肺癌におけるREG Iα遺伝子の発現は、腺癌、肩平上皮癌で異なったメカニズムにより、予後不良を示唆する。

The aim of the present study was to evaluate the effects of the REG Iα and REG Iβ genes on lung cancer cell lines, and thereafter, the expression of REG family genes (REG Iα, REG Iβ, REG III, HIP/PAP and REG IV) in lung cancer in relation to patient prognosis was evaluated. Lung adenocarcinoma (AD) and squamous cell carcinoma (SCC) cell lines expressing REG Iα or REG Iβ (HLC-1 REG Iα/Iβ and EBC-1 REG Iα/Iβ) were established, and cell number, cell invasive activity, and anchorage-independent cell growth were compared with these variables in the control cells. The expression levels of REG family genes were evaluated by real-time RT-PCR in surgically resected lung cancers, and disease-specific survival (DSS) curves were generated. The HLC-1 REG Iα/Iβ cell line showed significant increases in cell number and anchorage-independent cell growth compared with the control cells. EBC-1 REG Iα/Iβ cells showed significant increases in cell invasive activity and anchorage-independent cell growth as compared with the control cells. Except for the REG Iβ gene, expression of other REG family genes was observed in the surgically resected samples; however, DSS was significantly worse only in stage I patients who were positive for REG Iα expression than in patients who were negative for REG Iα expression. The effects of REG Iα on AD and SCC cells were different in the in vitro study, and a correlation between REG Iα expression and patient prognosis was noted in the in vivo study. Therefore, overexpression of REG Iα is a risk factor for poor prognosis caused by discrete mechanisms in AD and SCC patients.博士（医学）・乙第1339号・平成26年5月28日本文のリンク：http://dx.doi.org/10.3892/or.2013.2739Copyright © Spandidos Publications 201

Effects of a sleep hygiene education program on children in a Japanese elementary school

Our objective in this study was to evaluate the effects of a Sleep Hygiene Education Program (SHEP) on sleep quality in students aged 9 to 11 in a Japanese elementary school. In the SHEP we gave a 75-minute lecture to the students. Both before and after the program, we distributed sleep-related questionnaires to 110 students and then collected and analyzed them. Three items concerning sleep quality; \u27Time of going to bed\u27, \u27Feeling upon waking up\u27 and \u27Who wakes you up ?\u27 were statistically analyzed using McNemar\u27s Test. The results showed that there was no significant change in the items \u27Time of going to bed\u27 and \u27Who wakes you up ?\u27 comparing before and after the program. However, the item \u27Feeling upon waking up\u27 showed a significant positive change after the program. These results suggest that SHEP has the potential for improving sleep quality even in young students

Cardioversion in patients with newly diagnosed non-valvular atrial fibrillation: observational study using prospectively collected registry data

