The impact of rare cancer and early-line treatments on the benefit of comprehensive genome profiling-based precision oncology

BACKGROUND

Comprehensive genome profiling (CGP) serves as a guide for suitable genomically matched therapies for patients with cancer. However, little is known about the impact of the timing and types of cancer on the therapeutic benefit of CGP.

MATERIALS AND METHODS

A single hospital-based pan-cancer prospective study (TOP-GEAR; UMIN000011141) was conducted to examine the benefit of CGP with respect to the timing and types of cancer. Patients with advanced solid tumors (>30 types) who either progressed with or without standard treatments were genotyped using a single CGP test. The subjects were followed up for a median duration of 590 days to examine therapeutic response, using progression-free survival (PFS), PFS ratio, and factors associated with therapeutic response.

RESULTS

Among the 507 patients, 62 (12.2%) received matched therapies with an overall response rate (ORR) of 32.3%. The PFS ratios (≥1.3) were observed in 46.3% (19/41) of the evaluated patients. The proportion of subjects receiving such therapies in the rare cancer cohort was lower than that in the non-rare cancer cohort (9.6% and 17.4%, respectively; P = 0.010). However, ORR of the rare cancer patients was higher than that in the non-rare cancer cohort (43.8% and 20.0%, respectively; P = 0.046). Moreover, ORR of matched therapies in the first or second line after receiving the CGP test was higher than that in the third or later lines (62.5% and 21.7%, respectively; P = 0.003). Rare cancer and early-line treatment were significantly and independently associated with ORR of matched therapies in multivariable analysis (P = 0.017 and 0.004, respectively).

CONCLUSION

Patients with rare cancer preferentially benefited from tumor mutation profiling by increasing the chances of therapeutic response to matched therapies. Early-line treatments after profiling increase the therapeutic benefit, irrespective of tumor types.

A comparison of the physical demands generated by playing different opponents in basketball friendly matches

This study aimed to compare the physical demands of playing opponents of different skill levels in basketball. Eighteen men's college basketball players wore accelerometers to measure the relative accumulated acceleration load (AAL), estimated equivalent distance, and frequencies of sprint, jump, and exertion events during games against professional teams (Pro), teams at the same competition level (Collegiate), and teams comprising intra-team members in practice games (Scrimmage). Internal responses were calculated using the relative rating of perceived exertion (sRPE). A repeated measures analysis of variance, Bonferroni post-hoc tests, and standardized Cohen's effect sizes were calculated to compare the physical demands and internal responses across matches played against different levels of opponents. The results showed that in the game against the Pro, AAL (arbitrary units), sprint events (cases per min), and exertion events (cases per min) were significantly (p < .05) higher than those in games against the Collegiate and Scrimmage teams. As the competitive level of the opponents increased, the relative external load of the participants also increased. Conversely, internal responses measured using sRPE were lower after games against the Pro than those against the Collegiate. Internal and external loads may vary from each other depending on contextual factors.

A retrospective study on the effects of dry period length on milk yield and postpartum health in Holstein dairy cows

We retrospectively analyzed the effects of dry period length (DPL) on milk yield and postpartum health using 152 commercial dairy farm data, including 46,228 dairy cows in Hokkaido, Japan, and examined the optimal DPL. The DPL was divided into eight categories: ≤25, 26-35, 36-45, 46-55, 56-65 (reference), 66-75, 76-85, and ≥86 d. The total milk yields (the sum of milk yield during the 55 d before and the 305 d milk yield after calving) of cows with DPL of ≤55 d did not differ from the reference group. Cows with DPL of ≤55 d had lower odds ratios (OR) of a displaced abomasum (DA), ketosis, milk fever (MF), and abnormal milk fat-to-protein ratio but had higher puerperal fever (PF) and stillbirth ORs than the reference group. Cows with a DPL of 46-55 d had the lowest PF and stillbirth ORs among the short DPL categories. The extremely short (≤25 d) and long (≥86 d) DPL increased the ORs of mastitis and abnormal liner score of somatic cell counts (SCCs) compared with the reference group. We conclude that shortening DPL can reduce postpartum health problems without reducing milk yield and that the optimal DPL is 46-55 d.

