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Background: Transbronchial lung cryobiopsy is primarily used for diagnosing interstitial lung diseases and tumors, providing larger tissue samples with reduced tissue crushing than traditional biopsies. However, freezing during cryobiopsy may damage cells, potentially affecting diagnostic methods that require live cells, such as flow cytometry (FCM). We aimed to determine the extent of freezing-related cell damage in cryobiopsies using cells cultured in vitro., Methods: To investigate the relationship between freezing duration and sample volume, Jurkat cells underwent freezing for durations ranging from 2 to 6 s, with 1-s intervals, using either 1-mm- or 1.7-mm cryoprobes. FCM was conducted to assess both cell viability (2, 4, and 6 s) and cell-surface molecule expression (3 and 6 s) over varying freezing times. Additionally, we describe a clinical case involving a 70-year-old man suspected of malignant lymphoma, in which tissue samples were obtained via both forceps biopsy and cryobiopsy methods to compare the pathological and cytological features between the methods., Results: Harvested cell count increased with freezing duration, with a notable increase in viable cell percentage. Moreover, cells distant from the cryoprobe exhibited higher survival rates under milder freezing conditions. FCM revealed significantly higher marker expression levels in viable cryobiopsy samples than in non-viable samples. The clinical case demonstrated that cryobiopsy yields a significant proportion of live cells (>90%), with cytological findings consistent with those of non-frozen samples., Conclusions: Cryobiopsy may be beneficial for histopathological diagnosis, providing sufficient viable cells for FCM, and can be used for diagnosing malignant lymphomas and other pulmonary conditions., Competing Interests: Declaration of competing interest YM has received honoraria from AstraZeneca and GlaxoSmithKline. The other authors have no conflicts of interest., (Copyright © 2024 [The Author]. Published by Elsevier B.V. All rights reserved.)

Treatment outcomes for inoperable advanced non-small cell lung cancer have improved in recent years. However, information on coexisting haematological tumours is lacking. The present patient was a 65-year-old woman with stage IVA lung adenocarcinoma. The patient was administered a combination of platinum therapy and immune checkpoint inhibitors. The patient was subsequently diagnosed with chronic myeloid leukaemia (CML) following leukocytosis. Carboplatin and pemetrexed combination therapy resulted in shrinkage of lung cancer. Improvements in peripheral blood leukocyte counts and bone marrow findings were observed. These results suggested that the treatment of lung cancer may control the course of CML., Competing Interests: The authors declare that they have no competing interests., (Copyright: © 2024 Nagasue et al.)

Introduction: Oligometastasis and oligoprogression (OP) has not been adequately defined in extensive-stage SCLC (ES-SCLC) and may be a good indication for adding local treatment. Therefore, this multicenter study aimed to investigate the prognostic impact of oligometastasis and OP in ES-SCLC., Methods: We enrolled patients who received chemoimmunotherapy between September 2019 and June 2022. Patients were classified into oligometastasis and non-oligometastasis groups by determining the number of original tumor lesions and distant metastases (worsening or newly appearing lesions) at the time of initial diagnosis and disease progression after first-line treatment., Results: We retrospectively analyzed 265 consecutive patients with ES-SCLC. Synchronous oligometastasis (SOM) and OP was defined as less than or equal to five lesions in less than or equal to two organs, including lungs; 21.0% and 53.2% of patients had SOM and OP, respectively. Median progression-free survival was 5.8 months and 4.9 months in patients with and without SOM, respectively (hazard ratio [HR] = 0.72, 95% confidence interval [CI]: 0.51-1.02, p  = 0.065). Median overall survival was 20.5 months and 15.0 months in patients with and without SOM (HR = 0.58, 95% CI: 0.37-0.95, p  = 0.027) from the initiation of first-line treatment. The OP group revealed a better progression-free survival of 5.2 months (versus 3.2 mo, HR = 0.69, 95% CI: 0.50-0.96, p  = 0.026) and overall survival of 15.1 months (versus 7.5 mo, HR = 0.44, 95% CI: 0.29-0.66, p  = 0.027) from the initiation of second-line treatment compared with the non-OP group. The Lung Immune Prognostic Index score was significantly lower in the SOM and OP group., Conclusions: ES-SCLC in patients with SOM and OP may be more indolent than that of the nonoligometastasis group, therefore, new treatment strategies, including the addition of local treatment, should be explored., Clinical Trial Registration: This study was registered at UMIN-CTR (UMIN000053402)., Competing Interests: Dr. Asahina reported receiving grants from 10.13039/100004325AstraZeneca, receiving payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from Chugai Pharmaceutical, Merck Sharp & Dohme, Bristol-Myers Squib, Eli Lilly, Taiho Pharmaceutical, AstraZeneca, Ono Pharmaceutical, Merck, KyowaHakko-Kirin and reported participation on a data safety monitoring board or advisory board of AstraZeneca. Dr. Yokouchi reported receiving grants from Chugai Pharmaceuticals Co., Ltd., AstraZeneca, AbbVie, Daiichi Sankyo, Bristol-Myers Squibb Co., Ltd., Takeda Pharmaceutical Co., Ltd., and Sanofi, and personal fees from Chugai Pharmaceutical Co., Ltd. and AstraZeneca during the conduct of the study. Dr. Megumi Furuta reported receiving honoraria from AstraZeneca K.K., Daiichi Sankyo Co, Ltd., Nippon Kayaku Co, Ltd., and Chugai Pharmaceutical Co. during the conduct of the study. Dr. Konno reported receiving grants from 10.13039/100010795Chugai Pharmaceutical. Dr. Hosomi reported receiving payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing, and educational events from AstraZeneca, Eli Lilly Japan, Taiho Pharmaceutical, Chugai Pharmaceutical, Ono Pharmaceutical, Bristol-Myers Squibb, Kyowa Kirin, Nippon Kayaku, Takeda, Eisai, Novartis, Pfizer, Merck Sharp & Dohme during the conduct of the study. Dr. Oizumi reports receiving grants from 10.13039/100006483AbbVie, 10.13039/100002429Amgen, AstraZeneca, Bristol-Myers Squibb, Chugai Pharmaceutical, Daiichi Sankyo, Merck Sharp & Dohme, Pfizer, Sanofi, Taiho Pharmaceutical, and Takeda Pharmaceutical; honoraria from AstraZeneca, Chugai Pharmaceutical, Merck Sharp & Dohme. The remaining authors declare no conflict of interest., (© 2024 The Authors.)

