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Background: Muscle weakness is associated with adverse clinical outcomes including disability and mortality. We report demographic, anthropometric and lifestyle correlates of grip strength in UK and Japanese population-based cohorts. Aim: To report prevalence of low grip strength according to 2019 European Working Group on Sarcopenia in Older People (EWGSOP2) and 2019 Asian Working Group for Sarcopenia (AWGS 2019) thresholds and to consider correlates of grip strength in Eastern and Western populations. Methods: UK (1572 men; 1415 women) and Japanese (519 men; 1027 women) participants were recruited from two cohorts harmonised by consensus. Muscle strength was measured by grip strength dynamometry. Potential correlates of grip strength were examined using sex-stratified linear regression; univariate correlates (p < 0.05) were included in mutually adjusted models. Results: Mean (SD) age was 66.2 (2.8) and 65.8 (12.3) in UK and Japanese cohorts, respectively. Prevalence of low grip strength was higher in Japanese participants (EWGSOP2 5.4% versus 2.4%, AWGS 2019 9.0% versus 3.7%). In both cohorts and sexes, univariate correlates of lower grip strength were older age, shorter height, not consuming alcohol, leaving education earlier and greater comorbidity. Apart from older age and shorter height, the only factors related to lower grip strength in mutually adjusted analyses were greater comorbidity among UK participants (kg difference in grip strength (95%CI) per additional comorbidity − 0.60(− 0.98, − 0.21) among men and − 0.50(− 0.86, − 0.13) among women) and not consuming alcohol among Japanese men (− 1.33(− 2.51, − 0.15)). Discussion: Correlates of muscle strength were similar in both cohorts. Conclusions: A global approach to age-related muscle weakness prevention may be appropriate. [ABSTRACT FROM AUTHOR]

Background: Acute superior mesenteric artery (SMA) occlusion is an uncommon condition associated with high mortality. If extensive bowel resection is performed for patients with acute SMA occlusion and the patient survives, long-term total parenteral nutrition (TPN) may be needed due to short bowel syndrome. This study examined factors associated with the need for long-term TPN after the treatment of acute SMA occlusion. Methods: We retrospectively analyzed 78 patients with acute SMA occlusion. Patients were abstracted from a Japanese database from institutions with at least 10 patients with acute SMA occlusive disease from January 2015 through December 2020 Results: Among the initial cohort there were 41/78 survivors. Of these, 14/41 (34%) required permanent TPN who were compared with those who did not require long-term TPN (27/41, 66%). Compared to patients in the non-TPN group, those in the TPN group had significantly shorter remaining small intestine (90.7 cm vs. 218 cm, P<0.01), more patients with time from onset to intervention >6 hours (P=0.02), pneumatosis intestinalis on enhanced computed tomography scan (P=0.04), ascites (Odds Ratio 11.6, P<0.01), and a positive smaller superior mesenteric vein sign (P= 0.03). These were considered significant risk factors for needing long-term TPN. Age, gender, underlying disease, presence of peritoneal sign, presence of shock requiring vasopressors, site of obstruction (proximal vs. distal), and initial treatment (surgery vs. interventional radiology vs. thrombolytic therapy) were not significantly different between the two groups. Long-term TPN was significantly associated with longer hospital stay (52 vs. 35 days, P=0.04). Multivariate analysis identified the presence of ascites as an independent risk factor for needing long-term TPN. Conclusion: The need for permanent TPN after treatment of acute SMA occlusion is significantly associated with longer hospital stay, longer time to intervention, and characteristic imaging findings (pneumatosis intestinalis, ascites, Smaller SMV sign). Ascites is an independent risk factor. Level of evidence: III. [ABSTRACT FROM AUTHOR]

