Yonago acta medica最新文献

{"title":"Background for High Risk Drinking Habits Among Adult Women: A Qualitative Study of Trigger, Maintenance, and Promotion Factors.","authors":"Hideaki Kasuga, Aya Kinjo, Tomoo Hidaka, Yoshitaka Kaneita, Hideyuki Kanda, Osamu Itani, Hitoshi Maesato, Maki Jike, Hisashi Yoshimoto, Teruna Ito, Susumu Higuchi, Yuichiro Otsuka, Ruriko Minobe, Yuki Kuwabara, Yoneatsu Osaki","doi":"10.33160/yam.2026.05.003","DOIUrl":"10.33160/yam.2026.05.003","url":null,"abstract":"<p><strong>Background: </strong>Alcohol consumption can lead to significant health issues, such as non-communicable diseases. In recent years, an increase in alcohol consumption among women has been reported. However, previous research on alcohol consumption has mostly focused on young adults, and little is known on the drinking habits of adult women in general. The present study aimed to qualitatively examine the background characteristics and social factors of women at increased alcohol consumption.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with 30 adult women who consumed 20g or more of ethanol per day regarding their reasons for drinking and related factors. Data were analyzed using open coding to extract key concepts.</p><p><strong>Results: </strong>Three key domains were identified: the influences that initiate women's drinking habits, those that maintain and escalate drinking, and the social factors in which drinking takes place. In addition, the following were implicated as remarkable risk factors for alcohol-related non-communicable diseases in women: \"family stress\", which provides situations different in nature from what young people typically experience, can trigger the formation of drinking habits; \"positive emotional experience\" and \"misunderstanding of effects and risks\" can lead to high risk drinking without awareness; and casual drinking at home\" leads to an increase in drinking opportunities and a rise in consumption due to the absence of women who typically play a moderating role in regulating drinking behavior.</p><p><strong>Conclusion: </strong>Preventing alcohol-related health issues, including non-communicable diseases, requires implementing measures that take the underlying context into account.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"69 2","pages":"166-177"},"PeriodicalIF":1.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Understanding of Circulating Apolipoprotein E-Containing High-Density Lipoproteins and Their Clinical Utility in Cardiovascular Disease Risk Assessment.","authors":"Shinichi Usui","doi":"10.33160/yam.2026.05.001","DOIUrl":"10.33160/yam.2026.05.001","url":null,"abstract":"<p><p>Plasma high-density lipoprotein (HDL) plays a key role in transporting accumulated excess cholesterol from the peripheral tissues to the liver, and has other multiple cardioprotective functions, including antioxidant, anti-inflammatory, and antithrombotic effects. However, HDL-cholesterol (HDL-C) levels, which are commonly measured in a clinical testing, may not necessarily reflect the beneficial aspects of HDLs. In fact, recent studies have shown that increasing HDL-C with medication does not reliably prevent cardiovascular disease. Furthermore, recent advances in proteomic technology have revealed hundreds of proteins associated with HDLs, which contribute to their structural heterogeneity and functional diversity. Accordingly, identifying specific HDL family members is useful in assessing cardiovascular disease risk, rather than evaluating HDL as a single family. Certain HDLs contain apolipoprotein E (apoE), which plays an important role in cholesterol transport. However, our understanding of apoE-containing HDL (apoE-HDL) has become complex as apoE-HDL is a heterogeneous population that differs in particle compositions and sizes, as well as biological functions. This review focuses on apoE-HDL and summarizes its characteristics and functions as well as the clinical significance of its measurement, discussing its potential as a novel biomarker for cardiovascular disease risk assessment.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"69 2","pages":"149-159"},"PeriodicalIF":1.0,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment and Characterization of Canine Malignant Mesothelioma Cells.","authors":"Tomohiro Osaki, Taichi Kadohata, Miki Yasunaga, Sohta Hishikawa, Yuji Sunden, Kiwamu Takahashi","doi":"10.33160/yam.2026.05.007","DOIUrl":"10.33160/yam.2026.05.007","url":null,"abstract":"<p><strong>Background: </strong>We established persistently passable canine malignant mesothelioma (cMM) cell lines from tumor samples obtained from affected dogs, analyzed their characteristics, and investigated their sensitivity to anticancer drugs and photodynamic therapy (PDT) using 5-aminolevulinic acid hydrochloride (5-ALA).