Purpose: Patient safety climate is an important factor in promoting patient safety for healthcare organizations. This study investigated the relationship between collaborative leadership and patient safety climate, the mediation effect of workplace social capital, or interprofessional collaboration practice., Methods: A web-based cross-sectional questionnaire survey was administered between May 2021 and May 2022, to employees of three acute care hospitals in Japan. The relationship between variables was verified by structural equation modeling., Results: A total of 1,276 staff members participated in the study. Collaborative leadership affected the workplace social capital (β = .734) and interprofessional collaboration (β = .561), which were positively associated with patient safety climate (β = .403 and .405, respectively), verifying the mediating relationship of workplace social capital and interprofessional collaboration between collaborative leadership and patient safety climate., Conclusions: Collaborative leadership enhances the reciprocity and interprofessional practices of the healthcare team. The interaction among interprofessional team members fosters a patient safety climate. The results of this survey suggest that the development of collaborative leadership, which encourages interprofessional collaboration and fosters workplace social capital, is inherently crucial for cultivating a patient safety climate., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 National Association for Healthcare Quality.)

Purpose: This study, by applying the feedback process of the organizational learning model, examined the relationships among group learning, individuals' and groups' internalization of institutionalized evidence-based practice (I-EBP), and nurses' sustainment of I-EBP., Design/methodology/approach: Twelve hospitals were included in this cross-sectional study, with 1,741 nurses from 59 wards. Anonymous questionnaires were administered from October to December 2021. Participants self-reported their wards' group learning, internalization of I-EBP, sustainment of I-EBP, EBP beliefs, intra-hospital transfers, and nursing research experiences. The number of nurses and I-EBP introduction length and type of I-EBP were assessed. Internalization of I-EBP of nurses and groups was considered the mediating variable, while group learning and nurses' sustainment of I-EBP were the independent and dependent variables, respectively. Significant variables in bivariate analyses were used as control variables. Multi-level Mediation Analysis and a significance test of indirect effect using the bootstrap method were conducted., Findings: Responses from 360 nurses in 48 wards from 12 hospitals were analyzed. Groups' internalization of I-EBP significantly mediated the relationship between group learning and nurses' sustainment of I-EBP. In contrast, no significant mediating effect of nurses' internalization of I-EBP was observed., Originality/value: In the feedback process of organizational learning, group learning and its subsequent effects on individuals and groups have not been previously examined. Regardless of the nurses' degree of internalization of I-EBP, those who belong to the ward with a high degree of internalization of I-EBP are more likely to sustain it. Conducting group learning may prevent superficial practice, resulting in its sustainability., (© Emerald Publishing Limited.)

Supportive measures for employees raising children may have increased workloads on other nurses, causing psychological stress. This study aimed to clarify the differences in working conditions and psychological status among female Japanese nurses based on child-rearing attributes. We used data from 1,600 female nurses at 10 Japanese hospitals collected by the study of the Work Environment for Hospital Nurses in Japan conducted in 2016. The variables included work conditions (number of night shifts per month, daily overtime, number of paid holidays per year, and social support received), psychological status (sense of coherence, emotional exhaustion, and work engagement), and sociodemographic characteristics. An analysis of covariance was performed on the differences between the three groups (without children, with preschool-age children, and with children of other ages groups). The group without children had a relatively higher workload (p<0.01) and lower social support (p<0.01 and p<0.05). Additionally, they had higher emotional exhaustion and lower work engagement (p<0.01). This study confirmed the uneven distribution of work environment by work-life balance measures.

