Conectar
by Makiko Sasaki, Mamoru Tanaka, Akihiro Nomoto, Ryusei Yamasaki, Tomokazu Yoshimura, Shigenobu Yano, Yasunari Sasaki, Yuki Kojima, Taketo Suzuki, Hirotada Nishie, Keiji Ozeki, Takaya Shimura, Eiji Kubota, Hiromi Kataoka
Photodynamic therapy (PDT) is an anti-cancer therapy that employs a photosensitizer (PS) and an optimal wavelength of light, causing a photochemical reaction that releases reactive oxygen species, thereby inducing cancer cell death via oxidative stress. Because light irradiation is limited to the tumor site, PDT has minimal adverse effects. The cancer cell selectivity of the PS is important for reducing damage to the normal mucosa caused by scattered light. Antibody-drug conjugates (ADC) are novel anti-cancer therapies that combine a monoclonal tumor-surface-receptor-targeting antibody with a drug bonded through chemical linkers. ADCs enable the targeted delivery of a variety of drugs to cancer cells while minimizing their delivery to healthy tissues. One such tumor surface receptor is the human epidermal growth factor receptor 2 (HER2), which is of interest in the treatment of many cancers, including gastrointestinal cancer. To improve tumor selectivity and minimize damage to the mucosa surrounding the tumor in PDT, we established a novel PS glucose-linked chlorin e6-conjugated trastuzumab (G-Ce6-trastuzumab) that is conjugated to existing PS glucose-linked chlorin e6 (G-Ce6) and evaluated its anti-cancer effect compared to G-Ce6. The effect of PDT was evaluated using HER2-high-expression cells NCI-N87 and HER2-low-expression cells MKN-45. G-Ce6-trastuzumab is internalized by the intracellular organelles in cancer cells. Evaluation of cell death using the WST-8 assay also demonstrated a significantly higher cytotoxic effect of G-Ce6-trastuzumab in HER2-high-expression cells compared with conventional PS G-Ce6. Thereby, G-Ce6-trastuzumab may be an excellent novel PS for PDT because of its strong selectivity for HER2-high-expression cells.Guided parent-delivered cognitive behavioural therapy (GPD-CBT) is an evidence-based, low-burden treatment programme for childhood anxiety disorders with demonstrated efficacy, cost-effectiveness and accessibility. However, it has been tested primarily in Western countries, and the efficacy and cost-effectiveness have not been evaluated in Japanese families. The current study aims to examine GPD-CBT’s efficacy and cost-effectiveness in Japanese samples and explore potential cultural adaptations of the programme.
This study is designed as a Bayesian single-blind randomised controlled trial with two parallel groups: GPD-CBT (intervention group) and a waitlist control group. The primary outcome is remission of primary anxiety disorders evaluated through diagnostic interviews by independent evaluators. Secondary outcomes include child and parent-reported child anxiety symptoms, depressive symptoms and life interference. Additionally, measures of parental psychological characteristics, programme acceptability and quality of life are collected. We will conduct qualitative interviews with parents who participated in the programme and therapists who delivered the intervention to explore potential cultural adaptations. We aim to recruit 54–170 families, depending on the results of sequential Bayesian analyses. GPD-CBT consists of seven weekly 20 min sessions and a 1-month follow-up session. Assessments will be conducted at baseline, 13 weeks post randomisation (primary endpoint for between-group comparison), with an additional 25 weeks post randomisation. The waitlist control group will receive GPD-CBT after the 13-week assessment.
This study has been approved by the Ethics Review Committees of Chiba University and the University of Tokyo. We will disseminate results through academic conference presentations and peer-reviewed journal publications. If the GPD-CBT intervention proves efficacious, we will promote wider implementation in Japan through the development of training programmes for mental health professionals and key stakeholders.
jRCT1032250421 (https://jrct.mhlw.go.jp/latest-detail/jRCT1032250421) and jRCT1030250422 (
To clarify the role performance of gerontological nurse specialists (GNSs) and identify associated factors.
A cross-sectional survey.
