Sado General Hospital

Background/Aim. Prevalence studies, also known as cross-sectional studies, offer an effective approach for gathering high-quality data on particular health concerns. The aim of the study was to analyze the utilization of antimicrobial medications (AM) in a tertiary healthcare institution. Methods. A prevalence study on AM use was performed at the University Clinical Center Kragujevac, Serbia, in early November 2022. This research was conducted as part of the Fifth National Research Initiative and employed the standardized methodology established by the European Center for Disease Prevention and Control (ECDC). Data was collected on all patients admitted to the ward before 8 a.m. Results. Among the 567 patients included in the study, 246 received at least one AM, yielding a prevalence rate of 43.4% (95% confidence interval: 39.3?47.6). The most common indications for AM use were community-acquired infections (54.9%), followed by healthcare-associated infections (19.1%), surgical prophylaxis (20.7%), and medical prophylaxis (3.7%). Parenteral administration was the most common route for AM administration (89.6%). In 97.6% of cases, the rationale for the drug application was documented in the patient?s medical records. Third-generation cephalosporins were the most frequently utilized antimicrobial group, comprising 17.9% of usage, followed by carbapenems at 12.7%, glycopeptides also at 12.7%, and fluoroquinolones at 11.8%. According to the Access-Watch-Reserve (AWaRe) classification, antibiotics under supervision were prescribed most frequently (66.4%), followed by first-choice antibiotics (28.1%), with reserve antibiotics comprising 5.5%. Conclusion. The implementation of measures to regulate the use of AM is required to retain the efficacy of these medications in the future.

Oral health is not an isolated aspect of well-being but an essential component of overall health. A growing body of evidence highlights the significant impact of oral diseases, particularly periodontal infections, on systemic conditions such as cardiovascular disease, diabetes, respiratory illnesses, and neurodegenerative disorders. The "oral-systemic link" underscores the need for a multidisciplinary approach in identifying, managing, and preventing diseases that originate in the oral cavity but influence the entire body. General dentists, laboratory technicians, nursing technicians, and phlebotomists each play a distinct yet interconnected role in tackling these oral-systemic disease mysteries. Dentists serve as the frontline professionals in diagnosing and treating conditions like periodontitis, which contribute to systemic inflammation. Laboratory technicians analyze microbial profiles, biochemical markers, and inflammatory mediators to provide diagnostic insights. Nursing technicians assist in patient education, treatment adherence, and post-procedural care, ensuring that patients receive proper oral hygiene guidance to reduce systemic risks. Phlebotomists contribute by collecting and processing blood samples that help track inflammatory markers and correlate oral infections with systemic diseases. This review highlights the collaborative effort among these professionals in advancing research, refining diagnostic methods, and improving patient outcomes. By understanding the complexities of oral-systemic interactions, healthcare providers can develop more comprehensive strategies to prevent and manage diseases that affect both the oral cavity and the entire body.

Abstract Background: Previous retrospective studies have shown that sarcopenia (Sar) is associated with poor outcome in cancer patients (pts) receiving immune checkpoint inhibitors (ICIs). We conducted a prospective study to determine whether Sar-related proteins induce Sar and reduce the efficacy of ICI. Method: Non-small cell lung cancer (NSCLC) pts receiving ICI as first-line treatment at Niigata University Medical and Dental Hospital were eligible. Sar was diagnosed with physical performance and skeletal muscle mass. Comprehensive protein analysis of pre-treatment blood samples was performed to identify factors that correlate with muscle loss and ICI effects. Result: 41 patients were enrolled from October 2019 through August 2022. PFS for Sar was 4.6 months, 6.7 months for Pre-Sar, and 16.7 months for Non-Sar (P=0.0028). OS for Sar was not reached, 15.7 months for Pre-Sar, and not reached for Non-Sar (P=0.0014). Leptin, IL-1β, IL-12, and Pentraxin 3 were significantly correlated with loss of muscle mass. In contrast, leptin, insulin, IGF-1, GDF-8, Activin A, IL-2Ra, IL-8, MMP-3, osteopontin, and Pentraxin-3 were significantly associated with poor OS. Pentraxin 3 and leptin were associated with both the effectiveness of immunotherapy and sarcopenia. A multivariate analysis that considered factors commonly associated with the effectiveness of immunotherapy, including age, PD-L1 expression rate, and neutrophil-lymphocyte ratio, Pentraxin 3 was determined to be an independent prognostic factor. Conclusion: This study indicated that Sar-related proteins and inflammatory cytokines are involved in the development of Sar and ICI efficacy. Citation Format: Takaaki Masuda, Satoshi Watanabe, Tomoya Wakabayashi, Susumu Tanaka, Kunihiro Shono, Ryo Suzuki, Tomoki Sekiya, Naohiro Yanagimura, Masashi Arita, Aya Ohtsubo, Tomohiro Tanaka, Koichiro Nozaki, Yu Saida, Satoshi Hokari, Rie Kondo, Kenjiro Shima, Yosuke Kimura, Nobumasa Aoki, Yasuyoshi Ohshima, Toshiyuki Koya, Kazuko Sakai, Kazuto Nishio, Motohiko Yamazaki, Hiroyuki Ishikawa, Toshiaki Kikuchi. Comprehensive protein analysis to identify the proteins responsible for sarcopenia and their impact on antitumor immunotherapy in non-small cell lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3848.

