Disaster risk reduction (DRR) strategies often rely on national-level resilience indicators to evaluate their effectiveness. Yet, the adaptation of individual human resilience into DRR remains limited, particularly in the era of super-aging societies. This scoping review evaluates the utility of the Connor-Davidson Resilience Scale (CD-RISC) as a well-established quantitative, predictive indicator of human resilience, with a focus on its application in older populations across disaster contexts. A thematic synthesis of 25 included studies revealed a provider-centric hegemony, in which studies are concentrated on the occupational sustainability of healthcare professionals in disasters (n = 12) while neglecting the proactive assets of aging populations (n = 1). Furthermore, a 96% reactive bias was identified, with the scale used almost exclusively for retrospective assessment (n = 24) rather than pre-disaster assessment (n = 1). This review identifies the systemic oversights as a critical gap between macro-socioeconomic indicators and individual psychological reality. Consequently, current DRR systems assume societal resilience while underestimating the resilience capacity of older adults. To make inclusive policy into practice, disaster risk governance needs a paradigm shift from a provision-based to an asset-based model. In a super-aging society, it is imperative to quantify individual human resilience as invisible infrastructure, essential hidden load-bearing resources, for strengthening the coping capacity of individuals and the community. Further studies on the validity of the CD-RISC for pre-disaster assessment as a proactive tool are necessary to map the bases of human resilience before a disaster occurs.

Osteoglophonic dysplasia (OD) is a rare skeletal disorder marked by craniosynostosis, craniofacial anomalies, and abnormal bone development, primarily caused by FGFR gene mutations. We present the case of a 26-year-old Chinese female, who has been followed since age 11 for recurrent central giant cell granulomas (CGCG) and non-ossifying fibroma affecting her jaws and lower limbs. While her craniofacial and limb features have been described in two earlier publications, this report provides a detailed account of the aggressive and recurrent maxillary CGCG that resulted in significant clinical morbidity. Despite treatment with Alendronate targeting femoral lesions, the patient sustained a pathological fracture, resulting in long-term wheelchair dependency. Additionally, the maxillary lesion persisted and extended into the ethmoid sinus, causing recurrent epistaxis and anemia that required multiple surgical interventions. A multidisciplinary team initiated treatment with Denosumab, a monoclonal antibody that inhibits receptor activator of nuclear factor-κB ligand (RANKL) and directly targets osteoclast-like giant cells. Compared to bisphosphonates like Alendronate, which reduce bone resorption indirectly, Denosumab acts more selectively and showed superior clinical response in this case. The therapeutic switch resulted in marked tumor regression, effectively reducing surgical burden and improving quality of life. This case highlights the complexity of managing OD-associated CGCGs and the potential of Denosumab as a more effective therapeutic option than Alendronate. However, ongoing surveillance for adverse effects such as medication-related osteonecrosis of the jaw, hypocalcemia, and atypical fractures is essential.

High mobility group box-1 (HMGB1) regulates inflammation, immune response, DNA repair, and cell death, which is crucial in the pathogenesis of sepsis; while its role in sepsis susceptibility and mortality risk remains inconsistent. Hence, this meta-analysis systemically investigated the dysregulation level of HMGB1 and its association with mortality risk. PubMed, Web of Science, Embase, and Cochrane Library databases were searched until May 2024. Studies written in English and comparing HMGB1 level in serum or plasma detected by enzyme-linked immunosorbent assay between adult sepsis patients and controls, or non-survivors and survivors of sepsis, were eligible. Twenty-eight studies containing 3,110 subjects were included. The quality of studies was satisfactory evaluated by the Newcastle-Ottawa scale. Pooled analyses showed that HMGB1 was increased in sepsis patients versus controls (P < 0.001). Subgroup analysis revealed that HMGB1 was increased in sepsis patients versus healthy controls (P < 0.001), but less varied between sepsis patients and non-sepsis controls (P = 0.081). Additionally, HMGB1 was elevated in non-survivors versus survivors of sepsis (P = 0.030). Publication bias existed in HMGB1 differences between sepsis patients and controls; but it was adjusted using the trim-and-fill method, and the statistical significance did not change after that. Sensitivity analysis indicated acceptable robustness. In conclusion, this study suggests the potential of HMGB1 to serve as a possible biomarker for sepsis diagnosis and mortality risk stratification.

