Pediatric blunt liver and spleen injury treated in hospitals with pediatric intensive care units: Post-hoc analysis of a multicenter, retrospective observational study.

Background: We evaluated the outcomes of pediatric patients with blunt liver and spleen injury (BLSI) admitted to hospitals with pediatric intensive care units (PICUs).

Methods: A post-hoc analysis of a multicenter observational study on pediatric patients (≤16 years) with BLSI at 83 hospitals between 2008 and 2019 was conducted. Thirty-day mortality and BLSI-associated adverse events were compared between patients treated in hospitals with and without PICUs.

What medical students and residents learned from reflection through patients' perspectives: a qualitative study.

Objectives:  The purposes of this study were to identify reflective processes from patients' points of view for difficult patient-doctor interactions and learn how the processes made medical students and residents aware of their own medical practice.  These processes were compared in two countries (US and Japan).

Methods:  The study was a descriptive qualitative study utilizing semi-structured interviews.

Association between nighttime/weekend visits and patient outcomes in children with blunt liver and spleen injuries.

Purpose: The "out-of-hours effect," which indicates hospital admittance during weekends or nighttime, has poorer outcomes for patients than for those admitted on weekdays and is widely documented in various medical conditions. However, this effect remains understudied in pediatric trauma cases, including blunt liver and spleen injuries (BLSIs).

Methods: This was a secondary analysis of a nationwide multicenter retrospective study, focusing on pediatric patients with trauma (≤ 16 years old) with BLSI admitted from 2008 to 2019.

Metabolomic Profiling of Open-Angle Glaucoma Etiologic Endotypes: Tohoku Multi-Omics Glaucoma Study.

Purpose: The purpose of this study was to investigate biologically meaningful endotypes of open-angle glaucoma (OAG) by applying unsupervised machine learning to plasma metabolites.

Methods: This retrospective longitudinal cohort study enrolled consecutive patients aged ≥20 years with OAG at Tohoku University Hospital from January 2017 to January 2020. OAG was confirmed based on comprehensive ophthalmic examinations.

Non-consensual Sex Among Japanese Women in the COVID-19 Pandemic: A Large-Scale Nationwide Survey-Based Study.

Introduction and background Non-consensual sex, including rape and sexual assault, has been a global concern and may have been influenced by the COVID-19 pandemic. However, information on this topic is limited. Therefore, our objective was to survey the incidence rate of non-consensual sex among Japanese women aged 15-79 years between April and September 2020, during the early stages of the COVID-19 pandemic in Japan.

SARS-CoV-2 IgG seroprevalence in the Okinawa Main Island and remote islands in Okinawa, Japan, 2020-2021.

We estimated the seroprevalence of anti-SARS-COV-2 IgG in different island groups in Okinawa. A cross-sectional sero-survey was repeated in three periods between July 2020 and February 2021. A total of 2683 serum samples were collected from six referral medical centers, each covering a separate region in Okinawa.

How do mandatory emergency medicine rotations contribute to the junior residents' professional identity formation: a qualitative study.

Background: This study aims to investigate the impact of short-term mandatory emergency medicine rotations on professional identity formation of Japanese junior residents. Using situated learning theory as a theoretical framework, we explore how this rotation, which is part of a two-year Junior residency in the transition period from students to qualified physicians.

Methods: We conducted a qualitative study conducting semi-structured face-to-face interviews with Year 1 postgraduate residents in the 2020-2021 classes of the junior residency program in Okinawa Chubu Hospital, Japan (n = 10).

Comprehensive study on central precocious puberty: molecular and clinical analyses in 90 patients.

Context: Defects in MKRN3, DLK1, KISS1, and KISS1R and some disorders, such as Temple syndrome (TS14), cause central precocious puberty (CPP). Recently, pathogenic variants (PVs) in MECP2 have been reported to be associated with CPP.

Objective: We aimed to clarify the contribution of (epi)genetic abnormalities to CPP and clinical and hormonal features in each etiology.

Endovascular treatment for secondary basilar occlusion caused by spontaneous thrombus migration from the vertebral artery: Two case reports.

Thrombus migration is a well-known clinical condition that occurs before mechanical thrombectomy and after intravenous thrombolysis in patients with anterior circulation strokes. Although thrombus migration from the vertebral artery (VA) can result in life-threatening basilar artery (BA) occlusion, its occurrence in the posterior circulation has rarely been discussed. Two patients with secondary BA occlusion caused by spontaneous thrombus migration from the VA are presented.