This study examined the association of green tea consumption with influenza among Japanese workers in the Kanto and Tokai areas. We conducted a case-control study in a cohort of 4302 workers. Consumption frequency of green tea in 2011 and physician-diagnosed influenza that occurred over the winter season from November 2011 through April 2012 were ascertained using a self-administered questionnaire. Two controls matched by company, sex, and age (and checkup date in one company) were randomly selected for each case. Odds ratio of influenza were estimated by conditional logistic regression. One hundred and seventy-nine cases and 353 controls with complete data were included in the analysis. Green tea consumption was significantly associated with decreased odds of developing influenza; the multivariable-adjusted odds ratio for green tea consumption of ≥5 cups/week was 0.61 (95% CI 0.39-0.95) compared with <1 cup/week (P for trend = 0.028). When analysis was restricted to cases confirmed using a diagnostic kit, the corresponding value was 0.68 (95% CI 0.39-1.18; P for trend = 0.16). Our data suggest that green tea consumption is associated with a lower risk of influenza. The present findings require confirmation in large-scale prospective studies using diagnostic tool for influenza infection. [ABSTRACT FROM AUTHOR]

Hypophosphatasia (HPP) is highly variable in clinical expression and is generally classified into six subtypes. Although it would be beneficial to be able to predict the clinical course from the ALPL genotype, studies on this issue are limited. Here, we aimed to clarify the features of Japanese HPP and the relationships between genotype and clinical manifestations. We analyzed 98 unrelated Japanese patients to investigate the percentage of each clinical form, frequently detected mutations, and the relationship between the genotype and phenotype. Some of the identified mutants were characterized by transfection experiments. Perinatal severe form was the most frequent (45.9%), followed by perinatal benign form (22.4%). Among the 196 alleles, p.Leu520ArgfsX86 (c.1559delT) was detected in 89 alleles, and p.Phe327Leu (c.979T>C) was identified in 23 alleles. All of the homozygotes for p.Leu520ArgfsX86 were classified into perinatal severe form, and patients carrying p.Phe327Leu in one of the alleles were classified into perinatal benign or odonto HPP. Twenty of the 22 patients with perinatal benign HPP were compound heterozygous for p.Phe327Leu and another mutation. Most patients with odonto HPP were found to be monoallelic heterozygotes for dominant-negative mutations or compound heterozygotes with mutants having residual activity. The high prevalence of p.Leu520ArgfsX86 and p.Phe327Leu mutations might underlie the high rate of perinatal severe and perinatal benign forms, respectively, in Japanese HPP. Although ALPL genotyping would be beneficial for predicting the clinical course to an extent, the observed phenotypical variability among patients sharing the same genotypes suggests the presence of modifiers. [ABSTRACT FROM AUTHOR]

Background: Continuous regional arterial infusion (CRAI) of protease inhibitor nafamostat mesilate (NM) is used in the context of predicted severe acute pancreatitis (SAP) to prevent the development of pancreatic necrosis. Although this therapy is well known in Japan, its efficacy and safety remain unclear.Methods: This investigator-initiated and -driven, multicenter, open-label, randomized, controlled trial (UMIN000020868) enrolled 39 patients with predicted SAP and low enhancement of the pancreatic parenchyma on computed tomography (CT). Twenty patients were assigned to the CRAI group, while 19 served as controls and were administered NM at the same dose intravenously (IV group). The primary endpoint was the development of pancreatic necrosis as determined by CT on Day 14, judged by blinded central review.Results: There was no difference between the CRAI and IV groups regarding the percentages of participants who developed pancreatic necrosis (more than 1/3 of the pancreas: 25.0%, range 8.7-49.1% vs. 15.8%, range 3.4-39.6%, respectively, P = 0.694; more than 2/3 of the pancreas: 20%, range 5.7-43.7% vs. 5.3%, range 0.1-26.0%, respectively, P = 0.341). The early analgesic effect was evaluated based on 24-h cumulative fentanyl consumption and additional administration by intravenous patient-controlled analgesia. The results showed that the CRAI group used significantly less analgesic. There were two adverse events related to CRAI, namely bleeding and splenic infarction.Conclusions: CRAI with NM did not inhibit the development of pancreatic necrosis although early analgesic effect of CRAI was superior to that of IV. Less-invasive IV therapy can be considered a viable alternative to CRAI therapy. [ABSTRACT FROM AUTHOR]

