JMA journal最新文献

{"title":"Association between Preoperative Exercise Tolerance, Comorbidities, and Survival Rates in Patients with Pancreatic Cancer.","authors":"Makoto Onji, Shingo Kozono, Asuka Nakai, Shinji Kakizoe, Koichi Naito","doi":"10.31662/jmaj.2025-0105","DOIUrl":"10.31662/jmaj.2025-0105","url":null,"abstract":"<p><strong>Introduction: </strong>Despite treatment advancements, pancreatic cancer continues to have the lowest 5-year survival rate and a high age-adjusted mortality. Limited physical and functional reserves often restrict therapeutic options. Although the 6-minute walk distance (6MWD) and the Charlson Comorbidity Index (CCI) are established prognostic markers, their combined prognostic utility remains unexplored. This study evaluated the prognostic value of a composite index (6MWD-CCI) in patients who underwent pancreatic resection.</p><p><strong>Methods: </strong>This retrospective study included 85 patients with pancreatic cancer who underwent resection between July 2019 and September 2022. Preoperative 6MWD (<400 m) and CCI scores were used to classify patients into three 6MWD-CCI risk groups (low, middle, and high). Physical, nutritional, and frailty parameters were also assessed. Kaplan-Meier and Cox regression analyses were performed to evaluate survival outcomes, adjusting for confounders.</p><p><strong>Results: </strong>During a median follow-up of 802 days, 27 patients (31.8%) died. Low 6MWD, high CCI, and elevated 6MWD-CCI risk levels were significantly associated with reduced survival. The composite 6MWD-CCI demonstrated strong prognostic value, outperforming individual metrics even after adjustment for confounders.</p><p><strong>Conclusions: </strong>The 6MWD-CCI is a practical and predictive tool for pancreatic cancer prognosis, integrating physical function and comorbidity burden to enhance risk stratification. Its incorporation into clinical workflows could improve preoperative planning. Validation through larger studies is recommended.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"893-902"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818456","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":"Editorial for Delayed Perforation after Colorectal Cold Snare Polypectomy with Simultaneously Performed Endoscopic Submucosal Dissection: A Case Report and Literature Review.","authors":"Masaaki Kodama","doi":"10.31662/jmaj.2025-0262","DOIUrl":"10.31662/jmaj.2025-0262","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"979-980"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818464","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":"Exploring Undergraduate Medical Students' Perspectives towards Artificial Intelligence in Healthcare: A Qualitative Study from India.","authors":"Sonali Sharma, Neha Saboo, Vaseem Naheed Baig","doi":"10.31662/jmaj.2024-0402","DOIUrl":"10.31662/jmaj.2024-0402","url":null,"abstract":"<p><strong>Introduction: </strong>The term \"artificial intelligence (AI)\" refers to the development of systems that possess intellectual processes characteristic of humans, such as the ability to reason, discern meaning, generalize, and learn from experience. This study aimed to provide an overview of medical students' knowledge, perceptions, and concerns about AI in healthcare.</p><p><strong>Methods: </strong>This study utilized a qualitative approach, employing semi-structured interviews in focus groups of medical undergraduates to explore their perceptions, knowledge, and concerns about AI in healthcare. The interviews complied with the standards for reporting qualitative research set by the Consolidated Criteria for Reporting Qualitative Research (COREQ). Seven focus groups were formed, with an average size of 8-10 participants per group. Each group was diverse in terms of sex and year of study.</p><p><strong>Results: </strong>156 participants responded to the survey, of whom 124 completed the questionnaires. Sixty-six undergraduate medical students consented to attend in-person focus groups for discussions. Four major themes are the advantages of AI in healthcare, education, and training in AI, future implications of AI, and ethical concerns, and sixteen subthemes emerged from this study's data analysis. Most students (57.7%) believed that artificial intelligence (AI) should be integrated into medical education. A substantial proportion (42.2%) of medical students demonstrated varying knowledge regarding the advantages of AI in healthcare. A significant number of students, 37.8%, articulated concerns regarding the future implications of AI; a minority of students, 22.7%, expressed ethical concerns regarding biases, privacy issues, security risks, and unequal access.</p><p><strong>Conclusions: </strong>Medical students generally view AI positively, recognizing its benefits in diagnosis and treatment. Many emphasized the need to integrate AI into medical education to prepare for future changes in healthcare. Future research should focus on developing evidence-based training programs and strategies to tackle these issues.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"718-729"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818467","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":"Current Status and Management Strategies of Obstetric Hemorrhage Using Contrast-enhanced Dynamic Computed Tomography: Correspondence.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.31662/jmaj.2025-0072","DOIUrl":"10.31662/jmaj.2025-0072","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"1015-1016"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818457","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":"Diverse Functions of Extracellular Vesicles in Ovarian Cancer.","authors":"Akira Yokoi","doi":"10.31662/jmaj.2025-0086","DOIUrl":"10.31662/jmaj.2025-0086","url":null,"abstract":"<p><p>Extracellular vesicles (EVs) play various roles in cancer progression, mediating intercellular signaling. EVs carry bioactive substances such as ribonucleic acid, deoxyribonucleic acid, and proteins, each providing important functions in whole biological fields, not only in cancer. Particularly in clinical oncology, EVs have attracted much attention owing to their promising potential as new diagnostic and therapeutic targets. Ovarian cancer is one of the major causes of gynecologic cancer deaths and is often asymptomatic in the early stages; therefore, biomarkers that enable early diagnosis are critical to improving patient survival. Ovarian cancer cells easily spread through the abdominal cavity rather than through the bloodstream, forming direct metastatic foci in organs such as peritoneal membranes or omentum. The disease is treated multimodally with surgery and chemotherapy, even in advanced stages, and a certain degree of response to treatment is observed. However, most relapsed cancer gradually acquired resistance to chemotherapies. We have investigated various EV molecules in ovarian cancer and shown their clinical utility. In addition, the heterogeneity of EVs has emerged as a recent topic, and we have developed and used novel techniques to understand them. Applying these findings to clinical practice, EV-based approaches have the potential to revolutionize ovarian cancer management, enabling early detection, personalized monitoring, and targeted therapy. Continued innovation and interdisciplinary collaboration will be key to realizing the full potential of EV translational research to improve outcomes for patients with ovarian cancer.