Epithelial cells serve as a barrier by tightly adhering to each other and contribute to the homeostasis of living organisms by controlling substance permeation. Therefore, evaluation of the barrier function is important in pharmaceutical development processes. However, the widely used Transwell-based assays require the development of the defect-free epithelial cell monolayer above several tens of mm 2 , often resulting in low reproducibility and requiring a long incubation time. In addition, the culture surface of cells is far from the bottom of the well plate, making it difficult to observe the cell morphology using an optical microscope. Herein, we propose simple polydimethylsiloxane microfluidic devices for evaluating the barrier function of an epithelial monolayer using a microchamber array. After the formation of the epithelial monolayer over microchambers, the permeation of the marker molecules introduced above resulted in increased fluorescence intensity in microchambers, which was monitored using confocal laser scanning microscopy. We show that using this technique, alteration of the paracellular permeability induced by sodium caprate (C 10 ) and cytochalasin-D, permeation enhancing factors, can be elucidated. Furthermore, by tilting the microchamber device 90 degrees, the vertical cell section and microchambers were imaged in the same focal plane, allowing for live visualization of the passage of fluorescent substances across the cell monolayer. This technique is expected to be useful for investigating the relationship between paracellular permeability and cell morphology, which is unattainable through conventional methods.

Background and Objectives: Patient-safety climate is one of the most important organizational factors contributing to health care quality. We hypothesized that a patient safety climate is fostered by the willingness to collaborate and trust among members as well as by daily collaborative practices. This study aimed to clarify the effect of workplace social capital on patient safety climate. We also sought to investigate the mediating effect of interprofessional team collaboration on the relationship between workplace social capital and patient safety climate., Methods: This cross-sectional survey was conducted from November 2021 to January 2022 using anonymous web-based questionnaires. The survey was distributed to 1495 employees working in a hospital in Tokyo, Japan. The questionnaire included the patient safety climate scale, workplace social capital scale, Japanese version of the Assessment of Interprofessional Team Collaboration Scale-II (AITCS-II-J), and demographic items. Structural equation modeling was performed to verify the associations among the 3 variables. In addition, a significance test for indirect effects was conducted using the bootstrap method to confirm the mediating effect of AITCS-II-J., Results: A total of 725 employees participated in this survey, and 632 data items were analyzed. Nurses were the highest number of respondents (68.2%), followed by physicians (13.3%). Workplace social capital and patient safety were directly and significantly associated (β = .309, P < .01). Furthermore, the partially indirect effect of the AITCS-II-J on the association between workplace social capital and patient safety climate was also significant (β = .430, P < .01)., Conclusions: Workplace social capital was significantly and directly related to patient safety climate and was also significantly related to patient safety climate partially mediated by interprofessional team collaboration. Our findings suggest the importance of workplace social capital and routine multidisciplinary collaboration for a patient safety climate to manage health care quality., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Aim: Shift management and planning processes for shift-working nurses are important for their continued work. This study aimed to determine the association between shift assignments, organizational justice, and their interaction with turnover intention among shift-work nurses., Methods: This cross-sectional study used an online questionnaire administered to Japanese nurses between January and February 2020. Enquiries pertaining to their daily start and end times for each shift type, the shift assignments, organizational justice, and their turnover intention were made. To examine the association with turnover intention, logistic regression analysis was performed with shift assignments, organizational justice, and their interaction terms as independent variables., Results: A total of 386 nurses participated in the final analysis. Of these, 161 nurses (41.7%) had turnover intention. Unequal work assignments and procedural justice were significantly associated with turnover intention. However, the interaction between these factors was not significant., Conclusion: The results suggest that procedural justice in the workplace and turnover intention are related, but in shift planning, even procedural justice cannot buffer unequal work from leading to turnover intention. This study provides valuable insights for nursing managers who manage the schedules of shift-working nurses., (© 2023 The Authors. Japan Journal of Nursing Science published by John Wiley & Sons Australia, Ltd on behalf of Japan Academy of Nursing Science.)

Introduction: Sotorasib is a crucial therapeutic agent for patients with non-small cell lung cancer (NSCLC) harboring the KRAS p.G12C mutation. Despite its efficacy, the relationship between blood sotorasib concentrations and side effects remains largely unexplored., Methods: This study enrolled five patients with KRAS p.G12C-positive NSCLC treated with sotorasib (LUMAKRAS ® Tablets, Amgen, Japan) between July 2022 and February 2023 at Asahikawa Medical University Hospital. Blood sotorasib levels were monitored, and their association with adverse events was examined, with no adjustments made to drug dosages based on these levels., Results: Variable blood sotorasib levels were observed among the participants. Notably, one patient developed interstitial pneumonitis, although a definitive attribution to sotorasib was uncertain due to prior pembrolizumab treatment. The study revealed no consistent association between blood sotorasib levels and adverse events or therapeutic outcomes, with some patients experiencing severe side effects at higher concentrations, while others did not., Conclusion: Preliminary findings suggested that monitoring blood sotorasib levels may aid in anticipating adverse events in this small cohort. However, future studies with larger sample sizes and extended follow-up periods are required to validate these initial observations. Such studies could potentially offer insights into personalized dosing strategies, thereby mitigating adverse effects and enhance patient care for individuals with KRAS p.G12C-positive NSCLC., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Shigaki, Yoshida, Yagita, Nagasue, Naraoka, Nitanai, Yanada, Tenma, Kida, Umekage, Mori, Minami, Sato, Iwayama, Hashino, Fukudo and Sasaki.)

