Existence of density inhomogeneity of liquid Te associated with liquid-liquid phase transition.

We performed small-angle x-ray scattering measurements of liquid Te using a synchrotron radiation facility and observed maximum scattering intensity near 620 K in the supercooled region (melting temperature 723 K). This indicates that density inhomogeneity exists in liquid Te, and the fact that this temperature coincides with the temperature at which the specific heat, sound velocity, and thermal expansion coefficient reach their maxima means that this density inhomogeneity is the cause of these thermodynamic anomalies. The thermodynamic anomalies in liquid Te had already been shown in the 1980s to be comprehensively explained by the inhomogeneity associated with the continuous liquid-liquid phase transition (LLT), but direct experimental evidence for the existence of the inhomogeneity had not been obtained. The present results, together with those already obtained for mixture systems (Te-Se, Te-Ge), indicate the existence of inhomogeneity associated with LLT in liquid Te systems, and strongly support the model. Recently, similar maximum scattering intensity has also been observed in supercooled liquid water, which exhibits thermodynamic anomalies similar to those of Te, indicating the universality of the inhomogeneous model or LLT scenario to explain the thermodynamics of such 'anomalous liquids'. Further development of the LLT scenario is expected in near future.

Novel navigation for laparoscopic cholecystectomy fusing artificial intelligence and indocyanine green fluorescent imaging.

This preliminary study is the first to demonstrate that AI can precisely identify loose connective tissue during laparoscopic cholecystectomy and ICG fluorescent cholangiography. Tashiro and colleagues conclude that this novel real-time navigation modality fusing AI and ICG fluorescent imaging may enhance safety and provide more reliable laparoscopic or robotic surgery.

Primary retroperitoneal cavernous hemangioma: A case report and review of the literature.

Retroperitoneal cavernous hemangioma, a rare vascular tumor, has only 30 PubMed cases. Preoperative diagnostic criteria are unclear and often present asymptomatically until complications such as rupture or compression arise. We present a 73-year-old with chronic abdominal pain and a giant retroperitoneal tumor. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed an irregular space-occupying mass in the retroperitoneum, suggesting a retroperitoneal chronic expanding hematoma. Total surgical resection confirmed the diagnosis as retroperitoneal cavernous hemangioma.

Color-coded laparoscopic liver resection using artificial intelligence: A preliminary study.

Tashiro and colleagues demonstrated for the first time that an artificial intelligence system can precisely identify intrahepatic vascular structures during laparoscopic liver resection in real time through color coding under bleeding and indocyanine green fluorescent imaging. The system supports real-time navigation and offers potentially safer laparoscopic or robotic liver surgery.

Development of a Novel Artificial Intelligence System for Laparoscopic Hepatectomy.

BACKGROUND/AIM: Laparoscopic hepatectomy (LH) requires accurate visualization and appropriate handling of hepatic veins and the Glissonean pedicle that suddenly appear during liver dissection. Failure to recognize these structures can cause injury, resulting in severe bleeding and bile leakage. This study aimed to develop a novel artificial intelligence (AI) system that assists in the visual recognition and color presentation of tubular structures to correct the recognition gap among surgeons. PATIENTS AND METHODS: Annotations were performed on over 350 video frames capturing LH, after which a deep learning model was developed. The performance of the AI was evaluated quantitatively using intersection over union (IoU) and Dice coefficients, as well as qualitatively using a two-item questionnaire on sensitivity and misrecognition completed by 10 hepatobiliary surgeons. The usefulness of AI in medical education was qualitatively evaluated by 10 medical students and residents. RESULTS: The AI model was able to individually recognize and colorize hepatic veins and the Glissonean pedicle in real time. The IoU and Dice coefficients were 0.42 and 0.53, respectively. Surgeons provided a mean sensitivity score of 4.24±0.89 (from 1 to 5; Excellent) and a mean misrecognition score of 0.12±0.33 (from 0 to 4; Fail). Medical students and residents assessed the AI to be very useful (mean usefulness score, 1.86±0.35; from 0 to 2; Excellent). CONCLUSION: The novel AI presented was able to assist surgeons in the intraoperative recognition of microstructures and address the recognition gap among surgeons to ensure a safer and more accurate LH.

