Trends of Media Coverage on Human Papillomavirus Vaccination in Japanese Newspapers.

A sensational newspaper article concerning a possible adverse reaction to the human papillomavirus (HPV) vaccine was published in March 2013 in Japan. In June 2013, the Japanese government suspended their proactive recommendation for vaccination, despite the lack of proof for a causal relationship. We searched Nikkei Telecom 21, the largest newspaper database in Japan, for articles published from January 2011 to December 2015 to evaluate the characteristics of newspaper publications about human papillomavirus vaccination. We identified 1138 HPV vaccine-related articles. Compared with those published before March 2013, articles concerning human papillomavirus vaccination after March 2013 were more likely to include adverse reaction-related and authority-related keywords; articles that included efficacy-related keywords decreased significantly. Negative-negative and negative-neutral articles became more frequent, and positive-positive and positive-neutral articles were less frequent. A sensational case report shaped the tone of negative media coverage as a catalyst, regardless of scientific statements from health authorities.

A ferroelectric-like structural transition in a metal.

Metals cannot exhibit ferroelectricity because static internal electric fields are screened by conduction electrons, but in 1965, Anderson and Blount predicted the possibility of a ferroelectric metal, in which a ferroelectric-like structural transition occurs in the metallic state. Up to now, no clear example of such a material has been identified. Here we report on a centrosymmetric (R3c) to non-centrosymmetric (R3c) transition in metallic LiOsO3 that is structurally equivalent to the ferroelectric transition of LiNbO3 (ref. 3). The transition involves a continuous shift in the mean position of Li(+) ions on cooling below 140 K. Its discovery realizes the scenario described in ref. 2, and establishes a new class of materials whose properties may differ from those of normal metals.

Cefepime-induced encephalopathy in patients with haematological malignancies: clinical features and risk factors.

BACKGROUND: Cefepime is an antibiotic that is widely used in patients with haematological malignancies (HM). Although its use has been reported to be associated with encephalopathy, only case reports or small case series have been reported so far. PATIENTS AND METHODS: We conducted a retrospective cohort study of 243 patients with HM treated with cefepime at our hospital between August 2011 and May 2013. We also investigated the clinical features of patients with cefepime-induced encephalopathy (CIE). RESULTS: Among 243 HM patients treated with cefepime, 10 were diagnosed with CIE, indicating a cumulative incidence of approximately 4.1%. The median creatinine level on commencement of treatment was 2.13 mg/dl (range 0.60-19.85) and the median initial dose of cefepime was 4.0 g/day (range 1.0-6.0). The median time between commencement of treatment and symptoms was 4.0 days (range 2-5). The most common clinical manifestations were decreased level of consciousness and myoclonus. Symptoms resolved fully in all patients. Univariate analyses showed that impaired renal function (creatinine clearance (CLCr) < 30 ml/min, acute renal failure, and chronic dialysis) was significantly associated with the development of CIE (univariate p < 0.0001, p = 0.020, and p = 0.0025, respectively). Receiver operating characteristic (ROC) analysis demonstrated that the threshold levels of creatinine, CLCr, and estimated glomerular filtration rate for CIE were 1.22 mg/dl, 22.96 ml/min, and 43.9 ml/min/1.73 m(2), respectively. CONCLUSIONS: This study indicated that the development of CIE is associated with severely impaired renal function in patients with HM.

Acquisition of t(11;14) in a patient with chronic lymphocytic leukemia carrying both t(14;19)(q32;q13.1) and +12.

A rare recurrent chromosomal translocation, t(14;19)(q32;q13), has been identified in a variety of B-cell malignancies, including chronic lymphocytic leukemia (CLL). We report a unique case of CLL in a patient carrying both trisomy 12 and t(14;19) (q32;q13.1), in whom t(11;14)(q13;q32) developed at relapse. The patient was a 77-yr-old woman, and her lymphoma cells at presentation showed CD5(+), CD10(-), CD19(+), CD20(+)(dim), CD23(+), CD38(+), and CD11c(+). At relapse, the patient's lymphoma cells showed positive staining for cyclin D1 in addition to CD5, CD20, and CD23. Lymphoma cells in specimens at both presentation and relapse were positive for lymphoid enhancer factor 1 (LEF1) and negative for sex-determining region Y-box 11 (SOX11). IGH-BCL1 FISH became positive at relapse. Split FISH assay using BCL1, BCL3, IGH, and CCND1 probes on lymph node specimens obtained at presentation and at autopsy confirmed that the translocation of BCL3 was solely detected in the lymph node at presentation and detected BCL3 and CCND1 translocations in the specimen at autopsy. These observations indicated that IGH-BCL3 and IGH-CCND1 had occurred in the same clone after treatment of the disease. In line with immunohistochemical and cytogenetic studies, additional PCR analysis of the FR3-JH region showed the same sequence derived from IGHV4-34 in specimens obtained at disease onset and relapse.

