Yakult Honsha (Japan)

Prehabilitation is known to improve outcomes of gastrointestinal surgery; however, the issue of low adherence during the waiting period for surgery remains unresolved. This study evaluated the effectiveness and feasibility of a newly developed mobile health application, "Preha," designed to support home-based prehabilitation. A single-group pilot study involving patients scheduled for major hepatobiliary-pancreatic (HBP) surgery for malignancy between March 2023 and September 2024 was conducted. The patients downloaded the Preha application, and there was no direct intervention from the medical staff during the preoperative period. The application recorded step counts, moderate-intensity exercise times, and squat counts. Adherence was defined as meeting at least one of the following: ≥ 5,000 steps/day, ≥ 10min/day of ≥ 3 METS activities, or ≥ 30 squats/day, for more than three days per week. Among 30 eligible patients, 21 (median age, 67years) were included in the analysis. During prehabilitation, 52% achieved the step goal, 67% met the exercise time target, and 33% completed the squat goal. The "Preha" application facilitated good adherence to home-based prehabilitation without direct intervention, indicating its feasibility and potential as a perioperative support tool for patients undergoing HBP surgery. Trial registration https://jrct.niph.go.jp/ ; registration number: jRCTs042220106.

Occult bacteremia (OB), defined as blood stream micro-organisms confirmed by reverse transcriptase-quantitative polymerase chain reaction that target 16S or 23S ribosomal RNA, has been shown to increase the incidence of post-operative infections during pancreaticoduodenectomy. However, its impact on other surgical procedures remains unclear. This study aimed to evaluate the effect of pre-operative OB on post-operative surgical site infection (SSI) during esophageal cancer surgery. In this prospective observational study, 56 patients scheduled for esophagectomy were included. Pre-operative blood samples were tested for OB, and fecal samples were analyzed for microbiota. Ten patients (18%) exhibited pre-operative OB. These patients had more frequent SSIs than did those without OB (40% vs. 10.9%, p = 0.044). Other complications or clinical factors did not substantially differ between the OB-positive and OB-negative groups. Fecal samples from OB-positive patients presented a greater prevalence of Atopobium clusters. In addition, the same bacterial species were detected in both the blood and feces of five OB-positive patients, with Collinsella aerofaciens being the most commonly shared species among Atopobium clusters. Pre-operative OB increased the risk of SSI following esophagectomy. These findings emphasize the potential role of the gut microbiota, particularly Collinsella aerofaciens, in OB and subsequent infections.

Lacticaseibacillus paracasei strain Shirota (LcS) has shown benefits for stool consistency in populations with certain bowel complaints (e.g., constipation), but data in a United States population are limited. This study evaluated the effects of LcS on hard or lumpy stools (HLS) in an otherwise healthy population that generally represents the United States adult demographic. In this randomized, controlled, open-label study, 50 participants (41 females, 9 males) with HLS in ≥25% of bowel movements (BMs) during a 14-d run-in period were randomly assigned to receive either 80 mL fermented milk containing 8.0 × 109 colony forming units LcS/mL for 28 d (active group) or no intervention (control group) followed by a 14-d postintervention period. Bowel habits were recorded daily using a novel smartphone application. The primary endpoint was the presence of HLS in ≥25% of the participant-rated BMs using the Bristol Stool Form Scale over the 28-d intervention. Secondary endpoints included the presence of reduced frequency of BMs with HLS from baseline, stool frequency, straining, incomplete evacuation, artificial intelligence-derived stool image scores, and Patient Assessment of Constipation Quality of Life (PAC-QOL) scores. The active group showed a significantly lower proportion of participants with HLS in ≥25% of BMs [odds ratio: 0.34; 95% confidence interval (CI): 0.14, 0.80; P = 0.014] along with a higher proportion of participants with a reduced frequency of BMs with HLS from baseline (odds ratio: 2.86; 95% CI: 1.03, 7.92; P = 0.043). The active group also demonstrated positive improvements in total PAC-QOL scores (P = 0.003). Daily consumption of LcS-containing fermented milk significantly reduced constipation symptoms and improved quality of life in an otherwise generally healthy United States adult population with a history of intermittent BMs producing HLS. The intervention was well tolerated, with no serious adverse events related to the product, suggesting its safety and potential as a dietary strategy for managing constipation. This trial was registered at clinicaltrials.gov as NCT06014008 (https://clinicaltrials.gov/study/NCT06014008).

