{"title":"Phase II Protocol on the Safety and Nutritional Status of Postoperative Enteral Nutrition Using HINEX® E-gel LC in Patients with Esophageal Cancer Undergoing Minimally Invasive Esophagectomy.","authors":"Takashi Kato, Hironobu Goto, Michiko Takahashi, Yasufumi Koterazawa, Ryuichiro Sawada, Hitoshi Harada, Naoki Urakawa, Hiroshi Hasegawa, Shingo Kanaji, Kimihiro Yamashita, Takeru Matsuda, Taro Oshikiri, Yoshihiro Kakeji","doi":"10.24546/0100495984","DOIUrl":"10.24546/0100495984","url":null,"abstract":"<p><strong>Background: </strong>Enteral nutrition therapy in the early postoperative period is essential for patients with esophageal cancer following esophagectomy. HINEX® E-gel LC is an oligomeric formula with various nutrients, including dietary fiber pectin. It is expected to reduce symptoms, such as diarrhea, resulting in improved adherence and a decreased rate of weight loss. However, no reports have examined the adherence to or efficacy of nutritional support therapy using HINEX® E-gel LC after esophagectomy.</p><p><strong>Methods: </strong>This is a single-institution, single-arm phase II trial. We plan to recruit 32 patients with esophageal cancer who have undergone minimally invasive esophagectomy (MIE) and place an enteral feeding tube. Enteral feeding is to be initiated on the second postoperative day, and the patient is to remain on enteral feeding at 300 kcal/day after discharge. The primary endpoint is adherence to enteral nutrition with HINEX® E-gel LC for up to 2 months postoperatively. The secondary endpoint is the association between the adherence to HINEX® E-gel LC and each nutritional parameter, such as hematological examination, body weight, and psoas muscle.</p><p><strong>Discussion: </strong>Although enteral nutrition is usually initiated in the early postoperative period after esophagectomy, the use of fat-containing digestive agents in the early postoperative period is a novel approach. To the best of our knowledge, this study is the first to evaluate the safety and nutritional status of early postoperative enteral nutrition using fat-containing digestive agents after MIE. Efficient nutritional support therapy using fat-containing digestive agents is expected to be especially useful after esophagectomy when oral intake is significantly decreased.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"71 2","pages":"E50-E55"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Rare Case of Pseudohypercalcemia Associated with Multiple Myeloma.","authors":"Chiharu Mishima, Kimikazu Yakushijin, Hidenori Fukuoka, Ruri Takahashi, Yuri Okazoe, Miki Joyce, Sakuya Matsumoto, Rina Sakai, Yumiko Inui, Keiji Kurata, Hironobu Minami","doi":"10.24546/0100495981","DOIUrl":"https://doi.org/10.24546/0100495981","url":null,"abstract":"<p><p>We report a rare case of pseudohypercalcemia associated with multiple myeloma in a 77-year-old woman. Despite elevated albumin-corrected calcium levels (12.6 mg/dL), ionized calcium levels remained normal (1.25 mmol/L). Differential diagnoses excluded common causes of hypercalcemia, and the findings suggested calcium binding to negatively charged immunoglobulins and confirmed pseudohypercalcemia due to IgG-type myeloma. Treatment with isatuximab plus dexamethasone normalized albumin-corrected calcium levels as IgG levels decreased. This report highlights the importance of recognizing pseudohypercalcemia to prevent misdiagnosis of true hypercalcemia due to myeloma. Measuring ionized calcium levels is crucial for accurate diagnosis when hypercalcemia is suspected without corresponding clinical symptoms.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"71 2","pages":"E46-E49"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Pregnant Woman with Primary Hyperparathyroidism Who Underwent Parathyroidectomy in the Second Trimester of Her Third Pregnancy: A Case Report.","authors":"Masayuki Tanaka, Hitomi Imafuku, Iroha Kubota, Keitaro Yamanaka, Sonoko Suda, Naohisa Masuko, Akiko Uchida, Hidenori Fukuoka, Masanori Teshima, Kazumichi Fujioka, Masashi Deguchi, Kenji Tanimura, Yoshito Terai","doi":"10.24546/0100495980","DOIUrl":"10.24546/0100495980","url":null,"abstract":"<p><p>Primary hyperparathyroidism (PHPT) during pregnancy is rare, causing severe pregnancy complications. We report a pregnant woman with PHPT and a pregnancy complication history who underwent a single-gland parathyroidectomy during the second trimester and delivered at term. A 28-year-old pregnant woman, gravida 3, para 2, was referred to our hospital at 9 gestational weeks (GWs) because of previous intrauterine fetal death, preterm birth, and fetal growth restriction. She was diagnosed with PHPT during her second pregnancy, and her baby experienced neonatal hypocalcemia. However, she received no PHPT treatment afterward. Laboratory tests and neck ultrasound revealed hyperparathyroidism and an enlarged right superior parathyroid gland. She underwent a right superior parathyroidectomy at 24 GWs. She delivered a 2,136 g (-1.74 SD) healthy female infant at 37 GWs, and her baby demonstrated no neonatal hypocalcemia. Parathyroidectomy, even during pregnancy, should be considered among pregnant women with PHPT having a pregnancy or neonatal complication history.