Hepatitis E virus (HEV) is a major zoonotic pathogen, with pigs serving as the principal animal reservoir. While consumption of raw or undercooked pig liver is a well-recognized risk factor, systematic data on HEV contamination in retail pork meat remain limited. In this study, 1546 retail pork samples collected from eight geographic regions across Japan were analyzed for HEV RNA using a validated nested RT-PCR method. Analytical sensitivity was determined using the World Health Organization (WHO) International Standard for HEV RNA, yielding a 95% limit of detection (LOD95) of 134 IU/g (95% CI: 105–193). Overall, 15 samples (1.0%) tested positive for HEV RNA, with no significant regional variation (0.4–1.8%; p = 0.8375) or difference between domestically produced (1.0%, 12/1260) and imported pork (1.0%, 3/286; p = 0.7478). Viral loads in quantifiable samples (n = 11) ranged from 9.3 × 102 to 1.0 × 105 IU/g. Genotyping based on partial ORF2 sequences revealed subtype 3b as predominant (n = 7), followed by 3a (n = 5), 3f (n = 2), and 4c (n = 1). Each of the 15 strains showed high nucleotide sequence identity (98.8–100%) to its closest reported Japanese strain(s). Phylogenetic analysis showed that all strains clustered with their closest reported HEV strains, with high bootstrap support, despite genetic diversity within subtypes. These findings demonstrate that retail pork meat in Japan is contaminated with HEV RNA and may represent a potential source of human exposure. However, whether HEV RNA-positive retail pork meat contains infectious virus capable of causing human infection remains to be determined.
PURPOSE:This study aimed to clarify the current status and issues related to magnetic field experience in magnetic resonance imaging (MRI) among nurses as basic data for considering experiential education aimed at improving MRI safety. METHODS:A questionnaire survey was conducted among 674 nurses at our institution. The survey assessed experience of magnetic field exposure, awareness of MRI-related risks, and the perceived necessity of such experience. RESULTS:Responses were obtained from 438 nurses (response rate: 65.0%). Only 18.9% had experienced magnetic field exposure. In contrast, 90.6% considered such experience necessary. Among those without experience, 75.8% expressed a desire to undergo such training. CONCLUSION:Although nurses have basic knowledge of MRI magnetic fields, opportunities for experiential learning are limited. Magnetic field experience may be an effective educational approach to improve safety awareness.
BACKGROUND:Conversion therapy, which seeks to achieve curative treatment following systemic therapy, is increasingly acknowledged in the management of unresectable hepatocellular carcinoma (HCC). However, validated criteria for predicting eligibility for conversion remain unclear. We investigated the utility of the recently proposed borderline resectable (BR) classification combined with the barcelona clinic liver cancer (BCLC) staging system to identify patients most likely to benefit from conversion following atezolizumab plus bevacizumab (ATZ/BEV) therapy. METHODS:In this multicenter retrospective study, 532 patients with unresectable HCC treated with ATZ/BEV were categorized using the BR classification and stratified according to the BCLC stage. We evaluated objective response rate (ORR), conversion rate, and overall survival (OS) and carried out multivariate logistic regression analysis to identify predictors of conversion. RESULTS:Conversion therapy was performed in 5.9% of patients. Among those with BCLC-C HCC, the conversion rate was significantly higher in BR1 HCC than in BR2 HCC (15.2% vs. 2.0% and p < 0.01), and BR1 status was independently associated with conversion (odds ratio 7.0). Patients with BCLC-C/BR1 staging showed the highest ORR (45.0%) and favorable OS after conversion (p = 0.015). In contrast, the BR classification had limited predictive value in patients with BCLC-B HCC. Notably, downstaging from BR1 to resectable status was more common than from BR2, suggesting higher conversion feasibility. CONCLUSIONS:Integrating BR classification with BCLC staging identified BCLC-C/BR1 patients as optimal candidates for conversion therapy after ATZ/BEV treatment. These findings support incorporating anatomical and oncological criteria into systemic strategies to enable curative interventions in advanced HCC.
INTRODUCTION AND OBJECTIVE:Short sleep duration is associated with worse hemoglobin A1c (HbA1c), and treatment guidelines recommend sufficient sleep duration. However, it is unclear whether extending sleep duration of short-sleeping people with type 2 diabetes causes improved HbA1c. We aimed to assess the effect on HbA1c of increasing sleep duration. METHODS:We developed a personalized digital intervention based on the theory of planned behavior and conducted a single-blind, two-arm randomized controlled trial with 70 short-sleeping (≤6 hours) people with type 2 diabetes in Japan. Both arms measured sleep duration using an actigraph and a sleep diary. The intervention group received bedtime advancement support, including achievable bedtime goal setting and feedback. The primary outcome was between-arm difference in HbA1c change after 12 weeks. RESULTS:The baseline average sleep duration and HbA1c were 5.96 ± 1.26 (hours) and 8.30 ± 0.91 (%) in the intervention group, and 5.94 ± 0.96 (hours) and 8.09 ± 0.51 (%) in the control group, respectively. Sleep duration improved with statistical significance (between-arm difference in change: 32.8 minutes, P = .0042). However, HbA1c did not reduce significantly (between-arm difference in change: -0.11%, P = .51), and increases in sleep duration were not significantly associated with HbA1c reduction (P = .69). CONCLUSION:In this randomized trial, an average sleep extension of approximately 30 minutes over 12 weeks did not result in a significant improvement in HbA1c among short-sleeping adults with type 2 diabetes. Further studies with larger sample sizes and greater sleep extension are warranted.
