Hot spring and sauna use for improving blood lipid profiles: A systematic review and expert consensus on efficacy and recommendations.

Objectives: Dyslipidemia is a significant risk factor for cardiovascular disease. Traditional treatments often focus on pharmacological interventions; however, alternative therapies, such as hot spring and sauna use, have recently gained attention because of their potentially beneficial effects on lipid profiles and cardiovascular health.

Design And Setting: This systematic review aimed to synthesize current evidence on the efficacy of hot spring and sauna use, alone or combined with exercise therapy, in improving blood lipid profiles, with a focus on mechanisms, benefits, and limitations.

Age and Health Status Benefits Following Initiation of Atrial Fibrillation-Specific Treatments.

Background: Atrial fibrillation (AF) is managed with various strategies, including rate and rhythm control, to improve patients' health status. Although its incidence increases with age, how age affects health status improvements following AF treatment remains unknown.

Methods: Using data from a multicenter registry for outpatients with newly recognized AF, baseline and 1-year health status was assessed with the Atrial Fibrillation Effect on Quality-of-life quesTionnaire (AFEQT).

To fuse or not to fuse: surgical strategies for recurrent lumbar disc herniation from a 16-nation study.

Objective: Variations exist among surgeons in the treatment of recurrent lumbar disc herniation (LDH), generating major issues in decision-making models. The authors aimed to identify international nuances in surgical treatment patterns, highlight the differences in responses in each country group and different treatment trends across countries, and identify factors that influence surgical decisions.

Methods: An online survey with preformulated answers was submitted to 292 orthopedic surgeons and 223 neurosurgeons from 16 countries regarding 3 clinical vignettes (recurrence without low back pain, recurrence with severe low back pain, and recurrence with 2-level disc disease).

Practical Use of Mixed Reality for Transfacial Pinning in Monobloc Advancement for Syndromic Craniosynostosis.

Mixed reality (MR) enables real-time overlay of virtual anatomic structures in the surgical field and has potential applications in craniofacial surgeries. Although early monobloc advancements have benefited from transfacial pinning, the technique remains challenging owing to the limited safe insertion area and orbital injury risk. The authors processed DICOM-format computed tomography images for bone segmentation and added a rod representing the optimal pin insertion trajectory.

Loss-Prone HLA Class I Alleles Inform Outcomes of Early Hematopoietic Cell Transplantation in Acquired Aplastic Anemia.

HLA class I allele loss in acquired aplastic anemia (AA) represents an immune escape from the T cell-mediated pathogenesis. We investigated the impact of loss-prone HLA alleles on the hematopoietic cell transplantation (HCT) outcomes using registry data of 875 Japanese patients with acquired AA. HLA associations were evident exclusively among 399 patients who received HCT within 1 year of the diagnosis, consistent with the predominance of HLA loss in this group.

Efficacy and Safety of Voretigene Neparvovec in -Retinopathy: Results of a Phase III Trial in Japan.

Purpose: We report the efficacy and safety of voretigene neparvovec (VN) as an adeno-associated viral vector-based gene therapy for Japanese patients with inherited retinal dystrophy caused by biallelic pathogenic variants (-retinopathy).

Design: Open-label, single arm, phase III clinical trial.

Participants: Four subjects were recruited based on the following criteria: (1) a clinical and molecular genetic diagnosis of -retinopathy; (2) age ≥4 years; (3) a best-corrected VA (BCVA) worse than 20/60 or a visual field (VF) <20° by a III4e isopter or equivalent; and (4) sufficient viable retinal cells by OCT or ophthalmoscopy.

Vitreous Hemorrhage Following Blunt Ocular Trauma by a Cat's Forepaw: A Case Report and Literature Review.

Traumatic vitreous hemorrhage is most commonly associated with sports injuries or accidental falls. We report an exceptionally rare case of vitreous hemorrhage presumed to result from blunt trauma inflicted by the forepaw of a domestic cat. A 50-year-old man presented with blurred vision and ocular pain in his right eye after being struck by his pet cat.

Predictors of poor outcomes after posterior decompression surgery in patients with degenerative cervical myelopathy.

Study Design: Retrospective multicenter study.

Objectives: To identify predictors associated with failure of neurological improvement after posterior decompression surgery for degenerative cervical myelopathy (DCM).

Setting: 17 institutions in Japan.

Sodium Polystyrene Sulfonate and Heart Failure Risk: A Comparative Study With Calcium Polystyrene Sulfonate.

Aim: Sodium polystyrene sulfonate (SPS) is one of the classic potassium-binding agents that remains commonly used in the treatment of hyperkalaemia. However, the potential concern about its sodium load has not been fully investigated. In this study, we evaluated the association between SPS initiation and heart failure (HF), compared with calcium polystyrene sulfonate (CPS).

Pareidolic Illusions and Associated Lower Regional Gray Matter Volumes in Community-Dwelling Older Adults Without Dementia: The Arakawa 65+ Study.

Objectives: Pareidolic illusions involve perceiving meaningful objects in ambiguous or visually complex stimuli. Although seen in dementia, their presence and associated neuroanatomical basis in older adults without dementia remain unclear. Investigating these illusions in this population may reveal early neurodegenerative changes preceding overt dementia.

B cell depletion as a therapeutic strategy for neuromyelitis optica spectrum disorder: rationale, evidence, and challenges.

Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune disorder of the central nervous system that predominantly affects the spinal cord and optic nerves. Aquaporin-4 antibodies have been identified as a distinguishing biomarker of NMOSD, allowing for differentiation from multiple sclerosis and other mimicking neurological conditions. Targeted monoclonal antibody treatments are evolving based on an improved understanding of the pathophysiology underlying NMOSD.