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"71 1","pages":"E41-E45"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effects of Systemic and Skeletal Muscle-Specific Overexpression of Piezo1.","authors":"Tomoya Inoue, Tomoko Nishigaki, Yu Hirata, Kazuhiro Nomura, Kenji Sugawara, Wataru Ogawa","doi":"10.24546/0100495773","DOIUrl":"https://doi.org/10.24546/0100495773","url":null,"abstract":"<p><p>Piezo1, a mechanosensitive ion channel that opens in response to mechanical stimuli, is widely expressed among mammalian cell types, and regulates a diverse range of physiological processes. Although evidence has suggested potential clinical benefit of Piezo1 activation for various conditions, the safety and efficacy of such activation in living animals have remained unclear. To investigate the therapeutic potential of Piezo1 activation, we here generated genetically modified mouse models in which Piezo1 is overexpressed either specifically in skeletal muscle or systemically in response to tamoxifen treatment in adult animals. Cast immobilization induced a reduction in both muscle mass and the abundance of <i>Piezo1</i> mRNA in skeletal muscle of the affected limbs in control mice. Overexpression of Piezo1 in skeletal muscle prevented the immobilization-induced reduction both in soleus muscle mass and in the corresponding cross-sectional area of myofibers, suggesting the potential benefit of Piezo1 activation for prevention of immobilization-induced muscle atrophy. Furthermore, mice with systemic overexpression of Piezo1 showed no apparent abnormalities in growth or general activity. Red blood cells from these mice manifested slight resistance to hypoosmolarity-induced hemolysis, and the animals did not develop apparent hemolytic anemia. Our findings demonstrate promising efficacy and safety of Piezo1 activation in living animals and thereby highlight the therapeutic potential of targeting the Piezo1 signaling pathway.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"71 1","pages":"E31-E40"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dietary <i>Ficus carica</i> Inhibits Cognitive Impairment in Hypoxia-induced Non-alcoholic Fatty Liver Disease.","authors":"Dwi Widyawati, Andreanyta Meliala, Siswanto, Paramita Narwidina, Ayu Tiara Fitri","doi":"10.24546/0100495569","DOIUrl":"10.24546/0100495569","url":null,"abstract":"<p><p>Intermittent hypoxia (IH) can aggravate non-alcoholic fatty liver disease (NAFLD) by activating hypoxia-inducible Factor-α and increasing oxidative stress. Lipid peroxidation, which occurs as a consequence of reactive oxygen species (ROS) generation, is characterized by malondialdehyde (MDA) formation and decreased catalase (CAT) and superoxide dismutase (SOD) levels. Hence, inadequate management of NAFLD might induce cognitive impairment. However, although studies have shown that <i>Ficus carica</i> could prevent cognitive impairment due to NAFLD complications, the mechanism by which this is achieved remains unclear. The current study therefore aimed to clarify the effects of <i>Ficus carica</i> in suppressing cognitive impairments caused by hypoxia-induced NAFLD. <i>Sprague-Dawley</i> male rats were divided into five groups: negative control positive control (PC), and IH with <i>Ficus carica</i> treatment (6.25, 12.5, and 25 mL/kg/day) for 4 weeks before and 1 week during IH. Rats were exposed to IH exposure by placing them in a hypoxic chamber (90% N₂ and 10% O₂) for 7 days. Regardless of dosage, <i>Ficus carica</i> treatment reduced MDA levels when compared to PC, and low-dose increased liver SOD levels more than the other groups. In contrast, the medium <i>Ficus carica</i> dose was associated with increased CAT activity and decreased inflammatory marker levels compared to the other treatments. Meanwhile, the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index were all greatest in the medium-dose group. The PC group showed a significant decrease in the percentage of alteration. Our data implies that medium doses of <i>Ficus carica</i> can reduce cognitive impairment caused by hypoxia-induced NAFLD.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"71 1","pages":"E19-E30"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Istiqomah Marini, Rei Takamiya, Mitsuhiro Nishimura, Yasuko Mori