OBJECTIVE To investigate the clinical outcomes of patients who underwent cardioversion compared with those who did not have cardioverson in a large dataset of patients with recent onset non-valvular atrial fibrillation. DESIGN Observational study using prospectively collected registry data (Global Anticoagulant Registry in the FIELD-AF-GARFIELD-AF). SETTING 1317 participating sites in 35 countries. PARTICIPANTS 52 057 patients aged 18 years and older with newly diagnosed atrial fibrillation (up to six weeks' duration) and at least one investigator determined stroke risk factor. MAIN OUTCOME MEASURES Comparisons were made between patients who received cardioversion and those who had no cardioversion at baseline, and between patients who received direct current cardioversion and those who had pharmacological cardioversion. Overlap propensity weighting with Cox proportional hazards models was used to evaluate the effect of cardioversion on clinical endpoints (all cause mortality, non-haemorrhagic stroke or systemic embolism, and major bleeding), adjusting for baseline risk and patient selection. RESULTS 44 201 patients were included in the analysis comparing cardioversion and no cardioversion, and of these, 6595 (14.9%) underwent cardioversion at baseline. The propensity score weighted hazard ratio for all cause mortality in the cardioversion group was 0.74 (95% confidence interval 0.63 to 0.86) from baseline to one year follow-up and 0.77 (0.64 to 0.93) from one year to two year follow-up. Of the 6595 patients who had cardioversion at baseline, 299 had a follow-up cardioversion more than 48 days after enrolment. 7175 patients were assessed in the analysis comparing type of cardioversion: 2427 (33.8%) received pharmacological cardioversion and 4748 (66.2%) had direct current cardioversion. During one year follow-up, event rates (per 100 patient years) for all cause mortality in patients who received direct current and pharmacological cardioversion were 1.36 (1.13 to 1.64) and 1.70 (1.35 to 2.14), respectively. OBJECTIVE To investigate the clinical outcomes of patients who underwent cardioversion compared with those who did not have cardioverson in a large dataset of patients with recent onset non-valvular atrial fibrillation. DESIGN Observational study using prospectively collected registry data (Global Anticoagulant Registry in the FIELD-AF-GARFIELD-AF). SETTING 1317 participating sites in 35 countries. PARTICIPANTS 52 057 patients aged 18 years and older with newly diagnosed atrial fibrillation (up to six weeks' duration) and at least one investigator determined stroke risk factor. MAIN OUTCOME MEASURES Comparisons were made between patients who received cardioversion and those who had no cardioversion at baseline, and between patients who received direct current cardioversion and those who had pharmacological cardioversion. Overlap propensity weighting with Cox proportional hazards models was used to evaluate the effect of cardioversion on clinical endpoints (all cause mortality, non-haemorrhagic stroke or systemic embolism, and major bleeding), adjusting for baseline risk and patient selection. RESULTS 44 201 patients were included in the analysis comparing cardioversion and no cardioversion, and of these, 6595 (14.9%) underwent cardioversion at baseline. The propensity score weighted hazard ratio for all cause mortality in the cardioversion group was 0.74 (95% confidence interval 0.63 to 0.86) from baseline to one year follow-up and 0.77 (0.64 to 0.93) from one year to two year follow-up.Of the 6595 patients who had cardioversion at baseline, 299 had a follow-up cardioversion more than 48 days after enrolment. 7175 patients were assessed in the analysis comparing type of cardioversion: 2427 (33.8%) received pharmacological cardioversion and 4748 (66.2%) had direct current cardioversion. During one year follow-up, event rates (per 100 patient years) for all cause mortality in patients who received direct current and pharmacological cardioversion were 1.36 (1.13 to 1.64) and 1.70 (1.35 to 2.14), respectively. CONCLUSION In this large dataset of patients with recent onset non-valvular atrial fibrillation, a small proportion were treated with cardioversion. Direct current cardioversion was performed twice as often as pharmacological cardioversion, and there appeared to be no major difference in outcome events for these two cardioversion modalities. For the overall cardioversion group, after adjustments for confounders, a significantly lower risk of mortality was found in patients who received early cardioversion compared with those who did not receive early cardioversion. STUDY REGISTRATION ClinicalTrials.gov NCT01090362

Changes in Subjective Sleep, Physical Condition, and Mental Health during the COVID-19 Pandemic: A Nationwide Survey in Japan

 This study aimed to investigate how people’s subjective health changed after the coronavirus disease 2019 (COVID-19) pandemic. This survey was conducted in May 2021 as a nationwide online self-reported survey in Japan. The respondents indicated how their sleep, physical condition, and mental state altered after the pandemic. Furthermore, they answered questionnaires about their intention to get vaccinated, the means of gathering information, etc. A logistic regression analysis was performed. Of the 2,573 responses, there was a decline of approximately 13.6%, 14.0%, and 23.8% in subjective sleep, physical condition, and mental health after the pandemic, respectively. The logistic regression analysis demonstrated that regarding sleep, the affected group was younger, got vaccinated against influenza annually, had lower income, experienced poor sleep quality in the past month, and had worse physical and psychiatric symptoms than before the pandemic. Concerning the physical condition, the affected group lived alone, witnessed deficient sleep quality in the past month, and had deteriorated mental health status than before the COVID-19 pandemic. In terms of mental status, the affected group was younger, females, had access to more sources of information, and experienced worse sleep and physical conditions than the unchanged or improved group (p < 0.05). Each group indicated an association with the background factors, confirming that the subjective sleep, physical condition, and mental state affected each other. From a preventive perspective, the results of this study suggested that factors such as youth, gender, sleep quality, pregnancy, reduced income, and greater access to information, may be necessary for physical and mental support. The above-mentioned factors should be considered in light of community life and approached accordingly