The tale of donanemab: God is in the details.

Alzheimer's disease is a major cause of dementia, that affects approximately 7-8% of people aged 65 years and older (according to WHO & Alzheimer's Disease International) and thus is a major concern in public health world-wide. This review chronicles the foundational research and translational trajectory leading to the development of donanemab, a monoclonal antibody targeting pyroglutamyl amyloid-β (Aβ3pE-X) peptides, recently approved for the treatment of early Alzheimer's disease (AD). We trace a 30-year arc from the biochemical identification of Aβ species to the recognition of Aβ3pE-42 as a predominant pathological isoform in AD and Down syndrome brains-a fact still underrecognized among clinicians and researchers.

Prospective Comparison of Posterior Decompression and ACDF for 1-2-Level Degenerative Cervical Myelopathy.

Study Design: Prospective multicenter cohort study.

Objective: To compare clinical outcomes between posterior decompression without fusion (PD) and anterior cervical discectomy and fusion (ACDF) in patients with 1-2-level degenerative cervical myelopathy (DCM).

Summary Of Background Data: While numerous studies have assessed surgical strategies for multilevel DCM, limited evidence is available for cases involving only one or two levels.

A Retrospective Analysis of Outcomes of Nonoperative Therapy for Medication-Related Osteonecrosis of the Jaw.

Background: Limited research is available regarding the role of nonoperative therapy in managing medication-related osteonecrosis of the jaw (MRONJ) as it relates to progression or resolution of disease.

Purpose: The study purpose was to estimate the time to MRONJ stage improvement and risk for relapse among patients managed nonoperatively.

Study Design, Setting, Sample: This retrospective cohort study included subjects diagnosed with MRONJ at Keio University Hospital between April 2012 and July 2024.

HLA-B*15:01-positive severe COVID-19 patients lack CD8 T cell pools with highly expanded public clonotypes.

Understanding host factors driving asymptomatic versus severe disease outcomes is of key importance if we are to control emerging and re-emerging viral infections. HLA-B*15:01 has been associated with asymptomatic SARS-CoV-2 infection in nonhospitalized individuals of European ancestry, with protective immunity attributed to preexisting cross-reactive CD8 T-cells directed against HLA-B*15:01-restricted Spike-derived S peptide (B15/SCD8 T-cells). However, fundamental questions remained on the abundance and clonotypic nature of CD8 T-cell responses in HLA-B*15:01-positive patients who succumbed to life-threatening COVID-19.

Synthetic data generation with Worley-Perlin diffusion for robust subarachnoid hemorrhage detection in imbalanced CT Datasets.

Purpose: In this paper, we propose a novel generative model to produce high-quality SAH samples, enhancing SAH CT detection performance in imbalanced datasets. Previous methods, such as cost-sensitive learning and previous diffusion models, suffer from overfitting or noise-induced distortion, limiting their effectiveness. Accurate SAH sample generation is crucial for better detection.

Procedural Characteristics and Safety of Slender Percutaneous Coronary Intervention: Slender Is Better.

Objectives: We aimed to examine the procedural characteristics and safety profile of slender percutaneous coronary interventions (PCI) using a 5 Fr or smaller sheath.

Background: Smaller catheter size has been associated with fewer complications in PCI.

Methods: Our retrospective observational study included 259,401 cases of stable elective PCI from the Japan Percutaneous Coronary Intervention Registry between 2021 and 2022.

Identification of a CD138-negative therapy-resistant subpopulation in multiple myeloma with vulnerability to splicing factor inhibition.

The molecular basis of therapy resistance in multiple myeloma (MM) remains poorly understood. Here, we performed single-cell RNA sequencing coupled with VDJ-targeted sequencing of highly purified primary MM cells from patient bone marrow. This approach uncovered cellular heterogeneity and phenotypic plasticity along the CD138 axis, accompanied by drastic epigenetic alterations.

Polydoctoring and health outcomes among the very old population with multimorbidity: a retrospective cohort study in Japan.

To assess the relationship between polydoctoring and patient outcomes, we conducted a retrospective cohort study using a Japanese population-based dataset from April 2014 to December 2022. Overall, 2,338,965 patients aged 75-89 years with at least two chronic conditions were included. Polydoctoring was assessed by the number of regularly visited facilities (RVFs).

Subtalar joint kinematics defined by a rotational axis translating along the posterior talocalcaneal facet.

The subtalar joint is essential for the normal function of the human foot during bipedal walking, with its kinematics being pivotal for understanding foot biomechanics, disorders, and evolution. Traditionally, the helical axis representation has been used to assess subtalar joint movement, assuming translational motion along the rotational axis. However, recent observations challenge this assumption, revealing predominantly mediolateral translation during walking.

Successful treatment of chylous leakage with delayed presentation after endometrial cancer surgery using dietary therapy, octreotide, and computed tomography-guided lymphangiography: A case report and literature review.

Objective: Chylous ascites (CA) is a rare yet clinically significant complication following gynecologic cancer surgery, with incidence rates of 0.17 % to 9%. We aimed to describe a case of CA with a delayed clinical presentation nearly 100 days postoperatively in a patient with advanced endometrial cancer and to review the management strategies.

Prophylactic oral antibiotic bowel preparation for colorectal surgery in Japan: results of a nationwide questionnaire survey.

Purpose: Surgical site infections (SSIs) incur a large burden in colorectal surgery. The importance of oral antibiotic bowel preparation (OABP) in SSI prevention has been affirmed; however, the current trends in Japan are unknown. This investigated bowel preparation practices among Japanese surgeons, focusing on OABP.