Up-front resection for hepatocellular carcinoma: Assessing futility in the preoperative setting.

Objective: We sought to develop a predictive model to preoperatively identify patients with hepatocellular carcinoma (HCC) at risk of undergoing futile upfront liver resection (LR).

Methods: Patients undergoing curative-intent LR for HCC were identified from a large multi-institutional database. Futile LR was defined by death or disease recurrence within six months postoperatively.

Creatinine production rate is an integrative indicator to monitor muscle status in critically ill patients.

Background: Both quantitative and qualitative aspects of muscle status significantly impact clinical outcomes in critically ill patients. Comprehensive monitoring of baseline muscle status and its changes is crucial for risk stratification and management optimization. However, repeatable and accessible indicators are lacking.

A high fraction of inspired oxygen does not mitigate atelectasis-induced lung tissue hypoxia or injury in experimental acute respiratory distress syndrome.

Although alveolar hyperoxia exacerbates lung injury, clinical studies have failed to demonstrate the beneficial effects of lowering the fraction of inspired oxygen (FO) in patients with acute respiratory distress syndrome (ARDS). Atelectasis, which is commonly observed in ARDS, not only leads to hypoxemia but also contributes to lung injury through hypoxia-induced alveolar tissue inflammation. Therefore, it is possible that excessively low FO may enhance hypoxia-induced inflammation in atelectasis, and raising FO to an appropriate level may be a reasonable strategy for its mitigation.

A case report of exacerbation of extrapyramidal symptoms following the switch from risperidone to paliperidone during valproate therapy.

Background: Paliperidone is a second-generation antipsychotic and the main active metabolite of risperidone, formulated to provide consistent therapeutic effects through an extended-release system, designed to provide consistent therapeutic effects through an extended-release formulation. While commonly used in clinical practice, switching from risperidone to paliperidone, particularly during valproate therapy, can pose challenges due to potential pharmacokinetic interactions that may increase the risk of extrapyramidal symptoms (EPS). Despite clinical observations suggesting these interactions, case reports documenting such adverse effects are scarce.

The Acute Effect of Hot Water Immersion on Cardiac Function in Individuals with Cervical Spinal Cord Injury.

Thermotherapy is expected to assist in the prevention of arteriosclerosis and cardiovascular disease in individuals with spinal cord injuries. This study aimed to investigate the impact and underlying mechanisms of whole-body heat stress on cardiac function in patients with cervical spinal cord injury (CSCI) and healthy controls using head-out hot water immersion (HHWI). Eight male patients with complete motor CSCI and nine healthy controls were recruited.

Long-term prognostic outcomes in high-risk T1 colorectal cancer: A multicentre retrospective comparison of surgery versus observation postendoscopic treatment.

Aim: The risk of lymph node metastasis after endoscopic resection of high-risk T1 colorectal cancer prompts additional resection. However, age and comorbidities are considered in decision-making and some surgeons opt for observation. We compared the long-term outcomes of these approaches with the aim of clarifying the need for additional resection.

Textbook outcome in liver surgery for intrahepatic cholangiocarcinoma: defining predictors of an optimal postoperative course using machine learning.

Background: We sought to define textbook outcome in liver surgery (TOLS) for intrahepatic cholangiocarcinoma (ICC) by considering the implications of perioperative outcomes on overall survival (OS).

Methods: Using a multi-institutional database, TOLS for ICC was defined by employing novel machine learning (ML) models to identify perioperative factors most strongly predictive of OS ≥ 12 months. Subsequently, clinicopathologic factors associated with achieving TOLS were investigated.

Machine learning based prediction model for bile leak following hepatectomy for liver cancer.

Objective: We sought to develop a machine learning (ML) preoperative model to predict bile leak following hepatectomy for primary and secondary liver cancer.

Methods: An eXtreme Gradient Boosting (XGBoost) model was developed to predict post-hepatectomy bile leak using data from the ACS-NSQIP database. The model was externally validated using data from hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) multi-institutional databases.

Perioperative Changes in Serum Transaminases Levels Predicts Long-Term Survival Following Liver Resection of Hepatocellular Carcinoma.