Background: Tyrosine kinase inhibitors (TKIs) significantly improve clinical outcomes in patients with non-small cell lung cancer due to anaplastic lymphoma kinase ( ALK ) gene rearrangement. However, the rate of relapse with TKIs is high owing to the development of resistance mutations during treatment. Repeated biopsies during disease progression are crucial for elucidating the molecular mechanisms underlying the development of resistance to ALK inhibitors. Analysis of cell-free DNA (cfDNA) obtained from plasma is a novel approach for tumor genotyping., Methods: In this mixed prospective and retrospective observational cohort study, we investigated the clinical feasibility of continuous quantitative monitoring of ALK -acquired mutations in plasma obtained from patients with ALK + non-small cell lung cancer by using a highly sensitive and specific droplet digital polymerase chain reaction (ddPCR) assay. We enrolled nine patients, including three treatment-naïve patients recently diagnosed with ALK + non-small cell lung cancer via tissue biopsy and expected to receive ALK TKIs and six patients already receiving ALK TKIs. Plasma samples were collected from these patients every 3 months. cfDNA was extracted from 66 samples during the study period, and 10 ALK mutations were simultaneously evaluated., Results: The numbers of samples showing the G1202R, C1156Y, G1269A, F1174L, T1151ins, and I1171T mutations were 32, 16, 5, 4, 1, and 1, respectively. The L1196M, L1152R, V1180L, and S1206Y mutations were not detected. Correlation analyses between progression-free survival and the time from treatment initiation (or treatment modification) to the detection of resistance mutations revealed that although resistance mutations may occur before a drug change becomes necessary, there is a duration during which the disease does not progress., Conclusions: Our findings suggest that real-time quantitative monitoring of ALK resistance mutations during the response period could provide a time course of changes while acquiring resistance mutations. This information would be beneficial for designing an appropriate treatment strategy., Competing Interests: Conflicts of Interest: All the authors have completed the ICMJE uniform disclosure form (available at https://tlcr.amegroups.com/article/view/10.21037/tlcr-22-671/coif). TS received research funding from Pfizer Inc., Japan, and has received honoraria for lectures from Pfizer Japan, Inc., Chugal Pharmaceutical Co., Ltd., and Novartis Pharma. The other authors have no conflicts of interest to declare., (2023 Translational Lung Cancer Research. All rights reserved.)

Aim: This study aimed to examine the mediating effect of workplace social capital on the relationship between authentic leadership and the three dimensions of organizational commitment: affective, normative, and continuance., Methods: In January 2019, anonymous self-reported questionnaires were distributed to 1220 nurses working in the general wards of two university hospitals in Japan. Structural equation modeling was used to examine the mediating effects of workplace social capital on the relationship between nurse managers' authentic leadership and the three dimensions of organizational commitment., Results: Six hundred and fifty-nine data points were analyzed (valid response rate = 54.0%). Participants' average age was 28.6 years (standard deviation: 6.6), and 93.3% were female. The mediation indirect effect of workplace social capital between authentic leadership and organizational commitment was statistically significant in the models of affective organizational commitment and normative organizational commitment, but not in the model of continuance organizational commitment., Conclusions: The effects of authentic leadership and workplace social capital had different impacts on each of the three dimensions of organizational commitment. Nurse managers' authentic leadership and workplace social capital can enhance nurses' positive commitment to the organization., (© 2023 The Authors. Japan Journal of Nursing Science published by John Wiley & Sons Australia, Ltd on behalf of Japan Academy of Nursing Science.)

Female nurses experience work-family conflict due to performing multiple roles, leading to burnout. Thus, this study aimed to verify the association between burnout and the multiple work and family roles performed among Japanese female nurses. The data for 2,255 nurses at 23 Japanese hospitals obtained from the Work Environment for Nurses Study in Japan were used. The variables included burnout, demographic information, additional work roles, and child-rearing or caregiving. Half of the nurses were categorized under the "no-role" group (NRG), approximately a quarter under the "work-role" group (WRG), 16% under the "family-role" group (FRG), and 7.3% under the "multiple-role" group (MRG). Compared to the NRG, the FRG and MRG showed statistically lower emotional exhaustion (B=-0.79, p<0.05; B=-0.94, p<0.05, respectively) and depersonalization (B=-0.80, p<0.05; B=-1.09, p<0.05, respectively). Personal accomplishment was not statistically different among the four groups. Burnout was relatively low among nurses with family roles, suggesting that family roles may have a positive spillover effect on work-related emotions.

