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Background: Health-related patient-reported outcomes (HR-PROs) are crucial for assessing the quality of life among individuals experiencing low back pain. However, manual data entry from paper forms, while convenient for patients, imposes a considerable tallying burden on collectors. In this study, we developed a deep learning (DL) model capable of automatically reading these paper forms., Methods: We employed the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, a globally recognized assessment tool for low back pain. The questionnaire comprised 25 low back pain-related multiple-choice questions and three pain-related visual analog scales (VASs). We collected 1305 forms from an academic medical center as the training set, and 483 forms from a community medical center as the test set. The performance of our DL model for multiple-choice questions was evaluated using accuracy as a categorical classification task. The performance for VASs was evaluated using the correlation coefficient and absolute error as regression tasks., Result: In external validation, the mean accuracy of the categorical questions was 0.997. When outputs for categorical questions with low probability (threshold: 0.9996) were excluded, the accuracy reached 1.000 for the remaining 65 % of questions. Regarding the VASs, the average of the correlation coefficients was 0.989, with the mean absolute error being 0.25., Conclusion: Our DL model demonstrated remarkable accuracy and correlation coefficients when automatic reading paper-based HR-PROs during external validation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

It has been suggested that bone repair following craniofacial injury could be supported by a stem cell niche in the sutures. A new paper in Development identifies a key role for neural crest-derived progenitors in skull repair and suggests that injuries close to the sutures heal more efficiently, possibly due to better access to these progenitors. To learn more about the story behind the paper, we caught up with first author, Daniel Doro, and corresponding authors Sachiko Iseki, Professor at Tokyo Medical and Dental University, Japan, and Karen J. Liu, Professor of Genetics and Development at King's College London, UK., (© 2024. Published by The Company of Biologists Ltd.)

We conducted a systematic review of conference papers in social psychology at two large psychology conferences in Japan: the Japanese Psychological Association and the Japanese Society for Social Psychology. The conference papers were effectively not subjected to peer review; hence, they were suitable for testing if psychologists selectively reported statistically significant findings without pressure from journal editors and reviewers. We investigated the distributions of z -values converted from the p -values reported in the articles presented at the 2013 and 2018 conferences. The z -curve analyses suggest the existence of selective reporting by the authors in 2013. The expected discovery rate (EDR) was much lower than the observed discovery rate (ODR; 7% vs . 76%, respectively), and the 95% confidence interval (CI) did not include the ODR. However, this does not mean that the set of studies completely lacked evidential value. The expected replication rate (ERR) was 31%; this is significantly higher than 5%, which was expected under the null hypothesis of no effect. Changes were observed between 2013 and 2018. The ERR increased (31% to 44%), and the EDR almost doubled (7% to 13%). However, the estimation of the maximum false discovery rate (FDR; 68% in 2013 and 35% in 2018) suggested that a substantial proportion of the reported findings were false positives. Overall, while social psychologists in Japan engaged in selective reporting, this does not mean that the entire field was covered with false positives. In addition, slight signs of improvement were observed in how they reported their findings. Still, the evidential value of the target studies was weak, even in 2018, allowing for no optimism., Competing Interests: Kai Hiraishi, Asako Miura, Masataka Higuchi, and Yoshitsugu Fujishima are members of the JPA and the JSSP. Masaki Suyama is a member of the JSSP., (© 2024 Hiraishi et al.)

Involuntary non-regular employment is a severe inequity problem worldwide, and it may significantly affect the mental health of employees. The present study aimed to examine the relationship between employment type and mental health. Additionally, the characteristics of involuntary non-regularly employed workers were explored. An online-based cross-sectional study was conducted in Japan, and 1566 participants were included in the data analysis. The eligible participants were divided into four categories: regularly employed (n = 1092), voluntary (n = 134), average (n = 233) and involuntary (n = 107) non-regularly employed individuals, respectively. Involuntary non-regular employment was associated with greater lack of vigour, anger-irritability, fatigue, anxiety, and depression. It was higher among women, those who were single or had no childcare, and those who had lower personal income or shorter working hours, or who tended not to practice relaxation activities. Lower personal income was associated with a risk of anxiety and depressive symptoms. Those individuals experiencing involuntary non-regular employment had a higher risk of poor mental health; subgroup analysis showed that this was particularly true among men. Both encouragement of employment stability via policy reform and workplace mental health support for involuntary non-regularly employed individuals are urgent health concerns., (© 2023 International Union of Psychological Science.)