{"title":"Primary Infection with Early SARS-CoV-2 (D614G) Induces Cross Neutralization Antibodies against Omicron BA.5 and EG.5.1.","authors":"Maria Istiqomah Marini, Rei Takamiya, Mitsuhiro Nishimura, Yasuko Mori","doi":"10.24546/0100495531","DOIUrl":"https://doi.org/10.24546/0100495531","url":null,"abstract":"<p><p>SARS-CoV-2 Omicron sub-variants are still emerging and become highly diversified, resulting in increased transmissibility and immune evasion ability. Neutralizing antibody is very important to fight against the variants. However, the ability of neutralizing antibody induced by early SARS-CoV-2 (D614G) primary infection has not been analyzed in detail against lately emerged Omicron variants, such as BA.5 and EG.5.1. In this study the sera from severe/critically infected patients of D614G were investigated the potency of neutralization activity against SARS-CoV-2 BA.5 and EG.5.1 by using live virus neutralization assay. The neutralizing activity was observed and analyzed in detail from day 1 until 7 post infection. The sera of both severe and critical patients showed cross neutralizing activity for BA.5, and even for EG.5.1. It is suggested that neutralizing antibodies targeting conserved epitopes are partly induced upon the primary infection as the result of robust immune response.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"71 1","pages":"E1-E9"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Relationship between Commuting Distance Using Public Transportation and the Risk of SARS-CoV-2 Infection in Healthcare Workers in Japan: A Cross-sectional Study.","authors":"Ryohei Hashimoto, Kanako Teramoto, Soshiro Ogata, Koji Iihara, Yoshiharu Miyata, Yoichi Kurebayashi, Kunihiro Nishimura","doi":"10.24546/0100495532","DOIUrl":"https://doi.org/10.24546/0100495532","url":null,"abstract":"<p><p>This study aimed to explore the association between commuting distance using public transportation and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody-positivity among medical staff at a cardiovascular medical institution in Japan. Information on the commuting distance using public transportation, grouped into none, short (<11.3 km; median), and long (≥11.3 km); demographics; and the coronavirus disease 2019 (COVID-19) exposure were cross-sectionally collected from 956 employees in June 2022. SARS-CoV-2 antibody-positivity was defined based on serological tests for the nucleocapsid protein antigen. Among all participants (mean age 36 years; 68.6% female), 118 (12.3%) had SARS-CoV-2 antibody-positivity. Participants with long commuting distances were more likely to have ≥3 household members. Compared with non-use of public transportation, neither short nor long commuting distances by public transportation were associated with antibody-positivity (adjusted odds ratio 1.18 [95% confidence interval 0.70-1.98] and 1.62 [0.97-2.71], respectively). In participants with ≤2 household members (n = 706 [73.8%]; mean age 37 years; 72.4% female), a long commuting distance was associated with SARS-CoV-2 positivity compared with non-use of public transportation (1.98 [1.02-3.84]). In conclusion, commuting distance using public transportation was not associated with SARS-CoV-2 antibody-positivity in general; however, it may be relevant among healthcare workers with fewer household members.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"71 1","pages":"E10-E18"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of Intravenous Lidocaine on Rocuronium: A Randomized Controlled Trial.","authors":"Sawako Takebe, Shinya Taguchi, Norihiko Obata, Satoshi Mizobuchi","doi":"10.24546/0100493127","DOIUrl":"10.24546/0100493127","url":null,"abstract":"<p><strong>Purpose: </strong>Under general anesthesia, lidocaine shortens the onset time of vecuronium but it does not affect that of rocuronium. We suspected that the dose of rocuronium used in previous reports, 0.6 mg/kg, was too high to detect any difference due to lidocaine's effect. We investigated the effects of 1.5 mg/kg lidocaine on the onset time, 50% depression time, 100% depression time, and duration of action of 0.4 mg/kg rocuronium.</p><p><strong>Methods: </strong>Sixty adult patients who underwent elective operation under general anesthesia without tracheal intubation were randomly divided into two groups: including a lidocaine group (LG) and a placebo group (PG). Anesthesia was induced and maintained using propofol and remifentanil. After the loss of consciousness, a supraglottic device was inserted. After the neuromuscular monitor was calibrated, measurements were initiated with train-of-four stimulation at 20-second intervals, and 1.5 mg/kg lidocaine and the same volume of physiological saline were administered to the LG and the PG respectively. Ten seconds after the next train-of-four stimulation, 0.4 mg/kg rocuronium was administered.