome resequencing of the original Keio tusA knockout strain identified an unintended secondary mutation in lrhA, a transcriptional regulator of flagellar and chemotaxis genes. This secondary mutation impaired lrhA function, contributing to enhanced flagellar synthesis and swimming motility, as well as altered global gene expression. A tusA knockout strain in which the secondary mutation was corrected (ΔtusA) exhibited reduced swimming motility compared with the wild-type strain, despite showing no abnormalities in flagellar formation. Furthermore, ΔtusA displayed increased resistance to cationic antibacterial agents, including cetyltrimethylammonium bromide, cetylpyridinium chloride, and protamine sulfate. The reduced motility caused by tusA deletion was observed independently of Fur, a global regulator of iron homeostasis, whereas resistance to cationic antibacterial agents was abolished in the fur knockout background. In addition, altered expression of outer membrane protein (omp) genes was observed in ΔtusA, and deletion of these omp genes abolished resistance to cationic antibacterial agents. Together, these results indicate that, by disentangling the phenotypic effects of tusA deletion from those of the unintended secondary mutation, loss of tusA confers resistance to cationic antibacterial agents through a Fur-dependent and Omp-dependent mechanism.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama2637-61058112026Solution Structure and Counterion Condensation of Carboxymethyl Cellulose in Organic Solvents81838197ENAnishGulatiInstitute of Physical Chemistry, RWTH Aachen UniversityLingziMengMaterials Science and Engineering Department, The Pennsylvania State UniversityCanHouInstitute of Physical Chemistry, RWTH Aachen UniversityTakaichiWatanabeDepartment of Applied Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityCarlos G.LopezMaterials Science and Engineering Department, The Pennsylvania State UniversityWe report scattering (SANS and SAXS) and electrical conductivity data for aqueous and organic solutions of carboxymethyl cellulose with tetrabutylammonium counterions. For SANS in deuterated solvents, the contrast is heavily dominated by the hydrogen-rich counterions, while for SAXS the polymer backbone has a more significant contribution to the scattering signal. The correlation length calculated from the SAXS measurements follows a scaling law of ξ ∝ c–1/2, while that measured by SANS displays a weaker exponent at higher concentrations for solvents of high dielectric constants. These results indicate a decoupling in the characteristic length scales of fluctuations of the polymer backbone and counterions at high polyelectrolyte concentrations. The stretching parameter calculated from the correlation length indicates a highly stretched local conformation for TBACMC in water and several high dielectric constant solvents, consistent with the semiflexible nature of the cellulose backbone. In solvents of lower dielectric permittivity, the chains display a higher degree of local coiling. Combining electrical conductivity and scattering data, we find that the fraction of monomers bearing a dissociated charge is nearly independent of concentration and approximately proportional to the reciprocal of the Bjerrum length of the solvent, as expected by the Oosawa-Manning model.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2075-47011522025A Review on the Magnetovolume Effect of the Full Heusler Alloys Ni2MnZ (Z = In, Sn, Sb)215ENTakeshiKanomataResearch Institute for Engineering and Technology, Tohoku Gakuin UniversityXiaoXuDepartment of Materials Science, Graduate School of Engineering, Tohoku UniversityTakuoSakonFaculty of Advanced Science and Technology, Ryukoku UniversityYukiNagataFaculty of Advanced Science and Technology, Ryukoku UniversityShinImadaCollege of Science and Engineering, Ritsumeikan UniversityToshihiroOmoriDepartment of Materials Science, Graduate School of Engineering, Tohoku UniversityRyosukeKainumaDepartment of Materials Science, Graduate School of Engineering, Tohoku UniversityTetsujiroEtoKurume Institute of TechnologyYoshiyaAdachiGraduate School of Science and Technology, Yamagata UniversityTakumiKiharaResearch Institute for Interdisciplinary Science, Okayama UniversityYasushiAmakoFaculty of Science, Shinshu UniversityMasaakiDoiResearch Institute for Engineering and Technology, Tohoku Gakuin UniversityYoshiyaUwatokoInstitute for Solid State Physics, The University of TokyoThe full Heusler alloys Ni2MnZ (Z = In, Sn, Sb) exhibit ferromagnetic properties with a Curie temperature (TC) above room temperature. The magnetic properties of Ni2MnZ (Z = In, Sn, Sb) were studied through a combination of experiments and band calculations under ambient and elevated pressures. The main results of this study open up further prospects for controlling the magnetic properties of the multifunctional Heusler alloys Ni2Mn1+xZ1−x (Z = In, Sn, Sb) and their practical application.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2041-17231612025Grain boundary diffusion cannot explain the W isotope heterogeneities of the deep mantle1866ENYihangPengDepartment of Geosciences, Princeton UniversityTakashiYoshinoInstitute for Planetary Materials, Okayama UniversityJieDengDepartment of Geosciences, Princeton UniversityThe low 182W/184W and high 3He/4He in some ocean island basalts compared to the bulk mantle values may derive from the Earth’s core through long-term core-mantle interactions. It has been proposed that the grain boundary diffusion of siderophile elements is an efficient mechanism for core-mantle interaction and may effectively modify the W isotopic compositions of the plume-source mantle. In this study, we perform large-scale molecular dynamics simulations driven by machine learning potentials of ab initio quality to investigate the diffusion of W along ferropericlase grain boundaries and in (Mg,Fe)O liquid. Here we show that the diffusion of W is sluggish under core-mantle boundary conditions, and thus is unlikely to have observable impacts on the W isotopic compositions of terrestrial igneous rocks.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2041-17231612025Low melt viscosity enables melt doublets above the 410-km discontinuity3239ENLongjianXieCenter for High Pressure Science & Technology Advanced ResearchDenisAndraultUniversité Clermont Auvergne, CNRS, IRD, OPGC, Laboratoire Magmas et VolcansTakashiYoshinoInstitute for Planetary Materials, Okayama UniversityCunruiHanSchool of Natural Sciences, Birkbeck, University of LondonJames O. S.HammondSchool of Natural Sciences, Birkbeck, University of LondonFangXuSchool of Earth Sciences, Zhejiang UniversityBinZhaoInstitute for Planetary Materials, Okayama UniversityOliver T.LordSchool of Earth Sciences, University of BristolYingweiFeiEarth & Planets Laboratory, Carnegie Institution for ScienceSimonFalvardUniversité Clermont Auvergne, CNRS, IRD, OPGC, Laboratoire Magmas et VolcansShoKakizawaJapan Synchrotron Radiation Research InstituteNoriyoshiTsujinoJapan Synchrotron Radiation Research InstituteYujiHigoJapan Synchrotron Radiation Research InstituteLauraHenrySynchrotron SOLEILNicolasGuignotSynchrotron SOLEILDavid P.DobsonDepartment of Earth Sciences, University College LondonSeismic and magnetotelluric studies suggest hydrous silicate melts atop the 410 km discontinuity form 30–100 km thick layers. Importantly, in some regions, two layers are observed. These stagnant layers are related to their comparable density to the surrounding mantle, but their formation mechanisms and detailed structures remain unclear. Here we report a large decrease of silicate melt viscosity at ~14 GPa, from 96(5) to 11.7(6) mPa⋅s, as water content increases from 15.5 to 31.8 mol% H₂O. Such low viscosities facilitate rapid segregation of melt, which would typically prevent thick layer accumulation. Our 1D finite element simulations show that continuous dehydration melting of upwelling mantle material produces a primary melt layer above 410 km and a secondary layer at the depth of equal mantle-melt densities. These layers can merge into a single thick layer under low density contrasts or high upwelling rates, explaining both melt doublets and thick single layers.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1718-77293262025Global Incidence Trend of Early-Onset Obesity-Related and Non-Obesity-Related Cancers324ENMiyuTerashimaOkayama University Medical SchoolKotaNakayamaOkayama University Medical SchoolSatokoUgaiDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USAHwa-YoungLeeGraduate School of Public Health and Healthcare Management, The Catholic University of KoreaYutaTsukumoDepartment of Epidemiology, Harvard T.H. Chan School of Public HealthEtsujiSuzukiDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHirokiMizunoDepartment of Epidemiology, Harvard T.H. Chan School of Public HealthMinkyoSongLaboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of HealthNaokoSasamotoPublic Health Sciences Division, Fred Hutchinson Cancer CenterIchiroKawachiDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public HealthTomotakaUgaiDepartment of Epidemiology, Harvard T.H. Chan School of Public HealthThe global rise in obesity prevalence and the incidence of early-onset cancer (diagnosed between 20 and 49 years of age) is a serious public health concern. We, therefore, evaluated the recent global trends in the incidence of early-onset obesity-related cancers and compared them to those of non-obesity-related cancers. We obtained age-standardized incidence rates of early-onset cancers diagnosed between 2000 and 2012 in 44 countries from the Cancer Incidence in Five Continents database. Using joinpoint regression models, we calculated the average annual percentage changes (AAPCs) and their corresponding 95% confidence intervals (95% CIs) for combined and individual categories of obesity-related cancers (11 and 9 cancer types in females and males, respectively) and non-obesity-related cancers (12 cancer types in both females and males). Differences in the AAPC were assessed by comparing 95% CIs, where nonoverlapping 95% CIs were considered statistically significantly different. We observed statistically significant positive AAPCs for early-onset obesity-related cancers in all available countries combined among females (global AAPC, 4.3%; 95% CI, 4.1–4.6%) and males (global AAPC, 1.4%; 95% CI, 1.2–1.7%). When analyzed by countries, we observed statistically significant positive AAPCs in 26 countries among females and 11 countries among males. AAPCs for early-onset obesity-related cancers were statistically significantly higher than those of non-obesity-related cancers in several regions, especially North America and Oceania. In conclusion, this study indicates that the incidence of early-onset obesity-related cancers exhibited a more pronounced increasing trend than non-obesity-related cancers among both sexes in many countries and regions.No potential conflict of interest relevant to this article was reported.Microbiology SocietyActa Medica Okayama2057-58581142025Whole-genome-based characterization of Escherichia albertii strains isolated from paediatric diarrhoeal cases in Kolkata, India001363ENGoutamChowdhuryCollaborative Research Centre of Okayama University for Infectious Diseases, ICMR-National Institute of Cholera and Enteric DiseasesYukiHoshikoDivision of Microbiology, Department of Infectious Medicine, School of Medicine, Kurume UniversityMikiOkunoDivision of Microbiology, Department of Infectious Medicine, School of Medicine, Kurume UniversityKeiKitaharaCollaborative Research Centre of Okayama University for Infectious Diseases, ICMR-National Institute of Cholera and Enteric DiseasesM JohnAlbertDepartment of Microbiology, College of Medicine, Kuwait UniversityShin-ichiMiyoshiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshitoshiOguraDivision of Microbiology, Department of Infectious Medicine, School of Medicine, Kurume UniversityShantaDuttaDivision of Bacteriology, ICMR-National Institute of Cholera and Enteric DiseasesThandavarayanRamamurthyDivision of Bacteriology, ICMR-National Institute of Cholera and Enteric DiseasesAsish K.MukhopadhyayDivision of Bacteriology, ICMR-National Institute of Cholera and Enteric DiseasesEscherichia albertii is a Gram-negative facultative anaerobic bacterium that causes diarrhoea in humans. This study shows the isolation of E. albertii from hospitalized paediatric diarrhoeal cases and genome-based characteristics with putative virulence factors and antimicrobial resistance. E. albertii isolates were identified by species-specific PCR, targeting the gene encoding cytolethal distending toxin (Ea-cdt). The genome of E. albertii was sequenced to identify (i) genes encoding virulence factors (ii) antibiotic resistance-encoding genes, including the mobile genetic elements and (iii) core gene-based phylogenetic relationships and pan-genome features. A total of 10 (1.2%) E. albertii isolates were isolated from 854 faecal samples, of which 6 (60%) were found as the sole pathogen and the remaining 4 (40%) were identified along with other pathogens, such as enteroaggregative Escherichia coli, rotavirus and adenovirus. Patients from whom E. albertii was isolated presented cholera-like diarrhoea, i.e. with watery stool (60%) with moderate dehydration (100%), fever (20%) and abdominal pain (20%). The antimicrobial susceptibility testing of E. albertii showed that most of the isolates were susceptible or reduced susceptible to most of the antibiotics except resistance to erythromycin (80%), tetracycline (50%), nalidixic acid (40%), ampicillin (40%), doxycycline (30%) and ceftriaxone (20%). In the whole-genome sequence, E. albertii isolates revealed several virulence-encoding genes, namely the intimin (eae, E. coli attaching and effacing), the cytolethal distending toxin type II subunit A (cdt-IIA), adhesion (paa, porcine attaching- and effacing-associated), non-LEE (locus of enterocyte effacement) encoded effector A (nleA) and antimicrobial resistance genes (ARGs) conferring resistance to tetracycline (tetA, tetR), sulphonamides (sul2), fluoroquinolones (qnrS) and beta-lactamases (blaCTX-M, blaTEM). The SNP-based phylogenetic analysis of 647 whole genomes of E. albertii isolates from the National Center for Biotechnology Information databases did not reveal any comparable clustering pattern based on the biological source and place of isolation. The genome of some of the E. albertii was closely related to those of the isolates from China and the United Kingdom. The PFGE patterns revealed that most of the E. albertii isolates were distinct clones. This study reports on the extensive genome analysis of diarrhoea-associated E. albertii harbouring multiple virulence and ARGs.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1880-59817812026Electrical conductivity measurements of rhyolitic glass at high pressure and high temperature57ENYusukeHaraguchiGraduate School of Engineering, The University of OsakaKiyoshiFuji-TaGraduate School of Engineering, The University of OsakaTakashiYoshinoInstitute for Planetary Materials, Okayama UniversityMasashiNakamotoGraduate School of Engineering, The University of OsakaMasanoriSuzukiGraduate School of Engineering, The University of OsakaToshihiroTanakaGraduate School of Engineering, The University of OsakaWe performed electrical conductivity measurements of rhyolite glasses across the glass transition temperature at 1 GPa. Our experimental data show that, in the Arrhenius plot, the conductivity of rhyolite with 0.2 wt% H2O has an inflection point between around 760 K, while for rhyolite with 4.9 wt% H2O the gradient changes between 685 and 825 K. These inflection points correlate with the glass transition temperature, and are compared with results of previous experiments. The degree of welding of clastic and hydrous rock can be constrained by estimating glass transition temperatures of volcanic rocks combined with measurements of electrical conductivity structures obtained from electromagnetic soundings beneath volcanic bodies. This, in turn, can be used to aid predictions of volcanic eruption.No potential conflict of interest relevant to this article was reported.Ferrata Storti Foundation (Haematologica)Acta Medica Okayama1592-872111152025Distinct interleukin-6 production in IPL and TAFRO subtypes of idiopathic multicentric Castleman disease17051715ENAsamiNishikoriDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesMidori FilizNishimuraDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesYoshitoNishimuraDivision of Hematology/Oncology, Mayo ClinicRioYamadaDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesTomokaHaratakeDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesDaisukeEnnishiCenter for Comprehensive Genomic Medicine, Okayama University Hospital, Okayama, Japan; Department of Hematology and Oncology, Okayama University HospitalRyotaChijimatsuCenter for Comprehensive Genomic Medicine, Okayama University Hospital, Okayama, Japan; Department of Hematology and Oncology, Okayama University HospitalToshihiroItoDepartment of Immunology, Nara Medical UniversityTomohiroKogaDepartment of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical SciencesSayakaOchiDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesYuriKawaharaDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesHimawariUetaDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesYudaiTakedaDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesMichael V.GonzalezCenter for Cytokine Storm Treatment and Laboratory, Department of Medicine, Perelman School of Medicine, University of PennsylvaniaDavid C.FajgenbaumCenter for Cytokine Storm Treatment and Laboratory, Department of Medicine, Perelman School of Medicine, University of PennsylvaniaFritsVan RheeUniversity of Arkansas for Medical SciencesShujiMomoseDepartment of Pathology, Saitama Medical Center, Saitama Medical UniversityYasuharuSatoDepartment of Molecular Hematopathology, Okayama University Graduate School of Health SciencesIdiopathic multicentric Castleman disease (iMCD) is a rare lymphoproliferative disorder characterized by systemic inflammation and lymphadenopathy. Two major clinical subtypes, idiopathic plasmacytic lymphadenopathy (iMCD-IPL) and iMCD with thrombocytopenia, anasarca, fever, renal dysfunction/reticulin fibrosis, and organomegaly (iMCD-TAFRO), have distinct pathophysiological mechanisms. While interleukin-6 (IL-6) is known to be elevated in iMCD, differences in the sources of IL-6 production between subtypes remain unclear. We examined the source of IL-6 production and its transcriptional regulation across iMCD subtypes using immunohistochemistry, in situ hybridization, and gene expression profiling. Immunohistochemistry and in situ hybridization revealed that plasma cells were the predominant IL-6-expressing cells in iMCD-IPL, whereas vascular endothelial cells expressed IL-6 in iMCD-TAFRO. Plasma cells exhibited stronger IL-6 protein expression in iMCD-IPL than in iMCD-TAFRO. Gene expression analysis revealed upregulation of XBP1, MZB1, DERL3, SSR4, FKBP11, FKBP2, PIM2, RABAC1, and SDF2L1 in iMCD-IPL, implicating endoplasmic reticulum stress and plasma cell differentiation in IL-6 dysregulation. Our findings suggest that XBP1-mediated IL-6 production may contribute to the pathogenesis of iMCD-IPL, potentially explaining its favorable responses to IL-6 blockade therapy. In contrast, IL-6 production in iMCD-TAFRO may be predominantly from vascular endothelial cells, suggesting that elevated serum IL-6 is a secondary phenomenon of the cytokine storm in this subtype. Future studies should clarify how proteomics and gene expression profiling could inform subtype-specific therapeutic strategies in iMCD.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221612026Boulder populations and orientation trends on asteroid Ryugu: implications for rubble-pile surface processes14404ENAdityaRayInstitute for Planetary Materials, Okayama UniversityTrishitRujInstitute for Planetary Materials, Okayama UniversityGoroKomatsuInternational Research School of Planetary Sciences, Università G. d‘AnnunzioLisa M.VincentDepartment of Earth Sciences, Utrecht UniversityHiroshiKikuchiGakushuin UniversityRyodoHemmiInstitute of Space and Astronautical Science, Japan Aerospace Exploration AgencyJensOrmöCentro de Astrobiología (CAB), CSIC-INTAAsteroid (162173) Ryugu is a spinning-top shaped, rubble-pile C-type asteroid with a surface dominated by boulders spanning a broad size-range. Using Hayabusa2 ONC-T mosaics for mapping, we present the most extensive global boulder dataset to date, representing an eleven-fold increase over the earliest survey and greater completeness than later AI-based estimates. Crucially, this work provides the first global boulder orientation dataset. The cumulative size-frequency distribution follows a power-law slope of − 2.665 ± 0.066 (boulders ≥ 3 m), indicating its fragmented nature. Boulder density is lower along the equatorial ridge, consistent with regolith accumulation during earlier YORP-driven spin-up and poleward migration of blocks during the present spin-down phase. Orientation analyses reveal systematic hemispheric trends in what we define as slope-breaker zones (i.e., regions of high slope differentials), with NW–SE alignment in the northern hemisphere and NE–SW in the southern hemisphere, but absent at the equatorial ridge and poles. We interpret these as reorientations that developed during downslope boulder migration, as despite ongoing spin-down, the current spin rate remains high enough to drive such motion. In addition, fresh craters exhibit locally heightened boulder densities, recording ongoing resurfacing by impact events that exhume buried subsurface boulders and segregate them from finer regolith via seismic shaking induced granular convection. Together, these results yield new insights into rubble-pile surface evolution, rotational dynamics, and impact-driven resurfacing, with boulder orientations providing critical evidence of spin-related downslope transport and establish a framework for comparative asteroid studies.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0883-29272072026Effects of secondary hydrothermal fluids on gallium distribution and coordination in hot springs silica using Ga K-edge XANES106961ENM.C.RoweSchool of Environment, University of AucklandK.A.CampbellSchool of Environment, University of AucklandD.A.StallardSchool of Environment, University of AucklandB.LyonSchool of Environment, University of AucklandA.LangendamAustralian Synchrotron Facility (Ansto)E.KalininaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityM.YamanakaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityR.TanakaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityT.ChristopherSchool of Chemical Sciences, University of AucklandS.W.RuffArizona State University, School of Earth And Space ExplorationE.NersezovaSchool of Environment, University of AucklandT.OtaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama UniversityA.HamiltonSchool of Environment, University of AucklandGallium (Ga), a critical element in the electronics industry, is enriched in hot spring silica deposits (sinter) at concentrations comparable to, and in some cases greater than, bauxite, coal, and sphalerite deposits from which it is currently extracted. Focusing on well characterized Holocene and Pleistocene New Zealand sinters, we utilize synchrotron-X-ray fluorescence (sXRF) and Ga K-edge X-ray absorption near edge structure (XANES) spectroscopy to examine the spatial distribution of Ga as well as its changing coordination number. Ga+3 is the only observed oxidation state in the analyzed sinters. Gallium is predominantly found in tetrahedral coordination in sinter deposited from alkali chloride fluids, with analyses best matching Ga-aluminosilicate standards. However, Ga coordination is octahedral in sinter samples that have undergone alteration by acidic fluids/gases, associated with a change in hydrology from alkali-chloride to acid-sulfate fluid conditions. High Ga concentrations are found associated with both these coordination environments, with a heterogeneous distribution. Octahedral Ga is observed both as particles and in larger regions affected by Fe-rich fluid overprinting. The combined use of sXRF and XANES demonstrates an ability to fingerprint diagenesis and alteration in these complex geothermal settings where tetrahedral and octahedral Ga co-exist. The transition from tetrahedral to octahedral Ga also appears to mimic the inferred natural process forming lateritic bauxite deposits, where remobilized tetrahedral Ga is reconcentrated and adsorbed to oxides. A similar process may occur for sinter Ga enrichment, whereby introduced Ga in acidic conditions is adsorbed to oxide phases as the Fe-rich secondary fluids infiltrate porous sinter material.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0969-80432362026An algorithm to calculate physical density of biomedical objects having 3 ≤ Zeff ≤ 20: an application study using clinical photon-counting computed tomography equipment112768ENHiroakiHayashiCollege of Transdisciplinary Sciences for Innovation, Kanazawa UniversityRinaNishigamiGraduate School of Medical Sciences, Kanazawa UniversityTakashiAsaharaDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityNatsumiKimotoDepartment of Radiological Science, Faculty of Health Sciences, Junshin Gakuen UniversityDaikiKobayashiGraduate School of Medical Sciences, Kanazawa UniversityManaMitaniDivision of Radiological Technology, Medical Support Department, Okayama University HospitalNoriakiAkagiDivision of Radiological Technology, Medical Support Department, Okayama University HospitalFumiyoHigakiDepartment of Radiology, Medical Development Field, Okayama UniversityToshihiroIguchiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityRecently, photon-counting computed tomography (PC-CT) devices have become clinically available for X-ray diagnosis, and developments of analysis algorithms to generate various quantitative images have focused attention. This study proposes an algorithm to calculate the effective physical density (ρeff) of biological objects having an effective atomic number (Zeff) of 3–20. In our procedure, ρeff was determined when fitting the interaction cross sections (σs) to the measured linear attenuation coefficients (μs), which were determined from virtual monochromatic images (VMIs). In this process, the Zeff was analyzed in advance, and this information was fed back to the ρeff analysis. A key feature of our procedure is that it does not require calibration processes based on specific substances, which allow us to analyze any substance without making assumptions.<br>
To validate the availability of the proposed algorithm, we conducted an experiment using a clinical PC-CT scanner. A multi-energy CT phantom, a water phantom, an in-house low-density phantom, food samples, and a chest phantom were scanned. The results showed that our procedure can calculate ρeff of water with an uncertainty of 4.5%. The academic significance of the present research results lies in demonstrating that the factors contributing to contrast, previously obtained from CT values, can be physically interpreted using information from Zeff and ρeff. This analysis cannot be performed with conventional single-energy CT scanners and is possible with PC-CT and dual-energy CT scanners. Our novel procedure is expected to provide useful additional information in X-ray diagnosis.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2075-17291662026Disease-Suppressive Activity of Lecithin Against Foliar Infection by Rhizoctonia solani Isolates in Cabbage, Rice, and Brachypodium distachyon998ENTran XuanCuongGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMisakiAsanoSchool of Agriculture, Okayama UniversityDaikiHonmaSchool of Agriculture, Okayama UniversityMoekoSoedaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMegumiWatanabeGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNanamiSakataGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHidenoriMatsuiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKazuhiroToyodaGraduate School of Environmental, Life, Natural Science and Technology, Okayama University, Okayama 700-8530, JapanYukiIchinoseGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKentaroIkedaFaculty of Bioscience and Applied Chemistry, Hosei UniversityYoshiteruNoutoshiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityRhizoctonia solani is a necrotrophic phytopathogenic fungus that causes disease in various crops. In agriculture, many crops suffer from root or seedling rot caused by this soil-borne pathogen, whereas cabbage and rice develop lesion-like symptoms on aboveground tissues. Diseases caused by R. solani are generally controlled using chemical fungicides; however, environmentally friendly alternatives are needed for sustainable agriculture. In this study, we evaluated the efficacy of lecithin, a mixture of phospholipids previously registered in Japan as an agrochemical for controlling cucumber powdery mildew, against Rhizoctonia diseases. In cabbage, foliar spraying of 0.2–1.0% soybean lecithin effectively suppressed leaf symptoms caused by R. solani isolate RhiCa-2, which was identified as AG-1 IB. In rice and Brachypodium distachyon, 0.2–1.0% lecithin significantly suppressed leaf symptoms induced by R. solani AG-1 IA. Hyphal staining of inoculated leaves revealed reduced hyphal density on lecithin-treated leaves. Consistently, hyphal growth of R. solani on cellophane placed on water agar was retarded by lecithin treatment. However, 5.0% lecithin induced phytotoxicity in B. distachyon. Egg yolk-derived lecithin also exhibited disease-suppressive activity in cabbage and B. distachyon, with efficacy comparable to that of soybean lecithin under the conditions tested. These results suggest that lecithin suppresses foliar infection by R. solani, at least in part, through direct inhibitory effects on fungal hyphae, and may serve as a potential alternative material for disease control in sustainable crop production.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2075-17291662026UGT76B1 and 41 Additional Arabidopsis UDP-Glycosyltransferases Show No Detectable In Vitro Glycosylation Activity Toward N-Hydroxypipecolic Acid992ENJiyuanBaoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTaigaUchiyamaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKazukiKusunokiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYukaShinoharaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYurikaTanigawaSchool of Agriculture, Okayama UniversityMegumiWatanabeGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNanamiSakataGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHidenoriMatsuiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKazuhiroToyodaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYukiIchinoseGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYoshiteruNoutoshiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityN-hydroxypipecolic acid (NHP) is a key mobile signal in systemic acquired resistance in plants, and its glycosylation has been proposed to regulate immune signaling. Previous studies have demonstrated that the UDP-glycosyltransferase UGT76B1, known as an SA glycosyltransferase in Arabidopsis thaliana, also catalyzes NHP glycosylation. In this study, we re-evaluated NHP glycosylation activity of UGT76B1 using an in vitro enzyme-coupled fluorescence assay that quantitatively detects UDP released during UDP-sugar-dependent glycosylation. Unexpectedly, our biochemical analyses demonstrated that UGT76B1 lacks genuine glycosylation activity toward NHP under the in vitro assay conditions tested, although this system clearly detected UGT76B1 activity toward salicylic acid (SA), as well as the activities of UGT74F1 and UGT72B1 toward SA and hydroquinone, respectively. To explore potential UGTs responsible for NHP glycosylation, we evaluated the enzymatic activities of 41 UGT candidates successfully expressed in Escherichia coli, which are selected based on transcriptomic responses to tenoxicam treatment, molecular docking simulations using AlphaFold3/AutoDock Vina, phylogenetic criteria, and previous reports. Within this selected and successfully expressed UGT panel, none exhibited authentic NHP glycosylation activity, although this does not preclude the possibility that other members of the Arabidopsis UGT family possess NHP glycosyltransferase activity. Our findings challenge the prevailing view that UGT76B1 is the primary glycosyltransferase for NHP in A. thaliana and indicate that NHP metabolism may rely on undiscovered non-canonical enzymes or distinct metabolic pathways that warrant further investigation.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221612026Variations in the perceived value of anti-SARS-CoV-2 therapeutics based on physicians’ clinical backgrounds5705ENAkihikoHagiwaraRespiratory Medicine and Infectious Diseases, Oita University Faculty of MedicineKosakuKomiyaRespiratory Medicine and Infectious Diseases, Oita University Faculty of MedicineYuichiroShindoDepartment of Respiratory Medicine, Nagoya University Graduate School of MedicineKazufumiTakamatsuDepartment of Respiratory Medicine and Allergology, Kochi Medical School, Kochi UniversityNaokiNishimuraDepartment of Respiratory Medicine, National Center for Global Health and MedicineYukakoTakechiIki-iki ClinicEikiIchiharaCenter for Clinical Oncology, Okayama University HospitalTakahiroTakazonoDepartment of Respiratory Medicine, Nagasaki University Graduate School of Biomedical SciencesShinyuIzumiDepartment of Respiratory Medicine, National Center for Global Health and MedicineShimpeiGotohDepartment of Clinical Application, Center for iPS Cell, Research and Application, Kyoto UniversitySeiichiroSakaoDepartment of Pulmonary Medicine, School of Medicine, International University of Health and WelfareTakehiroIzumoDepartment of Respiratory Medicine, Japanese Red Cross Medical CenterKazukoYamamotoDivision of Infectious, Respiratory, and Digestive Medicine, First Department of Internal Medicine, University of the Ryukyus Graduate School of MedicineKazuhiroYateraDepartment of Respiratory Medicine, School of Medicine, University of Occupational and Environmental HealthHiroshiKakeyaDepartment of Infection Control Science, Osaka Metropolitan University Graduate School of MedicineYokoShibataDepartment of Pulmonary Medicine, Fukushima Medical University School of MedicineKeisukeTomiiDepartment of Respiratory Medicine, Kobe City Medical Center General HospitalHironoriSagaraDepartment of Medicine, Division of Respiratory Medicine and Allergology, Showa Medical University School of MedicineYukaSasakiCenter for Pulmonary Disease, National Hospital Organization Tokyo National HospitalToyohiroHiraiDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto UniversityAkihitoYokoyamaDepartment of Respiratory Medicine and Allergology, Kochi Medical School, Kochi UniversityHiroshiMukaeDepartment of Respiratory Medicine, Nagasaki University Graduate School of Biomedical SciencesTakashiOguraDepartment of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory CenterAlthough the global emergency phase of the coronavirus disease 2019 (COVID-19) pandemic has ended, antiviral therapy remains crucial for patients at high risk of severe illness. In Japan, the out-of-pocket costs for antiviral drugs shifted from full public coverage to partial patient payment in April 2024. However, the impact of physicians’ background characteristics on antiviral cost perceptions and prescribing behavior remains underexplored. This study involved a secondary analysis of a nationwide, web-based interventional survey of 1,500 physicians treating COVID-19. Participants reported whether they avoided prescribing antivirals owing to drug costs and identified what they considered an appropriate cost per treatment course. Associations between physicians’ characteristics and their cost perceptions were analyzed. Among 1,500 physicians surveyed, 1,193 (79.5%) reported avoiding antiviral prescriptions owing to drug costs. The most commonly selected appropriate cost was ≤ 33 USD (65.0%). Generalists, pulmonologists, ear, nose, and throat specialists, and clinic-based physicians were more likely to refrain from prescribing antivirals and favor lower treatment costs compared with physicians in other specialties or hospital settings. A multivariate analysis revealed workplace setting as the only factor independently associated with cost-related prescribing behavior. High antiviral drug costs in Japan may contribute to underprescription, particularly among clinic-based physicians, and this underprescription could hypothetically lead to delays in treatment, which might increase the risk of severe outcomes in high-risk patients. As high-risk patients with mild COVID-19 often first seek care in clinics, promoting appropriate antiviral use in these settings is essential. Strengthening communication and sharing clinical experiences between hospitals and clinics may help reduce prescribing disparities driven by drug costs.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1999-59031862026A Batch-Based VNF Deployment Mechanism for Privacy-Preserving Multi-Domain SFC Deployment Using Deep Reinforcement Learning312ENArif IndraIrawanGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYukinobuFukushimaFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityFuture 6G networks require higher performance and wider service coverage. Multi-domain Service Function Chain (SFC) deployment enables service provisioning across multiple network domains to meet these demands. However, when collaboration occurs among different network operators, privacy-preserving mechanisms are required to protect sensitive information such as internal topology and resource availability. Existing SIRM-based mechanisms, such as the Privacy-Preserving Deployment Mechanism (PPDM), address this challenge but suffer from structural limitations: PPDM performs whole-chain feasibility evaluation with extensive virtual occupation. This paper proposes a ℬ-Batch Sequential Deployment mechanism for privacy-preserving multi-domain SFC deployment. Instead of evaluating whole-chain feasibility at once, the proposed ℬ-Batch mechanism partitions each incoming SFC into fixed-size VNF batches and constructs a batch-level SIRM. This design confines virtual occupation to the current batch and reduces both its magnitude and duration while remaining fully compatible with the SIRM privacy model and the hierarchical multi-domain control architecture. A Deep Q-Network (DQN) is employed to learn substrate node selection policies based solely on SIRM-based state information, without exposing domain-internal topology or resource details. Simulation results on a three-domain AARNET substrate topology demonstrate that the proposed mechanism consistently improves deployment robustness under varying traffic intensities and SFC lengths, including short (3–6 VNFs), medium (6–9 VNFs), and long (9–12 VNFs) service chains. Compared with PPDM, the proposed ℬ-Batch mechanism achieves higher acceptance ratios under moderate-to-heavy traffic while reducing end-to-end delay and improving average substrate resource utilization. Node selection analysis further shows that smaller batch sizes preserve feasibility through compact node reuse, whereas larger batch sizes encourage broader substrate exploration. Overall, the proposed ℬ-Batch mechanism enhances feasibility preservation and deployment robustness in privacy-preserving multi-domain SFC orchestration.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8032026A Novel Flap Design to Reduce Urethral Complications in Anterolateral Thigh Phalloplasty: The Pipe Flap Technique213217ENToshiroImaiDepartment of Plastic and Reconstructive Surgery, Tohoku University Graduate School of MedicineToshiyukiWatanabeDepartment of Plastic and Reconstructive Surgery, Okayama University HospitalShihoWatanabeDepartment of Plastic and Reconstructive Surgery, National Hospital Organization Tokyo Medical CenterMasanobuHayashiDepartment of Plastic and Reconstructive Surgery, Tohoku University Graduate School of MedicineYusukeTominagaDepartment of Urology, Okayama University HospitalYuzaburoNambaGender Center, Okayama University HospitalCase Report10.18926/AMO/70857Phalloplasty is one of the most challenging procedures in gender-affirming surgery, and urethral complications remain common despite numerous preventive efforts. No definitive solution has been established, and many patients still require subsequent corrective procedures. We designed a novel anterolateral thigh flap that creates a planned external fistula at the penile base to mitigate urethral complications. The fistula was closed in a second-stage procedure one year later, and the postoperative course was uneventful. We report a case of a transgender man treated with this two-stage “pipe flap” technique, resulting in satisfactory urinary function. This approach may offer a safe and less invasive option for mitigating urethral complications in phalloplasty.