A self-designed questionnaire based on the Donabedian model was developed to assess structure, process, and outcome variables using a 5-point Likert scale. The questionnaire was administered to 230 GNSs. Descriptive statistics (e.g., means, standard deviations, frequencies) were calculated in SPSS to summarise GNSs' role performance, and multiple regression analysis identified factors influencing GNSs' role performance.
Ninety-six GNSs (response rate of 44.3%) scored 3.15 to 3.81 out of 5 in GNSs' role performance, including clinical practice, education and guidance, consultation, research, leadership and coordination. High self-ratings were observed in clinical practice and consultation, whereas research and leadership scored lower. Education and guidance, as well as consultation, were primarily performed among hospital nurses, with GNSs' role performance largely confined to the hospital. Multiple regression revealed that GNSs' role performance was significantly associated with factors such as GNS competency, identification of stakeholder needs and perceived social recognition of GNS.
To enhance the role performance of GNSs, it is necessary to expand their activities outside the hospital, improve gerontological nursing competency, and promote the social recognition of their role. The results also suggest that it is important for GNSs to understand the needs of patients, nurses, and other related healthcare workers, and enhance collaboration with multiple professionals.
Clarifying the role performance of GNSs in China enables future outcome evaluations. Identifying influencing factors provides insights for effective support, which will further contribute to the success and development of GNSs.
No public or patient involvement.
by Kazuyuki Iwakiri, Keiichi Miki, Takeshi Sasaki
BackgroundOccupational low back pain (LBP) has increased in Japanese social welfare facilities and hospitals. Understanding its occurrence is the first step in addressing this issue.
AimThis study investigated the caregiving activities that cause occupational LBP incidents in these contexts.
MethodsThe study analyzed 2,722 incidents of occupational LBP among staff in social welfare facilities and hospitals resulting in four or more days absent from work. Data were extracted from accident occurrences and causes in the 2018–2019 Reports of Worker Casualties. The caregiving situations related to the occupational LBP incidents at each facility were then analyzed.
ResultsApproximately half of the occupational LBP incidents surveyed occurred during transfer assistance. This assistance was mainly associated with eating, bathing, and toileting in both facilities and frequently occurred during patient transfers between a bed and a wheelchair. In social welfare facilities, nontransfer assistance also contributed significantly, which included bathing, toileting, childcare, diaper changing, lying, standing, sitting, walking, and car transportation. In hospitals, nontransfer assistance such as providing support for lying, diaper changing, medical care, and sitting were occupational LBP risk factors. Furthermore, most incidents of occupational LBP occurred among staff who worked alone during day shifts.
ConclusionCaregiving activities involving transfer assistance, such as bathing, toileting, and eating, were common risk factors in social welfare facilities and hospitals. However, the specific nontransfer assistance activities contributing to occupational LBP varied by facility. To effectively reduce the incidence of occupational LBP, prevention strategies should focus on these high-risk activities according to facility type and the types of caregiving required.
To examine the relationship between nurse managers' empowering leadership, nurses' resilience and organisational learning from incidents.
Cross-sectional observational study.
Secondary data from a study conducted in June–July 2022 was used. The sample included 1049 nurses working in three special-functioning hospitals. The self-administered questionnaires assessed nurse managers' empowering behaviours, nurses' resilience and attitudes and behaviours fostering organisational learning from incidents. The analysis employed multilevel analysis with hierarchical linear modelling.
Nurse managers' empowering behaviours and nurses' resilience were significantly positively associated with attitudes and behaviours fostering organisational learning from the following incident subscales: make efforts to identify the problem, discuss safety in the workplace, identify and give feedback to address the at-risk behaviour. The interaction of empowering behaviours and resilience was not significant.
Nurse managers' empowering behaviours and nurses' resilience can contribute to attitudes and behaviours that foster organisational learning, even when nurses face stressful incidents.
Fostering empowering leadership in nurse managers and resilience in nurses enhances organisational learning and improves safety and care quality.