</p><p><strong>Results: </strong>The mean (standard deviation) onset time (seconds) between the LG and PG were 368.0 (170.5) and 314.8 (161.1), respectively, with no significant difference ( <i>p</i> = 0.24). There were no significant differences between the groups in terms of the 50% depression time ( <i>p</i> = 0.71), 100% depression time ( <i>p</i> = 0.53), or duration of action ( <i>p</i> = 0.45).</p><p><strong>Conclusion: </strong>The pre-administration of 1.5 mg/kg lidocaine did not affect the onset time, 50% depression time, 100% depression time, or duration of action of 0.4 mg/kg rocuronium.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"70 4","pages":"E143-E151"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"312 nm UVB Phototherapy Limits Atherosclerosis by Regulating Immunoinflammatory Responses in Mice.","authors":"Aga Krisnanda, Naoto Sasaki, Ken Ito, Toru Tanaka, Masakazu Shinohara, Hilman Zulkifli Amin, Sayo Horibe, Motoaki Iwaya, Ken-Ichi Hirata, Atsushi Fukunaga, Yoshiyuki Rikitake","doi":"10.24546/0100492952","DOIUrl":"10.24546/0100492952","url":null,"abstract":"<p><strong>Aim: </strong>Our previous studies identified ultraviolet B (UVB) irradiation as a possible approach for preventing atherosclerosis. The aim of this study was to clarify the effect of 312 nm UVB, a wavelength similar to that of clinically available narrow-band UVB for the treatment of psoriasis, on atherosclerosis and the underlying mechanisms.</p><p><strong>Methods and results: </strong>Using a recently developed UVB-light-emitting diode device, we irradiated 6-week-old male atherosclerosis-prone apolipoprotein E-deficient mice with 312 nm UVB at 5 or 10 kJ/m² and examined its effect on the development of atherosclerosis and immunoinflammatory responses by performing histological analysis, flow cytometry, biochemical assays, and liquid chromatography/mass spectrometry-based lipidomics. UVB irradiation at 10 kJ/m² but not at 5 kJ/m² significantly attenuated the development of aortic root atherosclerotic plaques, while UVB irradiation at both doses induced a less inflammatory plaque phenotype. This atheroprotective effect was associated with a reduced effector T cell number, a shift toward anti-atherogenic helper T cell responses, and increased proportion of regulatory T cells in lymphoid tissues and increased levels of proresolving lipid mediators in the skin.</p><p><strong>Conclusions: </strong>We demonstrated that 312 nm UVB irradiation limits atherosclerosis by favorably modulating the T cell balance and lipid mediator profile. Our findings indicate that 312 nm UVB phototherapy could be an attractive immunomodulatory approach for preventing and treating atherosclerosis.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"70 4","pages":"E130-E142"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Association of Anti-dsDNA Antibodies with Patient-reported Outcomes of Patients with Systemic Lupus Erythematosus in a Two-consecutive Year Prospective Study.","authors":"Yuto Nakakubo, Hideaki Tsuji, Yudai Takase, Tsuneyasu Yoshida, Tomohiro Kozuki, Takeshi Iwasaki, Mirei Shirakashi, Hideo Onizawa, Ryosuke Hiwa, Koji Kitagori, Shuji Akizuki, Ran Nakashima, Akira Onishi, Hajime Yoshifuji, Masao Tanaka, Akio Morinobu","doi":"10.24546/0100492949","DOIUrl":"10.24546/0100492949","url":null,"abstract":"<p><strong>Objectives: </strong>To analyse the association of anti-dsDNA Ab with patient-reported outcomes (PROs) in patients with SLE under maintenance treatment, as it has not been clearly understood whether PROs are able to be reflected by anti-dsDNA, which are associated with SLE activities (SLE Disease Activity Index 2000, SLEDAI-2K).</p><p><strong>Methods: </strong>The SLE symptom checklist (SSC), LupusPRO, Medical Outcomes Study Short Form-36 (SF-36), and patient and physician visual analogue scale (Pt/Ph-VAS) at a time point were evaluated for correlation with anti-dsDNA using the Kyoto Lupus Cohort Registry (n = 310) from 2019 to 2020. Further, associations between changes in anti-dsDNA with those in Pt/Ph-VAS and SSC at two time points of short-term (3 months) or long-term (2 years) time points.</p><p><strong>Results: </strong>Cross-sectionally, anti-dsDNA slightly correlated with Ph-VAS (ρ = 0.18, p = 0.003) and SLEDAI-2K (ρ = 0.14, p = 0.03), while anti-dsDNA was not correlated with SSC, SF-36, and LupusPRO, or Pt-VAS. In short-term and long-term, anti-dsDNA demonstrated no significant correlation with alterations in SSC, Pt-VAS, or Ph-VAS. Further, they did not show associations when SLE activities (SLEDAI-2K) were worsened.</p><p><strong>Conclusion: </strong>PROs at a time point and changes were difficult to be captured by anti-dsDNA. It is desirable to explore objective laboratory measures to evaluate PROs.</p>","PeriodicalId":39560,"journal":{"name":"Kobe Journal of Medical Sciences","volume":"70 4","pages":"E113-E124"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}