The Long-Term Cost-Effectiveness of Tirzepatide 5 mg versus Dulaglutide 0.75 mg for the Treatment of People with Type 2 Diabetes in Japan.

Introduction: This analysis aimed to evaluate the long-term cost-effectiveness of tirzepatide 5 mg versus dulaglutide 0.75 mg (both administered once weekly) in people not achieving glycemic control on metformin, based on the results of the head-to-head SURPASS J-mono trial from a Japanese healthcare payer perspective.

Methods: A cost-utility analysis was performed over a 50-year time horizon using an implementation of the UKPDS Outcomes Model 2 developed in Microsoft Excel.

The importance of using interdental cleaning devices on prevention of tooth loss in an employee population: a cross-sectional study.

Background: Tooth loss can lead to an increased risk of physical disease and a reduced quality of life. The current study investigated the association of the use of interdental cleaning devices with oral health outcomes such as tooth loss among employees as a healthier population.

Method: Tooth loss was determined as the main outcome in 2017 in a company employee population (n = 845, average age = 47.

Current situation and overview of resorbable magnesium scaffolds: a perspective for overcoming the remaining issues of polymeric bioresorbable scaffold.

Bioresorbable scaffolds (BRS) were developed as an innovative solution to overcome the limitations of metallic stents. While polymeric BRS initially demonstrated comparable clinical outcomes to drug-eluting stent (DES) in clinical trials, subsequent large-scale studies revealed that patients implanted with polymeric BRS experienced higher rates of scaffold thrombosis (ScT) and target lesion failure compared to those with metallic stents. Resorbable magnesium scaffolds (RMS) have emerged as a promising alternative owing to magnesium's natural degradability and favorable mechanical properties.

Pelvic Lymph Node Dissection With Polymer Ligation Clips Significantly Reduces Hospital Stay Compared to Vessel Sealer: A Retrospective Study.

Introduction Lymphocele is a typical complication of pelvic lymph node dissection (PLND) in robot-assisted radical prostatectomy (RARP). This study aimed to compare postoperative lymphatic leakage between the polymer ligation clip and vessel sealer, and evaluated the costs associated with the former. Methods The study enrolled patients who underwent RARP with PLND at our institution between April 2018 and March 2023 and were treated with a vessel sealer (LigaSure Blunt Tip 44 NC; Medtronic, Dublin, Ireland) until September 2021, and Hem-o-lok polymer ligation clips(Teleflex, Wayne, PA, USA) thereafter.

Identification of KCNE6, a new member of the KCNE family of potassium channel auxiliary subunits.

The KCNE family (KCNE1-5) is a group of single transmembrane auxiliary subunits for the voltage-gated K channel KCNQ1. The KCNQ1-KCNE complexes are crucial for numerous physiological processes including ventricular repolarization and K recycling in epithelial cells. We identified a new member of the KCNE family, "KCNE6", from zebrafish.

Self-Reported Time-at-Bedside and Its Association with In-Training Examination Scores of Residents in Japan.

Background: Time-at-bedside plays a central role in clinical medicine. However, the amount of time Japanese clinical residents spend at patients' bedsides remains unexplored.

Objective: To quantify time-at-bedside and examine its association with in-training examination scores during clinical residency in Japan.

Early versus late administration of adrenaline in pediatric patients with out-of-hospital cardiac arrest.

Objectives: Optimal timing of adrenaline administration in pediatric out-of-hospital cardiac arrest (OHCA) is unclear. We aimed to evaluate the impact of early versus late adrenaline administration on survival and neurological outcomes at one month in children experiencing OHCA with non-shockable rhythm.

Methods: This study is retrospective cohort study.

Structural variant allelic heterogeneity in MECP2 duplication syndrome provides insight into clinical severity and variability of disease expression.

Background: MECP2 Duplication Syndrome, also known as X-linked intellectual developmental disorder Lubs type (MRXSL; MIM: 300260), is a neurodevelopmental disorder caused by copy number gains spanning MECP2. Despite varying genomic rearrangement structures, including duplications and triplications, and a wide range of duplication sizes, no clear correlation exists between DNA rearrangement and clinical features. We had previously demonstrated that up to 38% of MRXSL families are characterized by complex genomic rearrangements (CGRs) of intermediate complexity (2 ≤ copy number variant breakpoints < 5), yet the impact of these genomic structures on regulation of gene expression and phenotypic manifestations have not been investigated.