Recommendations for the use of next-generation sequencing in patients with metastatic cancer in the Asia-Pacific region: a report from the APODDC working group

INTRODUCTION

Next-generation sequencing (NGS) diagnostics have shown clinical utility in predicting survival benefits in patients with certain cancer types who are undergoing targeted drug therapies. Currently, there are no guidelines or recommendations for the use of NGS in patients with metastatic cancer from an Asian perspective. In this article, we present the Asia-Pacific Oncology Drug Development Consortium (APODDC) recommendations for the clinical use of NGS in metastatic cancers.

METHODS

The APODDC set up a group of experts in the field of clinical cancer genomics to (i) understand the current NGS landscape for metastatic cancers in the Asia-Pacific (APAC) region; (ii) discuss key challenges in the adoption of NGS testing in clinical practice; and (iii) adapt/modify the European Society for Medical Oncology guidelines for local use. Nine cancer types [breast cancer (BC), gastric cancer (GC), nasopharyngeal cancer (NPC), ovarian cancer (OC), prostate cancer, lung cancer, and colorectal cancer (CRC) as well as cholangiocarcinoma and hepatocellular carcinoma (HCC)] were identified, and the applicability of NGS was evaluated in daily practice and/or clinical research. Asian ethnicity, accessibility of NGS testing, reimbursement, and socioeconomic and local practice characteristics were taken into consideration.

RESULTS

The APODDC recommends NGS testing in metastatic non-small-cell lung cancer (NSCLC). Routine NGS testing is not recommended in metastatic BC, GC, and NPC as well as cholangiocarcinoma and HCC. The group suggested that patients with epithelial OC may be offered germline and/or somatic genetic testing for BReast CAncer gene 1 (BRCA1), BRCA2, and other OC susceptibility genes. Access to poly (ADP-ribose) polymerase inhibitors is required for NGS to be of clinical utility in prostate cancer. Allele-specific PCR or a small-panel multiplex-gene NGS was suggested to identify key alterations in CRC.

CONCLUSION

This document offers practical guidance on the clinical utility of NGS in specific cancer indications from an Asian perspective.

Effect of the COVID-19 Pandemic on Lower Extremity Injuries in Japanese Collegiate Men's Basketball Players

Background

The coronavirus disease 2019 (COVID-19) pandemic significantly affected the lives of Japanese collegiate men's basketball players.

Purpose

To describe the incidence of lower extremity injuries in Japanese collegiate men's basketball during the COVID-19 pandemic and examine the effects of the pandemic on injury patterns.

Study Design

Descriptive epidemiological study.

Methods

Using data from a surveillance project of the Department of Medicine and Science of the Kanto Collegiate Basketball Federation, the authors included data from 6 men's basketball teams during the 2020-21 and 2021-22 seasons (11 team seasons). Injury rates per 1000 athlete-exposures (AEs) were calculated according to injury type, location, and frequency. Injury burden was estimated by multiplying the injury rate by the mean days lost. Injuries from the 2020-21 to 2021-22 seasons were compared with those before the pandemic (2013-14 to 2019-20 seasons) using injury rate ratios (IRRs), with significant differences indicated when the 95% CI did not include 1.0.

Results

In total, 135 lower extremity injuries were reported during 27,249 AEs. The overall injury rate of the 2020-21 to 2021-22 seasons was significantly higher than that of the 2013-14 to 2019-20 seasons (IRR, 1.37; 95% CI, 1.12-1.67). Lateral ankle sprains (IRR, 1.37; 95% CI, 1.02-1.86), hamstring strains (IRR, 2.86; 95% CI, 1.34-6.12), jumper's knee (IRR, 2.68; 95% CI, 1.13-6.37), and stress fractures of the proximal fifth metatarsal (IRR, 7.16; 95% CI, 1.31-39.08) were significantly higher during the 2020-21 to 2021-22 seasons compared with the 2013-14 to 2019-20 seasons.

Conclusion

The rate of lower extremity injuries increased significantly in Japanese collegiate men's basketball players during the COVID-19 pandemic. The results of this study emphasize the importance of optimal screening and specific loads for injury prevention when detraining periods are anticipated.