Laparoscopic Anatomical Liver Resection Using Liver Mapping of Incidental Indocyanine Green Fluorescence due to Cholestasis.

BACKGROUND/AIM: Indocyanine green (ICG) fluorescence is useful in laparoscopic hepatectomy (LH) for tumor identification and staining, as well as determination of resection margins. At our Institution, patient-specific, three-dimensional simulations and rehearsal of surgical strategies are carried out preoperatively. We describe cases in which ICG administered preoperatively became stagnated and fluoresced in an area similar to the preoperatively established resection area and the pathological findings in these cases. PATIENTS AND METHODS: Four patients who underwent LH at our hospital between 2020 and 2023 (due to hepatocellular carcinoma in two and colorectal liver metastasis in two) were enrolled in the present study. The ICG-fluorescing liver segments were resected laparoscopically and their pathological characteristics were examined using a fluorescence microscope. RESULTS: In four cases, the areas of ICG fluorescence seen intraoperatively were due to stasis of preoperatively administered ICG, which fortuitously was equivalent to the planned resection area in the preoperative patient-specific simulation. The fluorescent areas were resected; there were no cases of bile leakage or recurrence. Fluorescence microscopy revealed areas with diffuse ICG fluorescence in normal hepatocytes on the tumor's peripheral side. CONCLUSION: It was suggested that resection of the liver area that was fluorescent due to stagnation of preoperatively administered ICG was rational and justified both anatomically and oncologically. This resection may also contribute to the prevention of bile leakage and recurrence.

Observation of plasmon excitation in liquid silicon by inelastic x-ray scattering.

Inelastic x-ray scattering (IXS) measurements were performed for observing the excitation of bulk plasmons in metallic liquid silicon (Si). The peak due to plasmon excitation was observed within the energy loss around 17 eV. Combined with IXS data of crystalline Si measured at several elevated temperatures, it was found that temperature dependence of the excitation energy in the crystalline solid state is explained by the electron gas including the band gap effect, whereas in the metallic liquid state near the melting point, it exhibits a departure from the electron gas; the plasmon energy takes a lower value than that of the electron gas. Such lowering of plasmon energies is reasonably explained by a model incorporating semiconducting component to the electron gas. Non-simple metallic nature in liquid silicon is highlighted by the observation of electron collective dynamics.

Quantitative and Qualitative Analyses of Mass Spectra of OEL Materials by Artificial Neural Network and Interface Evaluation: Results from a VAMAS Interlaboratory Study.

Quantitative analysis of binary mixtures of tris(2-phenylpyridinato)iridium(III) (Ir(ppy)3) and tris(8-hydroxyquinolinato)aluminum (Alq3) by using an artificial neural network (ANN) system to mass spectra was attempted based on the results of a VAMAS (Versailles Project on Advanced Materials and Standards) interlaboratory study (TW2 A31) to evaluate matrix-effect correction and to investigate interface determination. Monolayers of binary mixtures having different Ir(ppy)3 ratios (0, 0.25, 0.50, 0.75, and 1.00), and the multilayers containing these mixtures and pure samples were measured using time-of-flight secondary ion mass spectrometry (ToF-SIMS) with different primary ion beams, OrbiSIMS (SIMS with both Orbitrap and ToF mass spectrometers), laser desorption ionization (LDI), desorption/ionization induced by neutral clusters (DINeC), and X-ray photoelectron spectroscopy (XPS). The mass spectra were analyzed using a simple ANN with one hidden layer. The Ir(ppy)3 ratios of the unknown samples and the interfaces of the multilayers were predicted using the simple ANN system, even though the mass spectra of binary mixtures exhibited matrix effects. The Ir(ppy)3 ratios at the interfaces indicated by the simple ANN were consistent with the XPS results and the ToF-SIMS depth profiles. The simple ANN system not only provided quantitative information on unknown samples, but also indicated important mass peaks related to each molecule in the samples without a priori information. The important mass peaks indicated by the simple ANN depended on the ionization process. The simple ANN results of the spectra sets obtained by a softer ionization method, such as LDI and DINeC, suggested large ions such as trimers. From the first step of the investigation to build an ANN model for evaluating mixture samples influenced by matrix effects, it was indicated that the simple ANN method is useful for obtaining candidate mass peaks for identification and for assuming mixture conditions that are helpful for further analysis.

