Beam Energy and Centrality Dependence of Direct-Photon Emission from Ultrarelativistic Heavy-Ion Collisions

The PHENIX collaboration presents first measurements of low-momentum (0.4<p_{T}<3  GeV/c) direct-photon yields from Au+Au collisions at sqrt[s_{NN}]=39 and 62.4 GeV. For both beam energies the direct-photon yields are substantially enhanced with respect to expectations from prompt processes, similar to the yields observed in Au+Au collisions at sqrt[s_{NN}]=200. Analyzing the photon yield as a function of the experimental observable dN_{ch}/dη reveals that the low-momentum (>1  GeV/c) direct-photon yield dN_{γ}^{dir}/dη is a smooth function of dN_{ch}/dη and can be well described as proportional to (dN_{ch}/dη)^{α} with α≈1.25. This scaling behavior holds for a wide range of beam energies at the Relativistic Heavy Ion Collider and the Large Hadron Collider, for centrality selected samples, as well as for different A+A collision systems. At a given beam energy, the scaling also holds for high p_{T} (>5  GeV/c), but when results from different collision energies are compared, an additional sqrt[s_{NN}]-dependent multiplicative factor is needed to describe the integrated-direct-photon yield.

Efficacy and safety of nivolumab monotherapy as the late line for patients with advanced gastric cancer in the real-world

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Background: The ATTRACTION-2 study found that nivolumab showed a significant survival benefit for the patients with unresectable metastatic or locally advanced gastric cancer (AGC) following more than 2 regimens. Based on this trial, nivolumab was currently proved to be one of the most effective regimens for the patients with AGC as the 3rd-line treatment in Japan. We herein examined the clinical significance and validation of nivolumab as late line chemotherapy in patients with AGC. Methods: In October 2017 to December 2018, 26 patients received nivolumab monotherapy in our institute. We conducted a retrospective review of the data of 23 patients with AGC who received more than 2 cycles of nivolumab following the standard chemotherapy regimens including fluoropyrimidines, platinum derivatives and taxanes. Adverse events, tumor responses, and survival data were analyzed. Results: Only 2 patients enrolled here showed ECOG performance status (PS) 2 in the study. The time to treatment failure of them were shorter than those of the other patients with PS 0/1. Four patients quitted the continuation of nivolumab except for the progressive disease, due to non-hematological toxicities higher than grade 3 including myositis, hypothyroidism, dermatitis and liver dysfunction. The rate of hematological toxicities, which showed severe anemia of higher than grade 3 was 21.7%. The ORR and the DCR were 4.3% and 52.3% for the patients in this study. The survival data showed that the median PFS and the OS after nivolumab administration were 75 days and 274 days, respectively. Conclusions: Nivolumab monotherapy might be one of the best regimens for Japanese patients with AGC as the late line treatment following the standard chemotherapy.

Abstract P1-12-03: Prevalence, predictive factors, and clinical outcomes of anthracycline induced cardiac dysfunction among patients with breast cancer in Japan, where the normal body weight (BMI &lt; 25) is dominant

Objective: Cardiac dysfunction (CD) is a major clinical problem for survivors of breast cancer. ASCO released a guideline for prevention and monitoring CD in survivors of adult cancer in 2017. Exposure to anthracycline (A) and trastuzumab are both risk factor for CD, as well as obesity is a part of multiple risk factors in the guideline. Meta-analysis shown obesity itself increases risk of A induced CD (A-CD). Prevalence of obesity and CD among non-oncology patients vary in countries, as many Western countries have obesity dominant population. Then little is known about clinical characteristics of A-CD in survivors of adult cancer among normal weight dominant countries, especially in Asia. This study was conducted to understand characteristics of A-CD among patients with breast cancer in Japan.

Method: This study used electrical charts, breast oncology database, and cardiology database to find prevalence, predictive factors, and clinical outcomes of A-CD in Hyogo Cancer Center. The definition of CD is based on diagnosis by the cardiologist. Major Cardiac Events (MACE) is defined as cardiac death or emergency admission due to CD. Obesity is defined as BMI &gt; 30, normal body weight is defined as BMI &lt; 25, and elderly is defined as age &gt; 60 years old, same as in ASCO guideline. Patients gave written informed consent. IRB approved this study.