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8032026Evaluation of Bone Mineral Density and Bone Structure in the Cervical and Thoracic Spine203212ENShingoAoyamaDepartment of Orthopedic Surgery, Kindai University HospitalTerumasaIkedaDepartment of Orthopedic Surgery, Kindai University HospitalNobuhitoNangoRatoc System Engineering Co., Ltd.KojiGotoDepartment of Orthopedic Surgery, Kindai University HospitalOriginal Article10.18926/AMO/70856Dropped head syndrome, which has been increasingly reported in recent years, requires correction of cervical kyphosis and may require long-range fixation extending from the cervical to the thoracic spine. Assessing vertebral bone structure may be important for preventing instrumentation failure in the upper thoracic spine, which is a potential complication of surgery. In this study, we evaluated volumetric bone mineral density, trabecular bone porosity, and cortical calcification in the cervical and upper thoracic spine using three-dimensional (3D) trabecular structure measurement software. The study included 79 patients with cervical spine disorders who underwent various surgical procedures and preoperative imaging, including dual-energy X-ray absorptiometry and computed tomography (CT) scans from C3 to Th3. Quantitative analysis using specialized software assessed volumetric bone mineral density and trabecular and cortical bone parameters, and statistical analyses were performed to examine correlations between imaging metrics and indicators of bone fragility. Two-dimensional CT evaluation revealed different trends between cancellous and cortical bone in the cervical and thoracic spine, suggesting that detailed 3D evaluation may also be important.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8032026Reducing Hesitation in Resuscitation: Educational Effects of a Female-Appearing Simulator in Basic Life Support Training185193ENTakuyaKuboDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoheiTsukaharaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiHongoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakafumiObaraDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshinoriKosakiDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTsuyoshiNojimaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTetsuyaYumotoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiromichiNaitoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityOriginal Article10.18926/AMO/70854Women are less likely than men to receive timely defibrillation during out-of-hospital cardiac arrest. We investigated whether using a simulator that is visually modified to resemble a female affects learners’ attitudes, knowledge, and performance in basic life support (BLS) training. In a BLS simulation training, first-year medical students (n=220) used a standard gender-neutral simulator (control group) or a modified simulator with a female-like appearance (intervention group). Pre- and post-training questionnaires concerning attitudes and knowledge plus a post-training skills evaluation assessed the students’ training outcomes. The intervention group initiated chest compressions significantly faster than the control group (33.1 vs. 39.8 sec, p<0.01) and achieved a significantly higher rate of correct AED pad placement (64.2% vs. 38.5%, p<0.01). While performing the resuscitation on the female-appearing manikin, the intervention group showed significantly greater increases in self-efficacy (p<0.01) and larger decreases in discomfort about removing the patient’s clothes (p<0.01). They were also significantly more likely to recognize that chest compressions can be performed (p=0.016) and AED pads can be applied (p=0.015) without removing the patient’s underwear. Using a female-appearing simulator in BLS training was thus associated with faster chest compression initiation, more accurate AED pad placement, and improved gender-sensitive attitudes and knowledge.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8032026Oral Eicosapentaenoic Acid and Paclitaxel-Associated Peripheral Neuropathy: A Retrospective Study at Okayama University Hospital179184ENAyakoMoritaCenter for Clinical Oncology, Okayama University HospitalHidekiKatayamaCenter for Clinical Oncology, Okayama University HospitalEikiIchiharaCenter for Clinical Oncology, Okayama University HospitalYoshinobuMaedaDepartment of Hematology and Oncology, Okayama University HospitalOriginal Article10.18926/AMO/70853This retrospective study investigated whether eicosapentaenoic acid (EPA) reduces paclitaxel-associated chemotherapy-induced peripheral neuropathy (CIPN) and acute neuropathic pain in dyslipidemic cancer patients. The medical records of cancer patients treated with paclitaxel or nab-paclitaxel at Okayama University Hospital between January 2018 and December 2022 were reviewed. Patients receiving concomitant therapy for dyslipidemia were categorized as EPA users or non-EPA users. Numbness and pain severity were extracted from medical records. The primary endpoint was the change from baseline in Common Terminology Criteria for Adverse Events (CTCAE) grade for peripheral neuropathy and pain; groups were analyzed using the Mann–Whitney U test. Of 184 eligible patients, 18 received EPA. Bleeding events were more frequent in the EPA group; however, changes in numbness and pain did not differ significantly between groups at any time point. Overall, EPA did not show a preventive effect on paclitaxel-associated CIPN or acute neuropathic pain. Future studies should evaluate EPA in combination with other neuroprotective agents to better define its potential role in CIPN prevention.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8032026Peripheral Blood T-Cell Receptor Repertoire and Host Immune Background in Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy169178ENYukiNakamuraDepartment of Breast and Thyroid Surgery, Kawasaki Medical School HospitalTakayukiIwamotoDepartment of Breast and Thyroid Surgery, Kawasaki Medical School HospitalYukikoKajiwaraDepartment of Breast Surgery, Hiroshima City Hiroshima Citizens HospitalAkiraHidaDepartment of Pathology, Matsuyama Shimin HospitalShogoNakamotoDepartment of Breast and Endocrine Surgery, Okayama University HospitalYuichiroMiyoshiDepartment of Breast Endocrine Surgery, Kagawa Prefectural Center HospitalTadahikoShienDepartment of Breast and Endocrine Surgery, Okayama University HospitalMasahikoIkedaDepartment of Breast and Thyroid Surgery, Fukuyama City HospitalHiroyoshiDoiharaDepartment of General Surgery, Kawasaki Medical School General Medical CenterRyoheiOgataDepartment of Breast and Thyroid Surgery, Kawasaki Medical School HospitalYoshikazuKoikeDepartment of Breast and Thyroid Surgery, Kawasaki Medical School HospitalTsunehisaNomuraDepartment of Breast and Thyroid Surgery, Kawasaki Medical School HospitalKatsuhiroTanakaDepartment of Breast and Thyroid Surgery, Kawasaki Medical School HospitalKazutakaNakashimaDepartment of General Surgery, Kawasaki Medical School General Medical CenterTomokiYamatsujiDepartment of General Surgery, Kawasaki Medical School General Medical CenterNarutoTairaDepartment of Breast and Thyroid Surgery, Kawasaki Medical School HospitalOriginal Article10.18926/AMO/70852The association between peripheral blood T-cell receptor (TCR) repertoire and chemotherapy response remains unclear. We evaluated peripheral blood TCR repertoire and gut microbiota in 21 breast cancer patients receiving neoadjuvant chemotherapy (NAC) who were enrolled in the SBP-14 prospective cohort study between October 2019 and March 2022. We analyzed stool samples obtained pre-NAC and peripheral blood samples obtained pre- and post-NAC. The primary endpoint was the association between baseline peripheral blood TCR repertoire and treatment response. Eleven patients (52%) had hormone receptor-positive breast cancer. All patients received anthracyclines and taxanes, with anti-HER2 therapy for HER2-positive disease. TCR diversity (TCR alpha chain [TRA], p=0.095; TCR beta chain [TRB], p=0.051) and clonality (TRA, p=0.271; TRB, p=0.500) were not significantly associated with treatment response. Gut microbiota diversity was not correlated with TCR diversity (TRA: ρ=0.046, p=0.845; TRB: ρ=0.021, p=0.929); however, three bacterial orders (Erysipelotrichales, Bacillales, and Pasteurellales) were significantly associated with TCR repertoire. Baseline TCR repertoire was not associated with treatment response in this cohort of breast cancer patients.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8032026Self-Reported Adolescent Menstrual Symptoms and Delayed Gynecologic Consultation among Japanese Women with Endometriosis159168ENTomokoIkedaFaculty of Health Sciences, Okayama UniversityMikiyaNakatsukaFaculty of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/70851Endometriosis symptoms often first appear during adolescence, yet delays in seeking gynecologic consultation remain a persistent challenge worldwide. Despite growing international evidence, the specific patterns of symptom recognition and consultation delay among Japanese women ― particularly in relation to self-monitoring behaviors and cultural barriers ― remain poorly understood. This study aimed to provide foundational data to guide menstrual education and preconception care strategies by conducting a cross-sectional online survey with retrospective recall among women with endometriosis to assess menstrual characteristics and symptom patterns from adolescence to initial care seeking. The survey was conducted in Japan in January 2024 and enrolled 166 women with endometriosis and 200 controls. Participants reported current and adolescent menstrual characteristics, symptom recognition, analgesic and low-dose estrogen–progestin use, school/work impact, and age at first gynecologic consultation for menstrual problems. Women with endometriosis reported heavier bleeding, stronger pain, and greater school/work absence than controls, both currently and retrospectively. The median age at first recognition of heavy bleeding or school/work absence was 16 years, whereas consultation occurred at approximately 21-23 years, indicating a consultation delay of 5-6 years. Notably, while self-monitoring of symptoms was more frequent among women with endometriosis, it only modestly shortened consultation delays. This study provides evidence from Japan that consultation delay persists despite active self-monitoring of symptoms, highlighting the influence of educational and cultural barriers on health-seeking behavior. These findings underscore the importance of integrating menstrual education with clinical guidance to promote timely gynecologic consultation.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0721-832X2026Age-related changes in the orbital pulley array of older Japanese adults with acquired exotropiaENReikaKonoDepartment of Ophthalmology,, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesIchiroHamasakiLino Eye ClinicFumikoKishimotoDivision of Ophthalmology, Ibara City HospitalKiyoShibataLino Eye ClinicShinMorisawaDepartment of Ophthalmology,, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYukiMorizaneDepartment of Ophthalmology,, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesPurpose: To evaluate age-related changes in the orbital pulley array using magnetic resonance imaging (MRI) in older Japanese adults with acquired exotropia (XT) compared with young healthy participants (YHP).<br>
Methods: In this retrospective cross-sectional case series, MRI images of 30 eyes from fifteen patients (age ≥ 60 years) with distance XT and no high myopia were compared with those of 14 eyes from seven YHP. Rectus muscle (RM) pulley positions relative to the globe center were assessed. The lateral rectus muscle–superior rectus (LR–SR) band was evaluated for rupture.<br>
Results: Mean age of patients with XT was 73.7 ± 5.5 years. Compared with YHP, patients with XT showed significant inferior displacement of the lateral rectus (LR) pulley (–3.6 ± 1.2 mm vs. − 2.0 ± 1.1 mm, p < 0.01) and temporal displacement of the superior rectus (SR) pulley (–0.4 ± 1.2 mm vs. − 1.6 ± 0.8 mm, p < 0.01). No significant differences were observed in medial rectus or inferior rectus pulley positions. Inferior LR pulley displacement correlated with inferior SR pulley displacement (r = 0.41, p = 0.03), whereas no significant relationship was observed between LR pulley position and MR or IR pulley position. Rupture of the LR–SR band was observed in 24 orbits (80.0%).<br>
Conclusion: Older Japanese adults with XT exhibit localized pulley displacement and LR–SR band rupture. These structural changes differ from the global sagging observed in sagging eye syndrome and may contribute to the pathogenesis of acquired exotropia in older adults.No potential conflict of interest relevant to this article was reported.American Physiological SocietyActa Medica Okayama0022-307713542026Characteristics of cross-modal negative BOLD responses in the human sensory subcortex and cortex747759ENToshikazuMiyataDivision of Sensory and Cognitive Brain Mapping, Department of System Neuroscience, National Institute for Physiological SciencesMasakiFukunagaSection of Brain Function Information, National Institute for Physiological SciencesJunxiangLuoDivision of Sensory and Cognitive Brain Mapping, Department of System Neuroscience, National Institute for Physiological SciencesIsaoYokoiNational Institute for Physiological SciencesTetsuyaYamamotoSection of Brain Function Information, National Institute for Physiological SciencesAyumiYoshiokaSection of Brain Function Information, National Institute for Physiological SciencesJiajiaYangGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTomoyoMoritaCenter for Information and Neural Networks (CiNet), Advanced ICT Research Institute, National Institute of Information and Communications Technology (NICT)HiromasaTakemuraDivision of Sensory and Cognitive Brain Mapping, Department of System Neuroscience, National Institute for Physiological SciencesFunctional magnetic resonance imaging (fMRI) is a noninvasive method for measuring human brain activity based on blood oxygenation level-dependent (BOLD) responses. Although many studies have reported positive BOLD responses evoked by sensory stimuli, others have reported negative BOLD responses (NBRs) in the sensory cortex when stimuli from different sensory modalities are presented (i.e., cross-modal NBRs). We conducted an fMRI experiment to better understand the characteristics of cross-modal NBRs in subcortical and cortical regions. Auditory and visual stimuli were presented unilaterally to one ear and to either the left or right visual field, respectively. The lateral geniculate nucleus and medial geniculate nucleus did not show a significant cross-modal NBR. In contrast, the primary auditory cortex showed a significant cross-modal NBR when visual stimuli were presented in either the contralateral or ipsilateral visual fields. Finally, we found that the cross-modal NBR in the early visual cortex was highly variable across subjects and did not exhibit consistent trends. However, each subject’s data exhibited considerable split-half reliability. Our results suggest that cross-modal NBR in the auditory cortex likely reflects mechanisms such as interhemispheric suppression, rather than those coordinated within the same hemisphere.<br>
NEW & NOTEWORTHY This study demonstrated that the human primary auditory cortex showed a significant cross-modal negative BOLD response bilaterally, regardless of the visual field in which the visual stimuli were presented. This result suggests that the cross-modal negative BOLD response is not an epiphenomenon of visual cortex activation predominantly observed in the contralateral hemisphere, but is more likely to reflect interhemispheric suppression mechanisms.No potential conflict of interest relevant to this article was reported.American Physiological SocietyActa Medica Okayama1040-060533052026The role of S100A8/A9 in the pathogenesis of acute exacerbations of pulmonary fibrosisL593L609ENNaokiNakamuraDepartment of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHisaoHigoDepartment of Allergy and Respiratory Medicine, Okayama University HospitalSatoruSenooDepartment of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAkihikoTaniguchiDepartment of Respiratory Medicine, National Hospital Organization Fukuyama Medical CenterTaichiOzekiDepartment of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesRyotaSunamiDepartment of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYumiInukaiDepartment of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesShuseiYamamotoDepartment of Medical Laboratory Science, Okayama University Faculty of Health SciencesJunkoItanoDepartment of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAyakaTanakaDepartment of Respiratory Medicine, Kurashiki Central HospitalNahokoTomonobuDepartment of Cell Biology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesRieKinoshitaDepartment of Cell Biology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasakiyoSakaguchiDepartment of Cell Biology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYoshinobuMaedaDepartment of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNobuakiMiyaharaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalAcute exacerbation of idiopathic pulmonary fibrosis is a life-threatening condition characterized by neutrophilic inflammation. S100A8/A9, an alarmin released by activated neutrophils and monocytes/macrophages, plays a pivotal role in regulating inflammatory responses. However, its specific involvement in acute exacerbations of pulmonary fibrosis remains unclear. This study evaluated the role of S100A8/A9 in the pathogenesis of acute exacerbations of pulmonary fibrosis. S100A8/A9 levels were measured in bronchoalveolar lavage fluid and serum from patients with idiopathic interstitial pneumonia, with and without acute exacerbations. To model acute exacerbations of pulmonary fibrosis, mice were intratracheally administered bleomycin followed by lipopolysaccharide. Subsequently, inflammatory cell infiltration, cytokine levels, morphological changes, and fibrosis marker levels in lung tissue and airways were analyzed. S100A8/A9 levels were significantly higher in the bronchoalveolar lavage fluid and serum of patients with idiopathic interstitial pneumonia experiencing acute exacerbations relative to those without; these levels were correlated with patient prognosis. In an experimental mouse model, intratracheal administration of bleomycin followed by lipopolysaccharide resulted in a significant increase in airway S100A8/A9 levels compared with bleomycin alone and control mice. Anti-S100A8/A9 neutralizing antibody Ab45 mitigated airway inflammation and lung fibrosis in mice with acute exacerbations of pulmonary fibrosis, reducing S100A8/A9 levels and neutrophil extracellular traps. In vitro, recombinant S100A8/A9 or lipopolysaccharide and neutrophils activated and differentiated fibroblasts; these effects were inhibited by anti-S100A8/A9 neutralizing antibody Ab45 and the humanized form of Ab45 (HuAb45). These findings highlight S100A8/A9 as a potential prognostic biomarker and therapeutic target for acute exacerbations of pulmonary fibrosis.No potential conflict of interest relevant to this article was reported.American Society for MicrobiologyActa Medica Okayama2576-098X1542026Draft genome sequence of blaIMP-1-carrying Phytobacter ursingii OUH-01, isolated from the feces of an acute lymphoblastic leukemia patiente0087625ENShumaTsujiDepartment of Medical Laboratory Science, Okayama University Graduate School of Health SciencesHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalShinnosukeFukushimaDepartment of Infectious Diseases, Okayama University HospitalIoriUrakamiDepartment of Medical Laboratory Science, Okayama University Graduate School of Health SciencesKazuyoshiGotohDepartment of Medical Laboratory Science, Okayama University Graduate School of Health SciencesWe report the 5.7 Mbp draft genome of carbapenem-resistant Phytobacter ursingii strain OUH-01, recovered from the feces of a patient with acute lymphoblastic leukemia. The genome comprises a chromosome (G+C content of 53.5%), three plasmids, and four linear contigs, including the 222 kb plasmid pOUH-phyto-IMP-01 carrying blaIMP-1. Nanopore/Illumina sequencing achieved 235× coverage.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2041-17231712026Structural insights into YheS-mediated release of SecM-arrested ribosome4963ENKaishiIsoDepartment of Biological Sciences, Graduate School of Science, The University of TokyoTomaIkedaSchool of Life Science and Technology, Institute of Science TokyoKoheiYamasakiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYushinAndoDepartment of Biological Sciences, Graduate School of Science, The University of TokyoFumiya K.SanoDepartment of Biological Sciences, Graduate School of Science, The University of TokyoTadaomiFurutaSchool of Life Science and Technology, Institute of Science TokyoHidekiTaguchiSchool of Life Science and Technology, Institute of Science TokyoOsamuNurekiDepartment of Biological Sciences, Graduate School of Science, The University of TokyoYuheiChadaniFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityYuzuruItohDepartment of Biological Sciences, Graduate School of Science, The University of TokyoATP-binding cassette subfamily F (ABCF) proteins interact with the ribosome to resolve translation defects near the peptidyl transferase center (PTC). In Escherichia coli, four ABCF proteins (EttA, Uup, YbiT, and YheS) selectively promote translation of distinct problematic nascent peptide sequences, but their molecular mechanisms remain unclear. Here, we present a 2.8 Å cryo-EM structure of the ribosome in complex with an ATPase-deficient mutant of YheS and investigate how it releases ribosomes arrested by the SecM nascent chain. YheS binds to the ribosomal E-site via the L1 stalk, and its P-site tRNA-interaction motif (PtIM) extends toward the PTC, displacing the CCA end of the P-site tRNA. Notably, the cryo-EM density corresponding to the SecM nascent chain within the exit tunnel is largely lost upon YheS binding. These observations suggest that YheS relieves peptide sequence-dependent stalling by perturbing nascent chain-tunnel interactions through P-site tRNA relocation. Steered molecular dynamics simulations provide qualitative support for this model. Together, our findings provide mechanistic insight into a mode of arrest release distinct from the translocon-mediated release mechanism.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1755-43301862026Two-dimensional metal–organic frameworks offer all-in-one cocatalysts for photocatalytic overall water splitting10531061ENJingyanGuanDepartment of Energy and Hydrocarbon Chemistry, Graduate School of Engineering, Kyoto UniversityHajimeSuzukiDepartment of Energy and Hydrocarbon Chemistry, Graduate School of Engineering, Kyoto UniversityKazuhideKamiyaResearch Center for Solar Energy Chemistry, Graduate School of Engineering Science, The University of OsakaTakashiHaradaResearch Center for Solar Energy Chemistry, Graduate School of Engineering Science, The University of OsakaRintaroAdachiGraduate School of Natural Science and Technology, Okayama UniversityOsamuTomitaDepartment of Energy and Hydrocarbon Chemistry, Graduate School of Engineering, Kyoto UniversityHirofumiKurokawaInstitute of Multidisciplinary Research for Advanced Materials, Tohoku UniversityDaisukeUnabaraInstitute of Multidisciplinary Research for Advanced Materials, Tohoku UniversityKojiYonekuraInstitute of Multidisciplinary Research for Advanced Materials, Tohoku UniversityNaoyaFukuiResearch Institute for Science and Technology, Tokyo University of ScienceHiroakiMaedaResearch Institute for Science and Technology, Tokyo University of ScienceKunihisaSugimotoDepartment of Chemistry, Kindai UniversityYuichiYamaguchiDepartment of Applied Chemistry, Faculty of Science, Tokyo University of ScienceAkinoriSaekiInnovative Catalysis Science Division, Institute for Open and Transdisciplinary Research Initiatives, The University of OsakaAkiraYamakataGraduate School of Natural Science and Technology, Okayama UniversityAkihikoKudoDepartment of Applied Chemistry, Faculty of Science, Tokyo University of ScienceRyuAbeDepartment of Energy and Hydrocarbon Chemistry, Graduate School of Engineering, Kyoto UniversityRyotaSakamotoDepartment of Chemistry, Graduate School of Science, Tohoku UniversityPhotocatalytic overall water splitting holds great promise for sustainable hydrogen production. For overall water splitting performed by one-step excitation, both the hydrogen evolution and oxygen evolution reactions are hindered kinetically; hence, it is necessary to employ site-selective modification of photocatalysts with hydrogen-evolving and oxygen-evolving cocatalysts. However, critical challenges remain, including the need for cumbersome, multi-step photodeposition processes and durable blocking layers to inhibit the reverse reactions. Here we find a conductive, two-dimensional metal–organic framework to serve as a simple, multifunctional cocatalyst. We loaded this framework on SrTiO3:Al, an overall water-splitting photocatalyst, using a one-step self-assembly method. The framework cocatalyst promoted steady photocatalysis with an apparent quantum efficiency of 31.5% at 350 nm, free from the reverse reaction even without blocking layers. We proposed the operational principles for the cocatalyst activity using spectroscopic, electrochemical and theoretical analyses. This two-dimensional metal–organic framework offers an all-in-one approach for designing efficient and practical one-step excitation overall water-splitting systems.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1347-90322026Afatinib Overcomes Osimertinib Resistance via Egfr V804F Mutation in a Syngeneic Egfr-Mutant Lung Cancer Mouse Model117ENTakaakiTanakaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasatoFujitaniDivision of Experimental Chemotherapy, Cancer Chemotherapy Center, Japanese Foundation for Cancer ResearchMasatakaTaokaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesIwaoShimomuraDivision of Experimental Chemotherapy, Cancer Chemotherapy Center, Japanese Foundation for Cancer ResearchSachiOkawaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuntaMoriDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTadahiroKuribayashiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunNishimuraDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokaNishimuraDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAyakoMoritaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityNaofumiHaraDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityKiichiroNinomiyaCenter for Comprehensive Genomic Medicine, Okayama University HospitalGoMakimotoDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityHisaoHigoDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityKammeiRaiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityEikiIchiharaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityShutaTomidaCenter for Comprehensive Genomic Medicine, Okayama University HospitalKatsuyukiHottaCenter for Innovative Clinical Medicine, Okayama University HospitalYosukeTogashiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsuyukiKiuraDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityRyoheiKatayamaDivision of Experimental Chemotherapy, Cancer Chemotherapy Center, Japanese Foundation for Cancer ResearchKadoakiOhashiDepartment of Hematology, Oncology and Respiratory Medicine, Okayama UniversityOsimertinib is the standard first-line treatment for advanced EGFR-mutant non-small cell lung cancer. However, acquired resistance invariably develops, and identifying novel resistance pathways is clinically important as a substantial portion remains undefined. We used an immunocompetent syngeneic lung cancer mouse model harboring an Egfr exon 19 deletion (mDEL tumors) to establish acquired resistance. Osimertinib-resistant tumors were generated in vivo using a drug-holiday/re-challenge protocol. The resistance mechanism was identified using Sanger sequencing, receptor tyrosine kinase arrays, and western blotting. Egfr V804F knock-in cells were generated using CRISPR/Cas9, and their sensitivity to osimertinib and afatinib was assessed in vitro and in vivo. We established two distinct osimertinib-resistant tumor lines in a syngeneic lung cancer mouse model (mDEL OsiR #1/#3). The analysis revealed an on-target secondary Egfr V804F mutation (corresponding to human EGFR V802F) in both tumor lines. Importantly, Egfr V804F knock-in cells demonstrated significant osimertinib resistance, with a 5.7–10.5-fold increase in in vitro IC50 (mean, 8.2-fold), but remained highly sensitive to afatinib. Furthermore, afatinib effectively overcame osimertinib resistance in the V804F knock-in cell-derived mouse model. Consistently, afatinib treatment resulted in marked tumor shrinkage and suppression of EGFR signaling in the established mDEL OsiR #1/#3 in vivo. These findings establish secondary Egfr V804F/EGFR V802F as an on-target osimertinib resistance mechanism, providing a preclinical rationale for evaluating afatinib in biomarker-selected patients harboring this alteration.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama2753-670X4152026Lung Segmental Perfusion Defect Is Associated With Airway Complications After Living-Donor Lobar Lung Transplantationivag139ENKentaroImanishiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeiichiroSugimotoDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTsuyoshiRyukoDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuakiTomiokaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinTanakaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenSuzawaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhikoShienDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentarohMiyoshiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMikioOkazakiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesPURPOSE: Airway complications (ACs) are potentially fatal after lung transplantation (LT). Although bronchial blood flow to the graft is supplied mainly from the pulmonary circulation after LT, lung segmental perfusion defects (LSPDs) are occasionally identified on lung perfusion scintigraphy (Q-scinti) after living-donor lobar LT (LDLLT). Lung segmental perfusion defects may impair bronchial healing and contribute to the development of ACs. This study aimed to evaluate the relationship between LSPD and AC after LDLLT.<br>
METHODS: We retrospectively reviewed 86 recipients who underwent LDLLT and 163 living donors at our institution from October 1998 to December 2023. Transplanted lungs that developed AC were classified as the AC group, whereas those without AC were classified as the non-AC group. Blood flow in the transplanted lungs was evaluated using Q-scinti after LDLLT.<br>
RESULTS: AC developed in 8 (4.9%) of 163 transplanted lungs after LDLLT. Although there were no significant differences in recipient-related variables between the 2 groups, LSPD was detected significantly more frequently in the AC group (n = 8) than in the non-AC group (n = 155) (50.0% vs 6.5%, P = .002). Furthermore, transplanted lungs showing LSPD were associated with significantly higher grades of the pulmonary interlobar fissures at the time of living-donor lobectomy (P = .025). Overall survival did not differ between patients with and without AC after LDLLT.<br>
CONCLUSIONS: LSPD on Q-scinti, which may develop in grafts with incomplete interlobar fissures during living-donor lobectomy, is associated with the development of AC after LDLLT.<br>
CLINICAL REGISTRATION NUMBER: This study was approved by the Institutional Review Board of Okayama University Hospital (approval date: August 23, 2024; 2409-027).No potential conflict of interest relevant to this article was reported.Public Library of Science (PLoS)Acta Medica Okayama1553-74042222026Octopamine signaling from clock neurons plays dual roles in Drosophila long-term memorye1012045ENYutoKurataDepartment of Biological Sciences, Tokyo Metropolitan UniversityTaishiYoshiiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTakaomiSakaiDepartment of Biological Sciences, Tokyo Metropolitan UniversityCircadian clock genes are best known for regulating circadian rhythms, but they also play crucial roles in memory processes. This suggests that memory is modulated by neural networks containing clock neurons, although the underlying mechanisms remain unclear. In Drosophila melanogaster, approximately 240 clock neurons are grouped into at least eight distinct clusters. Among them, the dorsal–lateral neurons (LNds) are required for maintaining long-term memory (LTM). In contrast, the neuropeptide Pigment-dispersing factor (Pdf), expressed in both small and large ventral–lateral neurons (s-LNvs and l-LNvs, respectively), functions as a circadian output signal and is also essential for maintaining LTM. In addition, Pdf-expressing neurons (hereafter, Pdf neurons) release neurotransmitters other than Pdf, which are involved in LTM consolidation. However, the specific transmitters used by LNds and Pdf neurons in LTM processing have remained unknown. Here, we show that octopamine signaling from LNds is essential for LTM maintenance, whereas octopamine in Pdf neurons is essential for LTM consolidation. Temporally restricted knockdown of Tyramine β hydroxylase (Tbh), the gene encoding the enzyme required for octopamine synthesis, disrupted LTM maintenance when targeted in LNds, whereas it impaired LTM consolidation when targeted in Pdf neurons. Notably, Tbh knockdown in LNds or Pdf neurons had minimal effects on circadian behavioral rhythms or sleep. These findings reveal that octopamine released from specific subtypes of clock neurons independently regulates distinct phases of LTM in Drosophila.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1422-006727112026Rice Genotype-Dependent Phyllosphere Microbiome Assembly and Isolation of Antagonistic Burkholderia for Sheath Blight Biocontrol4879ENAndrewsDanso OforiState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityZohrehNasimiState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityMuhammad IrfanAhmedState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityYaotingYanState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityWangLiState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityAbdul GhaniKandroState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityKazunoriOkadaAgro-Biotechnology Research Center, The University of TokyoKeiichiMochidaBioproductivity Informatics Research Team, RIKEN Center for Sustainable Resource ScienceYoshiteruNoutoshiGraduate School of Environmental and Life Science, Okayama UniversityAipingZhengState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityRice sheath blight (RSB), caused by Rhizoctonia solani, causes 10–50% yield losses globally. Using 16S rRNA sequencing of 100 rice cultivars, we found that resistant varieties harbor significantly more diverse bacterial communities (3230 OTUs; 2064 unique) than susceptible cultivars (599 OTUs; 36 unique). Resistant varieties were enriched in beneficial Burkholderiaceae, Bacillaceae, and Pseudomonadaceae, while Sphingobacteriaceae and Enterobacteriaceae were predominant in the susceptible rice varieties. From the 260 bacterial isolates, Burkholderia vietnamiensis J14EPLEAF2 presented potent antifungal activity (77% inhibition), suppressed lesion development, and abolished sclerotia formation. This strain displayed multiple plant growth-promoting traits, enhanced seed germination, and primed defense responses by upregulating PR5 and PR10. Hypersensitive response assays confirmed B. vietnamiensis as non-pathogenic, unlike B. gladioli and B. cepacia. This study identifies B. vietnamiensis J14EPLEAF2 as a promising, safe biocontrol agent for sustainable rice disease management.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1422-006727112026Genomic Basis of Lifestyle Divergence in Rice-Associated Burkholderia: From Pathogenesis to Plant Growth Promotion4730ENAndrews DansoOforiState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityZohrehNasimiState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityFrank KwekucherAckahDepartment of Crop Science, School of Agriculture and Natural Sciences, University of Cape CoastMuhammad IrfanAhmedState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityYaotingYanState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityWangLiState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityAbdul GhaniKandroState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityKazunoriOkadaAgro-Biotechnology Research Center, The University of TokyoKeiichiMochidaBioproductivity Informatics Research Team, RIKEN Center for Sustainable Resource ScienceYoshiteruNoutoshiGraduate School of Environmental and Life Science, Okayama UniversityAipingZhengState Key Laboratory of Crop Gene Exploration and Utilization in Southwest China, Sichuan Agricultural UniversityThe genus Burkholderia encompasses both plant pathogenic and beneficial species, yet the genomic determinants underlying this lifestyle divergence remain poorly understood. Using 16S rRNA sequencing of 100 rice cultivars, our companion study demonstrated that resistant varieties are enriched in beneficial Burkholderiaceae, leading to the isolation of three phenotypically contrasting strains. Here, we present comparative genomic analyses of non-pathogenic biocontrol strain Burkholderia vietnamiensis J14EpLeaf2 and pathogenic strains Burkholderia gladioli A1EpSeed5 and Burkholderia cepacia J14Eple. Pathogenic strains possess significantly larger genomes (8.36–8.46 Mb) enriched in mobile genetic elements compared to the streamlined 6.95 Mb genome of B. vietnamiensis. CAZyme analysis revealed broader repertoires of glycoside hydrolases and polysaccharide lyases in pathogens, consistent with enhanced plant cell wall degradation. B. gladioli possesses a complete T3SS and expanded T6SS with 301 predicted effectors, while B. cepacia lacks structural T3SS genes but harbors 271 candidate effectors predicted to be secreted via alternative secretion pathways, compared to 180 in B. vietnamiensis. Notably, B. cepacia harbors cystic fibrosis-associated markers (cable pili, ZmpA/ZmpB), raising significant biosafety concerns that preclude its agricultural application. LC-MS validated IAA, ornibactin, and AHL production in B. vietnamiensis, supporting its plant growth-promoting and biocontrol functions. Computational PPI networks predicted distinct interaction landscapes requiring experimental validation. This study provides a genomic framework for distinguishing pathogenic from beneficial Burkholderia and supports B. vietnamiensis as a safe biocontrol agent while cautioning against B. cepacia J14Eple.No potential conflict of interest relevant to this article was reported.Frontiers Media SAActa Medica Okayama1664-2392172026Behavior of serum thyroglobulin in relation to thyroid function under low-thyrotropin conditions in general practice17568631756863ENYosukeSazumiDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiakiSoejimaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoichiroYamamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsuhitoSuyamaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyosukeTakaseDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiOguniDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMihoYasudaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasanoriFurukawaDepartment of Laboratory Medicine, Okayama University HospitalFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesIntroduction: Serum thyroglobulin (Tg) and thyroid hormones are essential biomarkers in the diagnosis and management of thyroid diseases. Although Tg is routinely measured as a marker for thyroid neoplasia and an adjunct in the diagnosis of thyrotoxicosis due to destructive thyroiditis, its clinical significance under conditions of abnormal thyroid function remains unclear.<br>Methods: We investigated the association between serum Tg levels and thyroid function in 292 patients who underwent simultaneous evaluation of serum Tg, free thyroxine (FT4), and free triiodothyronine (FT3) levels in routine clinical practice. Based on thyroid-stimulating hormone (TSH) levels, participants were classified into three groups: high-TSH (> 4.23 μIU/mL; n = 38), normal-TSH (0.61–4.23 μIU/mL; n = 191), and low-TSH (< 0.61 μIU/mL; n = 63).<br>Results: The low-TSH group exhibited significantly higher serum Tg levels (118.66 ± 32.13 ng/mL) than the normal-TSH (70.20 ± 23.48 ng/mL) and high-TSH (34.70 ± 13.62 ng/mL) groups. Among patients positive for TSH-receptor antibodies (TRAb) or thyroid-stimulating antibodies (TSAb), elevated Tg levels were observed exclusively in the low-TSH group. Correlation analyses revealed that Tg levels were positively correlated with the FT3/FT4 ratio in the low-TSH group (rho = 0.62, p < 0.01), and this association was more evident in patients positive for both TRAb and TSAb (rho = 0.71, p < 0.01). These associations remained significant after multivariable adjustment and were supported by correlations between Tg and SPINA-GD, a model-based index of thyroid function reflecting deiodinase activity, with similar findings observed in patients with autoimmune hyperthyroidism.<br>Conclusion: These findings suggest that serum Tg levels may reflect biochemical features consistent with T3 predominance in autoimmune hyperthyroidism and have potential clinical utility in characterizing disease pathophysiology.
