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Initial Experience with [177Lu]Lu-PSMA-617 After Regulatory Approval for Metastatic Castration-Resistant Prostate Cancer: Efficacy, Safety, and Outcome Prediction

[177Lu]Lu-PSMA-617 was approved by the U.S. Food and Drug Administration for patients with prostate-specific membrane antigen (PSMA)–positive metastatic castration-resistant prostate cancer (mCRPC). Since the time of regulatory approval, however, real-world data have been lacking. This study investigated the efficacy, safety, and outcome predictors of [177Lu]Lu-PSMA-617 at a major U.S. academic center. Methods: Patients with mCRPC who received [177Lu]Lu-PSMA-617 at the Johns Hopkins Hospital outside clinical trials were screened for inclusion. Patients who underwent [177Lu]Lu-PSMA-617 and had available outcome data were included in this study. Outcome data included prostate-specific antigen (PSA) response (≥50% decline), PSA progression-free survival (PFS), and overall survival (OS). Toxicity data were evaluated according to the Common Terminology Criteria for Adverse Events version 5.03. The study tested the association of baseline circulating tumor DNA mutational status in homologous recombination repair, PI3K alteration pathway, and aggressive-variant prostate cancer–associated genes with treatment outcome. Baseline PSMA PET/CT images were analyzed using SelectPSMA, an artificial intelligence algorithm, to predict treatment outcome. Associations with the observed treatment outcome were evaluated. Results: All 76 patients with PSMA-positive mCRPC who received [177Lu]Lu-PSMA-617 met the inclusion criteria. A PSA response was achieved in 30 of 74 (41%) patients. The median PSA PFS was 4.1 mo (95% CI, 2.0–6.2 mo), and the median OS was 13.7 mo (95% CI, 11.3–16.1 mo). Anemia of grade 3 or greater, thrombocytopenia, and neutropenia were observed in 9 (12%), 3 (4%), and 1 (1%), respectively, of 76 patients. Transient xerostomia was observed in 23 (28%) patients. The presence of aggressive-variant prostate cancer–associated genes was associated with a shorter PSA PFS (median, 1.3 vs. 6.3 mo; P = 0.040). No other associations were observed between circulating tumor DNA mutational status and treatment outcomes. Eighteen of 71 (25%) patients classified by SelectPSMA as nonresponders had significantly lower rates of PSA response than patients classified as likely responders (6% vs. 51%; P < 0.001), a shorter PSA PFS (median, 1.3 vs. 6.3 mo; P < 0.001), and a shorter OS (median, 6.3 vs. 14.5 mo; P = 0.046). Conclusion: [177Lu]Lu-PSMA-617 offered in a real-world setting after regulatory approval in the United States demonstrated antitumor activity and a favorable toxicity profile. Artificial-intelligence–based analysis of baseline PSMA PET/CT images may improve patient selection. Validation of these findings on larger cohorts is warranted.




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The 75-Year Anniversary of the Department of Physiology and Pharmacology at Karolinska Institutet--Examples of Recent Accomplishments and Future Perspectives [75th Anniversary Celebration Collection Special Section-Perspective]

Karolinska Institutet is a medical university encompassing 21 departments distributed across three departmental or campus groups. Pharmacological research has a long and successful tradition at the institute with a multitude of seminal findings in the areas of neuronal control of vasodilatation, cardiovascular pharmacology, neuropsychopharmacology, receptor pharmacology, and pharmacogenomics that resulted in, among many other recognitions, two Nobel prizes in Physiology and Medicine, one in 1970 to Ulf von Euler for his discovery of the processes involved in storage, release, and inactivation of neurotransmitters and the other in 1982 to Sune Bergström and Bengt Samuelsson for their work on prostaglandins and the discovery of leukotrienes. Pharmacology at Karolinska Institutet has over the last decade been ranked globally among the top 10 according to the QS World University Ranking. With the Department of Physiology and Pharmacology now celebrating its 75-year anniversary, we wanted to take this as an opportunity to showcase recent research achievements and how they paved the way for current activities at the department. We emphasize examples from preclinical and clinical research where the dpartment's integrative environment and robust infrastructure have successfully facilitated the translation of findings into clinical applications and patient benefits. The close collaboration between preclinical scientists and clinical researchers across various disciplines, along with a strong network of partnerships within the department and beyond, positions us to continue leading world-class pharmacological research at the Department of Physiology and Pharmacology for decades to come.

Significance Statement

Pharmacological research at Karolinska Institutet has a long and successful history. Given the 75-year anniversary of the Department of Physiology and Pharmacology, this perspective provides an overview of recent departmental achievements and future trajectories. For these developments, interdisciplinary and intersectoral collaborations and a clear focus on result translation are key elements to continue its legacy of world-leading pharmacological research.




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Enzyme Replacement Therapy for CLN2 Disease: MRI Volumetry Shows Significantly Slower Volume Loss Compared with a Natural History Cohort [CLINICAL PRACTICE]

BACKGROUND AND PURPOSE:

Neuronal ceroid lipofuscinoses are a group of neurodegenerative disorders. Recently, enzyme replacement therapy (ERT) was approved for neuronal ceroid lipofuscinosis type 2 (CLN2), a subtype of neuronal ceroid lipofuscinoses. The aim of this study was to quantify brain volume loss in CLN2 disease in patients on ERT in comparison with a natural history cohort using MRI.

MATERIALS AND METHODS:

Nineteen (14 female, 5 male) patients with CLN2 disease at 1 UK center were studied using serial 3D T1-weighted MRI (follow-up time, 1–9 years). Brain segmentation was performed using FreeSurfer. Volume measurements for supratentorial gray and white matter, deep gray matter (basal ganglia/thalami), the lateral ventricles, and cerebellar gray and white matter were recorded. The volume change with time was analyzed using a linear mixed-effects model excluding scans before treatment onset. Comparison was made with a published natural history cohort of 12 patients (8 female, 4 male), which was re-analyzed using the same method.

RESULTS:

Brain volume loss of all segmented brain regions was much slower in treated patients compared with the natural history cohort. For example, supratentorial gray matter volume in treated patients decreased by a mean of 3% (SD, 0.74%) (P < .001) annually compared with an annual volume loss of a mean of 16.8% (SD, 1.5%) (P < .001) in the natural history cohort.

CONCLUSIONS:

Our treatment cohort showed a significantly slower rate of brain parenchymal volume loss compared with a natural history cohort in several anatomic regions. Our results complement prior clinical data that found a positive response to ERT. We demonstrate that automated MRI volumetry is a sensitive tool to monitor treatment response in children with CLN2 disease.




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Comparative Evaluation of Lower Gadolinium Doses for MR Imaging of Meningiomas: How Low Can We Go? [CLINICAL PRACTICE]

BACKGROUND AND PURPOSE:

Gadolinium-based contrast agents are widely used for meningioma imaging; however, concerns exist regarding their side effects, cost, and environmental impact. At the standard gadolinium dose, most meningiomas show avid contrast enhancement, suggesting that administering a smaller dose may be feasible. The purpose of this study was to evaluate the impact of a lower gadolinium dose on the differentiation between meningiomas and adjacent intracranial tissues.