Aim: Temporary lodging facilities which were non-medical facilities were established to secure beds for severely and moderately ill patients with COVID-19, as well as for isolation, non-contact observation, and care of mildly ill and asymptomatic patients in Japan. This study aims to understand nursing management practices adopted in these facilities by examining cases of their establishment and operation., Methods: A multiple-case study design was used. Interviews for qualitative data collection were conducted from August to October 2020. After analyzing the nursing management practices in four temporary lodging facilities, common points were collated and integrated., Results: For the establishment and operation of temporary lodging facilities, a three-layer structure based on disaster management methods was adopted: headquarters at the helm as overseers, field supervisors in the middle, and frontline nursing staff at the base. The structure had clear roles, facilitated information exchange, and provided efficient and effective nursing care. Field supervisors mainly provided psychological and clinical support for staff and served as information and interprofessional hubs., Conclusion: It is recommended that temporary lodging facilities should be organized based on principles of the division of labor. The workforce should comprise nursing staff, and experienced nursing professionals should be recruited to the higher echelons., (© 2022 Japan Academy of Nursing Science.)

Aim: We aim to identify measures implemented by hospital nursing directors early in the COVID-19 pandemic and enabling factors., Background: Managerial factors affect nurses' physical and mental health and willingness to work, especially early in a pandemic., Method: We used multiple-case study of 15 hospitals, comparing management approaches by interviewing 28 nursing directors and their assistants from August to December 2020., Results: Hospitals that accepted COVID-19 patients and hospitals that unexpectedly experienced clusters underwent a nursing provision system organization phase, followed by an adjustment phase to maintain nursing organization function. Two factors aided measure implementation: an emergency system and staff protection policies., Conclusion: Early epidemic management strategies apply across contexts. The hospital's basic attitude is key to effective implementation of the strategies., Implications for Nursing Management: The results suggest that hospitals, nursing directors and nurses can each prepare for future emerging infectious disease epidemics., (© 2022 John Wiley & Sons Ltd.)

Aims: The study aimed to identify the aspects and items of nurse turnover impact on organizations as perceived by nursing management., Background: Turnover rate does not capture the extent to which an organization is affected by turnover. Another indicator is required to assess the control status of turnover impact., Methods: A Delphi study was conducted in 2021, where 2670 managers of nursing at 712 hospitals were asked to complete the survey three times. Factor analysis was conducted on these items for which a consensus was reached., Results: Overall, 232 managers who responded multiple times, including the third survey, were included in the analysis. Consensus was reached for 36 items affected by turnover and considered important for nursing management. Using exploratory factor analysis, the following six factors were extracted: quality of nursing care, physical and mental health of nursing staff, workload and working conditions of nursing staff, relationships among nursing staff members, sense of responsibility among nursing staff, and cost and benefit of hiring replacement personnel., Conclusions: Six factors consisting of 36 items were extracted that can be used to assess the impact of nurse turnover., Implications for Nursing Management: Nurse managers can assess the status of the organization more appropriately by understanding the factors that impact nurse turnover in vaious facilitites and look at strategies to overcome the impact on nurse staffing., (© 2022 John Wiley & Sons Ltd.)

Aim: This study investigates which work-related communication mediates the relationship between diversity climate and psychological empowerment among part-time nurses., Background: Part-time nurses' high psychological empowerment is desirable because it may lead to high quality nursing practice., Methods: Anonymous self-report questionnaires or web-based surveys were used to measure diversity climate (Climate for Inclusion Scale), psychological empowerment (Japanese version of the Psychological Empowerment Scale) and work-related communication (scale developed in this study). The respondents were part-time nurses from departments with shift work in six Japanese hospitals having over 200 beds. The surveys were conducted from September to October 2020. Multiple regression analyses and a significance test of indirect effects were then conducted., Results: Among the work-related communication components, 'expressing thoughts about their work' fully mediated the relationship between diversity climate and psychological empowerment., Conclusions: It is important for part-time nurses to be actively 'expressing thoughts about their work' to enhance their psychological empowerment. Positive diversity climate is also important because it allows part-time nurses to express their thoughts regarding work., Implications for Nursing Management: Managers can enhance part-time nurses' psychological empowerment by encouraging them to express their work-related opinions based on the diversity climate., (© 2022 John Wiley & Sons Ltd.)

Purpose: This study aimed to identify the working conditions (working hours, overtime work, number of night shifts, number of holidays, and work intervals) associated with fatigue, based on the shift patterns, and determine their thresholds., Methods: From January to February 2020, a web-based questionnaire was sent to 4601 shift work nurses at 47 hospitals in Japan. The multivariate logistic analysis was conducted to predict high- and low-fatigue groups by working conditions, and receiver operating characteristic analysis was performed to clarify the high-fatigue thresholds by shift pattern., Results: A total of 386 shift work nurses participated in this study. The threshold (fatigue was 3.0 or higher) of the two-shift rotation was 9 hours 50 minutes for daily working hours during day shifts (Odds ratio [OR] = 1.57, p < .01), 17 hours 15 minutes for daily working hours during night shifts (OR = 1.20, p < .01), and 8.0 days for the number of night shifts (OR = 1.09, p = .02). The threshold of the three-shift rotation was 9 hours 45 minutes (OR = 1.59, p < .01), 2.9 days for the number of midnight shifts (OR = 1.53, p < .01), and 2.0 times for the interval between day-shift and night-shifts within 12 hours (OR = 1.39, p < .01)., Conclusion: Working hours and the number of night shifts are important for two-shift rotation, and working hours for the assignment of midnight shift are important for three-shift rotations. Nurse managers should manage shifts according to nurses' shift patterns., Competing Interests: Conflict of interest There are no conflicts of interest to declare., (Copyright © 2022. Published by Elsevier B.V.)