Simultaneous tumor identification, cholangiography, and securing surgical margin for recurrence of hepatocellular carcinoma using the Medical Imaging Projection System.

BACKGROUND: Indocyanine green (ICG) fluorescence-guided surgery is a real-time navigation technology for tumor detection, securing surgical margins, segmentation mapping, and cholangiography in liver surgery [1]. According to recent reports, the Medical Imaging Projection System (MIPS) may be a useful new real-time navigation technology for open anatomical liver resection [2]. However, the efficacy of MIPS for tumor identification, cholangiography, and securing surgical margins is uncertain. In this report, we introduce MIPS-assisted liver resection for real-time navigation during simultaneous tumor identification, cholangiography, and securing surgical margins. METHODS: A 76-year-old man presented with a 30 × 30 mm recurrent hepatocellular carcinoma on the transection plane after right anterior sectionectomy. Eight radiofrequency ablations were performed after the first hepatectomy. Preoperative computed tomography and three-dimensional simulation revealed a tumor near the posterior Glissonean branch. One day before surgery, 2.5 mg/body ICG was administered. We analyzed whether MIPS could simultaneously facilitate tumor identification, cholangiography, and securing surgical margins. The relationship between fluorescent imaging and the surgical margin was evaluated with a fluorescent microscope [3]. RESULTS: Simultaneous tumor identification, cholangiography, and securing the surgical margins were demonstrated by adjusting the image projection of MIPS, and R0 resection was achieved without biliary injury (Figs. 1 and 2). The operative time and estimated blood loss were 287 minutes and 394 mL, respectively. He was discharged on postoperative day 12 without any complications. CONCLUSION: MIPS could be useful for real-time navigation for tumor identification, cholangiography, and securing surgical margins during liver surgery. The threshold of fluorescent intensity should be set for optimal image projection.

Phonon dispersion curves in the type-I crystalline and molten clathrate compound Eu8Ga16Ge30.

The dynamic structure factorS(Q,E), whereQandEare momentum and energy transfer, respectively, has been measured for liquid Eu8Ga16Ge30(EGG), using inelastic x-ray scattering. The excitation energy of the longitudinal acoustic mode in the liquid was scaled to that in liquid Ba8Ga16Sn30(BGS) with the effective mass. This result means that the local structure in both liquids are similar. The longitudinal acoustic excitation energy of type-I clathrate compound EGG disperses faster than that in the liquid, suggesting that the interatomic force is weakened on melting. The lower energy excitation was observed in both liquid EGG and liquid BGS. In comparison with the longitudinal phonon dispersion in crystalline clathrate compound EGG obtained by density functional theory-based calculations, the lower energy in the liquid was found to be near the optical mode energy. The result indicates that the lower energy mode arises from the relative motion between Eu and (Ga, Ge) atoms.

Quantitative analysis of ToF-SIMS data of a two organic compound mixture using an autoencoder and simple artificial neural networks.

RATIONALE: Matrix effects cause a nonlinear relationship between ion intensities and concentrations in mass spectrometry, including time-of-flight secondary ion mass spectrometry (ToF-SIMS). Here, two artificial neural network (ANN)-based methods, autoencoder-based and simple ANN methods, were employed for the quantitative and qualitative analyses of a two organic compound mixture via ToF-SIMS. METHODS: The multilayer model sample contained a mixture of Irganox 1010 and Fmoc-pentafluoro-L-phenylalanine (Fmoc-PFLPA). The sample's positive and negative ion depth profiles were collected through ToF-SIMS. ToF-SIMS-derived cross-sectional image datasets were analyzed using three unsupervised methods, namely principal component analysis (PCA), multivariate curve resolution (MCR), and use of a sparse autoencoder (SAE). The supervised simple ANN method was optimized based on the spectra and validated by predicting the test dataset ratios of Irganox 1010. RESULTS: The results obtained using the SAE demonstrated linear calibration curves and appropriate material distribution images. The Irganox 1010 and Fmoc-PFLPA positive and negative ion datasets exhibited >0.97 correlation coefficients. The PCA and MCR results demonstrated lower linearity than that of SAE. Moreover, SAE weights indicated the ions important for each organic compound. The simple ANN method accurately predicted the ratios in the test dataset and indicated the important ions. CONCLUSIONS: Both the supervised and unsupervised methods based on ANN, which were employed in regulating nonlinear relationships, were effective in the quantitative and qualitative analyses of the ToF-SIMS data of the two organic compound mixtures. Regarding qualitative analysis, both ANN-based methods indicated specific ions from the molecules in the sample.