Ephrin type-A receptor 10 (EphA10) is a receptor tyrosine kinase involved in tumor cell proliferation and metastasis in certain cancers. The expression profile and function of EphA10 in gastric cancer (GC) have not been well studied. The present study aimed to evaluate EphA10 expression and its clinicopathological significance in gastric cancer. Data from TCGA/GEPIA database were used to assess EphA10 mRNA expression in GC. EphA10 expression in GC tissues was analyzed via IHC to validate these findings. CCK8, flow cytometry, and Transwell migration assays were used to evaluate EphA10 functions. In addition, we investigated EphA10-linked immune infiltration and performed transcriptomic analysis of RNA-seq data to identify EphA10-associated DEGs and enriched pathways. Western blot analysis was performed to detect epithelial-to-mesenchymal transition (EMT) markers and PI3K/AKT pathway proteins following EphA10 knockdown and overexpression. EphA10 expression is significantly increased in GC tissues. High EphA10 expression was strongly associated with lymphatic metastasis, advanced tumor-node-metastasis (TNM) stage, and poor survival. The overexpression of EphA10 in GC cells promoted proliferation and migration and inhibited apoptosis. Enrichment analysis of differentially expressed genes between the EphA10 high- and low-expression groups revealed that these genes are involved in digestion and absorption, transcription regulation, and inflammatory responses. TIMER database analysis revealed that EphA10 expression was significantly associated with immune cell infiltration. Moreover, EphA10 promotes gastric cancer cell aggressiveness and EMT via PI3K/AKT activation. EphA10 overexpression in gastric cancer correlates with metastasis, advanced TNM stage and poor prognosis, highlighting its potential as a biomarker and therapeutic target.

The cost of hip fractures, which likely cause a secondary fracture, is a heavy burden. To address this issue, the Japanese government launched a new medical reimbursement policy in April 2022: hospitals that give patients with hip fractures appropriate tests and treatments for osteoporosis after the surgery earn extra fees. Aiming to evaluate the impact of this scheme, we calculated transitional change of test and administration rates of each anti-osteoporosis medicine using Diagnosis-Procedure-Combination data for FY2020 to FY2022. As a result, 846 eligible hospitals were categorized into the fracture-liaison-service (FLS) group of 555, which applied for the new policy, or the non-FLS group of 291, which did not apply. In the 846 hospitals, the total administration rates of osteoporosis medication increased significantly between FY2021 and FY2022, 27.6 ± 0.7 (mean ± standard error) and 46.6 ± 0.9, respectively, at the same time of the implementation of the new reimbursement policy, despite no significant change between FY2020 and FY2021. The administration rates of medicines, Alendronate, Risedronate, and Denosumab, recommended strongly by “The Japanese Guideline for Prevention and Treatment of Osteoporosis 2015,” increased significantly not only in the FLS group, 10.8 ± 0.6 and 21.1 ± 0.9, but also in the non-FLS group, 6.2 ± 0.5 and 9.4 ± 0.9, between FY2021 and FY2022. The test rates showed a similar tendency. The substantial increase in the test rates and administration rates are considered to be primarily attributable to the newly implemented policy, with a partial contribution from the published guidelines.

Drug resistance affects the therapeutic effect of adriamycin on gastric cancer (GC). Therefore, this study aimed to explore the mechanism of basic leucine zipper (bZIP) transcription factor ATF-like 2 (BATF2) on adriamycin resistant (ADR) in GC cells and the involvement of mitochondrial fission in this process. A BATF2-overexpressed lentiviral vector was transfected into SGC7901/ADR cells, and effects of elevated BATF2 expression on the sensitivity of SGC7901 cells to adriamycin was observed by Transwell assays. The changes in mitochondrial morphology, fission marker expressions, and ATP levels after BATF2 overexpression were evaluated using Mito-Tracker Red staining, laser confocal, western blot and a detection kit. A ERK agonist was added to observe the effect of BATF2 overexpression on ERK phosphorylation levels. Co-immunoprecipitation (Co-IP) was used to confirm protein interactions between BATF2 and p53. PFT-α was adopted to observe the effects of p53 inhibition on BATF2-mediated ADR. In vitro experiments revealed that BATF2 overexpression restored drug sensitivity to adriamycin in SGC7901 cells and inhibited Drp1-dependent mitochondrial fission. Meanwhile, BATF2 overexpression also achieved the reversal of ADR in GC cells by inhibiting the phosphorylation level of ERK. P53 is an upstream regulator of ERK and interacts with BATF2 at the protein level. The suppression of p53 can significantly attenuated the inhibition of BATF2 overexpression on ADR, ERK phosphorylation, and Drp1-dependent mitochondrial fission in SGC7901/ADR cells. To conclude, BATF2 targets p53 and reverses drug resistance to adriamycin in GC cells by inhibiting ERK phosphorylation levels and downstream Drp1-dependent mitochondrial fission.

