Journals
2025 EN
Suzuki Keita · Tsujiguchi Hiromasa · Hara Akinori
+10 more
ABSTRACT Aims/Introduction Leukocyte cell‐derived chemotaxin 2 (LECT2) is an obesity‐associated hepatokine that causes skeletal muscle insulin resistance. Since LECT2 is up‐regulated by the inactivation of the energy sensor AMPK in the liver, we hypothesized that LECT2 has potential as a biomarker for metabolic dysfunction‐associated steatotic liver disease (MASLD). Therefore, we investigated whether circulating LECT2 levels are associated with insulin sensitivity, liver enzymes, and MASLD. Materials and Methods This cross‐sectional study included 138 Japanese individuals. Plasma LECT2 levels were measured using fasting blood samples. B‐mode ultrasonography was used to assess hepatic steatosis. Results The mean age and body mass index (BMI) of participants were 63.5 ± 10.2 years and 23.0 ± 3.1 kg/m 2 , respectively. Higher LECT2 levels positively correlated with homeostatic model assessment for insulin resistance (HOMA‐IR) values and negatively correlated with the quantitative insulin sensitivity check index (QUICKI) among all participants (HOMA‐IR; non‐standardized β ( B ) = 6.38, P < 0.01: QUICKI; B = −161, P < 0.01). These correlations were stronger in the low BMI group (HOMA‐IR; B = 13.85, P < 0.01: QUICKI; B = −180, P < 0.01). LECT2 levels also positively correlated with gamma‐glutamyl transferase levels ( B = 0.01, P = 0.01) and alanine aminotransferase levels ( B = 0.33, P = 0.02). Higher LECT2 levels correlated with the prevalence of MASLD (odds ratio = 1.14, P = 0.02). Conclusions The present results suggest the potential of plasma LECT2 levels as a biomarker for insulin resistance in individuals who are not overweight and the prevalence of MASLD in the general population.
Asian Association for the Study of Diabetes
Journals
2025 EN
Hayashi Keiichiro · Hara Akemi · Endo Michioki
+3 more
ABSTRACT Rationale Pharmaceutical payments to healthcare providers can pose conflicts of interest. Long‐term trends in such payments in Japan remain under explored. Aims and Objectives This study examined pharmaceutical company payments to healthcare providers in Japan from 2016 to 2021, including the impact of the COVID‐19 pandemic. Methods We conducted a repeated cross‐sectional analysis using publicly disclosed data on payments (lectures, consulting, and writing) from pharmaceutical companies. Payments were analyzed by year, amount, and specialty. Results Total payments remained stable from 2017 to 2019 ($249 million), dropped in 2020 ($172 million), and rose in 2021 ($272 million). The number of recipients declined overall, but mean and median payments per healthcare provider steadily increased. The share receiving over $100,000 rose from 0.09% to 0.17%. Cardiovascular and diabetes/metabolism/endocrinology specialists consistently received the highest payments. Conclusion Payments became more concentrated among high‐earning physicians following the COVID‐19 pandemic. Continued monitoring is needed to manage potential conflicts of interest.
Journals
2025 EN
Kato Yuka · Kawahara Tae · Endo Yoshimi
+1 more
Abstract Background Children with neurodevelopmental disorders admitted to child and adolescent psychiatric units often exhibit aggressive behaviors, posing challenges for nurses. It is unclear what experiences and challenges nurses have in these cases within the unique environment of hospitalization. Purpose This study aimed to elucidate the difficulties faced by nurses in providing care for children due to their aggressive behavior in these units. Methodology Qualitative descriptive research was conducted through semi‐structured interviews with nurses with over 3 years of clinical experience in child and adolescent psychiatric units. The interviews were recorded and transcribed verbatim, and text units related to nursing difficulties were extracted and categorized. Results We interviewed 21 nurses, averaging 44 years old, with 6.8 years of experience in child and adolescent psychiatric units. Five categories of difficulties were identified: (1) building patient–nurse relationships, (2) encouraging behavior modification, (3) managing aggressive behavior, (4) facilitating reflection on aggressive behavior, and (5) establishing and maintaining appropriate behavior. Conclusions Nurses face numerous challenges in providing care for children with aggressive behavior. Despite experiencing physical and mental burdens in managing aggressive behavior, nurses strive to help children achieve social adjustment. Establishing systems to address nurses' difficulties can enhance the quality of nursing care.