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"944-946"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818463","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":"Anomalous Spike Mutations and Sporadic Global Detection of the SARS-CoV-2 BA.2.86 Lineage.","authors":"Hideki Kakeya","doi":"10.31662/jmaj.2025-0118","DOIUrl":"10.31662/jmaj.2025-0118","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"954-960"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818440","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":"Potential Corneal Donation in Patients with Out-of-hospital Cardiac Arrest: A Case-control Study.","authors":"Yuji Okazaki, Noritomo Fujisaki, Hideto Fukui, Kyungko Huh, Takayuki Otani, Toshihisa Ichiba, Hiroshi Naito, Yuki Kataoka","doi":"10.31662/jmaj.2024-0380","DOIUrl":"10.31662/jmaj.2024-0380","url":null,"abstract":"<p><strong>Introduction: </strong>The shortage of corneal donations has been a longstanding problem in Japan. However, there are limited data on the settings in which corneal donations occur. The aim of this study was to determine the association between out-of-hospital cardiac arrest (OHCA) and corneal donation. We also investigated potential corneal donors across various death settings (OHCA, in-hospital cardiac arrest (IHCA), and home death).</p><p><strong>Methods: </strong>This was a case-control study in Hiroshima Prefecture, Japan, from 2015 to 2023. Cases included all corneal donors based on data provided by the Hiroshima Eye Bank, while controls consisted of potential corneal donors aged ≥10 years at Hiroshima City Hiroshima Citizens Hospital. After matching cases with controls at a 1:5 ratio using age group, sex, and date of death, we employed unconditional logistic regression to analyze the association between OHCA and corneal donation.</p><p><strong>Results: </strong>From the combined data of the Hiroshima Eye Bank (n = 190), the hospital cohort (n = 4492), and the home cohort (n = 195), 190 were corneal donors and 3,394 were potential corneal donors. Among corneal donors, 5.3% (10/190) had OHCA, 26% (49/190) had IHCA, and 29% (55/190) died at home or in nursing homes. Among the various death settings, 72% (2,768/3,835) in the hospital cohort and 69% (134/195) in the home cohort were potential corneal donors, with OHCA patients in the hospital cohort showing the highest proportion (75%, 492/657). After adjusting for matching factors, OHCA was positively associated with corneal donation (13% [26/190] vs 15% [143/950]; odds ratio: 2.2, 95% confidence interval: 1.3-3.5, p = 0.0019).</p><p><strong>Conclusions: </strong>Individuals who experienced OHCA may be more likely than individuals in other settings of death to become corneal donors. Further research is needed to confirm this study's findings and to explore strategies to address the issue of Japan's corneal donation shortage.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"936-943"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818484","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":"Publication across Different Languages and Audiences: A Short Personal Note.","authors":"Shigeki Matsubara","doi":"10.31662/jmaj.2025-0242","DOIUrl":"10.31662/jmaj.2025-0242","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"1018-1019"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818487","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":"Sex and Age-specific Association between Isokinetic Knee Extensor Muscle Strength and Diabetes Mellitus: A Cross-sectional Study from the Sports Program Service Study.","authors":"Takahisa Ohta, Junzo Nagashima, Hiroyuki Sasai, Kazushige Sasaki, Naokata Ishii","doi":"10.31662/jmaj.2025-0111","DOIUrl":"10.31662/jmaj.2025-0111","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes mellitus (DM) is an increasing public health concern in Japan and worldwide, highlighting the need for effective prevention. Lower limb muscle strength, a modifiable factor, may influence glycemic control, potentially in sex- and age-specific ways. This study examined the association between isokinetic knee extensor strength and DM prevalence in a large Japanese cohort.</p><p><strong>Methods: </strong>A total of 14,017 Japanese individuals (men: 6,227; women: 7,790) aged 18-89 years participated in this study. All participants completed the maximum voluntary isokinetic knee extensor strength test (60°/s) and medical examination. DM was defined as blood glucose ≥126 mg/dL, hemoglobin A1c ≥6.5%, or hypoglycemic medication. Multivariable odds ratios (ORs) and 95% confidence intervals were calculated using the lowest quartile knee muscle strength category as a reference after adjusting for potential confounders.</p><p><strong>Results: </strong>The mean age of the participants was 50.1 years (standard deviation; 15.3); altogether, 1,225 participants (8.7%) had DM. Multivariable ORs of the highest quartile muscle strength were 0.61 (0.48-0.78) for men and 0.65 (0.57-0.88) for women, using the lowest quartile muscle strength as a reference. Knee extensor muscle strength was inversely associated with DM (p for trend <0.001 and 0.003, men and women, respectively). The inverse association was consistently observed in men aged 40 years and older, whereas it was less apparent in older women.</p><p><strong>Conclusions: </strong>Isokinetic knee extensor muscle strength is inversely associated with the prevalence of DM, with potential differences by sex and age. These findings may help inform DM risk assessment and prevention strategies.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"789-798"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818499","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":"Inferior Vena Cava Thrombi Related to Intravascular Temperature Management Catheters.","authors":"Shuhei Tada, Yuki Kondo, Tomoya Okazaki","doi":"10.31662/jmaj.2024-0300","DOIUrl":"10.31662/jmaj.2024-0300","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"990-991"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818475","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}