Individualized movement instructions provided by physical therapists (PT) improve physical function in social welfare workers. However, owing to the COVID-19 pandemic, visits to medical institutions and social welfare facilities were increasingly restricted, making it difficult for PTs to conduct face-to-face sessions. Therefore, the focus on providing online sessions has increased to prevent direct contact. Feasibility studies help identify issues before conducting a study and prevent problems in implementation. This study investigated the feasibility of online interventions by PTs and proposed improvements during the implementation of randomized controlled trials (RCTs). Questionnaires and semi-structured interviews were administered to interventionists and participants to collect quantitative and qualitative data on the acceptability and barriers to online interventions. A feasibility study design was employed and qualitative data were analyzed using the framework method. Questionnaires were completed by 7 of 8 participants and all 8 interventionists, and interviews were completed by 6 of the 8 participants and all 8 interventionists. Most of the participants and all of the interventionists showed good acceptance of the intervention program and online communication, but participants experienced barriers to time commitment and forced exercise, while interventionists experienced barriers to the participants' low intrinsic motivation and limited intervention tools. These results indicate that flexible interventions that consider the limited time and needs of an individual, efficient means, and enhanced resources for online treatment tools are required to increase the feasibility and acceptability of future RCTs.

Catatonia is a psychomotor syndrome that occurs in various psychiatric, neurological, and medical conditions. Differentiating malignant catatonia from neuroleptic malignant syndrome (NMS) and non-convulsive status epilepticus (NCSE) is particularly challenging in complex cases involving multiple contributing factors. Both catatonia and NCSE have been associated with dysfunction of the gamma-aminobutyric acid (GABA)-A receptor system, which may underlie overlapping clinical features. We report the case of a 43-year-old man with a long-standing history of schizophrenia who developed malignant catatonia following a suicide attempt that resulted in multiple traumatic injuries. Postoperatively, he exhibited autonomic instability, decreased consciousness, muscle rigidity, and catatonic signs. An electroencephalogram revealed generalized spike-and-wave activity consistent with NCSE, and levetiracetam was initiated. Despite the resolution of the epileptiform discharges, the catatonic symptoms persisted. A transient positive response to lorazepam supported the diagnosis of malignant catatonia. Modified electroconvulsive therapy (m-ECT) was introduced on day 40 of hospitalization. After four sessions, the patient showed marked improvement in both motor and autonomic symptoms. Thirteen sessions were completed, and the patient was discharged on day 81. He remained relapse-free for over five years. This case highlights the importance of considering malignant catatonia in patients with schizophrenia who present with persistent catatonic symptoms despite adequate treatment of NCSE. Although antiepileptic therapy suppressed epileptiform activity, resolution of catatonia required m-ECT, suggesting that seizure control alone may be insufficient. Clinicians should recognize that catatonia and NCSE may coexist and overlap in GABA-A-related pathophysiology, and that early GABA-A-targeted interventions, including m-ECT, may be critical for recovery.

This study aimed to assess disaster-related knowledge, attitudes, experience, trait emotional intelligence (EI), and disaster nursing core competencies among Jordanian emergency nurses. Additionally, it explores the factors influencing disaster nursing core competencies. The participants were 184 emergency nurses from military, governmental, and private hospitals in Jordan. Data was gathered through self-administered paper questionnaires using five standardized tools. Descriptive and inferential statistics were employed for analysis. Nurses showed positive attitudes toward disaster management, moderate knowledge (Mean = 8.7, SD ± 2.2), moderate experience during COVID-19 (Mean = 33.9/55), and good EI levels (Mean = 4.21/7). Disaster nursing core competencies were moderately high (Mean = 45.6/75). Significant correlations were found between core competencies and disaster-related knowledge (r = 0.16, P = 0.033), experience (r = 0.708, P = 0.000), and trait EI (r = 0.386, P<0.001). A positive correlation also existed between trait EI and disaster experience (r = 0.303, P<0.001). Findings suggest the importance of enhancing disaster education, hands-on training, and EI development for nurses and students.

Early-stage endometrial cancer can be cured surgically using three techniques: laparotomy, laparoscopic surgery, and robotic-assisted surgery. In this retrospective study, we used 4 years of data from the Japanese Diagnosis Procedure Combination to analyze perioperative sequelae for each surgical procedure. Patients with early-stage endometrial cancer were classified into three groups: laparotomy, laparoscopic surgery, and robotic-assisted surgery. The number of robotic-assisted surgeries is increasing, but hospitals with low surgical volumes performed laparotomy at a rate of 57.6%, while hospitals with higher surgical volume tended to perform fewer laparotomies and more laparoscopic and robotic-assisted surgeries. Compared with the laparotomy group, the in-hospital risk ratios and 95% confidence intervals for postoperative sequelae were 0.28 (0.18-0.44) and 0.39 (0.23-0.69) in the laparoscopic and robotic-assisted surgery groups, respectively (P = 0.001 for all). Regarding blood transfusion treatment, the incidence rate ratios were lower for laparoscopic and robotic-assisted surgery than for laparotomy (P < 0.001 for all), even after multivariable analysis. In conclusion, in early-stage endometrial cancer, laparotomy had the highest incidence of perioperative sequelae compared to laparoscopic surgery and robotic-assisted surgery.