When children around 2-year-old show leg bowing without lower-limb radiographic abnormalities for rickets, the leg bowing is classified as "physiologic" genu varum without conducting a blood test. However, it has recently been suggested that toddlers who are diagnosed with physiologic genu varum may in fact have some form of bone metabolic disorder. In this 1:2 case-control study, blood samples were obtained from 33 toddlers with genu varum without radiographic abnormalities for rickets and 66 age- and gender-matched healthy children. Serum alkaline phosphatase (sALP), intact parathyroid hormone (siPTH), 25-hydroxy vitamin D [s25(OH)D], calcium (sCa), and inorganic phosphate (sP) were measured. s25(OH)D of the subjects with genu varum (24.8 ng/ml) were significantly lower than those of the control (33.6 ng/ml) (p < 0.001). The frequency of vitamin D insufficiency/deficiency (< 20 ng/ml) of the subjects with genu varum (39%) was significantly higher than that in the control (14%) (p = 0.004) (odds ratio by vitamin D insufficiency/deficiency: 4.1 [1.5-11.1, p = 0.004]). sCa in subjects with genu varum (10.2 ng/ml) were significantly higher than in control (9.8 ng/ml) (p < 0.001), as were sALP (1057 IU/l) and siPTH (28.4 pg/ml) (740 IU/l and 8.8 pg/ml in control, respectively; p < 0.001). siPTH levels were associated with s25(OH)D levels in subjects with genu varum (r = - 0.57, p < 0.001), while no association was observed in the control (r = 0.11, p = 0.36). Genu varum without radiographic abnormalities of rickets was associated with both vitamin D and bone-metabolic disorders in toddlers, indicating that physiologic genu varum is not a physiologic condition in toddlers. [ABSTRACT FROM AUTHOR]

Background: The McMaster Health Utilities Index Mark 3 (HUI3) is a generic multi-attribute, preference-based system for assessing health-related quality of life (HRQOL). This study describes the translation procedures and cultural adaptation of the Japanese HUI3 and its measurement properties in a community sample. Methods: The Japanese HUI3 was developed through forward and back translations in cooperation with the developers of the HUI. Acceptability, comprehensibility of questionnaires, and test-retest reliability were assessed. In a community survey of a total of 3860 people (age: 41 ± 14.3, male/female: 2651/1209), the Canadian scoring function was used to calculate utility scores. Construct validity was assessed by examining the relationship between 20 personal characteristics and utility scores. Results: Linear regression estimates demonstrated a significant negative relation between HUI3 utility score and low education, male gender, poor interpersonal relationships, older age, and a higher number of chronic diseases. Single-attribute utility scores were associated with chronic conditions in the manner expected. The community samples were relatively healthy. More than 90% of the respondents were distributed in levels 1 and 2 in all attributes except cognition. Interpretability of utility score was assessed by estimation of the relationship between visual analogue scale (VAS) and the self-rated health and utility score. Independence of attributes was assessed. For only 3 of the 28 possible cross-comparisons among the 8 attributes were correlations coefficients greater than 0.25. Conclusion: Translation and adaptation of the HUI3 questionnaire into Japanese was successful, but the sample size and selection bias limit the interpretation of our study conclusions. [ABSTRACT FROM AUTHOR]

Purpose: Patient-level data from two large studies of the Zilver PTX drug-eluting stent (DES) with long-term follow-up and concurrent non-drug comparator groups were analyzed to determine whether there was an increased mortality risk due to paclitaxel.Methods: Data from the Zilver PTX randomized controlled trial (RCT) and Zilver PTX and bare metal stent (BMS) Japan post-market surveillance studies were analyzed. Five-year follow-up is complete in both DES studies; follow-up for the BMS study was limited to 3 years and is complete. Kaplan-Meier analyses assessed mortality. A Cox proportional hazards model identified significant factors related to mortality.Results: In the RCT, there were 336 patients treated with the DES and 143 patients treated with percutaneous transluminal angioplasty (PTA) or BMS. In Japan, there were 904 DES patients and 190 BMS patients. There was no difference in all-cause mortality for the DES compared to PTA/BMS in the RCT (19.1% DES versus 17.1% PTA/BMS through 5 years, p = 0.60) or Japan (15.8% DES versus 15.3% BMS through 3 years, p = 0.89). Cox proportional hazard models revealed that age, tissue loss, and congestive heart failure were significantly associated with mortality in the RCT, and critical limb ischemia, age, renal failure, and gender were significantly associated with mortality in Japan (all p < 0.05). Neither treatment with Zilver PTX (p = 0.46 RCT, p = 0.49 Japan) nor paclitaxel dose (p = 0.86 RCT, p = 0.07 Japan) was associated with mortality.Conclusion: Analyses of the Zilver PTX patient-level data demonstrated no increase in long-term all-cause mortality.Level Of Evidence: Zilver PTX RCT: Level 1, randomized controlled trial; Japan PMS studies: Level 3, post-market surveillance study. [ABSTRACT FROM AUTHOR]