MATERIALS AND METHODS:

One hundred eight patients with presumed or confirmed meningiomas who underwent a brain MRI at multiple doses of gadolinium were included in the study. The patients’ MRIs were categorized into 3 groups based on the gadolinium dose administered: micro (approximately 25% of the standard dose), low (approximately 62% of the standard dose), and standard dose. Multireader qualitative visual assessment and quantitative relative signal differences calculations were performed to evaluate tumor differentiation from the cortex and from the dural venous sinus. The relative signal differences for each dose were analyzed by using ANOVA for quantitative assessment and the McNemar test for qualitative assessment. Additionally, noninferiority testing was used to compare the low and micro doses to the standard dose.

RESULTS:

Decreasing the gadolinium dose to a low dose or micro dose resulted in a statistically significant decrease in signal difference between the tumor and the adjacent brain tissue (P < .02). However, on visual assessment, the low dose was noninferior to the standard dose. The proportion of cases with suboptimal differentiation was significantly higher for the micro dose than for the standard dose, both for the differentiation between the tumor and the cortex (P = .041) and the differentiation between the tumor and the sinus (P < .001).

CONCLUSIONS:

Reducing the gadolinium dose to 62% of the standard level still allows for sufficient visual delineation of meningiomas from surrounding tissues. However, further reduction to 25% substantially compromises the ability to distinguish the tumor from adjacent structures and is, therefore, not advisable.




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Preoperative Assessment of Meningioma Consistency Using a Combination of MR Elastography and DTI [RESEARCH]

BACKGROUND AND PURPOSE:

Preoperative assessment of meningioma consistency is beneficial for optimizing surgical strategy and prognosis of patients. We aim to develop a noninvasive prediction model for meningioma consistency utilizing MR elastography and DTI.

MATERIALS AND METHODS:

Ninety-four patients (52 ± 22 years old, 69 women, 25 men) diagnosed with meningioma were recruited in the study. Each patient underwent preoperative T1WI, T2WI, DTI, and MR elastography. Combined MR elastography–DTI model was developed based on multiple logistic regression. Intraoperative tumor descriptions served as clinical criteria for evaluating meningioma consistency. The diagnostic efficacy in determining meningioma consistency was evaluated by using a receiver operating characteristic curve. Further validation was conducted in 27 stereotactic biopsies by using indentation tests and underlying mechanism was investigated by histologic analysis.

RESULTS:

Among all the imaging modalities, MR elastography demonstrated the highest efficacy with the shear modulus magnitude (|G*|) achieving an area under the curve (AUC) of 0.81 (95% CI: 0.699–0.929). When combined with DTI, the diagnostic accuracy further increased (AUC: 0.88, 95% CI: 0.784–0.971), surpassing any technique alone. Indentation measurement based on stereotactic biopsies further demonstrated that the MR elastography–DTI model was suitable for predicting intratumor consistency. Histologic analysis suggested that meningioma consistency may be correlated with tumor cell density and fibrous content.

CONCLUSIONS:

The MR elastography–DTI combined model is effective in noninvasive prediction of meningioma consistency.




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Predictors and Outcomes of Periprocedural Intracranial Hemorrhage after Stenting for Symptomatic Intracranial Atherosclerotic Stenosis [CLINICAL PRACTICE]

BACKGROUND AND PURPOSE:

Periprocedural intracranial hemorrhage is one of common complications after stent placement for symptomatic intracranial atherosclerotic stenosis. This study was conducted to demonstrate predictors and long-term outcomes of periprocedural intracranial hemorrhage after stent placement for symptomatic intracranial atherosclerotic stenosis.

MATERIALS AND METHODS:

We retrospectively analyzed patients with symptomatic intracranial atherosclerotic stenosis stent placement in a prospective cohort at a high-volume stroke center. Clinical, radiologic, and periprocedural characteristics and long-term outcomes were reviewed. Periprocedural intracranial hemorrhage was classified as procedure-related hemorrhage (PRH) and non-procedure-related hemorrhage (NPRH). The long-term outcomes were compared between patients with PRH and NPRH, and the predictors of NPRH were explored.

RESULTS:

Among 1849 patients, 24 (1.3%) had periprocedural intracranial hemorrhage, including PRH (4) and NPRH (20). The postprocedural 30-day mRS was 0–2 in 9 (37.5%) cases, 3–5 in 5 (20.8%) cases, and 6 in 10 (41.7%) cases. For the 14 survivors, the long-term (median of 78 months) mRS were 0–2 in 10 (76.9%) cases and 3–5 in 3 (23.1%) cases. The proportion of poor long-term outcomes (mRS ≥3) in patients with NPRH was significantly higher than those with PRH (68.4% versus 0%, P = .024). Anterior circulation (P = .002), high preprocedural stenosis rate (P < .001), and cerebral infarction within 30 days (P = .006) were independent predictors of NPRH after stent placement.

CONCLUSIONS:

Patients with NPRH had worse outcomes than those with PRH after stent placement for symptomatic ICAS. Anterior circulation, severe preprocedural stenosis, and recent infarction are independent predictors of NPRH.




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Common clonal origin of three distinct hematopoietic neoplasms in a single patient: B-cell lymphoma, T-cell lymphoma, and polycythemia vera [RESEARCH ARTICLE]

The potential for more than one distinct hematolymphoid neoplasm to arise from a common mutated stem or precursor cell has been proposed based on findings in primary human malignancies. Particularly, angioimmunoblastic T-cell lymphoma (AITL), which shares a somatic mutation profile in common with other hematopoietic malignancies, has been reported to occur alongside myeloid neoplasms or clonal B-cell proliferations, with identical mutations occurring in more than one cell lineage. Here we report such a case of an elderly woman who was diagnosed over a period of 8 years with diffuse large B-cell lymphoma, polycythemia vera, and AITL, each harboring identical somatic mutations in multiple genes. Overall, at least five identical nucleotide mutations were shared across multiple specimens, with two identical mutations co-occurring at variable variant allele frequencies in all three specimen types. These findings lend credence to the theory that a common mutated stem cell could give rise to multiple neoplasms through parallel hematopoietic differentiation pathways.




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Prostate cancer patient stratification by molecular signatures in the Veterans Precision Oncology Data Commons [RESEARCH REPORT]

Veterans are at an increased risk for prostate cancer, a disease with extraordinary clinical and molecular heterogeneity, compared with the general population. However, little is known about the underlying molecular heterogeneity within the veteran population and its impact on patient management and treatment. Using clinical and targeted tumor sequencing data from the National Veterans Affairs health system, we conducted a retrospective cohort study on 45 patients with advanced prostate cancer in the Veterans Precision Oncology Data Commons (VPODC), most of whom were metastatic castration-resistant. We characterized the mutational burden in this cohort and conducted unsupervised clustering analysis to stratify patients by molecular alterations. Veterans with prostate cancer exhibited a mutational landscape broadly similar to prior studies, including KMT2A and NOTCH1 mutations associated with neuroendocrine prostate cancer phenotype, previously reported to be enriched in veterans. We also identified several potential novel mutations in PTEN, MSH6, VHL, SMO, and ABL1. Hierarchical clustering analysis revealed two subgroups containing therapeutically targetable molecular features with novel mutational signatures distinct from those reported in the Catalogue of Somatic Mutations in Cancer database. The clustering approach presented in this study can potentially be used to clinically stratify patients based on their distinct mutational profiles and identify actionable somatic mutations for precision oncology.