3D printing technology is a novel and practical approach for producing unique and complex industrial and medical objects. In the pharmaceutical field, the approval of 3D printed tablets by the US Food and Drug Administration has led to other 3D printed drug formulations and dosage forms being proposed and investigated. Here, we report novel ophthalmologic patches for controlled drug release fabricated using a semi-solid material extrusion-type 3D printer. The patch-shaped objects were 3D printed using hydrogel-based printer inks composed of hypromellose (HPMC), sugar alcohols (mannitol, xylitol), and drugs, then freeze-dried. The viscous properties of the printer inks and patches were dependent on the HPMC and sugar alcohol concentrations. Then, the physical properties, surface structure, water uptake, antimicrobial activity, and drug release profile of lyophilized patches were characterized. Lyophilized ophthalmologic patches with different dosages and patterns were fabricated as models of personalized treatments prepared in hospitals. Then, ophthalmologic patches containing multiple drugs were fabricated using commercially available eye drop formulations. The current study indicates that 3D printing is applicable to producing novel dosage forms because its high flexibility allows the preparation of patient-tailored dosages in a clinical setting., (Copyright © 2022 Elsevier B.V. All rights reserved.)

A patient with late phase of COVID-19 pneumonia presented peripheral cystic features on chest computed tomography, which were spontaneously resolved with no antibiotic therapy or surgery. Physicians should pay attention to follow up the late phase of COVID-19 pneumonia for better understanding its progression and clinical course., Competing Interests: The author declares that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported., (© 2022 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)

Aims: To investigate the number of bed transfers (patient transfers within the same ward) and their reasons in acute care wards of mid-sized hospitals with multibed and private rooms., Background: Bed transfers, even when necessary, are burdensome for patients; however, the reasons for bed transfers in various types of rooms remain unclear., Methods: An observational study was conducted in seven wards in three hospitals in Japan. Nurses completed a questionnaire regarding each bed transfer, which elicited the reasons for the transfer. We classified transfer patterns based on the functions of the patients' rooms and the number of beds in each room and analysed scores., Results: Overall, 560 responses were analysed. The average number of bed transfers per day was 2.7. In total, 43% of bed transfers were conducted for patients aged over 70. The most frequent bed transfer pattern was 'transfer between patient rooms with the same number of beds', and the most frequent reason was 'patient did not need that bed'., Conclusions: Unnecessary bed transfers could be reduced by ward designs that reflect nurses' clinical judgement., Implications for Nursing Management: Monitoring data for the reason regarding bed transfer contributes to hospital planning and decreases unnecessary bed transfers., (© 2021 John Wiley & Sons Ltd.)

Aims: The study aimed to determine the influence of learning circumstances (learning inside and outside hospitals, and communication about the nursing practice with colleagues) and on-the-job opportunities for professional growth on each dimension of person-environment fit (needs-supplies, demands-abilities, person-organisation and person-group fit) among nurses., Background: It is desirable for each dimension of person-environment fit to be high, as it links to many work-related outcomes., Methods: A longitudinal survey using a questionnaire was conducted in February 2019 (Time 1) and October 2019 (Time 2). A simple linear regression analysis and a multiple linear regression analysis were conducted, using data from 324 nurses., Results: The results of the simple regression analysis showed that three variables related to learning circumstances at Time 1 were positively related to each dimension of person-environment fit at Time 2. The multiple regression analysis showed on-the-job opportunities for professional growth at Time 1 related to person-environment fit at Time 2., Conclusions: To achieve high person-environment fit, nurses should be aware of on-the-job opportunities for professional growth., Implications for Nursing Management: To achieve high person-environment fit, nurse managers should evaluate nurses' abilities and assign them jobs that would help improve their nursing skills., (© 2020 John Wiley & Sons Ltd.)

Aim: To identify the effects of authentic leadership, structural empowerment and forms of communication as antecedent factors of workplace social capital in nursing., Background: Enhancing workplace social capital for nurses by management requires identifying antecedent factors of workplace social capital focusing on work environment and relationships between members., Methods: In 2019, self-administered questionnaires were sent to all nurses working on the general wards of two university hospitals in Japan. A multilevel analysis was conducted to evaluate relationships between perceived workplace social capital-the dependent variable-and authentic leadership, structural empowerment and forms of communication-the individual- and ward-level independent variables., Results: Data from 463 nurses and 28 nurse managers were analysed (valid response rates = 38.0% and 58.3%, respectively). Their average age was 28.64 years (standard deviation: 7.00), and 93.5% were female. Ward-level authentic leadership and semi-formal communication were found to be significantly related to workplace social capital., Conclusion: More authentic leadership and communication to promote mutual understanding between members can foster workplace social capital among hospital nurses. These findings can help inform effective workplace training in hospitals., Implications for Nursing Management: Workplace social capital can be produced by improved management, environment and communication opportunities., (© 2020 John Wiley & Sons Ltd.)