No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1877-959X1732026Epidemiological and molecular characteristics of human-biting ticks in areas endemic to Japanese spotted fever: a prospective study102635ENShinnosukeFukushimaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiSunamiSumiyoshi Fujii HospitalYasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaNakamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidemasaAkazawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshimiHidaniNumakuma HospitalKoujiKidaOkayama Prefectural Institute for Environmental Science and Public HealthGoTsurumiOkayama Prefectural Institute for Environmental Science and Public HealthHideharuHagiyaTick-borne diseases (TBDs) have become a great health concern worldwide. This study aimed to clarify the pathogenic and potentially pathogenic microorganisms carried by ticks that bite humans and to assess the risk of acquiring tick-borne infections in regions endemic for Japanese spotted fever. Tick specimens were prospectively collected from patients who presented with tick bites at 10 medical institutions in the Hiroshima, Okayama, and Kagawa prefectures, Japan between May 2023 and December 2024. The evaluated parameters included the estimated bite location, date of bite, patient age, tick species identification, and presence of TBD-associated pathogens in the collected ticks. Overall, 191 ticks were collected from 181 patients. Among patients with known sex, females were slightly more prevalent than males, and 45.9% of the patients were aged ≥ 70 years. Seasonal distribution demonstrated a peak incidence from April to July, with the highest number of cases observed in June (29.3%). Amblyomma testudinarium was the predominant species, accounting for 152 (79.6%) ticks, followed by Haemaphysalis hystricis (7.3%) and Haemaphysalis longicornis (6.8%). Nymphs represented the majority (83.8%), whereas adults and larvae accounted for 14.6% and 1.0%, respectively. A total of 27 ticks (14.1%) carried Rickettsia species, including two identified species (Rickettsia tamurae and Rickettsia monacensis) and one unclassified Rickettsia species. However, molecular analysis did not detect any known human pathogenic organisms, including Ehrlichia and Anaplasma species, Francisella tularensis, or Rickettsia japonica. Further epidemiological data regarding the abundance of tick-borne pathogens will provide valuable surveillance information with significant clinical utility for disease diagnosis and management.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1068-92653352026Novel Arterial Reconstruction of the Left Gastric Artery Supplying the Replaced Left Hepatic Artery in Distal Pancreatectomy with Celiac Axis Resection41184121ENKoseiTakagiDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineAteneItoDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTomokazuFujiDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineKazuyaYasuiDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTakeyoshiNishiyamaDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineYasuoNagaiDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineShoheiYokoyamaDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineBackground. Distal pancreatectomy with celiac axis resection (DP-CAR) with reconstruction of the left gastric artery (LGA) is a technically challenging procedure. The middle colic artery is commonly used for LGA reconstruction. This study highlights our novel arterial reconstruction of the LGA using the common hepatic artery (CHA) supplying the replaced left hepatic artery (rLHA) during DP-CAR.<br>
Patient and Methods. A 65-year-old man diagnosed with locally advanced unresectable pancreatic body cancer underwent DP-CAR following systemic chemotherapy. As a rLHA arising from the LGA was present, arterial reconstruction was necessary.<br>
Results. After confirming resectability, the CHA and LGA were encircled. Following division of the pancreas and radical lymphadenectomy, the origin of the celiac axis (CA) was divided. Subsequently, the CHA and LGA were transected and anastomosed. An indocyanine green fluorescence system was used to confirm adequate arterial blood supply and satisfactory tissue perfusion. Operative time was 215 min, with an estimated blood loss of 35 mL.<br>
Conclusions. This study demonstrated a novel arterial reconstruction of the LGA supplying the rLHA during DP-CAR. The CHA may be a candidate for the reconstruction of the LGA in DP-CAR.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2072-66941872026Predictive Nomogram for Recurrence After Upfront Surgery for Resectable Pancreatic Ductal Adenocarcinoma: A Multicenter Study (OS-HBP-2)1181ENRyuichiYoshidaDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKoseiTakagiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuyaYasuiDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasayoshiHiokiDepartment of Surgery, Fukuyama City HospitalTakehiroOkabayashiDepartment of Surgery, Kochi Health Sciences CenterToruKojimaDepartment of Surgery, Okayama Saiseikai General HospitalYoshikatsuEndoDepartment of Surgery, Himeji Red Cross HospitalDaisukeNobuokaDepartment of Surgery, Fukuyama City HospitalKentaSuiDepartment of Surgery, Kagawa Prefectural HospitalMasaruInagakiDepartment of Surgery, National Hospital Organization Fukuyama Medical CenterSusumuShinouraDepartment of Surgery, Tsuyama Chuo HospitalMasashiKimuraDepartment of Surgery, Matsuyama Shimin HospitalTatsuoMatsudaDepartment of Surgery, Tenwakai Matsuda HospitalHidekiAokiDepartment of Surgery, National Hospital Organization Iwakuni Clinical CenterToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground/Objectives: Postoperative recurrence is a critical issue in the treatment of resectable pancreatic ductal adenocarcinoma (rPDAC). Moreover, the prognosis after early recurrence is extremely poor. This study aimed to develop a recurrence prediction model and to define early recurrence after upfront surgery (UFS) for rPDAC. Methods: This multicenter retrospective study included patients who underwent UFS for anatomically rPDAC between January 2013 and December 2017. Multivariate analyses were conducted to identify the risk factors for recurrence-free survival and to construct a recurrence prediction model. Subsequently, a minimum p value approach was used to determine the optimal cutoff values for early and late recurrence. Results: The cohort included 603 patients (325 men and 278 women). During the median follow-up period of 25 months (interquartile range, 15–38 months), 381 patients (63.2%) experienced a recurrence. Multivariate analyses revealed carbohydrate antigen 19-9 ≥37 U/mL (hazard ratio [HR], 1.58; p < 0.001), tumor size ≥ 2.2 cm (HR, 1.59; p < 0.001), lymph node metastasis (HR, 1.86; p < 0.001), R1 resection (HR, 1.56; p = 0.002), and no adjuvant chemotherapy (HR, 1.54; p < 0.001) as independent predictors. The recurrence prediction model demonstrated an area under the curve of 0.72–0.75. The optimal threshold for early and late recurrences was a recurrence-free interval of five months. Carbohydrate antigen 19-9 ≥ 156 U/mL was a significant predictor of early recurrence (OR, 3.28; p < 0.001). Conclusions: This study identified the prognostic risk factors for recurrence and developed a recurrence prediction model for patients undergoing UFS for rPDAC. Moreover, a recurrence-free interval of five months was identified as the optimal threshold for distinguishing between early and late recurrences.No potential conflict of interest relevant to this article was reported.International Institute of Anticancer ResearchActa Medica Okayama0258-851X4012026Modified Subtraction Technique for the Middle Hepatic Vein Tributary and Glissonean Pedicle in Right Lobe Graft Procurement349354ENKOSEITAKAGIDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTOMOKAZUFUJIDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKAZUYAYASUIDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTAKEYOSHINISHIYAMADepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYASUONAGAIDepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSHOHEIYOKOYAMADepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYUZOUMEDADepartment of Hepatobiliary Pancreatic Surgery, Ehime University Graduate School of MedicineTOSHIYOSHIFUJIWARADepartment of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground/Aim: The procurement of right lobe grafts while preserving the middle hepatic vein (MHV) tributaries (V5 and V8) just before graft retrieval is technically challenging. Moreover, the safe isolation of the hepatic duct from the Glissonean pedicle is essential in living donor hepatectomy. To date, few studies have reported surgical techniques for preserving the MHV tributaries during right lobe graft procurement.<br>
Patients and Methods: This report presents our modified subtraction technique for managing the MHV tributaries and Glissonean pedicle during right lobe graft procurement. First, a subtraction technique for the MHV tributaries was initiated by isolating the right Glissonean pedicle. The lower tip of the tape was placed behind the caudate lobe and passed behind the right hepatic vein. Each end of the tape was then passed behind V5 and V8, followed by dissection of the remaining liver parenchyma between them. Subsequently, a subtraction technique for the Glissonean pedicle was applied to safely isolate the right hepatic duct and hilar plate.<br>
Results: Between September 2011 and May 2025, seven donors underwent right lobe graft procurement using the subtraction technique for the middle hepatic vein tributaries. The mean operative time was 381 min with an estimated blood loss of 217 ml. Using the subtraction technique, all middle hepatic vein tributaries were preserved just before graft retrieval.<br>
Conclusion: This study presents subtraction techniques used during living donor hepatectomy. The technique may facilitate liver parenchyma dissection while preserving MHV tributaries just before graft retrieval and isolating the Glissonean pedicle.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2072-669417182025Outcomes of Robotic Pancreatectomy in the Octogenarian: A Multicenter Retrospective Cohort Study3038ENKoseiTakagi Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityYuichiroUchida Department of Surgery, Fujita Health UniversityTomokazuFuji Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTakeshiTakahara Department of Surgery, Fujita Health UniversityKazuyaYasui Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTakeyoshiNishiyama Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityIchiroUyama Department of Advanced Laparoscopic and Robotic Surgery, Fujita Health UniversityKoichiSuda Department of Surgery, Fujita Health UniversityToshiyoshiFujiwara Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityBackground/Objectives: Due to the increasing incidence of pancreatic and periampullary cancers with advancing age, coupled with the growing evidence supporting minimally invasive pancreatectomy, the demand for such procedures is rising. However, data on the feasibility of robotic pancreatectomy in octogenarian patients remain scant. This study aimed to investigate overall outcomes of robotic pancreatectomy and evaluate its safety and feasibility in octogenarian patients. Methods: A multicenter, retrospective study was conducted, including 380 patients who underwent robotic pancreatectomy at two high-volume centers in Japan from April 2020 to December 2024. Using prospectively collected data, we compared outcomes between younger patients (<80 years) and octogenarian patients (≥80 years). Multivariable logistic regression analyses were performed to assess the impact of age on postoperative outcomes. Results: Among the 380 patients, with a median age of 72 (interquartile range: 61–77) years, 213 underwent robotic pancreatoduodenectomy (RPD), and 167 underwent robotic distal pancreatectomy (RDP). Octogenarian patients were found to have more comorbidities and a higher incidence of malignant diseases. Octogenarians experienced significantly longer hospital stays post-RPD (22 [octogenarian; n = 36] vs. 14 [younger; n = 177] days, p < 0.001) and post-RDP (14 [n = 23] vs. 10.5 [n = 144] days, p = 0.02), yet their perioperative outcomes were comparable. Multivariable analyses indicated that age (≥80 years) was not a significant risk factor for major complications following robotic pancreatectomy (odds ratio, 1.33; 95% confidence interval, 0.59–2.84; p = 0.479). Conclusions: This multicenter study conducted at high-volume centers suggests that robotic pancreatectomy can be safely performed in carefully selected octogenarian patients.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1068-92653372026Association of Preoperative Inspiratory Muscle Weakness and Respiratory Sarcopenia with Postoperative Pneumonia Following Esophagectomy: A Multicenter Retrospective Cohort Study62966305ENKazukiOkuraDepartment of Rehabilitation Medicine, Akita University HospitalTomohiroIkedaDepartment of Rehabilitation Medicine, Okayama University HospitalHirokiSatoDepartment of Rehabilitation, Kawasaki University of Medical WelfareShoKatayamaDepartment of Rehabilitation Medicine, Okayama University HospitalYusukeTakahashiDepartment of Rehabilitation Medicine, Akita University HospitalYushiNagakiDepartment of Esophageal Surgery, Akita University HospitalAkiyukiWakitaDepartment of Esophageal Surgery, Akita University HospitalNaoakiMaedaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShunsukeTanabeDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshinoriFujiwaraDepartment of Digestive Surgery, Kawasaki Medical SchoolKazuhiroNomaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYusukeSatoDepartment of Esophageal Surgery, Akita University HospitalYujiKasukawaDepartment of Rehabilitation Medicine, Akita University HospitalNaohisaMiyakoshiDepartment of Rehabilitation Medicine, Akita University HospitalBackground Esophagectomy is associated with a high rate of postoperative pneumonia, which significantly impacts patient outcomes, including survival and quality of life. While some modifiable risk factors have been identified, the specific role of preoperative respiratory muscle function remains to be fully elucidated. Therefore, this study was designed to investigate the association of preoperative inspiratory muscle weakness (IMW) and respiratory sarcopenia (RS) with postoperative pneumonia in patients with esophageal cancer who underwent esophagectomy.<br>
Methods Patients with esophageal cancer who underwent esophagectomy between July 2021 and June 2023 were enrolled in this multicenter, retrospective, cohort study. The primary outcome was postoperative pneumonia, while preoperative IMW and RS were the main exposures. Respiratory sarcopenia was defined as the presence of both IMW and low skeletal muscle mass, which is assessed by using bioelectrical impedance analysis. Associations were analyzed by using G-computation within a Bayesian framework.<br>
Results A total of 213 patients were enrolled in this study. Postoperative pneumonia occurred in 42 patients (19.7%). Preoperative IMW was strongly associated with an increased risk of pneumonia, with a mean risk difference (RD) of 18.1% (95% credible interval [CrI] 5–33.6). The posterior probability that the RD exceeds 5% was > 98%. Respiratory sarcopenia also showed a potential association, although with greater uncertainty (mean RD, 11.2%; 95% CrI − 3.8 to 27.9). The posterior probability that the RD exceeds 5% was 76.7%.<br>
Conclusions Preoperative IMW is a notable risk factor for postoperative pneumonia following esophagectomy. While a potential link with RS was found, its role remains uncertain and requires further investigation.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1347-90322026Plasma Protein Analysis for Biomarker Discovery in Lung Cancer Treated With Atezolizumab Combination Therapy in J-TAIL-2113ENYasushiGotoDepartment of Thoracic Oncology, National Cancer Center HospitalMakotoNishioDepartment of Thoracic Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchKadoakiOhashiDepartment of Respiratory Medicine, Okayama University HospitalAtsushiOsoegawaDepartment of Thoracic and Breast Surgery, Oita University Faculty of MedicineEikiKikuchiDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido UniversityHideharuKimuraDepartment of Respiratory Medicine, Kanazawa University HospitalJunichiShimizuDepartment of Thoracic Oncology, Aichi Cancer Center HospitalEisakuMiyauchiDepartment of Respiratory Medicine, Tohoku University HospitalHiroshigeYoshiokaDepartment of Thoracic Oncology, Kansai Medical UniversityIchiroYoshinoDepartment of Thoracic Surgery, International University of Health and Welfare Narita HospitalToshihiroMisumiDepartment of Data Science, National Cancer Center Hospital EastYasutakaWatanabeDepartment of Thoracic Oncology, Saitama Cancer CenterNobuyukiKatakamiDepartment of Pulmonary Medicine and Medical Oncology Takarazuka City Hospital Takarazuka JapanAkiraKisoharaDepartment of Respiratory Medicine, Kasukabe Medical CenterMasafumiYamaguchiDepartment of Thoracic Oncology, NHO Kyushu Cancer CenterHirotakaKurokiChugai Pharmaceutical Co., Ltd.MasamichiSugimotoChugai Pharmaceutical Co., Ltd.HisaoAshimuraChugai Pharmaceutical Co., Ltd.MisaTanakaChugai Pharmaceutical Co., Ltd.AkihikoGemmaNippon Medical SchoolJ-TAIL-2 evaluated the efficacy and safety of atezolizumab, an anti–programmed death-ligand 1 (PD-L1), plus chemotherapy in patients with non-small cell lung cancer (NSCLC) and extensive-stage small cell lung cancer (ES-SCLC) in Japanese clinical practice, demonstrating comparable outcomes to those in the corresponding Phase 3 trials. Although PD-L1 expression is predictive of atezolizumab efficacy in some settings, additional minimally invasive, blood-based biomarkers are needed. This exploratory biomarker study included 359 J-TAIL-2 patients. The NSCLC cohort received atezolizumab combined with carboplatin and nab-paclitaxel (CnP, n = 42), cisplatin/carboplatin and pemetrexed (n = 72), or bevacizumab plus carboplatin and paclitaxel (bev + CP, n = 135). The ES-SCLC cohort received atezolizumab plus carboplatin and etoposide (n = 100). Approximately 560 cancer- or immune-related proteins were evaluated using the Proximity Extension Assay from blood plasma collected at three timepoints: baseline, before the second atezolizumab dose, and at the onset of immune-related adverse events (irAEs). Protein-wise comparisons were made to evaluate significant changes (P < 0.05 and > 0.5 log2 fold change) and linked to clinical outcomes reported in J-TAIL-2. IL-6, MUC-16, and KRT-19 were associated with shorter progression-free survival across multiple regimens. Granzyme A and B, immune activation markers, were elevated in responders who received atezolizumab + CnP and atezolizumab + bev + CP. High levels of baseline immune stimulation proteins were associated with irAEs across regimens. Protein expression changes were varied and regimen-dependent in subgroup analyses including older patients and those with EGFR-mutant tumors. These data warrant further investigation across different cancer types and atezolizumab-containing regimens to determine their relevance to efficacy and irAE occurrence of atezolizumab combination therapy.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2050-09041462026CPPD-Induced Iliopsoas Bursitis Mimicking Pyomyositise72814ENHirokiOkunobuDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinnosukeFukushimaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCalcium pyrophosphate deposition disease may mimic an iliopsoas abscess on imaging. The combined use of polarized light microscopy and 16S rRNA gene analysis can help distinguish crystal-induced inflammation from infection, thereby preventing unnecessary antimicrobial therapy.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2077-038315102026Exploratory Analysis of Serum IGF-I Levels and Symptom Trajectories in Long COVID During the Omicron Period3702ENAtsuhitoSuyamaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazukiTokumasuDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasueSakuradaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuiMatsudaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiHondaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiakiSoejimaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToruHasegawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyosukeTakaseDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeOmuraDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiOguniDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeigoUedaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: Although several risk factors have been reported for long COVID (LC), reliable biomarkers for this illness remain lacking. Insulin-like growth factor (IGF)-I, a major mediator of growth hormones, plays an important role in metabolism, neuroprotection, and systemic homeostasis, and therefore may be useful in predicting the severity and prognosis of LC. Methods: This study included patients who visited a specialized clinic for long COVID between 2022 and 2025 during the Omicron period and had serum IGF-I measurements taken. IGF-I levels were expressed as age- and sex-adjusted standard deviation scores (IGF-I SD), and patients were classified into low (SD < −1.0), normal (−1.0 ≤ SD < 1.0), and high (SD ≥ 1.0) groups. Clinical characteristics, patient-reported outcomes, laboratory data, and follow-up duration were analyzed. Results: A total of 811 patients were included (median 42 years; 52.5% female). Compared with the normal group, the low-IGF-I group exhibited higher fatigue (FAS: 37.0 vs. 34.0; p < 0.05) and depressive (SDS: 50.0 vs. 49.0; p < 0.05) status. Multivariable linear regression analyses identified lower IGF-I SD as independently associated with higher scores of both FAS and SDS. IGF-I SD values showed negative correlations with ferritin (ρ = −0.125, p < 0.05) and TSH (ρ = −0.202, p < 0.01) and positive correlations with albumin (ρ = 0.227, p < 0.01) and FT4 (ρ = 0.165, p < 0.01). Among the 237 patients who completed follow-up, the median duration from the initial visit to recovery tended to be longer in the low-IGF-I group (221 days) compared with the normal (191 days) and high (109 days) groups, although these differences were not statistically significant overall. In patients aged < 50 years, the low-IGF-I group showed a relatively longer follow-up duration (p < 0.05). Furthermore, the low-IGF-I group had a longer time to recovery compared to the high-IGF-I group (p < 0.05), and this difference was more pronounced in patients under 50 years of age, with significant differences observed among the three IGF-I groups. Conclusions: Lower IGF-I levels in LC may be associated with greater fatigue and depressive symptoms and longer recovery time, particularly in younger patients. Further studies are needed to clarify the clinical significance of these findings.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0039-60601952026Biliverdin supplementation in perfusate and preservation solution attenuates ischemia-reperfusion injury in a rat donation-after-circulatory-death heart transplantation model110231ENKoheiTokiokaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTsuyoshiNojimaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakahiroHirayamaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiHongoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakafumiObaraDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiAgetaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuroIgawaDepartment of Pathology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiyukiAokageBiological Process of Aging, Tokyo Metropolitan Institute for Geriatrics and GerontologyKoheiTsukaharaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTetsuyaYumotoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiromichiNaitoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsunoriNakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: Heart transplantation faces a persistent donor shortage; therefore, hearts from donation after circulatory death have become a feasible option despite unavoidable warm ischemia and subsequent ischemia-reperfusion injury. Biliverdin, an endogenous bile pigment with strong antioxidant and anti-inflammatory properties, has shown protective effects against ischemia-reperfusion injury in several organ transplantation models. Whether biliverdin attenuates warm ischemic injury in donation after circulatory death heart transplantation remains unclear. This study evaluated biliverdin supplementation in the perfusate and preservation solution in a rat donation after circulatory death model.<br>
Methods: Circulatory death was induced under deep anesthesia, and warm ischemia was maintained for 18 minutes, including the mandatory 5-minute stand-off period. Donor hearts were then flushed and subsequently cold-stored in the same biliverdin-supplemented extracellular-type trehalose–containing Kyoto solution, whereas control grafts received extracellular-type trehalose–containing Kyoto without biliverdin at both stages before heterotopic transplantation. Grafts were assessed at 3 and 24 hours after reperfusion (n = 6 per group). Evaluations included early graft recovery, myocardial injury markers, histological and ultrastructural changes, and inflammatory and stress-response gene expression.<br>
Results: Biliverdin significantly improved early graft recovery, shortening reanimation time and increasing left ventricular fractional shortening at 24 hours. Serum troponin I levels were lower in biliverdin-treated grafts. Biliverdin also reduced histological injury and inflammatory cell infiltration. Ultrastructural analysis showed preserved mitochondrial architecture and ultrastructural integrity. Early proinflammatory gene expression was suppressed.<br>
Conclusion: Biliverdin supplementation in the perfusate and preservation solution attenuates ischemia-reperfusion injury in the experimental rat donation after circulatory death heart transplantation model. These findings provide proof of concept for further mechanistic and translational evaluation of biliverdin for myocardial protection in donation after circulatory death.No potential conflict of interest relevant to this article was reported.Portland Press Ltd.Acta Medica Okayama0144-84634662026Tubulogenesis of bovine uterine glands by epidermal growth factor and collagen I in 3D culture systemsBSR20260010ENYosukeSuginoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityReiIchikawaGraduate School of Bioagricultural Sciences, Nagoya UniversityShuichiMatsuyamaGraduate School of Bioagricultural Sciences, Nagoya UniversityYukiYamamotoDepartment of Veterinary Medicine, Tokyo University of Agriculture and TechnologyKoheiKawanoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKojiKimuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityUterine glands are endometrial exocrine epithelia that support early embryo development. Their secretions are particularly essential for conceptus elongation in cattle. Uterine glands develop from the luminal epithelium and elongate into the stromal layer toward the myometrium. This process is regulated by growth factors, WNT proteins, and the surrounding extracellular matrix (ECM); however, the precise mechanisms that govern bovine uterine gland morphogenesis remain unclear. In this study, we determined how these signaling factors and ECM components affect the tubular formation of bovine uterine gland fragments in 3D culture systems. Uterine gland fragments were enzymatically isolated from bovine endometria and 3D-cultured in Matrigel with or without growth factors (EGF, FGF1, FGF2, FGF7, FGF10, and IGF-1) and WNT (WNT3A, WNT5A, and WNT7A) proteins. Of these, only EGF stimulated the elongation of uterine gland fragments and eventually induced the formation of uterine gland-like structures. EGF-induced tubulogenesis was accompanied by a rapid increase in cell proliferation and alterations in cell–ECM interactions. The supplementation of collagen I with Matrigel further promoted the elongation of the tubular structures. Although the addition of collagen I did not alter the gene expression profiles of the uterine gland-like structures, the integrin-ROCK pathway contributed to the collagen-induced enhancement of elongation. Our findings clarified that EGF and collagen I, but not FGFs, IGF-1, or WNTs, are key regulators for the tubular formation of 3D-cultured bovine uterine gland fragments. This 3D culture system provides a new platform to examine the cellular and molecular mechanisms underlying bovine uterine gland morphogenesis.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0897-38062026What Is the Pterygomandibular Raphe? A Confluence of Fasciae Rather Than a Discrete Structure19ENJoeIwanagaDepartment of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of MedicineShionHamaSection of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu UniversityKeikoFukinoDepartment of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental UniversityShogoKikutaDental and Oral Medical Center, Kurume University School of MedicineMi‐SunHurDepartment of Anatomy, Daegu Catholic University School of MedicineMaria Cristina ManzanaresCespedesHuman Anatomy and Embryology Unit. Experimental Pathology and Therapeutics Department, Faculty of Medicine and Health Sciences, University of BarcelonaYoshioOhyamaOral and Maxillofacial Surgery, Shizuoka City Shizuoka HospitalMasayaAkashiDepartment of Oral and Maxillofacial Surgery, Kobe University Graduate School of MedicineNoritakaKomuneDepartment of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu UniversityHideakiKamochiDepartment of Maxillofacial Surgery, Institute of Science TokyoSoichiroIbaragiDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityThe pterygomandibular raphe (PMR) has traditionally been described as a fibrous or tendinous band connecting the bucinator (BM) and superior pharyngeal constrictor (SPCM) muscles. However, recent evidence has questioned its existence. This study aimed to reevaluate the anatomy of the pterygomandibular region by preserving fascial continuity and examining the relationships among adjacent muscles and connective tissues. Twenty-five sides from formalin-fixed cadaveric heads were examined. Twenty sides underwent macroscopic dissection under a surgical microscope, and five sides were sectioned axially and analyzed histologically using Masson's trichrome staining to assess muscle–fascia continuity. The buccopharyngeal fascia (BpF) adhered tightly to the posterolateral surface of the BM. A ligament-like bundle observed between the BM and medial pterygoid muscle corresponded to an artificial continuation of the BpF created by dissection. Axial sections revealed that the BpF, masseteric, and temporalis fasciae converged anteriorly on the lateral surface of the BM, while posteriorly, the BpF and temporalis fascia also merged, forming a confluence of fasciae. No discrete tendinous or ligamentous PMR was identified. The so-called PMR represents a dissection artifact rather than a true anatomical structure. These findings emphasize the importance of preserving fascial relationships and using precise terminology in anatomical and clinical contexts.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2090-67492026Arthroscopically Confirmed Complete Healing of Anterior Cruciate Ligament Avulsion Fracture Following Four‐Corner Pullout Repair Using Ultrahigh‐Molecular‐Weight Polyethylene Tapes: A Case Report5671446ENToshikiKoharaDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesYukiOkazakiDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesShinichiMiyazawaDepartment of Orthopedic Surgery , NHO Fukuyama Medical CenterTakayukiFurumatsuDepartment of Orthopedic Surgery , Japanese Red Cross Okayama HospitalYusukeYokoyamaDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesMasanoriTamuraDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesKokiKawadaDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesTsubasaHasegawaDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesTomonoriTetsunagaDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesKazukiYamadaDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopedic Surgery , Okayama University Graduate School of Medicine , Dentistry , and Pharmaceutical SciencesWe report a case of tibial insertion avulsion fracture of the anterior cruciate ligament (ACL). A 10-year-old boy who fell from a skateboard was diagnosed with a tibial insertion avulsion fracture of the ACL and was treated arthroscopically. The avulsed fragment was provisionally fixed with guide pins inserted into its four corners, and the lateral view was checked to avoid penetration of the growth plate. Two ultrahigh-molecular-weight polyethylene tapes were passed through the ACL just above its tibial insertion, pulled through the four-corner bone tunnels in an X-shaped configuration, and tightened. The patient was immobilized for 3 weeks, and partial weight bearing was initiated at 4 weeks. Bone union was confirmed at 6 months using plain radiographs, and second-look arthroscopy and implant removal were performed 8 months postoperatively. During arthroscopy, complete union with smooth continuity of the articular cartilage at the fracture site and a stable ACL were observed. The patient had a full knee range of motion and no pain at the final follow-up.No potential conflict of interest relevant to this article was reported.Institute of Electrical and Electronics Engineers (IEEE)Acta Medica Okayama2169-3536142026Construction of a Lightweight Simulation Environment Based on Topological Mapping73466 73478ENYukinagaKatoGraduate School of Environmental, Life, Natural Science, and Technology, Okayama UniversityYuichiroTodaFaculty of Environmental, Life, Natural Science, and Technology, Okayama UniversityTakayukiMatsunoFaculty of Environmental, Life, Natural Science, and Technology, Okayama UniversityAutonomous mobile robots require safe and efficient environmental representations for traversability-aware navigation and learning. In particular, self-learning of traversability from real-world driving experience can require robots to operate near the limits of their mobility, which introduces physical risks such as falls, malfunctions, or hardware damage. To provide a safer complementary environment for such validation and future learning, this paper proposes ATC-Mesh. This framework constructs a lightweight, simulation-ready mesh environment from the topological map produced by Adaptive Resonance Theory-based Topological Clustering with Different Topologies (ATC-DT) using high-density LiDAR point clouds. Unlike standard mesh reconstruction methods that directly process dense point clouds, ATC-Mesh generates a compact mesh from the node–edge structure of the topological map while preserving traversability attributes associated with the topological map. Experiments using two real-world LiDAR datasets show that ATC-Mesh achieves competitive mesh-construction quality compared with standard baseline methods while reducing construction time and mesh size. Gazebo experiments further show that the generated meshes can support waypoint-based navigation with a low simulation load.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0753-33221942026Elucidation of mechanisms underlying the therapeutic effects of cordycepin on pulmonary hypertension, with a focus on cell senescence and gut microbiota118923ENGaopengLiDepartment of Cardiovascular Physiology, Faculty of Medicine, Kagawa UniversityZhixinZhaoInner Mongolia Key Laboratory of Dairy Biotechnology and Engineering, Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs, Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural UniversityMitsuhiroMachitaniDivision of Cancer Stem Cell, National Cancer Center Research InstituteRyouIshikawaDepartment of Diagnostic Pathology, Kagawa University HospitalKaoriIshikawaDepartment of General Medicine, Kagawa University HospitalNaoyaYokotaDepartment of General Thoracic Surgery, Faculty of Medicine, Kagawa UniversityReijiHabaDepartment of Diagnostic Pathology, Kagawa University HospitalKazufumiNakamuraCenter for Advanced Heart Failure, Okayama University HospitalZhihongSunInner Mongolia Key Laboratory of Dairy Biotechnology and Engineering, Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs, Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural UniversityLin-HaiKuraharaDepartment of Cardiovascular Physiology, Faculty of Medicine, Kagawa UniversityKatsuyaHiranoDepartment of Cardiovascular Physiology, Faculty of Medicine, Kagawa UniversityIntroduction: Pulmonary hypertension (PH) is a progressive cardiopulmonary disorder characterized by excessive pulmonary vascular remodeling and aberrant proliferation of pulmonary artery smooth muscle cells (PASMCs). Emerging evidence suggests that gut microbiota dysbiosis contributes to PH development. Cordycepin, a natural adenosine analogue derived from Cordyceps militaris, has demonstrated antiproliferative and microbiota-modulating properties; however, its mechanism of action in PH remains unclear.<br>
Objective: Elucidate the mechanisms underlying the therapeutic effects of cordycepin on PH, focusing on cellular senescence and gut microbiota.<br>
Methods: The effects of cordycepin on PH pathology were investigated by transcriptome analysis of PASMCs from patients, and metagenomic analysis of rodent PH models. Cellular senescence was analyzed in lung tissue from p16Ink4a-CreERT2 reporter mice and in rat bone marrow-derived macrophages (BMDMs).<br>
Results: RNA sequencing analysis revealed activation of p53 signaling by cordycepin in PASMCs. Cordycepin suppressed CDK1 expression and TERT phosphorylation at threonine 249. It ameliorated vascular and cardiac remodeling in PH rat and mouse models. Cordycepin induced M1-like macrophage senescence in p16 Ink4a reporter mice lungs and rat BMDMs. Cordycepin significantly reshaped the gut microbiota, increasing beneficial genera (e.g. Alistipes and Acetatifactor) and reducing proinflammatory taxa (e.g., Ruminococcus), with modulating key metabolic pathways, including short-chain fatty acid, tryptophan, and vitamin K2 metabolism.<br>
Conclusion: Cordycepin exerts multi-target therapeutic effects in PH by inhibiting PASMC proliferation via the p53–CDK1/pTERT axis, modulating gut microbiota-linked immunometabolism and induces proinflammatory macrophage senescence. These findings support cordycepin as a promising candidate for PH therapies targeting the vascular, immune, and gut–lung axes.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0040-40391832026Photochemical oxidative synthesis of carboxylic acids from aldehydes or alcohols with water via CH bromination156163ENMohamed R.El-kholanyGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityAtsuyaMiyamotoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMorganeFalconeGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHiroyoshiTakamuraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityIsaoKadotaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKentaTanakaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThe photoinduced oxidation of aldehydes or alcohols with water to give the corresponding carboxylic acids is described. This photochemical carboxylation proceeds via the in-situ generation of acyl-bromide intermediates upon irradiation with purple or UV LED light; these intermediates subsequently react with water to give the desired carboxylic acids. This mild photochemical reaction affords diverse carboxylic acids without peroxide generation or the need to use transition-metal catalysts and a stoichiometric amount of base, highlighting its potential utility for the synthesis of natural products and bioactive compounds.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1865-72571932026Successful management and 10-year survival of a rectal neuroendocrine tumor with rare systemic metastases via a non-portal venous pathway491498ENShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalAkihiroMatsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalHiroyukiTerasawaDepartment of Gastroenterology and Hepatology, Okayama University HospitalYukiFujiiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKoseiTakagiDepartment of Gastroenterological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of MedicineTakashiKuiseDepartment of Gastroenterological Surgery, Okayama Red Cross HospitalTakehiroTanakaDepartment of Pathology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalMetastatic neuroendocrine tumors (NETs) typically involve the liver and lymph nodes. Metastases in the orbit, heart, and ovary are rare and present unique clinical challenges. We report a woman who was 70 years old at the time of initial presentation with liver metastases from a rectal neuroendocrine tumor. Following a right hepatectomy for liver metastases, she remained free of hepatic recurrence for 10 years. Notably, four years after the right hepatectomy, she developed new metastases in the left orbit, right ventricle, and left ovary, with diplopia as the sole clinical symptom. This clinical course suggests a distinct metastatic pathway associated with the lower rectum that bypasses the portal circulation, consistent with the dual drainage system of the rectal region. Management involved a strategic multimodal approach that includes systemic therapy with everolimus and lanreotide as well as targeted surgical resectioning of the cardiac and ovarian lesions. The orbital lesion achieved a complete response through systemic therapy alone, preserving visual function. Currently, 10 years after the initial treatment, the patient maintains an excellent performance status (ECOG PS 0) while receiving peptide receptor radionuclide therapy (PRRT). This case demonstrates that recognizing atypical metastatic pathways and employing strategic multimodal therapies can achieve long-term survival and functional preservation in rectal NETs.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2090-6528202612026Selective ARID1A Loss Restricted to the Undifferentiated Component of a Mismatch Repair‐Deficient Gastric Carcinoma: A Case Report8863202ENRikaOmoteDepartment of Diagnostic Pathology, NHO Fukuyama Medical CenterRyosukeHamanoDepartment of Surgery, NHO Fukuyama Medical CenterShinyaOtsukaDepartment of Surgery, NHO Fukuyama Medical CenterTakehiroTanakaDepartment of Pathology, Okayama University HospitalHiroyukiYanaiDepartment of Pathology, Okayama University HospitalMismatch repair-deficient (dMMR) gastric carcinomas often harbor ARID1A alteration, but a sharply demarcated undifferentiated/rhabdoid component with selective ARID1A loss is uncommon and may create a diagnostic dilemma. An 80-year-old man underwent esophagogastroduodenoscopy for anemia, which revealed a circumferential Borrmann Type 3 lesion in the gastric body, and distal gastrectomy was performed. Histologically, the tumor was composed predominantly of undifferentiated carcinoma with focal rhabdoid features and a minute well-differentiated adenocarcinoma component, with an abrupt transition between the two. Immunohistochemistry showed loss of nuclear MLH1 and PMS2 in both components, whereas loss of ARID1A expression was confined to the undifferentiated component; SMARCB1 (INI1), SMARCA2 (BRM), and SMARCA4 (BRG1) were retained. EBER in situ hybridization was negative. Because gene-level testing, MSI testing, and MLH1 promoter methylation analysis were not performed, the molecular basis of the dMMR phenotype and ARID1A loss could not be determined. The restricted scope of molecular testing limits the ability to draw broad or generalizable conclusions and to fully establish clinicopathological correlations. The value of this report is, therefore, not mechanistic proof but recognition of a practical morphologic-immunophenotypic observation: When a gastric carcinoma shows a sharply demarcated shift from differentiated to undifferentiated/rhabdoid morphology, dMMR should be considered, and selective ARID1A loss in the undifferentiated component may be associated with dedifferentiation. These findings should be interpreted with caution as preliminary, hypothesis-generating observations that require validation in larger studies with more extensive molecular profiling.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1340-68683342026Differences in drug efficacy and prognosis between primary and metastatic sites for de novo stage IV breast cancer: an exploratory analysis of a phase III trial, JCOG1017829838ENKiyoTanakaDepartment of Breast Surgery, Toranomon HospitalAkihikoShimomuraDepartment of Breast and Medical Oncology, National Center for Global Health and MedicineMakotoIshitobiDepartment of Breast Surgery, Osaka Habikino Medical CenterTakashiYamanakaDepartment of Breast Surgery, Kanagawa Cancer CenterTakahiroTsukiokiDepartment of Breast and Endocrine Surgery, Okayama University HospitalHirojiIwataDepartment of Advanced Clinical Research and Development, Nagoya City University Graduate School of Medical SciencesFumikataHaraDepartment of Breast Oncology, Aichi Cancer CenterTomomiFujisawaDepartment of Breast Oncology, Gunma Prefectural Cancer CenterKeitaSasakiClinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalRyoSadachiClinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalRikuKajikawaClinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalTakehikoSakaiDepartment of Breast Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer ResearchYasuakiSagaraDepartment of Breast Surgery, Sagara HospitalHideoShigematsuDepartment of Breast Surgery, Hiroshima University HospitalYukinoriOzakiDepartment of Breast Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer ResearchKazukiNozawaDepartment of Advanced Clinical Research and Development, Nagoya City University Graduate School of Medical SciencesKazukiSudoDepartment of Medical Oncology, National Cancer Center HospitalYoichiNaitoDepartment of General Internal Medicine, National Cancer Center Hospital EastKaoriTerataDepartment of Breast and Endocrine Surgery, Akita University HospitalToshiyukiIshibaDepartment of Breast Surgery, Institute of Science Tokyo HospitalHaruhikoFukudaClinical Oncology Group Data Center/Operations Office, National Cancer Center HospitalTadahikoShienDepartment of Breast and Endocrine Surgery, Okayama University HospitalBackground Breast cancer is a highly heterogeneous disease, with biological factors like estrogen receptor, progesterone receptor, and HER2 receptor differing between primary and metastatic sites, potentially affecting treatment response.<br>