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Novel inherited CDX2 variant segregating in a family with diverse congenital malformations of the genitourinary system [RAPID COMMUNICATION]

Anorectal malformations (ARMs) constitute a group of congenital defects of the gastrointestinal and urogenital systems. They affect males and females, with an estimated worldwide prevalence of 1 in 5000 live births. These malformations are clinically heterogeneous and can be part of a syndromic presentation (syndromic ARM) or as a nonsyndromic entity (nonsyndromic ARM). Despite the well-recognized heritability of nonsyndromic ARM, the genetic etiology in most patients is unknown. In this study, we describe three siblings with diverse congenital anomalies of the genitourinary system, anemia, delayed milestones, and skeletal anomalies. Genome sequencing identified a novel, paternally inherited heterozygous Caudal type Homeobox 2 (CDX2) variant (c.722A > G (p.Glu241Gly)), that was present in all three affected siblings. The variant identified in this family is absent from population databases and predicted to be damaging by most in silico pathogenicity tools. So far, only two other reports implicate variants in CDX2 with ARMs. Remarkably, the individuals described in these studies had similar clinical phenotypes and genetic alterations in CDX2. CDX2 encodes a transcription factor and is considered the master regulator of gastrointestinal development. This variant maps to the homeobox domain of the encoded protein, which is critical for interaction with DNA targets. Our finding provides a potential molecular diagnosis for this family's condition and supports the role of CDX2 in anorectal anomalies. It also highlights the clinical heterogeneity and variable penetrance of ARM predisposition variants, another well-documented phenomenon. Finally, it underscores the diagnostic utility of genomic profiling of ARMs to identify the genetic etiology of these defects.




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Synchronous T-lymphoblastic lymphoma and neuroblastoma in a 3-yr-old with novel germline SMARCA4 and EZH2 variants [RAPID CANCER COMMUNICATION]

T-lymphoblastic lymphoma (T-LLy) is the most common lymphoblastic lymphoma in children and often presents with a mediastinal mass. Lymphomatous suprarenal masses are possible but rare. Here, we discuss the case of a previously healthy 3-yr-old male who presented with mediastinal T-LLy with bilateral suprarenal masses. Following initial treatment, surgical biopsy of persisting adrenal masses revealed bilateral neuroblastoma (NBL). A clinical genetics panel for germline cancer predisposition did not identify any pathogenic variants. Combination large panel (864 genes) profiling analysis in the context of a precision oncology study revealed two novel likely pathogenic heterozygous variants: SMARCA4 c.1420-1G > T p.? and EZH2 c.1943G > C p.(Ile631Phefs*44). Somatic analysis revealed potential second hits/somatic variants in EZH2 (in the T-LLy) and a segmental loss in Chromosome 19p encompassing SMARCA4 (in the NBL). Synchronous cancers, especially at a young age, warrant genetic evaluation for cancer predisposition; enrollment in a precision oncology program assessing germline and tumor DNA can fulfill that purpose, particularly when standard first-line genetic testing is negative and in the setting of tumors that are not classic for common cancer predisposition syndromes.




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Healthcare avoidance during the early stages of the COVID-19 pandemic and all-cause mortality: a longitudinal community-based study

BackgroundDuring the COVID-19 pandemic, global trends of reduced healthcare-seeking behaviour were observed. This raises concerns about the consequences of healthcare avoidance for population health.AimTo determine the association between healthcare avoidance during the early stages of the COVID-19 pandemic and all-cause mortality.Design and settingThis was a 32-month follow-up within the population-based Rotterdam Study, after sending a COVID-19 questionnaire at the onset of the pandemic in April 2020 to all communty dwelling participants (n = 6241/8732, response rate 71.5%).MethodCox proportional hazards models assessed the risk of all-cause mortality among respondents who avoided health care because of the COVID-19 pandemic. Mortality status was collected through municipality registries and medical records.ResultsOf 5656 respondents, one-fifth avoided health care because of the COVID-19 pandemic (n = 1143). Compared with non-avoiders, those who avoided health care more often reported symptoms of depression (n = 357, 31.2% versus n = 554, 12.3%) and anxiety (n = 340, 29.7% versus n = 549, 12.2%), and more often rated their health as poor to fair (n = 336, 29.4% versus n = 457, 10.1%) . Those who avoided health care had an increased adjusted risk of all-cause mortality (hazard ratio [HR] 1.30, 95% confidence interval [CI] = 1.01 to 1.67), which remained nearly identical after adjustment for history of any non-communicable disease (HR 1.20, 95% CI = 0.93 to 1.54). However, this association attenuated after additional adjustment for mental and physical self-perceived health factors (HR 0.93, 95% CI = 0.71 to 1.20).ConclusionThis study found an increased risk of all-cause mortality among individuals who avoided health care during COVID-19. These individuals were characterised by poor mental and physical self-perceived health. Therefore, interventions should be targeted to these vulnerable individuals to safeguard their access to primary and specialist care to limit health disparities, inside and beyond healthcare crises.




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Do I know you? (well enough to complete your multisource feedback &#x2026; )




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The Odyssey of HOMER: Comparative Effectiveness Research on Medication for Opioid Use Disorder During the COVID-19 Pandemic [Special Report]

The usual challenges of conducting primary care research, including randomized trials, have been exacerbated, and new ones identified, during the COVID-19 pandemic. HOMER (Home versus Office for Medication Enhanced Recovery; subsequently, Comparing Home, Office, and Telehealth Induction for Medication Enhanced Recovery) is a pragmatic, comparative-effectiveness research trial that aims to answer a key question from patients and clinicians: What is the best setting in which to start treatment with buprenorphine for opioid use disorder for this patient at this time? In this article, we describe the difficult journey to find the answer. The HOMER study began as a randomized trial comparing treatment outcomes in patients starting treatment with buprenorphine via induction at home (unobserved) vs in the office (observed, synchronous). The study aimed to enroll 1,000 participants from 100 diverse primary care practices associated with the State Networks of Colorado Ambulatory Practices and Partners and the American Academy of Family Physicians National Research Network. The research team faced unexpected challenges related to the COVID-19 pandemic and dramatic changes in the opioid epidemic. These challenges required changes to the study design, protocol, recruitment intensity, and funding conversations, as well as patience. As this is a participatory research study, we sought, documented, and responded to practice and patient requests for adaptations. Changes included adding a third study arm using telehealth induction (observed via telephone or video, synchronous) and switching to a comprehensive cohort design to answer meaningful patient-centered research questions. Using a narrative approach based on the Greek myth of Homer, we describe here the challenges and adaptations that have provided the opportunity for HOMER to thrive and find the way home. These clinical trial strategies may apply to other studies faced with similar cultural and extreme circumstances.




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Lack of Knowledge of Antibiotic Risks Contributes to Primary Care Patients Expectations of Antibiotics for Common Symptoms [Research Briefs]

Patient expectations of receiving antibiotics for common symptoms can trigger unnecessary use. We conducted a survey (n = 564) between January 2020 to June 2021 in public and private primary care clinics in Texas to study the prevalence and predictors of patients’ antibiotic expectations for common symptoms/illnesses. We surveyed Black patients (33%) and Hispanic/Latine patients (47%), and over 93% expected to receive an antibiotic for at least 1 of the 5 pre-defined symptoms/illnesses. Public clinic patients were nearly twice as likely to expect antibiotics for sore throat, diarrhea, and cold/flu than private clinic patients. Lack of knowledge of potential risks of antibiotic use was associated with increased antibiotic expectations for diarrhea (odds ratio [OR] = 1.6; 95% CI, 1.1-2.4) and cold/flu symptoms (OR = 2.9; 95% CI, 2.0-4.4). Lower education and inadequate health literacy were predictors of antibiotic expectations for diarrhea. Future antibiotic stewardship interventions should tailor patient education materials to include information on antibiotic risks and guidance on appropriate antibiotic indications.