Result: From Apr. 2006, to Mar. 2017, 855 patients received A for the treatment of breast cancer. Median body weight was 55 Kg, median BMI was 23, and 93.4 % of patients are non-obese. Half of patients (46.9 %) are elderly. Almost a quarter (24 %) of patients received trastuzumab. At the median follow up 60 months, 20 patients (2.3 %) experienced CD, one patient (0.11 %) passed away due to CD, and four patients were admitted as emergency, then five patients (0.58 %) experienced MACE. Median time to onset of CD after the last dose of A is seven months. Among patients with CD, 18 patients (90 %) recovered their ejection fraction (EF), and the median time to recover of EF was two months. Predictive factors for CD include usage of trastuzumab (15 patients), elderly (eight patients), high dose anthracycline (four patients), and multiple cardiac risk factors at base line (four patients). Among patients treated without trastuzumab, only five (0.76 %) patients experienced CD, but four of them experienced MACE.

Conclusion: Prevalence of A-CD in the normal weight dominant population was lower than reported in obesity dominant population, especially in patients treated without trastuzumab. In this population, clinical outcome such as prevalence of MACE may vary depending on the usage of trastuzumab. Further study is warranted to set an optimal strategy for the prevention and monitoring of A-CD in non-obese dominant population.

Citation Format: Matsumoto K, Nonaka A, Ogata T, Ogata M, Sakai H, Nishimura M, Onoe T, Soyama M, Hashimoto K, Tane K, Hirokaga K, Takao S. Prevalence, predictive factors, and clinical outcomes of anthracycline induced cardiac dysfunction among patients with breast cancer in Japan, where the normal body weight (BMI &lt; 25) is dominant [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-12-03.

Pseudorapidity Dependence of Particle Production and Elliptic Flow in Asymmetric Nuclear Collisions of p+Al, p+Au, d+Au, and ^{3}He+Au at sqrt[s_{NN}]=200 GeV

Asymmetric nuclear collisions of p+Al, p+Au, d+Au, and ^{3}He+Au at sqrt[s_{NN}]=200  GeV provide an excellent laboratory for understanding particle production, as well as exploring interactions among these particles after their initial creation in the collision. We present measurements of charged hadron production dN_{ch}/dη in all such collision systems over a broad pseudorapidity range and as a function of collision multiplicity. A simple wounded quark model is remarkably successful at describing the full data set. We also measure the elliptic flow v_{2} over a similarly broad pseudorapidity range. These measurements provide key constraints on models of particle emission and their translation into flow.

Olive leaf tea may have hematological health benefit over green tea

Olive leaf extracts are rich in several polyphenols having potential health benefits. We conducted the current parallel-group randomized controlled trial to compare the effects of long-term consumption of olive leaf tea (OLT) and green tea (GT) on hematological parameters in 31 female volunteers aged between 40 and 70 years of old. We found that RBC count, hemoglobin, and hematocrit were increased significantly in the OLT group than those of in the GT group at 6 and 12 weeks of intervention. Within-group comparison showed that hematocrit was significantly increased in the OLT group at 6 weeks of intervention, whereas RBC count and serum iron was significantly decreased in the GT group at 12 weeks of intervention. This is the first clinical study reporting the beneficial effects of continuous intake of OLT on hematological parameters. This observation is supported by our previous in vitro study reporting the differentiation-inducing effect of certain olive leaf components on human hematopoietic stem cells. However, further investigations in larger cohorts with a careful consideration of target population are required to confirm the preventive effect of OLT against anemia and other red cell disorders.

Prevalence of Chronic Kidney Disease in Morbidly Obese Japanese and the Impact of Bariatric Surgery on Disease Progression

BACKGROUND

The prevalence of chronic kidney disease (CKD) among Japanese morbidly obese patients undergoing bariatric surgery and the impact of bariatric surgery on their renal function has not previously been investigated.

OBJECTIVES

The aims were to assess the prevalence of CKD patients who underwent bariatric surgery in our institution and to elucidate the impact of bariatric surgery on their kidney function as measured by the estimated glomerular filtration rate by Cystatin-C (eGFRcys).

SETTING

The setting of the study was in a single private hospital.