The parity affects the relationship between the insemination-ovulation interval and the conception rate in lactating dairy cows

The aim of the present study was to investigate the relationship between parity and the optimal insemination-ovulation interval (IOI) in lactating dairy cows, as well as the relationship between the optimal timing of artificial insemination (AI) based on the onset of estrus and parity. A total of 183 postpartum lactating Holstein cows participated in the study and underwent 522 AI procedures using unsorted frozen semen between 2011 and 2018. Transrectal ultrasound was used to detect ovulation times in 326 AI procedures, and a pedometer was used to detect estrus onset times in 470 AI procedures. An analysis was also performed on data from 265 AI procedures in which all the times of estrus onset, estrus end, and ovulation were detected. The results showed that ovulation occurring 6-12 hr after AI was associated with the numerical highest conception rate in multiparous cows. Moreover, the conception rate was higher when ovulation occurred between 6 and 12 hr after AI than when it occurred between 0 and 6 hr or 18 and 24 hr after AI. In contrast, the effect of IOI on the conception rate in primiparous cows was insignificant. There was no effect of AI timing based on the estrus onset on the conception rate in either primiparous or multiparous cows. Furthermore, the interval from estrus onset to ovulation was similar in primiparous and multiparous cows. The difference in optimal IOI between primiparous and multiparous cows may be due to the larger uterus size in multiparous cows. These findings suggest that the optimal timing for AI in multiparous cows is more restricted than in primiparous cows. Therefore, it is essential to carefully determine the timing of AI when it is performed in multiparous cows.

Descriptive epidemiology of injuries in Japanese collegiate men's basketball: 2013/2014 to 2019/2020

Background

Basketball is one of the most played sports in the world. However, only a few studies have examined the epidemiology of Japanese collegiate men’s basketball injuries. This study investigated the incidence of injury among Japanese collegiate men’s basketball from the 2013/2014 to the 2019/2020 seasons and identified unique patterns by comparing our data with the National Collegiate Athletic Association (NCAA) men’s basketball data.

Methods

Data from Japanese collegiate basketball teams of the Kanto Collegiate Basketball Federation Division I League during the 2013/2014 to 2019/2020 academic years (23 team-seasons) were used in this study. Injury rates per 1000 athlete exposures (AEs), injury proportions, and the injury rate ratio (IRR) were calculated according to the events, injury types, body parts, and common injury mechanisms. Injury rates were then compared with that from the time-loss injury data of the NCAA’s previous reports.

Results

In total, 480 injuries during 97,515 AEs were reported, leading to an injury rate of 4.92 per 1000 AEs (95% CI = 4.48–5.36). The overall injury rate was higher in Japan than in the NCAA ([2009/2010–2014/2015] IRR = 1.55, 95% CI = 1.39–1.73; [2014/2015–2018/2019] IRR = 1.64, 95% CI = 1.48–1.82). Lower extremity injuries occurred most frequently (73.5%). Ankle sprain was the most common injury in Japan, with higher injury rates than in the NCAA (IRR = 2.10; 95% CI = 1.72–2.57). The injury rate of concussion was lower in Japan than in the NCAA (IRR = 0.28; 95% CI = 0.14–0.55).

Conclusions

The rates of overall injury and ankle sprain were higher and that of concussion was lower in Japan than in the NCAA. These results suggested the existence of international differences in the pattern or features of injuries in basketball players.

Acceleration profile of high-impact movements during young football games: a cross-sectional study involving healthy children

Repetitive high-impact movements cause growth-related injuries in children. This study aimed to identify which movements during junior football games require >6 G and >8 G acceleration and the frequency at which they occur. Additionally, we compared the components of acceleration among movements with >8 G resultant acceleration. Eleven young male footballers (10.7 ± 0.4 years) played 8-a-side games while wearing a tri-axial accelerometer on their upper back. The number and frequency of the movements that generated >6 G and >8 G were calculated, and each directive acceleration of the top five items was compared using two-way ANOVA to examine the effect of movements. The frequency of movements that generated >6 G and >8 G acceleration during junior football games was 8.70 case/min and 2.62 case/min, respectively. The top five >8 G movements were braking and pre-braking in shuffle, slowdown, stop, and run/jog items. The vertical acceleration was significantly greater during braking in shuffle than during slowdown, stop, and run/jog and also greater during stop and pre-braking in shuffle than during run/jog movement. This pilot study suggests that decelerated movements mainly provoked high-impact situations and may be key actions for preventing overuse injury in young footballers.