Background: We sought to define whether and how hepatic ischemia/reperfusion (I/R) as manifested by perioperative aspartate aminotransferase (AST) and alanine aminotransaminase (ALT) levels impact long-term outcomes after curative-intent resection of hepatocellular carcinoma (HCC).

Patients And Methods: Intrasplenic injection of HCC cells was used to establish a murine model of HCC recurrence with versus without I/R injury. Patients who underwent curative resection for HCC were identified from a multi-institutional derivative cohort (DC) and separate external validation (VC) cohort.

Impact of board-certified intensive care training facilities on choice of adjunctive therapies and prognosis of severe respiratory failure: a nationwide cohort study.

Background: Patients with severe respiratory failure have high mortality and need various interventions. However, the impact of intensivists on treatment choices, patient outcomes, and optimal intensivist staffing patterns is unknown. In this study, we aimed to evaluate treatments and clinical outcomes for patients at board-certified intensive care training facilities compared with those at non-certified facilities.

It is time for reform: Results from a questionnaire survey on the current status of next generation HBP surgeons in Japan.

A questionnaire survey was designed and performed to assess the current status of "next generation" hepatobiliary and pancreatic (HBP) surgeons regarding surgical training, career, recruiting, and work-life balance in Japan. Using a valid email address, a questionnaire was sent to members of the Japanese Society of Hepato-Biliary-Pancreatic Surgeons (JSHBPS) who were under 45 years old. The questionnaire comprised 50 questions across the following four sections: (i) board certification of JSHBPS, (ii) research activity and overseas study, (iii) recruiting, and (iv) work-life balance.

Lymphadenectomy for perihilar cholangiocarcinoma: therapeutic benefit of lymph node number and station.

Background: We sought to characterize the benefit of lymphadenectomy among patients undergoing curative-intent surgery for perihilar cholangiocarcinoma (pCCA) utilizing the therapeutic index.

Methods: Data on patients who underwent curative-intent resection for pCCA were obtained from 8 high-volume international hepatobiliary centers. Multivariable Cox regression analysis was used to assess clinicopathological factors associated with overall survival (OS).

Head-to-head comparison among FAST, MAST, and multiparametric MRI-based new score in diagnosing at-risk MASH.

Objectives: New scores were developed to identify at-risk metabolic dysfunction-associated steatohepatitis (MASH) using multiparametric MRI (mpMRI).

Materials And Methods: A prospective study was conducted on 176 patients with suspected or diagnosed metabolic dysfunction-associated steatotic liver disease (MASLD) paired with an MR scan, vibration-controlled transient elastography (VCTE), and liver biopsy. Liver stiffness measurement (LSM) using magnetic resonance elastography (MRE), proton density fat fraction (PDFF), and mpMRI-based corrected T1 (cT1) were combined to develop a one-step strategy, named MPcT (MRE + PDFF + cT1, combined score), and a two-step strategy-MRE-based LSM followed by PDFF with cT1 (M-PcT, paired score) for diagnosing at-risk MASH.

Prospective changes in financial toxicity and health-related quality of life in patients with gynecologic cancer.

Background: Financial toxicity impacts the treatment choices, daily life, and health-related quality of life (HRQoL) of cancer patients. We investigated future variations in financial toxicity and HRQoL of patients with gynecologic cancer, evaluated using the COmprehensive Score for financial Toxicity (COST) questionnaire.

Methods: This multicenter study enrolled patients with gynecologic cancer incurring co-payments for anti-cancer drug treatment for over 2 months.

Rapid and Safe Neutralization Assay for Circulating H5N1 Influenza Virus in Dairy Cows.

Rapid and safe neutralization assays are required for highly pathogenic avian influenza viruses, including a clade 2.3.4.

Analyzing the interaction between time to surgery and tumor burden score in hepatocellular carcinoma.

Background: The effect of "time to surgery (TTS)" on outcomes for curative-intent hepatectomy of hepatocellular carcinoma (HCC) remains debated. The interaction between tumor burden score (TBS) and TTS remains unclear. We sought to evaluate the effects of TBS and TTS on long-term HCC outcomes.