The reporting is based on the STROBE guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
by Motoharu Hamano, Kazuya Niki, Keiki Imamura, Ken Sasaki
The chemical composition of the venom in social Hymenoptera differs between castes and ages. Biogenic amines are contained in the venom of honey bees and may be physiologically effective to vertebrate predators and insects. This study quantified the concentrations of biogenic amines in venom and compared them between different castes and ages of honey bees. The concentrations of dopamine and N-acetyldopamine in venom were significantly higher in virgin queens than workers of the same age. The concentrations of dopamine, norepinephrine, tyramine and serotonin increased with age in virgin queens and workers. There was a significant positive correlation between venom dopamine concentrations and ovarian development in queenless workers, suggesting that the concentration of dopamine in the venom transformed from normal workers to reproductive females as that in virgin queens. We also tested the possibility of dietary effects on the concentration of dopamine in venom. Workers fed tyrosine or royal jelly showed significantly higher concentrations of dopamine precursors, tyrosine, 3,4-dihydroxyphenylalanine (DOPA) and dopamine in the hemolymph, as well as higher concentrations of dopamine in venom than in controlled workers. These results suggest that compositions of biogenic amines in venom are influenced by nutrition and change based on their social roles in honey bee society.Neonatal haemochromatosis, considered to be a gestational alloimmune liver disease (NH-GALD), is a rare but serious disease that results in fulminant hepatic failure. The recurrence rate of NH-GALD in a subsequent infant of a mother with an affected infant is 70%–90%. Recently, antenatal maternal high-dose intravenous immunoglobulin (IVIG) therapy has been reported as being effective for preventing recurrence of NH-GALD in a subsequent infant. However, no clinical trial has been conducted to date.
This is a multicentre open-label, single-arm study of antenatal maternal high-dose IVIG therapy in pregnant women with a history of documented NH in a previous offspring. The objective of this study is to evaluate the efficacy and safety of antenatal maternal high-dose IVIG therapy in preventing or reducing the severity of alloimmune injury to the fetal liver.
The clinical trial is being performed in accordance with the Declaration of Helsinki. The trial protocol was approved by the Clinical Research Review Board at four hospitals. Before enrolment, written informed consent would be obtained from eligible pregnant women. The results are expected to be published in a scientific journal.
28 October 2024, V.8.0.
jRCT1091220353.
This study aimed to assess the methodological quality of published systematic reviews of exercise therapy in knee osteoarthritis and summarise their reported effectiveness on quality of life, knee joint function, or adverse events.
Overview of systematic reviews.
PubMed, Embase, CINAHL, Web of Science and CENTRAL (searched on 14 April 2025), plus grey literature (PROSPERO, Epistemonikos, OpenGrey).
We included systematic reviews of randomised controlled trials in patients diagnosed with knee osteoarthritis by imaging or clinical criteria and treated conservatively with exercise therapy; we excluded reviews that enrolled patients scheduled for surgery, with acute inflammation or osteoarthritis of other joints (hand, hip, ankle), for which relevant author data could not be obtained after one contact attempt, or that did not report at least one primary outcome (quality of life, knee joint function or adverse events).
Two reviewers independently extracted data on study characteristics, interventions and outcomes, and assessed methodological quality using the AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews 2) tool. Due to heterogeneity in outcome measures across systematic reviews, meta-analysis was not conducted. Effectiveness was defined as any reported beneficial outcome of exercise therapy on predefined outcomes, including quality of life, physical function, pain or adverse events.
58 systematic reviews were selected. Muscle-strengthening (74.1%) and aerobic (48.2%) exercises were the most commonly prescribed exercise-based interventions. SF-36 (36-Item Short Form Health Survey) and the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) were the most popular outcome-evaluation tools. Furthermore, 63.7% of the systematic reviews revealed that exercise therapy improved all outcomes. The number of intervention-related adverse events was small. Notably, almost all systematic reviews (87.4%) had a critically low quality.
Current evidence on exercise therapy for knee osteoarthritis is inadequate. Nevertheless, exercise therapy can be considered for conservative treatment of knee osteoarthritis. Future studies should use network meta-analyses to compare the effects of different exercise therapies and determine their superiority over other conservative therapies.
FreshRSS 