Yamagata Prefectural Central Hospital

BackgroundInterprofessional education (IPE) is a key strategy for enhancing collaboration and patient safety. While evidence for student populations is abundant, studies focusing on licensed physical therapists (PTs), occupational therapists (OTs), and speech-language pathologists (SLPs) remain limited. In contemporary rehabilitation practice, continuous IPE is increasingly important to address professional burnout and the growing complexity of patient needs.ObjectiveThis scoping review aimed to systematically map and synthesize the educational formats, content domains, and reported outcomes of IPE programs specifically targeting licensed PTs, OTs, and SLPs.MethodsFollowing Joanna Briggs Institute and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we searched the PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and Educational Resources Information Center databases through December 31, 2025. The eligibility criteria were based on the population, concept, and context framework, including peer-reviewed, English-language studies of licensed PTs, OTs, and SLPs (population) participating in structured IPE interventions (concept) within clinical or community settings (context). Studies focusing solely on students or prelicensure trainees were excluded. Following the screening of 3234 records by independent pairs of reviewers, 9 studies were ultimately selected for inclusion. Methodological quality was appraised using Joanna Briggs Institute critical appraisal checklists and the Mixed Methods Appraisal Tool. Data were synthesized using an evidence gap map to visualize research density across domains relative to established competency frameworks.ResultsA total of 9 studies from Australia, the United States, Canada, and the Philippines were included, with sample sizes ranging from 8 to 197. Most used single-group pre-post or mixed methods designs; notably, no randomized controlled trials were identified. Methodological quality was generally high, though limited by the lack of control groups. Systematic mapping identified 7 educational formats, with lectures and discussions being the most dominant across all competency domains. Primary content domains included communication and role clarification. Specific successful interventions included pharmacist-led medication safety workshops and the Kawa model for team building. While participants reported immediate improvements in role understanding and collaborative confidence, simulation-based training showed inconsistent effects on long-term clinical behavior. A substantial evidence gap was identified in experiential learning approaches targeting collaborative leadership.ConclusionsThis scoping review adds a novel perspective by focusing exclusively on licensed rehabilitation professionals (PTs, OTs, and SLPs), highlighting learning needs distinct from those of prelicensure students. It brings to the field a clearer understanding of a potential “leadership gap” and the current overreliance on didactic methods for experienced clinicians. Real-world implications suggest the need for health care institutions to transition toward systematic, practice-integrated IPE models that incorporate objective behavioral assessments. By addressing identified gaps in collaborative leadership and team functioning through longitudinal programs, health care institutions may contribute to more resilient team cultures, ultimately improving patient safety and the quality of rehabilitation care.

Chronic background mucosal inflammation contributes to colorectal cancer (CRC) development in ulcerative colitis (UC), but its prognostic impact is unclear. We evaluated whether background mucosal inflammation documented at cancer diagnosis is associated with oncologic outcomes. This retrospective study analyzed 1189 UC patients diagnosed with CRC using a nationwide, multicenter database in Japan. Patients were classified as CRC within the UC-involved area (within-area) or outside the UC-involved area (outside-area), based on tumor location relative to the UC disease extent documented endoscopically at cancer diagnosis. The primary end point was 5-year recurrence-free survival (RFS), and the secondary end point was 5-year cancer-specific survival (CSS). In within-area cases, inflammation severity was assessed using the Mayo Endoscopic Score (MES), stratified as Inactive, Mild-Moderate, and Severe. Of the 723 eligible patients, 683 had within-area and 40 outside-area CRC. Five-year RFS was significantly lower in within-area than outside-area CRCs (75.1% vs 87.6%, P = 0.022). Multivariable Cox regression analysis of RFS revealed this classification as an independent prognostic factor (hazard ratio = 2.99, 95% confidence interval: 1.09-8.18, P = 0.030). A significant difference was also observed in 5-year CSS (P = 0.038). Among within-area cases, higher MES was associated with stepwise declines in RFS (P = 0.150), and a similar, statistically significant gradient in CSS (P = 0.048). Background mucosal inflammation at cancer diagnosis is associated with significantly worse prognosis of CRC in UC patients. Systematic endoscopic assessment at cancer diagnosis may aid prognostic stratification and inform management.

