Impact of long-term trends on outcomes in the management of colonic diverticular bleeding: mediation analyses in a large multicenter study.

Background: Despite accumulating evidence and recommendations for management of colonic diverticular bleeding (CDB), the changes in its clinical management and outcomes remain unknown.

Methods: We performed a retrospective tendency analysis on a biennial basis, a propensity score-matched cohort study between the first and latter half groups, and mediation analyses to compare the diagnostic and treatment methods between January 2010 and December 2019 (CODE BLUE-J Study).

Results: A total of 6575 patients with CDB were included.

[Innovative Personalized Medicine for Immunosuppressive Drugs Based on Novel Control Theory of Pharmacokinetics].

Tacrolimus is widely recognized as an anti-rejection agent due to its immunosuppressive characteristics. It binds to the immunophilin FK506-binding protein (FKBP) and thus to calcineurin, and inhibits its activity. Tacrolimus' therapeutic concentration range in blood is narrow, and its pharmacokinetics are highly variable among individuals.

Efficacy of liposomal irinotecan + 5-FU/LV vs. S-1 in gemcitabine-refractory metastatic pancreatic cancer: a real-world study using inverse probability of treatment weighting.

Background: S-1 monotherapy had previously been widely used as a second-line treatment for pancreatic cancer (PC) after gemcitabine-based chemotherapy mainly in Japan. Based on the results of the NAPOLI-1 trial, the recommended second-line therapy is now liposomal irinotecan plus fluorouracil/folinic acid (nal-IRI + 5-FU/LV). However, there have been no studies comparing nal-IRI + 5-FU/LV therapy with S-1 monotherapy.

Characteristics of psychiatric patients with nightmares after suvorexant administration: A retrospective study.

Aim: Suvorexant is an orexin receptor antagonist (ORA) for the treatment of insomnia. The antagonistic action of suvorexant on orexin receptors is associated with an increase in rapid eye movement (REM) sleep, which can potentially lead to nightmares depending on the patient's condition. However, the precise risk factors for nightmares among patients taking ORAs, such as suvorexant, have yet to be identified.

Stepwise cardiovascular risk stratification in patients with type 2 diabetes based on coronary CT assessment.

Background: We aimed to examine the stepwise risk stratification for predicting major adverse cardiovascular events (MACE) in patients with DM and suspected coronary artery disease (CAD).

Method: 1187 patients with suspected CAD enrolled in a prospective cohort study were examined. The patients were evaluated step-by-step with coronary artery calcification (CAC), coronary artery stenosis (CAS), and FFR analysis.

Validation of British Society of Gastroenterology guidelines for acute lower gastrointestinal bleeding from 8,956 cases in Japan.

Background And Aims: We sought to validate the British Society of Gastroenterology (BSG) guidelines for acute lower gastrointestinal bleeding (ALGIB).

Methods: We analyzed 8,956 patients with ALGIB in CODE BLUE-J study and categorized them into four groups based on BSG guidelines. Outcomes included 30-day rebleeding, 30-day mortality, blood transfusion, therapeutic intervention, and severe bleeding.

Contemporary Use of β-Blockers in Heart Failure Patients With and Without Atrial Fibrillation: A Nationwide Database Analysis.

Evidence of the effectiveness of β-blockers in heart failure (HF) and atrial fibrillation (AF) in a contemporary cohort is controversial. This study investigated the association between the use of β-blockers and prognosis in hospitalized HF patients with and without AF in Japan. Patients hospitalized with the first episode of acute HF were identified from the National Database of Health Insurance Claims and Specific Health Checkups of Japan between April 2014 and March 2021.

Spatiotemporal gait characteristics post-total hip arthroplasty and its impact on locomotive syndrome: a before-after comparative study in hip osteoarthritis patients.

Background: Understanding the gait pattern of patients eligible for total hip arthroplasty (THA) due to hip osteoarthritis (OA) offers valuable information for improving locomotive syndrome (LS). This study aims to measure the gait patterns of THA-eligible patients using an optical motion capture system and to analyze these patterns using principal component analysis (PCA). Additionally, this study examines the relationship between THA-induced gait patterns and LS.