METHODS

Two hundred fifty-four consecutive Japanese patients who underwent bariatric surgery were retrospectively analyzed to elucidate the prevalence of CKD. The eGFRcys was calculated to assess the change in the kidney function for 1 year after surgery.

RESULTS

The preoperative prevalence of CKD was as follows: G1, 45.3%; G2, 47.2%; G3, 6.5%; and G4, 0.9%. The eGFRcys values before and after surgery were compared; the G1 and G2 patients showed significantly improved eGFRcys values after surgery (G1 101 [94-108] vs 114 [103-127]; G2 79 [74-84] vs 97 [87-104] ml/min/1.73 m²; p < 0.01) with significant weight loss (G1 38.1 ± 6.2 vs 26.5 ± 3.4; G2 38.5 ± 6.9 vs 26.7 ± 3.6 kg/m²; p < 0.01). Although the renal function of G3 patients was not improved after surgery (44 [42-47] vs 45 [43-63] ml/min/1.73 m²; p = 0.08), successful weight loss was achieved (36.1 ± 6.3 vs 26.6 ± 3.6 kg/m²; p < 0.01). In multivariate analysis, postoperative eGFRcys correlated negatively with proteinuria (p < 0.01), age (p < 0.01), and body mass index (p < 0.01) and positively with persistence of antihypertensive drugs.

CONCLUSION

Bariatric surgery resulted in the significant improvement in the eGFRcys values of Japanese patients with morbid obesity, particularly those with pre-CKD (eGFRcys ≥ 60 ml/min/1.73 m²), while the eGFRcys values of CKD patients (< 60 ml/min/1.73 m²) were not ameliorated by surgery.

Mid-term results of bariatric surgery in morbidly obese Japanese patients with slow progressive autoimmune diabetes

INTRODUCTION

Bariatric surgery is recognized as an effective treatment for type 2 diabetes mellitus, but data on its efficacy for type 1 diabetes mellitus, especially slowly progressive insulin-dependent diabetes mellitus, are limited.

METHODS

We investigated five Japanese patients with slowly progressive insulin-dependent diabetes mellitus who underwent bariatric surgery at our center.

RESULTS

Five morbidly obese glutamic acid decarboxylase antibody-positive diabetic patients underwent two different types of bariatric surgery. The mean titer of anti-glutamic acid decarboxylase antibody was 4.6 U/mL, and the mean preoperative bodyweight and BMI were 113 kg and 39.6 kg/m² , respectively. The mean hemoglobin A1c was 8.4%. The mean fasting serum C-peptide was 5.0 ng/mL. Laparoscopic sleeve gastrectomy was performed in two patients, while laparoscopic sleeve gastrectomy with duodenojejunal bypass was performed in three patients. At one year after surgery, the mean bodyweight and BMI significantly dropped, and the mean percentage of excess weight loss was 96.4%. The mean hemoglobin A1c was 5.7%. This favorable trend was maintained at mid-term.

CONCLUSION

Bariatric surgery for morbidly obese patients with anti-glutamic acid decarboxylase antibody-positive type 1 diabetes mellitus, especially slow progressive autoimmune diabetes, seemed effective in achieving mid-term glycemic control. Longer follow-up with a larger number of patients, as well as validation with more advanced patients with slowly progressive insulin-dependent diabetes mellitus, will be needed.

Serum cytokine concentrations, chorioamnionitis and the onset of bronchopulmonary dysplasia in premature infants

OBJECTIVE

To investigate the relationships between serum cytokine concentrations and chorioamnionitis (CAM) and CAM-related bronchopulmonary dysplasia (BPD) in premature infants.

METHODS

Serum was collected at 0 and 7 days after birth from 36 premature infants born at <32 weeks of gestation. We examined the relationships between 30 cytokine concentrations and CAM, BPD, and other perinatal factors.

RESULTS

On day 0, GM-CSF, IL-15, IL-17, IL-2, IL-2R, VEGF, and MIG concentrations were significantly higher in the CAM group (n = 17) than in the non-CAM group (n = 19). These concentrations had decreased by day 7 and were similar in both groups. The IL-12p70 concentration on day 0 was significantly lower in the BPD group (n = 16) than in the non-BPD group (n = 15). BPD incidence was similar between the CAM and non-CAM groups.