The Japanese National Research Group on Idiopathic Bone Marrow Failure Syndromes has been conducting prospective registration, central review, and follow-up study for patients with aplastic anemia and myelodysplastic syndrome (MDS) since 2006. Using this database, we retrospectively analyzed the prognosis of patients with MDS. As of May 2016, 351 cases were registered in this database, 186 of which were eligible for the present study. Kaplan-Meier analysis showed that overall survival (OS) curves of the five risk categories stipulated by the revised international prognostic scoring system (IPSS-R) were reasonably separated. 2-year OS rates for the very low-, low-, intermediate-, high-, and very high-risk categories were 95, 89, 79, 35, and 12%, respectively. In the same categories, incidence of leukemic transformation at 2 years was 0, 10, 8, 56, and 40%, respectively. Multivariate analysis revealed that male sex, low platelet counts, increased blast percentage (>2%), and high-risk karyotype abnormalities were independent risk factors for poor OS. Based on these data, we classified Japanese MDS patients who were classified as intermediate-risk in IPSS-R, into the lower risk MDS category, highlighting the need for careful assessment of treatments within low- and high-risk treatment protocols. [ABSTRACT FROM AUTHOR]

The article focuses on a study which examines the lateral posing bias for displaying trustworthiness during a trust game in which participants and their virtual partners cooperated or did not cooperate with their counterparts to earn a monetary reward. Topics discussed include the number of posers showing the left or right cheek as a function of cooperativeness and the mean rating of facial trustworthiness as a function of posing orientation and cooperativeness.

In addition to social and communicative deficits, many studies have reported motor deficits in autism spectrum disorder (ASD). This study investigated the macro and microstructural properties of the corpus callosum (CC) of 18 children with ASD and 12 typically developing controls using diffusion tensor imaging tractography. We aimed to explore whether abnormalities of the CC were related to motor deficits, as well as social and communication deficits in children with ASD. The ASD group displayed abnormal macro and microstructure of the total CC and its subdivisions and its structural properties were related to socio-communicative deficits, but not to motor deficits in ASD. These findings advance our understanding of the contributions of the CC to ASD symptoms. [ABSTRACT FROM AUTHOR]

We comprehensively compared all available questionnaires for measuring quantitative autistic traits (QATs) in terms of reliability and construct validity in 3,147 non-clinical and 60 clinical subjects with normal intelligence. We examined four full-length forms, the Subthreshold Autism Trait Questionnaire (SATQ), the Broader Autism Phenotype Questionnaire, the Social Responsiveness Scale2-Adult Self report (SRS2-AS), and the Autism-Spectrum Quotient (AQ). The SRS2-AS and the AQ each had several short forms that we also examined, bringing the total to 11 forms. Though all QAT questionnaires showed acceptable levels of test-retest reliability, the AQ and SRS2-AS, including their short forms, exhibited poor internal consistency and discriminant validity, respectively. The SATQ excelled in terms of classical test theory and due to its short length. [ABSTRACT FROM AUTHOR]