Comparison of Endotoxin Activity Assay and Various Biomarkers for Severity Assessment in Colorectal Perforation Patients.

Colorectal perforation is a serious disease with high mortality requiring emergency surgery. This study aimed to evaluate the role of the endotoxin activity assay (EAA) to assess the severity in patients admitted to the intensive care unit after emergency surgeries for colorectal perforations. Patients were divided into high (EAA ≥.4) and low (EAA <.4) groups based on the EAA levels, and the correlation between the EAA values and clinical variables related to the severity was evaluated. The SOFA scores were significantly higher in the high group than those in the low group. The high EAA value persisted even after 48 hours and extended the ICU length of stay. These results suggest that EAA may be a potential biomarker to assess severity and useful as one of the instrumental in predicting the outcomes for colorectal perforation patients.

Clinical Treatment of Perioperative Disseminated Intravascular Coagulation in Patients Who Underwent Gastrointestinal and Hepato-Biliary-Pancreatic Surgery.

BACKGROUND: It is unclear how effective recombinant thrombomodulin (rTM) treatment is in disseminated intravascular coagulation (DIC) during the perioperative period of gastrointestinal and hepato-biliary-pancreatic surgery. The current study aimed to evaluate the therapeutic outcomes of rTM for perioperative DIC. METHODS: We enrolled 100 consecutive patients diagnosed with perioperative DIC after gastrointestinal surgery, and hepato-biliary-pancreatic including emergency procedures, between January 2012 and May 2021. Patients received routine rTM treatment immediately after DIC diagnosis. Then, the DIC, Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were calculated and used for evaluation. The outcomes of rTM treatment and the predictors of survival were evaluated. RESULTS: The causative diseases of DIC were as follows: perforated peritonitis, n = 38; intestinal ischemia, n = 23; intra-abdominal abscess, n = 13; anastomotic leakage, n = 7; pneumonia, n = 7; cholangitis, n = 4; and others, n = 6. The 30-day mortality rate was 18.0%. There were significant differences in the platelet count (13.78 vs 10.41, P = .032) and the SOFA score (5.22 vs 9.89, P<.0001) at the start of DIC treatment between the survivor and non-survivor groups (day 0). The survivor group had a significantly lower DIC score (3.13 vs 4.93, P = .0006) and SOFA score (4.94 vs 12.14, P < .0001) and a higher platelet count (13.50 vs 4.34, P < .0001) than the non-survivor group on day 3. CONCLUSIONS: Comprehensive and systemic treatment is fundamentally essential for DIC, in which rTM may play an important role in the treatment of perioperative DIC.

Laparoscopic Resection of a Hepatic Epithelioid Angiomyolipoma Revealed by Indocyanine Green Fluorescence Imaging.

Indocyanine green fluorescence imaging (ICG-FI)-a sensitive tool for detecting tumor localization in laparoscopic surgery-produces false positive results for benign liver tumors. This report is the first case of hepatic angiomyolipoma (HAML) treated laparoscopically with ICG-FI. We present the case of a 31-year-old woman with a liver tumor that was a 13-mm mass in the anterior superior segment. Though a benign tumor was suspected, malignant potential could not be ruled out. Therefore, minimally invasive laparoscopic resection using ICG-FI was planned. ICG, intravenously injected preoperatively, revealed the tumor's existence. Pure laparoscopic hepatectomy with ICG-FI was performed for excisional biopsy, during which the tumor was resected with adequate surgical margins, followed by histological confirmation of HAML. In conclusion, it is suggested that laparoscopic resection with ICG-FI is an effective minimal invasive surgery for tumors that are difficult to detect, such as HAML, leading to a safe surgical margin.