Normalization of free light chain kappa/lambda ratio is a robust prognostic indicator of favorable outcome in patients with multiple myeloma.

PURPOSE: To clarify the impact of serum free light chain (sFLC) ratio normalization in patients with multiple myeloma (MM) treated with novel agents. PATIENTS AND METHODS: Treatment response in 126 consecutive patients over 7 years was assessed by IMWG criteria and sFLC assay. RESULTS: Thirty-four patients (27%) showed complete response (CR), 37 (29%) very good partial response (VGPR), 39 (31%) partial response (PR), and 16 (13%) stable disease (SD) or less at a median follow-up of 28 months. Fifty-two patients (41%) with sFLC ratio normalization showed superior progression-free survival (PFS) and overall survival (OS) compared to those who did not (3-yr OS, 94% vs. 48%; P < 0.001). This favorable effect of sFLC ratio normalization occurred irrespective of high (>1000 mg/dL) or low (<100 mg/dL) baseline sFLC. Rates of normal sFLC ratio were as follows: CR, 69%; VGPR, 64%; PR, 16%; and SD or less, 0%. OS was significantly superior in patients with than without normal sFCL ratio in respective response groups. Although various factors (advanced age >70, high LDH, ISS stage 3) showed negative prognostic impacts on PFS and OS on univariate analysis, normal sFLC ratio and achievement of CR emerged as the strongest prognostic predictors for longer OS in MM patients on multivariate analysis. CONCLUSIONS: This study demonstrated the significance of obtaining normal sFLC ratio independent of other clinical variables. Analysis of sFLC ratio could identify the favorable group of patients as well as immunofixation test and support the inclusion of sFLC ratio as part of the response criteria for MM.

Association between coronavirus disease morbidity and mortality rates and BCG vaccination policies in OECD countries. Authors' reply.

We appreciate the reviewer's comment to our article on the correlation between the national BCG vaccination policy and coronavirus disease 2019 among Organisation for Economic Co-operation and Development countries as of April 20, 2020. In this letter, we further updated the data up to November 1, 2020, and found that the updated results also arrive at the similar conclusion as the accepted article.

Transmission electron microscopy of precipitation in fine-grained heat-affected zone of Grade91 steel weld during creep exposure.

Precipitation during creep exposure at 550 °C in the fine grain heat-affected zone of a Grade91 steel weld produced by gas tungsten arc welding with no filler and post-weld heat treatment at 760 °C for 30 min. has been investigated. The applied tension load during creep testing was 165 MPa, the creep rupture time was 1138 hrs. (100% creep aging), and the creep exposure times were 911, 569, 341, 223 and 114 hrs. for 80%, 50%, 30%, 20% and 10% creep aging, respectively. Light microscopy and scanning electron microscopy were used to examine the heat-affected zone in the steel weld. Grain size in the fine grain heat-affected zone was measured by a circular intercept method on secondary electron images from scanning electron microscopy. Precipitates were detached from the fine grain heat-affected zone by a carbon-film extraction replica technique and investigated by transmission electron microscopy. During creep, a continual increase in grain size was observed in the fine grain heat-affected zone, starting from about 1.70 µm after post-weld heat treatment to about 2.30 µm at 100% creep aging. Precipitates found during creep were M23C6, M7C3, M6C, MX, M2X and high-Si Laves phase. M23C6 was found in all creep conditions until rupture, mainly at prior austenite grain boundaries and sub-boundaries. M7C3, M6C and high-Si Laves phase were observed during creep aging, mainly nearby grain boundaries and sub-boundaries. Relatively fine MX and M2X were found after 20% creep aging until rupture, mainly within grain interiors. Detailed criteria for identification of these precipitate phases, based mainly on energy dispersive X-ray spectrometry and selected area electron diffraction using transmission electron microscopy, is given and a major cause of premature loss of creep strength in Grade91 steel weld is discussed. This is important in understanding creep behavior of steel parts used for boiler tubing, heat exchangers, and steam piping systems in fossil-fuel power plants.