Objective: To investigate how birthplace influences the incidence of papillary thyroid cancer among Asian American women.Methods: Birthplace- and ethnic-specific age-adjusted and age-specific incidence rates were calculated using data from the California Cancer Registry for the period 1988-2004. Birthplace was statistically imputed for 30% of cases using a validated imputation method based on age at Social Security number issuance. Population estimates were obtained from the US Census. Incidence rate ratios (IRR) and 95% confidence intervals (CI) were estimated for foreign-born vs. US-born women.Results: Age-adjusted incidence rates of papillary thyroid cancer among Filipina (13.7 per 100,000) and Vietnamese (12.7) women were more than double those of Japanese women (6.2). US-born Chinese (IRR = 0.48, 95% CI: 0.40-0.59) and Filipina women (IRR = 0.74, 95% CI: 0.58-0.96) had significantly higher rates than those who were foreign-born; the opposite was observed for Japanese women (IRR = 1.55, 95% CI: 1.17-2.08). The age-specific patterns among all foreign-born Asian women and US-born Japanese women showed a slow steady increase in incidence until age 70. However, among US-born Asian women (except Japanese), substantially elevated incidence rates during the reproductive and menopausal years were evident.Conclusions: Ethnic- and birthplace-variation in papillary thyroid cancer incidence can provide insight into the etiology of this increasingly common and understudied cancer. [ABSTRACT FROM AUTHOR]

Basho-fu (Musa liukiuensis) weaving has long been part of the cultural identity of Ogimi villagers and has continued in the village as a cottage industry despite its almost complete disappearance throughout the rest of the Ryukyu archipelago. It has survived largely due to the concerted efforts of a few villagers and is now carried on mainly by middle-aged and older women. Almost every elderly woman in Ogimi has at least some experience in basho-fu weaving, and most still participate in some stage of the production process. Aged women form the bulk of the core group of workers that carries out the labor-intensive u-umi (spooling) and u-biki (fiber-cleaning) activities. Without this core group of elderly women, the whole production process would be in jeopardy. Thus, older women in Ogimi play a key role as valued workers in maintaining the basho-fu production process. In exchange for their continued participation, these elderly women receive symbolic capital in the form of respect and honors, as well as wages for their labor. We argue that participating in traditional basho-fu weaving helps these older women maintain an active engagement with life as healthy and productive members of society, a role that has been culturally sanctioned and has taken on moral import in Japan's rapidly aging society. Interestingly, "doing basho" may be considered one means to help achieve successful aging in this particular cultural context. [ABSTRACT FROM AUTHOR]

Rectangularization of human survival curves is associated with decreasing variability in the distribution of ages at death. This variability, as measured by the interquartile range of life table ages at death, has decreased from about 65 years to 15 years since 1751 in Sweden. Most of this decline occurred between the 1870s and the 1950s. Since then, variability in age at death has been nearly constant in Sweden, Japan, and the United States, defying predictions of a continuing rectangularization. The United States is characterized by a relatively high degree of variability, compared with both Sweden and Japan. We suggest that the historical compression of mortality may have had significant psychological and behavioral impacts. [ABSTRACT FROM AUTHOR]

This article develops and applies two expressions for the rate of change of a population's mean age. In one, aging is shown to be negatively related to contemporary birth rates and death rates. In a general sense, aging occurs when vital rates are too low, as illustrated through applications to the United States, the Netherlands, and Japan. The other expression relates the rate of aging to a population's demographic history, in particular to changes in mortality, migration, and the annual number of births. Applications to the United States and Sweden show that the dominant factor in current aging in these countries is a history of declining mortality. Migration also contributes significantly but in opposite directions in the two countries. The two approaches are integrated after recognizing that the rate of change in the mean age is equal to the covariance between age and age-specific growth rates. A decomposition of this covariance shows that the two seemingly unrelated expressions contain exactly the same information about the age pattern of growth rates. [ABSTRACT FROM AUTHOR]

This study reports on the findings from a WHO sponsored cross-national investigation of life events and schizophrenia. Data are presented from a series of 386 acutely ill schizophrenic patients selected from nine field research centers located in developing and developed countries (Aarhus, Denmark; Agra, India; Cali, Colombia; Chandigarh, India; Honolulu, USA; Ibadan, Nigeria; Nagasaki, Japan; Prague, Czechoslovakia; Rochester, USA). On a methodological level, the study demonstrates that life event methodologies originating in the developed countries can be adapted for international studies and may be used to collect reasonably reliable and comparable cross-cultural data on psychosocial factors affecting the course of schizophrenic disorders. Substantive findings replicate the results of prior studies which conclude that socioenvironmental stressors may precipitate schizophrenic attacks and such events tend to cluster in the two to three week period immediately preceding illness onset. [ABSTRACT FROM AUTHOR]