POS1482-HPR PAIN CATASTROPHIZING IS ASSOCIATED WITH RESIDUAL PAIN AFTER REACHING IMPROVED CONDITIONS OF SWOLLEN/TENDER JOINTS AND SERUM C-REACTIVE PROTEIN LEVEL

Background:

It has long been recognized that immune-mediated inflammatory diseases, such as rheumatoid arthritis (RA), are prone to coexist with depression due to the effects of cytokines, and that these two illnesses lead to an elevation in patients’ pain. However, we often encounter patients with RA who suffer from residual pain despite an improvement in disease activity and inflammation. The specific psychological factors associated with residual pain have not yet been clarified. In addition to the traditional psychological factors, such as depression and anxiety, we focused on pain catastrophizing due to the distortion of pain perception and explored its association with residual pain.

Objectives:

To examine whether psychological factors, such as pain catastrophizing, depression, and anxiety, are associated with self-reported pain visual analogue scale (pain-VAS) scores in RA patients with 1 or less on 28joints- swollen/tender counts (SJC/TJC) and CRP.

Methods:

This was a cross-sectional study of 290 RA outpatients (85% of whom were women) with scores of less than 1 on SJC, TJC, and CRP, with a median (IQR) age of 66 (57–73) years. The participants completed questionnaires, including pain VAS (0–100 mm), Pain Catastrophizing Scale (PCS, 0–52 scale), and Hospital Depression and Anxiety Scale (HADS, 0–42 scale). Using linear regression analyses, we analysed whether PC (PCS ≥30), depression (HADS-D ≥11), and anxiety (HADS-A ≥11) (independent variables) were associated with pain VAS scores (dependent variable). After univariate regression analysis, multivariate analysis adjusted for confounding factors was performed.

Results:

Patients reported a wide range of pain severity with a median (range) pain VAS score of 9 (0–96mm). The prevalence of anxiety and depression were 5.5% and 5.9%, respectively. Meanwhile, 24.1% of the patients experienced pain catastrophizing. Pain catastrophizing was associated with pain VAS scores in univariate and multivariate analyses (Table 1). The presence of anxiety and depression was not associated with pain VAS scores in any model. Multivariate analysis of other covariates showed that age, disease duration, and presence of SJC/TJC of joints other than the 28 joints were positively correlated with pain VAS scores.

Table 1.

Univariate and multivariate regression analysis for independent variables associated with pain-VAS scores

UnivariateMultivariate independent variablesModel 1*Model 2**Pain catastrophizingEstimate3.74.13.695%CI 0.7 to 6.61.1 to 7.00.5 to 6.6p-value0.0150.0060.021AnxietyEstimate3.74.40.595%CI -1.9 to 9.2 -1.0 to 9.9 -3.5 to 7.9p value0.1980.1080.453DepressionEstimate3.54.23.995%CI -1.9 to 8.9 -1.1 to 9.5 -1.9 to 8.7p-value0.2040.1190.210

The covariates in multivariate analysis are as follows: age, sex, body mass index, disease duration, Steinbrocker’s Stage, prednisolone dosage, biologic agents use, and presence of swollen joint counts/tender joint counts of joints other than the 28 joints.

*Model 1: each psychological independent variable and the above covariates.

**Model 2: all psychological independent variables and the above covariates.

Conclusion:

Pain catastrophizing was associated with pain VAS scores in RA patients with 1 or less on 28joints-SJC/TJC and CRP, emphasising that residual pain in the patients should be treated in a biopsychosocial framework focussing on pain catastrophizing.

Disclosure of Interests:

Tamami Yoshida: None declared, Motomu Hashimoto Speakers bureau: Mitsubishi Tanabe Pharma Corporation; Bristol-Myers Squibb; Eisai Co., Ltd.; and Eli Lilly and Company., Grant/research support from: Mitsubishi Tanabe Pharma Corporation; Bristol-Myers Squibb; Eisai Co., Ltd.; and Eli Lilly and Company., Kosaku Murakami Speakers bureau: Eisai Co., Ltd.; Chugai Pharmaceutical Co., Ltd.; Pfizer Inc.; Bristol-Myers Squibb; Mitsubishi Tanabe Pharma Co; UCB Japan Co., Ltd.; Daiichi Sankyo Co., Ltd.; and Astellas Pharma Inc., Consultant of: Eisai Co., Ltd.; Chugai Pharmaceutical Co., Ltd.; Pfizer Inc.; Bristol-Myers Squibb; Mitsubishi Tanabe Pharma Co; UCB Japan Co., Ltd.; Daiichi Sankyo Co., Ltd.; and Astellas Pharma Inc., Koichi Murata Speakers bureau: Eisai Co., Ltd. and Astellas Pharma Inc., Consultant of: Eisai Co., Ltd. and Astellas Pharma Inc., Kohei Nishitani Grant/research support from: Asahi-Kasei Pharma., Ryu Watanabe Speakers bureau: Mitsubishi Tanabe Pharma Co; Pfizer Inc.; Sanofi S.A.; AbbVie GK; Asahi Kasei Pharma; Eisai Co., Ltd.; Eli Lilly and Company; Bristol-Myers Squibb; and Janssen Pharmaceutical K.K., Teruhide Koyama: None declared, Ritei Uehara: None declared, Masao Tanaka Speakers bureau: AbbVie GK, Asahi Kasei Pharma., Astellas Pharma Inc., Ayumi Pharmaceutical Co., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Co., Novartis Pharma K.K., Pfizer Inc., Taisyo Pharma., Ltd., UCB Japan Co., Ltd., Grant/research support from: AbbVie GK, Asahi Kasei Pharma., Astellas Pharma Inc., Ayumi Pharmaceutical Co., Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., Janssen Pharmaceutical K.K., Mitsubishi Tanabe Pharma Co., Novartis Pharma K.K., Pfizer Inc., Taisyo Pharma., Ltd., UCB Japan Co., Ltd., Hiromu Ito Grant/research support from: Bristol-Myers Squibb, Eisai Co, Taisyo Pharma., and Mochida., Shuichi Matsuda: None declared

High-Impact Details of Play and Movements in Female Basketball Game

This study aimed to identify the high-impact details of play and movements with higher acceleration and their frequency during a female basketball match. Trunk acceleration was measured during a simulated basketball game with eight female players. The extracted instance was categorized, which generated at > 6 and 8 G resultant accelerations using a video recording and an accelerometer attached to the players’ trunk, as details of play and movements. The frequency and ratio of the details of play and movements regarding all detected movements were calculated. A total of 1062 and 223 play actions were detected for the resultant acceleration thresholds of > 6 and 8 G, respectively. For these acceleration thresholds, in terms of details of play, positioning on the half-court was the most frequently observed (29.6 and 23.8%, respectively). In terms of movements, deceleration was the most frequently detected movement (21.5 and 23.3%, respectively), followed by landing (7.6 and 15.7%, respectively). Deceleration during positioning on the half-court and defense as well as landing mostly after a shot were detected as high-impact frequent basketball-specific movements. The results also showed that characteristics of movements or playing style and playing position may have an effect on acceleration patterns during a basketball game.

Pathological assessment of osimertinib-associated cardiotoxicity in EGFR-mutated non-small cell lung cancer patients

Background

Osimertinib, a third-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI), inhibits both EGFR-TKI sensitizing mutations and resistant T790M mutations detected in non-small cell lung cancer (NSCLC) patients. Cardiac adverse events (AEs) induced by osimertinib are infrequent; however, cases of severe associated cardiac dysfunction have been reported and remain poorly understood.

Purpose

To assess pathogenesis of osimertinib-associated cardiac AEs, we analyzed myocardial specimens of three NSCLC cases with osimertinib-associated cardiac dysfunction.

Results

Analysis of LVEF prior to and after osimertinb administration in 36 NSCLC patients showed significant decrease of LVEF from 69% to 63%. Within this cohort, right ventricular (RV) biopsy was performed in 2 cases to further understand the pathophysiology of cardiac dysfunction. Case 1 was 78-year-old female with advanced NSCLC harboring an EGFR L858R mutation was treated with osimertinib as second line therapy. After 3 moths of osimetinib treatment, she presented with dyspnea, high NT-proBNP and troponin I, and significantly decreased left ventricular ejection fraction (LVEF) at 28%. RV biopsy showed moderate cardiomyocyte hypertrophy without inflammatory cell infiltration. Case 2 was 52-year-old female with advanced NSCLC harboring L858R mutation. She was treated with osimertinib as first line therapy. After 2 weeks of osimertinib, screening echocardiography revealed a reduction of LVEF from 63% to 41% without cardiac symptom. RV biopsy showed mild cardiomyocyte hypertrophy with infiltration of a few inflammatory cells in interstinum. We further analyzed death case of NSCLC. Case 3 was 63-year-old female with advanced NSCLC harboring EGFR ex. 19 del. and T790M mutations. After 6 months of osimertinib, she suffered from severe respiratory failure and severely reduced LVEF at 27%. She died on the 44th day after admission. Pathological autopsy revealed mild to moderate cardiomyocyte hypertrophy without inflammatory cell infiltration in both ventricles. These pathological findings may indicate neither myocyte injury nor myocarditis was induced by osimertinib in myocardium.