Differences in occupational stress by smoking intensity and gender in cross-sectional study of 59 355 Japanese employees using the Brief Job Stress Questionnaire (BJSQ): the Niigata Wellness Study.

OBJECTIVES: It has been hypothesised that smoking intensity may be related to occupational stress. This study aimed to investigate whether stress, including problems with superiors or co-workers, is a driver of smoking. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: 59 355 employees (34 865 men and 24 490 women) across multiple occupations who completed a self-reported questionnaire-based occupational stress survey between April 2016 and March 2017 in Niigata Prefecture. MAIN OUTCOME MEASURES: Stress scores for the Brief Job Stress Questionnaire subscales summed up after assigning high points for high stress and converted to Z-scores based on the mean of all participants. Heavy smokers (HS) smoked ≥15 cigarettes/day and light smokers (LS) smoked <15 cigarettes/day and were compared with non-smokers (NS) by gender. RESULTS: The main subscale items that were significantly associated with smoking status in both genders included 'physical burden', 'irritation' and 'physical symptoms'. In the analysis that included smoking intensity, the stress score for 'co-workers' support' was significantly lower for LS men than NS men (NS 0.091±0.98, LS -0.027±1.00, HS 0.033±0.99), and was significantly higher for HS women than NS women (NS -0.091±1.00, LS -0.080±1.05, HS 0.079±1.03). However, the stress score for 'co-workers' support' was low among LS women aged ≤39 years in the manufacturing industry. CONCLUSIONS: It was speculated that LS men and some LS women gained 'co-workers' support' using smoking as a communication tool while reducing the degree of smoking. The existence of such 'social smokers' suggested that to promote smoking cessation, measures are essential to improve the communication between workers in addition to implementing smoking restrictions in the workplace.

Indocyanine Green Labeling of Tumors in the Liver Recurring After Radiofrequency Ablation Enables Complete Resection by Fluorescence-guided Surgery.

BACKGROUND/AIM: Radiofrequency ablation (RFA) is used to treat primary and metastatic tumors in the liver. However, local recurrence after RFA is frequent and subsequent salvage hepatectomy is often ineffective due to difficulty in visualization of tumor margins. PATIENTS AND METHODS: In the present retrospective clinical trial, seven patients from the Department of General and Gastro-enterological Surgery, Showa University School of Medicine underwent salvage hepatectomy for recurrent hepatocellular carcinoma (HCC) (n=2), colorectal liver metastasis (n=4) and lung-carcinoid liver metastasis (n=1), after RFA, between 2011 and 2020. Tumors were labeled with indocyanine green (ICG) and resected under fluorescence guidance. Resected specimens were evaluated under fluorescence microscopy as well as by standard histopathological techniques. RESULTS: Pathological findings revealed negative tumor margins in all patients after fluorescence-guided surgery. Six of seven resected tumors had a fluorescent rim, including both HCC and liver metastasis. Fluorescence microscopy demonstrated that viable cancer tumor cells were located only on the inside of the fluorescent rim, and no malignant cells were detected within the fluorescent rim surrounding the tumor. Fluorescence microscopy showed that the tumor margin was secured if the fluorescence signal was completely resected. CONCLUSION: The present results demonstrate that ICG labeling of liver tumors recurring after RFA enabled complete resection under fluorescence guidance. The present study is the first clinical study to demonstrate that tumor types that generally cannot be completely resected with bright light are fully resectable under fluorescence guidance.

Relationship Between Remnant Pancreatic Volume and Endocrine Function After Pancreaticoduodenectomy.

BACKGROUND: Decreased pancreatic volume (PV) is a predictive factor for diabetes mellitus (DM) after surgery. There are few reports on PV and endocrine function pre- and post-surgery. We investigated the correlation between PV and insulin secretion. METHODS: Seventeen patients underwent pancreaticoduodenectomy (PD) Pre- and post-surgery PV and C-peptide index (CPI) measurements were performed. Additionally, the correlation between PV and CPI was analyzed. RESULTS: The mean preoperative PV (PPV) was 55.1 ± 31.6 mL, postoperative remnant PV (RPV) was 25.3±17.3 mL, and PV reduction was 53%. The mean preoperative C-peptide immunoreactivity (CPR) was 1.39 ± .51 and postoperative CPR was .85±.51. The mean preoperative CPI was 1.29±.72 and postoperative CPI was .73 ± .48. Significant correlations were observed between RPV and post CPR (ρ = .507, P = .03) and post CPI (ρ = .619, P = .008). DISCUSSION: There was a significant correlation between RPV and CPI after PD. A smaller RPV resulted in lower insulin secretion ability, increasing the potential risk of new-onset DM after PD.