This exploratory analysis aims to differentiate drug efficacy and long-term prognosis between these sites in stage IV breast cancer.<br>
Methods Patients from JCOG1017, a phase III trial evaluating the role of primary tumor resection, who received primary systemic therapy (PST) were evaluated at three months. In this analysis, treatment response was assessed separately in primary and metastatic sites. Patients were categorized into four groups: discordant I (primary non-PD, metastatic PD), concordant I (both PD), discordant II (primary PD, metastatic non-PD), and concordant II (both non-PD).<br>
Results Among 271 patients, overall discordance proportion of treatment response between primary and metastatic sites was 25.1%. Group distribution was 24.7% (discordant I), 9.6% (concordant I), 0.4% (discordant II), and 65.3% (concordant II). Discordance was more frequent in luminal (28.9%), triple-negative (25.0%), and luminal-HER2 (22.0%) subtypes than in HER2-enriched (11.1%). Survival analysis showed prognostic differences: concordant II, with both sites non-PD, demonstrated the most favorable outcome compared with discordant I (HR 0.556; 95% confidence interval, 0.396–0.782).<br>
Conclusions One-fourth of patients exhibited discordant responses between primary and metastatic sites in early treatment phases. These discrepancies were associated with survival differences, emphasizing the importance of evaluating both primary and metastatic lesions when assessing efficacy and determining treatment strategies in de novo stage IV breast cancer.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0007-104820862026Decreased renal function predicts severe cytokine release syndrome after CAR-T-cell therapy for large B-cell lymphoma21242133ENYasuyukiAraiDepartment of Hematology, Graduate School of Medicine, Kyoto UniversityTomoyasuJoDepartment of Hematology, Graduate School of Medicine, Kyoto UniversityTakayukiSatoDepartment of Hematology and Oncology, Kurashiki Central HospitalMasatoshiSakuraiDivision of Hematology, Department of Medicine, Keio University School of MedicineDaisukeKajiDepartment of Hematology, Toranomon HospitalToshioKitawakiDepartment of Hematology, Graduate School of Medicine, Kyoto UniversityKazuyukiShimadaDepartment of Hematology and Oncology, Nagoya University Graduate School of MedicineTatsuShimoyamaDivision of Clinical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome HospitalSatoshiYoshiharaDepartment of Hematology, Hyogo Medical University HospitalShinichiMakitaDepartment of Hematology, National Cancer Center HospitalNobuharuFujiiDepartment of Hematology and Oncology, Okayama University HospitalGoYamamotoDepartment of Hematology, Toranomon HospitalKeisukeKataokaDivision of Hematology, Department of Medicine, Keio University School of MedicineEmikoSakaidaDepartment of Hematology, Chiba University HospitalHidekiGotoDepartment of Hematology, Hokkaido University HospitalYasuhiroNakashimaDepartment of Hematology, Osaka Metropolitan University HospitalAkiyoYoshidaDepartment of Hematology, Kanazawa University HospitalYoshihiroUmezawaDepartment of Hematology, Institute of Science Tokyo HospitalHaryoonKimDivision of Hematology, Department of Medicine, Keio University School of MedicineMotohiroKatoDepartment of Pediatrics, The University of TokyoYoshikoAtsutaJapanese Data Center for Hematopoietic Cell TransplantationKojiKatoHematology, Oncology and Cardiovascular Medicine, Kyushu University HospitalCytokine release syndrome (CRS) remains a major toxicity of chimeric antigen receptor (CAR) T-cell therapy in large B-cell lymphoma (LBCL), and robust pre-infusion predictors are needed for risk-adapted management. We retrospectively analysed LBCL patients in the Japanese nationwide registry who underwent CD19 CAR-T-cell therapy between 2019 and 2024. Among 900 patients (median age 62 years), cumulative incidences of CRS within 30 days after infusion were 75.0% for any grade, 20.8% for grade ≥ 2 and 14.0% for grade ≥ 3. In multivariable analysis, lower estimated glomerular filtration rate (eGFR) (adjusted hazard ratio [aHR] 1.108 per 10 mL/min per 1.73 m2 decrease; 95% confidence interval [CI] 1.015–1.209; p = 0.022), higher ferritin (aHR 1.006 per 100 ng/mL; 95% CI 1.001–1.010; p = 0.016), C-reactive protein (CRP) (aHR 1.142 per mg/dL; 95% CI 1.091–1.195; p < 0.001) and lactate dehydrogenase (LDH) (aHR 1.073 per 100 U/L; 95% CI 1.008–1.142; p = 0.028) independently predicted grade ≥ 2 CRS. We then built a four-factor CRS pre-infusion risk evaluation model, cytokine release syndrome-pre-infusion risk evaluation (CRS-PRE), that stratified grade ≥ 2 CRS risk into low, intermediate and high groups with incidences of 2.8%, 26.0% and 50.0% respectively. Decreased eGFR, a surrogate of host renal reserve, with elevated ferritin, CRP and LDH emerged as predictors of high-grade CRS. The CRS-PRE may facilitate risk-adapted monitoring and intervention in clinical practice.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2667-2421202026Behavioral effects of a chronic envy-like stress paradigm in mice using an adjacent cage model148159ENHiroshiUenoDepartment of Medical Technology, Kawasaki University of Medical WelfareYoshihiroTanakaDepartment of Psychiatry, Kawasaki Medical SchoolErikoKitanoDepartment of Psychiatry, Kawasaki Medical SchoolYuTakahashiDepartment of Psychiatry, Kawasaki Medical SchoolSachikoMoriDepartment of Psychiatry, Kawasaki Medical SchoolShinjiMurakamiDepartment of Psychiatry, Kawasaki Medical SchoolKentaWaniDepartment of Psychiatry, Kawasaki Medical SchoolYosukeMatsumotoDepartment of Neuropsychiatry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMotoiOkamotoDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversityTakeshiIshiharaDepartment of Psychiatry, Kawasaki Medical SchoolBackground: Social comparison and envy are significant psychosocial stressors in humans and are known to be involved in the onset and persistence of psychiatric disorders. However, animal models capable of experimentally reproducing the effects of indirect social comparison without physical contact are limited. In this study, we used a newly developed "adjacent-cage paradigm" to investigate whether chronic vicarious exposure to conspecifics in different environments induces envy-like stress in mice.<br>
Methods: Male C57BL/6 N mice served as observers, while demonstrator mice were assigned to one of four conditions: (1) an environment enriched with objects, (2) an igloo, (3) a tube, or (4) social isolation. Observers were continuously exposed to these adjacent cages for 21 days. Subsequently, a comprehensive battery of behavioral tests was conducted to assess general health, anxiety-like behavior, spatial memory, social behavior, and depression-like behavior.<br>
Results: In the objects condition, a decrease in time spent in the light compartment of the light/dark box indicated an increase in anxiety-like behavior. In the isolation condition, the mean duration per social interaction was shortened, suggesting a qualitative change in social behavior. The igloo condition resulted in reduced immobility time in the forced swim test, suggesting a possible alteration in stress coping behavior. Furthermore, increased nociceptive sensitivity was observed in the hot plate test under both the objects and isolation conditions.<br>
Conclusion: Although the envy-like stress paradigm did not affect many behavioral indices, it did cause condition-dependent and limited behavioral changes. This suggests that the paradigm may serve as a novel model for capturing psychological and context-dependent social stress, which differs from conventional physical stress models. Elucidating the neural basis of this paradigm is expected to contribute to the understanding of how social comparison affects mental health in modern society.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221612026Adolescent envy-like social comparison stress induces HPA axis hypoactivity and anxiety in female mice: implications for somatic symptom disorder15771ENHiroshiUenoDepartment of Medical Technology, Kawasaki University of Medical WelfareYoshihiroTanakaDepartment of Psychiatry, Kawasaki Medical SchoolErikoKitanoDepartment of Psychiatry, Kawasaki Medical SchoolYuTakahashiDepartment of Psychiatry, Kawasaki Medical SchoolSachikoMoriDepartment of Psychiatry, Kawasaki Medical SchoolShinjiMurakamiDepartment of Psychiatry, Kawasaki Medical SchoolKentaWaniDepartment of Psychiatry, Kawasaki Medical SchoolYosukeMatsumotoDepartment of Neuropsychiatry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMotoiOkamotoDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversityTakeshiIshiharaDepartment of Psychiatry, Kawasaki Medical SchoolAdolescence is a critical developmental window marked by heightened neuroplasticity and maturation of the stress response system, conferring vulnerability to psychosocial stress. Chronic stress during this period increases the risk of anxiety and depressive disorders and may contribute to somatic symptom disorder (SSD), which is characterized by medically unexplained physical complaints and shows a striking female predominance. The impact of envy-like stress arising from social comparison, a pervasive psychosocial factor in modern society, remains poorly understood. Male and female C57BL/6N mice were exposed to chronic envy-like stress from postnatal day (P)21 to P52 by housing them adjacent to enriched cages, while control mice were housed without such exposure. From P52 onward, mice underwent behavioral testing of anxiety-like behavior, exploratory activity, social interaction, spatial working memory, motor coordination, nociception, and depression-like behavior. Serum corticosterone and adrenocorticotropic hormone (ACTH) concentrations were measured to assess hypothalamic–pituitary–adrenal (HPA) axis function. Envy-like stress induced sex-specific phenotypes. Male mice exhibited hyperactivity, reduced social interaction, and impaired spatial working memory. In contrast, female mice displayed robust increases in anxiety-like behavior, impaired motor coordination, and significant reductions in basal corticosterone and ACTH levels. Chronic envy-like stress during adolescence elicits distinct, sex-dependent behavioral and endocrine alterations. The phenotype observed in female mice―characterized by heightened anxiety and lower basal HPA axis hormone levels―shares some biological features with clinical observations in SSD. This model may serve as a starting point for elucidating the mechanisms linking psychosocial stress and somatic symptoms in a sex-dependent manner.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2045-23221512025Post-weaning maternal presence exerts a protective effect against social isolation-induced behavioural alterations in mice44248ENHiroshiUenoDepartment of Medical Technology, Kawasaki University of Medical WelfareErikoKitanoDepartment of Psychiatry, Kawasaki Medical SchoolYuTakahashiDepartment of Psychiatry, Kawasaki Medical SchoolSachikoMoriDepartment of Psychiatry, Kawasaki Medical SchoolShinjiMurakamiDepartment of Psychiatry, Kawasaki Medical SchoolKentaWaniDepartment of Psychiatry, Kawasaki Medical SchoolYosukeMatsumotoDepartment of Neuropsychiatry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMotoiOkamotoDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversityTakeshiIshiharaDepartment of Psychiatry, Kawasaki Medical SchoolParental “watchful presence” is considered an important factor influencing behavioural and emotional development in offspring across mammalian species, including humans. However, the effects of such parental presence remain insufficiently understood, even in human studies. In laboratory mice, offspring are typically weaned at approximately three weeks of age, leaving the impact of post-weaning maternal presence on behavioural development largely unexplored. This study aimed to investigate whether maternal presence in an adjacent cage after weaning can attenuate behavioural effects of social isolation stress in mice. Furthermore, we sought to assess whether this experimental paradigm could serve as a novel animal model for studying the effects of parental watchful presence, with potential relevance to human parent–child relationship research. Mouse pups were weaned at postnatal day 21 and housed either adjacent to their mother (maternal presence group) or without maternal presence (control group). The pups were subsequently housed either in groups with littermates or individually until eight weeks of age. After maturation, behavioural tests were conducted to assess locomotor activity, anxiety-like behaviour, social behaviour, and depression-like behaviour. In group-housed mice, maternal presence did not influence behavioural outcomes. However, in individually housed mice, maternal presence partially attenuated social isolation-induced behavioural alterations, suggesting a subtle protective effect, including hyperlocomotion, reduced anxiety-like behaviour, and abnormal social interactions. Our findings demonstrate that maternal presence during the post-weaning period can offer a protective effect against certain behavioural abnormalities induced by social isolation stress in mice. This simple adjacent-cage paradigm provides a novel and practical model for elucidating the impact of parental watchful presence on behavioural and emotional development, offering insights relevant to the understanding of parent–child relationships in humans.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1341-96253162026Barriers and facilitators for online genetic care for hereditary cancer in Japan: findings from surveys of both clients and medical professionals10631074ENSayakaUenoDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYusakuUrakawaDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFuminoKatoArisaUekiDivision of Clinical Genetic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer ResearchKeikaKanekoDivision of Clinical Genetic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer ResearchKojiMatsumotoDivision of Clinical Genetics, Hyogo Cancer CenterHiromiSugawaraDivision of Clinical Genetics, Hyogo Cancer CenterSayokoTakeuchiDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReikoYoshidaDepartment of Medical Genetics and Genomics, Saitama Cancer CenterMihoKakutaCenter for Genomic Diagnosis, International University of Health and Welfare (IUHW) Narita HospitalKiwamuAkagiCenter for Genomic Diagnosis, International University of Health and Welfare (IUHW) Narita HospitalKazuoTamuraCenter for Genomic Diagnosis, International University of Health and Welfare (IUHW) Narita HospitalAkiraHirasawaDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground Online genetic care can offer a promising solution to the shortage of qualified medical professionals in genetic medicine, which leads to regional disparities in access. However, despite global adoption, its use in Japan remains limited.<br>
Methods Two questionnaire surveys were conducted to investigate potential needs and barriers regarding online genetic care: one involving 858 medical professionals (738 physicians and 120 genetic counselors or nurses), and the other involving 443 clients who received in-person genetic counseling.<br>
Results Only 14.0% of the medical professionals had experience with online genetic care, although 85.9% of the professionals engaged in cancer genetics were willing to consider providing it in the future. Notably, a discrepancy was found regarding hospital selection: clients prioritized access to specialized medical care, whereas professionals assumed clients valued accessibility for family members. Professionals expressed greater concerns about adequacy of online communication, client environments and internet security. Among clients, 89.1% estimated they would sufficiently understand and accept total content of counseling session if were conducted online. Older age and infrequent internet use were associated with lower acceptance and higher anxiety regarding online methods. Concerns about ability to use the necessary technology affected clients’ willingness to encourage online care for their relatives.<br>
Conclusion Online genetic care shows high potential for client acceptance and can effectively address regional disparities in Japan. To bridge the gap between client needs and professional perceptions and to overcome the digital divide, it is necessary to develop secure, accessible systems and provide education for both patients and healthcare providers.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0006-291X8272026Staphylococcus aureus activates dendrite elongation in dendritic cells154001ENKaiKobataGraduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityKazuyukiFurutaGraduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityYukiIkeyaGraduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityYoheiChishakiGraduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityKazuyaIshikawaGraduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityChikaraKaitoGraduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityDendritic cells (DCs) are thought to extend dendrites to enhance the efficiency of antigen uptake and presentation. We previously reported that short-chain fatty acids (SCFAs), such as butyrate and valerate, promote dendrite extension in DCs. In this study, we found that the human pathogen Staphylococcus aureus also induces dendrite extension in DCs and investigated the underlying mechanisms. Dendrite extension in DC2.4 cells was induced not only by live S. aureus but also by heat-killed bacteria and purified peptidoglycan (PGN). DC2.4 cells lacking TLR2 or its adaptor protein MyD88 extend dendrites in response to SCFAs, but failed to extend dendrites in response to S. aureus. Furthermore, inhibitors of ERK, PI3K, and Cdc42 suppressed dendrite extension triggered by S. aureus. Co-stimulation with S. aureus and butyrate enhanced dendrite extension beyond either stimulus alone. DC2.4 cells co-stimulated with S. aureus and butyrate also showed increased uptake of insoluble beads and, upon co-culture with T cells, induced elevated production of IL-17 and IL-10 by T cells. Collectively, these findings suggest that S. aureus activates ERK/PI3K/Cdc42 signaling through TLR2 recognition of PGN to drive dendrite extension in DCs. In addition, S. aureus promotes dendrite extension in DCs via a pathway distinct from that of SCFAs, thereby acting cooperatively with SCFAs to enhance immune responses.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0916-70054322026Machine learning prediction of the Madden–Julian oscillation using reservoir computing25ENTamakiSuematsuRIKEN Center for Computational ScienceKengoNakaiGraduate School of Environmental Life, Natural Science and Technology, Okayama UniversityTsuyoshiYonedaGraduate School of Economics, Hitotsubashi UniversityDaisukeTakasukaDepartment of Geophysics, Tohoku UniversityTakuyaJinnoGraduate School of Science, The University of TokyoYoshitakaSaikiGraduate School of Business Administration, Hitotsubashi UniversityHiroakiMiuraGraduate School of Science, The University of TokyoThe prediction of the Madden–Julian Oscillation (MJO), a massive tropical weather event with global socio-economic impacts, has been infamously difficult with physics-based weather prediction models. We employ the reservoir computing, a brain-inspired machine-learning technique, to construct a machine learning model that forecasts the real-time multivariate MJO index (RMM), a macroscopic variable that represents the state of the MJO. The training data was refined by development of a novel real-time band-pass filter that extracts the recurrency of MJO signals only from the past raw atmospheric data, and by selection of a suitable time-delay coordinate of the RMM that enhances the recurrency of the input data. The constructed model demonstrated the skill to forecast the time sequence of the RMM for a month from pre-developmental stages of the MJO. Examination of best-performing cases suggested that RMM sequences may be predicted for over two months in some cases. These results imply that inherent predictability limit of the MJO is longer than that has been estimated from physics-based weather prediction models.No potential conflict of interest relevant to this article was reported.Ovid Technologies (Wolters Kluwer Health)Acta Medica Okayama0090-34935462026Institutional Variability in Brain-Dead Organ Donation Processes and Practices: A Multicenter Cohort Study13191328ENTetsuyaYumotoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityHiromichiNaitoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityMinejiHayakawaDepartment of Emergency Medicine, Hokkaido University HospitalShojiYokoboriDepartment of Emergency and Critical Care Medicine, Nippon Medical SchoolKeiNishiyamaDivision of Emergency and Critical Care Medicine, Niigata University Graduate School of Medical and Dental ScienceTakahiroAtsumiDepartment of Emergency and Disaster Medicine, Hamamatsu University School of MedicineOsamuTasakiAcute and Critical Care Center, Nagasaki University HospitalJunyaTsurukiriEmergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical CenterMarikoHayamizuDepartment of Emergency Medicine, Hokkaido University HospitalShimonMurahashiAcute and Critical Care Center, Nagasaki University HospitalMunehiroHayashiDepartment of Emergency and Critical Care Medicine, Japanese Red Cross Medical CenterTakeshiNishimuraDepartment of Emergency and Critical Care Medicine, Hyogo Emergency Medical CenterYukariGotoDepartment of Emergency Medicine, Nagoya Ekisaikai HospitalHiromichiNarumiyaDepartment of Emergency and Critical Care Medicine, Japanese Red Cross Kyoto Daini HospitalAtsushiMizutaniDepartment of Emergency Medicine, Hamamatsu Medical CenterMamoruMiyajimaEmergency and Critical Care Center, Nagaoka Red Cross HospitalJunyaShimazakiDepartment of Emergency and Critical Care Medicine, Kansai Medical University Medical CenterTakeshiMiuraDepartment of Emergency and Critical Care Medicine, Institute of Medicine, University of Tsukuba HospitalNozomuShimaDepartment of Emergency and Critical Care Medicine, Wakayama Medical UniversityKazukiDeuchiDivision of Emergency and Critical Care Medicine, Niigata University Graduate School of Medical and Dental ScienceHitomiNakayasuEmergency and Critical Care Medicine, Seirei Hamamatsu General HospitalHitoshiKanoDepartment of Emergency and Critical Care Medicine, Nippon Medical SchoolTakashiYorifujiDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityJapan Comprehensive Process for End-of-Life Care and Organ Donation after Brain Death (J-RESPECT) study groupOBJECTIVES: To determine whether key institutional and clinical differences exist between highly and moderately active hospitals in Japan with respect to brain-dead organ donation practices.<br>
DESIGN: Retrospective multicenter cohort study.<br>
SETTING: Sixteen tertiary emergency and critical care centers across Japan.<br>
PATIENTS: All brain-dead organ donors from participating institutions who had at least one organ procured and transplanted between July 17, 2010, and December 31, 2023. Hospitals were categorized as highly active (≥ 14 donations) or moderately active (≤ 13 donations) during the study period.<br>
INTERVENTIONS: None.<br>
MEASUREMENTS AND MAIN RESULTS: Institutional donation practices were compared, including donor management strategies, use of vasopressors and corticosteroids, time intervals in the donation process, and frequency of multidisciplinary team meetings. A total of 204 donors were included; the median age was 47 years (interquartile range, 37–56), and 92 (45.1%) were female. Donor characteristics were similar between groups. Vasopressin was used in nearly all donors, though dosing protocols varied. Corticosteroid use was significantly higher in highly active hospitals compared with moderately active ones (58.3% vs. 38.0%; p = 0.004). Time from admission to coordinator notification was similar; however, time to family consent (median, 8 vs. 5 d; p < 0.001) and time to organ procurement (median, 12 vs. 9 d; p = 0.006) were longer in highly active hospitals. These hospitals also conducted more multidisciplinary meetings during donor management (median, 2 vs. 0; p < 0.001).<br>
CONCLUSIONS: Highly active hospitals demonstrated more intensive donor management practices, longer timeframes for key donation steps, and greater multidisciplinary engagement. Standardization of donation practices may enhance efficiency and support broader dissemination of effective institutional strategies to improve brain-dead organ donation rates in Japan.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0378-38202882026Hydrogen-lean two-stage upgrading of highly acidic palm acid oil via decoupled acid reduction and deoxygenation108478ENHirofumiNogeGraduate school of education, Okayama universityChiyuNakanoDepartment of comprehensive technical solutions, Okayama UniversityYoshieUenoDepartment of Food and Nutrition, Faculty of Home Economics, Kyoto Women's UniversityWira JazairYahyaInstitute for Sustainable Transport HICoE, University Teknologi MalaysiaHasannuddinAbd KadirFaculty of Mechanical Engineering, Universiti Teknologi MARASachiMasunagaDepartment of comprehensive technical solutions, Okayama UniversityUpgrading highly acidic waste lipids into liquid hydrocarbons under limited hydrogen availability remains challenging due to catalyst deactivation, excessive cracking, and poor process stability. Palm acid oil (PAO), characterized by extremely high free fatty acid content, represents a particularly demanding feedstock. This study proposes a hydrogen-lean two-stage upgrading strategy that decouples acid value (AV) reduction from hydrocarbon formation through staged reactor operation. In the first stage, batch pretreatment under low hydrogen pressure (initial 0.1 MPa) enabled rapid apparent AV reduction. However, increasing temperature promoted thermally driven degradation, highlighting intrinsic limitations of single-stage severity intensification. Methanol-assisted pretreatment further decreased AV mainly through esterification and formation of oxygenated intermediates. In the second stage, hydrogen-free fixed-bed upgrading over oxide-based catalysts exhibited a distinct operating window near 365 °C, where stable condensed liquid recoveries of 50–60 wt% were obtained. Deoxygenation proceeded predominantly via decarbonylation/decarboxylation pathways. Among the catalysts investigated, ZrO₂–Co showed superior stability and lower residual AV. Overall, reactor staging enabled AV reductions exceeding 90% within 1.5–2 h while maintaining stable liquid recovery, demonstrating an effective upgrading strategy for highly acidic waste lipids under hydrogen-lean conditions.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2730-71822612026Revised taxonomy reveals sustained introgression and secondary contact in ancient lake ricefishes46ENYukiYashimaTropical Biosphere Research Center, University of the RyukyusAndy B.NofriantoTropical Biosphere Research Center, University of the RyukyusHandungNuryadiTropical Biosphere Research Center, University of the RyukyusRyoKakiokaDepartment of Applied Aquabiology, National Fisheries UniversityHirozumiKobayashiThe Natural History Museum and InstituteSatoshiAnsaiUshimado Marine Institute, Okayama UniversityIxchel F.MandagiFaculty of Fisheries and Marine Science, Sam Ratulangi UniversityKawilarang W. A.MasengiFaculty of Fisheries and Marine Science, Sam Ratulangi UniversitySjamsu A.LawelleFaculty of Fisheries and Marine Science, Halu Oleo UniversityAtsushi J.NaganoBioscience and Biotechnology Center, Nagoya UniversityJunkoKusumiFaculty of Social and Cultural Studies, Kyushu UniversityKazunoriYamahiraTropical Biosphere Research Center, University of the RyukyusBackground Biotic diversification in ancient lakes is shaped by complex geological histories and genetic exchange among populations. The Malili Lake system on Sulawesi Island represents a classic natural laboratory for studying freshwater fish evolution and harbors multiple endemic Oryzias species that diversified under repeated hydrological reorganizations. Previous genomic analyses inferred that two sympatric species in Lake Towuti (O. profundicola and O. loxolepis) experienced a single ancient introgression event from a “ghost lineage” derived from O. marmoratus inhabiting another lake. However, recent taxonomic re-evaluation has revealed the presence of an extant O. marmoratus population within Lake Towuti itself. This finding suggests that the putative ghost lineage may in fact represent a living population co-occurring in the lake, calling for a re-examination of the introgression history and speciation mode in Lake Towuti.<br>
Results By incorporating newly generated ddRAD-seq data from the true O. marmoratus in Lake Towuti, we reanalyzed phylogenetic relationships and population genetic structure among Malili Lake Oryzias. Previously reported major phylogenetic relationships and inter-lake introgression patterns were largely reproduced. In contrast, TreeMix and f4-statistic analyses revealed that introgression signals previously attributed to a “ghost lineage” into O. profundicola and O. loxolepis instead originated from the extant O. marmoratus population coexisting within Lake Towuti. Demographic model comparisons explicitly incorporating within-lake gene flow further supported a scenario in which O. profundicola and O. loxolepis diverged in allopatry, subsequently came into secondary contact within Lake Towuti, and later experienced additional gene flow following secondary contact with O. marmoratus that entered the lake.<br>
Conclusion Our results demonstrate that introgression from the O. marmoratus lineage into O. profundicola and O. loxolepis was not a single ancient event, but rather a more sustained process. This finding highlights the critical importance of taxonomic resolution for accurately inferring introgression and divergence history. Comparative studies across other ancient lakes on Sulawesi will be valuable for understanding how the timing and nature of gene flow from third lineages influence patterns of population divergence and the strength of reproductive isolation.No potential conflict of interest relevant to this article was reported.Pharmaceutical Society of JapanActa Medica Okayama0918-61584932026Bortezomib Induces Apoptosis via Upregulation of Abhd4 in Peripheral Nerve Cells496 502ENYusukeKonishiDepartment of Pharmacy, Kobe University HospitalTomohiroOmuraDepartment of Pharmacy, Kobe University HospitalTakeshiIjichiDepartment of Pharmacy, Kobe University HospitalHirokiNishiguchiDepartment of Pharmacy, Kobe University HospitalRyunosukeHayakawaEducation and Research Center for Clinical Pharmacy, Kobe Pharmaceutical UniversityYumiKitahiroDepartment of Pharmacy, Kobe University HospitalKotaroItoharaDepartment of Pharmacy, Kobe University HospitalKazuhiroYamamotoDepartment of Integrated Clinical and Basic Pharmaceutical Sciences, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityIkukoYanoDepartment of Pharmacy, Kobe University HospitalBortezomib, a first-in-class proteasome inhibitor, is widely used to treat multiple myeloma and other hematological malignancies. Despite its therapeutic efficacy, bortezomib causes peripheral neuropathy (PN) in approximately 20–30% of patients, often leading to dose reduction or discontinuation. Preventive or therapeutic approaches to bortezomib-induced PN are currently unavailable, as its precise mechanism remains unclear. In this study, we compared the effects of bortezomib and the second-generation proteasome inhibitor carfilzomib on peripheral nerve cells to identify candidate molecules involved in PN development. Transcriptome profiling of differentiated F11 cells, a hybridoma of a rat embryonic dorsal root ganglion and mouse neuroblastoma cell line N18TG2, revealed that bortezomib selectively upregulated α/β-hydrolase containing domain 4 (Abhd4), whereas carfilzomib did not. This finding was confirmed by quantitative RT-PCR and immunoblotting, which demonstrated consistent increases in Abhd4 mRNA and protein levels following bortezomib treatment. Functional analysis further revealed that Abhd4 overexpression promoted early apoptosis, suggesting a mechanistic link between bortezomib-induced Abhd4 elevation and neuronal vulnerability. Therefore, these results suggest that Abhd4 represents a candidate molecular signature associated with bortezomib-induced PN. Although further in vivo validation is needed, these findings warrant further investigation of Abhd4 as a potential contributor to bortezomib-induced PN.No potential conflict of interest relevant to this article was reported.Japan Medical AssociationActa Medica Okayama2433-3298932026Post Hoc Analysis of Frailty and Tracheostomy Risk in Older Patients Intubated and in an Intensive Care Unit in Japan: An Inverse Association in Older Patients with Advanced Age643650ENTakehideUmedaTakashiHongoMototakaInabaHiromichiNaitoYoshinoriAriyasuTakashiYorifujiIntroduction: This post hoc analysis of a prospectively collected intensive care unit (ICU) cohort examined the association between frailty and the likelihood of tracheostomy in older Japanese patients (aged ≥65 years). Frailty, a condition of increased vulnerability to stressors, is common among older patients in the ICU and may influence clinical decision-making and outcomes. We aimed to explore whether baseline frailty is associated with the likelihood of receiving tracheostomy in older patients in the ICUs.<br>
Methods: We analyzed data from a multicenter prospective study conducted from November 2019 to April 2020 at 17 hospitals in Japan. Patients aged ≥65 years, admitted directly from the emergency department, and requiring mechanical ventilation, were included. After excluding early deaths (≤5 days) or treatment-limit cases, 363 patients with intubation remained. Frailty was assessed using the Clinical Frailty Scale (CFS), with primary cutoff CFS ≥4. The primary outcome was the occurrence of tracheostomy during ICU stay. Risk ratios (RRs) and 95% confidence intervals (CIs) were estimated using generalized linear models with a Poisson distribution, adjusted for age, sex, Charlson Comorbidity Index, and Acute Physiology and Chronic Health Evaluation II score.<br>
Results: Among 363 patients, patients with frailty (CFS ≥4) had a significantly lower adjusted risk of having tracheostomy than did those with less frailty (CFS <4) (adjusted RR: 0.40; 95% CI: 0.27-0.61). In patients aged ≥75 years, the adjusted RR for CFS ≥4 was 0.32 (95% CI: 0.20-0.50), indicating a pronounced reduction in tracheostomy use among patients with frailty.<br>
Conclusions: Frailty (CFS ≥4) was independently associated with a lower likelihood of tracheostomy, particularly in patients aged ≥75 years.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1341-80765252026Survey to Document the Adverse Reactions After Human Papillomavirus Vaccination Among Japanese Female Youth at a Universitye70314ENChigusaHiguchiEducational and Research Management Field, Health Management Department, Okayama UniversityChikakoOgawaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of MedicineYoshiakiIwasaki1Educational and Research Management Field, Health Management Department, Okayama UniversityHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalHisashiMasuyamaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of MedicineAim: Concerns about possible adverse events remain a critical barrier in implementing human papillomavirus (HPV) vaccination among Japanese youth. This study aimed to understand the time course of adverse events experienced by HPV vaccine recipients.<br>
Methods: An online questionnaire survey was given to students, faculty, and staff aged 18–26 years, at Okayama University Hospital, who received the HPV vaccine. The survey gathered information on the number of HPV vaccine doses received, prevaccination health conditions, adverse reactions within 2 h and between 2 h and 7 days postvaccination, menstrual irregularities after vaccination, reasons for getting vaccinated, feelings before and after vaccination, and factors providing reassurance during vaccination. Prevalence of symptoms was expressed as numbers and percentages, and analyses were performed using Chi-squared or Fisher's exact tests.<br>
Results: Responses were obtained from 299 participants, yielding a 75% response rate. Approximately 60% participants reported local pain, 30% swelling, and 4% fever. Most symptoms resolved on the vaccination day itself or the following day, although some persisted for 3–7 days. Over 80% participants rated their pain between 0 and 3 on numerical rating scale of 0–10. While 60% experienced anxiety before vaccination, 90% reported no anxiety afterward.<br>
Conclusions: Our study presents one of the first comprehensive accounts of post-HPV vaccination adverse events and their time course, and underpins the importance of disseminating detailed information about vaccine-associated adverse reactions to encourage greater vaccine uptake.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1615-4150368122026Synthesis of Aromatic Aldehydes by C─H Formylation of Aromatics with Silyl Formates Prepared from CO2 and Hydrosilanese70571ENNatsumiNittaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKeiHirokawaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversitySoSaibaraGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityBikash DevNathGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityKazutoTakaishiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTadashiEmaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityDespite the recent remarkable progress in CO2 fixation reactions, the methods for the synthesis of aldehydes from CO2 are quite limited partly because of the lability of the resulting formyl group and difficulty in the controlled deoxygenative CO2 conversions leading to C─H and C─C bond formation. Here, we have developed the direct C─H formylation of electron-rich aromatics using silyl formates, prepared from CO2 and hydrosilanes, in the presence of BCl3 or BBr3. This is the first report on the direct C─H formylation of aromatics with silyl formates. Useful compounds including a biologically active compound and octaethylporphyrin were synthesized by fixing one to four CO2 molecules in a stepwise manner. DFT calculations have been done to elucidate the reaction mechanism including a dual role of BBr3 in the activation of silyl formate, HCO2SiMe2Ph, and electrophilic aromatic substitution.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1432-08517542026Immunological effects of amivantamab in EGFR or MET-expressing non-small cell lung cancer121ENRyoYoshichikaDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityFumiakiMukoharaDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKotaroYamadaDepartment of Respiratory Medicine, Okayama University HospitalJojiNagasakiDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHirokoWatanabeDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoukiUedaDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKenSuzawaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama UniversityKazuhikoShienDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama UniversityShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama UniversityTakamasaIshinoDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYosukeTogashiDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground Epidermal growth factor receptor (EGFR) mutations represent one of the most frequent oncogenic driver in non-small cell lung cancer (NSCLC). Amivantamab, a bispecific antibody targeting EGFR and MET proto-oncogene, receptor tyrosine kinase (MET), has demonstrated clinical benefit in EGFR-mutant NSCLC through dual blockade, but its immunological role in human clinical specimens, especially tumor-infiltrating lymphocytes (TILs), has not been directly evaluated.<br>
