Ehime Prefectural University of Health Science

BackgroundThe quality of oral cancer resection is extremely important for patient outcomes, such as local control and survival. However, most current simulators either provide only rater-dependent feedback or are not compatible with electrosurgery. Therefore, we developed an electrosurgical simulation task for oral cancer resection that provides objective quantitative metrics and collected initial validity evidence.MethodsWe developed a soft tissue simulation task using a plant-derived model that supports electrosurgery. As quantitative measures demonstrating “ensuring appropriate margins” in oral cancer resection and “maintaining safety” during electrosurgery, we employed nine-directional margin error distance and tumor bed carbonization degree measured using a spectral colorimeter. As validity evidence of the task, 10 expert surgeons completed a questionnaire about the task. In addition, five experts and 12 novices performed the task, and quantitative data obtained from their performance was used for evaluation.ResultsThe replication of oral cancer resection was highly evaluated (4.4 out of 5 points), and quantitative measures for evaluating the skills of surgeons (4.8 out of 5 points) were agreed upon by experts. The internal consistency of the measures was good (Cronbach's alpha: 0.803). Compared to novices, experts had smaller margin errors (0.79 mm vs 2.45 mm), lower carbonization (ΔE: 2.33 vs 8.70), faster resection times, and fewer grasping attempts (all P < 0.001).ConclusionThis user-friendly plant-derived simulation task is compatible with electrosurgery and provides objective quantitative performance metrics. These findings support its use as a practical assessment tool for formative feedback in simulation-based training.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12909-026-08743-5.

Abstract Purpose: To develop and validate an oral cancer simulation task that could quantitatively assess tumor resection skills. Methods: This prospective study employed Messick’s contemporary framework. A focus group of six board-certified head and neck surgeons facilitated articulation of experts' understanding of oral cancer resection into two primary categories: "ensuring adequate margins" and "maintaining safety." According to the results, we developed a simulation task. "Ensuring adequate margins" in oral cancer resection was assessed using extracted phantom-model specimens; "maintaining safety" during electrosurgery was assessed by the degree of tumor bed carbonization during electrosurgery. The validity evidence sources of the task were gathered from questionnaire responses and quantitative measurements obtained by performing the task. Results: Ten expert surgeons completed the questionnaire after performing the task. The replication of oral cancer resection was rated highly (4.4 out of 5), and experts agreed with quantitative measures used to assess surgeons' skills (4.8 out of 5). Five experts and 12 students performed the task, and their skills were measured. The internal consistency of the measures was good (Cronbach’s alpha: 0.803). Margin error distances were significantly smaller for experts than for students (P&lt;0.0001). Spectral colorimetric analysis revealed that lesser tumor bed carbonization was achieved by experts than by students (P&lt;0.0001). Principal component analysis showed that experts’ performance was stable, whereas students’ skill was varied. Conclusions: We developed an oral cancer simulation task to quantitatively measure surgeons’ skills. Using this simulation task may promote early acquisition of tumor resection skills and improve outcomes for oral cancer patients.

This study aimed to assess the localization of chondroitin sulfate (CS), a primary extracellular matrix component, in the stromal region of endometrial carcinoma (EC). Immunostaining was performed on 26 endometrial endometrioid carcinoma (EEC) samples of different grades and 10 endometrial serous carcinoma (ESC) samples to evaluate CS localization. This was further confirmed by Alcian Blue (AB) staining as well. In the G1-EEC samples, CS showed reactivity with fibrovascular stroma, supporting closely packed glandular crowding and papillary structures. As the grade increased, the original interstitial structure was re-established, and the localization of CS in the perigulandular region decreased. In the ESC samples, the thick fibrous strands supporting the papillary architecture showed reactivity with CS; however, the delicate stromal region branching into the narrow region showed poor reactivity. The AB staining results showed similar characteristics to the immunostaining ones. The characteristic localization of CS in various EC types was elucidated. The present study provides new information on endometrial stromal assessment.

Dental drilling sounds can induce anxiety in some patients. This study aimed to use functional magnetic resonance imaging (fMRI) to assess the relationship between dental fear and auditory stimuli. Thirty-four right-handed individuals (21 women and 13 men; average age, 31.2 years) were selected. The level of dental fear was assessed using the dental fear survey (DFS). Based on a threshold DFS score > 52, participants were categorized into two groups: dental fear (DF) group (n = 12) and control group (n = 22). Two types of stimuli were presented in a single session: dental and neutral sounds. Cerebral activation during the presentation of these sounds was evaluated using contrast-enhanced blood oxygenation level-dependent fMRI. In the DF group, dental sounds induced significantly stronger activation in the left inferior frontal gyrus and left caudate nucleus (one-sample t test, P < 0.001). In contrast, in the control group, significantly stronger activation was observed in the bilateral Heschl’s gyri and left middle frontal gyrus (one-sample t test, P < 0.001). Additionally, a two-sample t test revealed that dental sounds induced a significantly stronger activation in the left caudate nucleus in the DF group than in the control group (P < 0.005). These findings suggest that the cerebral activation pattern in individuals with DF differs from that in controls. Increased activation of subcortical regions may be associated with sound memory during dental treatment.

In an interesting turn of events, just as things were getting all ramped up for the author to begin writing this paper, she caught her son’s cold and became bedridden. Her sore throat and fever became so bad that she decided to go to a nearby clinic. Even though there did not seem to be any other patients there, she was taken to a special room set aside for patients with fevers, where a nurse proceeded to interview her. After that, the doctor came in, gave her a short examination, and diagnosed her as having tonsillitis. He briefly explained her condition and what medicine he would prescribe. The whole examination only took a few minutes and she came away with the feeling that the procedure was a bit cold and remote. This led her to wonder whether she was expecting “too much” in desiring somewhat more from a medical practitioner.