Conclusion

Although additional data collection of advanced NSCLC patients will be important in understanding the pathophysiology of cardiac AEs with osimertinib, osimertinib-associated cardiotoxicity may result from functional inhibition of myocyte contractility by osimertinib without induction of cell death or inflammation.

Funding Acknowledgement

Type of funding source: None

Acceleration Profile of High-Intensity Movements in Basketball Games

Koyama, T, Rikukawa, A, Nagano, Y, Sasaki, S, Ichikawa, H, and Hirose, N. Acceleration profile of high-intensity movements in basketball games. J Strength Cond Res XX(X): 000-000, 2020-This study aimed to elucidate movements that require greater acceleration during basketball games, their occurrence frequency, and compare acceleration components. Eighteen male collegiate basketball players (age: 19.5 ± 0.8 years) were enrolled. Triaxial accelerometer was used to measure acceleration and a synchronized video was recorded. Moments that generated resultant accelerations >4, 6, and 8 G, and their coincided movements were identified. Ratios and frequencies of the extracted movements were calculated and Jonckheere-Terpstra trend test was used to examine which movement rate increased when acceleration threshold increased. In addition, the top 7 movements that generated a resultant acceleration >6 G among the combination of basketball-specific movements were extracted. Their resultant, mediolateral, vertical, and anteroposterior accelerations were identified and compared using one-way analysis of variance. Cohen's d was used to calculate effect sizes. All p < 0.05 were considered statistically significant. The extracted frequencies were 33.6, 9.1, and 2.3 cases per minute for >4 G, >6 G, and >8 G, respectively. As the threshold increased, the rate of deceleration, landing, and physical contact increased. The mediolateral acceleration of physical contact was significantly greater than other movements, whereas the vertical acceleration of landing and deceleration was significantly greater than other movements. Thus, acceleration component analysis was performed to classify movement types. Greater acceleration appeared frequently in movement during defense. It is suggested that many defense movements involve a reaction to the ball and opponent. There are many passive movements during defense and speed changes rapidly. If many passive movements occur when defending, larger physical load is applied, and may lead to fatigue.

Psychiatric Comorbidities in Adult Attention-deficit/Hyperactivity Disorder: Prevalence and Patterns in the Routine Clinical Setting

Objective: While attention-deficit/hyperactivity disorder (ADHD) is associated with a high prevalence of comorbid psychiatric disorders in every age group, the etiology and epidemiology of comorbid disorders are less clear in adult patients with ADHD. In this surveillance study, investigators sought to assess the prevalence of comorbid psychiatric disorders, evaluate relationships between comorbid psychiatric disorders and demographic characteristics, and explore the patterns of these comorbid disorders and their relationships with ADHD subtypes. Methods: Data obtained from postmarketing surveillance of methylphenidate extended-release tablets for adult ADHD were used to evaluate the prevalence of psychiatric comorbidities. Age, sex, age at diagnosis, number of comorbidities, and severity of ADHD symptoms were used as external variables for exploratory analyses. Nonmetric multidimensional scaling (NMDS) was performed to explore correlations among comorbidities and ADHD subtypes and extract major dimensions underlying variations in the pattern of comorbid disorders. Results: Data were collected from 575 patients with adult ADHD, including 301 (52.35%) with at least one concurrent psychiatric disorder. Analysis by NMDS demonstrated that different patterns of psychiatric comorbidities were related to the subtypes of ADHD. Conclusions: Psychiatric comorbidities have a high prevalence in patients with adult ADHD. Understanding these patterns could provide useful information in the diagnosis of adult ADHD and future investigations of its etiology.