Methods We analyzed surgically resected tumor samples from 40 patients with NSCLC to investigate immune responses and their associations with EGFR and MET expression. TILs were characterized by flow cytometry (FCM) and immunohistochemistry (IHC). To assess the immunomodulatory potential of amivantamab, fresh tumor digests containing live tumor cells and TILs were cultured ex vivo with CD3 and CD28 stimulation in the absence or presence of amivantamab, followed by FCM. EGFR and MET expression were also evaluated by IHC.<br>
Results EGFR mutations and high EGFR protein expression were associated with a trend toward reduced CD8⁺ T-cell and dendritic cell (DC) infiltration. In ex vivo TIL assays, exposure to amivantamab significantly activated CD8⁺ T cells, such as programmed cell death-1 expression and cytokine production, and promoted DC maturation. These effects were most pronounced in tumors with high EGFR or MET protein expression rather than EGFR mutations.<br>
Conclusions This study provides the first direct evidence from ex vivo fresh TIL assays using human NSCLC clinical specimens that amivantamab can activate immune responses. EGFR and MET expression may serve as potential biomarkers for amivantamab-induced immune responses.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2666-3643732026Potential Immune Microenvironment Biomarkers in SCLC: J-TAIL-2 Observational Study100926ENMasayukiShirasawaDepartment of Thoracic Oncology, National Cancer Center HospitalMakotoNishioDepartment of Thoracic Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchKadoakiOhashiDepartment of Respiratory Medicine, Okayama University HospitalAtsushiOsoegawaDepartment of Thoracic and Breast Surgery, Oita University Faculty of MedicineEikiKikuchiDepartment of Respiratory Medicine, Faculty of Medicine, Hokkaido UniversityHideharuKimuraDepartment of Respiratory Medicine, Kanazawa University HospitalYasushiGotoDepartment of Thoracic Oncology, National Cancer Center HospitalJunichiShimizuDepartment of Thoracic Oncology, Aichi Cancer Center HospitalEisakuMiyauchiDepartment of Respiratory Medicine, Tohoku University HospitalHiroshigeYoshiokaDepartment of Thoracic Oncology, Kansai Medical UniversityIchiroYoshinoInternational University of Health and Welfare Narita HospitalToshihiroMisumiDepartment of Data Science, National Cancer Center Hospital EastYasushiYatabeDepartment of Diagnostic Pathology, National Cancer Center HospitalTatsuyaYoshidaDepartment of Thoracic Oncology, National Cancer Center HospitalJumpeiKashimaDepartment of Diagnostic Pathology, National Cancer Center HospitalMasahideOkiDepartment of Respiratory Medicine, NHO Nagoya Medical CenterHisaoAshimuraChugai Pharmaceutical Co., Ltd.YukiKobayashiChugai Pharmaceutical Co., Ltd.MisaTanakaChugai Pharmaceutical Co., Ltd.AkihikoGemmaNippon Medical SchoolIntroduction: Effective predictors of response to atezolizumab plus carboplatin/etoposide (CE) therapy in extensive-stage SCLC (ES-SCLC) remain limited. This exploratory analysis from J-TAIL-2 aimed to identify markers of survival benefit with atezolizumab plus CE therapy in ES-SCLC.<br>
Methods: J-TAIL-2 (ClinicalTrials.gov ID, NCT04501497) was a multicenter observational study that enrolled patients receiving atezolizumab plus CE (ES-SCLC cohort) in clinical practice in Japan per local label and treatment guidelines. In this exploratory analysis, the association of CD8+ tumor-infiltrating lymphocyte (TIL) density and SCLC subtypes (SCLC-A [ASCL1 dominant], SCLC-N [NEUROD1 dominant], SCLC-P [ASCL1/NEUROD1 double-negative with POU2F3 expression], and SCLC-O [ASCL1/NEUROD1 double-negative not otherwise specified]) with overall survival (OS) and progression-free survival (PFS) was evaluated. SCLC subtyping was performed by immunohistochemistry.<br>
Results: SCLC samples (n = 100; data cutoff, February 3, 2023) were categorized as SCLC-A (73%), SCLC-N (16%), SCLC-P (8%), and SCLC-O (3%). Among 96 patients who received first-line atezolizumab plus CE, median age was 72 (range, 39–87) years and 81% were male. Furthermore, 56 patients were classified into the CD8+ TIL-high subgroup and 40 into the TIL-low subgroup. Median (m)PFS with atezolizumab plus CE was 6.1 months (95% confidence interval [CI]: 4.5–7.5) in the TIL-high versus 4.4 months (95% CI: 4.0–5.1) in the TIL-low subgroup (p = 0.01); mOS was 18.4 (95% CI: 11.8–not estimable) versus 10.8 months (95% CI: 7.7–16.2; p = 0.04). mOS and mPFS were not significantly different between SCLC subtypes but were numerically shorter in the SCLC-N group.<br>
Conclusions: CD8+ TIL density is a potential biomarker of clinical benefit in ES-SCLC and may facilitate patient selection for atezolizumab combination therapy.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1865-13801912026Pseudoaneurysm of the thoracoacromial artery associated with habitual shoulder dislocation: a case report139ENHonokaWadaDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityAyaHamasakiDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversitySoichiroOkamotoDepartment of Radiology, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityShunkiYamamotoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTsuyoshiNojimaDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTetsuyaYumotoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityBackground Shoulder dislocation is one of the most common joint dislocations encountered in emergency departments, but vascular complications are rare and often underrecognized. Pseudoaneurysms of the thoracoacromial artery, a branch of the axillary artery, are extremely uncommon and may present with subtle symptoms, delaying diagnosis.<br>
Case presentation An 82-year-old woman with a history of habitual anterior shoulder dislocation presented with a 10-day history of progressive pain and swelling in the left shoulder. She was on edoxaban for atrial fibrillation. Examination revealed localized tenderness and swelling without neurological deficits. Computed tomography angiography showed a 30 × 35 × 35 mm pseudoaneurysm arising from the acromial branch of the thoracoacromial artery. Endovascular embolization was performed using a proximal oxidized regenerated cellulose sheet placement followed by injection of N-butyl cyanoacrylate and Lipiodol due to the risk of coil migration into the joint space. The procedure achieved complete exclusion of the lesion. At three-month follow-up, the patient remained asymptomatic with preserved left upper limb function. Computed tomography angiography demonstrated the pseudoaneurysm remains excluded.<br>
Conclusion Although rare, pseudoaneurysms of the thoracoacromial artery can occur after repeated shoulder dislocation and reduction, especially in elderly patients on anticoagulation therapy. Early recognition through imaging and prompt endovascular intervention can prevent serious vascular and neurological complications.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1471-24582612026Community health worker-supported oral health promotion in low- and middle-income countries: a scoping review of roles, interventions, and outcomes1612ENJunkoYasuokaDivision of Global Health Sciences, Graduate School of Public Health, St. Luke’s International UniversityShunsukeOkadaDepartment of Oral and Maxillofacial Radiology, Medical Development Field, Okayama UniversityYoheiTakeshitaDepartment of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground Oral diseases are among the most prevalent conditions worldwide and disproportionately affect populations in low- and middle-income countries (LMICs). The shortage and maldistribution of the oral health workforce have widened inequalities in prevention and treatment. Task-sharing through community health workers (CHWs) has been promoted as a cost-effective and sustainable strategy for extending services to underserved populations; however, evidence on their roles in oral health promotion in LMICs remains fragmented. This scoping review mapped evidence on CHW-supported oral health promotion and identified common roles, interventions, and system-level challenges.<br>
Methods A comprehensive search was conducted in PubMed, CINAHL, CENTRAL, and Google Scholar, using keywords and MeSH terms related to “community health workers,” “oral health,” and LMICs, based on the EPOC LMIC filter of the World Bank’s classifications. No publication date restrictions were applied, and gray literature was included. The review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews and was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Data were charted on CHW characteristics, roles, target populations, oral conditions addressed, and implementation challenges, and synthesized narratively. This protocol was registered on Open Science Forum (https://doi.org/10.17605/OSF.IO/NZPHA).<br>
Results Thirty-two studies from 11 LMICs were included, approximately half from India. The evidence mapped a wide range of CHW roles and interventions, most commonly focusing on oral cancer screening, followed by dental caries prevention and periodontal care. CHWs were involved in home visits, education, screening, basic treatment, and referrals. Some programs integrate mobile health (mHealth) tools for remote diagnosis. System-level challenges were variably reported across settings, including inadequate infrastructure, fragmented referral systems, limited supervision, and constrained career development opportunities for CHWs.<br>
Conclusions This scoping review highlights the contributions of CHWs to oral health promotion in LMICs, while underscoring health system and workforce constraints. The available evidence is largely descriptive, suggesting the need for strengthened training, supervision, referral linkages, and career development to support CHWs’ integration into oral health services. Family-centered and Continuum of Care approaches warrant further exploration to inform equitable and sustainable oral health within primary health care systems.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2227-739014122026Toward Convergence in Multi-Agent Reinforcement Learning: Best-Response Space Shrinking as a Sufficient Condition2134ENNatchanonManatphaiboonGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityAkitoMondenGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityZeynepYücelDepartment of Environmental Sciences, Informatics and Statistics, Ca’Foscari University of VeniceWe study convergence in multi-agent reinforcement learning (MARL) through the lens of sufficient conditions, using a single-point-of-failure analysis applied to multi-agent policy iteration integrated with linear programming (MAPI-LP), where results are proven for pure coordination games, and extension to broader settings is conjectured. We identify two sufficient conditions for convergence to Markov Perfect Equilibrium (MPE). The first is stability in best-response space that emerges from value monotonicity. The second, monotonic best-response space shrinking (MBRSS), is a novel condition requiring that each agent’s best-response space contracts monotonically across iterations until it collapses to a stable space. Furthermore, we show that MBRSS does not necessarily imply monotonic improvement in this setting. However, value monotonicity and stability in best-response space imply each other when a complementary condition is applied. Building on this hierarchical relationship, we propose conjectures on sufficient condition relationships in both serial and parallel MARL. In addition, we propose conjectures on generalized MBRSS to arbitrary finite repeated games and validation of stability in best-response space. We further discuss connections between MBRSS and existing related frameworks, and outline directions toward a taxonomy of sufficient conditions for MARL convergence.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1422-00672722026Possible Involvement of Hypothalamic Dysfunction in Long COVID Patients Characterized by Delayed Response to Gonadotropin-Releasing Hormone832ENYukiOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiakiSoejimaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsuhitoSuyamaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyosukeTakaseDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiOguniDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoheiMasudaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeOmuraDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasueSakuradaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuiMatsudaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToruHasegawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiHondaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazukiTokumasuDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeigoUedaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesLong COVID (LC) may involve endocrine dysfunction; however, the underlying mechanism remains unclear. To examine hypothalamic–pituitary responses in patients with LC, we conducted a single-center retrospective study of patients with refractory LC referred to our University Hospital who underwent anterior pituitary stimulation tests. Between February 2021 and November 2025, 1251 patients with long COVID were evaluated, of whom 207 (19%) had relatively low random ACTH or cortisol levels. Ultimately, 16 underwent anterior pituitary stimulation tests and were included. All tests were performed in an inpatient setting without exogenous steroids. Fifteen patients (six women, mean age 35.6 years) underwent corticotropin-releasing hormone (CRH), thyrotropin-releasing hormone (TRH), and gonadotropin-releasing hormone (GnRH) tests. All patients had mild acute COVID-19, eight had ≥2 vaccinations, and the mean interval from infection was 343 days. Frequent symptoms included fatigue (100%), insomnia (66.7%), headache (60.0%), anorexia/nausea (40.0%), and brain fog (40.0%). Mean early-morning cortisol and 24 h urinary free cortisol were 7.5 μg/dL and 41.0 μg/day, respectively. MRI showed an empty sella in one case. Peak hormonal responses were preserved (ΔACTH 247%, ΔTSH 918%, ΔPRL 820%, ΔFSH 187%, ΔLH 1150%); however, peaks were delayed beyond 60 min in ACTH (13%), LH (33%), and FSH (87%). Notably, significantly delayed elevations remained at 120 min in the responses of TSH (4.1-fold), PRL (1.8-fold), LH (9.3-fold), and FSH (2.8-fold), suggesting possible hypothalamic involvement, particularly in the gonadotropin responses. Additionally, serum IGF-I was lowered (−0.70 SD), while GH response (mean peak 35.5 ng/mL) was preserved by growth hormone-releasing peptide (GHRP)-2 stimulation. Low-dose hydrocortisone and testosterone were initiated for three patients. Although direct viral effects and secondary suppression have been proposed, our findings may suggest that, at least in part, the observed response characteristics are consistent with functional secondary hypothalamic dysfunction rather than irreversible primary injury. These findings highlight the need for objective endocrine evaluation before initiating hormone replacements.No potential conflict of interest relevant to this article was reported.American Association for Cancer Research (AACR)Acta Medica Okayama2767-9764642026Constitutive EGFR Activation Induced by PTPRR Downregulation Confers Resistance to KRAS Inhibitors728 741ENHiroakiKanemuraDepartment of Medical Oncology, Kindai University Faculty of MedicineToshiyukiTakeharaDivision of Cell Biology for Regenerative Medicine, Institute of Advanced Clinical Medicine, Kindai University Faculty of MedicineOsamuMaenishiDepartment of Pathology, Kindai University Faculty of MedicineShutaTomidaCenter for Comprehensive Genomic Medicine, Okayama University HospitalNatsumiIwawakiDivision of Cell Biology for Regenerative Medicine, Institute of Advanced Clinical Medicine, Kindai University Faculty of MedicineKeiKunimasaDepartment of Thoracic Oncology, Osaka International Cancer InstituteTomohiroNakayamaDepartment of Medical Oncology, Kishiwada City HospitalSatomiWatanabeDepartment of Medical Oncology, Kishiwada City HospitalShinichiroSuzukiDepartment of Medical Oncology, Kindai University Faculty of MedicineKazukoSakaiDepartment of Genome Biology, Kindai University Faculty of MedicineKoichiAzumaDivision of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of MedicineKeitaKudoDepartment of Medical Oncology, National Hospital Organization Osaka Minami Medical CenterKazutoNishioDepartment of Genome Biology, Kindai University Faculty of MedicineKazuhikoNakagawaDepartment of Medical Oncology, Kindai University Faculty of MedicineHidetoshiHayashiDepartment of Medical Oncology, Kindai University Faculty of MedicineTakeshiTeramuraDivision of Cell Biology for Regenerative Medicine, Institute of Advanced Clinical Medicine, Kindai University Faculty of MedicineKimioYonesakaDepartment of Medical Oncology, Kindai University Faculty of MedicineKRASG12C inhibitors, such as sotorasib, show clinical efficacy for non–small cell lung cancer (NSCLC) positive for the G12C mutations of KRAS, but primary and acquired resistance to these drugs remains a clinical problem. In this study, we show that the development of resistance to sotorasib in KRASG12C-positive NSCLC cells was mediated by constitutive activation of EGFR resulting from downregulation of the protein tyrosine phosphatase receptor type R (PTPRR). PTPRR has been identified as a physiologic regulator of ERK signaling in several cancer types. In our study, PTPRR was demonstrated to bind directly to EGFR, facilitating its dephosphorylation on tyrosine residues. Resumption of PTPRR expression in the resistant cells attenuated EGFR phosphorylation and restored sotorasib sensitivity. PTPRR downregulation was associated with gene promoter hypermethylation in the sotorasib-resistant cells and NSCLC tissue samples. Furthermore, low PTPRR expression in tumor specimens was associated with shorter progression-free and overall survival for patients with NSCLC treated with sotorasib. In contrast to sotorasib, high PTPRR expression was associated with a poor response to EGFR tyrosine kinase inhibitors in EGFR-mutated NSCLC, suggesting that PTPRR may broadly regulate EGFR dependence in NSCLC. Finally, dual blockade of KRASG12C and EGFR showed a substantial antitumor effect in a xenograft model of sotorasib-resistant NSCLC. This approach is therefore a rational therapeutic strategy for KRASG12C-positive NSCLC, especially for tumors showing PTPRR downregulation.<br>
Significance: The current study shows that downregulation of PTPRR induces EGFR activation and resistance to KRASG12C inhibitors in NSCLC, suggesting dual KRAS-EGFR blockade as a rational therapy. PTPRR may help identify patient subgroups that would benefit from the addition of EGFR inhibitors to KRASG12C-targeted therapies.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2214-1804512026Highly sensitive detection of cancer cells using a voltage-tuned terahertz chemical microscope100972ENXueDingGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityYutoOhmiGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityJinWangGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityHirofumiInoueDepartment of Medical Support, Okayama University HospitalToshihikoKiwaGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTerahertz chemical microscopy (TCM) is a promising label-free technique for detecting biochemical interactions by monitoring changes in terahertz (THz) wave emission from semiconductor sensing plates. However, quantitative biological detection has been hindered by large plate-to-plate variations originating from uncontrolled depletion-layer electric fields formed during fabrication. These variations shift the response curve of THz amplitude and reduce reproducibility and sensitivity. Here, we introduce a voltage-tuned sensing plate that allows direct control of the depletion-layer electric field by applying a bias voltage to the Si layer of the sensing plate. This enables deliberate adjustment of surface potential and alignment of the THz response curve to the region of highest gain. Using lung adenocarcinoma cells (PC9) captured via AE1/AE3 antibodies targeting specific cell-surface antigens, we demonstrate that voltage tuning enhances detection sensitivity by up to 50-fold and restores linearity between THz amplitude and the logarithm of cell concentration, even in plates with negligible response at 0 V. These findings establish voltage control as a simple, universally applicable strategy to stabilize TCM performance, reduce fabrication-induced variability, and improve analytical sensitivity for biosensing and materials-analysis applications.No potential conflict of interest relevant to this article was reported.The Company of BiologistsActa Medica Okayama0022-094922922026Insulin-like peptide has antagonistic pleiotropic effects on male combat traits and survival traits in an armed beetlejeb251318ENTakumiKatoGraduate School of Science, Nagoya UniversityChihoYoshimineGraduate School of Science, Tokyo Metropolitan UniversityHarunaFujiokaGraduate School of Environmental, Natural Science and Technology, Okayama UniversityMasakoKatsukiGraduate School of Science, Nagoya UniversityKensukeOkadaGraduate School of Environmental, Natural Science and Technology, Okayama UniversityYasukazuOkadaGraduate School of Science, Nagoya UniversityThe expression of sexually selected traits, such as exaggerated weapons and ornaments, often entails trade-offs against life-history traits. While phenotypic trade-offs are well documented, the underlying molecular physiological mechanisms remain largely unexplored. In this study, we investigated the potential role of an insulin-like peptide, ILP2, in mediating the trade-off between sexually selected combat traits and survival traits in the broad-horned flour beetle, Gnatocerus cornutus. RNA interference (RNAi)-mediated knockdown (KD) of ILP2 during larval stages resulted in a reduction in the development of mandibular horns and overall body size. Interestingly, ILP2 KD males had increased lipid storage and enhanced starvation tolerance, indicating a shift in resource allocation from sexually selected traits to survival traits. Behaviorally, ILP2 KD males showed decreased locomotor activity and reduced aggression, leading to lower combat success. These findings suggest that ILP2 functions as a key mediator in the allocation of resources between combat and survival traits, highlighting its pleiotropic effects on morphology, metabolism and behavior. Our study provides novel insights into the molecular physiological mechanisms underlying life-history trade-offs associated with sexually selected traits.No potential conflict of interest relevant to this article was reported.Frontiers Media SAActa Medica Okayama2673-253X82026Development of a generative AI agent for family support in implementing family-based treatment for children and adolescents with anorexia nervosa1759690ENManaHanzawaDepartment of Pediatrics, Okayama University Hospital Medical Center for ChildrenJoeHaseiDepartment of Medical Informatics and Clinical Support Technology Development, Faculty of Medicine, Dentistry and Pharmaceutical SciencesAyumiOkadaDepartment of Pediatrics, Okayama University Hospital Medical Center for ChildrenChieTanakaDepartment of Pediatrics, Okayama University Hospital Medical Center for ChildrenYoshieShigeyasuDepartment of Pediatrics, Okayama University Hospital Medical Center for ChildrenChikakoFujiiDepartment of Pediatrics, Okayama University Hospital Medical Center for ChildrenMakikoHoriuchiClinical Psychology Section, Department of Medical Support, Okayama University HospitalAkikoSugiharaDepartment of Pediatrics, Okayama University Hospital Medical Center for ChildrenKoichiTakeuchiLife Natural Science and Technology, Graduate School of Environmental, Okayama UniversityRyuichiNakaharaDepartment of Musculoskeletal Health Promotion, Faculty of Medicine, Dentistry and Pharmaceutical SciencesHidekiKatayamaDepartment of Palliative and Supportive Care, Okayama University HospitalYasushiTakahashiNEC CorporationToshifumiOzakiDepartment of Orthopaedic Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHirokazuTsukaharaDepartment of Pediatrics, Okayama University Hospital Medical Center for ChildrenIntroduction: Family-based treatment (FBT) is a first-line psychotherapy for children and adolescents with anorexia nervosa (AN). However, families must understand the principles of FBT, provide meal support, and manage their children's pathological behaviors. Difficulties occur outside clinic hours when it is impossible to consult professionals. This “support gap” increases caregivers’ psychological distress and threatens their treatment continuity. To the best of our knowledge, this is the first domain-specific generative artificial intelligence (AI) agent designed to provide situation-specific, FBT-concordant advice and psychological support.<br>
Methods: The system integrates three components: (1) an FBT-specific knowledge base constructed from treatment manuals, family guides, guideline-compliant resources, and a clinical Q&A corpus; (2) a multistage natural language processing pipeline using Retrieval-Augmented Generation (RAG), with intent and sentiment analyses; and (3) safety guardrails that prohibit unsolicited numerical goals or direct hospitalization recommendations and standardized escalation to clinicians. When strong negative emotions are detected, empowerment messages are dynamically incorporated to maintain caregivers’ confidence. Six clinicians with expertise with pediatric mental health authored queries that simulated common FBT-related concerns and evaluated each response for clinical appropriateness and safety, and classified problems as information insufficiency, not FBT concordant, or escalation insufficiency.<br>
Results: Of the 477 queries, 57.0% were FBT-related, 24.5% were general AN, 16.5% were parental psychological distress, and 1.8% were related to other topics. The clinically appropriate response rate was 91.6% (437/477), including 92.3% for FBT-related questions, 88.0% for general knowledge, 93.7% for psychological distress, and 100.0% for other questions. Clinically inappropriate responses (8.4%) were mainly attributable to information insufficiency; not FBT concordant (1.8% of FBT-related responses) and escalation insufficiency (0.6% of all dialogs) rarely occurred.<br>
Discussion: In this expert review, the safety-gated RAG system predominantly generated FBT-concordant responses that provided meal-level guidance and empathic empowerment-oriented support to families. By proceduralizing complex FBT concepts and presenting multiple response options for pathological behaviors, the system translates FBT principles into practical guidance supporting refeeding adherence, preserving family self-efficacy, and suggesting that domain-specific AI may help bridge structural limitations in FBT. Usability studies and randomized controlled trials are warranted to determine their impact on caregiver burden, self-efficacy, treatment adherence, and clinical outcomes.No potential conflict of interest relevant to this article was reported.Royal Society of Chemistry (RSC)Acta Medica Okayama1477-92262026Unraveling the structural features of Dion–Jacobson-type layered perovskite-related material HCa2Nb3O10·1.5H2OENZihaoZhangFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityJunKanoFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityShuMoritaInstitute of Materials and Systems for Sustainability (IMaSS), Nagoya UniversityHiromuShimokawaGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityMinoruOsadaDepartment of Materials Chemistry and Institute of Materials and Systems for Sustainability (IMaSS), Nagoya UniversityHydrated layered oxides are widely encountered, yet the presence of disordered interlayer water often complicates crystal structure determination from laboratory X-ray diffraction. Here, we report the crystal structure of the Dion–Jacobson-type layered perovskite-related material HCa2Nb3O10·1.5H2O, solved from synchrotron X-ray diffraction data by combining direct methods in reciprocal space, Le Bail whole-pattern fitting, and Rietveld refinement. The hydrate crystallizes in a tetragonal structure with space group P42212 (a = 7.7070(5) Å, c = 32.4870(3) Å). Incorporation of partially occupied interlayer water-oxygen sites on the (110) plane at z = 0 and 1/2 successfully reproduces the low-angle 00l reflections while preserving the Ca2Nb3O10 framework. The resulting crystallographic model explicitly resolves the arrangement of interlayer water molecules and provides a robust structural foundation for band-structure calculations as well as for the rational design of hydration-controlled intercalation, exfoliation, and composite materials based on layered perovskite-related materials.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1880-65467622026Pharmaceutical agents targeting KATP channel modulate sweet taste sensitivity in mice100082ENChikaSawaiDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKuanyuWangDepartment of Oral Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKengoHorieDepartment of Oral Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshihiroMitohDepartment of Oral Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHirotakaUedaDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiroshiKamiokaDepartment of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityRyusukeYoshidaDepartment of Oral Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySweet detection involves at least two mechanisms: a G-protein coupled sweet taste receptor (Tas1r2/Tas1r3) and glucose transporters. As in pancreatic β-cells, glucose transport may lead to closure of ATP-sensitive potassium (KATP) channels. Since expression of KATP channels in sweet taste cells has been reported, modulation of KATP channel activity would affect sweet taste sensitivity. Here, we examined the effect of glibenclamide (a KATP channel closer) and diazoxide (an opener) on mouse taste behavior. Glibenclamide selectively reduced taste sensitivity to glucose without affecting responses to sucrose or sucralose compared to insulin, suggesting selective impairment of the transporter-dependent pathway. In contrast, diazoxide broadly suppressed responses to all tested sweeteners, indicating a generalized effect on sweet detection. Neither drug altered responses to non-sweet taste. These findings suggest that pharmacological modulation of KATP channel differently influences sweet taste; closers reduce glucose sensitivity whereas openers attenuate response to multiple sweeteners.No potential conflict of interest relevant to this article was reported.Castledown PublishersActa Medica Okayama2982-3749212026AI-assisted writing feedback in EFL: Tracking student performance and reflections103382ENJunkoOtoshiOkayama UniversityNaomiFujishimaKawasaki Medical SchoolThis study explores how AI-assisted writing feedback supports English as a Foreign Language (EFL) learners' writing development and feedback literacy in a Japanese university. Twenty-one first-year students completed nine Write & Improve (W&I) tasks, progressing from descriptive to argumentative essays. Each task was revised following W&I feedback, and students were asked to write a short reflective log. An explanatory mixed-methods approach was adopted, combining quantitative analyses of writing performance and linguistic features with qualitative coding of students' reflections. Findings showed measurable gains in both higher- and lower-level groups, with particularly notable improvement among lower-level students in complexity, fluency, and sophistication. While the higher group consistently outperformed the lower group in Term 1, this gap narrowed in Term 2. Reflection logs provided important insights into feedback literacy: students initially valued W&I for surface-level corrections but later expressed frustration as tasks became more complex and scores plateaued. This tendency was especially evident among lower-level students, reflecting both the affordances and limitations of automated feedback. The study concludes that AI-assisted tools can foster writing development and emerging feedback literacy, but sustained progress requires teacher mediation. Integrating Automated Writing Evaluation (AWE) into ecological feedback environments - combining AI, teacher, and student reflection - offers a promising approach for sustainable L2 writing instruction.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2168-81841862026Pathway Enrichment Analysis of Whole-Exome Sequencing Data from Formalin-Fixed, Paraffin-Embedded Enucleated Eyes with Retinoblastoma and Choroidal Malignant Melanomae110548ENToshihikoMatsuoOphthalmology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTakehiroTanakaPathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityDaisukeEnnishiMedical Oncology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityAkiraSaitoGenomic Statistics, Stagen Co. Ltd.MitsuhiroAmemiyaGenomic Statistics, Stagen Co. Ltd.ShigeoKamitsujiGenomic Statistics, Stagen Co. Ltd.Objectives: Intraocular tumors are extremely rare, small in size, and difficult to approach by biopsy. In the era of cancer genome analysis, we designed a pilot study to perform whole-exome sequencing of formalin-fixed paraffin-embedded enucleated eyes of retinoblastoma and choroidal malignant melanoma as two major intraocular malignancies.<br>
Methodology: Genomic DNA was isolated from intraocular tumor areas of 105 paraffin sections with a 5 μm thickness of seven enucleated eyes with retinoblastoma and seven eyes with choroidal malignant melanoma. One of 7 samples of retinoblastoma and another of seven samples of choroidal malignant melanoma were excluded from the study since the sequencing output and depth of reads were lower compared with the other samples. The sequencing data after quality control were aligned to the reference genome sequence (hg38, GRCh38 Assembly, Genome Reference Consortium Human Build 38), and the mapped reads were processed to improve data quality. Somatic mutations (single nucleotide variants, insertions and deletions, and multiple nucleotide variants) in each sample were extracted after excluding variants reported in a Panel of Normals (PON) from the 1000 Genomes Project. Additional selection criteria included a mutation depth of ≥5 reads and either no registration in or an allele frequency of less than 5% in the Tohoku Medical Megabank of Japan (ToMMo 60KJPN-SNV/INDEL Allele Frequency Panel).<br>
Results: Candidate genes with somatic mutations were selected by three criteria: genes with the same mutation shared by two samples or more, recurrently mutated genes three times or over, and genes of driver candidates identified in combining several different driver mutation-detecting programs by Integrative OncoGenomics (IntOGen). Using candidate genes detected by any of the three criteria as input, enrichment analyses identified 28 pathways in Gene Ontology (GO) and 2 pathways in the Kyoto Encyclopedia of Genes and Genomes (KEGG) for retinoblastoma, while 385 pathways in GO, 12 in KEGG, 2 in the Hallmark gene set of the Molecular Signatures Database (MSigDB), and 47 in Reactome were identified for choroidal malignant melanoma. The enrichment maps showed three major pathways differently in retinoblastoma and choroidal malignant melanoma: one with dynein in retinoblastoma and another with MET in choroidal malignant melanoma.<br>
Conclusions: Although there were limitations related to the small amounts of DNA available from formalin-fixed, paraffin-embedded small-sized tissues and the absence of matched normal control tissue, whole-exome sequencing provided clues to somatic mutations that were enriched in specific pathways and differed between retinoblastoma and choroidal malignant melanoma.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1055-79032232026Reticulate evolution, introgression, and recent diversification in Epimedium sect. Macroceras108646ENEmiKusatakeDepartment of Biology, Okayama UniversityMomokaKonishiDepartment of Biology, Okayama UniversityShutoTomokuniDepartment of Biology, Okayama UniversityYosukeYanagiDepartment of Biology, Okayama UniversityShungoKariyamaSociety of Kurashiki Museum of Natural HistoryTakehitoItohSchool of Life Science and Technology, Institute of Science TokyoAtsushiToyodaDepartment of Genomics and Evolutionary Biology, National Institute of GeneticsSeung-ChulKimDepartment of Biological Sciences, Sungkyunkwan UniversityMakikoMimuraDepartment of Biology, Okayama UniversityHybridization can hinder or promote diversification, and growing genomic evidence suggests that it can facilitate adaptation and speciation. Despite recent progress, however, the quantitative contribution and temporal scope of hybridization to diversification remain poorly understood. The genus Epimedium is a recently diverged lineage, and sect. Macroceras largely consists of endemic species in Japan that are distributed across diverse environments, including limestone, serpentine, coastal habitats, heavy-snow regions, and regions with mild winters. Although natural hybridization and hybrid species have been reported in this section, molecular evidence demonstrating the contribution of hybridization to lineage diversification is limited. We reconstructed phylogenetic relationships using genome-wide single-nucleotide polymorphism (SNP) data from Epimedium sect. Macroceras and tested for genomic signatures consistent with hybridization. Phylogenetic analyses suggest that E. koreanum from Korea is sister to Japanese Epimedium lineages, consistent with an initial colonization of Japan from the Korean Peninsula. The analyses also revealed complex relationships among Japanese species and frequent signals of historical interspecific introgression. Our results are consistent with a history of recent diversification in sect. Macroceras accompanied by introgressive hybridization, which may have contributed to diversification across heterogeneous environments in Japan. This study provides the first genome-wide insights into the evolutionary history of Epimedium sect. Macroceras and reveals complex reticulate relationships among the lineages.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0924-42474082026A flexible PVDF-based galloping flow sensor117978ENMitsukiKuroseGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTakefumiKandaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYuyaSatoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityShuichiWakimotoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityDaisukeYamaguchiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityShinjiHiejimaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityTakejiUedaHydro-VENUS Co., Ltd., Okayama UniversityEffective monitoring of low flow velocities in small rivers and irrigation channels is hindered by the power requirements and maintenance costs of existing technologies. This study proposes a novel flexible piezoelectric polymer flow sensor utilizing galloping vibration to detect flow velocity in the low range (≤ 0.1 m/s). The sensor features a flexible cantilever structure composed of a silicone rubber beam embedded with a polyvinylidene fluoride (PVDF) film and a tip pillar. Unlike conventional devices based on flow-induced vibration, the use of low-stiffness materials enables the induction of self-excited vibration even under weak fluid forces. Computational fluid dynamics (CFD) analysis has been conducted to optimize the tip shape; a D-shaped semicylinder is selected over a cylinder and a square prism because the geometry maximizes the lift force per unit mass, ensuring efficient energy conversion. To predict sensor behavior, a coupled mechanical-fluid-electrical model was developed. Specifically, the model accounts for the static deflection angle caused by fluid drag. Water channel experiments demonstrated that sensors with beam thicknesses under 4 mm successfully generated stable periodic outputs at 0.1 m/s, a regime previously difficult for galloping-based devices. Conversely, thicker beam which has a thickness of 8 mm achieved higher outputs at higher velocities but failed to actuate at low speeds. Furthermore, the study showed a vibration suppression phenomenon in flexible beams at high flow velocities due to excessive static deflection, which was accurately reproduced by the analytical model. These findings establish structural stiffness as the critical design parameter for optimizing the operable velocity range of flow sensors.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0924-42474082026Tip position estimation of a 3-DOF soft mechanism using artificial muscles with optical fibers117938ENRikimaruOkadaGraduate School of Environment, Life, Natural Science and Technology, Okayama UniversityShuichiWakimotoGraduate School of Environment, Life, Natural Science and Technology, Okayama UniversityYuichiroTodaGraduate School of Environment, Life, Natural Science and Technology, Okayama UniversityShunMiuraGraduate School of Environment, Life, Natural Science and Technology, Okayama UniversityDaisukeYamaguchiGraduate School of Environment, Life, Natural Science and Technology, Okayama UniversityTakefumiKandaGraduate School of Environment, Life, Natural Science and Technology, Okayama UniversityMcKibben-type pneumatic artificial muscles (PAMs) are lightweight and flexible soft actuators with a high power-to-weight ratio, and have been widely applied to rehabilitation devices, power-assist systems, and soft robotic mechanisms. By integrating sensing functions into PAMs, their usability and controllability can be enhanced, enabling the development of more practical and advanced soft mechanisms. We previously proposed a smart artificial muscle (SAM) by integrating an optical fiber into the braided sleeve of a McKibben-type PAM, which enables displacement estimation by measuring optical bending loss. The SAM is compatible with conventional PAM fabrication processes; however, the sensor output exhibits strong nonlinearity and time dependency. In this study, an LSTM-based state estimation framework is extended from a single SAM to a three-degree-of-freedom soft mechanism composed of multiple SAMs, where strong nonlinear coupling and mutual interference arise among actuators. In the proposed framework, the LSTM model jointly processes time-series data of multi-channel optical sensor outputs and applied pressures of the three SAMs, along with past estimated states as inputs. This structure enables the model to capture nonlinear coupling, hysteresis, and time-dependent behavior, allowing estimation of the tip position of the soft mechanism. Experimental results demonstrate that the proposed method accurately captures complex nonlinear dynamics and mutual mechanical interference among multiple SAMs, achieving accurate tip position estimation. These results indicate that SAMs with integrated sensing and actuation capabilities, combined with machine-learning-based estimation, provide an effective approach for state estimation of multi-DOF soft robotic mechanisms.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1865-15693012026Three-dimensional virtual planning reduces operative time in orthognathic surgery: a procedure-specific retrospective study incorporating additive manufacturing94ENYukiKunisadaDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNorieYoshiokaDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAkiyoshiNishiyamaDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasanoriMasuiDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoichiKadoyaDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiroakiTakakuraDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKyoichiObataDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKishoOnoDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKokiUmemoriDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySoichiroIbaragiDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityPurpose Three-dimensional virtual surgical planning (3D-VSP) is increasingly used in orthognathic surgery; however, procedure-specific evidence regarding its real-world impact on operative efficiency and intraoperative blood loss remains limited. This study evaluated the association between 3D-VSP implementation and operative time, and intraoperative blood loss across different orthognathic procedures.<br>