</p><p><strong>Methods: </strong>Histopathological analyses were performed on SDK cells cultured under two-dimensional (2D) and three-dimensional (3D) conditions, as well as on tumor tissues derived from SDK cells. Cell proliferation in both culture systems and sensitivity to anticancer agents and PDT were assessed.</p><p><strong>Results: </strong>In 2D culture, SDK cells appeared round to polygonal, with marked variability in size and the presence of pyknotic nuclei. In 3D culture, both large and small cells formed loose clusters with scattered cellular processes. Following subcutaneous transplantation into mice, tumor masses exhibited nodular lesions composed of tumor cells and fibroblasts. Cytokeratin expression was prominent in 3D-cultured cells and tumor tissues but weak in 2D-cultured cells. Vimentin and calretinin were expressed in all cells. SDK cells showed minimal sensitivity to carboplatin but were sensitive to doxorubicin. Notably, SDK cells were also sensitive to 5-ALA-mediated PDT.</p><p><strong>Conclusion: </strong>SDK cells may serve as a novel cell line for elucidating the pathogenesis of cMM and for developing new therapeutic strategies.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"69 2","pages":"195-203"},"PeriodicalIF":1.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Prenatal Echocardiographic Diagnosis in Early Postnatal Management of Congenital Heart Disease at a Single Center Without Neonatal Cardiac Surgery.","authors":"Yoichi Mino, Takashi Harada, Hitoshi Uemasu, Juntaro Yamasaki, Keita Shimizu, Fumiko Miyahara, Aya Imamoto, Noriyuki Namba","doi":"10.33160/yam.2026.05.006","DOIUrl":"10.33160/yam.2026.05.006","url":null,"abstract":"<p><strong>Background: </strong>Fetal echocardiography is essential for the prenatal diagnosis of congenital heart disease (CHD) and plays a key role in planning early postnatal management, delivery, and inter-facility transfer. However, prenatal diagnoses do not always correspond to postnatal diagnoses, and diagnostic discordance occurs at a certain frequency. This issue is particularly relevant in centers without neonatal cardiac surgery, where the clinical value of prenatal diagnosis must be evaluated primarily in the context of early neonatal management.</p><p><strong>Methods: </strong>We retrospectively reviewed 43 cases in which fetal echocardiography was performed collaboratively by pediatric cardiologists and obstetricians specializing in fetal echocardiography at our institution between 2014 and 2021, with a prenatal diagnosis of CHD and a confirmed postnatal diagnosis. The concordance between prenatal and postnatal primary diagnoses was assessed. The primary endpoint was whether clinically significant changes in early postnatal management were required compared with prenatal expectations.</p><p><strong>Results: </strong>Prenatal and postnatal primary diagnoses were discordant in seven cases (16%). In most discordant cases, the anticipated circulatory physiology and early management strategies remained appropriate after birth. Only two cases (5%) required clinically significant changes in early postnatal management. In one case, anticipated early postnatal hemodynamic instability due to an unrecognized systemic outflow obstruction prompted an urgent transfer to a specialized cardiac center after birth. In the other case, unanticipated duct-dependent systemic circulation required early postnatal medical management to support systemic circulation. Subsequent evaluation revealed multiple extracardiac anomalies, and genetic testing confirmed a severe chromosomal syndrome with a poor life prognosis. After extensive discussion with the family, cardiac surgery was not pursued.</p><p><strong>Conclusion: </strong>The role of prenatal echocardiographic diagnosis of CHD lies not in achieving complete diagnostic concordance, but in accurately anticipating hemodynamic risks requiring early postnatal intervention. Even in centers without neonatal cardiac surgery, prenatal echocardiography supports appropriate early postnatal management and facilitates timely coordination with specialized cardiac centers.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"69 2","pages":"188-194"},"PeriodicalIF":1.