For young women with little exercise habits, establishing exercise habits from a young age is important for preventing lifestyle-related diseases and frailty. This study aimed to examine effective methods for establishing walking as a daily habit and was conducted on 74 female students belonging to a junior college in Fukuoka Prefecture. The intervention was divided into three periods (2 weeks each) from July to December 2023. In the first period, participants wore a pedometer but were unable to check their step count, and in the second period, they were asked to go about their daily lives while being able to check their step count. In the third period, participants were divided into four groups, and a step count ranking and a footrace were displayed. The control group (living a normal life) was compared with a control group (living a normal life) that combined feedback and chat communication. Step counts were measured at the end of each period, and the average number of steps significantly increased from period 1 to period 2 (4,494±1,403 steps/day to 9,581±3,061 steps/day). Furthermore, there was a significant difference between Group 1 (P = 0.02) and Group 3 (P = 0.008) in the additional intervention in period 3. Based on the above, it is believed that an intervention that combines wearing a pedometer, step count rankings and feedback, and SNS is effective in encouraging continued exercise.

Indonesia ranks second globally in natural disaster risk, underscoring the urgency of strengthening emergency preparedness. Generation Z, representing 28% of the population, plays a strategic role due to its digital fluency and entry into the workforce. This study assessed the disaster preparedness of Generation Z students using a modified Disaster Preparedness Evaluation Tool (DPET). A cross-sectional survey was conducted among 445 respondents aged 21-25 years. Data were collected through an online questionnaire covering demographics, knowledge, skills, and preparedness. Descriptive statistics, independent t-tests, one-way ANOVA, Pearson correlation, and multiple linear regression were used for analysis. Knowledge (M = 4.87), skills (M = 4.74), and preparedness (M = 4.65) were in the moderate range (scale 1-6). Prior disaster training, university region, and frequency of social media use significantly influenced preparedness (p < 0.05). Strong positive correlations were found between knowledge, skills, and preparedness (r = 0.77-0.82). Regression analysis identified skills, prior training, and knowledge as significant predictors, with skills being the most influential. The findings highlight the need to integrate structured disaster education, simulations, and digital interventions into higher education curricula. Enhancing experiential learning is critical to bridging the gap between digital awareness and real-world emergency response among youth in disaster-prone regions.

Periodontal disease is multifactorial, influenced by both local and systemic factors. Environmental variables, such as sleep quality, may affect periodontal health; however, scant literature has addressed this relationship in factory workers. The present study aimed to investigate the impact of sleep quality on periodontal health in night-shift factory workers in Ahmedabad city. A cross-sectional questionnaire study was conducted on 360 workers from six selected factories in Ahmedabad city, Gujarat. Demographic data including age, sex, marital status, and tobacco use were recorded. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index. A clinical assessment was done to assess the oral hygiene status and periodontal status by using the Oral Hygiene Index-Simplified and the WHO 1997 methodology, respectively. There were a total 198 (55%) day-shift workers and 162 (45%) night-shift workers. The global sleep quality mean scores in the day shift and night shift workers were 3.85 ± 2.14 and 4.80 ± 2.27, with a significant difference. The night shift workers had a significantly (P<0.05) worse score as compared to day shift workers when the oral hygiene status and periodontal status mean score were compared. Age (AOR=5.52; 95% CI=1.98-15.39; P<0.001), sex (AOR=5.89; 95% CI=1.74-19.94; P=0.004), oral hygiene (AOR=6.75; 95% CI=3.67-12.42; P<0.001), night shift (AOR=2.13; 95% CI=1.27-3.59; P=0.004), and poor sleep quality (AOR=2.65; 95% CI=1.47-4.78; P<0.001) were the independent risk factors for periodontal status. In conclusion, the findings indicate that night-shift factory workers exhibit significantly poorer sleep quality, oral hygiene, and periodontal health as compared to their day-shift counterparts.

Musculoskeletal disorders (MSDs) are prevalent among agricultural workers, particularly during harvesting activities involving awkward postures and heavy manual handling. Despite Thailand's significant role in global lychee production, ergonomic risks in lychee harvesting remain under-investigated, even though exposure is evident. This cross-sectional observational study was conducted during the 2022 lychee harvest season across eight orchards in Phayao Province, Thailand. A total of 104 male harvesters were systematically video-recorded during full-task execution. Hierarchical Task Analysis (HTA) was used to segment workflows into goal-directed sub-tasks, and ergonomic exposures were assessed using the Posture, Activity, Tools, and Handling (PATH) method, with postures coded as neutral or non-neutral using a structured checklist. The harvesters were predominantly older working-age adults (mean age 53.5 years) who worked long hours (7.65 hours/day), often carrying 9.5 kg baskets unilaterally on one shoulder. Postural analysis revealed frequent ergonomic risks: 59% of neck postures and 58% of trunk postures were non-neutral, including 15% with severe forward flexion and 24% involving lateral bending or twisting. Arm elevation above shoulder height was common during climbing and fruit detachment. Spatial layout imposed long travel distances (over 30 meters), contributing to cumulative fatigue. Ladder height, tool design, and task repetition further exacerbated biomechanical strain. Lychee harvesting imposes significant ergonomic risks due to non-neutral postures, load asymmetry, and task repetition. Evidence supports the urgent implementation of ergonomic interventions, including bilateral-carry basket redesign, improved ladder safety, and participatory workflow reorganization to reduce WMSD risks in seasonal fruit agriculture.