John Wiley & Sons Australia
Journals
2025 EN
Nishioka Michele Akemi · Brassolatti Patricia · Alves Ana Carolina Araruna
+6 more
ABSTRACT Background Reverse the fat accumulation and to improve body contouring with more safely than invasive procedures has become a necessary therapeutic approach, but little detailed when using LED photobiomodulation. Aims To evaluate an application protocol with two different wavelengths (red and infrared LED) consecutively in the abdomen region alone or associated with the dermocosmetics application with lipolytic properties. Methods Ninety patients with a significant amount of adipose tissue in the abdomen region were selected and randomized into three groups: Sham (SG), in which patients received a simulation of the treatment; LED (LG), in which participants received the application with LED; LED with dermocosmetic (LDG), in which the participants underwent a combination of LED and dermocosmetic treatment. The following assessments were carried out: anthropometric data (weight, height, perimetry, and adipometry); ultrasound examination to adipose layer; patient satisfaction questionnaire; histology of a donated a tissue sample. Results The main findings were a decrease in umbilical perimetry, a significant decrease in the body fat layer determined by ultrasound and significant histological changes that indicated an improvement in the appearance of the skin and an increase in the amount of macrophages in the subcutaneous layer. Histological data also showed an improvement in the appearance of the skin with an increase in collagen deposition and an increase in macrophages in the subcutaneous layer. Conclusions The LED phototherapy application protocol, both alone and in association with the dermocosmetic, with the emission of two consecutive wavelengths, was effective in reducing the fat tissue in the abdomen region.
Journals
2025 EN
Veronese Sheila · Ossanna Riccardo · Tehrani Sara Ghazanfar
+6 more
ABSTRACT Background Acoustic Wave Therapy (AWT) is a particular shock wave treatment that combines focused and radial shock waves, resulting in particular efficiency in the body's superficial layers. Its application before fat grafting has the potential to enhance it, favoring a better result of the graft. Aims The aim of this study was to analyze the effects of AWT on fat tissue. Methods Histological analysis of fat harvested from the abdomen of 40 subjects was evaluated. Twenty subjects had been pre‐treated with AWT, while 20 had not. Extraction and characterization of adipose‐derived stem cells (ADSCs) were performed for all. The multilineage differentiation capacity of extracted ADSCs and exosome extracellular vesicles' production from the fat samples were analyzed in both groups of specimens. Results All 40 specimens presented both preservation of the structure of the tissue and of the cells, particularly of adipocytes. The cell growth resulted higher for pre‐treated samples. All ADSCs from all the samples were able to differentiate along adipogenic, chondrogenic, and osteogenic lineages. In particular, for pre‐treated samples, in the adipogenic lineage, a more advanced maturation phase was observed, and in the chondrogenic lineage, a chondroid matrix was evident around chondrocyte aggregates. All the samples reacted with exosome extracellular vesicles' production to stress. Conclusions The results highlighted that AWT aligns with the in‐force minimal manipulation regulations, as the tissue and cells' structure and functionality were preserved. The types of differentiation observed permitted us to speculate about possible new applications in aesthetic and regenerative medicine.