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resection for an Extremely Rare Pleomorphic Carcinoma of the Mediastinal Lymph Nodes of Unknown Primary: A Case Report.","authors":"Ken Miwa, Takashi Ohno, Tatsuya Miyamoto, Hiroshige Nakamura","doi":"10.33160/yam.2026.05.004","DOIUrl":"10.33160/yam.2026.05.004","url":null,"abstract":"<p><p>Pleomorphic carcinoma of the mediastinal lymph nodes with an unknown primary site is extremely rare. A 68-year-old man was referred to our department after an enlarged lymph node in the right upper mediastinum was noted on computed tomography. An irregular nodule was also detected in the right upper lobe, showing no change compared with findings from 2 years earlier. FDG-PET (18F-fluorodeoxyglucose positron emission tomography) revealed strong uptake only in the mediastinal lymph nodes. EBUS-TBNA (Endobronchial ultrasound-guided transbronchial needle aspiration) of the lymph nodes revealed findings consistent with pleomorphic carcinoma. No other abnormalities were identified, and surgery was performed. As rapid pathology of the pulmonary nodule revealed no malignant findings, right upper mediastinal lymph node dissection was performed. The final pathological diagnosis was pleomorphic carcinoma. No malignant lesions were identified in the lungs. The patient has remained under strict observation, with no recurrence detected 1 year after surgery. Mediastinal lymph node carcinoma of unknown primary involving pleomorphic carcinoma, which carries a poor prognosis, needs strict follow-up owing to the risk of developing a future primary lung tumor.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"69 2","pages":"213-217"},"PeriodicalIF":1.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Changing Landscape of Urological Surgery: 10-Year Trends in Benign Prostatic Hyperplasia and Upper Urinary Tract Stone Management in the San-in Region, Japan.","authors":"Yusuke Kimura, Shuichi Morizane, Atsushi Yamamoto, Rumiko Omatsu, Hiroshi Yamane, Shogo Teraoka, Ryoma Nishikawa, Noriya Yamaguchi, Katsuya Hikita, Atsushi Takenaka","doi":"10.33160/yam.2026.05.005","DOIUrl":"10.33160/yam.2026.05.005","url":null,"abstract":"<p><strong>Background: </strong>The surgical management of benign prostatic hyperplasia (BPH) and upper urinary tract stones has remarkably evolved with technological advances. In this study, the trends in surgical techniques for these conditions in the San-in region of Japan were analyzed over a 10-year period.</p><p><strong>Methods: </strong>A retrospective survey was conducted across 17 urological facilities in the San-in region (Tottori and Shimane prefectures) from 2014 to 2023. Data on the surgical procedures for BPH and upper urinary tract stones were collected, including the facility adoption rates and annual case volumes.</p><p><strong>Results: </strong>For BPH treatment, HoLEP and bipolar TUR-P were the commonly performed procedures, with HoLEP accounting for approximately 50% of all cases. Minimally invasive surgical treatments, including water vapor energy (WAVE) and prostatic urethral lift (PUL), were introduced in 2022. For upper urinary tract stones, the utilization of TUL/URS equipped with holmium laser dramatically increased from 33.9% to 64.9% of all cases, whereas that of extracorporeal shock wave lithotripsy (ESWL) decreased from 59.9% to 32.1%.</p><p><strong>Conclusion: </strong>This study shows the successful adoption of advanced urological techniques in rural Japan, with clear trends toward laser-based procedures for BPH and stone treatment. The observed decline in ESWL utilization is consistent with national and international trends, reflecting a global paradigm shift toward the endoscopic management of upper urinary tract stones.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"69 2","pages":"178-187"},"PeriodicalIF":1.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient Oxygen Desaturation Associated with Persistent Right Venous Valve-Mediated Right-to-Left Atrial Shunt in Term Neonates.","authors":"Yoichi Mino, Hitoshi Uemasu, Juntaro Yamasaki, Keita Shimizu, Fumiko Miyahara, Aya Imamoto, Hiromi Fuji, Masahiro Suzuki, Kazuki Yoshioka, Chisaki Moriwaki, Aya Tomomori, Mayumi Sakaguchi, Yukiko Nakashima, Ayano Okuda, Noriyuki Namba","doi":"10.33160/yam.2026.05.002","DOIUrl":"10.33160/yam.2026.05.002","url":null,"abstract":"<p><strong>Background: </strong>Persistent right venous valve (PRVV), a remnant of the fetal right valve of the sinus venosus, may facilitate right-to-left atrial shunting through the patent foramen ovale (PFO). Although PRVV has been reported to cause severe neonatal cyanosis requiring surgical intervention, its clinical significance in otherwise healthy term neonates remains poorly defined.</p><p><strong>Methods: </strong>We retrospectively analyzed consecutive term neonates (≥ 37 weeks' gestation) with stable general conditions who exhibited periodic breathing-like oxygen saturation (SpO₂) fluctuations and were found to have PRVV-associated right-to-left atrial shunting on transthoracic echocardiography. Clinical characteristics and SpO₂ values recorded during routine monitoring were reviewed, and the minimum, median, and maximum SpO₂ values during hospitalization were assessed.