Hyogo University of Health Sciences

BackgroundThis study examines whether acute psychosocial stress induced by the Trier Social Stress Test (TSST) alters pressure pain threshold (PPT) in healthy university students. Furthermore, we investigated how overall social skills and its subscales relate to stress-induced changes in PPT and whether trait anxiety moderates these relationships.MethodsA total of 34 healthy university students (14 males, 20 females; mean age = 21.2 ± 1.0 years) participated in the study. TSST was used to induce acute psychosocial stress. PPT, subjective stress, and autonomic activity (pulse wave amplitude and length) were assessed at three time points: pre, post, and 10-min recovery. Social skills were measured using the Adult Social Skills Scale, and trait anxiety was assessed using the STAI. Linear mixed-effects and regression models were applied to examine time effects and anxiety’s moderating role.ResultsSubjective stress increased significantly immediately after TSST and returned to near baseline at the 10-min recovery. No significant changes were observed in pulse wave amplitude or length. A linear mixed-effects model revealed no significant main effect of time (F(2, 64) = 0.01, p = .99) or interaction between time and total social skills (F(2, 64) = 0.03, p = .97). A trend-level main effect of total social skills was observed (F(1, 31) = 3.28, p = .08), indicating that higher social skills were associated with greater PPT overall. Regression analyses of subscales revealed that only encoding skill exhibited a trend-level association with pre-to-post PPT change. A subsequent interaction model established a significant moderation by trait anxiety: the protective association of encoding skill with increased PPT was significant among low to average anxiety participants but not among high-anxiety participants.ConclusionsIndividuals with higher social skills, particularly those with effective encoding abilities and lower trait anxiety, exhibited greater pain tolerance under stress, although acute social stress did not produce an overall change in PPT. These findings suggest that social communication competence may serve as a resilience factor in stress-related pain modulation, although elevated anxiety levels may attenuate such benefits.

Peer review is a systematic process in which experts evaluate the content of a paper before it is published in a journal.The results of the peer review serve as a basis for determining whether or not to publish the paper.Understanding the peer review process is useful when aiming for paper acceptance.The Journal of International Nursing Research (JINR) requires peer review by two or more experts in the field.The peer review method is a single anonymized review, in which the authors of the paper are not informed of who will be reviewing it, but the reviewers are informed of the authors' identity.At JINR, following a paper's submission, the editorial department first conducts a technical check to ensure that the submission guidelines are met and that there are no issues with plagiarism.The Editor-in-Chief then assigns the paper to an

Skeletal muscle-derived extracellular vesicles (SkM-EVs) are promising candidates for non-invasive, systemically delivered therapies, but their functional specificity relative to clinically advanced mesenchymal stem cell-derived EVs (MSC-EVs) remains unclear. We reanalyzed public miRNA-seq datasets of SkM-EVs and MSC-EVs and integrated validated miRNA-mRNA interactions to infer pathway-level repression potential of EV miRNA cargo. Two complementary approaches were used: a differential-expression-based relative evaluation with RBiomirGS, and an abundance-weighted absolute evaluation that converts miRNA profiles into gene-level Impact Scores followed by preranked KEGG enrichment. Despite their different formulations, both approaches converged on a shared pattern. SkM-EV miRNAs showed a predicted repression bias in FoxO, TGF-β and ErbB signaling pathways linked to muscle atrophy, metabolic homeostasis and pro-proliferative signaling. By contrast, MSC-EV miRNAs showed a predicted repression bias in immune signaling pathways. These source-dependent pathway signatures provide hypothesis-generating evidence that SkM-EVs may be better suited for muscle-, metabolic-, and cancer-related indications, whereas MSC-EVs may be more appropriate for immunomodulatory indications, pending experimental validation. Our miRNA-target-based framework provides a general strategy to benchmark EV sources at the pathway level directly from miRNA profiles.

Esophagectomy with gastric conduit reconstruction is one of the standard treatment for esophageal cancer; however, anastomotic leakage remains a major complication, occurring in approximately 13% of cases. Impaired perfusion of the gastric conduit is a key risk factor, highlighting the need for objective intraoperative blood flow assessment. Although indocyanine green (ICG) fluorescence imaging has been used, quantitative evaluation is lacking, and perfusion of the remnant esophagus has not been assessed. The SPY-QP system provides objective, real-time perfusion analysis using fluorescence intensity metrics. This study examines the role of SPY-QP–guided perfusion assessment in supporting intraoperative anastomotic decision-making and explores its association with a reduced incidence of anastomotic leakage compared with conventional near-infrared evaluation. This investigator-initiated, prospective, single-arm clinical study (SPYMIE study) aims to evaluate the feasibility and effectiveness of quantitative perfusion assessment using the SPY-QP fluorescence system during minimally invasive esophagectomy for esophageal cancer. Intraoperative ICG fluorescence imaging is performed to quantify blood flow in the gastric conduit and remnant esophagus. The primary endpoint is the incidence of anastomotic leakage, with secondary outcomes including anastomotic stricture, gastric conduit necrosis, and relative fluorescence intensity at anastomotic sites. Historical controls with conventional near-infrared evaluation will be used for comparison. Anastomotic leakage after minimally invasive esophagectomy remains a major concern, largely attributed to inadequate perfusion at the anastomotic site. Conventional intraoperative assessments are subjective and lack quantitative reliability. The SPY-QP system enables real-time, quantitative perfusion analysis, providing measurable parameters such as relative ICG fluorescence intensity and time-to-peak intensity. Prior studies demonstrated that SPY-QP detects low-perfusion regions unseen with qualitative imaging and influences surgical decision-making, leading to reduced leakage rates. Therefore, SPY-QP–guided quantitative perfusion assessment may enhance intraoperative blood flow evaluation of anastomotic sites, standardize perfusion-based surgical quality indicators in esophagectomy. This SPYMIE study was prospectively registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN-CTR) on May 12, 2025 (registration number: UMIN000057825) under the title “Prospective, single-arm study on the usefulness of blood flow evaluation of the gastric conduit and remnant esophagus using the SPY-QP software system in minimally invasive esophagectomy for esophageal cancer.”