Depression is a mental disorder characterized by biological and psychosocial diversity, hindering the identification of effective diagnostic biomarkers. Brain-derived neurotrophic factor (BDNF), a neurotrophic factor, has garnered attention recently, with its blood levels, genetic polymorphisms, and cerebrospinal fluid concentrations correlating with depression severity and treatment response. In particular, changes in the mBDNF/proBDNF ratio, p75NTR, and tropomyosin receptor kinase B concentrations have been suggested to be associated with neuroplasticity. The Val66Met polymorphism and epigenetic changes in the BDNF gene may also influence treatment responsiveness. Standardization of measurement methods, artificial intelligence analysis, and multifactorial integration are expected to facilitate the application of personalized medicine for depression treatment in the future.

Isolated fallopian tube torsion (IFTT) is a rare cause of acute abdominal pain in adolescents. Its preoperative diagnosis is often challenging because imaging findings are usually nonspecific. Here we report the case of a 16-year-old girl with IFTT that closely mimicked a functional ovarian cyst. The patient, who had no history of abdominal surgery or pelvic infection, presented with persistent left lower quadrant pain. Initial computed tomography and ultrasonography showed a 30-mm simple cyst without signs of a twisted vascular pedicle, and a functional ovarian cyst was suspected. Her pain persisted, and on day 5 repeat ultrasonography again demonstrated the same simple cyst as at the initial visit, but the left ovary was clearly visualized separately, raising suspicion of a tubal origin. Diagnostic laparoscopy was performed, revealing a 1080° counterclockwise torsion of the left fallopian tube with necrosis, while the ovary appeared normal. As detorsion failed to restore color, a left salpingectomy was performed. Histopathology confirmed torsion secondary to hydrosalpinx. The postoperative course was uneventful, and the patient has remained symptom-free for one year. This case demonstrates that IFTT can occur even in adolescents without risk factors. Identifying a normal ovary on ultrasonography is crucial for suspecting IFTT, and early diagnostic laparoscopy is essential for confirming the diagnosis and preserving future fertility.

Older adult patients with acute-onset minimal change nephrotic syndrome (MCNS) often have difficulties with exercise therapy due to uremia caused by severe generalized edema and acute kidney injury (AKI). Rehabilitation treatment targeting increased light-intensity physical activity (LPA) is typically implemented to address this limitation. An 81-year-old man with suspected MCNS complicated by stage I AKI was admitted to our hospital. The patient's short physical performance battery (SPPB) score was 10 points, while his total physical activity (TPA) was 411 steps per day. To increase his LPA, the patient performed resistance exercises in the sitting position and standing activities with support under supervision five times per week at low load and high frequency. Physical activity education with self-monitoring using an activity meter and check sheet was also implemented during the unmonitored periods. After uremia and other symptoms improved, aerobic and resistance exercises were added. At discharge, the patient's moderate-vigorous physical activity (MVPA) increased from 0.1 to 3.2 minutes per day; his LPA increased from 5.1 to 34.6 minutes per day; and his TPA increased from 411 to 3,233 steps per day. His SPPB score improved from 10 to 12 points, while the motor component of the functional independence measure (FIM) increased from 66 to 82 points, leading to improved activities of daily living (ADL). These results indicate that LPA-focused rehabilitation treatment in older patients with MCNS and AKI is both effective and feasible, potentially contributing to improved physical activity and ADL and facilitating the transition to exercise therapy after clinical improvement.

The aim of this study was to examine the association between Family Supportive Supervisor Behaviors (FSSB), defined as supervisors' behaviors that assist subordinates in balancing work and family life, and work functioning impairment. A cross-sectional online survey was conducted among 17,893 employees from six Japanese companies, and data from 12,027 respondents were included in the analysis. FSSB was assessed using the Japanese version of Hammer's 14-item scale, and work functioning impairment was measured with the Work Functioning Impairment Scale (WFun). Multivariate regression analyses were performed to evaluate the association between FSSB and WFun scores, adjusting for age, gender, marital status, presence of children under age 18, presence of intra-family caregivers, and companies. After testing for interaction effects between FSSB and gender, stratified analyses were conducted. Additionally, we assessed the relationship between each of the four FSSB subdimensions and work functioning impairment. The results indicated a significant negative association between FSSB and WFun scores. The interaction between FSSB and gender was statistically significant. Stratified analyses revealed that higher FSSB scores were associated with lower WFun scores in both males and females, with a stronger association among males. Among the four subdimensions, emotional support, instrumental support, and creative work-family management were significantly associated with lower work functioning impairment, while role modeling behaviors was not. These findings suggest that strengthening FSSB may help reduce work functioning impairment in workplaces with increasingly diverse workforces.