</p><p><strong>Results: </strong>Ten term neonates were included. Minimum SpO₂ values ranged from 81% to 94% (median, 87%), whereas median SpO₂ values remained high (95-100%) in all cases. These desaturation episodes occurred predominantly during sleep and were frequently synchronized with inspiration, suggesting a circulatory rather than respiratory mechanism. Although some neonates experienced transient desaturation reaching as low as 80%, none developed sustained hypoxemia, required prolonged oxygen supplementation, or underwent additional respiratory investigations or therapeutic interventions. All neonates remained clinically stable throughout hospitalization.</p><p><strong>Conclusion: </strong>In otherwise healthy term neonates, PRVV with PFO-related right-to-left atrial shunting may cause transient oxygen desaturation, occasionally reaching as low as 80%; however, it is generally self-limiting and clinically benign. Recognition of this hemodynamic mechanism may help clinicians appropriately interpret transient SpO₂ decreases and avoid unnecessary respiratory evaluations in selected neonates.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"69 2","pages":"160-165"},"PeriodicalIF":1.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Dynamics of Soluble NKG2D Ligands in Mild and Moderate Coronavirus Disease-2019.","authors":"Kyosuke Nagamizu, Yukari Nishikawa, Miyako Takata, Kosuke Yamaguchi, Yuki Hashimoto, Shota Morishita, Ma'arif Athok Shofiudin, Kensaku Okada, Tsuyoshi Kitaura, Masaki Nakamoto, Akira Yamasaki, Hiroki Chikumi","doi":"10.33160/yam.2026.02.015","DOIUrl":"10.33160/yam.2026.02.015","url":null,"abstract":"<p><strong>Background: </strong>The soluble form of NKG2D (sNKG2D) ligands has been implicated in the severity of coronavirus disease-2019 (COVID-19). However, their longitudinal dynamics from the acute phase to hospital discharge and their relationships with clinical parameters are unclear. This study aimed to investigate the longitudinal dynamics of these ligands and determine their relationship with clinical parameters.</p><p><strong>Methods: </strong>This retrospective observational cohort study evaluated 64 patients with mild or moderate COVID-19. sULBP-2, soluble MIC-A (sMIC-A), and soluble MIC-B (sMIC-B) concentrations at admission, recovery, and discharge were analyzed. Associations with patient characteristics and laboratory parameters (white blood cell count and C-reactive protein, lactate dehydrogenase, Krebs von den Lungen-6, ferritin, and interleukin-6 levels), natural killer (NK) cell and T cell counts, and severe acute respiratory syndrome coronavirus 2 viral copy numbers were examined. Principal component analysis (PCA) was performed in the moderate group, and the relationship between sNKG2D ligands and clinical parameters using hierarchical cluster analysis.</p><p><strong>Results: </strong>Serum sULBP-2 concentrations were significantly higher in the moderate group at both admission and discharge. In contrast, sMIC-A and sMIC-B levels did not significantly differ. Higher sULBP-2 levels at admission persisted until discharge. PCA demonstrated that admission sULBP-2 levels were associated with inflammatory components; admission sMIC-A levels were associated with components related to NK cells and lung injury. Their discharge levels both converged into a shared principal component closely associated with NK cell. Clusters characterized by older age, elevated sULBP-2, and increased inflammatory responses and lung injury markers had worse disease severity.</p><p><strong>Conclusion: </strong>NKG2D ligand levels increase via distinct mechanisms during acute COVID-19 but converge toward a shared dynamics during recovery. sULBP-2 is the only sNKG2D ligand related with disease severity, and its elevation persists through discharge, suggesting prolonged impairment of NK cell function after clinical recovery. sULBP-2 may be an important biomarker of disease severity.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"69 1","pages":"105-118"},"PeriodicalIF":1.0,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Labor Epidural Analgesia with Neonatal Umbilical Arterial Blood pH and Apgar Score: The Japan Environment and Children's Study (JECS).","authors":"Misako Suto, Youichi Kurozawa, Shinji Otani, Toshio Masumoto, Keisuke Miyamoto, Akihiro Otsuki, Hiroki Amano, Akemi Morita","doi":"10.33160/yam.2026.02.003","DOIUrl":"10.33160/yam.2026.02.003","url":null,"abstract":"<p><strong>Background: </strong>Labor epidural analgesia is recognized worldwide as the gold standard for maternal pain relief during delivery and has been increasingly used in Japan. However, studies on labor analgesia in Japan are scarce, and evaluation of neonatal outcomes associated with this procedure remains limited. Among the key aspects in the safety evaluation of labor epidural analgesia are the potential effects on neonatal umbilical arterial blood pH (UmA-pH) and Apgar score. Therefore, we determined whether labor epidural analgesia during vaginal delivery is associated with neonatal UmA-pH and Apgar score among women delivering in Japan.