Isolation of Single-Wired Transition-Metal Monochalcogenides by Carbon Nanotubes

The successful isolation of single layers from two-dimensional (2D) van der Waals (vdW)-layered materials has opened new frontiers in condensed matter physics and materials science. Their discovery and unique properties laid the foundation for exploring 1D counterparts. However, the isolation of 1D vdW-wired materials has thus far remained a challenge, and effective techniques are demanded. Here we report the facile synthesis of isolated transition-metal monochalcogenide MoTe nanowires by using carbon nanotubes (CNTs) as molds. Individual nanowires are perfectly separated by CNTs with a minimal interaction, enabling detailed characterization of the single wires. Transmission electron microscopy revealed unusual torsional motion of MoTe nanowires inside CNTs. Confinement of 1D vdW-wired materials to the nanotest tubes might open up possibilities for exploring unprecedented properties of the nanowires and their potential applications such as electromechanical switching devices.

Anomalous Temperature Behavior of the Chiral Spin Helix in CrNb_{3}S_{6} Thin Lamellae

Using Lorentz transmission electron microscopy and small-angle electron scattering techniques, we investigate the temperature-dependent evolution of a magnetic stripe pattern period in thin-film lamellae of the prototype monoaxial chiral helimagnet CrNb_{3}S_{6}. The sinusoidal stripe pattern appears due to formation of a chiral helimagnetic order (CHM) in this material. We found that as the temperature increases, the CHM period is initially independent of temperature and then starts to shrink above the temperature of about 90 K, which is far below the magnetic phase transition temperature for the bulk material T_{c} (123 K). The stripe order disappears at around 140 K, far above T_{c}. We argue that this cascade of transitions reflects a three-stage hierarchical behavior of melting in two dimensions.

Repeatability of antral follicle count according parity in dairy cows

Ovarian reserve in cattle can be predicted by an indicator, the antral follicle count (AFC), which is easily determined via ovarian ultrasonography. However, the repeatability of AFC measurements in the same individual taken approximately 1 year apart after first parity remains unclear. This study, thus, aimed to clarify the between-lactation repeatability of AFC after first parity in dairy cows. We measured the AFC of the same individual cows consecutively across both first and second parity, both second and third parity, and both third and fourth parity in 31, 37, and 26 heads, respectively. The values of the intraclass correlation coefficients (ICC) for the AFCs in first–second and second–third parity cows were more than 0.8, and the value of the ICC for the AFCs in third–fourth parity cows was significantly lower than that in first–second parity cows (P = 0.01). Subsequently, based on the average number of AFCs measured at some points from first to third parity, we classified the cows into three tertiles: <11 (low), 11–15 (intermediate), and ≥ 15 (high). We then compared the reproductive performance of the first through third parity cows among the groups. The hazards of pregnancy by 200 days postpartum were higher in the high group than in the other groups (P < 0.05). Our findings demonstrate that between-lactation repeatability of AFC from first through third parity in dairy cows is very high, and that cows with an AFC of ≥ 15 have a better reproductive performance than cows with a low AFC.

Relationship between the administration of nicardipine hydrochloride and the development of delirium in patients on mechanical ventilation

A history of hypertension is a known risk factor for delirium in patients in intensive care units, but the effect of antihypertensive agents on delirium development is unclear. Nicardipine, a calcium channel blocker, is widely used in ICU as a treatment agent for hypertensive emergency. This study investigated the relationship between the administration of nicardipine hydrochloride and delirium development in patients under mechanical ventilation. We conducted a medical chart review of 103 patients, who were divided into two groups according to the use of nicardipine hydrochloride. The prevalence of delirium was compared with respect to factors such as age, sex, laboratory data, and medical history, by multivariate analysis. 21 patients (20.4 %) were treated with nicardipine hydrochloride in 103 patients. The treatment and non-treatment groups differed significantly in age (72 vs. 65 years) and history of high blood pressure (57% vs. 11%). Multivariate analysis revealed that patients in the treatment group developed delirium significantly less often than those in the non-treatment group (19% vs. 48%). These results suggested that treatment of high blood pressure with nicardipine hydrochloride is a possible method for preventing the development of delirium.