The 3D printing of drug formulations is a promising method for preparing tailored medicines following the approval of 3D printed tablets by the US FDA in 2015. Appropriate dosage forms for pediatric patients are deficient because drugs have been developed for mainly adult patients. Here, we fabricated gummy drug formulations for pediatric patients using a 3D bioprinter compatible with semi-solid materials such as hydrogels and pastes. The gummy drug formulations were composed of gelatin, HPMC, reduced syrup, water and the antiepileptic drug lamotrigine. The formulations were extruded from the nozzle of the 3D bioprinter under air pressure and laminated from the bottom in a layer-by-layer process. The incorporation of HPMC aided smooth printing at room temperature, and gelatin and HPMC affected the viscosity of the drug formulation and the printability of the formulations. The strength of the gummy formulations was remarkably influenced by the gelatin concentration. Dissolution tests showed 85% drug release within 15 min from most formulations. The results suggest that 3D printing is an effective method for preparing gummy drug formulations with various shapes in different colors, and that the methodology may improve drug adherence of pediatric patients in future clinical settings., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The Initial Upper Paleolithic (IUP) temporally overlaps with the range expansion of Homo sapiens populations in various parts of Eurasia and is often considered a key archaeological phase for investigating behavioral changes from the Middle Paleolithic. This paper reports upon new data from IUP occupations at Wadi Aghar, a rock shelter site in the southern Levant. In combining the results of radiometric dates and lithic analyses, we clarify the chronological and cultural position of Wadi Aghar assemblages in the Levantine IUP. As for the records about mobility, on-site activities, and resource procurement behaviors, we present analyses of lithic use-wear, tool-type composition, soil micromorphology, and marine shells. The lithic analyses and the optically stimulated luminescence (and subsidiary radiocarbon) dating of the Wadi Aghar materials suggest their chronocultural position in the IUP (45-40 ka for Layers C-D1; 39-36 ka for Layer B; possibly 50 ka for Layer D2), providing the southernmost location for the IUP in Eurasia. In the Levant, Wadi Aghar represents one of the few IUP sites in the inland areas. The results also indicate that the timing and technological sequences from the IUP to the following bladelet industries differed between the inland and coastal zones, likely reflecting geographically variable adaptive behaviors and/or cultural transmissions. One of the behavioral characteristics of IUP foragers at Wadi Aghar is the procurement of remote resources, represented by the transportation of marine shells from the Red Sea: Canarium fusiforme and Canarium cf. mutabile. Whether it was a direct procurement with increased mobility or a result of intergroup exchanges, it was not part of behavioral repertoires during the late MP in the same area. This can be understood as the expansion of resource procurement range, functioning as additional buffers from risk in the semiarid environments in the inland Levant., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

It has been known that organic anion-transporting polypeptides (Oatps) involve hepatic transports several organic anionic compounds and drugs. This study aimed to investigate sulforhodamine-101 (SR-101) distribution in the rat liver, determine the molecules responsible for the distribution, and delineate the manner of distribution. After intravenous SR-101 administration, its distribution in frozen rat hepatic sections was examined. SR-101-derived signals were detected in regions around the hepatic central vein (CV), where immunohistochemistry (IHC) indicated high Oatp1a4 expression. The signals decreased with treatment by digoxin, a specific substrate for Oatp1a4. In vitro studies using isolated rat hepatocytes and rat Oatp1a4-expressing Xenopus laevis oocytes have suggested that SR-101 is an Oatp1a4 substrate and is taken up into rat hepatocytes mainly via Oatp1a4. Therefore, results suggested SR-101 zonation because of Oatp1a4 involvement and that Oatp1a4 function is dominant in the region around the hepatic CV in rat hepatic lobules., (Copyright © 2019 The Japanese Society for the Study of Xenobiotics. Published by Elsevier Ltd. All rights reserved.)

We previously showed that brown (pre)adipocytes express Trpv1, a capsaicin receptor, and that capsaicin stimulates differentiation of brown preadipocytes in the late stages of brown adipogenesis. The present study revealed that treatment with 100 μM capsaicin stimulates brown adipogenesis by inducing endoplasmic reticulum (ER) stress. Treatment with capsaicin (100 μM) during brown adipogenesis enhanced lipid accumulation and the expression of Ucp1, a gene selectively expressed in brown adipocytes. Capsaicin treatment also caused an increase in the cytosolic calcium concentration even when extracellular calcium was removed. I-RTX, a Trpv1 inhibitor, did not modulate the increase in cytosolic calcium concentration, lipid accumulation or Ucp1 expression. Previous studies revealed that the release of calcium from the ER induces ER stress, leading to the conversion of X-box binding protein 1 (Xbp1) pre-mRNA to spliced Xbp1 (sXbp1) as well as the up-regulation of Chop expression. Capsaicin treatment increased the expression of sXbp1 and Chop in brown preadipocytes and did not enhance lipid accumulation or Ucp1 expression in Xbp1 knockdown cells. The present results describe a novel mechanism of brown adipogenesis regulation via ER stress that is induced by a supra-pharmacological concentration of capsaicin.