Hamartomas are abnormal tissue growths that can occur in various organs including the sinonasal tract. In this region, they are categorized into four subtypes, with respiratory epithelial adenomatoid hamartoma (REAH) being the most frequently reported. However, seromucinous hamartomas (SMHs) are rare, and only a limited number of case reports are available. This paper presents a case of an SMH located in the posterior nasal septum in a 45-year-old woman. The lesion was successfully excised in an outpatient procedure without complications. A pathological examination confirmed the diagnosis of SMH. At the three-month postoperative follow-up examination, no recurrence was observed and complete wound healing was noted, leading to the conclusion of follow-up. The continued accumulation of cases is needed to enhance the understanding of SMH, and it is important to recognize SMH as a potential differential diagnosis for tumorlike lesions in the sinonasal area. Although patient factors such as lesion location and comorbidities may influence treatment decisions, outpatient surgery can be a cost-effective option for SMHs when en bloc resection is feasible.

In Japan, at-home deaths are not always popular, yet many people hope to spend their end-of-life at home, which makes this a socio-medical issue. Regional factors are associated with at-home deaths, but their relative importance has not been known. The present study investigated the relationship between at-home deaths and regional factors and ranked their importance at the municipal level in Japan. We used national open data on at-home deaths, population, medical resources, causes of death, economic factors and geographic factors as well as built the prediction model for at-home deaths using Extreme Gradient Boosting (XGBoost) regression. The Shapley Additive Explanations (SHAP) value was applied to rank the importance of regional factors and explain the XGBoost model. As a result, the median prevalence of at-home deaths across municipalities was 12.7%. A higher prevalence of at-home deaths was observed in large metropolitan areas such as Tokyo, Osaka, and Nagoya. SHAP values revealed that latitude was the most important factor in rank, followed by the number of clinics providing end-of-life care, longitude, population density, and population change rate. In conclusion, geographic and population-related factors were ranked highly among regional factors associated with at-home deaths. These findings may be informative for community planning to realize at-home deaths nationwide.

Epidural analgesia is widely used for pain management, but catheter placement requires a high level of skill. Recently, mixed reality (MR) technology has gained attention in medicine, with potential applications in improving procedural success and training anesthesiologists. We developed a novel approach for three-dimensional (3D) visualization of a patient’s spine using MR technology. A patient with a history of difficult epidural catheter placement successfully received epidural anesthesia from a second-year anesthesiology resident using MR-assisted 3D spine visualization. The MR technology was used for 3 min and 8 s, and catheter placement took 10 min and 54 s. This case shows that MR-based 3D spine visualization may enhance the success and safety of epidural anesthesia. To our knowledge, this is the first report of MR technology being used for this purpose, highlighting its potential for both clinical practice and anesthesiology training. Further investigation is warranted.

The study evaluated the treatment outcomes of patients undergoing ureteroscopic holmium:YAG (Ho:YAG) laser lithotripsy after implementation of enhanced recovery after surgery (ERAS) protocols. The retrospective study included 200 patients undergoing ureteroscopic Ho:YAG laser lithotripsy and they were assigned into the conventional care cohort and the ERAS cohort. The ERAS cohort showed shorter time for first food intake, for duration of the urinary catheter, for out-of-bed activity, and for duration of the double J tube than the conventional care cohort after ureteroscopic Ho:YAG laser lithotripsy (p < 0.05). A reduced length of hospital stay (LOS) was noted in the ERAS cohort compared to the conventional care cohort (p < 0.05). The numerical rating scale (NRS) scores at 12 h postoperatively were reduced but the scores of daily living ability (ADL) at 24 h postoperatively were increased in the ERAS cohort compared to the conventional care cohort (p < 0.05). The ERAS cohort had a higher score of patient satisfaction towards the responsible nurses in term of health care than the conventional care cohort (p < 0.05). The study demonstrates that the ERAS protocols could be touted during ureteroscopic holmium laser lithotripsy due to its improvement on surgical recovery.