Optimization of diagnostic methods and criteria of endometritis for various postpartum days to evaluate infertility in dairy cows

Postpartum endometritis is the main cause of infertility in dairy cows, but there is a lack of critical diagnostic criteria. We aimed to 1) determine the optimal diagnostic method and criteria of endometritis for various postpartum days to evaluate infertility, and 2) assess the diagnostic accuracy of a combination of diagnostic methods. Holstein dairy cows (n = 441) from nine commercial dairy herds were examined at 42 ± 7 days postpartum by using 5 methods: 1) transrectal palpation measurement of the cervical diameter, 2) ultrasonographic measurement of the fluid in uterus (FIU) score, 3) vaginoscopic detection of external uterine orifice hyperemia, 4) vaginal discharge score (VDS), and 5) endometrial cytological percentage of polymorphonuclear leukocytes (PMN%). The clinical findings that were significant in the Pearson chisquare test and had the highest sum of sensitivity and specificity for infertility at 100, 125, 150, 175, and 200 days after parturition were determined the optimal criteria of endometritis. Logistic regression and the Cox proportional hazards model were used to compare the accuracies of the different diagnostic methods for infertility at various postpartum days. The combinations of methods which were significant in Pearson chisquare test and had the highest sum of sensitivity and specificity for infertility were proposed as the optimal combination for determination of endometritis status for various postpartum day. The optimal diagnostic criteria were PMN% ≥ 6.0, FIU ≥ 2 (continuous hyperechogenic or large amount of storage material), or VDS ≥ 2 (mucopurulent or worse vaginal discharge) for postpartum days 100 and 125; PMN% ≥ 8.0, FIU = 3 (large amount of storage material), VDS ≥ 2, or external uterine orifice hyperemia for day 150; PMN% ≥ 6.0, FIU = 3, VDS ≥ 2, or external uterine orifice hyperemia for day 175; and PMN% ≥ 5.0, FIU = 3, VDS ≥ 2, or external uterine orifice hyperemia for day 200. Only the results of endometrial cytology were related to infertility regardless of the postpartum days to evaluate infertility or statistical models. Compared with the sensitivity and specificity of a single diagnostic method, the sensitivity of a combination of methods improved but specificity decreased. We concluded that different diagnostic methods and criteria were required for postpartum days to evaluate infertility and diagnostic accuracy was improved by a combination of diagnostic methods rather than by a single method.

Energetics and electronic structures of perylene confined in carbon nanotubes

The energetics and geometries of perylene encapsulated in carbon nanotubes (CNTs) have been investigated employing density functional theory using the generalized gradient approximation combined with the van der Waals correction. Our calculations show that the encapsulated perylene molecules possess two metastable molecular conformations with respect to the CNT wall, which are almost degenerate with each other. A standing conformation, with respect to the CNT wall, is the ground state conformation for a semiconducting (19,0)CNT, while a lying conformation is the ground state for a metallic (11,11)CNT. Cooperation and competition between perylene-perylene and perylene-CNT interactions cause these possible perylene conformations inside CNTs. However, the electronic structure of the CNT encapsulating the perylene molecules is found to be insensitive to the molecular conformation.

Element Selectivity in Second-Harmonic Generation of GaFeO_{3} by a Soft-X-Ray Free-Electron Laser

Nonlinear optical frequency conversion has been challenged to move down to the extreme ultraviolet and x-ray region. However, the extremely low signals have allowed researchers to only perform transmission experiments of the gas phase or ultrathin films. Here, we report second harmonic generation (SHG) of the reflected beam of a soft x-ray free-electron laser from a solid, which is enhanced by the resonant effect. The observation revealed that the double resonance condition can be met by absorption edges for transition metal oxides in the soft x-ray range, and this suggests that the resonant SHG technique can be applicable to a wide range of materials. We discuss the possibility of element-selective SHG spectroscopy measurements in the soft x-ray range.

Microscopic Investigation into the Electric Field Effect on Proximity-Induced Magnetism in Pt

Electric field effects on magnetism in metals have attracted widespread attention, but the microscopic mechanism is still controversial. We experimentally show the relevancy between the electric field effect on magnetism and on the electronic structure in Pt in a ferromagnetic state using element-specific measurements: x-ray magnetic circular dichroism (XMCD) and x-ray absorption spectroscopy (XAS). Electric fields are applied to the surface of ultrathin metallic Pt, in which a magnetic moment is induced by the ferromagnetic proximity effect resulting from a Co underlayer. XMCD and XAS measurements performed under the application of electric fields reveal that both the spin and orbital magnetic moments of Pt atoms are electrically modulated, which can be explained not only by the electric-field-induced shift of the Fermi level but also by the change in the orbital hybridizations.