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[PERSPECTIVES] The Complex Roles of Redox and Antioxidant Biology in Cancer

Redox reactions control fundamental biochemical processes, including energy production, metabolism, respiration, detoxification, and signal transduction. Cancer cells, due to their generally active metabolism for sustained proliferation, produce high levels of reactive oxygen species (ROS) compared to normal cells and are equipped with antioxidant defense systems to counteract the detrimental effects of ROS to maintain redox homeostasis. The KEAP1-NRF2 system plays a major role in sensing and regulating endogenous antioxidant defenses in both normal and cancer cells, creating a bivalent contribution of NRF2 to cancer prevention and therapy. Cancer cells hijack the NRF2-dependent antioxidant program and exploit a very unique metabolism as a trade-off for enhanced antioxidant capacity. This work provides an overview of redox metabolism in cancer cells, highlighting the role of the KEAP1-NRF2 system, selenoproteins, sulfur metabolism, heme/iron metabolism, and antioxidants. Finally, we describe therapeutic approaches that can be leveraged to target redox metabolism in cancer.




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Des politiques pour mieux soutenir les chirurgiennes enceintes [Commentaire]




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"Steroids in severe community-acquired pneumonia". S. Ananth, A.G. Mathioudakis, J. Hansel. Breathe 2024; 20: 240081.




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Steroids in severe community-acquired pneumonia

There is conflicting evidence regarding the use of steroids in severe community-acquired pneumonia (CAP), with previous randomised controlled trials limited by small sample sizes. ESCAPe and CAPE COD are two recently published large trials on steroids in severe CAP. ESCAPe assessed the initiation of methylprednisolone within 72–96 h of hospital admission, while CAPE COD studied the use of hydrocortisone within 24 h of the development of severe CAP. ESCAPe did not show any differences in all-cause 60-day mortality or any of its secondary outcomes. CAPE COD showed that hydrocortisone improved all-cause 28-day mortality and reduced the risk of intubation or vasopressor-dependent shock. Important differences between the trials included the steroid regimens used, timing of steroid administration and baseline characteristics, with more diabetic patients included in ESCAPe. The results of CAPE COD support the initiation of hydrocortisone within 24 h of developing severe CAP, but more research is needed to evaluate long-term outcomes and optimum dosing regimens for steroids in severe CAP.




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Pulmonary complications of bone marrow transplantation

Bone marrow transplantation, now often known as haematopoietic stem cell transplantation (HSCT), is a complex choreographed procedure used to treat both acquired and inherited disorders of the bone marrow. It has proven invaluable as therapy for haematological and immunological disorders, and more recently in the treatment of metabolic and enzyme disorders. As the number of performed transplants grows annually, and with patients enjoying improved survival, a knowledge of both early and late complications of HSCT is essential for respiratory trainees and physicians in practice. This article highlights the spectrum of respiratory complications, both infectious and non-infectious, the timeline of their likely occurrence, and the approaches used for diagnosis and treatment, keeping in mind that more than one entity may occur simultaneously. As respiratory issues are often a leading cause of short- and long-term morbidity, consideration of a combined haematology/respiratory clinic may prove useful in this patient population.




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Palliative care in lung cancer: tumour- and treatment-related complications in lung cancer and their management

Palliative care pertains to the holistic multidimensional concept of "patient-centred" care. It is an interprofessional specialty, primarily aiming to improve quality of care for cancer patients and their families, from the time of diagnosis of malignant disease, over the continuum of cancer care, and extending after the patient's death to the period of bereavement to support the patient's family. There are various complex and frequently unmet needs of lung cancer patients and their families/caregivers, not only physical but also psychological, social, spiritual and cultural. Systematic monitoring of patients’ symptoms using validated questionnaires and patient-reported outcomes (PROs), on a regular basis, is highly encouraged and recommended in recent guidelines on the role of PRO measures in the continuum of cancer clinical care. It improves patient–physician communication, physician awareness of symptoms, symptom control, patient satisfaction, health-related quality of life and cost-effectiveness. This implies that all treating physicians should improve their skills in communication with lung cancer patients/relatives and become more familiar with this multidimensional assessment, repeatedly screening patients for palliative care needs. Therefore, they should receive education and training to develop palliative care knowledge, skills and attitudes. This review is dedicated to lung cancer palliative care essentials that should be within the competences of treating physicians, i.e. pneumologists/thoracic oncologists.




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Squid Game Season 2 Will Be All About Divisions—and the Fight to Overcome Them



Netflix's mega-violent mega-hit series returns December 26.





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SNP MSP welcomes contest with Flynn as she declares bid to restand for seat

"I look forward to any contest, where of course it will be for branch members to select those they wish to represent them in Holyrood in the 2026 Scottish Parliament elections.”




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'We had to come and help, to do what we can'- Valencia flood volunteers fear and hope

As parts of Spain are on alert for new flood warnings, Dominic Hinde meets the volunteers still involved in the aftermath and recovery following the initial disaster




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Backlash after former Labour Spin Doctor's comment on Farmers and Thatcher

A former aid to Tony Blair has been criticised by the SNP after he said the Government "should do farmers what Thatcher did to the miners".




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Housebuilder completes 'one of the largest' new Highland homes projects since 1970s

A rural housing project branded as ‘truly transformative’ has been completed




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SNP's Stephen Flynn announces bid to become MSP in 2026 election

The SNP's Westminster leader has announced he is to contest a seat at Holyrood – and will ‘double-job’ as an MP and MSP if he wins.




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Libraries recognised for community contributions in annual award ceremony

Shetland Library and the National Library of Scotland have been praised for "providing optimist for the future."




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RPG Cast – Episode 563: “Isn’t Compile Heart Jail Against the Geneva Convention?”

We can't believe we have to say this, but this week Chris tries to understand water vapor. Anna Marie takes a week off to go date some demons. Josh frequents a sex shop to pick up some weapons. Pascal starts vaping in his Xbox. And Robert and Kelley are testing the jiggle physics of sacks in World of Warcraft.

The post RPG Cast – Episode 563: “Isn’t Compile Heart Jail Against the Geneva Convention?” appeared first on RPGamer.



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  • Yakuza: Like a Dragon

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RPG Cast – Episode 700: “Come Here, Barney!”

Chris puts on his tummy control sumo pants and gets uploaded into a big booby robot girl. Kelley married a Lego elitist who won't pirate a pirate ship. Robert stares into catfinity, and the bunny stares back.

The post RPG Cast – Episode 700: “Come Here, Barney!” appeared first on RPGamer.




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Commercial flying ‘never safer’

A 10-year analysis of air accidents reveals good news for most passengers but worrying trends in training and drones.




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Switch Comfortably Best-Seller - Japan Hardware Estimates for October 2024

The Nintendo Switch was the best-selling console in Japan with 241,803 units sold for October 2024, according to VGChartz estimates. The Nintendo Switch has now sold an estimated 34.30 million units lifetime in Japan.