Sparse autoencoder-based feature extraction from TOF-SIMS image data of human skin structures.

Time-of-flight secondary ion mass spectrometry (TOF-SIMS) is a useful and versatile tool for surface analysis, enabling detailed compositional information to be obtained for the surfaces of diverse samples. Furthermore, in the case of two- or three-dimensional imaging, the measurement sensitivity in the higher molecular weight range can be improved by using a cluster ion source, thus further enriching the TOF-SIMS information. Therefore, appropriate analytical methods are required to interpret this TOF-SIMS data. This study explored the capabilities of a sparse autoencoder, a feature extraction method based on artificial neural networks, to process TOF-SIMS image data. The sparse autoencoder was applied to TOF-SIMS images of human skin keratinocytes to extract the distribution of endogenous intercellular lipids and externally penetrated drugs. The results were compared with those obtained using principal component analysis (PCA) and multivariate curve resolution (MCR), which are conventionally used for extracting features from TOF-SIMS data. This confirmed that the sparse autoencoder matches, and often betters, the feature extraction performance of conventional methods, while also offering greater flexibility.

Determinative Structural Features Identified With Probe-based Confocal Endomicroscopy for the Accurate Diagnosis of Gallbladder Malignancy.

BACKGROUND: Probe-based confocal laser endomicroscopy (pCLE) can visualize microscopic structures at high resolution but has not yet yielded definitive diagnostic features of gallbladder malignancy, as opposed to benign changes. PATIENTS AND METHODS: A total of 73 patients had their gallbladder evaluated with pCLE performed on resected benign and malignant gallbladder surgical specimens, which were sprayed with fluorescein. Malignant and benign features of pCLE findings were identified on the basis of Miami and Paris Classifications. Standard histopathological diagnoses and individual patient pCLE findings of gallbladder lesions were correlated. RESULTS: Of the 73 consecutive patients that had their gallbladder evaluated ex vivo with pCLE, 11 were identified with gallbladder malignancy. pCLE identified features of gallbladders examined ex vivo, including the presence of thick dark bands and dark clumps, which together correlated with histopathologically-determined biliary malignancy at 100% sensitivity. Thick white bands and visualized epithelium, also identified with pCLE, together correlated with histopathologically-determined malignancy at 100% specificity. CONCLUSION: pCLE can be used for real-time differentiation of cancerous/non-cancerous regions in the gallbladder using the diagnostic criteria identified in the present study.

Crystallization kinetics of atomic crystals revealed by a single-shot and single-particle X-ray diffraction experiment.

Crystallization is a fundamental natural phenomenon and the ubiquitous physical process in materials science for the design of new materials. So far, experimental observations of the structural dynamics in crystallization have been mostly restricted to slow dynamics. We present here an exclusive way to explore the dynamics of crystallization in highly controlled conditions (i.e., in the absence of impurities acting as seeds of the crystallites) as it occurs in vacuum. We have measured the early formation stage of solid Xe nanoparticles nucleated in an expanding supercooled Xe jet by means of an X-ray diffraction experiment with 10-fs X-ray free-electron laser (XFEL) pulses. We found that the structure of Xe nanoparticles is not pure face-centered cubic (fcc), the expected stable phase, but a mixture of fcc and randomly stacked hexagonal close-packed (rhcp) structures. Furthermore, we identified the instantaneous coexistence of the comparably sized fcc and rhcp domains in single Xe nanoparticles. The observations are explained by the scenario of structural aging, in which the nanoparticles initially crystallize in the highly stacking-disordered rhcp phase and the structure later forms the stable fcc phase. The results are reminiscent of analogous observations in hard-sphere systems, indicating the universal role of the stacking-disordered phase in nucleation.