CONCLUSIONS

These data support the hypothesis that intrauterine inflammation is not a primary risk factor for BPD. The immunological environment at birth or soon after, rather than intrauterine fetal inflammation (e.g., CAM), is a primary risk factor for BPD onset in preterm infants. Decreased inflammatory responses are particularly relevant, as indicated by the relationship between BPD and low serum IL-12p70 concentrations on day 0.

Metabolic/inflammatory/vascular comorbidity in psychiatric disorders; soluble epoxide hydrolase (sEH) as a possible new target

The common and severe psychiatric disorders, including major depressive disorder (MDD) and bipolar disorder (BD), are associated with inflammation, oxidative stress and changes in peripheral and brain lipid metabolism. Those pathways are implicated in the premature development of vascular and metabolic comorbidities, which account for considerable morbidity and mortality, including increased dementia risk. During endoplasmic reticulum stress, the soluble epoxide hydrolase (sEH) enzyme converts anti-inflammatory fatty acid epoxides generated by cytochrome p450 enzymes into their corresponding and generally less anti-inflammatory, or even pro-inflammatory, diols, slowing the resolution of inflammation. The sEH enzyme and its oxylipin products are elevated post-mortem in MDD, BD and schizophrenia. Preliminary clinical data suggest that oxylipins increase with symptoms in seasonal MDD and anorexia nervosa, requiring confirmation in larger studies and other cohorts. In rats, a soluble sEH inhibitor mitigated the development of depressive-like behaviors. We discuss sEH inhibitors under development for cardiovascular diseases, post-ischemic brain injury, neuropathic pain and diabetes, suggesting new possibilities to address the mood and cognitive symptoms of psychiatric disorders, and their most common comorbidities.

Concurrent Umbilical Hernia Repair at the Time of Liver Transplantation: A Six-Year Experience from a Single Institution

BACKGROUND

Umbilical hernias are common in patients with end-stage liver disease undergoing liver transplantation. Management of those persisting at the time of liver transplantation is important to define.

OBJECTIVE

To evaluate the long-term results of patients undergoing simultaneous primary umbilical hernia repair (UHR) at the time of liver transplantation at a single institution.

METHODS

Retrospective chart review was performed on patients undergoing simultaneous UHR and liver transplantation from 2010 through 2016. 30-day morbidity and mortality outcomes and long-term hernia recurrence were investigated.

RESULTS

59 patients had primary UHR at the time of liver transplantation. All hernias were reducible with no overlying skin breakdown or leakage of ascites. 30-day morbidity and mortality included 5 (8%) superficial surgical site infections, 1 (2%) deep surgical site infection, and 7 (12%) organ space infections. Unrelated to the UHR, 10 (17%) patients had an unplanned return to the operating room, 16 (27%) were readmitted within 30 days of their index operation, and 1 (2%) patient died. With a mean follow-up of 21.8 months, 7 (18%) patients experienced an umbilical hernia recurrence.

CONCLUSION

Despite the high perioperative morbidity associated with the transplant procedure, concurrent primary UHR resulted in an acceptable long-term recurrence rate with minimal associated morbidity.

Quantum-disordered state of magnetic and electric dipoles in an organic Mott system

Strongly enhanced quantum fluctuations often lead to a rich variety of quantum-disordered states. Developing approaches to enhance quantum fluctuations may open paths to realize even more fascinating quantum states. Here, we demonstrate that a coupling of localized spins with the zero-point motion of hydrogen atoms, that is, proton fluctuations in a hydrogen-bonded organic Mott insulator provides a different class of quantum spin liquids (QSLs). We find that divergent dielectric behavior associated with the approach to hydrogen-bond order is suppressed by the quantum proton fluctuations, resulting in a quantum paraelectric (QPE) state. Furthermore, our thermal-transport measurements reveal that a QSL state with gapless spin excitations rapidly emerges upon entering the QPE state. These findings indicate that the quantum proton fluctuations give rise to a QSL—a quantum-disordered state of magnetic and electric dipoles—through the coupling between the electron and proton degrees of freedom.

The organic material κ-H₃(Cat-EDT-TTF)₂ has been suggested to exhibit a quantum spin liquid phase in which quantum fluctuations prevent the formation of magnetic order. Here, the authors show that this may be a result of fluctuations of hydrogen atoms, rather than more conventional geometric frustration.