Conectar
by Yuta Nemoto, Fumie Otsuka, Shihoko Suzuki, Saori Kataoka, Tomoko Nakanishi, Takuya Ueda, Susumu Ogawa, Sumika Karasawa, Mikiko Shimaoka, Hiroto Narimatsu, Ung-il Chung
BackgroundEsports (competitive and organised video gaming) may enhance physical and cognitive health in older adults. The aim of this study was to examine the feasibility and effects of a multicomponent program incorporating esports on physical and cognitive function in community-dwelling older adults.
MethodsThis parallel, non-randomised controlled trial was conducted in Yokosuka, Kanagawa, Japan. Twenty-six participants who 1) were aged 60 years or older, 2) had no cognitive impairment, 3) had no major health problems, and 4) had no prior experience with digital games were allocated to either the intervention (n = 12) or the control (n = 14) group. Participants in the intervention group attended weekly 90-minute sessions consisting of health education, exercise, and esports for 12 weeks. The feasibility of the program was assessed based on adverse events, participant retention, adherence to the program, engagement in digital games outside the program, enjoyment of the program, and willingness to continue playing esports after the study period. Additionally, psychological status, physical and cognitive function, and body composition were assessed.
ResultsNo adverse events were reported; 10 of the 12 participants attended ≥80% of the sessions, all participants reported enjoying the program, and no participants dropped out during follow-up. Positive psychological status scores increased from before to after each session among participants in the intervention group. Furthermore, adjusted analyses showed more favourable changes in gait speed and balance in the intervention group than in the control group (p < 0.05). However, the effects on physical function remain uncertain because the analyses were exploratory.
ConclusionsThe program showed potential for high retention and adherence among older adults, with no adverse events. Larger-scale trials are needed to confirm the effectiveness of this intervention program, as the analyses in this study were exploratory.
Trial registrationThe study protocol was registered with the UMIN-CTR (ID: UMIN000055350; date of first registration: 27 August 2024).
by Akihito Nakanishi, Noriko Nagase, Hirokazu Kousaki, Bakushi Ogawa, Kazuhiro Horii, Iori Niitsu Morimoto, Yuka Morita, Fumiaki Nin
Cisplatin is widely used in cancer treatment but can cause hearing loss, predominantly at high frequencies. Auditory responses to bone-conducted ultrasonic stimulation have been proposed as a potential indicator of cochlear function, but it remains unclear how such responses are affected by cochlear damage. In this study, we measured auditory brainstem response (ABR) thresholds within and beyond the conventional hearing range in a mouse model of cisplatin-induced hearing loss. Of 32 mice initially examined, 9 were excluded at baseline because of pre-existing high-frequency hearing impairment. The remaining animals received either saline or cisplatin, and post-treatment analysis in the cisplatin group was based on 16 surviving mice. Cisplatin administration increased ABR thresholds within the conventional hearing range. In contrast, threshold shifts evoked by bone-conducted ultrasonic stimulation were often smaller. Paired comparison of mean threshold shifts showed that changes evoked by bone-conducted ultrasonic stimulation were significantly smaller than those within the conventional hearing range. These findings show that ABR threshold shifts evoked by bone-conducted ultrasonic stimulation do not necessarily parallel those within the conventional hearing range in cisplatin-treated mice.To quantify Scope 1 and Scope 2 greenhouse gas (GHG) emissions associated with surgical care and identify key modifiable drivers at the institutional level, including operative duration and operating room (OR) type.
Retrospective cohort study.
A tertiary university hospital with 17 ORs in Japan.
All 6996 elective surgeries were performed under general anaesthesia between 1 January and 31 December 2022.
The primary outcome was per-case total Scope 1 and Scope 2 carbon dioxide equivalent emissions (CO2e) emissions. Secondary analyses evaluated emission differences across specialties, surgical approaches (open, endoscopic, and robotic), and temporal electricity consumption patterns. Multivariable linear regression was performed to assess the associations between per-case scope 2 emissions, operative time, and OR type.
Total emissions were 1943.4 t CO2e, of which Scope 1 accounted for 71.0%, predominantly driven by desflurane (69.2% of total emissions). Although scope 2 accounted for 29.0% of total institutional emissions, scope 1 emissions dominated the carbon footprint of most individual procedures because of volatile anaesthetic use. Weekday daytime electricity consumption accounted for only 47.7% of total weekly use, with more than half occurring during nighttime and weekend periods, largely due to continuous heating, ventilation and air conditioning (HVAC) operation. Regression analysis demonstrated that operative time had a limited independent effect on per-case scope 2 emissions, whereas OR type—including hybrid and bio-clean rooms—was strongly associated with higher emissions.
Anaesthetic choice and infrastructure-related energy demand are the principal determinants of surgical GHG emissions. Within direct and energy-related emissions, reducing volatile anaesthetic use and optimising OR energy consumption—particularly during non-operative periods—represent the most effective strategies for emission reduction.
The establishment of an effective strategy for recurrence prevention following curative treatment for hepatocellular carcinoma (HCC), including radiotherapy, remains a critical unmet clinical need. Despite favourable local control and safety profiles, recurrence after particle therapy remains a major challenge, highlighting the need for effective adjuvant strategies to improve long-term outcomes. The present phase Ib/II trial is designed to evaluate the safety and efficacy of atezolizumab plus bevacizumab (Atezo+Bev) administered after carbon-ion radiotherapy (C-ion RT) in patients with unresectable non-metastatic large HCC. This study aims to explore the potential of this multimodal approach as a novel adjuvant strategy to improve outcomes in patients at high risk of recurrence.