Aim: Contribution to the authorship, including that for case reports, should be appropriately evaluated. I have noticed a scarcity of case reports with clinic doctors listed as coauthors, prompting this investigation. I sought to offer suggestions on the possible reasons for this trend., Methods: I checked case reports published in the Journal of Obstetrics and Gynaecology Research, the Journal of Medical Case Reports, and the BMJ Case Reports. I identified case reports listing a clinic doctor as a coauthor. I consulted eight professors at Jichi Medical University to ascertain whether case reports from their departments included clinic doctors as coauthors and, if not, the reasons., Results: Among 65 case reports from Japanese institutes published in the Journal of Obstetrics and Gynaecology Research, only one paper lists a clinic doctor as a coauthor. Of 100 and 50 papers published in the Journal of Medical Case Reports and BMJ Case Reports, respectively, none listed a clinic doctor as a coauthor. Six out of eight professors admitted to never considering the idea of including clinic doctors as coauthors., Conclusions: The scarcity of case reports with clinic doctors as coauthors extends beyond Japanese obstetrics and gynecology, encompassing various specialties worldwide. Center doctors do not think of the idea that a clinic doctor should be a coauthor. A clinic doctor who transferred the patient should be considered as a candidate coauthor depending on his/her scientific contribution. Such an approach could foster an environment encouraging doctors to contribute to academic writing, regardless of their workplace., (© 2024 Japan Society of Obstetrics and Gynecology.)

Background: The number of older patients with cancer has been increasing. This study aimed to determine the proportion of postoperative decline in activities of daily living (ADL), hospital mortality rate, home healthcare services use, and adjuvant chemotherapy treatment patterns of patients with early-stage non-small cell lung cancer (NSCLC) across age groups., Methods: We analyzed health service utilization data of patients aged ≥ 40 years diagnosed with clinical stage I or II NSCLC in 2015 who underwent thoracoscopy or thoracotomy. The Barthel index was used to determine the proportions of patients aged 40-64, 65-74, ≥ 75 years who experienced a decline in the ADL of ≥ 10 points at postoperative discharge compared to the ADL at admission., Results: Overall, 19,780 patients were analyzed. The proportion of patients with ADL decline slightly increased with increasing age: 1.1%, 1.6%, and 3.5% after thoracoscopic surgery, and 1.4%, 2.8%, and 4.8% after thoracotomy among those aged 40-64, 65-74, and ≥ 75 years, respectively. The hospital mortality rate and proportion of home healthcare services use was fewer than 10 cases, or < 2%. The unexpected readmission rate was slightly higher among those aged ≥ 75 years (3.7% for thoracoscopic surgery, 4.7% for thoracotomy) than among those aged 40-64 years (1.8% for thoracoscopic surgery, 2.5% for thoracotomy)., Conclusion: The difference in the proportion of patients with ADL decline between those aged 40-64 and ≥ 75 years was approximately 3%. This study provides practical information for clinicians involved in the care of older patients who undergo thoracic surgery., (© 2023. Society of Surgical Oncology.)

To explore the current status of anesthesia research activity in Japan, we analyzed the number of abstracts presented at the Japanese Society of Anesthesiologists (JSA) annual meetings by several factors including gender, society branches, and subspecialty categories. The number of abstracts at JSA annual meetings has declined sharply since 2016 with no gender gap. A decrease in the neurological field predated the overall decline, but other subspecialty categories showed a similar decline. Although the Tokyo, Tokai-Hokuriku, and Kyushu branches were responsible for more than half of the reduction, the trend was similar among all branches. In a survey regarding academic activities of university hospital residents and faculty, Ph.D. aspirants' rate was only 20-30%. Residents had never presented an abstract at scientific conferences and never published any papers at nearly 40% and 30% of the university hospitals, respectively. Our survey suggests that junior anesthetists are losing interest in research. Senior faculty and mentors must redouble efforts to embed and encourage research in departments and by anesthetists in training. If a revival of anesthesia research in Japan does not occur then a service only specialty awaits., (© 2023. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.)

