Pembrolizumab monotherapy has shown survival benefit as a first-line therapy for patients with metastatic non-small cell cancer (NSCLC) with a programmed death ligand 1 (PD-L1) tumor proportion score of 50% or greater and without epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma receptor tyrosine kinase (ALK) translocation (1). The addition of pembrolizumab to pemetrexed and a platinum-based chemotherapy also prolongs overall survival in patients with metastatic non-squamous NSCLC without EGFR or ALK alterations regardless of the tumor proportion score (2). Although pembrolizumab is generally well-tolerated compared to cytotoxic chemotherapy, immune-related adverse events (irAEs) are sometimes severe or even fatal. The severity of irAEs is graded according to the Common Terminology Criteria for Adverse Events (CTCAE) (3). The incidence of immune-mediated pneumonitis of any grade was 5.8% and that of grade ≥ 3 was 2.6% in the phase 3 KEYNOTE-024 trial (1). For grade ≥ 3 pneumonitis, the guidelines of the European Society for Medical Oncology (ESMO) (4) and American Society of Clinical Oncology (5) recommend intravenous methylprednisolone at 2-4 mg/kg/day and Summary Immune checkpoint inhibitors are associated with a wide spectrum of immune-related adverse events (irAEs) that are typically transient but are sometimes severe or even fatal. No consensus exists for the treatment of severe immune-mediated pneumonitis that is refractory to corticosteroids. Here, we report an autopsy case of pembrolizumab-induced pneumonitis that was transiently improved using infliximab. A 67-year-old male with advanced lung adenocarcinoma developed pneumonitis two weeks after a single dose of first-line pembrolizumab. The pneumonitis was refractory to corticosteroids, and the patient required mechanical ventilation. Addition of a single dose of infliximab rapidly improved the respiratory status and chest CT showed resolution of ground-glass opacities in the right upper and middle lobes. However, the patient died from re-exacerbation of pneumonitis 17 days after infliximab administration. The autopsy confirmed organizing phase diffuse alveolar damage in the right lower lobe, while the right upper lobe remained almost intact consistent with the CT findings, which is suggestive of the therapeutic effect of infliximab. The half-life of infliximab is 7-12 days, and a second dose of infliximab two weeks after the first dose is sometimes required for the treatment of gastrointestinal toxicity induced by anti-CTLA4 antibodies. Although the current guidelines do not recommend repeated administration of infliximab for immune-mediated pneumonitis, the present case suggests that repeated infliximab therapy may be beneficial in the treatment of immunemediated pneumonitis.

Behavioral neuroscience has dealt with short-term decision making but has not defined either daily or longer-term life actions. The individual brain interacts with the society/ world, but where that point of action is and how it interacts has never been an explicit scientific question. Here, we redefine value as an intrapersonal driver of medium-and

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Aim: Young carers (YCs) refer to children under the age of 18 who assume responsibilities that would normally be assumed by adults, such as caring for family members in need of care. In recent years, the concept of YCs has been expanding in Japan, and the government has been rapidly implementing strategies to support them. There is a need for a survey scale for YCs that uses standardized methods that can be compared internationally.

By nature, humans are “ tojisha (participating subjects/player–witnesses)” who encounter an unpredictable real world. An important characteristic of the relationship between the individual brain and the world is that it creates a loop of interaction and mutual formation. However, cognitive sciences have traditionally been based on a model that treats the world as a given constant. We propose incorporating the interaction loop into this model to create “world-informed neuroscience (WIN)”. Based on co-productive research with people with minority characteristics that do not match the world, we hypothesize that the tojisha and the world interact in a two-dimensional way of rule-based and story-based. By defining the cognitive process of becoming tojisha in this way, it is possible to contribute to the various issues of the real world and diversity and inclusion through the integration of the humanities and sciences. The critical role of the brain dopamine system as a basis for brain–world interaction and the importance of research on urbanicity and adolescent development as examples of the application of WIN were discussed. The promotion of these studies will require bidirectional translation between human population science and animal cognitive neuroscience. We propose that the social model of disability should be incorporated into cognitive sciences, and that disability-informed innovation is needed to identify how social factors are involved in mismatches that are difficult to visualize. To promote WIN to ultimately contribute to a diverse and inclusive society, co-production of research from the initial stage of research design should be a baseline requirement.