Daily Associations Between Presenteeism and Health-Related Factors Among Office Workers: An Ecological Momentary Assessment Approach.

OBJECTIVE: The study examined daily associations between presenteeism and health-related factors among office workers using ecological momentary assessment (EMA). METHODS: Diurnal mood and physical symptoms were repeatedly recorded over 2 weeks with EMA. Daily work performance (WP) was also recorded. Recalled WP and baseline health conditions were assessed via questionnaires. Daily sleep was assessed using actigraphy. Reliability between recalled and daily WP was compared. Hierarchical linear modeling (HLM) was used to analyze the effects of sleep, mood, and physical symptoms on daily WP. RESULTS: Weak yet significant agreement was found between recalled and daily WP, with EMA capturing occasional declines in performance overlooked by recalled assessments. HLM indicated that longer sleep, reduced depressive mood, and decreased shoulder stiffness were significantly associated with increased daily WP. CONCLUSIONS: These factors are associated with daily fluctuations in presenteeism, suggesting potential targets of intervention.

A large-scale clinicopathological and long-term follow-up study of solid papillary carcinoma of the breast.

Solid papillary carcinoma of the breast (SPC) is a rare tumor of the breast with the unique histology and frequent neuroendocrine differentiation. However, a real nature and diagnostic importance of the neuroendocrine differentiation have not been properly handled. And relationship between SPC and the other types of invasive breast carcinoma, especially neuroendocrine tumor of the breast (NETb), has not been fully explained. We conducted a clinicopathological study of SPC to tackle these problems.In the study, we included 127 cases of SPC with long-term follow-ups of up to 30 years. The incidence in the breast carcinoma was 2.0%. The patients with SPC had a significantly better prognosis and no patients died of the tumor. The 35 cases had only SPC in situ (SPC-IS), while the 92 cases had both SPC-IS and SPC with invasion (SPC-INV). Immunohistochemically, 123 of the 127 cases exhibited diffuse expression of one or more neuroendocrine markers. Fifty of the 92 cases had exclusively invasive SPC (iSPC) as the invasive component. Twenty-two cases of iSPC were combined with NETb and the 18 cases with MUC. Six of 8 cases with metastatic SPC-INV disclosed iSPC in the axillary lymph node.This study suggests that SPC is immunohistochemically compatible with NET of the systemic organs (NETs). And the unique morphology of SPC may represent a traditional histology of NETs. The study also indicates that SPC has close relationship between NETb and type B MUC. And SPC and NETb may represent a spectrum of the same disease.

The Effects of Objective Push-Type Sleep Feedback on Habitual Sleep Behavior and Momentary Symptoms in Daily Life: mHealth Intervention Trial Using a Health Care Internet of Things System.

BACKGROUND: Sleep is beneficial for physical and mental health. Several mobile and wearable sleep-tracking devices have been developed, and personalized sleep feedback is the most common functionality among these devices. To date, no study has implemented an objective push-type feedback message and investigated the characteristics of habitual sleep behavior and diurnal symptoms when receiving sleep feedback. OBJECTIVE: We conducted a mobile health intervention trial to examine whether sending objective push-type sleep feedback changes the self-reported mood, physical symptoms, and sleep behavior of Japanese office workers. METHODS: In total, 31 office workers (mean age 42.3, SD 7.9 years; male-to-female ratio 21:10) participated in a 2-arm intervention trial from November 30 to December 19, 2020. The participants were instructed to indicate their momentary mood and physical symptoms (depressive mood, anxiety, stress, sleepiness, fatigue, and neck and shoulder stiffness) 5 times a day using a smartphone app. In addition, daily work performance was rated once a day after work. They were randomly assigned to either a feedback or control group, wherein they did or did not receive messages about their sleep status on the app every morning, respectively. All participants wore activity monitors on their nondominant wrists, through which objective sleep data were registered on the web on a server. On the basis of the estimated sleep data on the server, personalized sleep feedback messages were generated and sent to the participants in the feedback group using the app. These processes were fully automated. RESULTS: Using hierarchical statistical models, we examined the differences in the statistical properties of sleep variables (sleep duration and midpoint of sleep) and daily work performance over the trial period. Group differences in the diurnal slopes for mood and physical symptoms were examined using a linear mixed effect model. We found a significant group difference among within-individual residuals at the midpoint of sleep (expected a posteriori for the difference: -15, 95% credible interval -26 to -4 min), suggesting more stable sleep timing in the feedback group. However, there were no significant group differences in daily work performance. We also found significant group differences in the diurnal slopes for sleepiness (P<.001), fatigue (P=.002), and neck and shoulder stiffness (P<.001), which was largely due to better scores in the feedback group at wake-up time relative to those in the control group. CONCLUSIONS: This is the first mobile health study to demonstrate that objective push-type sleep feedback improves sleep timing of and physical symptoms in healthy office workers. Future research should incorporate specific behavioral instructions intended to improve sleep habits and examine the effectiveness of these instructions.

Association of ABCB1 polymorphisms with the antiemetic efficacy of granisetron plus dexamethasone in breast cancer patients.