Evidence on structural valve deterioration (SVD) after aortic valve neocuspidization (AVNeo) remains limited. While transcatheter aortic valve replacement (TAVR) offers a less invasive option, its feasibility is unclear. This study aimed to characterize SVD patients post-AVNeo and to assess TAVR feasibility. This retrospective study included 11 patients who underwent TAVR for SVD after AVNeo in Sendai Kousei Hospital between June 2017 and August 2024. Four patients with aortic stenosis (AS) and seven with aortic regurgitation (AR) due to SVD were included. AS-SVD group showed shorter time interval from AVNeo to TAVR (50.5 [28.3-98.3] vs. 107.0 [97.0-131.0] months, p = 0.04) and smaller aortic annulus area (316.5 [259.8-375.0] vs. 538.0 [440.0-582.0] mm2, p = 0.005) than AR-SVD group. In TAVR, technical success was achieved in 91% of cases. Although coronary obstruction is a concern due to the long leaflet, no case occurred. Misidentification of the basal ring plane caused by the slack cusp resulted in second valve implantation (one case) and new conduction disturbance (two cases) due to deep implantation, and aortic contained rupture (one case) for oversized valve selection. Rapid AS-SVD progression and AR-SVD occurring later than previously reported were observed, highlighting the need for further studies on AVNeo durability. TAVR after AVNeo was feasible. Special precautions for coronary obstruction may be unnecessary. Careful hinge point placement at the boundary between pericardial cusps and the annulus was a key to CT-based basal ring determination in patients after AVNeo.

Background: Active nasal surveillance culture (ANSC) is recognized to enable rapid detection of antibiotic-resistant bacteria in the intensive care unit (ICU), which can contribute to the prevention of Ventilator-associated pneumonia (VAP). This study aims to evaluate the usefulness of ANSC in assessing the development of VAP in ICU patients. Methods: Patients admitted to the Yamagata Prefectural Central Hospital ICU from January 2017 to 2018 (Term 1) or January 2020 to December 2021 (Term 2) and underwent invasive mechanical ventilation supports were eligible for this study. Nasal swab samples were collected from the patients upon their admission to the ICU. The diagnosis of VAP was made according to the criteria set by the Centers for Disease Control and Prevention. Results: A total of 467 patients (156 women) in term 1, and 312 patients (113 women) in term 2 were enrolled. The incidence of VAP in term 2 was higher than in term 1 (7.1% vs. 12.8%, respectively). ANSC isolated several causative pathogens from the patients on admission who later developed VAP. Haemophilus influenza, Streptococcus pneumoniae, Stenotrophomonas maltophilia, and Pseudomonas aeruginosa had a 100% match rate with the sputum culture, indicating a perfect relation between ANSC results and sputum culture in VAP (+) cases. Conclusions: The isolation of high-risk bacterial species by ANSC could foresee the development of VAP in ICU patients and efficiently prevent VAP in critically ill patients.

AimsThere is a lack of compelling evidence supporting the benefit of surgical resection for para‐aortic lymph node metastasis (PALNM) from colorectal cancer (CRC). We aimed to investigate the true impact of surgical resection on survival for patients with PALNM from CRC.Patients and MethodsPatients diagnosed with PALNM from CRC at the Japanese Society for Cancer of the Colon and Rectum institutions between January 2011 and December 2015 were analyzed. Those who had received surgical resection and those who did not were matched one‐on‐one by the propensity score (PS)‐matching method. A total of 77 PS‐matched pairs extracted from 347 patients at 36 institutions were compared.ResultsThirty‐one (40.3%) patients each in the surgical resection and chemotherapy groups had distant metastasis other than PALNM, and the most dominant organ was the liver in 18 (23.4%) patients in both groups. In the surgical resection group, 56 (72.7%) patients achieved curative resection of all disease lesions, of which 49 (63.6%) were R0 resection. Three‐ and 5‐year relapse‐free survival of patients who achieved curative resection were 24.4% and 24.4%, respectively. Three‐ and 5‐year overall survival (OS) of patients in the surgical resection were 68.4% and 40.2%, which were significantly better than that in the chemotherapy groups (40.9% and 27.7%), respectively (Log‐rank p = 0.003).ConclusionThe OS of patients with surgical resection for PALNM was significantly better than those without surgical resection. These results highlight the benefit of surgical intervention to survival for patients with resectable PALNM.

BackgroundPseudomonas aeruginosa infections in the lungs affect millions of children and adults worldwide. To our knowledge, no clinically validated prognostic biomarkers for chronic pulmonary P. aeruginosa infections exist. Therefore, this study aims to identify potential prognostic markers for chronic P. aeruginosa biofilm lung infections.MethodsHere, we screened the expression of 11 P. aeruginosa regulatory genes (tesG, algD, lasR, lasA, lasB, pelB, phzF, rhlA, rsmY, rsmZ, and sagS) to identify associations between clinical status and chronic biofilm infection.ResultsRNA was extracted from 210 sputum samples from patients (n = 70) with chronic P. aeruginosa lung infections (mean age; 29.3–56.2 years; 33 female). Strong biofilm formation was correlated with prolonged hospital stays (212.2 days vs. 44.4 days) and increased mortality (46.2% (18)). Strong biofilm formation is associated with increased tesG expression (P = 0.001), influencing extended intensive care unit (P = 0.002) or hospitalisation stays (P = 0.001), pneumonia risk (P = 0.006), and mortality (P = 0.001). Notably, tesG expression is linked to the modulation of systemic and sputum inflammatory responses and predicts biofilm biomass.ConclusionsThis study provides the first clinical dataset of tesG expression levels as a predictive biomarker for chronic P. aeruginosa pulmonary infections.