Lack of an association between spleen volume and risk of pneumococcal infection in cancer patients: a nested case-control study.

Background: The spleen is a key organ in preventing pneumococcal infection, especially in patients with immunocompromised condition such as those with cancer. Previous studies have shown that a small spleen volume in pneumococcal pneumonia patients is associated with severe disease course. However, it is unknown whether a small spleen increases risk of pneumococcal infection.

Prognosis and tumor microenvironment in pseudohypoxic pheochromocytoma/paraganglioma.

Pheochromocytoma and paraganglioma (PPGL) are rare tumors that occur in the adrenal medulla and extra-adrenal tissues, respectively. The prognosis and tumor microenvironment (TME) of pseudohypoxic PPGL as a major entity have not been fully described. Based on the clinical database of 65 patients with PPGL, we assessed the morphological features as well as the immunohistochemistry of pseudohypoxia-related proteins (SDHB and CAIX) and TME-related immune cell markers.

Inadequate Efficacy of Biologics for Treating Proximal Ileal Lesions in Crohn's Disease; a prospective multicenter study.

Background And Aims: While biologic therapy has revolutionized the treatment of Crohn's disease (CD), surgery remains unavoidable in cases involving ileal complications. We aimed to evaluate the efficacy of biologics on proximal ileal lesions using balloon-assisted enteroscopy (BAE).

Methods: This open-label multicenter prospective study was conducted at tertiary referral centers in Japan.

Prophylactic Clip Closure in Preventing Delayed Bleeding After Colorectal Endoscopic Submucosal Dissection on anticoagulants: A multicenter retrospective cohort study in Japan.

Background And Study Aims: Prophylactic clip closure after colorectal endoscopic submucosal dissection (ESD) among patients on anticoagulants is of uncertain effectiveness in reducing delayed bleeding (DB) risk. We aimed to assess the effect of prophylactic clip closure in preventing DB after colorectal ESD among patients on anticoagulants.

Patients And Methods: We used the ABCD-J study database, a large-scale multicenter study analyzing DB among 34,455 colorectal ESD cases from 47 Japanese institutions.

Postoperative Outcomes of Laparoscopic Hepatic Resection Combined With Radiofrequency Ablation for Two or Three Hepatocellular Carcinomas: A Case Series of Nine Patients.

Introduction: Hepatic resection (HR) and radiofrequency ablation (RFA) are curative treatments for three or fewer hepatocellular carcinomas in Japan. The laparoscopic approach in both has been used in recent years; however, its treatment outcome in combination with HR with RFA is unclear. We aimed to gain insights into this combined treatment.

Associations of sarcopenia and malnutrition with 30-day in-hospital morbidity and mortality after cardiac surgery.

Objectives: Sarcopenia and malnutrition often occur simultaneously in adults with cardiovascular diseases. Our objective was to determine the associations of preoperative sarcopenia and malnutrition with major adverse cardiac and cerebral events (MACCE) after cardiac surgery.

Methods: We retrospectively analyzed 154 consecutive patients who underwent elective cardiac surgery between January 2015 and June 2018 at two institutions in Japan.

Axonal Selectivity of Myelination by Single Oligodendrocytes Established During Development in Mouse Cerebellar White Matter.

Myelin formation by oligodendrocytes regulates the conduction velocity and functional integrity of neuronal axons. While individual oligodendrocytes form myelin sheaths around multiple axons and control the functions of neural circuits where the axons are involved, it remains unclear if oligodendrocytes selectively form myelin sheaths around specific subtypes of axons. Using the combination of rabies virus-mediated single oligodendrocyte labeling and immunostaining with tissue clearing, we revealed that approximately half of the oligodendrocytes preferentially myelinate axons originating from Purkinje cells in the white matter of adult mouse cerebella.

The Impact of the Coronary Artery Calcium Score on the Clinical Outcomes in Patients with Acute Myocardial Infarction.