Resistance to antiemetic treatment with 5-hydroxytryptamine 3 receptor antagonists is a problem, with 20-30% of patients showing unsatisfactory responses. Efflux transport by P-glycoprotein, encoded by the ATP-binding cassette ABCB1 gene in the blood-brain barrier, has been the suggested resistance mechanism. We evaluated the association between the antiemetic efficacy of granisetron plus dexamethasone and ABCB1 polymorphisms 3435C>T and 2677G>T/A. Sixty-four breast cancer patients treated with doxorubicin plus cyclophosphamide were evaluated for their responses to antiemetic therapy. Genotyping of patient DNA samples for ABCB1 single nucleotide polymorphisms was performed; the genotypes were then investigated for their association with the efficacy of prophylactic antiemetics. The acute phase complete response rate was 83% in GG subjects (n = 12), and 69% (n = 35) and 41% (n = 17) in heterozygous and homozygous carriers of the 2677T/A allele, respectively (p = 0.047). The ABCB1 2677 TT genotype group showed significantly lower rates of complete control of acute emesis than the group with GG genotypes (p = 0.045). No significant association with complete response was found for 3435C>T (p = 0.190). ABCB1 polymorphisms may influence the extent of acute emesis control in granisetron-treated patients, making the ABCB1 genotype a predictor of prophylactic antiemetic response.

Possible involvement of phosphatidylinositol 3-kinase, but not protein kinase B or glycogen synthase kinase 3beta, in progesterone-induced oocyte maturation in the Japanese brown frog, Rana japonica.

It is known that amphibian oocytes undergo maturation through the formation and activation of maturation-promoting factor (MPF) in response to stimulation by the maturation-inducing hormone progesterone; however, the signal transduction pathway that links the hormonal stimulation on the oocyte surface to the activation of MPF in the oocyte cytoplasm remains a mystery. The aim of this study was to investigate whether the signal transduction mediated by phosphatidylinositol 3-kinase (PI3K), protein kinase B (PKB), and glycogen synthase kinase 3beta (GSK3beta) is involved in progesterone-induced oocyte maturation in the Japanese brown frog, Rana japonica. Inhibitors of PI3K, wortmannin and LY294002, inhibited progesterone-stimulated germinal vesicle breakdown (GVBD) only when the oocytes were treated at the initial phase of maturation, suggesting that PI3K is involved in the progesterone-induced maturation of Rana oocytes. However, we also obtained results suggesting that PKB and GSK3beta are not involved in Rana oocyte maturation. A constitutively active PKB expressed in the oocytes failed to induce GVBD in the absence of progesterone despite its high level of kinase activity. A Myc-tagged PKB expressed in the oocytes (used to monitor endogenous PKB activity) was not activated in the process of progesterone-induced oocyte maturation. Overexpression of GSK3beta, which is reported to retard the progress of Xenopus oocyte maturation, had no effect on Rana oocyte maturation. On the basis of these results, we propose that PI3K is involved in the initiation of Rana oocyte maturation, but that neither PKB nor GSK3beta is a component of the PI3K signal transduction pathway.

Solid-papillary carcinoma of the breast: clinicopathological study of 20 cases.

The purpose of the present paper was to evaluate the clinicopathological and biological features of 20 Japanese patients with solid-papillary carcinoma of the breast (SPC) or SPC associated with invasive breast cancer. All the patients were Japanese women, including two sisters. The mean age was 66.0 years. The incidence of SPC among all the breast cancers treated at two institutions was 1.1% and 1.7%, respectively. The mean disease-free interval was 4 years 11 months. Axillary lymph node metastasis or tumor recurrence did not occur in any of the cases. Fifteen cases of SPC contained invasive cancers that ranged from <5% to 60% of the entire tumor area. Histological types of invasive cancers were mucinous carcinoma in five cases and neuroendocrine cell carcinoma in 10 cases. These results indicate that SPC is a potential precursor lesion for neuroendocrine carcinoma as well as mucinous carcinoma. When all the cases were classified and analyzed according to both the 2002 tumor node metastasis (TNM) classification system and the Nottingham histological grade, SPC patients, even those with invasive cancers, seemed to have longer disease-free survival compared to patients with the other invasive breast cancers of matching grade and stage. Clinicopathologically, SPC could be regarded as a separate type of ductal carcinoma in situ.

Which is the better pathological prognostic factor, the Nottingham histological grade or the Japanese nuclear grade? A large scale study with a long-term follow-up.

BACKGROUND: We compared the Nottingham histological grade (H-grade) and the Japanese nuclear grade (N-grade) to select the better prognostic factor for breast cancers. METHODS: The series included 1786 patients with breast cancers with the exception of non-invasive and stage 4 cancers. They were classified according to the H- and N-grade. We analyzed their survival curves and also performed multivariate Cox regression analyses. RESULTS: According to the H-grade classification, 476 cases were grade 1, 647 cases were grade 2 and 663 cases were grade 3. According to the N-grade, 381 cases were grade 1, 215 cases were grade 2, and 1129 cases were grade 3. In the survival curves of those cases with lymph node metastases (N+) and recurrent cases, there were statistically significant differences in different categories of the H-grades, but not in the N-grades. The survival curves of all the cases and those cases without lymph node metastases (N-) always exhibited statistically significant differences. According to the 2003 St Gallen consensus, the N- group was classified as a minimal risk and an average risk groups. Both H- and N-grade exhibited statistically significant differences between the minimal risk and the average risk groups in the disease-free survival. The multivariate analyses proved that the H-grade was a statistically significant prognostic factor in all the cases and N+ group, but the N-grade was not significant in any of the studies. CONCLUSIONS: The H-grade is clearly proved to be a more significant prognostic factor for wider stage cases than the N-grade.