Avacopan with Short-term Reduced-dose Glucocorticoids Vs Reduced-dose Glucocorticoids Added to Rituximab on Remission Induction in ANCA-associated Vasculitis

The goal of this clinical trial is to learn if avacopan in combination with short-term (4 weeks) reduced-dose glucocorticoid and rituximab works to treat patients with newly-onset ANCA-associated vasculitis. It will also learn about the long-term safety of avacopan. The main questions it aims to answer are:
Is avacopan in combination with short-term reduced-dose glucocorticoid and rituximab as effective as the combination of 20 week reduced-dose glucocorticoid and rituximab in the proportion of the patients achieving remission? Does avacopan lower the relapse rate compared to the 6 monthly rituximab maintenance therapy? What medical problems do participants have when taking long-term avacopan?
Participants will:
Be treated with avacopan in combination with short-term (until 4 weeks) reduced-dose glucocorticoid and rituximab (at 0 week) or reduced-dose glucocorticoid (until 20 weeks) and rituximab (at 0, 26, 52 and 78 weeks).
Be assessed at 0, 4, 8, 16, 26, 52, 78 and 104 weeks regarding disease status (remission/relapse), disease activity by Birmingham Vasculitis Activity Score ver3, disease damage by Vasculitis Damage Index and adverse events.
The primary endpoint is remission rates at 26 weeks.

开始日期2024-09-30

申办/合作机构

Chiba University

[+2]

JPRN-UMIN000053916 / SuspendedIIT

Elucidation of metabolic response mechanisms in exercise matched to chronotype and time of execution. - Elucidation of metabolic response mechanisms in exercise matched to chronotype and time of execution.

开始日期2024-05-31

申办/合作机构

International University of Health & Welfare

JPRN-UMIN000053907 / SuspendedIIT

Elucidation of metabolic response mechanisms in exercise matched to chronotype and time of execution - Elucidation of metabolic response mechanisms in exercise matched to chronotype and time of execution

开始日期2024-05-01

申办/合作机构

International University of Health & Welfare

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项与 International University of Health & Welfare 相关的文献（医药）

2024-12-01·Techniques in Coloproctology

Updated evidence of the effectiveness and safety of transanal drainage tube for the prevention of anastomotic leakage after rectal low anterior resection: a systematic review and meta-analysis

Review

作者: Suzuki, K ; Mohri, Y ; Yoshida, M ; Fujimoto, T ; Haji, S ; Yamashita, C ; Tamura, K ; Nakamura, M ; Shinji, S ; Uchino, M ; Kitagawa, Y ; Mizuuchi, Y ; Shimizu, J ; Mizuguchi, T ; Mayumi, T ; Nomura, S ; Kouzu, K ; Ohge, H ; Kobayashi, M ; Nagayoshi, K

BACKGROUNDS:

Anastomotic leakage (AL) represents a major complication after rectal low anterior resection (LAR). Transanal drainage tube (TDT) placement offers a potential strategy for AL prevention; however, its efficacy and safety remain contentious.

METHODS:

A systematic review and meta-analysis were used to evaluate the influence of TDT subsequent to LAR as part of the revision of the surgical site infection prevention guidelines of the Japanese Society of Surgical Infectious Diseases (PROSPERO registration; CRD42023476655). We searched each database, and included randomized controlled trials (RCTs) and observational studies (OBSs) comparing TDT and non-TDT outcomes. The main outcome was AL. Data were independently extracted by three authors and random-effects models were implemented.

RESULTS:

A total of three RCTs and 18 OBSs were included. RCTs reported no significant difference in AL rate between the TDT and non-TDT groups [relative risk (RR): 0.69, 95% confidence interval (CI) 0.42-1.15]. OBSs reported that TDT reduced AL risk [odds ratio (OR): 0.45, 95% CI 0.31-0.64]. In the subgroup excluding diverting stoma (DS), TDT significantly lowered the AL rate in RCTs (RR: 0.57, 95% CI 0.33-0.99) and OBSs (OR: 0.41, 95% CI 0.27-0.62). Reoperation rates were significantly lower in the TDT without DS groups in both RCTs (RR: 0.26, 95% CI 0.07-0.94) and OBSs (OR: 0.40, 95% CI 0.24-0.66). TDT groups exhibited a higher anastomotic bleeding rate only in RCTs (RR: 4.28, 95% CI 2.14-8.54), while shorter hospital stays were observed in RCTs [standard mean difference (SMD): -0.44, 95% CI -0.65 to -0.23] and OBSs (SMD: -0.54, 95% CI -0.97 to -0.11) compared with the non-TDT group.

CONCLUSIONS:

A universal TDT placement cannot be recommended for all rectal LAR patients. Some patients may benefit from TDT, such as patients without DS creation. Further investigation is necessary to identify the specific beneficiaries.