The PlayStation 5 sold an estimated 49,056 units to bring its lifetime sales to 6.12 million units. The Xbox Series X|S sold 5,862 units to bring their lifetime sales to 0.64 million units. The PlayStation 4 sold an estimated 162 units to bring its lifetime sales to 9.68 million units.

PS5 sales compared to the same month for the PS4 in 2017 are down by nearly 53,000 units, while the Xbox Series X|S compared to the same month for the Xbox One are up by over 5,000 units. PS4 sold 101,851 units for the month of October 2017 and Xbox One sales were at 563 units.

Nintendo Switch sales compared to the same month a year ago are down by 41,368 units (-14.6%). PlayStation 5 sales are down by 17,208 (-26.0%) and Xbox Series X|S sales are down by 2,294 units (-28.1%). The PlayStation 4 is down by 5,362 units (-97.1%) year-over-year.

Looking at sales month-on-month, Nintendo Switch sales are down up nearly 67,000 units, the PlayStation 5 sales are down by over 4,000 units, and Xbox Series X|S sales are up by over 2,000 units.

2024 year-to-date, the Nintendo Switch has sold an estimated 2.47 million units, the PlayStation 5 has sold 1.16 million units, and the Xbox Series X|S has sold 0.09 million units.

Monthly Sales:

Japan hardware estimates for October 2024 (Followed by lifetime sales):

  1. Switch - 241,803 (34,300,699)
  2. PlayStation 5 - 49,056 (6,121,649)
  3. Xbox Series X|S - 5,862 (636,764)
  4. PlayStation 4 - 162 (9,679,626)

Weekly Sales:

Japan October 12, 2024 hardware estimates:

  1. Switch - 55,097
  2. PlayStation 5 - 11,810
  3. Xbox Series X|S - 429
  4. PlayStation 4 - 31

Japan October 19, 2024 hardware estimates:

  1. Switch - 58,866
  2. PlayStation 5 - 11,324
  3. Xbox Series X|S - 1,612
  4. PlayStation 4 - 36

Japan October 26, 2024 hardware estimates:

  1. Switch - 67,736
  2. PlayStation 5 - 11,951
  3. Xbox Series X|S - 1,207
  4. PlayStation 4 - 40

Japan November 2, 2024 hardware estimates:

  1. Switch - 60,104
  2. PlayStation 5 - 13,971
  3. Xbox Series X|S - 2,614
  4. PlayStation 4 - 55

A life-long and avid gamer, William D'Angelo was first introduced to VGChartz in 2007. After years of supporting the site, he was brought on in 2010 as a junior analyst, working his way up to lead analyst in 2012 and taking over the hardware estimates in 2017. He has expanded his involvement in the gaming community by producing content on his own YouTube channel and Twitch channel. You can contact the author on Twitter @TrunksWD.

Full Article - https://www.vgchartz.com/article/463008/switch-comfortably-best-seller-japan-hardware-estimates-for-october-2024/




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Capcom Updates Its Best-Sellers List - Monster Hunter World at 20.9M, RE4 Remake at 8M, More

Capcom has updated its list of Platinum Titles, games that have sold over one million units as of September 30, 2024. The list includes 122 games with sales over one million units, 64 over two million units, 14 over five million units, and six over 10 million units sold.

Resident Evil 4 remake sold 400,000 units to bring lifetime sales to eight million units, Resident Evil 2 remake sold 300,000 units to bring sales to 14.5 million units, and Resident Evil 3 remake sold 200,000 units to bring lifetime sales to 9.2 million units. 

Resident Evil 7: biohazard sold 300,000 units to bring lifetime sales to 14 million units and Resident Evil Village sold 400,000 units to bring sales to 10.5 million units.

Monster Hunter Rise sold 600,000 units in the quarter to bring lifetime sales to 16 million units. Monster Hunter Rise: Sunbreak sold 400,000 units to bring lifetime sales to 8.8 million units.

Monster Hunter: World sold 400,000 units in the quarter to bring lifetime sales to 20.9 million units, while the Iceborne expansion sold 600,000 units for a total of 14 million units.

Dragon's Dogma 2 sold 300,000 units in the quarter to bring lifetime sales to 3.3 million units. Street Fighter 6 sold 400,000 units in the quarter to bring lifetime sales to 4.1 million units. Devil May Cry 5 sold 300,000 units to bring sales to 8.7 million units. 

Check out the complete list below:

Release Title Platform Million
units
1 Jan 2018 Monster Hunter: World

*Unit sales including Monster Hunter World: Iceborne Master Edition: 27.00 million units