Postgraduate Year Two Medical Residents' Awareness of Personal Development as a Physician during the Management of Inpatients: A Qualitative Study.

Clinical experiences, helping relationships, and reflection are key factors for personal development for physicians. However, few studies have shown which experiences are important for personal growth and how medical residents specifically use their experiences for personal growth. The aim of this study was to identify from the medical residents' perspective which clinical experiences contribute to their personal development.

Interval cholecystectomy following drainage procedures for acute cholecystitis: percutaneous transhepatic vs endoscopic transpapillary gallbladder drainage.

Background: Gallbladder drainage procedures are often considered for acute cholecystitis (AC) patients with significant peri-operative risks. While percutaneous transhepatic gallbladder drainage (PTGBD) has been evaluated in previous studies, there is scarce data on the feasibility and efficacy of endoscopic transpapillary gallbladder stenting (ETGBS) in patients with AC. This study aimed to compare the characteristics of interval cholecystectomy following ETGBS and PTGBD.

Recipients of public assistance with advanced chronic kidney disease: insights into receiving a presentation of kidney replacement therapy options and polypharmacy from Japanese investigators with innovative network about kidney disease study.

Background: The characteristics of patients with advanced chronic kidney disease (CKD) who are recipients of public assistance in Japan, and the adequacy of their medical care have not been reported previously.

Methods: The records of patients with CKD stage G5 who visited nine facilities in Japan from April to June 2013 were retrospectively reviewed to compare the characteristics and care of recipients of public assistance with those of non-recipients. Receiving a presentation of kidney replacement therapy (KRT) options and polypharmacy were used as indicators of suboptimal medical care.

Predictors of relapse of polymyositis/dermatomyositis associated interstitial lung disease.

Background: Polymyositis/dermatomyositis (PM/DM) patients often develop interstitial lung disease (ILD), which can lead to relapse despite anti-inflammatory treatments. This study aims to elucidate the clinical characteristics of relapses in PM/DM-associated ILD patients.

Methods: We gathered clinical data, including laboratory results, pulmonary function tests, chest high-resolution computed tomography findings from patients treated at Okinawa Chubu Hospital between January 1, 2010 and December 31, 2018.

Pathological examination of factors involved in PD-L1 expression in patients with oral tongue squamous cell carcinoma.

Background: Tumor tissues comprise cancer cells and stromal cells, and their interactions form the cancer microenvironment. Therefore, treatments targeting cells other than cancer cells are also actively being developed, and among them, treatment targeting PD-1, an immune checkpoint molecule that is important in tumor immune evasion, has also been indicated for head and neck cancer. PD-L1, a ligand of PD-1, is expressed in both tumor cells and stromal cells, and the scoring system based on the combined positivity rates of both types of cells, the combined positive score (CPS), is used for predicting treatment effect.

Real-world retrospective analysis of immune checkpoint inhibitor therapy for relapsed or refractory Hodgkin's lymphoma.

Immune checkpoint inhibitors (ICI) are promising therapeutic agents for relapsed or refractory classical Hodgkin's lymphoma (RRcHL). This retrospective study evaluated patients with RRcHL registered in the clinical research program Tohoku-Hematology-Forum-26, between 2016 and 2020, and treated with ICI in 14 centers in Northeast Japan. We analyzed the usage, efficacy, and safety of ICI therapy (ICIT).

Proposed Clinical Algorithm for Pleuroparenchymal Fibroelastosis (PPFE).

Pleuroparenchymal fibroelastosis (PPFE) is characterized by fibrosis involving the pleura and subpleural lung parenchyma, predominantly in the upper lobes. As PPFE appears to occur in patients with heterogeneous etiologies, the disease course is thus also heterogenous, with some patients showing rapid progression while others have slow progression. Therefore, it is very difficult to predict prognosis with PPFE.

Height, body mass index, physical activity, and risk of colorectal cancer in relation to expression of insulin receptor: The Japan Public Health Center-based Prospective Study.

To ascertain the involvement of insulin receptors (IRs) in colorectal carcinogenesis, we investigated the association of height, body mass index (BMI), and physical activity with colorectal cancer (CRC) and two subtypes of CRC according to the expression level of IR. We utilized data from a large-scale, population-based prospective cohort study of 18,158 middle-aged and elderly subjects in Akita and Okinawa, Japan. In the statistical analysis, we used the Cox proportional hazards model and estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of CRC and its subtypes as defined by immunohistochemistry of IRβ, a transmembrane subunit of IR.