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The prognosis of primary central nervous system lymphoma (PCNSL) in the elderly remains poor. We aimed to evaluate the outcome of rituximab, methotrexate, procarbazine, and vincristine (RMPV) chemotherapy in elderly patients with new-onset PCNSL. Twenty-eight patients aged ≥ 70 years treated for PCNSL between 2010 and 2020 were examined retrospectively. Nineteen patients received RMPV and nine did not qualify. Patients received five to seven cycles of RMPV plus response-adapted whole-brain radiotherapy (WBRT) and cytarabine. Ten of the 19 patients who received RMPV (52.6%) completed the induction, but only four patients (21.1%) completed RMPV chemotherapy, WBRT 23.4 Gy, and cytarabine. Median progression-free survival (PFS) and overall survival (OS) in the RMPV group was 54.4 and 85.0 months, respectively. Both PFS and OS were significantly longer in patients who received RMPV chemotherapy than in those who did not, and in patients who started but did not complete RMPV than in those who did not receive RMPV. Patients who received incomplete RMPV tended to have a favorable prognosis. Initial treatment with RMPV chemotherapy was effective in elderly patients with PCNSL. Adjusting the number of courses of RMPV may improve the prognosis of elderly patients with PCNSL, but further verification is necessary.

The optimal postoperative surveillance strategy after curative resection in patients with stage IV colorectal cancer remains unclear. The present study aimed to assess the cost-effectiveness of postoperative surveillance strategies recommended by the various academic societies for stage IV colorectal cancer after curative resection. This economic evaluation used a Markov state-transition model to compare the cost-effectiveness of postoperative surveillance programs proposed in guidelines published by the American Society of Clinical Oncology, American Society of Colon and Rectal Surgeons, European Society for Medical Oncology, National Comprehensive Cancer Network, and Japanese Society for Cancer of the Colon and Rectum. Model parameters were extracted from our retrospective data for patients with colorectal cancer who had synchronous liver and/or lung metastases and underwent curative resection. Cost-effectiveness was assessed using an incremental cost-effectiveness ratio for quality-adjusted life years, with a maximum acceptable value of 5 000 000-6 000 000 JPY/33333-40 000 USD. Uncertainty in the model was assessed by probabilistic sensitivity analyses. For patients with stage IV colorectal cancer after curative resection, the JSCCR-strategy was the most cost-effective, with an incremental cost-effectiveness ratio of 2 888 628 JPY/19256 USD compared with the next most cost-effective program. Probabilistic sensitivity analysis showed that the JSCCR-strategy was most likely to be selected as the most cost-effective (76.1%-77.9%). This modeling analysis found that the JSCCR-strategy was the most cost-effective strategy for stage IV colorectal cancer. Our findings suggest that intensive postoperative surveillance is acceptable for stage IV colorectal cancer.

Diamond and cubic boron nitride (c-BN) are the top two hardest materials on the Earth. Clarifying how the two seemingly incompressible materials can actually join represents one of the most challenging issues in materials science. Here we apply the temperature gradient method to grow the c-BN single crystals on diamond and report a successful epitaxial growth. By transmission electron microscopy, we reveal a novel misfit accommodation mechanism for a {111} diamond/c-BN heterointerface, that is, lattice misfit can be accommodated by continuous stacking fault networks, which are connected by periodically arranged hexagonal dislocation loops. The loops are found to comprise six 60° Shockley partial dislocations. Atomically, the carbon in diamond bonds directly to boron in c-BN at the interface, which electronically induces a two-dimensional electron gas and a quasi-1D electrical conductivity. Our findings point to the existence of a novel misfit accommodation mechanism associated with the superhard materials. Interfaces between two materials often show interesting properties. Here, the authors demonstrate that diamond and cubic boron nitride, the hardest materials known, can be grown on top of each other through a novel misfit accommodation mechanism, forming a two-dimensional electron gas at the interface.

In the original publication of the article, the authors would like to alter the color of characters in the Supplemental Table 1 and 2.

