Growth speed of large brain metastases between diagnostic and radiosurgical planning MRI and predictors of rapid tumor growth.

PURPOSE: We aimed to assess volumetric changes of large brain metastases (≥ 2 cm) between their diagnosis and planning for treatment with fractionated stereotactic radiation surgery (fSRS). Predictors of rapid tumor growth were also analyzed. MATERIALS AND METHODS: One hundred nine patients harboring 126 large brain metastases were retrospectively evaluated. Tumor characteristics were evaluated on diagnostic magnetic resonance imaging (dMRI) and MRI performed when planning fSRS (pMRI). Average tumor growth rate and percentage growth rate were calculated. Predictors of rapid growth (percentage growth rate > 5%) were determined using multivariate logistic regression. RESULTS: Both tumor diameter and volume were significantly larger on pMRI than on dMRI (P < 0.001). Median tumor percentage growth rate was 2.6% (range, - 10.8-43.3%). Eighty-eight tumors (70%) were slow-growing (percentage growth rate < 5%) and 38 (30%) grew rapidly (percentage growth rate ≥ 5%). Major peritumoral edema and no steroids were predictors of rapid tumor growth. CONCLUSION: Large brain metastases can grow considerably between the time of diagnosis and the time of fSRS treatment planning. We recommend the time between dMRI and fSRS treatment initiation be as short as possible.

Association Between Low Back Pain, Workaholism, and Work Engagement in Japanese Hospital Workers: A Quantitative Cross-sectional Study.

OBJECTIVE: This study aimed to examine the association between two types of heavy work investment, workaholism and work engagement, and low back pain prevalence. METHODS: We conducted a paper-based survey of Japanese hospital workers. The Dutch Workaholism Scale (DUWAS) and the Utrecht Work Engagement Scale (UWES) were used to classify the participants into four groups and perform multiple logistic regression analyses. RESULTS: Among 699 participants, the group with low DUWAS and high UWES at 37.1% had the lowest low back pain prevalence. In order, the groups with low DUWAS and UWES were at 51.7%; those with high DUWAS and UWES, 58.5%; and those with high DUWAS and low UWES, 62.4%, with multivariate-adjusted odds ratios of 1.77, 2.01, and 2.33, respectively. CONCLUSIONS: Low back pain prevalence among Japanese hospital workers was reduced by high levels of work engagement, even at high levels of workaholism.

Effects of the environment of a simulated shelter in a gymnasium on sleep in children.

Effects of the environment of a simulated shelter in a gymnasium on sleep were investigated in 20 healthy school-aged children. Measurements were obtained during a one-night stay in a school gymnasium during the summer (C). Activity levels were monitored using a wrist actigraph, and temperature and humidity of the bedrooms in the subjects' homes were monitored from 3 days before to 3 days after C. The subjects were asked to provide information regarding subjective sleep estimations and thermal sensations. The results for the days before C (BC), C, the first day after C (A1), and the second day after C (A2) were compared. The bedroom temperature was significantly lower on BC than on the other nights. No significant difference was observed in bedtime, whereas wake-up time was significantly earlier on C and later on A1 than on the other nights. Total sleep time was significantly decreased on C (3.6 h) and increased on A1 when compared to the other nights. Daytime nap was significantly increased on A1 when compared to the other days. Subjective estimation of sleep quality was decreased and sweat sensation before sleep was increased on C when compared to the other nights. The main reason for sleep disturbances on C was heat. These results indicate that the environment of the simulated shelter in the gymnasium severely disturbed sleep in children. The resulting loss of sleep was compensated for by increased nocturnal sleep time and daytime napping on the next day.

Activity changes in the left superior temporal sulcus reflect the effects of childcare training on young female students' perceptions of infants' negative facial expressions.

In many developed countries, the number of infants who experience non-parent childcare is increasing, and the role of preschool teachers is becoming more important. However, little attention has been paid to the effects of childcare training on students who are studying to become preschool teachers. We used functional magnetic resonance imaging (fMRI) to investigate whether and how childcare training affects brain responses to infants' facial expressions among young females studying to become preschool teachers. Twenty-seven subjects who attended a childcare training session (i.e., the experimental group) and 28 subjects who did not attend the training (i.e., the control group) participated in this study. The participants went through fMRI scanning twice: before and after the childcare training session. They were presented with happy, neutral, and sad infant faces one by one during fMRI scanning. The present neuroimaging results revealed that the activity patterns of the left superior temporal sulcus (STS) for sad faces were modulated by the interaction between the time point of the data collection and group differences. The present results are the first to highlight the effects of childcare training on the human brain.

Sleep in a Gymnasium: A Study to Examine the Psychophysiological and Environmental Conditions in Shelter-Analogue Settings.

We aimed to examine sleep in shelter-analogue settings to determine the sleep and environmental conditions in evacuation shelters. A summer social/educational event was conducted in an elementary school, wherein children and their parents (n = 109) spent one night in the school gymnasium; a total of 15 children and 7 adults completed the study. Data were recording using wrist actigraphy and questionnaires, from two days before the event to two days after the event. During the night in the gymnasium, sleep initiation in the children was found to be significantly delayed, whereas adults did not show any significant change in actigraphic sleep parameters. Although 57% of adults complained of stiffness of the floor, only 7% of children had the same complaint. The nocturnal noise recorded at four locations in the gymnasium showed that the percentage of 1-min data epochs with a noise level >40 dB ranged from 53% to 74% during lights-out. The number of subjects that woke up during the night showed a similar pattern with the changes in the noise level. The changes in sleep might represent event-specific responses, such as to a noisy environment, and the different complaints between adults and children could be useful in shelter management.

Effect of cardboard under a sleeping bag on sleep stages during daytime nap.

Fourteen healthy male subjects slept from 13:30 to 15:30 under ambient temperature and relative humidity maintained at 15 °C and 60%, respectively. They slept under two conditions: in a sleeping bag on wooden flooring (Wood) and in a sleeping bag with corrugated cardboard between the bag and the flooring (CC). Polysomnography, skin temperature (Tsk), microclimate, bed climate, and subjective sensations were obtained. The number of awakenings in the CC had significantly decreased compared to that in the Wood. The mean, back, and thigh Tsk, and bed climate temperature were significantly higher in the CC than that in the Wood. Subjective thermal sensations were warmer in the CC than in the Wood. These results suggest that using corrugated cardboard under a sleeping bag may reduce cold stress, thereby decreasing the number of awakenings and increasing subjective warmth; the mean, back, and thigh Tsk; and bed climate temperature.

Communication training improves sense of performance expectancy of public health nurses engaged in long-term elderly prevention care program.

This study examines the effectiveness of a communication skill training based on a coaching theory for public health nurses (PHNs) who are engaged in Japan's long-term care prevention program. The participants in this study included 112 PHNs and 266 service users who met with these PHNs in order to create a customized care plan within one month after the PHNs' training. The participants were divided into three groups: a supervised group in which the PHNs attended the 1-day training seminar and the follow-up supervision; a seminar group attended only the 1-day training seminar; a control group. The PHNs' sense of performance expectancy, and user's satisfaction, user's spontaneous behavior were evaluated at the baseline (T1), at one month (T2), and at three months (T3) after the PHNs' training. At T3, the PHNs performed a recalled evaluation (RE) of their communication skills before the training. The PHNs' sense of performance expectancy increased significantly over time in the supervised group and the control group (F = 11.28, P < 0.001; F = 4.03, P < 0.05, resp.). The difference score between T3-RE was significantly higher in the supervised group than the control group (P < 0.01). No significant differences in the users' outcomes were found.