Real-World Analysis of the Correlation between Overall Survival and Progression-Free Survival in Advanced Pancreatic Cancer: Results of NAPOLEON-1 and 2 Studies.

Introduction: Fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) improve overall survival (OS) and progression-free survival (PFS) in patients with pancreatic cancer, compared with gemcitabine (GEM). However, whether PFS is a surrogate marker of OS in pancreatic cancer chemotherapy focusing on FOLFIRINOX or GEM plus nab-paclitaxel remains unknown. We aimed to verify whether PFS can be a surrogate marker of OS in prognosis prediction.

Basal inferoseptal segment is highly susceptible to deformation in the clinical spectrum of transthyretin-derived amyloid cardiomyopathy.

Aims: While the prevalence of transthyretin-derived amyloid cardiomyopathy (ATTR-CM) is on the rise, detailed understanding of its morphological and functional characteristics within the left ventricle (LV) across heart failure (HF) remains limited.

Methods And Results: Utilizing two-dimensional (2D) speckle-tracking echocardiography, we assessed longitudinal strain (LS) in 63 histology-confirmed ATTR-CM patients. Additionally, cardiac magnetic resonance (CMR) images measured native T1 and extracellular volume (ECV), compared with LS across 18 LV segments.

Gut Dysbiosis in Patients With Fontan Circulation.

Background: The process underlying Fontan pathophysiology is multifactorial and may include gut dysbiosis (GD). We investigated the presence of GD and elucidated its correlation with Fontan pathophysiology.

Methods And Results: Gut microbiomes of 155 consecutive patients with Fontan pathophysiology and 44 healthy individuals were analyzed using 16S rRNA sequencing of bacterial DNA extracted from fecal samples.

Long-term Major Adverse Cardiac Event Prediction by Computed Tomography-derived Plaque Measures and Clinical Parameters Using Machine Learning.

Objectives The present study evaluated the usefulness of machine learning (ML) models with the coronary artery calcification score (CACS) and clinical parameters for predicting major adverse cardiac events (MACEs). Methods The Nationwide Gender-specific Atherosclerosis Determinants Estimation and Ischemic Cardiovascular Disease Prospective Cohort study (NADESICO) of 1,187 patients with suspected coronary artery disease (CAD) 50-74 years old was used to build a MACE prediction model. The ML random forest (RF) model was compared with a logistic regression analysis.

Evaluating the relaxation effects of Shikuwasa (Citrus depressa Hayata) essential oil inhalation in young female adults: Study protocol for a randomised controlled trial.

Introduction: The essential oil of Shikuwasa ( Hayata) primarily contains limonene and γ-terpinene, which have potential applications in stress management and relaxation. However, the psychological or physiological relaxation effects of Shikuwasa essential oil on humans are still unknown. This study aims to investigate the short-term relaxation effects of Shikuwasa essential oil, one of the less-studied varieties, compared to inhaling odour-free air in young female adults.

Acceptance of Virtual Reality Simulation Training for Stoma Care by Healthcare Providers: A Pilot Questionnaire Study After Viewing Prototype Imagings.

Objectives:  Educational simulation systems using virtual reality (VR) with head-mounted devices are spreading into the medical field. We developed an innovative training system whereby experienced ostomates can share their proficient stoma self-care techniques with novice ostomates through VR simulations, enabling anytime, anywhere learning. We examined the questionnaire study to assess the acceptance of VR simulation training for stoma care by healthcare providers.

Real-World Effectiveness and Predictors of Nurse-Led Individual Cognitive Behavioral Therapy for Mental Disorders: An Updated Pragmatic Retrospective Cohort Study.

The importance of nurses integrating effective psychological techniques into their clinical practice is widely recognized. Nevertheless, further evidence from real-world settings is needed to establish nurse-led cognitive behavioural therapy (CBT) as an effective approach in clinical practice. This study aimed to examine the clinical effectiveness and predictors of individual CBT for mental disorders delivered by nurses in various routine clinical settings.