Journals
2025 EN
Hatanaka Takeshi · Yata Yutaka · Hiraoka Atsushi
+45 more
ABSTRACT Aim This study aimed to evaluate the therapeutic efficacy and prognostic significance of C‐reactive protein (CRP) in patients with advanced hepatocellular carcinoma (HCC) receiving durvalumab and tremelimumab (Dur/Tre). Methods A total of 167 patients treated with Dur/Tre between March 2023 and March 2024 in Japanese hospitals were included in this retrospective multicentre study. Patients were divided into two groups based on pre‐treatment serum CRP levels: the low‐CRP group (< 1 mg/dL, n = 106) and the high‐CRP group (≥ 1 mg/dL, n = 61). Results The median age of the cohort was 74.0 years (interquartile range, 67.5–79.5), and 139 patients (83.2%) were male. The median progression‐free survival (PFS) was 3.6 months (95% CI: 2.6–5.4) in the low‐CRP group and 2.4 months (95% CI: 1.9–4.1) in the high‐CRP group, with statistical significance ( p = 0.02). The median overall survival (OS) was not reached in the low‐CRP group, with a 1‐year survival rate of 64.7% (95% CI: 49.0–76.7), while it was 7.9 months (95% CI: 5.8–11.8) in the high‐CRP group. The low‐CRP group demonstrated significantly better survival outcomes compared to the high‐CRP group ( p < 0.001). Multivariate analysis identified serum CRP level as an independent predictive factor for both PFS and OS ( p = 0.04 and < 0.001, respectively). No significant differences in immune‐related adverse events were observed between the two groups. Conclusions Serum CRP may serve as a prognostic biomarker in HCC patients receiving Dur/Tre, with a potential association with treatment efficacy.
Journals
2025 EN
Matono Tomomitsu · Tada Toshifumi · Kumada Takashi
+48 more
ABSTRACT Background and Aims To assess the outcomes of patients with hepatocellular carcinoma (HCC) who were treated with atezolizumab plus bevacizumab (Atezo/Bev), categorised by oncological resectability criteria, which reflect tumour burden and extent of disease. Methods A cohort of 467 HCC patients who received Atezo/Bev was enrolled. Patients were classified into two groups based on oncological resectability criteria: BR (borderline resectable) 1 ( n = 153) and BR2 ( n = 314). Results The median progression‐free survival (PFS) was 9.0 months in the BR1 group and 6.8 months in the BR2 group ( p = 0.014). Multivariable analysis identified the following independent prognostic factors for PFS: age ≥ 75 years (hazard ratio [HR], 1.309), albumin–bilirubin (ALBI) grade ≥ 2 (HR, 1.494), neutrophil‐to‐lymphocyte ratio (NLR) ≥ 3 (HR, 1.289), α‐fetoprotein ≥ 100 ng/mL (HR, 1.523) and BR2 classification (HR, 1.360). The median overall survival (OS) was 25.3 months in the BR1 group and 22.3 months in the BR2 group ( p = 0.048). Multivariable analysis identified the following independent prognostic factors for OS: age ≥ 75 years (HR, 1.522), ALBI grade ≥ 2 (HR, 2.411), NLR ≥ 3 (HR, 1.635), α‐fetoprotein ≥ 100 ng/mL (HR, 1.530) and BR2 classification (HR, 1.421). When oncological resectability factors (tumour number and size, vascular invasion and extrahepatic spread) were incorporated into the multivariable analysis, major vascular invasion emerged as a significant predictor of both PFS (HR, 3.188) and OS (HR, 2.650). Conclusions In patients with HCC characterised by limited resectability undergoing Atezo/Bev, vascular invasion, in addition to liver function, is a critical prognostic determinant of tumour progression.
Journals
2025 EN
Tanaka Kazunari · Tsuji Kunihiko · Hiraoka Atsushi
+41 more
ABSTRACT Aim/Background This study aimed to validate the CLEAR score, a simple prognostic tool for hepatocellular carcinoma (HCC) patients undergoing atezolizumab plus bevacizumab (Atez/Bev) therapy, based on serum lactate dehydrogenase (LDH) and C‐reactive protein (CRP) levels. Materials/Methods From 2020 to 2023, 498 Japanese HCC patients receiving Atez/Bev therapy were enrolled. They were divided into a training set ( n = 280; 13 designated cancer care hospitals) and a validation set ( n = 218; 11 universities and their affiliated Japanese hospitals). In the training set, prognostic factors were analysed, leading to the development of the CLEAR score, which was then evaluated on the validation set. Results Baseline LDH beyond the upper normal limit (hazard ratio [HR] 1.97, 95% CI 1.48–2.64) and CRP (≥ 0.50 mg/dL) (HR 1.61, 95% CI 1.19–2.00) were identified as independent prognostic factors on multivariate analysis and used in the CLEAR score. In the training set, the median progression‐free survival (PFS) times in patients with scores 0, 1 and 2 were 11.1 months, 9.1 months and 3.3 months, respectively ( p < 0.001). The median overall survival (OS) times in patients with scores 0, 1 and 2 were not available, 15.3 months and 10.6 months, respectively ( p < 0.001). Similar results were obtained in the validation set (median PFS and OS times for scores 0, 1 and 2 = 9.4, 6.9 and 4.3 and 30.6, 20.8 and 8.9 months, respectively, each p < 0.001). Conclusion The CLEAR score provides a distinct and simple prediction of the prognosis of HCC patients receiving Atez/Bev therapy.