PS4, Xbox One, PC, DL 20.90*
2 Mar 2021 Monster Hunter Rise NSW, PS4, PS5, Xbox One, XSX, PC, DL 16.00
3 Jan 2019 Resident Evil 2 PS4, PS5, Xbox One, XSX, NSW, PC, DL 14.50
4 Jan 2017 RESIDENT EVIL 7 biohazard PS4, PS5, Xbox One, XSX, NSW, PC, DL 14.00
5 Sep 2019 Monster Hunter World: Iceborne PS4, Xbox One, PC, DL 14.00
6 May 2021 Resident Evil Village PS4, PS5, Xbox One, XSX, NSW, PC, DL 10.50
7 Mar 2009 Resident Evil 5 PS3, Xbox 360, DL 9.40
8 Oct 2012 Resident Evil 6 PS3, Xbox 360, DL 9.30
9 Apr 2020 Resident Evil 3 PS4, PS5, Xbox One, XSX, NSW, PC, DL 9.20
10 Jun 2022 Monster Hunter Rise: Sunbreak NSW, PS4, PS5, Xbox One, XSX, PC, DL 8.80
11 Mar 2019 Devil May Cry 5 PS4, Xbox One, PC, DL 8.70
12 Mar 2023 Resident Evil 4 PS4, PS5, XSX, PC, DL 8.00
13 Feb 2016 Street Fighter V PS4、PC、DL 7.70
14 Jun 1992 Street Fighter II SNES 6.30
15 Jan 1998 Resident Evil 2 PS 4.96
16 Dec 2010 Monster Hunter Freedom 3 PSP, DL 4.90
17 Mar 2017 Monster Hunter Generations Ultimate 3DS, NSW, DL 4.90
18 Nov 2014 Resident Evil PS3, DL 4.50
19 Jan 2016 Resident Evil 0: HD Remaster PS3, PS4, Xbox One, PC, DL 4.40
20 Nov 2015 Monster Hunter Generations 3DS, DL 4.30
21 Oct 2014 Monster Hunter 4 Ultimate 3DS, DL 4.20
22 Jun 2023 Street Fighter 6 PS4, PS5, XSX, PC, DL 4.10
23 Sep 2013 Monster Hunter 4 3DS, DL 4.10
24 Jul 1993 Street Fighter II Turbo SNES 4.10
25 Apr 2013 Dragon’s Dogma: Dark Arisen PS3, Xbox 360, DL 4.00
26 Mar 2008 Monster Hunter Freedom Unite PSP, DL 3.80
27 Feb 2019 Phoenix Wright: Ace Attorney Trilogy PS4, NSW, DL 3.80
28 Nov 2013 Dead Rising 3 Xbox One, DL 3.80
29 Feb 2009 Street Fighter IV PS3, Xbox 360, DL 3.60
30 Mar 2015 Resident Evil Revelations 2 PS3, PS4, Xbox 360, Xbox One, PC, DL 3.60
31 Mar 2016 Resident Evil 6 PS4, Xbox One, DL 3.50
32 Sep 1999 Resident Evil 3 Nemesis PS 3.50
33 May 2018 Street Fighter 30th Anniversary Collection PS4, Xbox One, NSW, PC, DL 3.40
34 Jun 2016 Resident Evil 5 PS4, Xbox One, DL 3.30
35 Aug 2016 Resident Evil 4 PS4, Xbox One, DL 3.30
36 Mar 2024 Dragon’s Dogma 2 PS5, XSX, DL 3.30
37 Sep 2010 Dead Rising 2 PS3, Xbox 360, PC, DL 3.20
38 Jan 2013 DmC Devil May Cry PS3, Xbox 360, DL 3.10
39 Jan 2008 Devil May Cry 4 PS3, Xbox 360, DL 3.00
40 Feb 2014 Resident Evil 4: Ultimate HD Edition PC, DL 3.00
41 Jun 2015 Devil May Cry 4 Special Edition PS4, Xbox One, DL 2.80
42 Mar 1996 Resident Evil PS 2.75
43 May 2013 Resident Evil Revelations PS3, Xbox 360, Wii U, PC, DL 2.70
44 Mar 2012 Resident Evil: Operation Raccoon City PS3, Xbox 360, DL 2.70
45 Dec 2011 Monster Hunter 3 Ultimate 3DS, DL 2.60
46 Oct 2017 Dragon’s Dogma: Dark Arisen PS4, Xbox One, DL 2.50
47 Dec 2017 Okami HD PS4, Xbox One, NSW, DL 2.50
48 Feb 2021 Capcom Arcade Stadium DL (PS4, Xbox One, NSW, PC) 2.40
49 Feb 2007 Monster Hunter Freedom 2 PSP 2.40
50 Feb 2010 Resident Evil 5: Gold Edition PS3, Xbox 360, DL 2.40
51 Jul 1999 Dino Crisis PS 2.40
52 Sep 2017 Marvel vs. Capcom: Infinite PS4, Xbox One, PC, DL 2.30
53 Dec 2005 Resident Evil 4 PS2 2.30
54 Aug 2014 Ultra Street Fighter IV PS3, Xbox 360, PC, DL 2.20
55 Feb 2011 Marvel vs. Capcom 3: Fate of Two Worlds PS3, Xbox 360 2.20
56 May 2010 Lost Planet 2 PS3, Xbox 360, DL 2.20
57 Aug 2001 Devil May Cry PS2 2.16
58 Mar 2002 Onimusha 2: Samurai’s Destiny PS2 2.10
59 Jan 2001 Onimusha: Warlords PS2 2.02
60 Jul 2021 Monster Hunter Stories 2: Wings of Ruin NSW, PS4, PC, DL 2.00
61 Mar 2017 Ultimate Marvel vs. Capcom 3 PS4, Xbox One, DL 2.00
62 May 2007 Resident Evil 4 Wii edition Wii, DL 2.00
63 Mar 2018 Devil May Cry HD Collection PS4, Xbox One, DL 2.00
64 Jun 1994 Super Street Fighter II SNES 2.00
65 Aug 2009 Monster Hunter Tri Wii 1.90
66 Oct 2018 Mega Man 11 PS4, Xbox One, NSW, DL 1.90
67 Apr 2010 Super Street Fighter IV PS3, Xbox 360, DL 1.90
68 Mar 2012 Street Fighter X Tekken PS3, Xbox 360, DL 1.90
69 Aug 2006 Dead Rising Xbox 360, DL 1.80
70 Jul 2022 Capcom Arcade 2nd Stadium DL (PS4, Xbox One, NSW, PC) 1.80
71 Dec 2006 Lost Planet Extreme Condition Xbox 360, DL 1.70
72 Nov 2013 DuckTales: Remastered PS3, Xbox 360, Wii U, DL 1.70
73 Jan 2003 Devil May Cry 2 PS2 1.70
74 Sep 1993 Street Fighter II’ Special Champion Edition MD 1.65
75 Jun 1986 Ghosts’n Goblins NES 1.64
76 Aug 2015 Mega Man Legacy Collection PS4, Xbox One, DL 1.60
77 Dec 2016 Dead Rising 4 Xbox One, PC, DL 1.60
78 Jan 2005 Resident Evil 4 GC 1.60
79 Feb 2004 Onimusha 3: Demon Siege PS2 1.52
80 Dec 1988 Mega Man 2 NES 1.51
81 Sep 2016 Dead Rising PS4, Xbox One, DL 1.50
82 Jun 2013 Remember Me PS3, Xbox 360, PC, DL 1.50
83 Nov 2017 Resident Evil Revelations Collection NSW, DL 1.50
84 Feb 2014 Strider DL(PS3, PS4, Xbox 360, Xbox One, PC) 1.50
85 Oct 2010 Dead Rising 2 Off The Record PS3, Xbox 360, DL 1.50
86 Dec 1990 Final Fight SNES 1.48
87 Dec 2003 Resident Evil Outbreak PS2 1.45
88 Mar 2001 Resident Evil Code: Veronica X PS2, DC 1.40
89 Jul 2009 Marvel vs. Capcom 2: New Age Of Heroes DL (PS3, Xbox 360) 1.40
90 Sep 2014 Dead Rising 3 Apocalypse Edition PC, DL 1.40
91 Mar 2015 DmC Devil May Cry Definitive Edition PS4, Xbox One, DL 1.40
92 Mar 2002 Resident Evil GC 1.35
93 Dec 2003 Mega Man Battle Network 4 GBA 1.35
94 Jul 2018 Mega Man X Legacy Collection PS4, Xbox One, NSW, DL 1.30
95 Jun 2009 Bionic Commando PS3, Xbox 360, PC, DL 1.30
96 May 2012 Dragon’s Dogma PS3, Xbox 360 1.30
97 Feb 2011 Super Street Fighter IV 3D Edition 3DS, DL 1.30
98 Dec 2005 Monster Hunter Freedom PSP, DL 1.30
99 Mar 2012 Resident Evil 4 DL(PS3, Xbox 360) 1.30
100 Nov 2007 Resident Evil: The Umbrella Chronicles Wii 1.30
101 Feb 2005 Devil May Cry 3 PS2 1.30
102 Nov 2002 Resident Evil 0 GC 1.25
103 Jun 2011 Super Street Fighter IV Arcade Edition PS3, Xbox 360, DL 1.20
104 Sep 2000 Dino Crisis 2 PS 1.20
105 Nov 2011 Ultimate Marvel vs. Capcom 3 PS3, Xbox 360, DL 1.20
106 Mar 2012 Devil May Cry HD Collection PS3, Xbox 360, DL 1.20
107 Apr 2019 Dragon’s Dogma DARK ARISEN NSW, DL 1.20
108 Sep 2016 Dead Rising 2 Off The Record PS4, Xbox One, DL 1.20
109 Aug 1998 Resident Evil Director’s Cut Dual Shock PS 1.20
110 Dec 1993 Mega Man X SNES 1.16
111 Feb 2000 Resident Evil Code: Veronica DC 1.14
112 Sep 1986 Commando NES 1.14
113 Sep 1997 Resident Evil Director’s Cut PS 1.13
114 Aug 2017 Resident Evil Revelations PS4, Xbox One, DL 1.10
115 Jul 2021 The Great Ace Attorney Chronicles PS4, NSW, DL 1.10
116 Oct 1991 Super Ghouls’n Ghosts SNES 1.09
117 Sep 1990 Mega Man 3 NES 1.08
118 May 1993 Final Fight 2 SNES 1.03
119 Oct 2019 Resident Evil 6 DL (NSW) 1.00
120 Dec 1998 Street Fighter Alpha 3 PS 1.00
121 Jul 2018 Megaman X Anniversary Collection 2 PS4, Xbox One, NSW, DL 1.00
122 Feb 2006 Devil May Cry 3 Special Edition PS2 1.00

A life-long and avid gamer, William D'Angelo was first introduced to VGChartz in 2007. After years of supporting the site, he was brought on in 2010 as a junior analyst, working his way up to lead analyst in 2012 and taking over the hardware estimates in 2017. He has expanded his involvement in the gaming community by producing content on his own YouTube channel and Twitch channel. You can contact the author on Twitter @TrunksWD.

