Study Protocol for a Prospective Self-Controlled Trial on Success in Meeting Comprehensive Genomic Profiling Analysis Criteria for Specimens Obtained by Endoscopic Ultrasound-Guided Tissue Acquisition Using a 19G Needle from Primary and Metastatic Lesions in Pancreatic Cancer with Metastatic Lesions: The PRIMATE Study.

EUS-TA in unresectable pancreatic cancer requires not only a tissue diagnosis but also tissue collection in anticipation of comprehensive genomic profiling. However, the optimal puncture target remains controversial. Therefore, the Primary and Metastatic Lesions in Pancreatic Cancer (PRIMATE) study was designed to clarify the optimal target by comparing the success rates for meeting OncoGuide NCC Oncopanel (NOP) analysis criteria on pre-check primary and metastatic lesion specimens obtained during the same EUS-TA session in patients with invasive pancreatic ductal adenocarcinoma. In this ongoing prospective study, two specimens, each from primary and metastatic lesions, are obtained by EUS-TA (typically using a 19G fine-needle biopsy needle) in patients with invasive pancreatic ductal adenocarcinoma. The primary endpoint is the proportion of EUS-TA specimens that meet NOP analysis criteria during pre-check (i.e., tumor cellularity of ≥20% and a tissue area of ≥4 mm2), which are then compared between primary and metastatic lesions. This study has been approved by the National Cancer Center Institutional Review Board (Research No. 2022-168). The results of this study will be reported at an international conference and published in an international peer-reviewed journal. The trial registration number is UMIN 000048966.

Utility of Transpapillary Biopsy and Endoscopic Ultrasound-Guided Tissue Acquisition for Comprehensive Genome Profiling of Unresectable Biliary Tract Cancer.

Tissue sampling in biliary tract cancer (BTC) is generally performed through transpapillary biopsy (TPB) or endoscopic ultrasound-guided tissue acquisition (EUS-TA). For the first time, we compared the suitability of specimens obtained using TPB and EUS-TA to determine the optimal tissue-sampling method for comprehensive genome profiling (CGP) analysis in patients with unresectable BTC (UR-BTC). Pathology precheck criteria for CGP analysis comprised the OncoGuide NCC Oncopanel System (NCCOP) and FoundationOne CDx (F1CDx). Seventy-eight patients with UR-BTC (35 TPB and 43 EUS-TA) were included. The NCCOP analysis suitability achievement rate was higher in EUS-TA specimens than in TPB specimens (34.9% vs. 8.6%, p = 0.007), whereas that of F1CDx was 0% in both groups. EUS-TA was identified as an independent factor that contributed to the suitability of the NCCOP analysis. The suitability of the NCCOP analysis of EUS-TA specimens showed a tendency to be higher for mass lesions (43.8% vs. 9.1%, p = 0.065), especially for target size ≥ 18.5 mm, and lower for perihilar cholangiocarcinoma (0% vs. 41.7%, p = 0.077). In TPB, papillary-type lesions (66.7% vs. 3.2%, p = 0.016) and peroral cholangioscopy-assisted biopsies (50.0% vs. 3.3%, p = 0.029) showed better potential for successful NCCOP analysis. EUS-TA is suitable for NCCOP analysis in UR-BTC and may be partially complemented by TPB.

Synergistic Effect of Binary Electrolyte on Enhancement of the Energy Density in Li-O2 Batteries.

Enhancement of the discharge capacity of lithium-oxygen batteries (LOBs) while maintaining a high cell voltage is an important challenge to overcome to achieve an ideal energy density. Both the cell voltage and discharge capacity of an LOB could be controlled by employing a binary solvent electrolyte composed of dimethyl sulfoxide (DMSO) and acetonitrile (MeCN), whereby an energy density 3.2 times higher than that of the 100 vol % DMSO electrolyte was obtained with an electrolyte containing 50 vol % of DMSO. The difference in the solvent species that preferentially solvates Li+ and that which controls the adsorption-desorption equilibrium of the discharge reaction intermediate, LiO2, on the cathode/electrolyte interface provides these unique properties of the binary solvent electrolyte. Combined spectroscopic and electrochemical analysis have revealed that the solvated complex of Li+ and the environment of the cathode/electrolyte interface were the determinants of the cell voltage and discharge capacity, respectively.

Successful Outcome in an Adult Patient with Influenza-associated Hemorrhagic Shock and Encephalopathy Syndrome.

A 50-year-old woman presented with coma and hemorrhagic shock. A rapid influenza antigen test revealed influenza A infection; other laboratory examinations ruled out any other suspected infections. She was diagnosed with hemorrhagic shock and encephalopathy syndrome (HSES) induced by influenza A. She was administered methylprednisolone pulse therapy and peramivir. Subsequently, she was discharged without any sequelae. Only a few cases of influenza-induced HSES have been reported, and the clinical outcomes were very poor. We herein report a successfully treated adult case of influenza-induced HSES and review this rare syndrome.

Publisher Correction: Negative differential resistance as a critical indicator for the discharge capacity of lithium-oxygen batteries.

The original version of this Article contained an error in the title, which was previously incorrectly given as 'Negative differential resistance as a critical indicator for the discharge capacity of lithium-oxygene batteries'. The correct version states 'lithium-oxygen' in place of 'lithium-oxygene'. This has been corrected in both the PDF and HTML versions of the Article.

Negative differential resistance as a critical indicator for the discharge capacity of lithium-oxygene batteries.

In non-aqueous lithium-oxygen batteries, the one-electron reduction of oxygen and subsequent lithium oxide formation both occur during discharge. This lithium oxide can be converted to insulating lithium peroxide via two different pathways: a second reduction at the cathode surface or disproportionation in solution. The latter process is known to be advantageous with regard to increasing the discharge capacity and is promoted by a high donor number electrolyte because of the stability of lithium oxide in media of this type. Herein, we report that the cathodic oxygen reduction reaction during discharge typically exhibits negative differential resistance. Importantly, the magnitude of negative differential resistance, which varies with the system component, and the position of the cathode potential relative to the negative differential resistance determined the reaction pathway and the discharge capacity. This result implies that the stability of lithium oxide on the cathode also contributes to the determination of the reaction pathway.