Colorectal cancer (CRC) remains a leading cause of cancer-related mortality worldwide. Despite advances in surgical and systemic treatments, recurrence continues to impact prognosis. Paraaortic lymph node metastasis (PALM) is an uncommon site of recurrence, occurring in only 1-2% of CRC cases. Among PALMs, solitary lymph node metastasis located posterior to the inferior vena cava (IVC) is exceptionally rare and challenging to diagnose. We present the case of a 66-year-old woman initially diagnosed with sigmoid colon cancer and multiple liver metastases. Following laparoscopic sigmoidectomy for tumor-related bleeding, the cancer was staged as pT3, pN3, cM1 (H), Stage IV. Chemotherapy resulted in significant regression of liver lesions. However, fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) revealed increased FDG uptake in a solitary 5-mm lymph node (LN) located posterior to the IVC. The patient subsequently underwent hepatic resection and lymphadenectomy. Histopathological examination confirmed metastatic adenocarcinoma in both the hepatic lesions and the solitary LN; however, the liver lesions showed a marked therapeutic response, while the LN did not. The discrepancy in therapeutic response between the liver metastases and the LN may be attributed to variable drug distribution and tissue-specific responses to chemotherapy. Solitary metastasis to the LN posterior to the IVC is extremely rare and difficult to diagnose. This case highlights the diagnostic and therapeutic challenges of solitary PALM in CRC. Accurate diagnosis of PALM is limited due to the difficulty for performing biopsy and imaging sensitivity, particularly for small LNs. Multidisciplinary evaluation, including PET/CT and surgical biopsy, is essential to guide treatment decisions.

Leigh syndrome (LS), characterized by progressive impairment and necrosis of the bilateral basal ganglia and brainstem structures, is the most prevalent mitochondrial disorder in children. Among the genetic causes of LS, the m.10191T>C variant in the mitochondrial complex I subunit gene MT-ND3 (NC_012920.1) is recognized as one of the most common. This variant is associated with a broad clinical spectrum, ranging from infantile lethality to adult-onset symptoms. Due to multisystem involvement, clinical manifestations are diverse, and treatment remains challenging. We present two patients with LS carrying the m.10191T>C variant of the MT-ND3 gene. Despite the severe clinical features and early disease onset, both patients demonstrated prolonged survival. Both patients exhibited psychomotor regression, and magnetic resonance imaging findings were indicative of bilateral basal ganglia and brainstem involvement. Subsequently, each patient developed rectal bleeding accompanied by elevated fecal calprotectin levels, which are indicative of intestinal inflammation. They also developed marked systemic edema and pleural effusions, which were exacerbated by infectious episodes and consistent with capillary leak syndrome. To the best of our knowledge, this is the first report describing severe capillary leak syndrome attributable to mitochondrial dysfunction in vascular endothelial cells. The observed rectal bleeding may reflect mitochondrial impairment within the intestinal wall. These findings extend the phenotypic spectrum of the m.10191T>C variant in LS.

The vasohibin (VASH) family is composed by VASH1 and VASH2. VASH1 is initially isolated as a negative feedback regulator of angiogenesis from endothelial cells, and VASH2 is identified as a homolog of VASH1. VASH1 is mainly expressed in endothelial cells under basal conditions, and its expression is upregulated during angiogenesis. In contrast, VASH2 expression is negligible in healthy organs except the testes after birth but augmented under pathological conditions, including cancer. It appears that VASHs exhibits tyrosine carboxypeptidase activity and removes the C-terminal tyrosine residue of α-tubulin. Along with others, we have previously shown that VASH1 and VASH2 play critical roles in cancers. In this review, we particularly highlight the significance of VASH2 in cancers and propose VASH2 to be a potential molecular target for cancer treatment.

Breast cancer (BRCA) is a major global health challenge. This study is aimed to discover the cuproptosis-related genes and their roles in BRCA treatment. Bioinformatic analyses, including clinicopathological, enrichment, and protein interaction studies, were performed. A predictive risk model was established and consensus clustering was conducted to detect new molecular subtypes. The tumor immune microenvironment (TIME) and immune status of the identified subgroups were assessed. GRIA3 was knocked down by shRNA, and CCK-8, EdU, wound healing, and Transwell assays were used to assess changes in cell viability, proliferation, migration, and invasion. CD8+ T cell migration was analyzed using Transwell assays, and the expression levels of IFN-γ and TNF-α were monitored via ELISA. Cuproptosis-related genes in BRCA patients were characterized. An immune prognostic model (IPM) predicted high-risk patients. Key markers (FABP7, PLA2G2D, RDH16, etc.) were linked to BRCA stages. TIME analysis revealed higher immune checkpoint expression (CD274, CTLA-4, etc.) in low-risk groups. The GRIA3 gene was shown to be highly expressed in BRCA cells, promoting cell proliferation, migration and invasion. Conversely, knockdown of GRIA3 attenuated these oncogenic properties and, importantly, enhanced the migration and effector cytokine (IFN-γ, TNF-α) secretion of co-cultured CD8+ T cells. The expression of cuproptosis-related genes is correlated with the immune microenvironment of BRCA patients and could serve as a predictive marker for prognosis as well as a target for treatment. GRIA3 exhibits pro-tumor activity in BRCA cells and may represent a potential therapeutic target.