2024-12-01·Body Image

Body talk and body dissatisfaction in Japanese university students: Longitudinal study using the Japanese Body Talk Scale

Article

作者: Tomita, Takuro ; Adachi, Masaki ; Yamamoto, Tetsuya ; Oura, Shin-Ichi ; Ito, Nahori ; Hasegawa, Akira ; Matsuda, Yuko

This study evaluated the reliability and validity of the Japanese version of the Body Talk Scale (BTS), designed to measure negative fat talk, negative muscle talk, and positive body talk. The study also explored the longitudinal associations between each body talk category and body dissatisfaction. We conducted two separate studies among university students in Japan. Separate confirmatory factor analyses for female and male data indicated that the initially proposed three-factor model demonstrated an acceptable fit, whereas the bi-factor model provided a better fit. The Japanese BTS showed good construct validity, acceptable to adequate internal consistency, and test-retest reliability within 2 weeks. A four-week longitudinal study involving 386 women and 216 men (mean age = 19.22 and 19.62, respectively) revealed that negative fat talk predicted an increase in the discrepancy between the thin ideal body image and the actual body image among women. In contrast, positive body talk was linked to reduced body dissatisfaction and body image discrepancy in women. There were no such significant associations in men. These findings support the use of the Japanese BTS as a valuable instrument for future research on the intrapersonal and interpersonal effects of various types of body talk.

2024-11-01·International journal of clinical oncology

Current status and prospects of artificial intelligence in breast cancer pathology: convolutional neural networks to prospective Vision Transformers

Review

作者: Aoki, Yuki ; Oyama, Tetsunari ; Katayama, Ayaka ; Rakha, Emad A ; Horiguchi, Jun ; Watanabe, Yukako

Breast cancer is the most prevalent cancer among women, and its diagnosis requires the accurate identification and classification of histological features for effective patient management. Artificial intelligence, particularly through deep learning, represents the next frontier in cancer diagnosis and management. Notably, the use of convolutional neural networks and emerging Vision Transformers (ViT) has been reported to automate pathologists' tasks, including tumor detection and classification, in addition to improving the efficiency of pathology services. Deep learning applications have also been extended to the prediction of protein expression, molecular subtype, mutation status, therapeutic efficacy, and outcome prediction directly from hematoxylin and eosin-stained slides, bypassing the need for immunohistochemistry or genetic testing. This review explores the current status and prospects of deep learning in breast cancer diagnosis with a focus on whole-slide image analysis. Artificial intelligence applications are increasingly applied to many tasks in breast pathology ranging from disease diagnosis to outcome prediction, thus serving as valuable tools for assisting pathologists and supporting breast cancer management.

项与 International University of Health & Welfare 相关的新闻（医药）

2022-10-14

·NS Medical Devices

Philips ClarifEye yields positive results in first patient treatment in Japan

The 3D AR ClarifEye solution aids in the treatment of patients with spinal stenosis and scoliosis via minimally-invasive image-guided procedures Philips’ augmented reality (AR) surgical navigation solution ClarifEye. (Credit: Koninklijke Philips N.V.) Health technology company Royal Philips has extended the rollout of its augmented reality (AR) surgical navigation solution, ClarifEye, to Japan which yielded positive results in the first patient treatment in Japan. Using the 3D AR solution, the first patient was treated by orthopaedic surgeon Dr Ken Ishii at the International University of Health and Welfare, Mita Hospital, Tokyo. ClarifEye was installed on Philips’ interventional X-ray system in a hybrid operating at the hospital to treat patients with spinal stenosis and scoliosis via minimally-invasive image-guided procedures. Philips’ latest augmented reality surgical navigation device is said to integrate 3D AR navigation with 2D and 3D graphics at minimal X-ray exposure. It enables surgeons to define and traverse crucial trajectories for accurate device placement while minimising damage to neurological and circulatory systems near the patient’s spine. Philips Image Guided Therapy Systems general manager Karim Boussebaa said: “Mita Hospital’s positive experience of using ClarifEye to deliver the benefits of minimally-invasive therapy to its spine patients mirrors that of hospitals in Europe and the Middle East who also recently adopted the system. “ClarifEye adds a new dimension to surgical precision for patients. It is a great example of how we are innovating procedures and helping clinicians to deliver on the Quadruple Aim of better health outcomes, improved patient and staff experiences, and lower cost of care.” Philips said ClarifEye’s live-video computer vision and augmented reality (AR) technology applies non-invasive position markers to the patient’s skin in order to track the patient location. The resulting live video is then superimposed on a 3D cone-beam CT scan of the patient’s spinal column. The firm claimed that the solution allows surgeons to see both the inside and outside of the patient in the same picture, together with the planned and actual route of a Philips ClarifEye needle without any use of live X-ray imaging. According to the healthcare firm, data published in the Scientific Reports Journal suggested that in open deformity cases, ClarifEye showed 94% accuracy while similar surgeries performed with no help from intra-operative navigation showed 89.6% accuracy. Additionally, data published in European Spine Journal demonstrated 98% accuracy of pedicle screw placement in comparison to other navigation and robotic systems.

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100 项与 International University of Health & Welfare 相关的转化医学

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