Older individuals with care needs and lower body mass indices (BMIs) are more likely tobe malnourished. Unintentional weight loss, an indicator of malnutrition, significantlyimpacts the physical function and poor prognosis of older adults. This study aimed toexplore the effects of long-term consumption of Lacticaseibacillusparacasei strain Shirota-fermented milk (LcFM) on body weight in the oldest oldamong nursing-home residents. In total, 118 participants in 21 nursing homes wererecruited. Owing to its preliminary nature, randomization and blinding were not conducted,and subjects in the intervention (consuming LcFM daily for 12 months) and non-interventiongroups were recruited separately from different nursing homes. Changes in body weight andthe proportion of participants with ≥5% body-weight loss were assessed at 6 and 12 months.As intergroup discrepancies in care-needs levels were observed at baseline, a subgroupanalysis by these levels was conducted to align baseline characteristics. In the mildcare-needs level subgroup (long-term care level ≤2), the LcFM group had a significantlylower proportion of participants with ≥5% weight loss than the control group.Additionally, a subgroup analysis by BMI demonstrated that an effect of LcFM on bodyweight decline was observed only in the subgroup with a BMI <22 kg/m2, whichindicates malnutrition risk in older adults. In conclusion, long-term consumption of LcFMmight reduce unintentional weight loss in the institutionalized oldest-old individuals whohave a risk of malnutrition and have a mild care-needs level. To confirm these preliminaryresults, further well-designed randomized trials will be required (UMIN000036684).

The Yakult Lady system, established in Japan in 1963, is a unique model that delivers Yakult beverages to households, significantly contributing to public health and women's employment.However, declining numbers of Yakult Ladies necessitate an examination of factors influencing sustainable workstyles within this system.These demographic changes underscore the urgent need for sustainable work practices to boost productivity and maintain social stability in Japan nationwide.Data were collected from 2,070 participants, including Yakult Ladies, Center Managers, and other staff, from three companies in the Yakult Group located in Yamaguchi, Fukuoka, and the Kinki-Chuo regions.The study employed the 143-item "Sustainable Work-styles for Individuals and Team Challenges (SWITCH)" questionnaire, with responses recorded on a 5-point Likert scale.Statistical analyses, including Kruskal-Wallis tests, covariance analyses, and covariance structure analysis using IBM SPSS version 28, were performed to assess occupational differences, years of service characteristics, and sales performance.Occupational analysis revealed that the proactive work attitude of Yakult Ladies significantly influenced the motivation of Center Managers, reducing their fatigue and improving work adjustment.Analysis by years of service indicated that longer tenure was associated with enhanced numerical ability, which appeared to alleviate daily work stress.Furthermore, centers with higher sales per Yakult Lady exhibited a motivational profile marked by lower stubbornness and higher levels of effort, achievement, and social evaluation.This study, the first investigation into sustainable workstyles within the Yakult Lady system, reveals that fostering sustainable employment and mitigating turnover amid Japan's demographic shifts requires new strategies and organizational structures to support long-term work.

近年来,对益生元和益生菌作用机制的科学认识有了很大的发展。虽然保健功效往往来自菌株及其产品的特异性,但一些益生元和益生 菌的保健作用可能是由它们的互作机制驱动的,并且可能是可遗传的。在多学科研究环境中使用新兴的生理学和分析工具将有助于进一步 阐明其作用机制。通过这种方式,将有可能提高对人们对益生元、益生菌和合生元保健作用的理解。本简版专论的编写基于最新的科学证据,是一本有价值的参考书, 旨在向广大读者介绍肠道微生物群以及益生元和益生菌的健康概念。