Methods This retrospective cohort study included consecutive patients who underwent orthognathic surgery at a single academic institution before (2019–2020) and after (2023–2024) the full implementation of 3D-VSP integrated with in-house additive manufacturing (n = 344). Procedure-specific multivariable linear regression analyses were performed, adjusting for age, sex, and surgeon experience.<br>
Results After 3D-VSP implementation, operative time was reduced by approximately 36 min in sagittal split ramus osteotomy (SSRO), 50 min in Le Fort I (LF1) combined with SSRO, and 42 min in segmental LF1 combined with SSRO, representing a 15–20% reduction in total operative time. No meaningful reduction was observed in intraoral vertical ramus osteotomy (IVRO)-based procedures. A statistically significant, but modest, reduction in intraoperative blood loss was observed only in SSRO. The time-saving effect was independent of surgeon experience.<br>
Conclusion The clinical benefit of 3D-VSP in orthognathic surgery is procedure-dependent and most evident in geometrically complex SSRO-based operations. These findings support the targeted implementation of digital planning and additive manufacturing workflows to improve operative efficiency in routine practice.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1432-058410552026HLA-matched versus haploidentical donor transplantation with post-transplant cyclophosphamide: a study on behalf of the donor/source working group of the Japanese society for transplantation and cellular therapy255ENYosukeNakayaDepartment of Hematology, Osaka Metropolitan University Graduate School of MedicineHirohisaNakamaeDepartment of Hematology, Osaka Metropolitan University Graduate School of MedicineJunichiSugitaDepartment of Hematology, Sapporo Hokuyu HospitalJunyaKandaDepartment of Hematology, Graduate School of Medicine, Kyoto UniversityYutaHasegawaDepartment of Hematology, Hokkaido University HospitalTetsuyaEtoDepartment of Hematology, Hamanomachi HospitalTakahiroFukudaDepartment of Hematopoietic Stem Cell Transplantation, National Cancer Center HospitalNaokiKuritaDepartment of Hematology, University of Tsukuba HospitalNobuhiroHiramotoDepartment of Hematology, Kobe City Medical Center General HospitalKojiNagafujiDivision of Hematology and Oncology, Department of Medicine, Kurume University HospitalDepartment of Hematology, Sapporo Hokuyu HospitalShuichiOtaDepartment of Hematology, Sapporo Hokuyu HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalToshihikoAndoDivision of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga UniversityToshiroKawakitaDepartment of Hematology, NHO Kumamoto Medical CenterTakashiAkasakaDepartment of Hematology, Tenri HospitalYasuoMoriHematology, Oncology & Cardiovascular medicine, Kyushu University HospitalTomohikoKamimuraDepartment of Hematology, Harasanshin HospitalMakotoOnizukaDepartment of Hematology/Oncology, Tokai University School of MedicineYoshikoAtsutaJapanese Data Center for Hematopoietic Cell TransplantationHidekiNakasoneDivision of Hematology, Jichi Medical University Saitama Medical CenterPost-transplant cyclophosphamide (PTCy) is now being increasingly applied to HLA-matched donor (MD) transplantation. Prior studies in Western countries have demonstrated that allogeneic hematopoietic cell transplantation (allo-HCT) employing PTCy yields better outcomes with HLA-matched donors (MDs) than with haploidentical donors (HIDs). However, the effect of HLA mismatch may differ among racial groups. We retrospectively analyzed adult patients with hematological malignancies who underwent their first allo-HCT with PTCy from MDs or HIDs registered to the Japanese registry database between 2013 and 2021. Among 63 (related, n = 33; unrelated, n = 30) and 1261 patients who received MD and HID allo-HCT with PTCy, 50 (related, n = 30; unrelated, n = 20) and 100 patients were assigned to MD and HID groups by 1:2 propensity score matching (PSM). The results showed that MD recipients had better neutrophil recovery (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.04–2.10; P = 0.031) and lower risk of non-relapse mortality (NRM) (HR, 0.19; 95% CI, 0.05–0.81; P = 0.024) than HID recipients. Multivariable analyses in the entire cohort before PSM confirmed these findings. Fatal infection was the primary cause of NRM in the HID group. This study is the first to demonstrate that, within a homogeneous Asian cohort, MD may have an advantage over HID in PTCy-based allo-HCT in facilitating neutrophil engraftment and reducing the risk of NRM.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1432-058410552026Donor selection for patients with HLA-homozygous haplotypes in allogeneic hematopoietic stem cell transplantation244ENNoriyoshiYoshinagaDepartment of Hematology, Graduate School of Medicine, Kyoto UniversityMakotoIwasakiDepartment of Hematology, Graduate School of Medicine, Kyoto UniversityKojiKatoDepartment of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical SciencesFumihikoKimuraDivision of Hematology, Department of Internal Medicine, National Defense Medical CollegeMasahiroHirayamaDepartment of Pediatrics, Mie University Graduate School of MedicineMinoruKanayaBlood Disorders Center, Aiiku HospitalSatokoMorishimaCentral Japan Cord Blood BankNaoyukiUchidaDepartment of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon HospitalNorikoDokiHematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalTakahiroFukudaDepartment of Hematopoietic Stem Cell Transplantation, National Cancer Center HospitalYoshinobuKandaDivision of Hematology, Jichi Medical UniversityTetsuyaNishidaDepartment of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi HospitalYutaHasegawaDepartment of Hematology, Hokkaido University HospitalShinichiKakoDivision of Hematology, Jichi Medical University Saitama Medical CenterMasatsuguTanakaDepartment of Hematology, Kanagawa Cancer CenterMineoKurokawaDepartment of Cell Therapy and Transplantation Medicine, The University of Tokyo HospitalNoboruAsadaDepartment of Hematology and Oncology, Okayama University HospitalToshiroKawakitaDepartment of Hematology, NHO Kumamoto Medical CenterKeisukeKataokaDivision of Hematology, Department of Medicine, Keio University School of MedicineYukioKondoDepartment of Hematology, Toyama Prefectural Central HospitalKazunoriImadaDepartment of Hematology, Japanese Red Cross Osaka HospitalTatsuoIchinoheDepartment of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima UniversityMakotoOnizukaDepartment of Hematology/Oncology, Tokai University School of MedicineYoshikoAtsutaJapanese Data Center for Hematopoietic Cell TransplantationJunyaKandaDepartment of Hematology, Graduate School of Medicine, Kyoto UniversityHLA homozygous haplotypes occur worldwide, but outcomes after allogeneic hematopoietic stem cell transplantation using alternative donor sources remain uncertain. We retrospectively analyzed the Japanese national transplantation registry to compare outcomes after first allogeneic hematopoietic stem cell transplantation in patients with HLA homozygous haplotypes. Donors were classified as homo-to-homo, defined as HLA-matched, or hetero-to-homo, defined as allele-level mismatches at HLA-A, -B, -C, and/or -DRB1 restricted to the host-versus-graft direction. The unrelated donor homo-to-homo group served as the reference. We included 691 patients: related donor homo-to-homo (n = 121), related donor hetero-to-homo (n = 76), unrelated donor homo-to-homo (n = 374), unrelated donor hetero-to-homo (n = 22), cord blood homo-to-homo (n = 40), and cord blood hetero-to-homo (n = 58). Compared with the unrelated donor homo-to-homo group, overall survival was inferior in the cord blood homo-to-homo group (adjusted hazard ratio [HR], 1.71; 95% confidence interval [CI], 1.11–2.64; P = 0.015), whereas the unrelated donor hetero-to-homo group showed a nonsignificant trend toward inferior overall survival (adjusted HR, 1.77; 95% CI, 0.97–3.22; P = 0.061). In this Japanese cohort, cord blood homo-to-homo transplantation was associated with inferior overall survival, whereas related donor hetero-to-homo and cord blood hetero-to-homo transplantation were not. These findings should be interpreted cautiously given the retrospective design and long study period, and require validation in contemporary, ethnically diverse cohorts.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2090-6447202612026A Case of Peripheral Odontogenic Myxofibroma Arising in the Palatal Gingiva of the Maxillary Second Premolar Region: A Case ReportENMasanoriMasuiDepartment of Oral and Maxillofacial Surgery , Faculty of Medicine , Dentistry and Pharmaceutical Sciences Okayama UniversityHirokazuYutoriDepartment of Oral and Maxillofacial Surgery , Kagawa Prefectural Central HospitalAiFujimuraDepartment of Oral and Maxillofacial Surgery , Kagawa Prefectural Central HospitalSoichiroIbaragiDepartment of Oral and Maxillofacial Surgery , Faculty of Medicine , Dentistry and Pharmaceutical Sciences Okayama UniversityOdontogenic myxofibroma (OMF) is a rare benign mesenchymal odontogenic tumor characterized by myxoid stroma with a prominent fibrous component. Although it usually arises intraosseously within the jaws, the peripheral variant, peripheral odontogenic myxofibroma (POMF), which occurs in extraosseous soft tissues, is uncommon and may be clinically misdiagnosed as a reactive gingival lesion. We report a case of POMF in a 68-year-old man who was referred for evaluation of a painless, slowly enlarging swelling of the palatal gingiva in the left maxillary second premolar region, which had initially been diagnosed as chronic periodontitis at a local clinic. An intraoral examination revealed an elastic, firm mass with partial erythema on the palatal marginal gingiva. Panoramic radiography showed mild generalized horizontal bone loss without lesion-specific changes, and computed tomography revealed no bone resorption associated with the lesion. Exfoliative cytology was negative for intraepithelial lesions or malignancy. The lesion was excised with a 5-mm clinical margin, including periosteum, and superficial peripheral ostectomy of the adjacent cortical bone was performed. Histopathological examination revealed a myxoid stroma rich in mucinous matrix and collagen fibers, containing sparsely distributed spindle-shaped cells and scattered nests of odontogenic epithelium. Alcian blue staining revealed diffuse positivity, supporting the diagnosis of POMF. No recurrence was observed during a 2-year follow-up period. This case highlights a diagnostic pitfall in the tooth-bearing gingiva and underscores the importance of histopathological confirmation of persistent gingival masses. When imaging shows no apparent bone involvement, and clinical suspicion of malignancy is low, complete excision with an adequate soft-tissue margin and selective, limited bone removal may achieve local control while preserving the adjacent teeth; long-term follow-up remains advisable.No potential conflict of interest relevant to this article was reported.Public Library of Science (PLoS)Acta Medica Okayama1932-62032162026A multicenter, randomized, parallel-group confirmatory study protocol to evaluate the efficacy of Soft Protector CPC, a novel oral mucosal protectant, in preventing oral mucositis and alleviating pain in patients with breast cancere0350803ENKazuhiroOmoriDepartment of Pathophysiology-Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoheiFurukawaDepartment of Dentistry and Oral Surgery, Shikoku Cancer CenterMasatoshiUsubuchiDepartment of Dentistry, Miyagi Cancer CenterTomofumiHamadaDepartment of Dentistry and Oral Surgery, Sagara HospitalTadahikoShienDepartment of Breast and Endocrine Surgery, Okayama University HospitalMichihiroYoshidaCenter for Innovative Clinical Medicine, Okayama University HospitalYukiNakatsukaCenter for Innovative Clinical Medicine, Okayama University HospitalKatsuyukiHottaCenter for Innovative Clinical Medicine, Okayama University HospitalSoichiroIbaragiDepartment of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShogoTakashibaDepartment of Pathophysiology-Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityOral mucositis is a frequent and debilitating adverse event observed in patients undergoing chemotherapy or radiotherapy. Current management strategies are limited in duration, require frequent application, and fail to address the mechanical irritation from teeth. A novel device, Soft Protector CPC, was developed to overcome these limitations. This multicenter, randomized, two-arm, open-label, confirmatory trial aims to evaluate the efficacy and safety of Soft Protector CPC in patients with breast cancer undergoing chemotherapy. A total of 154 participants will be randomly assigned in a 1:1 ratio to receive either oral care with Soft Protector CPC or oral care alone. The primary endpoint will be oral mucositis as assessed according to the Common Terminology Criteria for Adverse Events (CTCAE) v3.0 during the comparative treatment period. The secondary endpoints will include CTCAE v3.0 during the continuous treatment period, oral mucositis, pain (CTCAE v5.0), quality of life (Patient Reported Outcomes-CTCAE version 1.0 [PRO-CTCAE v1.0], the 15-item oral health questionnaire of the European Organization For Research And Treatment Of Cancer [EORTC QLQ-OH15], and the pain Numeric Rating Scale), onset and site of mucositis, completion of chemotherapy, use of rescue medications, technical feasibility, and patient preference. The safety endpoints will include adverse events, device malfunction, and laboratory tests. This trial is expected to establish the clinical utility of the Soft Protector CPC for the prevention and management of oral mucositis, with the potential to improve the patients’ quality of life and adherence to cancer therapy. This study was approved by the Clinical Research Review Board and registered with the Japan Registry of Clinical Trials, jRCTs062250005, on April 18, 2025.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2041-17231712026Photooxidative Copper(II) Catalysis for Promoting anti-Markovnikov Hydration of Alkenes3003ENNaokiOkuDivision of Applied Chemistry, Okayama UniversityKeitoFukeDivision of Applied Chemistry, Okayama UniversityRikakoMasuiDivision of Applied Chemistry, Okayama UniversityKenYamazakiDivision of Applied Chemistry, Okayama UniversityYasunoriMatsuiDepartment of Applied Chemistry, Graduate School of Engineering, Osaka Metropolitan UniversityHiroshiIkedaDepartment of Applied Chemistry, Graduate School of Engineering, Osaka Metropolitan UniversityTomoyaMiuraDivision of Applied Chemistry, Okayama UniversityPhotoredox catalysis enables the generation of radical intermediates under mild conditions, yet photoredox catalysts have heavily relied on precious transition metal complexes. Therefore, the development of photocatalysts based on earth-abundant metals is increasingly demanded. Here, we report a highly photooxidative capability of a heteroleptic copper(II) complex for promoting anti-Markovnikov hydration of alkenes. The copper(II) complex containing bathophenanthroline and 3,4-dimethoxybenzenethiolate ligands is generated in situ from copper(II) chloride dihydrate. Upon visible-light irradiation, the copper(II) complex is photoexcited and exhibits an excited-state lifetime sufficiently long to oxidize various alkenes, including aliphatic substrates. Consequently, anti-Markovnikov hydration can be achieved under mild conditions, and the late-stage functionalization of natural products and pharmaceutical derivatives is also feasible. The developed catalytic system can be extended for photooxidative reactions of alkenes, such as intramolecular cyclization reactions and anti-Markovnikov addition of nucleophiles other than water.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1471-24312612026Hypernatremia during the first week of life in very preterm infants and neurodevelopmental outcomes at 3 to 4 years of age: a cohort study181ENMichikoMurakamiDivision of Neonatology, NHO Okayama Medical CenterKeiTamaiDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNaomiMatsumotoDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAkihitoTakeuchiDivision of Neonatology, NHO Okayama Medical CenterMakotoNakamuraDivision of Neonatology, NHO Okayama Medical CenterTakashiYorifujiDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMisaoKageyamaDivision of Neonatology, NHO Okayama Medical CenterBackground Hypernatremia is a common electrolyte disorder in both term and preterm infants. Previous studies have suggested a correlation between hypernatremia and short-term complications in preterm infants, such as intraventricular hemorrhage and chronic lung disease. However, the relationship between hypernatremia and neurodevelopmental outcomes is less well understood. This study aimed to assess the association between hypernatremia during the first week of life and neurodevelopmental outcomes at 3–4 years of age in very preterm infants.<br>
Methods This single-center, retrospective cohort study analyzed data from preterm infants born at less than 32 weeks of gestation between 2010 and 2020. Infants with peak whole blood sodium levels > 145 mEq/L during the first week of life were included in the hypernatremia group and those with ≤ 145 mEq/L in the non-hypernatremia group. The primary outcome was neurodevelopmental impairment (NDI) at 3–4 years of age, defined as developmental impairment (developmental quotient < 70), cerebral palsy, hearing impairment, or visual impairment. Secondary outcomes were the components of the primary outcome. We conducted Poisson regression analyses with robust variance, adjusting for perinatal confounders.<br>
Results Of 272 infants with neurodevelopmental data, 82 and 190 infants were in the hypernatremia and non-hypernatremia groups, respectively. The median (interquartile range) gestational age and birth weight were 26.4 (25.1–28.0) and 28.7 (26.6–30.3) weeks and 860 (670–1062) and 997 (778–1264) g for infants in the hypernatremia and non-hypernatremia groups, respectively. Infants in the hypernatremia group had a greater incidence of NDI (29.3% vs. 14.7%, adjusted risk ratio [RR] 1.75, 95% CI 1.08–2.84) and cerebral palsy (8.5% vs. 1.6%, adjusted RR 5.5, 95% CI 1.72–17.63) than those in the non-hypernatremia group.<br>
Conclusions Hypernatremia during the first week of life was associated with an increased risk of NDI at 3–4 years of age in very preterm infants.No potential conflict of interest relevant to this article was reported.AIP PublishingActa Medica Okayama2468-20471112025Pressure calibrations of high-pressure large-volume presses at HPSTAR017803ENYongjiangXuCenter for High Pressure Science and Technology Advanced ResearchPeiyanWuCenter for High Pressure Science and Technology Advanced ResearchShengShangCenter for High Pressure Science and Technology Advanced ResearchXueWangCenter for High Pressure Science and Technology Advanced ResearchTaihangLiCenter for High Pressure Science and Technology Advanced ResearchShuchangGaoCenter for High Pressure Science and Technology Advanced ResearchShijieLvCenter for High Pressure Science and Technology Advanced ResearchHangChengCenter for High Pressure Science and Technology Advanced ResearchQianzhiXuCenter for High Pressure Science and Technology Advanced ResearchShangLeiCenter for High Pressure Science and Technology Advanced ResearchJiajiaFengCenter for High Pressure Science and Technology Advanced ResearchLeiZhaoCenter for High Pressure Science and Technology Advanced ResearchWimvan WestrenenCenter for High Pressure Science and Technology Advanced ResearchTakayukiIshiiInstitute for Planetary Materials, Okayama UniversityBinChenCenter for High Pressure Science and Technology Advanced ResearchLeiSuCenter for High Pressure Science and Technology Advanced ResearchYangDingCenter for High Pressure Science and Technology Advanced ResearchWengeYangCenter for High Pressure Science and Technology Advanced ResearchHo-KwangMaoCenter for High Pressure Science and Technology Advanced ResearchYanhaoLinCenter for High Pressure Science and Technology Advanced ResearchLarge-volume presses (LVPs) are widely utilized in diverse research fields―including high-pressure physics, chemistry, materials science, and Earth and planetary sciences―to investigate the physical and chemical properties of materials under extreme high-pressure and high-temperature conditions. A prerequisite for achieving reproducible property measurements is the determination and control of pressure within experimental setups. However, the lack of precise pressure calibration in LVPs hinders the broader application of such devices in ultrahigh-pressure studies. This study employs a suite of standard phase transition-based pressure markers―comprising metallic conductors, semiconductors, and minerals―through both in situ and ex situ identification approaches, to establish pressure calibration curves ranging from 0.4 to >30 GPa for various types of LVP installed at the Center for High Pressure Science and Technology Advanced Research (HPSTAR), Beijing, including piston–cylinder, cubic, and multi-anvil presses. The results provide a unified and traceable pressure reference for high-pressure experiments conducted at HPSTAR, while also offering technical guidance and calibration standards for other researchers utilizing similar LVP systems, thereby enabling more consistent comparison between different laboratories. This work facilitates the advancement of LVP research toward broader applications in higher-pressure regimes.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1342-17512026Optimizing low-dose rituximab protocol for ABO-mismatched kidney transplantation: long-term outcomes in a single-center retrospective cohort studyENTomoakiYamanoiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakanoriSekitoDepartment of Inflammation and Immunity, Lerner Research Institute, Cleveland ClinicMotoTokunagaDepartment of Urology, NHO Okayama Medical CenterIchiroTsuboiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKasumiYoshinagaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiMaruyamaDepartment of Inflammation and Immunity, Lerner Research Institute, Cleveland ClinicTatsushiKawadaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRisaKubotaDepartment of Urology, NHO Okayama Medical CenterYusukeTominagaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaSadahiraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKatayamaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakehiroIwataDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShingoNishimuraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKensukeBekkuDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroOnishiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidemiTakeuchiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsuyukiTanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiMorinagaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoichiroWadaDepartment of Urology, Shimane University Faculty of MedicineMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground ABO-mismatched kidney transplantation (KTx) expands donor availability but increases risks of antibody-mediated rejection and passenger lymphocyte syndrome (PLS). While rituximab (Rit) potentially mitigates these complications, conventional high-dose regimens (375 mg/m2) elevate infectious and hematologic toxicity. We implemented low-dose Rit induction (200 mg/body) for desensitization in minor/major ABO-mismatched and DSA-positive KTx, evaluating its efficacy and safety over 15-years.<br>
Methods This single-center retrospective cohort (May 2009–April 2024) analyzed 161 adult KTx recipients: Rit (n = 107) and Non-Rit (n = 54) groups. All received tacrolimus, mycophenolate mofetil, prednisolone, and basiliximab; high-risk patients also underwent plasmapheresis. Outcomes included graft survival, biopsy-proven acute rejection, de novo donor-specific antibody (DSA) formation, infection, severe neutropenia, and PLS.<br>
Results 1-year graft survival was 100% in both groups. 5-year death-censored graft survival was 95.8% (Rit) vs 95.9% (Non-Rit), respectively (log-rank P = 0.43). Biopsy-proven acute rejection (7.5% vs 3.7%, P = 0.50) and de novo DSA production were equivalent (Class I: 5.5% vs 2.2%; Class II: 6.6% vs 8.7%; both P = 1.00), with lower mean fluorescent intensity (MFI) in the Rit group. Cytomegalovirus disease, urinary tract infection and fungal infection rates were comparable between both groups. Grade 4 neutropenia was not associated with Rit (OR 2.65; 95% CI 0.63–11.0; P = 0.18). Blood transfusion for hemoglobin declines occurred in 5.6% vs 7.4%, with preserved haptoglobin in all cases, indicating no PLS.<br>
Conclusions Low-dose Rit induction achieves excellent graft survival and effective PLS prevention, without increasing toxicity, supporting its adoption as an optimal desensitization strategy.No potential conflict of interest relevant to this article was reported.American Geophysical Union (AGU)Acta Medica Okayama0094-827653102026Spin Transition of Fe3+ in δ-(Al,Fe)OOH and Implication for Mid-Lower Mantle Seismic Heterogeneitiese2025GL121007ENChaoshuaiZhaoState Key Laboratory of Precision Geodesy, University of Science and Technology of ChinaZhuMaoState Key Laboratory of Precision Geodesy, University of Science and Technology of ChinaXinyueZhangState Key Laboratory of Precision Geodesy, University of Science and Technology of ChinaYingxinYuState Key Laboratory of Precision Geodesy, University of Science and Technology of ChinaNingyuSunState Key Laboratory of Precision Geodesy, University of Science and Technology of ChinaJianboZhangCenter for High Pressure Science and Technology Advanced ResearchYuzhuWangShanghai Advanced Research Institute, Chinese Academy of SciencesTakayukiIshiiInstitute for Planetary Materials, Okayama Universityδ-(Al,Fe)OOH is an important water carrier and plays a critical role on Earth's deep water cycle. Lattice parameters of δ-(Al0.89Fe0.11)OOH were measured by synchrotron single-crystal X-ray diffraction at simultaneously high temperature and pressure up to 65 GPa and 800 K in diamond anvil cells. The results reveal that the spin crossover increases from 30 to 37 GPa at 300 K to 36–48 GPa at 700 K. Moreover, at the spin crossover, the KT and VΦ of δ-(Al0.89Fe0.11)OOH occur significant elastic softening, with maximum reductions of 50% on KT and 29% on VΦ at 33 GPa and 300 K to 37% on KT and 23% on VΦ at 41 GPa and 700 K. The anomalous elastic properties of δ-(Al,Fe)OOH at the spin crossover enhance our understanding of local seismic observations anomalies and help identify potential water-rich regions in the mid-lower mantle.No potential conflict of interest relevant to this article was reported.American Geophysical Union (AGU)Acta Medica Okayama2169-931313082025Linking the Spin Transition of Ferric Iron in δ‐(Al,Fe)OOH to Water Storage in the Lower Mantlee2025JB031715ENJohannesBuchenBayerisches Geoinstitut, Universität BayreuthOlivia S.PardoSeismological Laboratory, California Institute of TechnologyVasilije V.DobrosavljevicSeismological Laboratory, California Institute of TechnologyWolfgangSturhahnSeismological Laboratory, California Institute of TechnologyTakayukiIshiiNow at Institute for Planetary Materials, Okayama UniversityStellaCharitonGSECARS, The University of ChicagoEranGreenbergGSECARS, The University of ChicagoThomas S.ToellnerAdvanced Photon Source, Argonne National LaboratoryJennifer M.JacksonSeismological Laboratory, California Institute of TechnologyAs the most massive geochemical reservoir, the lower mantle affects the Earth's budget of volatile elements, including hydrogen or H2O. The properties of minerals in the lower mantle are further affected by changes in the electronic configurations of iron cations, that is, by spin transitions. The feedback between spin transitions and potential storage of H2O in solid hydrous phases in the lower mantle, however, remains unexplored. By combining high-pressure nuclear resonant inelastic X-ray scattering and high-pressure high-temperature X-ray diffraction experiments, we constrained the thermal equation of state of δ-(Al,Fe)OOH, a member of the phase H solid solution. Based on the derived thermal equation of state of δ-(Al,Fe)OOH and the underlying thermodynamic model, we calculate the excess Gibbs free energy that arises from the spin transition of ferric iron in this compound and evaluate the effect on phase equilibria. The results of our analysis show that the spin transition of ferric iron in phase H may significantly reduce the thermodynamic activity and hence the concentration of H2O in a coexisting hydrous melt. As a consequence, nominally anhydrous minerals of the lower mantle may become dehydrated in the presence of phase H. Our analysis further suggests that, under certain conditions, the spin transition may expand the thermal stability of Fe3+-bearing phase H and create a geochemical link between the storage of H2O in phase H and ferric iron in the lower mantle.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0892-03621152026Long-term neurological and neurocognitive deficits in adults prenatally exposed to methylmercury: Minamata disease107590ENTakashiYorifujiDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYukaYamamuraDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityItsukaNaganoNon-Profit Organization HamachidoriMarikoYasudaClinical Psychology Center, Kawasaki Medical School HospitalTerukoMorookaDivision of Medical Support, Okayama University HospitalYokoKadoDepartment of Psychology, Faculty of Letters, Kansai UniversityMinamata disease, officially recognized in 1956, is a well-known food poisoning event that was caused by the consumption of fish and seafood contaminated with methylmercury. Although patients with congenital Minamata disease (CMD) with severe neurological impairments after birth are widely recognized, few studies have examined the effects of prenatal methylmercury exposure among residents, which is likely at lower levels than in CMD patients. We aimed to investigate the relationship between prenatal methylmercury exposure and subsequent neurological and neurocognitive outcomes. We conducted a cross-sectional study during 2024–2025 among 51 individuals aged approximately 70 years, 27 residents from an existing cohort established in 1970 in Minamata and 24 age-matched individuals who had lived in less-exposed regions. We performed a battery of neurological and neurocognitive tests in both groups and compared the results using multiple linear regression analyses. We also examined the association between intelligence scores obtained in 1970, and intelligence scores obtained in the present investigation, only among exposed participants. We found that exposed individuals had unfavorable neurological and neurocognitive test scores, in comparison with less-exposed controls. Scores on the Montreal Cognitive Assessment, Japanese Edition were 5.91 points lower (95% confidence interval: 3.09 to 8.73) for exposed residents than for the less-exposed group. Moreover, intelligence scores evaluated during exposed participants' adolescence were correlated with their neurocognitive scores in adulthood. Our findings showed that prenatal methylmercury exposure affected subsequent neurological and neurocognitive functions, including among individuals with lower exposure than in CMD patients, and even approximately 70 years after the initial exposure.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0342-17915322026High-pressure spectroscopic investigation of ε-FeOOH: toward a better understanding of pressure-induced hydrogen-bond symmetrization18ENIzumiMashinoInstitute for Planetary Materials, Okayama UniversityShigeruYamashitaInstitute for Planetary Materials, Okayama UniversityTakashiYoshinoInstitute for Planetary Materials, Okayama UniversityHigh-pressure spectroscopic measurements of ε-FeOOH were conducted up to ~ 65 GPa at room temperature in diamond anvil cells. The pressure evolution of the Raman vibrational modes confirms that a hydrogen-bond-symmetrization-induced phase transition from P21nm to Pnnm occurs at ~ 18 GPa. Infrared (IR) spectroscopic measurements suggest that the Pnnm phase has a disordered hydrogen state, and no spectroscopic evidence for fully centered hydrogen bonds is observed within the investigated pressure range. Above ~ 45 GPa, Fe3+ in ε-FeOOH undergoes a high-spin to low-spin transition as indicated by a reduction of the unit cell volume, together with reductions in IR transmitted and Raman signals. These results demonstrate that ε‑FeOOH preserves a disordered hydrogen‑bond configuration up to at least 45 GPa, whereas δ-AlOOH transforms to a centered hydrogen-bond configuration at ~ 18 GPa. This compositional contrast suggests that Fe‑bearing oxyhydroxides follow a distinct evolution of hydrogen bonding under compression, providing insight into hydrogen behavior in deep Earth materials.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026Long intervals between repetitive concussions reduce risk of cognitive impairment and limit microglial activation, astrogliosis, and tauopathy in adolescent ratsENYuichiHIRATAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026ADAR1 as a prognostic marker for patients with colorectal cancer and synchronous liver metastasis and a predictor of chemotherapy efficacyENKaoriNITTAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026Total Thymectomy Is Oncologically Superior to Partial Thymectomy in Patients with Thymic Carcinoma: Insights from a Multicenter Real World Data AnalysisENTatsuyaHAYASHIGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026Induction of IL-9-producing CD8+ T cells by ascochlorin derivatives ENNatsumiIMANOGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026iTRAQ-based quantitative proteomics reveals reduced expression of KRT19, KRT7, and PTGDS in cutaneous specimens after kidney transplantationENIchiroTSUBOIGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026Enhancement of drug delivery through fibroblast activation protein-targeted near-infrared photoimmunotherapyENSeitaroNISHIMURAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026Prognostic Impact of Tumor-Infiltrating Lymphocytes, Tertiary Lymphoid Structures, and Neutrophil-to-Lymphocyte Ratio in Pulmonary Metastases from Uterine LeiomyosarcomaENNaokiMATSUDAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026Serum extracellular vesicles containing adenoviral E1A-DNA as a predictive biomarker for liquid biopsy in oncolytic adenovirus therapyENChiakiYAGIGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026ROS produced by Dual oxidase regulate cell proliferation and haemocyte migration during leg regeneration in the cricketENMisaOKUMURAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026Risk Stratification for the Prediction of Skeletal-Related Events in Patients With Bone Metastases From Non-small Cell Lung CancerENYoshihiroSAKAMOTOGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026Osmotic pressure‐induced calcium response statesENZIDANGAOGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026Effect of mechanical stretching stimulation on maturation of human iPS cell-derived cardiomyocytes co-cultured with human gingival fibroblastsENMENGXUEWANGGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026Energy Price Shocks and Macroeconomic and Financial Dynamics : Evidence from Gas and Oil MarketsENPENGCHENGraduate School of Humanities and Social Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026Does Human Depopulation Reduce Resource Consumption? Evidence from Anthropocene JapanENBARRAHMOUNE ANASSGraduate School of Humanities and Social Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026Long-term trends in disease burden at global, regional, and national levels: findings from the Global Burden of Disease Study 2019 and the World Health Organization Mortality DatabaseENVU THI QUYNHGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026Continuous glucose monitoring reveals periodontitis-induced glucose variability, insulin resistance, and gut microbiota dysbiosis in miceENMoyukaTAKAMORIGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2026CXCR4 Inhibition Induces Tumor Necrosis by Selectively Targeting the Proliferating Blood Vessels in Oral Squamous Cell CarcinomaENYAMINSOEGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Japan Surgical SocietyActa Medica Okayama2198-77931212026Tailored Management of Anomalous Systemic Arterial Supply to the Basal Segment of the Lung: A Case Report and Literature Reviewcr.26-0288ENShunsukeMoriDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenSuzawaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiTomitaDepartment of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHaruchikaYamamotoDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKumiNakajimaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinTanakaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidejiroTorigoeDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhikoShienDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentarohMiyoshiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMikioOkazakiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeiichiroSugimotoDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakaoHirakiDepartment of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesINTRODUCTION: Parenchyma-preserving strategies for anomalous systemic arterial supply to the basal segment of the lung have gained increasing attention. However, pulmonary infarction of the preserved lung has been reported, and clear criteria for selecting the optimal treatment have yet to be established. We report 2 cases in which detailed preoperative imaging informed tailored management―right posterior basal segmentectomy in 1 patient and endovascular embolization of the aberrant artery in the other―both without postoperative complications. A review of the relevant literature is also provided, with an emphasis on potential selection criteria.<br>
CASE PRESENTATION: Case 1: A 20-year-old asymptomatic woman was referred after an abnormal screening chest radiograph. CT demonstrated an aberrant artery arising from the abdominal aorta supplying the right posterior basal segment (S10) with a large intravascular thrombus. The pulmonary artery showed hypoplasia limited to A10, while the other branches were normal, and no parenchymal congestion was identified. Following resection of the aberrant artery, robot-assisted right S10 segmentectomy was performed. The postoperative course was uneventful, and the patient was discharged on POD 6. Case 2: A 27-year-old woman was incidentally diagnosed on CT for an unrelated indication. An aberrant artery arising from the descending thoracic aorta supplied the left basal segment. Pulmonary arterial branches were preserved, with only minimal congestion in S9-10. Angiography revealed no evidence of an arteriovenous fistula. As surgical lung resection was considered unnecessary, coil embolization of the aberrant artery was performed. No complications occurred, and the patient was discharged on day 3 after the procedure.<br>
CONCLUSIONS: In patients with anomalous systemic arterial supply to the basal segment of the lung, when pulmonary arterial branches are preserved and background parenchymal congestion is minimal, parenchyma-sparing approaches should be considered.No potential conflict of interest relevant to this article was reported.Informa UK LimitedActa Medica Okayama1751-24332026Treatment strategies for pulmonary arterial hypertension associated with adult congenital heart diseasesENSatoshiAkagiDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesShingoKasaharaDepartment of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKentaroEjiriDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesKazufumiNakamuraDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesShinsukeYuasaDepartment of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesIntroduction<br>