In most developed countries, cervical cancer screening and human papillomavirus vaccination have reduced cervical cancer incidence. However, the incidence has been increasing in Japan, possibly because of the low screening rate. Although cervical cancer incidence has increased in people in their 20s, the screening rate among 20-24-year-olds in Japan is only 10.2%, meaning that cervical cancer screening rates should be increased among young Japanese women. We conducted a questionnaire survey among students at health sciences universities to determine their knowledge of cervical cancer, screening rates, and barriers to screening. Students taking specialized medical courses were highly knowledgeable; recognition of the facts that "cervical cancer can be prevented through screening" and that "the risk of cervical cancer increases in one's 20s" was significantly high among those who underwent screening. On the other hand, only 7.5% of students used the free coupons provided for screening. Knowledge of cervical cancer improves screening rates. Therefore, educational programs to raise awareness of the importance of cervical cancer screening among non-medical and health sciences university students and young women in general are required.

Non-alcoholic steatohepatitis (NASH) is a progressive form of non-alcoholic fatty liver disease (NAFLD) that causes cirrhosis and hepatocellular carcinoma. Iron is an essential trace element in the body; however, excess iron can cause tissue damage and dysfunction. Iron overload is often observed in patients with NASH, and the amount of iron accumulated in the liver positively correlates with the histological severity of NASH. Ferroptosis, a novel form of iron-dependent cell death, is caused by the accumulation of lipid peroxidation and oxidative stress and is related to NASH. In addition, ferroptosis is closely related to autophagy, an intracellular self-degradation process. Although autophagy has many beneficial effects, it may also be harmful to the organism, for example, inducing ferroptosis. It is unclear whether iron overload aggravates NASH via autophagy. The aim of this research is to determine the mechanism by which iron overload induces ferroptosis via autophagy and aggravates NASH. Stroke-prone spontaneously hypertensive rats (SHRSP5/Dmcr) were divided into two groups and fed a high-fat and high-cholesterol (HFC) diet for eight weeks. Iron dextran was administered to the Fe group in addition to the HFC diet. Blood analysis, histological staining, calcineurin activity assay, quantitative reverse transcription polymerase chain reaction (RT-PCR), immunofluorescence staining, and electron microscopy were performed. The results showed that iron overload promoted autophagy via nuclear translocation of transcription factor EB (TFEB) and induced ferritinophagy, which is the autophagic degradation of ferritin. In addition, the HFC diet induced lipophagy, the autophagic degradation of lipid droplets. The Fe group also exhibited promoted ferroptosis and aggravated hepatic inflammation and fibrosis. In conclusion, iron overload accelerates ferritinophagy and lipophagy, aggravating NASH pathology via ferroptosis. These findings indicate the therapeutic potential of inhibiting autophagy and ferroptosis for treating NASH.

Abstract Background In most developed countries, cervical cancer screening and human papillomavirus vaccination have reduced the incidence of cervical cancer. However, the incidence of cervical cancer has been increasing in Japan, possibly because of the low screening rate. Although the incidence of cervical cancer has increased in people in their 20s, the screening rate among 20–24-year-olds in Japan is only 10.2%. Therefore, it is necessary to increase the cervical cancer screening rates in Japan, particularly among young women. Methods We conducted a questionnaire survey among students at a health sciences university to determine their knowledge of cervical cancer, screening rates, and factors that prevent young women from undergoing screening. Results We observed that knowledge of cervical cancer was high among students taking specialized medical courses; recognition of the facts that “cervical cancer can be prevented through screening” and “the risk of cervical cancer increases in one’s 20s” was high among those who had undergone screening. Coupons for free screening had an unsatisfactory effect. Conclusions The cervical cancer screening rate among Japanese university students is low. Therefore, educational programs are required to increase awareness of the importance of cervical cancer screening among young women.

Introduction: In Japan, the direct smearing preparation (conventional preparation) has been widely used for cytological examination of the endometrium. Problems with the conventional preparation can be dissolved by liquid-based cytology (LBC) preparation. The Yokohama System is a method for reporting endometrial cytology, but the system lumps cancers together and does not distinguish between histological types. The objective of this study was to clarify morphometrical differences among endometrial endometrioid carcinoma grade 1 (G1), grade 3 (G3), and serous carcinoma (Serous) by image analysis of endometrial LBC. Methods: Using Papanicolaou smears prepared by LBC after sampling with a brush from 32 G1, 16 G3, and 16 Serous patients, image analysis was performed concerning the following 11 items: (1) number of layers of cluster, (2) area of cluster, (3) perimeter of cluster, (4) roundness of cluster, (5) complexity of cluster, (6) area of nucleus, (7) perimeter of nucleus, (8) roundness of nucleus, (9) complexity of nucleus, (10) area of nucleolus, and (11) nucleolus/nucleus (N/N) ratio. The data were statistically compared among G1, G3, and Serous. Results: Significant differences were observed in the number of layers of cluster (G1<G3<Serous), area of cluster (G1>G3<Serous), area of nucleus (G1<G3<Serous), area of nucleolus (G1<G3<Serous), roundness of cluster (G1>G3, G1>Serous), complexity of cluster (G1<G3, G1<Serous), roundness of nucleus (G1<Serous), complexity of nucleus (G1>Serous), and N/N ratio (G1>G3, G3<Serous). Conclusion: The number of layers and area of cluster, complexity of cluster, area and complexity of nucleus, area of nucleolus, and N/N ratio were suggested to be useful for the differentiation of histological types among G1, G3, and Serous. Particularly, differences in the number of layers of cluster, size of nucleus, and size of nucleolus among histological types were large and are considered to be potentially effective points of differential diagnosis.