Brown adipocytes dissipate chemical energy in the form of heat through the expression of mitochondrial uncoupling protein 1 (Ucp1); Ucp1 expression is further upregulated by the stimulation of β-adrenergic receptors in brown adipocytes. An increase in energy expenditure by activated brown adipocytes potentially contributes to the prevention of or therapeutics for obesity. The present study examined the effects of milk by-products, buttermilk and butter oil, on brown adipogenesis and the function of brown adipocytes. The treatment with buttermilk modulated brown adipogenesis, depending on the product tested; during brown adipogenesis, buttermilk 1 inhibited the differentiation of HB2 brown preadipocytes. In contrast, buttermilk 3 and 5 increased the expression of Ucp1 in the absence of isoproterenol (Iso), a β-adrenergic receptor agonist, suggesting the stimulation of brown adipogenesis. In addition, the Iso-induced expression of Ucp1 was enhanced by buttermilk 2 and 3. The treatment with buttermilk did not affect the basal or induced expression of Ucp1 by Iso in HB2 brown adipocytes, except for buttermilk 5, which increased the basal expression of Ucp1. Conversely, butter oil did not significantly affect the expression of Ucp1, irrespective of the cell phase of HB2 cells, ie, treatment during brown adipogenesis or of brown adipocytes. The results of the present study indicate that buttermilk is a regulator of brown adipogenesis and suggest its usefulness as a potential food material for antiobesity., (Copyright © 2016 John Wiley & Sons, Ltd.)

The ingestion of capsaicin, the principle pungent component of red and chili peppers, induces thermogenesis, in part, through the activation of brown adipocytes expressing genes related to mitochondrial biogenesis and uncoupling such as peroxisome proliferator-activated receptor (Ppar) γ coactivator-1α (Pgc-1α) and uncoupling protein 1 (Ucp1). Capsaicin has been suggested to induce the activation of brown adipocytes, which is mediated by the stimulation of sympathetic nerves. However, capsaicin may directly affect the differentiation of brown preadipocytes, brown adipocyte function, or both, through its significant absorption. We herein demonstrated that Trpv1, a capsaicin receptor, is expressed in brown adipose tissue, and that its expression level is increased during the differentiation of HB2 brown preadipocytes. Furthermore, capsaicin induced calcium influx in brown preadipocytes. A treatment with capsaicin in the early stage of brown adipogenesis did not affect lipid accumulation or the expression levels of Fabp4 (a gene expressed in mature adipocytes), Pparγ2 (a master regulator of adipogenesis) or brown adipocyte-selective genes. In contrast, a treatment with capsaicin in the late stage of brown adipogenesis slightly increased the expression levels of Fabp4, Pparγ2 and Pgc-1α. Although capsaicin did not affect the basal expression level of Ucp1, Ucp1 induction by forskolin was partially inhibited by capsaicin, irrespective of the dose of capsaicin. The results of the present study suggest the direct effects of capsaicin on brown adipocytes or in the late stage of brown adipogenesis., (Copyright © 2016 John Wiley & Sons, Ltd.)

We previously reported the presence of brown/beige adipocytes in the white fat depots of mature cattle. The present study examined the effects of dietary vitamin A on the expression of brown/beige adipocyte-related genes in the white fat depots of fattening cattle. No significant differences were observed in the expression of Ucp1 between vitamin A-deficient cattle and control cattle. However, the expression of the other brown/beige adipocyte-related genes was slightly higher in the mesenteric fat depots of vitamin A-deficient cattle. The present results suggest that a vitamin A deficiency does not markedly affect the expression of Ucp1 in white fat depots, but imply that it may stimulate the emergence of beige adipocytes in the mesenteric fat depots of fattening cattle.

Selectins play an important role on leukocytes infiltration into inflammatory tissues. To understand the role of selectins, we investigated the effects of selectin-IgG chimeras and anti selectin antibodies on the murine IgE-mediated skin inflammation model. Biphasic skin reactions were induced by intradermal challenge with ovalbumin (OA) to ears of actively sensitized mice. This reaction was characterized by immediate and late phase responses observed as which were induced via a rapid increase in capillary permeability and leukocyte infiltration, respectively. The expression of E-selectin mRNA was significantly increased to reach its highest level at 2 h after OA challenge. E-, P-, and L-selectin-IgG chimeras inhibited the late phase responses, i.e. ear swelling, neutrophil infiltration and eosinophil infiltration at 24 h after OA challenge in a dose-dependent manner at dose range of 0.1 - 10 mg kg(-1), i.v. Antiselectin antibodies did not inhibit the increase of ear swelling. But anti E- and P-selectin antibodies significantly inhibited neutrophil infiltration and eosinophil infiltration. These results indicate that selectins play an important role on the late phase response of the murine IgE-mediated skin inflammation model by mediating inflammatory cell adhesion to endothelium.