The number of patients with adult congenital heart disease (ACHD) is gradually increasing worldwide due to advances in surgical techniques and pharmacological therapies. ACHD can lead to pulmonary arterial hypertension (PAH), and treatment strategies for PAH associated with ACHD have also evolved.<br>
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Areas covered<br>
Several PAH-targeted drugs including endothelin receptor antagonists, phosphodiesterase type 5 inhibitors, soluble guanylate cyclase stimulators, and prostacyclin analogs are available for treatment of PAH. In this review, we summarized the current evidence regarding the use of PAH-targeted drugs in patients with PAH associated with ACHD. We also propose a ‘treat and repair’ strategy, which involves initial medical treatment to improve PAH followed by surgical or interventional repair of the systemic-to-pulmonary shunt. A PubMed literature search was conducted from 2000 to 2025.<br>
<br>
Expert opinion<br>
In cases of PAH associated with a systemic-to-pulmonary cardiac shunt, advanced PAH-targeted drugs can improve hemodynamics, and reduce the risk of cardiac defect repair and further improvement in PAH. The treat and repair strategy represents a promising therapeutic approach for PAH patients associated with systemic-to-pulmonary shunts.No potential conflict of interest relevant to this article was reported.BMJActa Medica Okayama2053-36241312026Predictive value of simple echocardiographic parameters for screening pulmonary hypertension under the revised definition: a study for general hospitalse004185ENYoshitakeFukudaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesSatoshiAkagiDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesSatoshiTayaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesKentaroEjiriDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesYoichiTakayaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesYoshihiroDohiDepartment of Cardiovascular Medicine, Kure Kyosai HospitalShinsukeYuasaDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesBackground The current guideline recommends a peak tricuspid regurgitation velocity (TRV) ≥2.9 m/s on echocardiography for pulmonary hypertension (PH) screening; however, this threshold was based on the previous PH definition (mean pulmonary arterial pressure (mPAP) ≥25 mm Hg) and derived largely from PH referral centres.<br>
Methods We retrospectively analysed 755 patients who underwent both transthoracic echocardiography and right heart catheterisation at two general hospitals. The discrimination of peak TRV and estimated right atrial pressure (eRAP), derived from inferior vena cava diameter and respiratory variation, for screening for PH was assessed by receiver operating characteristic curve analysis. Optimal cut-off values were determined with the Youden Index.<br>
Results The c-statistic for peak TRV in detecting PH was 0.82 (95% CI 0.79 to 0.85). An optimal cut-off of 2.7 m/s provided higher sensitivity (72%) than the conventional 2.9 m/s threshold (60%) while maintaining high specificity (82%). In 681 patients with available TRV and eRAP data, adding eRAP improved discrimination compared with TRV alone (c-statistic 0.83 vs 0.80; net reclassification improvement=0.14, p=0.002). eRAP ≥5 mm Hg was associated with a higher risk of PH, and the combination of elevated TRV and eRAP yielded the strongest association.<br>
Conclusion For screening under the revised PH definition, a peak TRV of 2.7 m/s is suggested as the optimal cut-off. Although TRV alone showed good discriminative performance, combining it with eRAP further improved diagnostic accuracy using simple echocardiographic measures.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0021-925830262026A photoactivatable Cre-loxP system for spatiotemporal genetic manipulation in mouse taste buds113085ENYuZuoDepartment of Oral Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKengoHorieDepartment of Oral Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshihiroMitohDepartment of Oral Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYasuhiroYamadaDepartment of Molecular Pathology, Graduate School of Medicine and Faculty of Medicine, The University of TokyoTomokaTakaoFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakeshiTakaradaFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShoichiroKokabuDivision of Biochemistry, Kyushu Dental UniversityRyusukeYoshidaDepartment of Oral Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityConventional genetic approaches, including global gene KO and conditional KO strategies such as the Cre-loxP system, have some limitations arising from systemic effects or insufficient temporal resolution. The recently developed photoactivatable Cre (PA-Cre) system may have a potential to improve spatiotemporal control of gene manipulation. In this study, we established and validated the feasibility of the PA-Cre system using taste buds as a model. We generated TRE-PA-Cre:R26-rtTA/tdTomato mice to evaluate blue-light-induced Cre recombinase activity. Through systematic optimization of illumination parameters, we found that a single session of blue-light-illumination resulted in limited recombination efficiency, whereas a multisession illumination strategy markedly increased recombination efficiency. To further assess the utility of the PA-Cre system for gene KO, we generated TRE-PA-Cre:R26-rtTA:Tas1r3-flox mice and targeted a taste-related gene Tas1r3. Genomic DNA quantitative PCR and reverse transcription-quantitative PCR both showed partial reductions in Tas1r3 at the DNA and mRNA levels, respectively. Behavioral assays further revealed a selective decrease in sensitivity to sweet and umami stimuli. Together, these findings demonstrate PA-Cre-mediated gene manipulation in taste buds and establish a practical optical activation paradigm, providing a high-spatiotemporal-resolution tool for investigating gene function in optically targeted regions.No potential conflict of interest relevant to this article was reported.Royal Society of Chemistry (RSC)Acta Medica Okayama2633-0679712026Programmable synthesis of alkaloidal frameworks integrating Michael acceptor generates covalent probes for targeting POLE3 in HBV replication105119ENNobutoKanekoDepartment of Chemistry, Graduate School of Science, The University of TokyoMisaoHimenoDepartment of Developmental Medical Sciences, Graduate School of Medicine, The University of TokyoYuhiKobayashiDepartment of Chemistry, Graduate School of Science, The University of TokyoRyoTanifujiDepartment of Chemistry, Graduate School of Science, The University of TokyoHirokiKubotaDepartment of Applied Chemistry, Graduate School of Engineering, Tokyo University of Agriculture and TechnologyHarukiMizoguchiGraduate School of Natural Science and Technology, Okayama UniversityMakotoMuroiCentre for Sustainable Resource Science, RIKENTakehiroSuzukiCentre for Sustainable Resource Science, RIKENMasayaSugiyamaDepartment of Viral Pathogenesis and Control, National Institute of Global Health and Medicine, Japan Institute for Health SecurityNaoshiDohmaeCentre for Sustainable Resource Science, RIKENHiroyukiOsadaCentre for Sustainable Resource Science, RIKENTaketomoKidoLaboratory of Cell Growth and Differentiation, Institute for Quantitative Biosciences, The University of TokyoAtsushiMiyajimaLaboratory of Cell Growth and Differentiation, Institute for Quantitative Biosciences, The University of TokyoHirokiOguriDepartment of Chemistry, Graduate School of Science, The University of TokyoThe growing need for effective HBV treatments and lead compounds with novel mechanisms prompted us to explore synthetic strategies for generating skeletally diverse alkaloidal Michael acceptors. Our approach uniquely embeds Michael acceptors directly within multicyclic alkaloid-inspired frameworks, exploiting the azepinoindole scaffold―a privileged structure in indole alkaloids. A single-step assembly between the versatile intermediate 13 with methyl propiolate 14 or its derivatives enabled the rapid and divergent synthesis of six alkaloidal Michael acceptors (15–20). This strategy facilitated systematic diversification of three-dimensional functional group arrangements and precise tuning of the electronic and steric properties of the embedded α,β-unsaturated carbonyl moieties. The optimal hit 15 inhibited hepatitis B surface antigen (HBsAg) production with an IC50 of 2.48 μM and significantly reduced levels of covalently closed circular DNA (cccDNA), the master template of HBV. Unlike existing nucleoside/nucleotide-based anti-HBV drugs that primarily inhibit reverse transcription, the alkaloidal Michael acceptor 15 suppressed both cccDNA and relaxed circular DNA (rcDNA) levels, suggesting a potential pathway toward a functional HBV cure. Our study also streamlined the target identification by leveraging the covalent binding properties of the Michael acceptors and the operational simplicity of biotin- or fluorescent-tag attachment via a pre-installed alkyne moiety. Competitive pull-down experiments identified several potential target proteins, involving DNA polymerase epsilon subunit 3 (POLE3). Notably, the alkaloidal Michael acceptor 15 was demonstrated to covalently modify Cys51 in POLE3, providing new insights into virus–host interactions and opening novel avenues for targeted anti-HBV therapies. This approach represents a significant advance beyond traditional screening methods and underscores the potential of skeletally diverse alkaloidal Michael acceptors in antiviral drug development.No potential conflict of interest relevant to this article was reported.American Geophysical Union (AGU)Acta Medica Okayama0094-8276532026Discovery of Repeating Shallow Moonquakes in the Apollo Lunar Seismic Datae2026GL122541ENKeisukeOnoderaInstitute for Planetary Materials, Okayama UniversityShallow moonquakes have been considered unique due to their large magnitudes and affinities with intraplate earthquakes. However, the small number of detections (<80 events) has prevented detailed characterization. In this study, I identified a pair of repeating shallow moonquakes by analyzing a recently updated moonquake data set. Relative-phase assessment revealed that these events exhibit a consistent fault-slip direction despite their occurrence at opposite tidal phases. This differs from what was observed for repeating deep moonquakes, which are closely related to tides, implying that tidal stress does not dominantly control fault-slip initiation of the repeating shallow moonquakes. Also, the identified repeating shallow moonquakes exhibit a similar relationship between seismic moment and the spatial scale of the slip area to earthquakes. This may indicate that earthquake-like fault physics operates on the Moon, albeit with a different driving mechanism than on Earth.No potential conflict of interest relevant to this article was reported.SAGE PublicationsActa Medica Okayama1756-2848192026Second-look endoscopy does not reduce delayed bleeding after endoscopic papillectomy: a multicenter propensity score-matched analysisENYukiFujiiDepartment of Endoscopy, Okayama University HospitalKazuyukiMatsumotoDepartment of Endoscopy, Okayama University HospitalToruUekiDepartment of Gastroenterology, Fukuyama City HospitalHitomiHimeiDepartment of Gastroenterology, Hiroshima City Hiroshima Citizens HospitalIchiroSakakiharaDepartment of Gastroenterology, Kagawa Prefectural Central HospitalEijiroUetaDepartment of Gastroenterology, National Hospital Organization Iwakuni Clinical CenterTatsuyaToyokawaDepartment of Gastroenterology, NHO Fukuyama Medical CenterRyoHaradaDepartment of Gastroenterology, Japanese Red Cross Okayama HospitalTaijiOgawaDepartment of Gastroenterology, Tsuyama Chuo HospitalTakeshiTomodaDepartment of Gastroenterology, Okayama City HospitalHironariKatoDepartment of Gastroenterology, Okayama City HospitalToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Medical Development Field, Okayama UniversityRyosukeSatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalAkihiroMatsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalDaisukeUchidaDepartment of Gastroenterology and Hepatology, Okayama University HospitalShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKoichiroTsutsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalBackground: Delayed bleeding is a frequent and serious complication after endoscopic papillectomy (EP). Second-look endoscopy (SLE) is often scheduled on the following day for wound assessment and prophylactic hemostasis, but its clinical value remains unclear.<br>
Objectives: This study evaluated the effectiveness of SLE in preventing delayed bleeding after EP.<br>
Design: This study was a multicenter, retrospective cohort study.<br>
Methods: We retrospectively reviewed 132 consecutive patients who underwent EP at nine high-volume centers between 2003 and 2024 (SLE group, n = 73; non-SLE group, n = 59). Propensity score matching was performed to balance baseline characteristics. The primary outcome was delayed bleeding, and secondary outcomes were risk factors, the impact of prophylactic hemostasis during SLE, and hospital stay.<br>
Results: After matching, 43 patients were included in each group. The incidence of delayed bleeding did not differ between the SLE and non-SLE groups (14% vs 9%, p = 0.50). Multivariate analysis identified a lack of preventive clipping closure as the only independent risk factor (odds ratio 15, 95% confidence interval 1.3–177, p = 0.030). Prophylactic hemostasis during SLE did not reduce bleeding but was associated with prolonged hospitalization (13 vs 9 days, p = 0.012).<br>
Conclusion: Routine SLE after EP does not reduce delayed bleeding. Moreover, prophylactic hemostasis in asymptomatic patients may unnecessarily prolong hospitalization. Hemostasis should be reserved for patients who develop clinical signs of bleeding.No potential conflict of interest relevant to this article was reported.Fuji Technology Press Ltd.Acta Medica Okayama1883-80143032026A Verification of Relationship Between Multiplicatively Weighted Voronoi Diagram and Huff Model: A Case Study on Order Assignment in E-Commerce921930ENTakakiKawamotoFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityTakashiHasuikeDepartment of Industrial and Management Systems Engineering, School of Creative Science and Engineering, Waseda UniversityThis study examines the relationship between a multiplicatively weighted (MW-) Voronoi diagram and the Huff model. A mathematical comparison demonstrates that the models are structurally equivalent when the Huff model is deterministic and the distance decay parameter λ takes a specific value. This theoretical finding was empirically validated using real-world e-commerce order assignment data. The experiments demonstrate the distinct strengths of each model. The Huff model enables the flexible balancing of competing objectives through parameter adjustment, whereas the MW-Voronoi diagram provides geometric clarity in the interpretation of territories. We conclude that the selection of the two models should be guided by the problem objectives, depending on whether probabilistic flexibility or deterministic spatial partitioning is required.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama1574-69683732026Intercellular signal transduction within the mother cell compartment during Bacillus subtilis sporulation fnag055ENNobukiKuwabaraDepartment of Frontier Bioscience, Hosei UniversityMasatoAnzueDepartment of Frontier Bioscience, Hosei UniversityShin-ichiMiyoshiResearch Center for Intestinal Health Science, Okayama UniversityTsutomuSatoDepartment of Frontier Bioscience, Hosei UniversityDaisukeImamuraResearch Center for Intestinal Health Science, Okayama UniversityIntercellular signaling contributes to the spatiotemporal regulation of gene expression during sporulation in Bacillus subtilis. The mother cell transcription factor σE is initially produced as an inactive precursor protein pro-σE and activated by the processing enzyme SpoIIGA in response to the forespore-produced putative signaling molecule SpoIIR. However, the mechanism underlying the SpoIIR-mediated signal transduction remains poorly understood. In this study, we showed that the spoIIR-positive, spoIIGA-deleted strain was able to induce SpoIIGA-dependent pro-σE processing in co-cultured spoIIR-deleted, spoIIGA-positive strains. This signaling was dependent on SpoIIR expression and did not involve DNA transfer. Extracellular materials including secreted proteins and membrane vesicles were unlikely to be involved in this signaling pathway. Interestingly, cessation of co-incubation shaking enhanced the signaling, while the addition of membrane-solubilizing detergent abolished it. In addition, SpoIIR signaling did not necessitate release from the forespore membrane or extracellular translocation. A SpoIIR variant lacking the putative signal peptide-like hydrophobic domain produced solely in the mother cell compartment was still able to activate pro-σE. Overall, the study findings suggested that the forespore-produced SpoIIR is neither secreted nor externally translocated. Instead, SpoIIR appeared to be transferred into the mother cell compartment and interacts with the SpoIIGA cytoplasmic domain to trigger pro-σE processing.No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama2637-6105892026Ion-Conductive Vitrimers Based on Backbone-Type Triazolium Poly(Ionic Liquid)s: Counterion-Dependent Dynamics and Backbone Flexibility62256235ENHikariTsunekawaDepartment of Applied Chemistry, Graduate School of Environmental, Life, Natural Science, and Technology, Okayama UniversityAtsushiMatsumotoDepartment of Applied Chemistry and Biotechnology, Graduate School of Engineering, University of FukuiYuyaIidaDepartment of Applied Chemistry, Graduate School of Environmental, Life, Natural Science, and Technology, Okayama UniversityTsutomuOnoDepartment of Applied Chemistry, Graduate School of Environmental, Life, Natural Science, and Technology, Okayama UniversityTakaichiWatanabeDepartment of Applied Chemistry, Graduate School of Environmental, Life, Natural Science, and Technology, Okayama UniversityTo simultaneously achieve high ionic conductivity and recyclability, vitrimers were prepared using backbone-type triazolium poly(ionic liquid)s (TPILs) that integrate ionic transport and dynamic network rearrangement via trans-N-alkylation. TPIL elastomers bearing I–, BF4–, PF6–, and TFSI– counteranions were synthesized from “clickable” ionic liquid monomers, and their glass transition temperature (Tg), ionic conductivity, and vitrimeric dynamics were compared. Only the I–-based network exhibited stress relaxation at 170 °C, indicating that nucleophilic anions are important for bond exchange. However, a trade-off was observed between ionic transport and dynamic network rearrangement. We overcome this trade-off by mixing anions. Mixed-anion TPIL elastomers using I– and TFSI– exhibited lower Tg and higher ionic conductivity than I–-based elastomer, while still maintaining vitrimer-like relaxation. Rheological analysis revealed a decoupling between segment relaxation and bond exchange dynamics in vitrimer-like elastomers. The design combining flexible polymer backbones and mixed-anion engineering can create recyclable, highly conductive polymer electrolyte networks.No potential conflict of interest relevant to this article was reported.The Japanese Society for Neuroendovascular TherapyActa Medica Okayama1882-40722012026Current Status of Middle Meningeal Artery Embolization for Chronic Subdural Hematoma: An International Perspective Including Japanra.2025-0153ENMasatoKawakamiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenjiSugiuDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasafumiHiramatsuDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunHarumaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyuKimuraDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYutaSoutomeDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJuntaroFujitaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuichiHirataDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFukikoBabaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShotaTanakaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMiddle meningeal artery embolization (MMAE) for chronic subdural hematoma (CSDH) is gaining global prevalence as a minimally invasive treatment aimed at serving as an adjunct to or method of avoiding surgery; however, its optimal positioning remains unclear. This study outlines the current status of MMAE in Japan, Germany, and the United States based on nationwide survey reports, recently published consensus guidelines, and meta-analyses including randomized controlled trials (RCTs) reported in the New England Journal of Medicine (NEJM; EMBOLISE, STEM, and MAGIC-MT) and examines its efficacy and limitations. Real-world clinical data from Japan, Germany, and the United States indicate that MMAE is primarily used as an adjunctive therapy following surgery for older and high-risk or recurrent cases, or as a stand-alone therapy in selected cases to safely reduce the risk of recurrence and reoperation. While a multidisciplinary consensus statement takes a cautious stance that limits MMAE to recurrent or inoperable cases such as those at high risk associated with interrupting antithrombotic medication, the Society of Vascular and Interventional Neurology guidelines published after the RCTs strongly recommend the concurrent use of MMAE with standard therapy in de novo cases. Meta-analyses integrating the 3 NEJM trials and other RCTs showed that MMAE suppressed recurrence and reoperation versus standard treatment, with particularly pronounced effects in the nonsurgical (conservative treatment) group; however, the additive effect was limited in the surgical adjunct group. No improvement in functional outcomes (modified Rankin Scale score) was observed. Cost-effectiveness analyses suggest that, while MMAE reduces reoperations, routine implementation for all cases is difficult to justify economically because of high procedural costs, indicating the need to narrow the indication to populations at high risk of recurrence. In conclusion, although MMAE is an effective treatment option, the current evidence does not support its uniform introduction in all patients with CSDH. Thus, it is necessary to individualize and adapt the indications for specific patient subgroups, such as those at high risk of recurrence or those for whom surgery is difficult. Finally, we propose a pragmatic treatment strategy for MMAE stratified by disease stage (de novo vs. recurrent) and clinical severity to guide the individualized selection of adjunctive and stand-alone embolization.No potential conflict of interest relevant to this article was reported.American Association for Cancer Research (AACR)Acta Medica Okayama1078-04322026Incidence of B-cell Malignancies in Patients with Lung Cancer Receiving PD-1 Blockade TherapyENToshifumiNinomiyaDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityCaiyangFangDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHirofumiHamanoDepartment of Pharmacy, Okayama University Hospital, Okayama UniversityTeruyaMorinagaDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityWenhaoZhouDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityToshihiroKoyamaDepartment of Pharmaceutical Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversitySakuraMikiDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityLiZhuDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYusukeNaoiDepartment of Hematology, Oncology and Respiratory Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityDaisukeEnnishiDepartment of Hematology, Oncology and Respiratory Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomoyaKatsutaDepartment of Respiratory Medicine, Ehime Prefectural Central HospitalKadoakiOhashiDepartment of Respiratory Medicine, Okayama University Hospital, Okayama UniversityShinMorizaneDepartment of Dermatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomokaOhki-IkedaDepartment of Pathology, Okayama University Hospital, Okayama UniversityTatsuyaNishiDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoukiUedaDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakamasaIshinoDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityIsamuOkamotoDepartment of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu UniversityYoshitoZamamiDepartment of Pharmacy, Okayama University Hospital, Okayama UniversityJojiNagasakiDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYosukeTogashiDepartment of Tumor Microenvironment, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityPurpose: Many patients with various cancer types have received immune checkpoint inhibitors (ICI) worldwide since their approval, and novel unexpected complications from their long-term use are apparent. We identified some cases of B-cell lymphoma occurring during PD-1 blockade therapy as such unexpected complications. In this study, we aimed to evaluate the incidence of hematologic malignancies in patients with lung cancer receiving PD-1 blockade therapy and to elucidate the mechanisms underlying the progression of these malignancies.<br>
Experimental Design: We performed IHC staining on the clinical samples from patients with B-cell lymphoma that developed during PD-1 blockade therapy and analyzed large-scale real-world datasets. We further investigated the underlying mechanisms through in vitro and in vivo experiments.<br>
Results: A higher incidence of B-cell malignancies has been observed in patients with lung cancer treated with PD-1 blockade therapies based on large-scale real-world data analyses (n = 15,670). The identified lymphomas had a large amount of CD4+ T follicular helper (TFH) cell infiltration. In addition, PD-1 blockade activated PD-1+ TFH cells, which promoted lymphoma proliferation via the IL4/IL4R, IL21/IL21R, and CD40L/CD40 axes. Notably, the lymphomas exhibited high expression of IL4R, IL21R, and CD40.<br>
Conclusions: Our findings highlight the need for careful monitoring and consideration of the potential B-cell malignancy complications in clinical settings in which ICIs are used.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2055-02941212026Adverse events of romidepsin versus tucidinostat for peripheral T-cell lymphoma: a pharmacovigilance study using the Japanese adverse drug event report database48ENNaoTakatsuDepartment of Pharmacy, Okayama University HospitalJunMatsumotoDepartment of Pharmacy, Okayama University HospitalYurieOkaDepartment of Pharmacy, Okayama University HospitalTomonoriSakaiDepartment of Pharmacy, Okayama University HospitalNaohiroIwataDepartment of Pharmacy, Okayama University HospitalTsukasaHigashionnaDepartment of Pharmacy, Okayama University HospitalTatsuakiTakedaDepartment of Pharmacy, Okayama University HospitalHirofumiHamanoDepartment of Clinical Pharmacology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshitoZamamiDepartment of Clinical Pharmacology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityBackground Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of lymphomas with poor prognosis, particularly in patients with relapsed or refractory (R/R) disease. Romidepsin and tucidinostat are histone deacetylase inhibitors used to treat R/R PTCL. No head-to-head post-marketing surveillance studies have compared adverse events (AEs) between the two agents. In this brief report, the AE profiles of romidepsin and tucidinostat were compared using the Japanese Adverse Drug Event Report (JADER) database to facilitate their differentiation and promote the management of AEs.<br>
Methods We conducted a descriptive analysis using data from the JADER database from April 2018 to July 2025. The reported AEs for romidepsin and tucidinostat were extracted and classified according to preferred terms (PTs) and system organ classes (SOCs). Reporting odds ratios with 95% confidence intervals were calculated to compare the AE profiles between the groups.<br>
Results In total, 998,397 reports were analysed for all drugs, including 323 for romidepsin and 753 for tucidinostat. Compared with all drugs, both agents showed significant disproportionality signals in four SOCs: Blood and lymphatic system disorders; General disorders and administration site conditions; Investigations; and Neoplasms benign, malignant and unspecified. Romidepsin exhibited additional significant signals in six SOCs: Cardiac disorders, Eye disorders, Gastrointestinal disorders, Immune system disorders, Infections and infestations, and Metabolism and nutrition disorders. Direct comparison between the two agents revealed broader AE profiles for romidepsin, with AEs more frequently reported in eight SOCs, whereas tucidinostat showed AEs in only two SOCs. Romidepsin was associated with AEs more frequently reported in several PTs, including atrial fibrillation and gastrointestinal toxicities, such as constipation, tumour lysis syndrome, hepatotoxicity, and peripheral neuropathy, which was consistent with the results at the SOC level. In contrast, several significant PTs for tucidinostat were observed in General disorders and administration site conditions and Investigations.<br>
Conclusions The Japanese real-world pharmacovigilance analysis showed differences in the AE profiles between romidepsin and tucidinostat. These differences in safety profiles may be useful for treatment selection and AE management in routine clinical practice among patients with R/R PTCL. Further studies are warranted to confirm these findings and better characterise the safety profiles of these agents.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2673-3943722026Relationship Between Numbers of Patients Registered and Procedures Performed at Lung Transplantation Centers in Japan9ENTakashiInoueDepartment of General Thoracic Surgery, School of Medicine, Dokkyo Medical UniversityMasayukiChidaDepartment of General Thoracic Surgery, School of Medicine, Dokkyo Medical UniversityYoshinoriOkadaDepartment of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku UniversityMasaakiSatoDepartment of Thoracic Surgery, University of TokyoHidemiSuzukiDepartment of General Thoracic Surgery, Chiba University Graduate School of MedicineYasushiHoshikawaDepartment of Thoracic Surgery, Fujita Health University School of MedicineToyofumiChen-YoshikawaDepartment of Thoracic Surgery, Nagoya University Graduate School of MedicineDaisukeNakajimaDepartment of Thoracic Surgery, Kyoto University Graduate School of MedicineYasushiSintaniDepartment of General Thoracic Surgery, The Osaka University Graduate School of MedicineShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeiichiroSugimotoDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama ToshihikoSatoDepartment of General Thoracic, Breast and Pediatric Surgery, Fukuoka University School of MedicineTakeshiShiraishiDepartment of General Thoracic, Breast and Pediatric Surgery, Fukuoka University School of MedicineKeitaroMatsumotoDepartment of Surgical Oncology, Nagasaki University Graduate School of Biomedical SciencesTakahiroNakajimaDepartment of General Thoracic Surgery, School of Medicine, Dokkyo Medical UniversitySumikoMaedaDepartment of General Thoracic Surgery, School of Medicine, Dokkyo Medical UniversityBackground: Recently, there has been a dramatic increase in deceased lung transplantation (DLT) procedures performed in Japan. However, there is concern that the number of transplantations may reach the limit of capacity in some centers. The present study was conducted to analyze the relationship between the numbers of individuals registered for DLT by the Japan Organ Transplantation Network (JOT) and procedures subsequently performed at lung transplantation centers. Methods: Using a database and registry reports provided by the Japanese Society of Lung and Heart-lung Transplantation, the numbers of individuals registered in the JOT and DLT procedures performed from January 2014 to December 2023 were analyzed. Results: The number of registrations was found to be correlated with the number of DLTs, with the coefficient of determination (R2) 0.962 and slope of the regression line (X coefficient) 0.407. The facility with the greatest number of registrations, with a registration-to-transplantation ratio of 0.353, was identified as an outlier (p < 0.05) and excluded from analysis. This exclusion increased both the correlation coefficient value to 0.986 and X coefficient value to 0.461. Conclusions: The present analysis showed that the number of DLTs was well correlated with number of registrations at each of the transplantation facilities. Both registration and transplantation numbers have increased in the recent decade. The facility with the highest number of registrations showed a lower registration-to-transplantation ratio, because the increase in registrations outpaced the number of transplantations.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2575-6265722026Exogenous Glutathione and Nitric Oxide Improve Waterlogging Stress Tolerance in Maizee70136ENProdipto BishnuAngonApplied Plant Biology and Bioinformatics Lab, Department of Biochemistry and Molecular Biology, Bangladesh Agricultural UniversityMd.Tahjib‐Ul‐ArifApplied Plant Biology and Bioinformatics Lab, Department of Biochemistry and Molecular Biology, Bangladesh Agricultural UniversityMd. SarwarJahanApplied Plant Biology and Bioinformatics Lab, Department of Biochemistry and Molecular Biology, Bangladesh Agricultural UniversityMd. MahadiHasanBasic and Applied Scientific Research Centre, Imam Abdulrahman Bin Faisal UniversityYoshiyukiMurataGraduate School of Environmental and Life Science, Okayama UniversityMaize (Zea mays L.) is one of the major grain crops worldwide that is particularly vulnerable to waterlogging (WL) stress. Glutathione (GSH) and nitric oxide (NO) are known to protect plants from a variety of abiotic stresses; however, their potential for improving WL tolerance in maize remains unexplored. The present study examined the impact of exogenously applied GSH and NO on maize plants exposed to WL-stress. Our findings revealed that GSH + NO-treated waterlogged maize plants grew better and produced more biomass than only WL-stressed plants. The improved performance of GSH + NO-sprayed WL-stressed maize seedlings was supported by the increased root dry and fresh weight, shoot length, shoot dry and fresh weight, chlorophyll a, chlorophyll b, and carotenoid content. Exogenous GSH and NO treatments significantly enhanced the amounts of leaf proline, leaf soluble sugars, and total protein in maize seedlings, suggesting adaptive metabolic reprogramming under stress. The increased malondialdehyde (MDA) levels and accumulation of hydrogen peroxide (H2O2) in maize leaves and roots revealed that WL caused significant oxidative damage. Exogenous GSH, NO individually, and combinedly significantly decreased total H2O2 and MDA contents in both leaves and roots. Exogenous GSH and NO reduced oxidative stress by increasing peroxidase activity, ascorbic acid, and anthocyanin content in maize leaf and root tissues. Our findings emphasize the possible relevance of GSH and NO, simultaneously and individually, in enhancing adaptive mechanisms in maize seedlings for reducing WL-induced damage. Although the GSH + NO-mediated approach shows promise for mitigating WL-stress in maize under controlled conditions, further field-based investigations are required to validate its practical applicability.No potential conflict of interest relevant to this article was reported.BMJActa Medica Okayama2044-60551632026Protocol for an open-label, randomised, controlled trial to evaluate the efficacy and safety of sotatercept add-on therapy compared with pulmonary vasodilator-based standard of care for pulmonary vasodilator-resistant pulmonary arterial hypertension associated with unrepaired congenital shunts (atrial septal defect, ventricular septal defect or patent ductus arteriosus), including Eisenmenger syndrome: the SuMILE triale113430ENKeimeiYoshidaDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu UniversityKazuyaHosokawaDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu UniversityTakahiroHiraideDepartment of Cardiology, Keio University School of MedicineSatoshiAkagiDepartment of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKentaroEjiriDepartment of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYuTaniguchiDivision of Cardiovascular Medicine, Kobe University HospitalShiroAdachiDepartment of Cardiology, Nagoya University HospitalTakumiInamiDepartment of Cardiovascular Medicine, Kyorin University School of MedicineNaohikoNakanishiDepartment of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of MedicineMasaharuKataokaThe Second Department of Internal Medicine, University of Occupational and Environmental HealthTaijyuSatohDepartment of Medical Science and Innovation, SiRIUS Institute of Medical Research, Tohoku UniversityShunsukeTatebeDepartment of Cardiovascular Medicine, Tohoku University Graduate School of MedicineToshiroShinkeDivision of Cardiology, Department of Medicine, Showa Medical University HospitalHideshiTomitaPeriatric Heart Disease and Adult Congenital Heart Disease Center, Showa Medical University HospitalYusukeAkazawaDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of MedicineTakashiHigakiDepartment of Pediatric and Adolescent Therapeutic and Developmental Education, Ehime University Graduate School of MedicineKoshiroTagawaCenter for Clinical and Translational Research, Kyushu University HospitalAyakoIshikitaDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu UniversitySoshunAsakawaDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu UniversityKohtaroAbeDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu UniversityIntroduction Eisenmenger syndrome and pulmonary arterial hypertension (PAH) due to unrepaired congenital shunts, including atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA), remain life-threatening conditions despite advances in congenital heart disease (CHD) care. In this population, vasodilator-based therapies effective in other forms of PAH have shown limited benefit, and no disease-modifying treatment has been established. Sotatercept, an activin-signalling inhibitor, improved exercise capacity and haemodynamics in phase 2/3 PAH trials; however, patients with unrepaired CHD, including Eisenmenger syndrome, were excluded. The efficacy and safety of sotatercept in this population remain unknown.<br>
Methods and analysis The SuMILE trial is a prospective, exploratory, multicentre, open-label, randomised, controlled trial conducted at 11 Japanese tertiary centres. 36 adults with vasodilator-resistant PAH due to unrepaired ASD, VSD or PDA, including Eisenmenger syndrome, will be randomised 2:1 to sotatercept add-on therapy plus vasodilator-based PAH therapy versus vasodilator-based PAH therapy alone. Sotatercept will be administered subcutaneously every 3 weeks in accordance with label-approved dose-modification rules for haemoglobin and platelet changes. The primary endpoint is the change in 6-min walk distance from baseline to week 24. Key clinical events will be independently adjudicated. Secondary endpoints include all-cause mortality or lung transplantation; pulmonary hypertension-related hospitalisation or initiation of parenteral prostacyclin and changes in WHO functional class, N-terminal pro-brain natriuretic peptide and emPHasis-10. Exploratory endpoints include genotype, right heart catheterisation and cardiac MRI parameters. The primary analysis will use ANCOVA, adjusting for baseline 6-min walk distance and randomisation stratum in the intention-to-treat population.<br>
Ethics and dissemination The protocol has been reviewed and approved by the certified central review board (Kyushu University Hospital Clinical Ethics Review Board) and participating institutions. Written informed consent will be obtained from all participants. Findings will be disseminated through peer-reviewed journals, scientific conferences and trial registries.<br>
Trial registration number Japan Registry of Clinical Trials no. 1071250069; ClinicalTrials.gov NCT07356778. Protocol version and date: V.1.3; 23 October 2025No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1557-1963212026Surface Plasmon Resonances in Silver Nanodendrites : Trunk Length and Branch Connectivity Dependence22472258ENQingyuanMaGraduate School of Informatics and Engineering, The University of Electro-communicationsYukiKishidaGraduate School of Informatics and Engineering, The University of Electro-communicationsNobuyukiTakeyasuGraduate School of Natural Science and Technology, Okayama UniversitySatoruShojiGraduate School of Informatics and Engineering, The University of Electro-communicationsThis study systematically investigates how trunk length and branch connectivity govern surface plasmon resonances in silver nanodendrites in the infrared (IR) region using a computational modeling strategy. We show that a continuous conductive trunk is essential for exciting long-wavelength collective plasmon modes. In a simulated bottom-up construction scheme, the trunk length is gradually increased to conductively connect additional branches to the backbone. Our results reveal that the fundamental δ mode resonance can be deterministically tuned across the mid-infrared spectrum (from 3840 nm to 4360 nm) primarily by controlling the trunk connectivity. As the number of connected branches grows, the lowest-order collective resonance peak exhibits a systematic redshift, and its resonance wavelength scales linearly with the effective dipole length Leff of the electron oscillation path. Concurrently, new higher-order modes emerge as local resonances of the connected substructures. These observations indicate that interrupting the conductive pathway causes a global collective mode to decompose into multiple resonances associated with more weakly coupled subsystems. The established linear scaling relationship provides a highly predictable design rule for this “programmable” connectivity, offering a robust platform for advanced applications such as multi-spectral infrared imaging, selective chemical sensing, and surface-enhanced infrared absorption (SEIRA) spectroscopy, where precise, a priori control over narrow-band infrared resonances is essential.