: It is essential to identify the risk factors for poor clinical outcomes in patients with acute myocardial infarction (AMI). The coronary artery calcium score (CACS) is gathering attention as a predictor for future cardiovascular events. This study aimed to (1) measure CACSs in patients with AMI by non-ECG-gated computed tomography (CT), (2) compare clinical outcomes between patients with a high CACS and a low-intermediate CACS and (3) to elucidate the association between high CACS and clinical outcomes.

Risk Factors for Long-Term Nutritional Disorders One Year After COVID-19: A Post Hoc Analysis of COVID-19 Recovery Study II.

: COVID-19 patients develop various clinical symptoms, including malnutrition. However, the risk factors for long-term nutritional disorders remain unclear. Identifying these factors is crucial for preventing nutritional disorders by initiating early nutritional interventions.

Comparison of nocturnal blood pressure dipping status detected by home vs. ambulatory blood pressure monitoring: analysis of J-HOP Nocturnal BP Study data.

Nocturnal blood pressure (BP) dipping is a risk factor for cardiovascular disease, independent of nighttime BP levels. We compared nocturnal BP dipping detected by conventional ambulatory BP monitoring (ABPM) with that detected by nocturnal home BP monitoring (HBPM), which can measure BP during sleep with a timer function. We analyzed data of 927 subjects in the nationwide practice-based J-HOP Nocturnal BP Study and observed that the prevalences of nocturnal BP dipping status for HBPM and ABPM respectively were: extreme dipper, 6.

Periannular extension of infective endocarditis with atrioventricular block successfully treated with antibiotic therapy after transcatheter aortic valve implantation: a case report.

Background: Although transcatheter aortic valve implantation (TAVI) is performed for very elderly patients in whom surgical aortic valve replacement (SAVR) poses unacceptably high operative risk, some of these patients are ultimately forced to undergo open surgery when TAVI is complicated by infective endocarditis (IE). To our knowledge, there have been no reports of cases with periannular extension of IE and atrioventricular block successfully treated by antibiotics without valve replacement.

Case Summary: An 80-year-old Japanese man who had undergone TAVI developed IE with loss of consciousness on Day 39 after the procedure.

Assisted reproductive technology in Japan: A summary report for 2022 by the Ethics Committee of the Japan Society of Obstetrics and Gynecology.

Purpose: This descriptive analysis evaluated the 2022 assisted reproductive technology (ART) data collected by the Japan Society of Obstetrics and Gynecology registry.

Methods And Results: In 2022 (cutoff date 30 November 2023), 634 of 635 registered ART facilities participated; 602 implemented ART treatment, with 543 630 registered cycles and 77 206 neonates (9.1% and 10.

Analysis of Trends and Influencing Factors of Cytokine-Adsorbing Therapies: A Nationwide Ecological Study in Japan.

Background: Cytokine-adsorption therapy has garnered attention as a potential treatment for conditions such as sepsis, although supporting evidence remains limited. Consequently, its utilization is expected to vary significantly across regions. To date, no ecological studies have investigated this regional heterogeneity.

Management strategy and experience of vasa previa in perinatal centers: A nationwide survey in Japan.

Aim: To clarify the current situation and outcomes of vasa previa (VP) in Japan.

Methods: A questionnaire survey on VP was conducted at all 408 perinatal centers in Japan. The content of the survey included (1) the management strategy for pregnant women who were diagnosed with VP and (2) the number and outcomes of VP cases managed between January 2020 and December 2022.

[Thymic Carcinoma with Massive Pericardial Effusion:Report of a Case].

A 70-years-old man visited our hospital with complaints of palpitations and shortness of breath from five days ago. Chest computed tomography( CT) revealed a solid tumor with 74 mm in diameter at the right anterior mediastinum and massive pericardial effusion. No malignant cells were noted in the pericardial effusion collected by pericardiocentesis.

Safety and quality of life with maintenance olaparib plus bevacizumab in older patients with ovarian cancer: subgroup analysis of PAOLA‑1/ENGOT-ov25.

Background: In PAOLA-1/ENGOT-ov25, the addition of olaparib to bevacizumab maintenance improved overall survival in patients with newly diagnosed advanced ovarian cancer. We describe the safety profile and quality of life (QoL) of this combination in older patients in PAOLA-1.

Methods: Safety (CTCAE v4.