Abstract Annual seedfall was measured over a 24‐year period for three canopy species, Fraxinus platypoda, Pterocarya rhoifolia, and Cercidiphyllum japonicum, in a riparian forest in the Chichibu Mountains, central Japan. We collected seeds from 20 traps approximately every month, except in the winter. Fraxinus platypoda and P. rhoifolia seedfall fluctuated, with a 2‐year cycle. The seedfall of C. japonicum also fluctuated, but this species produced seeds every year, with an approximate 4‐year cycle. The simple moving average over 5 years for F. platypoda and P. rhoifolia was maintained at a constant level over the 24‐year period, but it gradually increased for C. japonicum. Each year's seedfall for the three species was influenced by the previous year's seedfall. The results for F. platypoda suggest that the fluctuations in the amount of seedfall were almost entirely dependent on fluctuations in stored resources, regardless of the previous year's weather. Conversely, the amount of seedfall for P. rhoifolia and C. japonicum was influenced by fluctuations in stored resources and the average temperature or precipitation in the summer of the year before flowering. These differences in seed production patterns were associated with differences in life history characteristics such as seed size and regeneration mechanisms.

Communities in socio-ecological production landscapes and seascapes are aging and depopulating. While longstanding interdependence of humans and nature in such areas holds crucial hints for sustainable development, they continue to be undervalued by existing economic frameworks. We suspect omission of non-material nature’s contributions to people (NCPs) as a possible reason for this undervaluation and focus on the intangible aspects of human–nature relationships: people’s direct and emotional attachment to their land and interrelationships between close-knit human communities and a thriving natural environment. Field observations on Sado Island, Japan, and literature reviews informed our hypothesis that perceived nature, conceptual human–nature relationships, place attachment, and social relationships contribute to subjective wellbeing. Structural equation modeling of island-wide questionnaire responses confirmed our hypothesis. Nature contributes to wellbeing by enhancing place attachment and social relationships; ecocentrism contributes to greater values of perceived nature. Free-response comments elucidated how local foods and close interpersonal relationships enhance residents’ happiness and good quality of life, as well as how aging and depopulation impact their sense of loneliness. These results lend empirical support to the understanding of human–nature interdependency in socio-ecological production landscapes and seascapes. In assessing their value to local residents and society at large, greater consideration should be given to intangible aspects of human–nature relationships and quality of life.

BackgroundA decrease in pediatric hospitalizations during the coronavirus disease 2019 (COVID‐19) pandemic has been reported worldwide; however, few studies examined areas with a limited number of COVID‐19 cases, where influenced by viral interference by severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) is minimum.MethodsWe conducted an epidemiological study of pediatric hospitalizations on Sado, an isolated island in Niigata, Japan, that was unique environment with few COVID‐19 cases and reliable pediatric admissions monitoring. We compared numbers of monthly hospitalizations and associated diagnoses for the periods April 2016 through March 2020 (pre‐pandemic period) and April 2020 through March 2021 (pandemic period).ResultsData were analyzed for 1,144 and 128 patients in the pre‐pandemic and pandemic periods, respectively. We observed only 3 adults and no pediatric COVID‐19 cases during the pandemic period. The number of monthly admissions was significantly lower in the pandemic period (median [interquartile ranges(IQR)]: 11.0 [7.0‐14.0]) than in the pre‐pandemic period (23.0 [20.8‐28.3]) (P < 0.001). Similar decreases were observed for hospitalizations due to respiratory tract infection (P < 0.01), but not for asthma exacerbation (P = 0.15), and gastrointestinal tract infection (P = 0.33).ConclusionsPediatric hospitalizations during the pandemic significantly decreased on an isolated Japanese island where COVID‐19 was not endemic and all pediatric admissions were ascertainable. This observation highlights the impact of decreased travel and increased awareness of infection control measures on pediatric hospitalizations due to infectious diseases, not by the SARS‐CoV‐2 viral interference.

Abstract Identification of acquired resistant mutation has been essential in non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) active mutations. Re-biopsy plays a pivotal role to select the optimal treatment for patients who develop resistance to initial EGFR-tyrosine kinase inhibitors (EGFR-TKIs). This multicenter, observational study was conducted to investigate the details of re-biopsy in Japanese clinical practice.The primary endpoints were the implementation rate of re-biopsy and the concordance rate for the T790M mutation detection between histology and cytology specimens using the Cobas ® EGFR mutation test v2. 194 patients with EGFR-mutant NSCLC were enrolled and 120 patients developed acquired resistance to EGFR-TKIs. The median age was 68 years (range 20-87), and 52.5% of the patients were women. Re-biopsy was performed on 109 patients with the implementation rate of re-biopsy was 90.8%. The success rate of re-biopsy in total/histology/cytology/liquid biopsy population was 78.0%, 94.9%, 83.3% and 43.8%, respectively. The positive percent agreement and the negative percent agreement in the detection of T790M mutations between the histology and cytology specimens was both of 90.9%. Aggressive obtaining histological or cytological tissue samples at re-biopsy may contribute to improvement of the detection rate of T790M mutation. (trial registration number: UMIN000026019)