A 68-year-old male was diagnosed with acute promyelocytic leukemia (APL). A G-banding chromosomal analysis revealed the co-existence of two clones: one with del(20q) and t(15;17)(q22;q12) and another with del(20q) alone. During the remission of APL following treatment with all-trans-retinoic acid, del(20q) was persistently identified, indicating a diagnosis of cytogenetic abnormalities of undetermined significance (CCAUS) with isolated del(20q). Bicytopenia developed 48 months after the remission of APL. The presence of isolated del(20q) was detected in the G-banding analysis, whereas morphological dysplasia of hematopoietic cells was not confirmed. This case showed indolent progression from CCAUS after the remission of APL to clonal cytopenia of undetermined significance (CCUS). CCUS with isolated del(20q) persisted for 24 months without any finding of hematological malignancies. At the most recent follow-up, targeted capture sequencing showed the U2AF1 S34F mutation. Considerable attention needs to be paid in follow-ups for CCAUS with del(20q) after the treatment of leukemia.

Wurtzite boron nitride (w-BN) is a metastable superhard material that is a high-pressure polymorph of BN. Clarifying how the metastable high-pressure material can be stabilized at atmospheric pressure is a challenging issue of fundamental scientific importance and promising technological value. Here, we fabricate millimeter-size w-BN bulk crystals via the hexagonal-to-wurtzite phase transformation at high pressure and high temperature. By combining transmission electron microscopy and ab initio molecular dynamics simulations, we reveal a stabilization mechanism for w-BN, i.e., the metastable high-pressure phase can be stabilized by 3D networks of planar defects which are constructed by a high density of intersecting (0001) stacking faults and {10a10} inversion domain boundaries. The 3D networks of planar defects segment the w-BN bulk crystal into numerous nanometer-size prismatic domains with the reverse crystallographic polarities. Our findings unambiguously demonstrate the retarding effect of crystal defects on the phase transformations of metastable materials, which is in contrast to the common knowledge that the crystal defects in materials will facilitate the occurrence of phase transformations.

Nationwide surveys of adult T-cell leukemia/lymphoma (ATL) have played an important role in helping us to understand the pathophysiology of this disease and analyze its prognosis in Japan. Classifications of clinical subtypes have been proposed based on the results of nationwide surveys of patients with ATL diagnosed in the 1980s. This article highlighted the classification and prognosis of ATL based on different surveys and focused on the comparison of data derived from the available surveys. The 11th nationwide hospital-based survey was conducted in patients with ATL diagnosed in 2010–2011 using the same method as that used in the 1980s survey. The median age of disease onset was 68 years, which was increased compared with previous surveys. While median survival of patients with the acute and lymphoma types had not improved much since the 1980s, the 4-year survival rate was higher. Little improvement in the prognosis was observed for the chronic and smoldering types. The 12th nationwide survey of patients with ATL diagnosed in 2012–2013 also showed an increase in age at onset. Further epidemiological research that includes more cases is needed to deepen our understanding of the actual state of treatment and prognosis of this disease.

Evaluating ion-conductive solid electrolytes (SEs) accurately is crucial for advancing solid-state battery technology. Scanning/transmission electron microscopy (S/TEM) is a valuable technique for examining the local characteristics of battery materials. However, the tolerance of SEs to high-energy electron beams is notably lower than that of electrode active materials, because SEs generally have low electron conductivity. Here, we propose a specialized coating technique for TEM samples, termed “nano-shield,” which enables stable and accurate observation of their micro-/nano-structures. Nano-shield consists of a dual-layer coating combining an amorphous insulating layer of aluminum oxide (AlO x ) with a conductive carbon (C) film. The AlO x layer blocks ion diffusion in the TEM samples, and the C layer minimizes electron charging during electron-beam irradiation. By applying a nano-shield, we successfully visualized the atomic structures of a lithium-ion-conductive SE, Li 1.3 Al 0.3 T 1.7 (PO 4 ) 3 (LATP), by using STEM at room temperature. Additionally, we performed a precise elemental analysis of a sodium-ion-conductive SE, Na 3 Zr 2 Si 2 PO 12 (NZSP), via STEM equipped with energy-dispersive X-ray spectroscopy (STEM-EDS). Our findings demonstrate that nano-shield enhances the reliability of S/TEM observations of SEs and sheds light on its underlying protective mechanisms.