This prospective study aimed to investigate the dynamic changes in the gut microbiota (GM) and associated intestinal environment, which were assessed by measuring fecal organic acid (OA) concentrations, during the early period after liver transplantation (LT). To understand the fundamental characteristics of the human GM, data obtained from living donors were also analyzed. Fixed-point observation was performed in 23 recipients and 21 donors for up to 2 weeks after LT. The GM and OA concentrations were investigated using ribosomal RNA-targeted reverse-transcription quantitative polymerase chain reaction and high-performance liquid chromatography, respectively. Before LT, the recipients exhibited remarkable dysbiosis and OA depletion, which were proportional to the model for end-stage liver disease score. Correlations between the abundances of some specific strains and OA concentrations were observed. After LT, while donor lobectomy caused only slight, transient and reversible changes in the GM and OA concentrations, recipients exhibited delayed recovery in these factors. However, no clear evidence of causality was observed between the GM or OA concentrations and LT outcomes. The GM and intestinal environment in LT recipients exhibited characteristics that were clearly different from those in donors. LT did not normalize but rather disrupted the GM during the early post-LT period, but its negative clinical impact could be minimized with perioperative management.

Mononuclear phagocytic cells (MPCs) are classified into monocytes (Mos)/macrophages anddendritic cells (DCs) based on their functions. Cells of MPCs lineage act as immunemodulators by affecting effector cells, such as NK cells, T cells, and B cells. This studyaimed to investigate the effects of Lacticaseibacillus paracasei strainShirota (LcS) ingestion on peripheral MPCs, particularly on their expression of functionalcell-surface molecules enhanced in healthy adults. Thus, twelve healthy office workersconsumed a fermented milk drink containing 1.0 × 1011 cfu of LcS (LcS-FM) or acontrol unfermented milk drink (CM) once a day for 6 weeks. Peripheral blood mononuclearcells (PBMCs) were prepared from blood samples, and immune cells and functionalcell-surface molecules were analyzed. We observed remarkable differences in the expressionof HLAABC, MICA, CD40, and GPR43 in plasmacytoid DCs (pDCs) between the LcS-FM and CMgroups, whereas no difference was found in CD86 or HLADR expression. The LcS-FM groupexhibited higher CD40 expression in both conventional DCs (cDCs) and Mos, especially intype 2 conventional DCs (cDC2s) and classical monocytes (cMos); higher percentages ofcMos, intermediate monocytes (iMos), and nonclassical monocytes; and higher numbers ofcMos and iMos in PBMCs than the CM group. LcS ingestion increased the expression ofHLAABC, MICA, CD40, and GPR43 in pDCs and CD40 in cDCs and Mos, particularly cDC2s andcMos. These results suggest that LcS modulates the function of MPCs that may lead to theregulation of immune effector functions in healthy adults.

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We investigated early tumor shrinkage (ETS) and depth of response (DpR) using data from the G-SOX study comparing S-1 plus oxaliplatin with S-1 plus cisplatin as the first-line treatment for advanced gastric cancer (AGC). ETS was determined as % decrease in the sum of the longest diameters of the target lesions at the first evaluation of week 6 compared to baseline. DpR was the maximum % shrinkage during the study treatment. The impact of ETS (cutoff value 20%) and DpR (continuous value) on progression-free survival (PFS) and overall survival (OS) were assessed by the log-rank test and Cox regression analysis including prognostic factors obtained in the G-SOX study; ECOG performance status, baseline sum of tumor diameters, disease status (recurrent/unresectable), and histology (diffuse/intestinal). Among 685 patients enrolled in the G-SOX study, 632 patients who had the first tumor evaluation were analyzed. Patients with ETS ≥ 20% had longer PFS (median 4.5 vs. 2.8 months, p < 0.0001) and OS (median 14.8 vs. 10.5 months, p < 0.0001) than those with ETS < 20%. Adjusted hazard ratios of ETS < 20 vs. ≥ 20% were 0.606 (95% confidence interval (CI) 0.506-0.725) for PFS and 0.589 (95% CI 0.492-0.704) for OS. DpR was also significantly associated with PFS and OS (both p < 0.0001). These results were similar between the SOX and CS groups. In AGC patients receiving the first-line therapy, ETS and DpR might be predictors for PFS and OS.