Kyorin University

To evaluate temporal trends in clinical outcomes among nontraumatic out-of-hospital cardiac arrest (OHCA) patients transported to critical care medical centers (CCMCs) in Japan. Retrospective cohort study. Nationwide multicenter registry involving CCMCs in Japan, which are government-designated advanced emergency care institutions specializing in intensive resuscitation and post-cardiac arrest management. Data were obtained from the Japanese Association for Acute Medicine OHCA (JAAM-OHCA) registry from June 1, 2014, to December 31, 2022. Adult patients (≥ 18 yr old) with nontraumatic OHCA who were transported to CCMCs and had Utstein-style prehospital data available. Patients were categorized into three calendar periods (2014-2016, 2017-2019, and 2020-2022) for temporal comparison. None. Among 61,725 eligible patients, the proportion with favorable neurologic outcomes decreased from 3.6% (2014-2016) to 3.3% (2017-2019) and further to 2.5% (2020-2022). Using multivariable logistic regression, the adjusted odds ratios (aORs) for favorable neurologic outcome were 1.01 (95% CI, 0.89-1.15) in 2017-2019 and 0.83 (95% CI, 0.72-0.94) in 2020-2022, compared with 2014-2016. Similarly, 30-day survival declined during the same period, from 6.9% to 6.8% and 5.4%. In most predefined subgroups, similar trends were observed. In contrast, neurologic outcomes improved among candidates for extracorporeal cardiopulmonary resuscitation (ECPR), with an aOR of 1.43 (95% CI, 1.06-1.93) in 2020-2022 compared with 2014-2016. Outcomes among OHCA patients transported to CCMCs remained stable until 2019 but declined during the COVID-19 pandemic period. However, improved outcomes among patients eligible for ECPR suggest that timely and targeted post-arrest interventions may improve outcomes in selected populations.

Bronchopulmonary dysplasia (BPD) is the most common complication of prematurity, characterised by impaired alveolarisation and pulmonary vascular development. BPD has been associated with an increased risk of respiratory morbidity, neurodevelopmental impairment and death, intensifying a lifelong health and economic burden. The current standard of neonatal care is primarily supportive, with no approved therapies to restore lung development, promote maturation and lung growth or prevent long-term sequelae. Therefore, there is a critical unmet need for novel interventions, particularly in high-risk, extremely premature (EP) infants. In EP infants, serum insulin-like growth factor-1 (IGF-1) levels decrease rapidly and remain low for the first weeks after birth relative to the corresponding foetal levels in utero. OHB-607, a recombinant human IGF-1 combined with its binding protein-3, may replenish IGF-1 during this period of deficiency and support lung and vascular maturation. OHB-607 is being investigated as a first-line therapy to prevent severe BPD in EP infants in a Phase 2b, multicentre, open-label, randomised trial. Here, we present the Phase 2b study protocol. Target enrolment is 338 EP infants. To mimic physiological IGF-1 levels in utero, OHB-607 will be administered starting within 24 hours of birth until 29+6 weeks postmenstrual age (PMA) via continuous intravenous infusion. The primary endpoint is the incidence of severe BPD, based on the modified National Institute of Child Health and Human Development criteria, or death by 36 weeks PMA. Key secondary endpoints include weaning from respiratory support at 12 months corrected age and BPD severity (Grade 2/3) by the 2019 Neonatal Research Network definition. Other secondary endpoints include other complications of prematurity, neurodevelopmental outcomes and family and infant well-being and social functioning through 24 months' corrected age, and pharmacokinetic and dynamic impact of OHB-607 on the multisystem consequences of prematurity, and overall safety in modifying the natural history of BPD and its consequences. Findings will be disseminated via local and international congresses and publications. ClinicalTrials.gov (NCT03253263), Clinicaltrialsregister.eu (EudraCT: 2018-001393-16), Euclinicaltrials.eu (EUCT: 2024-515914-41-00) and Pmda.go.jp (PMDA: jRCT2031240339).

Circulating microRNA (miR)-1246, a fragment of U2 small nuclear RNA, represents a promising biomarker for certain cancers, including lung adenocarcinoma. The gene that encodes miR-1246, RNU2-1, is located on human chromosome 17q21.31 and is organized as a tandem array that exhibits copy number variations (CNVs). The range of copy numbers has been reported to be quite wide, ranging from 5 to 82 per haploid genome. The present study analyzed the correlation between RNU2-1 copy numbers and serum miR-1246 levels in healthy controls and patients with stage IV lung adenocarcinoma. Serum miR-1246 levels were quantified using reverse transcription-quantitative polymerase chain reaction (PCR), and RNU2-1 copy numbers per diploid genome were measured via digital PCR using blood-derived DNA. The median copy numbers were 50 and 49 in the control and lung adenocarcinoma groups, respectively, with no significant difference observed between the groups. In addition, no correlation between RNU2-1 copy number and serum miR-1246 level was identified in either group. These results suggest that CNVs of RNU2-1 do not affect serum levels of the lung adenocarcinoma biomarker miR-1246.