[Purpose] This study aimed to investigate variations in step time and trunk acceleration during the first five steps of walking initiationwhen rhythmic auditory stimuli matched to a comfortable walking tempo, were provided before walking. [Participants and Methods] Seventeenhealthy, right-foot dominant adults (10 males, 7 females; mean age 23.2 ± 4.9 years; mean height 165.3 ± 10.2 cm) without orthopedic orneurological abnormalities were enrolled in this study. The participants were instructed to perform 10 steps of indoor-level walking withrhythmic auditory stimulation in two tasks. In Task 1, participants began walking after hearing the 1st auditory stimulus, while in Task 2,they initiated walking after the 10th auditory stimulus. Step times; peak trunk acceleration values in the vertical, lateral, andforward/backward directions; and the coefficients of variation for these measures over the first five steps were compared between the twotasks. [Results] The step time during Task 2 was significantly longer than that during Task 1. The coefficients of variation for step timeand lateral and forward trunk accelerations during Task 2 were significantly lower than those during Task 1. [Conclusion] This study foundthat the variability in step time and lateral and forward trunk accelerations during the five steps of walking initiation decreased whenhealthy participants listened to rhythmic auditory stimuli 10 times before walking.

ABSTRACTHospital‐associated sarcopenia (HAS) is a preventable and reversible condition characterized by rapid muscle loss during hospitalization. Although its prevalence is higher than that of age‐related sarcopenia, the clinical recognition and structured management of this condition remain limited. In this narrative review, the pathophysiology of HAS is synthesized, the effectiveness of acute‐phase interventions is evaluated, and the implementation challenges are examined to propose multifaceted strategies for optimizing treatment outcomes. The development of HAS involves a vicious cycle of activity limitation, inflammation, malnutrition, and iatrogenic stress. Initiating interventions within 48 h may aid in preserving muscle function and improving the patients' quality of life. However, protocol variability, inadequate patient stratification, fragile transitional care systems, and other challenges persist. The proposed solutions include modular protocols, electronic medical record‐integrated adaptive algorithms, and strengthened team coordination. To prevent HAS progression and improve patient‐centered outcomes, timely, structured multidisciplinary interventions in the acute phase are imperative. Standardized evaluations, scalable protocols, and sustainable post‐discharge systems are key to advancing the clinical implementation of HAS management strategies.

In 2017, a large outbreak of Legionnaires' disease, involving 58 patients, occurred in a public bath facility in Hiroshima Prefecture, Japan. We analyzed 94 Legionella pneumophila strains isolated from patients and the public bath facility using molecular typing methods, including Pulsed-Field Gel Electrophoresis, sequence-based typing, multi-locus variable number tandem repeat analysis, and Whole-Genome Sequencing (WGS). Genotypes obtained using these molecular epidemiological typing methods were highly correlated with each other. L. pneumophila strains of various genotypes were isolated from the public bath facility, of which only ST2398 and ST2399 were isolated from patients. ST2398 and ST2399, isolated from patients, bath water, and swabs, derived from one common circulating system at the bath facility out of seven were found to be novel genotypes and a highly clonal genetic lineage by single nucleotide variant (SNV) analysis based on WGS. The result of haplotype network analysis based on SNVs showed that ST2398 and ST2399 differed only approximately 30-42 SNVs, and some environmental strains that differed by only 0-3 SNVs from patient strains were isolated. These results demonstrated that this outbreak was caused by L. pneumophila assigned to the ST2398 and ST2399 clades. We found that at least three patients were co-infected with different clusters of L. pneumophila serogroup 1. Our results show that several strains must be isolated from a single sample to consider the accumulation of mutations in water and co-infection when investigating outbreaks.

ObjectiveTo predict walking independence in patients with incomplete cervical cord injury (ICCI) using electromyography of the trunk and lower extremity during straight-leg raising (SLR).DesignProspective cohort study. Prediction model using logistic regression.SettingSingle acute-care hospital.ParticipantsForty patients equally split between walking dependent and walking independent groups (mean ages: 70.7±14.4 and 63.7±15.4 years; male-to-female ratios: 18:2 and 16:4; total length of stay: 31.2±20.9 and 25.7±16.5 days).InterventionsNot applicable.Main Outcome MeasuresTrunk and lower extremity acceleration and surface electromyography data measured during nondominant SLR and basic information were used to predict the level of walking independence at discharge or transfer from the acute-care hospital.ResultsThe results showed that the model with the lower extremity motor score (LEMS) and the root mean square (RMS) of the contralateral external oblique (EO) had the lowest Akaike information criterion of 22.24, and both were significant factors in predicting walking independence at discharge or transfer from the acute-care hospital (P=.019 and .034). The predictive accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve were 0.875, 0.850, 0.900, and 0.975 (95% confidence interval: 0.939-1.000), respectively.ConclusionsA higher LEMS and lower RMS of the contralateral EO during nondominant SLR are significant predictors of walking independence at discharge or transfer from an acute-care hospital in patients with ICCI.