Because of pressing global environmental challenges, focus has been placed on materials for efficient energy use, and this has triggered the search for nanostructural modification methods to improve performance. Achieving a high density of tunable-sized second-phase nanoparticles while ensuring the matrix remains intact is a long-sought goal. In this paper, we present an effective, scalable method to achieve this goal using metal organic deposition in a perovskite system REBa 2 Cu 3 O 7 (rare earth (RE)) that enhances the superconducting properties to surpass that of previous achievements. We present two industrially compatible routes to tune the nanoparticle size by controlling diffusion during the nanoparticle formation stage by selecting the second-phase material and modulating the precursor composition spatially. Combining these routes leads to an extremely high density (8 × 10 22  m −3 ) of small nanoparticles (7 nm) that increase critical currents and reduce detrimental effects of thermal fluctuations at all magnetic field strengths and temperatures. This method can be directly applied to other perovskite materials where nanoparticle addition is beneficial. Nanoparticle fabrication: Enhancing the properties of cuprate superconductors An industrially compatible method for creating nanoparticles with controllable size has been demonstrated by a team in Japan and the USA. The thermoelectric and superconducting properties of a perovskite material can be improved by adding nanoparticles. But while a technique known as metal organic deposition enables high-performance materials to be grown, it is difficult to control nanoparticle size because it is determined by the diffusion of atoms. Now, Masashi Miura from the Seikei University/Los Alamos National Laboratory and co-workers have achieved a high density of tunable nanoparticles using metal organic deposition. They controlled diffusion by selecting the second-phase material and modulating the precursor composition. The team showed that BaHfO 3 nanoparticles created in this way increased the critical current and reduced thermal fluctuations in a perovskite-composite cuprate superconductor. Nanostructural modifications, in particular nanoparticle (NP) additions, have been shown to have great success in improving energy-related material performance. We show how an economically viable method, namely metal organic deposition, can be used to obtain tunable small size (7 nm) and high number density NPs (8 × 10 22  m −3 ) while maintaining the crystallinity of the perovskite-composite cuprate superconductor film matrix. Critical current density J c ( H ) measurements demonstrate that the NPs are highly effective as pinning centers, decreasing vortex motion and fluctuation effects for all temperatures, magnetic field strengths and orientations measured. Our synthesis method can be applied to other perovskite-composite materials to improve their functionality.

Due to the poor prognosis of adult T-cell leukemia/lymphoma (ATL), new treatments are urgently needed, especially for elderly patients with aggressive ATL. The anti-CCR4 antibody drug mogamulizumab (MOG) has been approved for the treatment of untreated ATL. To analyze the impact of MOG on elderly patients, we conducted a retrospective analysis of patients aged 70 years and older with aggressive ATL diagnosed at our institution between 2015 and 2021. Among 32 patients, including those who received best supportive care, the median survival time (MST) and 2-year overall survival (OS) rate were 14.6 months (range, 0.0–83.7), and 34.7% [95% confidence interval (CI), 18.2–51.9], respectively, which were better than outcomes in our previous study. The MST and 2-year OS for patients treated with MOG-containing chemotherapy were 18.1 months (range, 4.0–83.7) and 45.0% (95%CI, 23.1–64.7), respectively, demonstrating clear improvement. Adverse events observed with MOG-containing treatment, such as myelosuppression and skin rash, were similar to those reported previously. Univariate analysis identified comorbidity as a predictor of poor outcomes, but not intensity of MOG-containing treatment, suggesting a different mechanism of action than that of classical chemotherapy. Our study suggests that MOG-containing treatments are an option for elderly patients with ATL.