Preparation of strong fiber with ultrahigh strength and modus is a dream of polymer scientists and engineers. It is believed that a shish-kebab is the structure origin of the ultrahigh strength and modulus fiber. This article presents our investigation on the inner structure of shish-kebab precursor of isotactic polystyrene in μm scale formed by shear flow above the nominal melting temperature T m using microbeam wide-and small-angle X-ray scattering (WAXS and SAXS). The microbeam WAXS experiments indicated that the precursor included crystallites with degree of crystallinity of ∼0.15%, which had higher melting temperature than normal lamellar crystals, meaning that its size (the length) was longer in the c-axis of crystals than the normal lamellar crystals. The microbeam SAXS experiments confirmed that approximately 1% of the crystallites in the precursor were rather long in the direction of c-axis. It is expected that such crystallites work as an initiator of a shish when it is below T m .

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PurposeWe investigated that preoperative membranous urethral length (MUL) would be associated with the recovery of urinary continence after robot-assisted laparoscopic prostatectomy (RALP).Patients and methodsWe studied 204 patients who underwent RALP between May 2013 and March 2016. All patients underwent pelvic magnetic resonance imaging (MRI) preoperatively to measure MUL. Urinary continence was defined as the use of one pad or less (safety pad). The 204 patients were divided into two groups: continence group, those who achieved recovery of continence at 3, 6, and 12 months after RALP, and incontinence group, those who did not. We retrospectively analyzed the patients in terms of preoperative clinical factors including age, body mass index (BMI), estimated prostate volume, neurovascular bundle salvage, history of preoperative hormonal therapy, and MUL.ResultsThe safety pad use rate was 69.6%, 86.9%, and 91.1% at 3, 6, and 12 months, respectively. On univariate and multivariate analyses, MUL were significant factors in every term of recovery of urinary continence in both groups. According to the receiver operating characteristic (ROC) curve analysis, the preoperative MUL that could best predict early recovery of urinary continence at 3 months after RALP was 12 mm.ConclusionsWe suggest that preoperative MUL > 12 mm would be a predictor of early recovery of urinary continence after RALP.

We have investigated the inner structure of shear-induced precursor of shish kebab of isotactic polystyrene (iPS) above the nominal melting temperature T m using microbeam wide-angle X-ray scattering. We first studied the effects of the shear rate on the inner structure and found that the crystallinity in the precursor increased with the shear rate while the crystallite size was independent of that. This was explained in terms of effects of chain entanglements on shear-induced crystallization. We also studied effects of annealing below the nominal melting temperature T m and found no changes in the crystallites size before and after the annealing, suggesting that the crystallites did not grow into shishs during the annealing below T m although the kebabs grew.

BackgroundA high incidence of severe hematological adverse events during sunitinib treatment complicates decision making on dose and treatment cycle. We identified the characteristics of early-onset hematotoxicity of sunitinib in Japanese patients with renal cell carcinoma (RCC).MethodsSeventy-nine patients were treated with sunitinib as 6-week cycles of “4-week on 2-week off” schedule. To evaluate early-onset hematotoxicity, we compared patients with dose reduction during the first cycle (dose-reduced group, n = 57) and those who maintained the initial dose (dose-maintained group, n = 22). ABCG2 and FLT3 genotypes were analyzed for association between hematotoxicity and reported gene polymorphisms.ResultsMean relative dose intensity (RDI) was similar in the two groups during the first 2 weeks of dosing in the first cycle, but was significantly lower in the dose-reduced group during the last 2 weeks. Lymphocytopenia and thrombocytopenia were observed in the dose-reduced group within the first 2 weeks. Genetic analysis indicated a significantly higher frequency of FLT3 738 T/C polymorphism in the dose-reduced group, but no significant difference in the ABCG2 421 C/A polymorphism.ConclusionsThis study showed a high incidence of sunitinib-induced hematotoxicity in Japanese patients with RCC, many of whom need dose adjustment during the first cycle. Further studies should verify whether dose adjustment based on early-onset thrombocytopenia prolongs sunitinib treatment.

Highlights Multi-IF analysis was performed to identify novel prognostic biomarker for advanced RCC patients treated with anti-PD-1 therapy. The strongest prognostic factor of response to anti-PD-1 therapy was identified as TIM3 expression on tumor cells. Patients with TIM3-positive tumor cells showed significantly longer OS and PFS than those with TIM3-negative tumor cells.

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Background A virtual reality (VR) simulator is utilized as an inexpensive tool for gaining basic technical competence in robotic-assisted surgery (RAS). We evaluated operator 3D motion sickness while using a VR simulator and assessed whether it can be reduced by repeating the training. Methods This prospective observational study was conducted at the Department of Urology, Iwate Medical University, a tertiary training hospital in an urban setting. A total of 30 undergraduate medical students participated in the study. We compared whether the VR simulator improved the students’ skills in operating the da Vinci robot. Fifteen students underwent training with a VR simulator for 4 h a day for 5 days. Then, motion sickness was determined using the Visual Analog Scale and Simulator Sickness Questionnaire (SSQ) before and after the training. Results Manipulation time significantly improved after training compared to before training (293.9 ± 72.4 versus 143.6 ± 18.4 s; p < 0.001). Although motion sickness worsened after each training session, it gradually improved with continuous practice with the VR simulator. SSQ subscores showed that the VR simulator induced nausea, disorientation, and oculomotor strain, and oculomotor strain was significantly improved with repeated training. Conclusions In undergraduate students, practice with the VR simulator improved RAS skills and operator 3D motion sickness caused by 3D manipulation of the da Vinci robot.