Full Article - https://www.vgchartz.com/article/463020/capcom-updates-its-best-sellers-list-monster-hunter-world-at-209m-re4-remake-at-8m-more/




com

Nintendo and The Pokemon Company Seeking Injunction and Damages from Pocketpair

Nintendo and The Pokémon Company in September filed a patent infringement lawsuit against Palworld developer Pocketpair. 

At the time Nintendo did not share which patents Palworld infringed on, however, Pocketpair has now revealed what patents Nintendo are claiming were infringed on.

"As announced on September 19, 2024, The Pokémon Company and Nintendo Co Ltd (hereinafter referred to as the Plaintiffs) have filed a patent infringement lawsuit against us," said Pocketpair. "We have received inquiries from various media outlets regarding the status of the lawsuit, and we would like to report the details and current status of this case as follows.

"The Plaintiffs claim that Palworld, released by us on January 19, 2024, infringes upon the following three patents held by the Plaintiffs, and are seeking an injunction against the game and compensation for a portion of the damages incurred between the date of registration of the patents and the date of filing of this lawsuit."

Nintendo and The Pokémon Company are each seeking an injunction and damages of five million yen plus late payment damages.

Pocketpair added, "We will continue to assert our position in this case through future legal proceedings. Please note that we will refrain from responding individually to inquiries regarding this case. If any matters arise that require public notice, we will announce them on our website, etc."

A life-long and avid gamer, William D'Angelo was first introduced to VGChartz in 2007. After years of supporting the site, he was brought on in 2010 as a junior analyst, working his way up to lead analyst in 2012 and taking over the hardware estimates in 2017. He has expanded his involvement in the gaming community by producing content on his own YouTube channel and Twitch channel. You can contact the author on Twitter @TrunksWD.

Full Article - https://www.vgchartz.com/article/463022/nintendo-and-the-pokemon-company-seeking-injunction-and-damages-from-pocketpair/




com

PS5 vs Xbox Series X|S vs Switch 2024 Japan Sales Comparison Charts Through October

Here we see data representing the sales through to consumers and change in sales performance of the three current platforms (PlayStation 5, Xbox Series X|S, and Nintendo Switch) and two legacy platforms (PlayStation 4 and Xbox One) over comparable periods for 2021, 2022, 2023, and 2024. Also shown is the market share for each of the consoles over the same periods.

Year to Date Sales Comparison (Same Periods Covered)

Market Share (Same Periods Covered)

2021 – (January 2021 to October 2021)

2022 – (January 2022 to October 2022)

2023 – (January 2023 to October 2023)

2024 – (January 2024 to October 2024)

"Year to date" sales for 2021, 2022, 2023, and 2024 sales are shown in series at the top of the table and then just below a comparison of 2024 versus 2023 and 2024 versus 2022 is displayed.  This provides an easy-to-view summary of all the data.

Total Sales and Market Share for Each Year

Microsoft

  • Xbox Series X|S
    • 0.09 million units sold year-to-date
    • Down year-on-year 0.03 million units (-23.2%)

Nintendo

  • Nintendo Switch
    • 2.47 million units sold year-to-date
    • Down year-on-year 0.75 million units (-23.4%)

Sony

  • PlayStation 5
    • 1.16 million units sold year-to-date
    • Down year-on-year 0.94 million units (-44.9%)
  • PlayStation 4
    • 0.01 million units sold year-to-date
    • Down year-on-year 0.05 million (-77.2%)

Note: VGChartz 2024 estimates through October includes 44 weeks, while 2023, 2022, and 2021 estimates includes 43 weeks.

A life-long and avid gamer, William D'Angelo was first introduced to VGChartz in 2007. After years of supporting the site, he was brought on in 2010 as a junior analyst, working his way up to lead analyst in 2012 and taking over the hardware estimates in 2017. He has expanded his involvement in the gaming community by producing content on his own YouTube channel and Twitch channel. You can contact the author on Twitter @TrunksWD.

Full Article - https://www.vgchartz.com/article/463009/ps5-vs-xbox-series-xs-vs-switch-2024-japan-sales-comparison-charts-through-october/




com

PS5 vs PS4 Sales Comparison in Japan - October 2024

The VGChartz sales comparison series of articles are updated monthly and each one focuses on a different sales comparison using our estimated video game hardware figures. The charts include comparisons between the PlayStation 5, Xbox Series X|S, and Nintendo Switch, as well as with older platforms. There are articles based on our worldwide estimates, as well as the US, Europe, and Japan.

This monthly series compares the aligned Japanese sales of the PlayStation 5 and PlayStation 4.

The PlayStation 5 launched in November 2020 in Japan, while the PlayStation 4 launched in February 2014. This does mean the holiday periods for the two consoles do not lineup.

PS5 Vs. PS4 Japan:

Gap change in latest month: 277,262 - PS4

Gap change over last 12 months: 300,542 - PS4

Total Lead: 234,400 - PS4

PlayStation 5 Total Sales: 6,121,649

PlayStation 4 Total Sales: 6,356,049

October 2024 is the 48th month the PlayStation 5 has been available for. In the latest month, the gap grew in favor of the PlayStation 4 when compared to the aligned launch of the PlayStation 5 by 0.28 million units.

In the last 12 months, the PS4 has outsold the PS5 by 0.30 million units. The PS5 is currently behind the PS4 by 0.23 million units.

The 48th month for the PS5 in Japan is October 2024, while for the PS4 it is January 2018. The PS5 has sold 6.36 million units, while the PS4 sold 6.12 million units during the same timeframe.

The PS4 crossed 7 million in month 53, 8 million in month 61, and 9 million in month 72. The PS4 has sold 9.68 million units to date. The PS5 is currently 3.56 million units behind the lifetime sales of the PS4 in Japan.

A life-long and avid gamer, William D'Angelo was first introduced to VGChartz in 2007. After years of supporting the site, he was brought on in 2010 as a junior analyst, working his way up to lead analyst in 2012 and taking over the hardware estimates in 2017. He has expanded his involvement in the gaming community by producing content on his own YouTube channel and Twitch channel. You can contact the author on Twitter @TrunksWD.

Full Article - https://www.vgchartz.com/article/463011/ps5-vs-ps4-sales-comparison-in-japan-october-2024/




com

Elder Scrolls: Legends has been removed from sale and will become unplayable in January 2025

The Elder Scrolls: Legends, the free-to-play card game set in Bethesda's fantasy world, has been removed from sale on Steam. Its servers will shut down for good on January 30th, 2025, after which it will no longer be playable. The closure comes five years after the game was last updated.