Hypertension is the leading cardiovascular risk factor worldwide. However, in Japan, only 30% of patients have their blood pressure controlled under 140/90 mmHg, and nonadherence to antihypertensives is thought to be a reason for the poor control of hypertension. We therefore sought to assess the adherence to hypertension treatment and to evaluate factors influencing patients' adherence in a large, representative sample of the Japanese population. To this end, we analyzed claims data from the LIFE Study database, which includes 112 506 Japanese adults with newly diagnosed hypertension. Medication adherence was measured for a year postdiagnosis using the proportion of days covered (PDC) method. Factors associated with adherence to antihypertensives were also assessed. Among the total 112 506 hypertensive patients, the nonadherence rate (PDC ≤ 80%) for antihypertensives during the first year after initiation of the treatment was 26.2%. Younger age [31-35 years: odds ratio (OR), 0.15; 95% confidence interval (95% CI), 0.12-0.19 compared with 71-74-year-old patients], male gender, monotherapy, and diuretics use [OR, 0.87; 95% CI, 0.82-0.91 compared with angiotensin II receptor blockers (ARBs)] were associated with poor adherence in the present study. Cancer comorbidity (OR, 0.84; 95% CI, 0.79-0.91 compared with no comorbidity), prescription at a hospital, and living in a medium-sized to regional city were also associated with poor adherence. Our present findings showing the current status of adherence to antihypertensive medications and its associated factors using claims data in Japan should help to improve adherence to antihypertensives and blood pressure control., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Demographers have studied the Japanese mortality pattern since Japan became the most longevous population worldwide, half a century ago. Nutrition and lifestyle were considered by epidemiologists, gerontologists and other scientists as the most important reasons explaining the Japanese superiority. In Okinawa, the mortality pattern is even more exceptional, but few demographers have pointed out this exception. Other scientists proposed different explanations - for example some genetic characteristics, less salt and more animal protein in the food, a mild climate, a higher level of activity, a better consideration of the oldest in the population and, globally speaking, a more traditional lifestyle. At the end of the 1980s, lower improvements of mortality among young adults were identified in Okinawa. In 2002, Okinawa fell from the 4th to the 26th place in the ranking of the 47 Japanese prefectures by male life expectancy. This has been considered by the population of Okinawa as a 'shock'. Our in-depth analysis of available life tables and associated mortality rates proves that the population of Okinawa is divided into two groups of generations: those born before World War II and those born after. The older generations clearly experience a highly favourable mortality pattern, whereas the younger generations show mortality levels that are definitively higher compared to mainland Japan. This contribution considers which factors may explain such a situation, including the plausible invalidation of the age of some oldest in the population. We plea for in-depth demographic age validation that will enhance all scientific findings so far and boost the exceptional longevity in Okinawa., (© 2023 The Association for the Publication of the Journal of Internal Medicine.)

Aim: We developed a self-assessment scale-Older Adults' Perceptions of Community-based Connectedness with People-to assess older adults' comprehensive perceptions of their connectedness with others in the community. A specific aim of this study is to evaluate the reliability and validity of this scale., Methods: Participants consisted of 1000 men and women aged 65 years or older, living in Sapporo, Hokkaido, Japan. Factorial validity was assessed using exploratory and confirmatory factor analysis, while concurrent validity was assessed using correlation analysis. Reliability was confirmed by Cronbach's α coefficient using the internal consistency method, and the stability coefficient was confirmed using the test-retest method., Results: Responses were received from 380 participants, and 358 participants who responded to all items were included in the analysis. The developed scale comprised 22 items with three factors: "Perception of Inclusion" (α = .947), "Perception of Reciprocity through Reception" (α = .937), and "Perception of Reciprocity through Provision" (α = .910). Correlation analyses indicated that concurrent scales were positively correlated with Ikigai and negatively correlated with loneliness on the total scale. The model fit was comparative fit index = 0.933, goodness-of-fit index = 0.854, adjusted goodness-of-fit index = 0.818, and root mean square of approximation = 0.081. The stability coefficient of the total scale scores was 0.875 (95% CI: [0.830, 0.908])., Conclusions: The developed scale had adequate reliability and validity. The perceptions of connectedness measured using this scale can be used by public health and nursing care professionals to prevent loneliness and isolation among older adults living in the community., (© 2024 Japan Academy of Nursing Science.)