</p><p><strong>Methods: </strong>In this birth cohort study, we prospectively analyzed data collected from the Japan Environment and Children's Study (JECS). We included Japanese pregnant women who had singleton vaginal deliveries. The primary exposure was labor epidural analgesia, and the primary outcomes were UmA-pH and Apgar score at 1 and 5 min following birth. Multivariate logistic regression was employed to examine the associations between labor epidural analgesia and neonatal outcomes, with adjustment for potential confounders. Adjusted odds ratios (aOR) and 95% confidence intervals (CIs) were reported. Furthermore, a sensitivity analysis using stabilized inverse probability of treatment weighting (IPTW) was conducted.</p><p><strong>Results: </strong>Of the 96,443 women who had singleton deliveries in the JECS, 55,227 were included in the final analysis, 1,311 (2.4%) of whom received labor epidural analgesia. In the multivariate logistic regression analysis, a statistically significant association was observed between labor epidural analgesia and a 1-min Apgar score < 7 (aOR: 1.54; 95% CI: 1.03-2.29). However, only one neonate in the labor epidural analgesia group had a 5-min Apgar score < 7. Moreover, no significant association was observed between labor epidural analgesia and UmA-pH < 7.2 (aOR: 0.94; 95% CI: 0.76-1.17). In the IPTW-based sensitivity analysis, the effect estimates were consistent in direction with the primary analysis, supporting the robustness of the main findings.</p><p><strong>Conclusion: </strong>In this large cohort of singleton vaginal births in Japan, the use of labor epidural analgesia had little to no clinically meaningful effect on neonatal outcomes, including UmA-pH < 7.2 and Apgar score < 7. These findings support informed decision-making for pregnant women in Japan who are considering labor epidural analgesia.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"69 1","pages":"24-34"},"PeriodicalIF":1.0,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Next-Generation Artificial Intelligence for ADME Prediction in Drug Discovery: From Small Molecules to Biologics.","authors":"Soyoka Tanihata, Hiroaki Iwata","doi":"10.33160/yam.2026.02.001","DOIUrl":"10.33160/yam.2026.02.001","url":null,"abstract":"<p><p>Pharmacokinetic (PK) behavior, which emerges from the underlying processes of absorption, distribution, metabolism, and excretion (ADME), is central to drug discovery and development, dose optimization, and safety assessment. Despite decades of experimental and computational research, early-stage prediction of human PK remains a major challenge, contributing to clinical attrition and inefficiency in pharmaceutical pipelines. Advances in artificial intelligence (AI) and machine learning (ML) have significantly improved ADME predictions, particularly for small molecules. Traditional descriptor-based quantitative structure-activity relationship and classical ML methods offer interpretability and robust performance on standardized datasets. In contrast, graph neural networks, deep learning architectures, and chemical language models facilitate the learning of complex nonlinear structure-property relationships and multitask predictions. Multimodal frameworks further integrate experimental measurements, structural data, and biological contexts, enhancing predictive accuracy under low-data and heterogeneous conditions. Emerging modalities, including peptides, oligonucleotides, and antibody-based therapeutics, pose additional challenges owing to their sequence-dependent stability, conformational flexibility, and mechanistically distinct determinants of ADME and toxicity (ADMET). AI approaches that incorporate sequence-, structure-, and mechanism-aware representations combined with multimodal data integration have demonstrated improved predictability for medium- and large-molecule therapeutics. Recent developments in foundation-model architectures offer unified representations across chemical, biological, and biophysical domains, enabling cross-modality ADMET modeling with enhanced generalization and mechanistic interpretability. In this review, we summarize the evolution of computational ADME- and PK-oriented prediction frameworks from small molecules to complex biologics, highlighting methodological advances, representative studies, and emerging trends in multimodal and foundation-model approaches. We also discuss the limitations and future perspectives of the practical implementation of AI-driven ADMET predictions to support rational drug design and development.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"69 1","pages":"1-13"},"PeriodicalIF":1.0,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}