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com

Thysiastery is an anime Legend Of Grimrock, and you can attack the dinosaur merchants if you’re a complete monster

One of my lesser quality tests for an RPG is whether the shopkeepers complain at you for not buying anything. Grumpy shopkeepers, good RPG. This most specific of litmus tests has served me well, although I must admit that I’d happily upgrade it to ‘shopkeepers you can attack’, would that not disqualify 99% of games. But not turn based dungeon crawler Thysiastery, it turns out. This “dungeon crawler RPG featuring traditional roguelike and turn-based gameplay” apparently trusts you enough to let you recklessly batter its friendly wandering lizard merchants. You’d be a monster for it, of course, but it’s nice to have options.

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com

No, you're not imagining Monster Hunter Wilds' beta combat feeling off - there's a good reason for it

I didn’t get much further in the extremely popular beta for the haute-couture-asaurus action of Monster Hunter Wilds than perfecting the exact orange-to-white ratio of my cat. Not because I wasn’t having fun, but because I immediately started looking up GPU prices after playing for ten minutes. As such, I didn’t spend enough time with the combat to get a proper feel for it. Cultural osmosis has once again allowed me to form an uneducated take, however, and I’m getting the sense there’s been some mixed reactions re: bonk quality. According to a clip shared on X by user Blue Stigma, there's a good reason for those misgivings. It's all about frames, you see.

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com

The Forever Winter devs answer complaints about water scarcity... by adding thieves who invade your HQ and steal your water

When nightmarish sci-fi extraction shooter The Forever Winter launched into early access in September it was somewhat messy. Bugs and maddening enemy spawns diminished the tension of being a fleshy human scavenger in a mech battlefield. But one feature annoyed some players much more - fresh water. See, you need to keep your headquarters stocked with water, as it gets steadily used by your settlement's inhabitants. The catch being that this water diminishes even while you're not playing the game. If it runs out completely, then everything you've collected gets wiped. The developers have listened to complaints about this most Farmville of mechanics, and they've answered in an interesting way. Water thieves! Now, on top of the usual downward trickle, burglars will come to steal your H2O as well.

It's not as bad as it sounds.

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  • Shooter: Third Person
  • The Forever Winter
  • PC
  • Shooter: Loot Shooter
  • Science Fiction
  • Survival & Crafting
  • Fun Dog Studios

com

Call Of Duty: Black Ops 6 campaign review: a military shooter that comes disguised as other, better games

As a yearly blockbuster, Call of Duty, through sheer expense and effort, would like you to think it is the Die Hard of video games. Or, depending on the setting, the Saving Private Ryan of video games. But it is barely Black Hawk Down. This latest campaign in Call Of Duty: Black Ops 6 reminds me more of the forgettable Netflix shootfests that thumbnail their way across your TV screen as you try to find some gritty nothing to aid you in zoning out of life. Still, there is an anecdotal contingent of casual sofa sitters for whom Call Of Duty is the game. A balls-to-the-wall shooter to return to every winter and rinse through in a weekend. Ed has already gestured at its multiplayer, announcing: "yup, it's COD", like a deeply tired Captain Birdseye inspecting the day's catch, wondering when his life will change. But never mind that. How does the single player story mode hold up? Some are calling it the best campaign in years. And I guess that's true, in the sense that it is the least worst.

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com

Oh thank Horace, our comments system is up and running again

"Never read the comments," is a truth much-rehearsed by senior games journalists, but I have long since levelled-up past this axiom and entered into a new world of benevolent narcissism. I always read the comments, for all commenters are my children. They exist to glorify and preserve me in my dotage. True, occasionally my children say things like "I think your writing and opinions are appalling, and that you deserve to be repeatedly run over by a herd of deer", but it is the nature of children to rebel.

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com

Foxhole is getting planes next summer and an infantry combat overhaul later this month

Foxhole is one of my favourite games to read about, even if I don't play it. It's a massively multiplayer World War 2 game, viewed from above, where battlefield logistics matters as much as aiming and flanking. Its developers have just announced a major new update coming next summer, Foxhole: Airborne, which adds planes to the game for the first time.

Planes, in a topdown MMO? It makes a little more sense if you watch the trailer.

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com

Some guy complained this fishing game only caters to queer players, so the dev added a "straight" title - it costs $9999

When multiplayer fishing game Webfishing came out last month, it offered a relaxing hangout zone for cats and dogs. Everything revolves around catching, selling, and collecting the fish that gather in the rivers of a small island. It also lets you customise your character with clothing. Mostly simple hats and shorts, but some options let players celebrate their sexuality, such as a rainbow-adorned t-shirts, or titles that hang above your character which simply say "Trans" or "Bi". All this led one player to complain there was no "Straight" title. So, the developer added one. It costs 10 grand.

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com

VED: Purification is a free prologue to the full hand-drawn RPG, complete with Stetson hats and Evil Dead trees

Got an email about this. Looks cool. Is free. “I’ll write about that,” I thought. “I’ll write about that for Rock Paper Shotgun, a place that semi-regularly posts articles about cool and free games.” So here we are. If you’re waiting for the other shoe to drop, assuming the only reason I’d open an article in a superfluous and straightforward manner is because I’m about to deliver some sort of third sentence twist, you’re completely wrong! There’s no twist at all. I’m simply going to deliver some information about the game in a neutral tone. You can find VED: Purification, a free prologue demo to RPG VED, here.

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com

Here are the patents Nintendo and the Pokémon Company are suing Palworld about, according to Pocketpair

Palworld developers Pocketpair have finally revealed which patents Nintendo and the Pokémon Company are suing them about. It looks like they're focusing on the act of throwing capsular items to catch or release monsters, together with the usage of monsters as mounts.

If you've somehow yet to encounter Palworld, it's a bestselling survival game that takes hefty - some would say, scandalous - inspiration from Pokémon, with players poaching Pokésque critters using magic spheres, and deploying them as soldiers and minions.

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com

The Warframe devs want you to come try their luxurious fantasy action-RPG Soulframe

Warframe developers Digital Extremes have announced a new round of early access for their 2025-bound fantasy action-RPG Soulframe, which I saw a bit of last year and think is pretty promising. They're now adding 2000 players to a Preludes build of the game every week, with each invite email including an additional four invite codes, so you can get your friends involved.

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com

The next limited-edition Steam Deck OLED comes in white, and will be available globally this time

The Steam Deck OLED – which is like a Steam Deck but better in almost every way – is getting a new, if potentially more smudge-susceptible Limited Edition. A successor to the translucent version that only went on sale in the US and Canada last year, the Steam Deck OLED: Limited Edition White offers both a snowy look and, for those of us outside North America, the chance to actually buy one. It’ll go on sale November 18th, in all the countries that the Steam Deck currently ships in.

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com

Ubisoft is being sued over The Crew in a lawsuit that compares the server shutdown to a bumperless pinball machine

"Imagine you buy a pinball machine, and years later, you enter your den to go play it, only to discover that all the paddles are missing, the pinball and bumpers are gone, and the monitor that proudly displayed your unassailable high score is removed". As reported by Polygon, that's an argument put forth by a new lawsuit against Ubisoft, filed by two Californian players of The Crew. They're suing the company in a proposed class action lawsuit over shutting down the racing game's servers, rendering it unplayable.

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