Journals
2025 EN
Cristoferi Laura · Maino Cesare · Bernasconi Davide Paolo
+21 more
ABSTRACT Background and Aim Risk assessment in primary sclerosing cholangitis (PSC) by magnetic resonance imaging (MRI) relies on semi‐quantitative analysis, which can result in interpretation variability. Radiomics may offer a quantitative approach for risk stratification. This study aims to explore and validate MRI‐derived radiomic features to identify high‐risk PSC patients. Methods In this prospective study (January 2019–December 2022), consecutive PSC patients undergoing routine gadoxetate disodium‐enhanced MRI were recruited. Using PyRadiomics, whole liver parenchyma features were extracted from five MRI sequences according to the Image Biomarker Standardisation Initiative (IBSI). Patients were categorised into risk groups based on the Mayo risk score (MRS) and liver stiffness measurement (LSM). Features associated with high‐risk patients were selected and validated in an independent cohort. A survival analysis was conducted in the combined cohort to assess the prognostic value of the radiomic features for clinical events. Results One hundred and two PSC patients were enrolled in this study. Five radiomics features were associated with high risk in the training cohort. In the validation setting, GLRLM‐Run Entropy in the fat‐saturation T2 weighted imaging (FS‐T2W) sequence was the only significant feature, with an odds ratio of 3.90 (CI 1.46–10.42, p = 0.007) for MRS and 2.97 (CI 1.33–6.66, p = 0.008) for LSM. Its prognostic potential on clinical outcome was confirmed by Cox regression analysis in the combined cohort (hazard ratio per 0.1 increase = 1.480, CI 1.226–1.786), showing excellent predictive performance (C‐index = 0.857). Conclusions GLRLM‐Run Entropy in FS‐T2W is a novel radiomics‐based biomarker for risk stratification in PSC patients. It is quantitative, standardised, easy to compute and cost‐free, positioning it as a potential key innovation in PSC radiology‐based biomarkers. Trial Registration Clinicaltrial.gov ID: NC705618145
Journals
2025 EN
Mariot Márcia Dornelles Machado · Kretzer Daniela Cortés · Becker Patrícia Cemin
+4 more
Abstract The aim of the current study was to assess the influence of maternal weight gain in different clinical gestational conditions on the child's weight at pre‐school age. This was a longitudinal observational study of a prospective and controlled multiple cohort of 372 mother–child pairs with four causal groups of different adverse intrauterine environments (smoking, diabetic, hypertensive and intrauterine growth‐restricted pregnant women) and a control group, in the period of, from 2011 to 2016 in three hospitals in Porto Alegre (Brazil). Sociodemographic, prenatal and perinatal data were analysed. Gestational weight gain (GWG) was categorised as ‘insufficient’, ‘adequate’ and ‘excessive’. The generalised estimation equations (GEE) model was used to assess changes in the z ‐score of the child's body mass index from birth to pre‐school age according to the GWG and gestational group. The child's GWG and weight gain were adjusted for maternal age and education, marital status, family income, pregnancy planning, number of children, prepregnancy BMI, prenatal consultations and type of delivery. A triple interaction effect was observed involving the gestational group, weight gain and study time ( p = 0.020) through an adjusted model. Maternal weight gain above the recommended is associated with a significant increase in the child's z − BMI score over time, except for children from pregnant smokers. Children from diabetic mothers , hypertensive mothers and the control group who had a weight gain above that recommended during pregnancy changed their nutritional status from eutrophic to overweight, becoming obese in the DM and hypertension groups and overweight in control. Monitoring of the GWG, especially in the presence of hypertensive diseases and DM, should be effective to prevent children from developing overweight or obesity in pre‐school age with an important impact on health conditions in the future.