No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama2077-038315102026Long-Term Outcomes of Endoscopic Ultrasound-Guided Gallbladder Drainage for Acute Cholecystitis in Non-Surgical Candidates: A Multicenter Retrospective Study3621ENKeiHaradaDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyaMiyamotoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKazuyukiMatsumotoDepartment of Endoscopy, Okayama University HospitalKosakuMorimotoDepartment of Internal Medicine, Tsuyama Chuo HospitalEijiroUetaDepartment of Gastroenterology, National Organization Iwakuni Clinical CenterYutakaAkimotoDepartment of Gastroenterology, Japanese Red Cross Okayama HospitalNaoHattoriDepartment of Gastroenterology and Hepatology, Okayama University HospitalTaisukeObataDepartment of Gastroenterology and Hepatology, Okayama University HospitalRyosukeSatoDepartment of Gastroenterology and Hepatology, Okayama University HospitalAkihiroMatsumiDepartment of Endoscopy, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, JapanHiroyukiTerasawaDepartment of Gastroenterology and Hepatology, Okayama University HospitalYukiFujiiDepartment of Endoscopy, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, JapanDaisukeUchidaDepartment of Gastroenterology and Hepatology, Okayama University HospitalShigeruHoriguchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalKoichiroTsutsumiDepartment of Gastroenterology and Hepatology, Okayama University HospitalMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Okayama University HospitalBackground/Objectives: Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is a minimally invasive alternative for managing acute cholecystitis in patients who are unsuitable for surgery. Although its short-term efficacy is well-established, its long-term outcomes, especially in patients with malignancy-associated cholecystitis, remain unclear. Methods: This multicenter, retrospective study included 139 patients who underwent EUS-GBD with a plastic stent for inoperable acute cholecystitis between January 2010 and October 2023. Patients were divided into two groups: a malignant group (n = 60) with cystic duct obstruction caused by cancer invasion or self-expandable metal stents, and a benign group (n = 79) with calculous or acalculous cholecystitis. The outcomes assessed included cholecystitis recurrence, time to recurrence, adverse events, and risk factors for recurrence. Results: Technical success was achieved in all patients, with an overall clinical success rate of 94.6%. Cholecystitis recurred significantly more frequently in the malignant group than in the benign group (13.3% vs. 2.5%; p = 0.015). Univariate analysis identified malignancy as a significant risk factor of recurrence (odds ratio, 5.92; p = 0.028). Conclusions: EUS-GBD is a safe and effective long-term treatment for cholecystitis in non-surgical candidates. However, malignancy-associated cholecystitis carries a high risk of recurrence, warranting careful follow-up and individualized management.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0168-17023672026Mycoviruses diversity in the black kōji mold, Aspergillus luchuensis (section Nigri) isolated from liquor-production environments in Japan199724ENHidekiKondoInstitute of Plant Science and Resources, Okayama UniversityMisakiNanajiGraduate School of Tokyo Kasei UniversityHitomiSugaharaInstitute of Plant Science and Resources, Okayama UniversityMikiFujitaInstitute of Plant Science and Resources, Okayama UniversityIda BagusAndikaNorthwest A&F UniversityNobuhiroSuzukiInstitute of Plant Science and Resources, Okayama UniversityFujimoriFumihiroGraduate School of Tokyo Kasei UniversitySome fungal species in the genus Aspergillus are economically important due to their role in the production of liquors and various foods; however, their viromes, which may affect their performance, remain unexplored. Therefore, this study examined the viromes of nine strains of Aspergillus luchuensis (section Nigri), the black kōji mold used in the production of shochu (a traditional Japanese liquor) in Japan. It identified virus-like sequences related to alterna-, partiti-, curvula, botourmia-, narna-like, and umbra-like viruses. Some sequences appear to represent new variants (e.g., alterna- and gammapartitiviruses), while many others correspond to novel viral species within established or proposed mycoviral families. All A. luchuensis strains harbored multiple virus infections, with 2 to 7 viruses per strain. Three alternavirus strains with four-segmented double-stranded RNA (dsRNA) genomes were confirmed, along with minor variants co-present with the predominant strains. Notably, a gammapartitivirus appears to have two additional dsRNA genome segments, along with two satellite-like short dsRNA segments in some fungal isolates. Furthermore, at least five short RNAs (0.48–1.31 kb) were identified, three of which are possibly satellite-like RNAs associated with novel single-stranded RNA viruses (botourmia- and umbra-like viruses). These findings reveal the great diversity of mycoviruses in A. luchuensis populations and lay the foundation for further investigation into their impact on fungal phenotypes and liquor production.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2731-58942026Comparative study of Ni–CeO2 catalysts prepared by impregnation and coprecipitation for CO2 methanationENNobukoFukudaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityShuichiImanoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityNozomiNakaharaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThis study explores how synthesis methods affect the structure and CO2 methanation performance of Ni–CeO2 catalysts prepared by coprecipitation and impregnation under identical conditions. Coprecipitation generated particles below 100 nm with uniform elemental distribution, together with large bulk-like particles exhibiting locally concentrated Ni species, attributed to differences in hydroxide solubility. Impregnation, by contrast, produced very large particles (> 500 nm) with smaller particles attached, while maintaining relatively homogeneous elemental distribution. Coprecipitated catalysts showed slightly higher surface area and oxygen vacancy concentration, resulting in higher apparent turnover frequencies (TOFapp) below 300 °C due to enhanced CO2 adsorption and high Ni site density. However, at temperatures above 350 °C, impregnated catalysts displayed higher CH4 selectivity and TOFapp, indicating reduced kinetic limitations and more efficient active-site utilization. These results provide insights for rational design of efficient CO2 methanation catalysts.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0012-821X6872026Phase diagram of Fe-C-S ternary system under planetary core conditions120087ENBinZhaoInstitute for Planetary Materials, Okayama UniversityJintaoZhuInstitute for Planetary Materials, Okayama UniversityDanieleAntonangeliMuséum National d’Histoire Naturelle, Sorbonne Université, UMR CNRS 7590, Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie, IMPMCGuillaumeMorardMuséum National d’Histoire Naturelle, Sorbonne Université, UMR CNRS 7590, Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie, IMPMCQiChenCenter for Advanced Radiation Sources, University of ChicagoTakashiYoshinoInstitute for Planetary Materials, Okayama UniversityHigh-pressure, high-temperature experiments were conducted to investigate melting relations and phase assemblages in the Fe-C-S ternary system at 5 and 15 GPa, covering a temperature range of 1300–1900 K, conditions directly relevant to the Moon’s and Mercury’s cores. At 1300 K, the system is primarily governed by Fe-S eutectic melting, exhibiting notable complexity in the carbon-rich and sulfur-poor regions. With increasing temperature, the phase diagram simplifies: at 5 GPa and 1700 K, the Fe-Fe₃C-FeS system features three regions (Fe+L, C + L, and L). Similar phase assemblages are observed at 15 GPa, with Fe7C3 and diamond replacing Fe3C and graphite, respectively. Extensive Fe+L, C + L, and L regions are observed at 1900 K.<br>
For a Moon’s core composed of a Fe-C-S alloy, nearly pure Fe is the only viable inner core phase above 1700 K. Below this temperature, both Fe and Fe₃C are potential solid inner core phases, depending on carbon content; a two-phase solid inner core is also theoretically possible. The inferred compositions of the outer core suggest densities of 6200–7300 kg/m³, with tighter constraints for models featuring an Fe₃C core.<br>
At Mercury-relevant pressures, either Fe or Fe₇C₃ may form the solid inner core, again depending on carbon content. If the inner core is nearly pure Fe, the liquid outer core density ranges from 7300 to 7900 kg/m³. In both scenarios, a “snow” regime is plausible, though with distinct settling times. The ternary phase diagram indicates that Mercury is likely to develop a structurally layered inner core during secular cooling.<br>No potential conflict of interest relevant to this article was reported.American Chemical Society (ACS)Acta Medica Okayama2574-09709142026Reversible Droplet Bridging and Tunable Viscoelasticity in Emulsions Using Biocompatible PLA-b-PEO-b-PLA Telechelic Block Copolymers: Implications for Injectable Emulsion Gels61766185ENHinakoNakayamaDepartment of Applied Chemistry, Graduate School of Environmental, Life, Natural Science, and Technology, Okayama UniversityAtsushiMatsumotoDepartment of Applied Chemistry and Biotechnology, Graduate School of Engineering, University of FukuiYuyaIidaDepartment of Applied Chemistry, Graduate School of Environmental, Life, Natural Science, and Technology, Okayama UniversityTsutomuOnoDepartment of Applied Chemistry, Graduate School of Environmental, Life, Natural Science, and Technology, Okayama UniversityTakaichiWatanabeDepartment of Applied Chemistry, Graduate School of Environmental, Life, Natural Science, and Technology, Okayama UniversityTelechelic polymers are known to form reversible networks through end-group association; however, their application as structuring agents in emulsion-based soft materials remains underexplored. Herein, we systematically investigate the biocompatible amphiphilic triblock copolymer poly(d,l-lactic acid)-block-poly(ethylene oxide)-block-poly(d,l-lactic acid)(PLA-b-PEO-b-PLA) as a rheology modifier in toluene-in-water model emulsions. Owing to the selective adsorption of PLA end blocks at the oil–water interface and the solvation of the PEO midblock in the aqueous phase, this polymer is expected to form reversible droplet-bridging networks. During the process, the polymer concentration, molecular weight of the mid and end blocks, and the dispersed phase volume fraction were adjusted, and the factors governing network formation were elucidated using oscillatory rheology and stress-relaxation measurements. The results show that anchoring of the PLA end blocks and PEO-mediated bridging predominantly control the strength and dynamic reversibility of the network. Step-strain experiments further reveal that the droplet-bridging interactions can be disrupted under large deformation and partially recover when small-strain conditions are restored, confirming the presence of reversible physical associations. These findings establish a molecular design strategy for biodegradable telechelic copolymers as effective and reprocessable structuring agents in emulsion gels. The shear-responsive, tunable, and reversible nature of the droplet-bridging network makes this material platform particularly suitable for injectable emulsion gels for advanced soft matter and biomedical engineering applications.No potential conflict of interest relevant to this article was reported.American Geophysical Union (AGU)Acta Medica Okayama0094-82765392026Apollo 17 Lunar Surface Gravimeter as a Seismometer: Relocating Shallow‐Moonquake Sources and Implications for Source Mechanisme2025GL121619ENKeisukeOnoderaInstitute for Planetary Materials, Okayama UniversityTaichiKawamuraInstitut de Physique du Globe de Paris, Université Paris CitéAmong the reported seismic events on the Moon, shallow moonquakes are known for their unique features, such as high-frequency energy excitation, similarity to intraplate earthquakes, and the largest energy release of all reported moonquakes. Despite these interesting features, a small number of samples (<80 events) and sparse seismic network observations prevented us from gaining an in-depth understanding of shallow moonquakes. In this study, by using the Apollo 17 gravimeter as a pseudo-seismometer, we extend the Apollo lunar seismic network and located a few shallow moonquakes more accurately. In addition, comparing the located shallow-moonquake epicenters with surface/subsurface geological features indicates that at least one event may be better explained by deep-seated faults within the crust. Along with a previous demonstration of low-frequency moonquakes, our analysis of high-frequency events shows that the Apollo 17 gravimeter can serve as a seismometer over a broader frequency range than previously considered.No potential conflict of interest relevant to this article was reported.Frontiers Media SAActa Medica Okayama2474-0896832026Clinical Utility of SARS-CoV-2 Antibody Titers in the Management of Patients With Long COVID Infected With the Omicron Variant16255ENMarinaKawaguchiDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasueSakuradaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazukiTokumasuDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuiMatsudaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiHondaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeOmuraDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuyoshiMatsukiDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasanoriFurukawaDepartment of Laboratory Medicine, Okayama University HospitalAkihitoHigashikageDepartment of Laboratory Medicine, Okayama University HospitalFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: Long COVID (LC) presents persistent symptoms that pose a major clinical challenge. Identification of reliable biomarkers to evaluate LC pathophysiology is needed.<br>
Objectives: To investigate whether serum S- and N-antibody titers against SARS-CoV-2 spike and nucleocapsid proteins reflect the clinical features of LC.<br>
Methods: This retrospective observational study included patients diagnosed with Omicron variant-related LC who attended a post-COVID-19 outpatient clinic between July 2023 and November 2024 and provided informed consent for antibody testing.<br>
Results: Among 275 patients (129 men and 146 women), 57 (21%) were unvaccinated. Median S- and N-antibody titers in vaccinated versus unvaccinated patients were 20,963 U/mL and 24.8 cut-off index (COI) versus 24 U/mL and 44.5 COI, respectively. S-antibody titers were associated with the number of vaccine doses received, whereas N-antibody titers correlated with disease severity during the acute phase of COVID-19 infection, with females having higher titers by multivariable analysis. N-antibody titers in unvaccinated patients with LC were negatively correlated with time interval from infection to clinic visit, with an estimated daily decline of 0.34% in measured N-antibody levels. Patients with LC having memory impairment had low S-antibody titers by multivariable logistic regression analysis, and low S-antibody levels were associated with reduced quality of life (QOL). Additionally, N-antibody titers positively correlated with lymphocyte counts and immunoglobulin levels.<br>
Conclusion: Serum N-antibody titers reflect immune responses to COVID-19, although they are affected by gender differences and interval between infection and evaluation. Lower S-antibody titers were associated with brain fog symptoms and reduced QOL in patients with LC.No potential conflict of interest relevant to this article was reported.American Geophysical Union (AGU)Acta Medica Okayama1525-20272752026Chemical Geodynamics of Granitoid Magmatism During a Pacific‐Philippine Sea Plate Transition in Southwest Japane2026GC012945ENNghiem V.DaoThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University at MisasaTsegereda A.YemerThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University at MisasaTulibako T.MwaisubaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University at MisasaChieSakaguchiThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University at MisasaHiroshiKitagawaThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University at MisasaKatsuraKobayashiThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University at MisasaTeruyoshiImaokaDivision of Earth Science, Graduate School of Sciences and Technology for Innovation, Yamaguchi UniversityEizoNakamuraThe Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University at MisasaGranitoid magmatism along the western Pacific margin records interactions between subduction dynamics and crust–mantle processes; however, the links between plate reorganization and magma-source evolution remain debated. Here we integrate U–Pb zircon geochronology with Pb–Sr–Nd–Hf isotope systematics to investigate Cretaceous–Paleogene granitoids in Southwest Japan. Zircon U–Pb ages define two discrete magmatic episodes at 110–60 Ma and 45–30 Ma, separated by a magmatic hiatus of ∼10–15 Myr. These granitoid groups exhibit distinct isotopic signatures, indicating derivation from isotopically distinct magma sources linked to the paleo-Pacific (Izanagi) plate and the Philippine Sea plate, respectively. Isotope-based mass-balance modeling indicates higher sediment contributions to the older granitoids, with decreasing sediment input both landward and through time. The magmatic lull at ca. 52–40 Ma coincides with an abrupt isotopic shift and is interpreted to reflect plate reorganization, during which subduction of the paleo-Pacific plate was replaced by a transform or highly oblique plate boundary associated with the northward migration of the proto–Philippine Sea plate. Independent constraints from convergence rates, sediment flux, and accretionary complex development support this interpretation. These results demonstrate that granitoid magmatism in Southwest Japan was fundamentally controlled by temporal changes in subducted lithosphere and sediment flux driven by plate reorganization, highlighting the sensitivity of arc magmatism to transient tectonic regimes.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0953-81943842026Type III CD38 is present in the membrane of neurosecretory vesicles and has a cytosol-facing catalytic domain in primate oxytocin neuronse70187ENTatsukiMiyamotoDepartment of Biology, Faculty of Environmental, Life, Natural Science and Technology, Okayama UniversityAkariMatsushimaDepartment of Biology, Faculty of Science, Okayama UniversityAkitoOtuboDepartment of Biology, Faculty of Environmental, Life, Natural Science and Technology, Okayama UniversityChihongSongExploratory Research Center on Life and Living Systems (ExCELLS), National Institutes of Natural SciencesKazuyoshiMurataExploratory Research Center on Life and Living Systems (ExCELLS), National Institutes of Natural SciencesTakumiOtiDepartment of Biology, Faculty of Environmental, Life, Natural Science and Technology, Okayama UniversityHirotakaSakamotoDepartment of Biology, Faculty of Environmental, Life, Natural Science and Technology, Okayama UniversityCD38, an ADP-ribosyl cyclase that generates cyclic ADP-ribose (cADPR), is essential for Ca2+-dependent oxytocin release. However, its subcellular localisation and membrane topology within oxytocin neurones have remained unclear. We investigated the distribution and orientation of CD38 in oxytocin-producing neurones of Japanese macaques (Macaca fuscata) using immunoelectron microscopy combined with biochemical isolation of neurosecretory vesicles (NSVs). CD38 immunoreactivity was selectively detected on oxytocin-containing NSVs in axon terminals in the posterior pituitary and dendrites of the supraoptic nucleus, whereas vasopressin vesicles and the plasma membrane lacked detectable labelling. Cryo-electron microscopy confirmed the structural integrity of purified NSV fractions, and Western blotting verified the presence of CD38 protein within these fractions. Permeabilisation-dependent immunogold labelling further demonstrated that the NSV membrane localisation of CD38 and that the N-terminal region of CD38 is oriented toward the vesicle lumen, consistent with a type III membrane topology in which the catalytic domain faces the cytosol. This arrangement positions the active site near cytosolic NAD+, enabling localised cADPR production adjacent to Ca2+-mobilising channels that support regulated exocytosis. These findings identify, in primate oxytocin neurones, a previously unrecognised, vesicle-associated pool of CD38 with a cytosol-facing catalytic domain and provide a structural framework for understanding how intracellular type III CD38 contributes to neuropeptide release.No potential conflict of interest relevant to this article was reported.岡山英文学会Acta Medica Okayama0389-7788532026『青と緑』から『波』への実験的手法の考察―色彩と語りの融合―1527ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813812026婦人科領域におけるロボット支援下手術の現状と課題1518ENShojiNagaoDepartment of Perinatal Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHisashiMasuyamaDepartment of Obstetrics and Gynecology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.American Geophysical Union (AGU)Acta Medica Okayama2169-90971312026Lateral Variations in Lunar Crustal Thickness Inferred From Apollo Seismic and GRAIL Gravity Datae2025JE009453ENXiangZhangUniversité Paris Cité, Institut de physique du globe de Paris, CNRSTaichiKawamuraUniversité Paris Cité, Institut de physique du globe de Paris, CNRSMélanieDrilleauUniversité Paris Cité, Institut de physique du globe de Paris, CNRSPhilippeLognonnéUniversité Paris Cité, Institut de physique du globe de Paris, CNRSSamuelHenriUniversité Paris Cité, Institut de physique du globe de Paris, CNRSZongboXuUniversité Paris Cité, Institut de physique du globe de Paris, CNRSKeisukeOnoderaInstitute for Planetary Materials, Okayama UniversityThomasBodinInstituto de Ciencias del Mar (ICM)–CSICThe internal structure of the Moon is key to understanding its formation, evolution, and bulk composition. In particular, determining the structure of the crust–mantle interface (Moho), including its lateral variations, is of significant importance, but current knowledge is still insufficient to fully constrain it. To address this, we used seismic wave arrivals from impact events, which yield constraints on the crust at both the impact sites and the Apollo stations, to invert for local crustal thickness. Based on a series of assumed crust and mantle density models, we compared Moho depths inferred from global gravity recovery and interior laboratory gravity data with those from seismic observations. Although the gravity‐derived results broadly capture the overall Moho relief, local discrepancies remain, with differences reaching up to 10 km in the vicinity of the Apollo 17 Saturn IVB impact site. These results may reflect regional geological anomalies and highlight the importance of incorporating multiple seismically constrained crustal thickness estimates as anchors in gravity inversions. Using seven seismic anchor points and assuming an upper mantle velocity of Vp = 7.68 km/ s, an upper mantle density of 3,280 kg/m3, and a crustal density of 2,693 kg/m3, we obtain an average lunar crustal thickness of 43.6 ± 1.9 km. The findings also provide valuable guidance for future global 3D modeling of the Moon.No potential conflict of interest relevant to this article was reported.John Wiley & Sons LtdActa Medica Okayama1362-10173132026Early sedation intensity and psychological outcomes in critically ill adultse70500ENMikikoIwataniOkayama University Hospital; Graduate School of Health Sciences, Doctoral Program, Okayama UniversityMichikoMorimotoFaculty of Health Sciences, Okayama UniversityBackground: Long-term psychological impairment is a major concern for intensive care unit (ICU) survivors. Early deep sedation during mechanical ventilation has been associated with poor short-term outcomes and mortality after ICU discharge; however, its relationship with psychological outcomes remains unclear.<br>
Aim: To investigate sedation intensity during the first 24 h of mechanical ventilation and its association with psychological impairment 3 months after ICU discharge.<br>
Study Design: This retrospective ancillary analysis of a single-centre cohort study was conducted in two general ICUs at a university hospital in Japan. Eligible patients stayed in the ICU for more than 48 h and received mechanical ventilation for more than 8 h. Sedation intensity was quantified using the Sedation Index (SI) and Agitation Index (AI) derived from Richmond Agitation-Sedation Scale scores during the first 24 h. Psychological impairment 3 months post-ICU discharge was assessed based on symptoms of post-traumatic stress, anxiety and depression. Associations were examined using hierarchical logistic regression.<br>
Results: Among 130 participants, the median age was 64 years, and the median ventilation duration was 14 h. The median SI was 3.0; 47% had SI > 3, and 8.5% had AI > 0. Sedation intensity showed no significant association with psychological impairment (SI: adjusted odds ratio [OR] 0.87, 90% confidence interval [CI] 0.57–1.33, p = 0.59; AI: adjusted OR 0.21, 90% CI 0.01–3.08, p = 0.34). However, any agitation during the ICU stay was associated with psychological outcomes (adjusted OR 2.61, 90% CI 1.16–5.88, p = 0.05).<br>
Conclusions: This study did not identify a statistically significant association between early sedation intensity and psychological impairment 3 months after ICU discharge.<br>
Relevance to Clinical Practice: Critical care nurses should carefully titrate sedation from the initiation of mechanical ventilation to avoid unnecessary deep sedation, considering sedation intensity over time, while actively assessing agitation and its underlying causes.No potential conflict of interest relevant to this article was reported.Japan Poultry Science AssociationActa Medica Okayama1346-7395632026Supplementation of 5-Aminolevulinic Acid Suppressed Body Weight Loss and Reduced Disease Severity During Eimeria tenella Infection in Broiler Chickens2026010ENTaqi AhmadHanifLaboratory of Animal Physiology, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMakotoMatsubayashiDepartment of Veterinary Science, Graduate School of Veterinary Sciences, Osaka Metropolitan UniversityToshimitsuHatabuLaboratory of Animal Physiology, Graduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityThis study aimed to evaluate the effects of 5-aminolevulinic acid (5-ALA) supplementation in broiler chickens infected with Eimeria tenella. To assess these effects, chickens supplemented with 20 ppm 5-ALA (5-ALA group) were compared with non-supplemented controls (control group). Sporulated E. tenella oocysts (2.0 × 103 oocysts per animal) were administered orally to 2-week-old broiler chickens. Body weight was measured weekly, and fecal samples were collected daily from 4 to 15 days post-infection (dpi). Fecal oocyst shedding was quantified using the sucrose flotation method. Cecal tissues were collected at 5 dpi for histopathological analysis and lesion scoring. The animals in the 5-ALA group exhibited significantly greater weight gain and milder clinical signs than those in the control group. Fecal oocyst shedding was highest at 7 dpi in both groups; however, the 5-ALA group exhibited significantly lower oocyst output than the control group. The total number of fecal oocysts shed during the acute infection period was significantly lower in the 5-ALA group than in the control group. Histopathological analysis revealed that although both groups exhibited epithelial hyperplasia and E. tenella schizonts in the cecal submucosa, inflammatory cell infiltration, cecal tissue damage, and histological lesion scores were significantly lower in the 5-ALA group than in the control group. These results suggest that 5-ALA supplementation may mitigate the clinical, parasitological, and histological effects of E. tenella infection in broiler chickens.No potential conflict of interest relevant to this article was reported.