Aims: Attenuation imaging (ATI) is a new ultrasonography method of evaluating hepatic steatosis. Attenuation coefficients (ACs) in the region of interest are measured using two-dimensional ultrasonography. ATI also displays the coefficient of determination (R²) as an index of AC reliability. This study aimed to elucidate R² values in patients who underwent ATI in clinical practice and to determine factors that influence R² values.
Methods: This study included 749 patients who underwent ATI to evaluate hepatic steatosis at a single center. All abdominal ultrasound examinations were performed by one of the five experienced ultrasonographers. The AC and R² values were measured five times, and the median values were calculated. Multivariate analysis was conducted to identify factors affecting R² values.
Results: One hundred and nine (15%) patients showed R² values of < 0.80, of which 108 had non-fatty liver. Further, the R² value was strongly correlated with AC (correlation coefficient = 0.842). Uncomplicated diabetes (Odds ratio [OR], 2.68) and AC (< 0.60 dB/cm/MHz; OR, 72.76) were identified as independent factors associated with low R² values (< 0.80).
Conclusion: ATI in patients with non-fatty liver showed low R² values. Worldwide standardization of the ATI measurement method is urgently needed for consistent results.

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Background: Absolute lymphocyte count (ALC) and neutrophil lymphocyte rate (NLR) as immune system and inflammatory markers have been suggested as prognostic factors in eribulin treatment. However, the respective cut-off values have not been determined. Hence, we investigated the relationship between overall survival (OS) and baseline ALC (bALC) and baseline NLR (bNLR) in eribulin-treated patients with human epidermal growth factor receptor 2 (HER2)-negative breast cancer (BC) by using 2 types of cut-off values for each.
Methods: Univariate and multivariate analyses were performed to investigate the association of bALC and bNLR with OS among 114 female patients with HER2-negative BC treated with eribulin.
Results: The OS of patients with HER2-negative BC was compared based on bALC (cut-off value: 1,200/μL and 1,500/μL) and bNLR (cut-off values: 2 and 3). A significant difference was observed in median OS between patients with bALC of ≥ 1,200/μL and those with bALC of < 1,200/μL (hazard ratio [HR]: 0.596 [0.395, 0.889], p = 0.014). For bNLR (cut-off value: 2), the median OS was significantly higher in patients with a bNLR of < 2 than in those with a bNLR of ≥ 2 (HR: 0.629 [0.406, 0.974], p = 0.038).
Conclusions: Patients with HER2-negative BC with a bALC of ≥ 1,200/μL showed a longer OS than patients with a bALC of < 1,200/μL, thus suggesting that survival prediction using bALC was effective for eribulin-treated patients with recurrent HER2-negative BC. It should be noted that the optimal cut-off value for ALC may change depending on the target patient group.

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The immune system produces antibodies following SARS-CoV-2 infection and vaccination. However, we lack comprehensive information about the humoral responses after infection and vaccination, which are similar but might differ in type or amount of produced antibodies. Therefore, we compared different types and amounts of antibodies produced by the immune system in response to infection versus those produced by BNT162b2 (Pfizer/BioNTech) vaccines. Our findings indicated that naturally infected individuals had 14-fold higher anti-SARS-CoV-2 spike protein (anti-S) and 41-fold higher anti-SARS-CoV-2 receptor-binding domain of the viral spike protein (anti-RBD) IgM titers than SARS-CoV-2-naïve vaccinees. Remarkably, naturally infected individuals maintained high levels of IgM antibody titers up to six weeks after symptom onset. A significantly rapid increase in anti-S IgG titers in primary infection was observed, eventually reaching a level similar to that in people who had third booster vaccination. This study revealed the characteristics of the target antigen and immunoglobulin isotypes after natural SARS-CoV-2 infection and COVID-19 vaccination.

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