BackgroundSelf-management is essential for coping with depressive symptoms, yet little is known about its associations with depressive symptoms and personal recovery.MethodsWe conducted a cross-sectional questionnaire survey of 183 outpatients with major depressive disorder in Japan between October 2024 and June 2025. Participants reported the use and perceived usefulness of 63 self-management strategies. Associations between the number of strategies and symptom severity and recovery were examined using Spearman’s rank correlation coefficients with the Japanese versions of the Quick Inventory of Depressive Symptomatology (QIDS-J) and the Questionnaire about the Process of Recovery (QPR-J).ResultsOf the 183 respondents (mean age 43.6 ± 12.4 years; 54.1% female), the mean QIDS-J score was 9.55 ± 5.25 and 60.7% were in remission. Fourteen of the 63 strategies were used by at least half of the participants. The most frequently used strategies were “ensure enough rest to avoid exhaustion through overexertion” (88.0%), “engage in leisure activities (e.g. reading, watching TV, cooking, traveling, and driving)” (78.9%), and “eat a healthy diet” (65.0%). The strategies rated most useful included “discuss information about depression with a therapist” (86.7%), “meet with friends with whom I can be myself” (83.5%), and “avoid or minimize contact with people who tend to make me stressed or depressed” (83.3%). Participants reported using an average of 20.8 ± 13.5 strategies, of which 13.1 ± 9.16 were rated as useful. The number of strategies rated as useful was weakly negatively correlated with the QIDS-J scores (Spearman’s ρ = −0.207, p = 0.006) and moderately positively correlated with the QPR-J scores (Spearman’s ρ = 0.472, p < 0.001).ConclusionThe number of self-management strategies rated as useful showed a stronger correlation with personal recovery than with depressive symptom severity. The use of a greater number of self-management strategies may be associated with higher levels of personal recovery.

Abstract Background: Surgical decision-making in breast cancer involves not only clinical and oncological considerations but also psychosocial factors such as personal values, social support, and anticipated quality of life. Although shared decision-making (SDM) is increasingly emphasized, factors influencing patients’ surgical choices remain unclear. This study aimed to identify determinants associated with the selection of total mastectomy (MT), breast-conserving surgery (BCS), or immediate breast reconstruction (IBR) using patient-reported outcomes. Patients and Methods: A multicenter study was conducted across six institutions in Japan. We included 577 female patients who underwent breast cancer surgery between 2008 and 2018. Using patient-reported outcomes, we collected data on sociodemographic background and 15 decision-influencing factors, including opinions of healthcare providers, family, and peers; radiation therapy; fear of recurrence; hospitalization; and perceived impacts on childcare, work, and hobbies. Patients were categorized into MT, BCS, or IBR groups. Chi-square tests were used for group comparisons, and multinomial logistic regression was performed using the IBR group as the reference. Results: Among 577 patients, 194 underwent MT, 185 BCS, and 198 IBR. The mean age was 53.6 years (±11.5), with the IBR group significantly younger (48.2) than MT (58.1) and BCS (54.8) (p&amp;lt;0.001). The mean interval from surgery to questionnaire response was 56.0 months. IBR patients were more likely to have avoided chemotherapy (p&amp;lt;0.001), be non-smokers (p&amp;lt;0.001), have smaller tumors (p&amp;lt;0.001), no nodal metastasis (p=0.003), and be full-time employed (p&amp;lt;0.001). The incidence of postoperative complications (grade ≥3) was highest in the IBR group (p&amp;lt;0.001). The most reported influence was the surgeon’s opinion (92.2%), followed by fear of recurrence (43.8%), partner’s opinion (35.5%), family (22.4%), and breast cancer survivors (21.0%). Patients influenced by nurses were more likely to select IBR (MT: 3.1%, BCS: 4.5%, IBR: 10.8%; p=0.004). Other significant differences included partner’s opinion (p=0.012), hospitalization (p=0.022), radiation therapy (p&amp;lt;0.001), recurrence fear (p=0.002), and concerns about hobbies (p=0.004) and work (p=0.025). Univariable analysis showed that IBR was more likely in patients who were younger (p&amp;lt;0.001), had smaller tumors (p&amp;lt;0.001), no nodal metastasis (p=0.036), no chemotherapy (p=0.007), were non-smokers (p=0.001), employed full-time (p&amp;lt;0.001), and had higher income (p=0.004). IBR was also associated with influence from nurses (p=0.005), partners (p=0.005), hospitalization (p=0.009), hobbies (p=0.017), and work concerns (p=0.011). Recurrence fear was associated with higher IBR selection over BCS (p=0.017). In multivariable analysis, independent predictors of selecting IBR over both MT and BCS included younger age (p&amp;lt;0.001), non-smoking status (p=0.012), being influenced by nurses’ opinions (p=0.022), and absence of fear of cancer recurrence (p=0.042). Conclusions: This study is the first large-scale, multicenter collaborative study to identify factors influencing surgical decision-making in Japanese breast cancer patients. Predictors influencing the choice of IBR compared with MT and BCS were age, smoking status, nurses' opinions, and anxiety about recurrence. The results of this study suggest the importance of multidisciplinary collaboration and surgical decision-making support that considers the individual background of patients. Citation Format: H. Seki, T. Komiya, M. Kato, Y. Sowa, J. Takano, Y. Nishida, N. Tamura, M. Saiga. Factors influencing surgical decision-making in breast cancer using patient-reported outcomes- A multicenter collaborative study- [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS2-01-28.

Methotrexate (MTX) has been widely used for patients with autoimmune diseases as a corticosteroid-sparing agent. We here report an 86-year-old Japanese woman treated with MTX for rheumatoid arthritis who presented with panuveitis along with a yellowish retinal mass. Both Epstein-Barr virus (EBV) and cytomegalovirus (CMV) were detected in aqueous humor and vitreous fluid by quantitative polymerase chain reaction. The retinal mass gradually regressed over eight months after MTX withdrawal. The present case indicates that intraocular MTX-lymphoproliferative disorder (MTX-LPD) should be considered in the differential diagnosis of patients presenting with uveitis who are undertaking long-term MTX therapy. Multiplex PCR along with quantitative PCR for intraocular fluids may be helpful for understanding the pathogenesis of intraocular MTX-LPD.