This is a phase Ib/II, single-arm clinical trial designed to evaluate the safety and efficacy of adjuvant Atezo+Bev following C-ion RT in patients with HCC. Eligible patients will be enrolled in the first registration phase. C-ion RT (60 Gy) will be administered over four consecutive treatment days ideally within one calendar week. Patients will receive a combination of atezolizumab (1200 mg) and bevacizumab (15 mg/kg) administered intravenously every 21 days for one treatment cycle. The primary endpoint of the phase Ib part is the proportion of patients with dose-limiting toxicity (DLT). DLT is defined as prespecified toxicities associated with the investigational drug among the adverse events that occurred from the start date of the investigational drug (Day 1) to Day 21. If there is one or fewer cases of DLT out of six cases, the trial will proceed to the phase II part. The primary endpoint of the phase II part is the 1-year recurrence-free survival rate.
This study was approved by the ethics committee of two participating institutions (Chiba University Hospital (approval No. 2024021) and National Institute for Quantum and Radiological Science and Technology, QST Hospital (approval No. C24-001)). Trial results will be reported in a peer-reviewed journal publication.
jRCT2031240284.
by Akihiro Ito, Akane Morito, Masahiro Ishizaka, Yukihiro Ogawa, Yuki Kawai, Yuta Hanawa, Naotaka Onodera, Yoshiaki Endo, Isato Fukushi, Kotaro Takeda, Taichi Mochizuki, Yasushi Inoue, Yasuo To, Seiichiro Sakao, Kazuyuki Chibana, Hideaki Yamasawa, Satoshi Fuke, Sarah Kesler, David Gozal, Yasumasa Okada, Akira Umeda
BackgroundPulmonary rehabilitation (PR) for patients with chronic obstructive pulmonary disease (COPD) improves exercise tolerance and COPD assessment test score (CAT). Oxygen supplementation during PR facilitates exercise physiological benefits. This study aimed to assess the feasibility of a trial comparing two oxygen supplementation methods, with the hypothesis that both would be effective and produce distinct outcomes.
MethodsThis double-blind, crossover, randomized controlled trial compared two PR programs—Program A (including PR under FiO₂ 0.3) and Program B (including PR under FiO₂ 0.5)—using high-flow nasal cannula oxygen therapy in patients with COPD and exertional dyspnea (n = 6). Data on the 6-minute walk distance (6MWD), CAT, muscle strength, body composition analysis, respiratory function, and joint range of motion were collected. Participants underwent one month of regular PR followed by two months of oxygen-supplemented PR, with data collected again after this period. Statistical significance was set at 0.05 with a power of 0.8, and the required sample size was calculated accordingly.
ResultsThe required sample size could not be calculated based on the 6MWD. The improvement in CAT by Program A was greater than that by Program B. The improvements in muscle parameters by Program B were greater than those by Program A. The standardized effect size and the corresponding required sample sizes for the CAT, quadriceps muscle power, lower leg circumference, trunk muscle mass, and leg muscle mass were 0.32/81, 0.66/8, 0.17/114, 0.27/88, and 0.24/56, respectively.
ConclusionsGiven the small number of participants, the 6MWD and CAT were not appropriate primary endpoints for comparing the effectiveness of the two oxygen supplementations during PR in patients with COPD. However, the quadriceps muscle power was identified as the most suitable primary endpoint among all the investigated parameters.
Keloids are chronic fibroproliferative skin disorders with high recurrence rates and limited treatment options, yet reliable diagnostic biomarkers are lacking. Current classification systems rely heavily on clinical observation, underscoring the need for objective, noninvasive tools. In this exploratory study, serum-based 1H nuclear magnetic resonance (NMR) measurement combined with short-time Fourier transform (STFT) for time-frequency analysis was performed, followed by principal component analysis (PCA), to investigate potential patient subgroups. Serum samples from 29 patients were analysed and PC1 scores suggested two potential patient subgroups. Retrospective analysis showed that these subgroups differed primarily in keloid aetiology: one group predominantly included cases arising from unclear or minimal causes (e.g., acne, folliculitis), whereas the other comprised cases following clear traumatic events (e.g., surgery). Although most clinical variables showed no significant differences, significant differences in aetiology and Japan Scar Workshop Scar Scale (JSS) scores support the biological relevance of this separation of subgroups. These findings suggest that the time-frequency features of NMR signals from serum samples capture systemic characteristics associated with keloid pathophysiology. If validated in larger cohorts, this approach may serve as a noninvasive adjunct to clinical assessment and lay the foundation for objective patient stratification and precision-guided treatment strategies.
by Naoya Nakagawa, Ami Igarashi, Hideaki Yokogawa, Akira Kobayashi, Tomomi Higashide, Satoru Yamagami, Takahiko Hayashi
The aim of this study was to identify the clinical factors associated with postoperative visual acuity following Descemet’s membrane endothelial keratoplasty (DMEK), with emphasis on the impact of macular diseases. This retrospective multicenter study included consecutive eyes that underwent DMEK between March 1, 2011, and June 30, 2022, and had available optical coherence tomography findings. Eyes with other ocular diseases causing visual loss were excluded. Overall, 77 eyes of 66 patients were included in the study. Univariable and multivariable regression analyses were performed to identify the predictors of best-corrected visual acuity (BCVA) at the final follow-up. Worse preoperative visual acuity and macular comorbidity were identified as independent predictors of poorer postoperative BCVA. Among macular pathologies, cystoid macular edema was most strongly correlated with reduced vision in the univariable analysis (β = 0.195; p = 0.016). In the subgroup analysis, worse preoperative visual acuity and macular comorbidity remained significant predictors (p
FreshRSS 